WorldWideScience

Sample records for assisted treatment study

  1. Effects of feedback assisted treatment on post-treatment outcome for eating disordered inpatients: A follow-up study

    Directory of Open Access Journals (Sweden)

    Megan M. Bowen

    2016-05-01

    Full Text Available Only one randomized clinical trial (RCT has examined feedback-assisted (Fb treatment in an inpatient eating-disordered population. Results from this study suggested that those who received Fb treatment were more likely to recover than participants in the treatment-as-usual condition; however, long-term effects of this treatment have not been investigated. This is especially pertinent in eating-disordered populations, where outcomes tend to be poor and course of illness chronic. In the current study, fifty-three women from the aforementioned RCT were contacted three to four years after leaving inpatient care to assess their current distress level and psychological functioning. Results suggested no significant difference between treatment conditions. The vast majority of women sought out multiple forms of treatment over the follow-up period, regardless of treatment condition. This is consistent with past research suggesting that women with more severe pathology (i.e. those requiring inpatient treatment tend to experience a more chronic pattern of symptoms even after intensive treatment. Overall, the superiority of feedback-assisted treatment found at discharge diminished over time and could not be detected at follow-up. Suggestions for further research are delineated.

  2. NAOMI: The trials and tribulations of implementing a heroin assisted treatment study in North America

    Directory of Open Access Journals (Sweden)

    Laliberté Nancy

    2009-01-01

    Full Text Available Abstract Background Opioid addiction is a chronic, relapsing disease and remains a major public health challenge. Despite important expansions of access to conventional treatments, there are still significant proportions of affected individuals who remain outside the reach of the current treatment system and who contribute disproportionately to health care and criminal justice costs as well as to public disorder associated with drug addiction. The NAOMI study is a Phase III randomized clinical trial comparing injectable heroin maintenance to oral methadone. The study has ethics board approval at its Montréal and Vancouver sites, as well as from the University of Toronto, the New York Academy of Medicine and Johns Hopkins University. The main objective of the NAOMI Study is to determine whether the closely supervised provision of injectable, pharmaceutical-grade opioid agonist is more effective than methadone alone in recruiting, retaining, and benefiting chronic, opioid-dependent, injection drug users who are resistant to current standard treatment options. Methods The case study submitted chronicles the challenges of getting a heroin assisted treatment trial up and running in North America. It describes: a brief background on opioid addiction; current standard therapies for opioid addiction; why there is/was a need for a heroin assisted treatment trial; a description of heroin assisted treatment; the beginnings of creating the NAOMI study in North America; what is the NAOMI study; the science and politics of the NAOMI study; getting NAOMI started in Canada; various requirements and restrictions in getting the study up and running; recruitment into the study; working with the media; a status report on the study; and a brief conclusion from the authors' perspectives. Results and conclusion As this is a case study, there are no specific results or main findings listed. The case study focuses on: the background of the study; what it took to get

  3. Methotrexate treatment for ectopic pregnancy after assisted reproductive technology: A case-control study.

    Science.gov (United States)

    Ohannessian, A; Crochet, P; Courbiere, B; Gnisci, A; Agostini, A

    2016-06-01

    Ectopic pregnancy (EP) occurs in 2% to 5.6% of pregnancies achieved by assisted reproductive technology (ART). EP treatment options include medical treatment by uses of methotrexate (MTX) systemic injection. The objective of this study was to compare MTX treatment effectiveness for EP occurring spontaneously or following ART. A case-control study performed in the department of obstetrics and gynecology at a tertiary health care center in France. Twenty EP achieved by ART (ART group) and 60 spontaneous EP (SEP group) received MTX treatment between January 2002 and May 2012. The main outcome measures were MTX treatment failure rates, number of MTX injections administered and recovery time. MTX treatment failure rates observed in ART and SEP groups were similar (3/20 [15%] versus 10/60 [17%]: OR=0.88 [0.22-3.58]). Mean duration of recovery time in patients with successful MTX treatment did not differ between ART and SEP groups (33±14 days versus 28±13 days, P=0.39). A second MTX injection was required more frequently in ART group than in SEP group (10/20 [50%] versus 10/60 [17%]: OR=5 [1.65-15.15]). It is concluded that MTX treatment is equally effective for spontaneous EP and EP achieved by ART, two injections of MTX being more frequently required in case of ART. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. The experience of pregnancy resulting from Assisted Reproductive Technology (ART) treatment: A qualitative Brazilian study.

    Science.gov (United States)

    Dornelles, L M N; MacCallum, F; Lopes, R C S; Piccinini, C A; Passos, E P

    2016-04-01

    Pregnancies achieved through medical treatments following a period of infertility may demand extra emotional and practical investment from women. This paper aims at understanding the experience of pregnancy after Assisted Reproductive Technology, and exploring whether this experience is affected by previous failed infertility treatments. This paper uses a qualitative approach. Participants were nineteen expectant first-time mothers from Brazil who conceived through Assisted Reproductive Technology treatment. During the third trimester of gestation, a semi-structured interview was administered to assess perceptions of and feelings about treatment and pregnancy. Interview transcripts were analysed using thematic analysis, and the sample was divided into two groups according to whether it was the participant's first treatment or not. Themes identified include: tolerance of the demands of treatment and pregnancy, consideration of the mechanics of treatment and pregnancy, and emotionally painful aspects of treatment and pregnancy. Pregnancy itself was regarded as a reward or compensation for the difficulties undergone. Perspectives differed according to whether pregnancy followed the first Assisted Reproductive Technology treatment; those who had undergone previously unsuccessful treatments focused less on the mechanical aspects of the process but were more concerned about possible physical problems. The similarities and differences found according to number of treatments attempted should be taken into consideration when providing psychological support for expectant Assisted Reproductive Technology mothers. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  5. Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men.

    Science.gov (United States)

    Agostini, Francesca; Monti, Fiorella; Andrei, Federica; Paterlini, Marcella; Palomba, Stefano; La Sala, Giovanni Battista

    2017-10-01

    Quality of life (QoL) may represent a comprehensive indicator for the assessment of the psychological impact of complex clinical conditions, such as infertility. Infertile women have a worse QoL compared to both infertile men and non-infertile controls. However, the initial phases of infertility treatments have been frequently investigated using cross-sectional study designs. This prospective longitudinal study aimed at assessing the health-related QoL change across different phases of assisted reproductive technology (ART) treatments in subfertile women and men. Eighty-five subfertile women and men undergoing ART cycles were assessed at the beginning of the ovarian stimulation, during oocyte retrieval before discharging, and around 14 days after the embryo transfer. QoL was assessed through the Short Form 36. Irrespective of the cause of infertility, work status, and age, QoL levels decreased from the first to the third assessment, and women scored significantly lower than men to each QoL indicator. Additionally, a higher number of previous ART failures had a negative impact on QoL, irrespective of gender and the phase of treatment. ART outcome marginally affected women's QoL across time. Infertile women have a worse QoL throughout all phases of ARTs compared to men, and this difference increases in infertile patients with more than one previous ART failure.

  6. Corticotomy-assisted orthodontic treatment

    Science.gov (United States)

    Hassan, Ali H.; Al-Saeed, Samar H.; Al-Maghlouth, Basma A.; Bahammam, Maha A.; Linjawi, Amal I.; El-Bialy, Tarek H.

    2015-01-01

    Objectives: To systematically review the literature to assess the quality of evidence related to corticotomy-assisted orthodontic treatment (CAOT) as adjunctive treatment in orthodontics. Methods: The study was conducted in the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia between 2013 and 2014. Various electronic databases were searched and abstracts were retrieved. Defined inclusion criteria were then applied to the obtained original articles for further evaluation by 2 examiners independently. The criteria of selection included human, or animal studies, which assessed some aspects of CAOT and/or the biological principles behind it. Case reports and series were excluded. The quality of the studies was evaluated by the methodological score for clinical trials developed. Results: Fourteen articles were retrieved initially, but only 12 articles were finally selected for the study. The CAOT was found to accelerate tooth movement by 2-2.5 folds when compared with conventional orthodontic tooth movement. The CAOT was found safe on periodontal health and exhibits no or little risk of root resorption. A localized turnover of alveolar spongiosa and the absence of a hyalinized zone was the acceptable biological explanation of CAOT. There is no evidence to support that CAOT enhances the movement of ankylosed teeth, closing old extraction sites, post-orthodontic stability, or transverse expansion. Conclusions: Corticotomy-assisted orthodontic treatment should be considered with caution. Long term randomized clinical trials are still needed. PMID:26108582

  7. Multicenter pivotal study of vacuum-assisted precise tissue release for the treatment of cellulite.

    Science.gov (United States)

    Kaminer, Michael S; Coleman, William P; Weiss, Robert A; Robinson, Deanne M; Coleman, W Patrick; Hornfeldt, Carl

    2015-03-01

    Cellulite refers to the dimpled appearance of skin occurring where the dermis is tethered by subcutaneous fibrous septa arranged perpendicularly to the skin surface. To demonstrate the safety and efficacy of a new system for vacuum-assisted precise tissue release for the treatment of cellulite. Adult women with moderate to severe cellulite (N = 55) underwent a single treatment. Post-treatment assessments were performed after 3 and 14 days; 1, 3, and 6 months; and at 1 year. Outcome measures included blinded assessments of subject photographs, a validated Cellulite Severity Scale (CSS), and the Global Aesthetic Improvement Scale. Subject satisfaction and pain ratings were also recorded. The mean baseline CSS score of 3.4 decreased to 1.3 at 3 months (p cellulite. There was no reduction in treatment benefits for up to 1 year. These results supported the Food and Drug Administration clearance of the device for the long-term reduction in the appearance of cellulite.

  8. Male and female alcohol consumption and live birth after assisted reproductive technology treatment: a nationwide register-based cohort study.

    Science.gov (United States)

    Vittrup, Ida; Petersen, Gitte Lindved; Kamper-Jørgensen, Mads; Pinborg, Anja; Schmidt, Lone

    2017-08-01

    The objective was to assess the potential association between female and male alcohol consumption and probability of achieving a live birth after assisted reproductive treatment. From a nationwide Danish register-based cohort information on alcohol consumption at assisted reproductive treatment initiation was linked to information on births and abortions. From 1 January 2006 to 30 September 2010, 12,981 women and their partners went through 29,834 treatment cycles. Of these, 22.4% and 20.4% led to a live birth for female abstainers and heavy consumers (>7 drinks/week), respectively. Concerning men, 22.6% and 20.2% of cycles resulted in a live birth for abstainers and heavy consumers (>14 drinks/week), respectively. No statistically significant associations between alcohol consumption and live birth were observed. Adjusted odds ratios from trend analyses were 1.00 (95% confidence interval (CI) 0.99-1.01) and 0.99 (95% CI 0.97-1.01) for every one-unit increase in female and male weekly alcohol consumption at assisted reproductive treatment initiation, respectively. In conclusion, this study did not show significant associations between male or female alcohol consumption and odds of live birth after assisted reproductive treatment. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-07-28

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

  10. Clinical study on microsurgical treatment of lumbar disc herniation assisted by METRx system

    Directory of Open Access Journals (Sweden)

    Xin-gang ZHAO

    2016-04-01

    Full Text Available Objective To explore the techniques and curative effect of microsurgical procedures assisted by minimal exposure tubular retractor system (METRx in the treatment of lumbar disc herniation (LDH.  Methods A total of 51 LDH patients, including 24 patients with L4-5 herniation and 27 patients with L5-S1 herniation, underwent discectomy assisted by METRx system. The operation time, intraoperative blood loss, postoperative complications and hospital stay were recorded. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate the degree of low back pain before operation, one week, 3 months after operation, and in the last follow-up. Lumbar MRI was used to evaluate the decompression of spinal canal.  Results The success rate of operations in 51 cases was 98.04% (50/51. The average operation time was 125 min, the average intraoperative blood loss was 50 ml, the mean hospital stay was 5 d, all patients were followed up for 6-48 months (average 24 months. Compared with preoperation, both VAS and ODI scores decreased significantly one week after operation (P = 0.036, 0.029, 3 months after operation (P = 0.018, 0.023 and in the last follow-up (P = 0.007, 0.013. The improvement rate of ODI was 35.37% in the last follow-up. No infection, postoperative cerebrospinal fluid (CSF fistula, neurological defects or incision infection was found. One patient presented acute abdominalgia on the 2nd day after operation, and was diagnosed as annexitis. One patient showed nerve root irritation symptoms after operation caused by thick nerve root during the surgery. They were cured after symptomatic treatment.  Conclusions Microsurgical procedures for treating LDH assisted by METRx system can effectively relieve nerve root compression, protect the dural sac and nerve roots, and reduce surgical complications. DOI: 10.3969/j.issn.1672-6731.2016.04.008

  11. The impact of successful assisted reproduction treatment on female and male mental health during transition to parenthood: a prospective controlled study

    National Research Council Canada - National Science Library

    Repokari, L; Punamäki, R-L; Poikkeus, P; Vilska, S; Unkila-Kallio, L; Sinkkonen, J; Almqvist, F; Tiitinen, A; Tulppala, M

    2005-01-01

    .... Our prospective longitudinal study was designed to reveal whether there are differences in mental health during the transition to parenthood between parents undergoing treatment with assisted reproduction techniques (ART...

  12. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study.

    Science.gov (United States)

    Bogenschutz, Michael P; Forcehimes, Alyssa A; Pommy, Jessica A; Wilcox, Claire E; Barbosa, P C R; Strassman, Rick J

    2015-03-01

    Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants' responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration (p psilocybin session (at week 4) strongly predicted change in drinking during weeks 5-8 (r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5. There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms. NCT02061293. © The Author(s) 2015.

  13. Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder: a national cohort study.

    Science.gov (United States)

    Ebdrup, Ninna H; Assens, Maria; Hougaard, Charlotte O; Pinborg, Anja; Hageman, Ida; Schmidt, Lone

    2014-06-01

    To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders. We used a national register-based cohort of 42,915 Danish women in ART treatment from 1.1.1994 to 30.9.2009. All women with a diagnosis of schizophrenia or related psychotic disorders before, during or after their ART treatment were identified by individual-level linkage of nationwide registers of ART treatment, psychiatric admission, birth and socio-demographic status. The comparison group (N=42,671) consisted of all women in the study cohort never diagnosed with psychotic disorders. Conventional descriptive methods were used for the statistical analyses. Two hundred and forty-four (0.6%) women in the study cohort received a diagnosis of psychotic disorder before (N=135-55.3%), during (N=7-2.9%) or after (N=102-41.8%) ART treatment. The mean time from last diagnosis of psychotic disorder to their first ART treatment in the 135 women with a psychiatric diagnosis prior to their first ART treatment was 7.1 ± 5.6 years (25-75% percentile: ±2.8-10.4 years). The most frequent diagnoses were acute and transient psychotic disorder. Women with a diagnosis of schizophrenia or related psychotic disorder before their first ART treatment had a lower ART treatment success rate as significantly fewer women obtained a live birth (40.0% vs. 51.9%, Pstudy population and comparison group. The prevalence of women with a psychotic diagnosis in fertility treatment is lower than the prevalence in the general population. Women with a psychotic disorder prior to ART treatment have a lower fertility treatment success rate compared to women without psychotic disorder. Women with a psychotic disorder achieving delivery show similar obstetric outcomes to women with no psychotic disorder. Copyright © 2014 Elsevier Ireland Ltd. All

  14. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5-year follow-up cohort study.

    Science.gov (United States)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra; Ziebe, Søren; Mikkelsen Englund, Anne L; Hald, Finn; Boivin, Jacky; Schmidt, Lone

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Specialized public fertility clinics in Denmark. Seven hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic. Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottom-up procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis. Costs were adjusted to 2012 prices using a constructed medical price index. Live birth, costs. Total costs per live birth in 2012 prices were estimated to 10,755€. Costs per treated couple - irrespective of whether the treatment was terminated by a live birth or not - were estimated at 6607€. Costs per live birth of women assisted reproduction treatment are relatively modest. The results can be generalized to public fertility treatment in Denmark and to other public treatment settings with similar limitations in numbers of public treatment cycles offered. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. A Comparative Study of Da Vinci Robot System with Video-assisted Thoracoscopy in the Surgical Treatment of Mediastinal Lesions

    Directory of Open Access Journals (Sweden)

    Renquan DING

    2014-07-01

    Full Text Available Background and objective In recent years, Da Vinci robot system applied in the treatment of intrathoracic surgery mediastinal diseases become more mature. The aim of this study is to summarize the clinical data about mediastinal lesions of General Hospital of Shenyang Military Region in the past 4 years, then to analyze the treatment effect and promising applications of da Vinci robot system in the surgical treatment of mediastinal lesions. Methods 203 cases of mediastinal lesions were collected from General Hospital of Shenyang Military Region between 2010 and 2013. These patients were divided into two groups da Vinci and video-assisted thoracoscopic surgery (VATS according to the selection of the treatments. The time in surgery, intraoperative blood loss, postoperative drainage amount within three days after surgery, the period of bearing drainage tubes, hospital stays and hospitalization expense were then compared. Results All patients were successfully operated, the postoperative recovery is good and there is no perioperative death. The different of the time in surgery between two groups is Robots group 82 (20-320 min and thoracoscopic group 89 (35-360 min (P>0.05. The intraoperative blood loss between two groups is robot group 10 (1-100 mL and thoracoscopic group 50 (3-1,500 mL. The postoperative drainage amount within three days after surgery between two groups is robot group 215 (0-2,220 mL and thoracoscopic group 350 (50-1,810 mL. The period of bearing drainage tubes after surgery between two groups is robot group 3 (0-10 d and thoracoscopic group: 5 (1-18 d. The difference of hospital stays between two groups is robot group 7 (2-15 d and thoracoscopic group 9 (2-50 d. The hospitalization expense between two groups is robot group (18,983.6±4,461.2 RMB and thoracoscopic group (9,351.9±2,076.3 RMB (All P<0.001. Conclusion The da Vinci robot system is safe and efficient in the treatment of mediastinal lesions compared with video-assisted

  16. [A comparative study of Da Vinci robot system with video-assisted thoracoscopy in the surgical treatment of mediastinal lesions].

    Science.gov (United States)

    Ding, Renquan; Tong, Xiangdong; Xu, Shiguang; Zhang, Dakun; Gao, Xin; Teng, Hong; Qu, Jiaqi; Wang, Shumin

    2014-07-20

    In recent years, Da Vinci robot system applied in the treatment of intrathoracic surgery mediastinal diseases become more mature. The aim of this study is to summarize the clinical data about mediastinal lesions of General Hospital of Shenyang Military Region in the past 4 years, then to analyze the treatment effect and promising applications of da Vinci robot system in the surgical treatment of mediastinal lesions. 203 cases of mediastinal lesions were collected from General Hospital of Shenyang Military Region between 2010 and 2013. These patients were divided into two groups da Vinci and video-assisted thoracoscopic surgery (VATS) according to the selection of the treatments. The time in surgery, intraoperative blood loss, postoperative drainage amount within three days after surgery, the period of bearing drainage tubes, hospital stays and hospitalization expense were then compared. All patients were successfully operated, the postoperative recovery is good and there is no perioperative death. The different of the time in surgery between two groups is Robots group 82 (20-320) min and thoracoscopic group 89 (35-360) min (P>0.05). The intraoperative blood loss between two groups is robot group 10 (1-100) mL and thoracoscopic group 50 (3-1,500) mL. The postoperative drainage amount within three days after surgery between two groups is robot group 215 (0-2,220) mL and thoracoscopic group 350 (50-1,810) mL. The period of bearing drainage tubes after surgery between two groups is robot group 3 (0-10) d and thoracoscopic group: 5 (1-18) d. The difference of hospital stays between two groups is robot group 7 (2-15) d and thoracoscopic group 9 (2-50) d. The hospitalization expense between two groups is robot group (18,983.6±4,461.2) RMB and thoracoscopic group (9,351.9±2,076.3) RMB (All Pvideo-assisted thoracoscopic approach, even though its expense is higher.

  17. Multimedia patient education to assist oral impression taking during dental treatment: A pilot study.

    Science.gov (United States)

    Pei, Dandan; Liang, Beilei; Du, Wenzhi; Wang, Peng; Liu, Jie; He, Min; Lu, Yi

    2017-06-01

    Proper cooperation between patient and dentist is of great help to make a good oral impression. However, patients are frequently confused when information is given through traditional verbal description. The present study compared the effectiveness of the multimedia information delivery ways with the traditional verbal manner on patients' understanding level in oral impression taking. The recruited 191 participating patients were randomly assigned to the control group (the verbal group) and two intervention groups (the video group and the picture group) according to the information delivery manner. After intervention, the patients' understanding degree was measured by questionnaire and performance evaluation of behavior feedback on the provided information quantitatively. Also, patients' self-assessment of satisfaction was interviewed by telephone. All data was analyzed by SPSS 14.0 software, and p≤0.05 was set as significant difference in advance. One-Way ANOVA and Chi-square showed there were no statistically significant differences in the mean age, gender composition, and educational level among the three groups (P>0.05). In both questionnaire assessment and performance evaluation, One-Way ANOVA followed by LSD indicate that the video group gained a higher score than the verbal group or the picture group (P0.05). Higher percentage of satisfaction was reported by patients in the two multimedia groups than that in the control group. Oral impression taking is a consecutive process that requires action cooperation between dentists and patients simultaneously. This particularity makes it more suitable for multimedia delivery. The delivery of tailored information using multimedia in this study was favored by most patients and could improve the degree of patient understanding of the oral impression taking procedures. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. The effect of an expressive writing intervention (EWI) on stress in infertile couples undergoing assisted reproductive technlogy (ART) treatment: A randomized controlled pilot study

    DEFF Research Database (Denmark)

    Matthiesen, Signe Maria Schneevoigt; Klonoff-Cohen, Hillary; Zachariae, Robert

    2012-01-01

    Objectives. Infertile couples undergoing fertility treatments may experience stress and could benefit from psychological intervention. Expressive Writing Intervention (EWI) has shown promising results on various psychological outcomes, yet only one study has applied the method to infertility......-related stress. Our aim was to assess feasibility and effectiveness of EWI for patients in treatment with Assisted Reproductive Technology (ART). Design and participants. Patients enrolling in their first ART treatment at the fertility clinic, Aarhus University Hospital, Denmark were offered to participate...

  19. [Case-control study on suture-assisted locking plate for the treatment of proximal humeral fractures in elderly].

    Science.gov (United States)

    Dai, Zhang-sheng; Huang, Jie-miao; Zhuang, Xun-rong; Chen, Shou-bo; Wu, Shi-qiang; Yao, Xue-dong; Ye, Hui

    2014-12-01

    To explore clinical effects of suturing-assisted locking plate in treating elderly proximal humeral fractures. From January 2005 to January 2013, 55 elderly patients with three- and four-part fractures of proximal humeral fractures were divided into treatment group and control group. In treatment group, there were 31 patients including 12 males, and 19 females aged from 65 to 85 with an average of (74.00±5.42) years old, and treated with suturing-assisted locking plates; 19 patients were Neer 3-part fractures, and 12 patients were Neer 4-part fractures of proximal humerus; 23 patients were suffered from low-energy injuries and 8 patients were caused by high-energy injuries. In control group, there were 24 patients including 7 males, and 17 females aged from 65 to 85 with an average of (72.79±5.34) years old, and treated with locking plates; 16 patients were Neer 3-part fractures, and 8 patients were Neer 4-part fractures of proximal humerus; 17 patients were suffered from low-energy injuries and 7 patients were caused by high-energy injuries. Operative time, blood loss during operation, and bone healing time between two groups were observed and compared. Postoperative Neer scoring were used to evaluate recovery of shoulder joint function. All patients were followed up from 6 to 24 months with an average of 16.1 months. In treatment group, blood loss was (495.806±143.150) ml, function of Neer scoring was 22.645±2.443, range of action was 18.194±2.613, anatomy was 7.935±1.504 and total score of Neer scoring was 77.161±8.335; while in control group, blood loss was (641.667±169.851) ml, function of Neer scoring was 13.958±1.989, range of action was 13.083±2.165, anatomy was 5.500±1.978 and total score of Neer scoring was 58.792±7.313. There were sigificant difference between two groups in these indexes. Suturing-assisted locking plate for the treatment of proximal humerus fractures in elderly, has advantages of less blood loss, simple fracture reduction and

  20. Surgical Treatment of Middle Cerebral Artery Aneurysms Without Using Indocyanine Green Videoangiography Assistance: Retrospective Monocentric Study of 263 Clipped Aneurysms.

    Science.gov (United States)

    Hallout, Sabrina

    2015-10-01

    Middle cerebral artery (MCA) aneurysms represent 20% of intracranial aneurysms. Most (80%) of them are located on the sylvian bifurcation, the seat of hemodynamic turbulence flow. Morbidity and mortality related to surgery of MCA aneurysms are not negligible. MCA vascularization areas are important eloquence functional territorial of Brain tissue. Indocyanine green videoangiography assistance (ICG-VA) is an emergent tool for intraoperative assessment of aneurysmal occlusion and for checking a possible stenosant clip in vascular area. The purposes of this study were to evaluate the safety of clipping procedure in terms of morbidity, mortality, and efficiency of aneurysm occlusion without using ICG-VA, recurrence and bleeding/rebleeding at short and long terms, and angiographic and clinical follow-ups. This study is a monocentric retrospective study performed at Pitié-Salpêtrière-Charles Foix Hospital Center, reporting clinical and angiographic follow-up of consecutive patients treated for MCA aneurysms (ruptured and unruptured) by clipping procedures. From 2002-2012, 251 consecutive patients were admitted at the author's institution for treatment of 263 MCA aneurysms (163 ruptured and 100 unruptured). Procedure-related death and complications were systematically assessed without video-angiography availability. The degree of aneurysms exclusion was evaluated according to the Raymond-Roy scale after the procedure and at long-term angiographic follow-up (mean delay = 36 months). The death rate related to aneurysmal exclusion procedure was 1.2%. The major complication rate related to surgery was 5.3%. Postprocedure, an aneurysm occlusion rate Raymond-Roy grade A or B was 95.6%. Neither recanalization controlled clipped aneurysms nor re-aneurysmal rupture was observed in the long-term clinical follow-up (mean time = 83.5 months). The institution's series of surgical outcomes reported 95.6% of complete exclusion and 4.5% incomplete procedures without ICG-VA. A clip of

  1. Assisted reproductive technology treatment outcomes.

    LENUS (Irish Health Repository)

    Naasan, M

    2012-05-01

    Information on the outcomes of ART treatments in Ireland is not readily available to Irish practitioners. The data for hospital affiliated clinics has been made available for many years and is included in the hospital reports. We present a 10-year analysis of the Irish ART results voluntarily reported by six out of seven IVF clinics. The data was collected from published ESHRE reports and from results (2007-8) not yet published. Data collected included: number of clinics and ART cycles, female age, clinical and multiple pregnancy rates and treatment complications. The clinical pregnancy rate per embryo transfer was 31.7% for IVF and 29.8% for ICSI. The proportion of singleton, twin and triplet deliveries for IVF and ICSI combined was 75%, 23.35% and 1.64%. The rate of ovarian hyperstimulation was 0.8%. ART practice in Ireland is safe, effective and responsible. Financial and societal savings could result from the introduction of state funded IVF with compulsory eSET where recommended.

  2. Ablative Fractional Laser-Assisted Topical Fluorouracil for the Treatment of Superficial Basal Cell Carcinoma and Squamous Cell Carcinoma In Situ: A Follow-Up Study.

    Science.gov (United States)

    Hsu, Sarah H; Gan, Stephanie D; Nguyen, Bichchau T; Konnikov, Nellie; Liang, Christine A

    2016-09-01

    The authors previously reported the safety and short-term efficacy of ablative fractional laser (AFXL)-assisted delivery of topical fluorouracil in the treatment of superficial basal cell carcinoma (sBCC) and squamous cell carcinoma in situ (SCCis). This follow-up study was conducted to assess whether tumor clearance was sustained in this cohort of patients at >9 months post-treatment. Thirty primary sBCC or SCCis treatment, 20 patients presented for this follow-up study and underwent shave biopsy to confirm histologic clearance. Mean follow-up time was 15 months. Considering those who had persistent tumor at 4 to 8 weeks post-treatment and those who presented for follow-up at >9 months post-treatment, overall treatment success was 79% (95% confidence interval: 67%-96%), with 92% (11/12) for SCCis and 67% (8/12) for sBCC. Neither the tumor location nor size significantly impacted treatment outcome (p = .96 and 0.87, respectively). Ablative fractional laser-assisted topical fluorouracil is a reasonable noninvasive treatment option for primary SCCis and sBCC, especially for lesions located in areas where self-application is not possible, or when clinician-administered therapy is preferred.

  3. Birth Outcomes by Infertility Treatment: Analyses of the Population-Based Cohort: Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART).

    Science.gov (United States)

    Luke, Barbara; Stern, Judy E; Kotelchuck, Milton; Declercq, Eugene R; Anderka, Marlene; Diop, Hafsatou

    2016-01-01

    To evaluate pregnancy and birth outcomes by type of infertility treatment received. Assisted reproductive technology (ART) data on women who were both treated and gave birth in Massachusetts were linked to vital records and hospital data. Singleton and twin live births were categorized by ART treatment parameters. Risks for adverse outcomes (pregnancy-induced hypertension [PIH], gestational diabetes [GDM, primary cesarean [CS], prematurity [PTB], low birthweight [LBW], small for gestational age [SGA], large for gestational age [LGA], and birth defects [BD]) were modeled using logistic regression (adjusted odds ratios and 95% confidence intervals), adjusted for parental and treatment factors. GDM and PIH were additionally modeled as adverse outcomes. Among the 8,948 pregnancies, risks were significantly higher among twins (PIH 2.58, GDM 1.30, CS 5.83, PTB 11.84, LBW 10.68, SGA 2.17, BD 2.54), donor oocytes (PIH 1.87, CS 1.43, PTB 1.43), ICSI (SGA 1.20), and the presence of > 1 fetal heartbeat at 6 weeks' gestation (2 fetal heartbeats: PTB 1.49, LBW 1.57; 3 fetal heartbeats: PTB 2.07, LBW 2.30, SGA 2.04). Thawed embryos were associated with a higher risk for PIH (1.30) but lower risks for LBW (0.79) and SGA (0.38). GDM was associated with increased risks for CS (1.22), LGA (1.40), and BD (1.50); PIH was associated with risks for CS (1.86), PTB (2.70), and LBW (1.83). Plurality is the predominant ART treatment risk factor associated with substantial excess morbidity for both mother and infants.

  4. [Mexican National Consensus on Assisted Reproduction Treatment].

    Science.gov (United States)

    Kably Ambe, Alberto; López Ortiz, Carlos Salazar; Serviere Zaragoza, Claudio; Velázquez Cornejo, Gerardo; Pérez Peña, Efrain; Santos Haliscack, Roberto; Luna Rojas, Martha; Valerio, Emilio; Santana, Héctor; Gaviño Gaviño, Fernando

    2012-09-01

    It is estimated that 15% of couples living in industrialized countries are infertile, ie have failed to conceive, reproductive age, after 12 months ormore of regular intercourse without contraception. During the past decade has increased the demand for fertility treatments because they believe are moreeffective now. To unify the therapeutic approach and service to patients and set a precedent for a Mexican Official Standard respect and support for the legislation of these procedures. Consensus by technical experts group panel with the participation of 34 national centers accredited for use in assisted reproduction. He organized seven workshops with the following themes: 1) selection of patients for assisted reproduction treatment, 2) schemes controlled ovarian stimulation for assisted reproduction techniques of high complexity, 3) preparation and egg retrieval technique, 4) transferembryo; 5) luteal phase supplementation; 6) indications and techniques of cryopreservation and 7) informed consent. Each table had a coordinator who wrote and presented the findings to the full, it made a number of observations until they reached unanimity of criteria, which are reflected in this document. Patient selection for assisted reproduction techniques is the first step of the process. Proper selection lead to success, in the same way that a bad pick up for failure. In the case of egg donation the most important recommendation is that only one to two embryos transferred in order to reduce multiple pregnancy rates and maintaining high pregnancy rates.

  5. [Effectiveness study on minimally invasive transforaminal lumbar interbody fusion assisted with microscope in treatment of lumbar spondylolisthesis].

    Science.gov (United States)

    Ding, Yingsheng; Zhang, Wenzhi; Duan, Liqun; Li, Xu; Zhang, Feng

    2014-05-01

    To investigate the effectiveness of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) assisted with microscope in treatment of lumbar spondylolisthesis. Between January 2011 and June 2012, 52 patients with lumbar spondylolisthesis underwent MI-TLIF assisted with microscope. There were 29 males and 23 females with an average age of 46 years (range, 32-67 years). The median disease duration was 3.2 years (range, 3 months to 6 years). There were 38 cases of lumbar isthmic spondylolisthesis and 14 cases of degenerative spondylolisthesis; 12 cases had stenosis secondary to lumbar spondylolisthesis. The affected segments were L4,5 (29 cases) and L5, S1 (23 cases). According to the Meyerding evaluating system, 24 cases were classified as degree I and 28 cases as degree II. The visual analogue scale (VAS) score and Oswestry disability index (ODI) were used for clinical assessment, and the clinical effects were also analyzed by Macnab criterion at last follow-up. The radiographic data were used to evaluate reduction of spondylolisthesis, including slipping degree, slipping angle, and intervertebral space height. The fusion rate was assessed by Suk criterion. The operations were performed successfully in all patients. No dural tear or cerebrospinal fluid leakage occurred during operation. The average operation time was 105 minutes; the average intraoperative blood loss was 225 mL; the average postoperative drainage volume was 75 mL; and the average hospitalization days were 5.5 days. Superficial infection of incision occurred in 1 case and was cured after change dressing, and primary healing of incision was obtained in the others. All patients were followed up 12-26 months (mean, 18 months). No loosening, breakage, and displacement of pedicle screw and no Cage dislocation occurred by X-ray films after operation. The lumbar spondylolisthesis all got good correction. The three-dimensional CT showed continuous bone trabecula between centrums. The VAS score

  6. Studying the Relationship between the Attitude to Infertility and Coping Strategies in Couples Undergoing Assisted Reproductive Treatments

    OpenAIRE

    Yazdani, Fatemeh; Kazemi, Ashraf; Ureizi-Samani, Hamid Reza

    2016-01-01

    Background: Using appropriate coping strategies has a positive influence on moderating mental pressures caused by infertility and the stress during treatment. Using these strategies needs personal skills and they could be influenced by individual's inner psychological and environmental factors. The aim of this study was to assess the relationship between the attitude toward infertility and coping strategies considering the couple's social and financial situation. Methods: This was a cross sec...

  7. Computer-Assisted Exposure Treatment for Flight Phobia

    Science.gov (United States)

    Tortella-Feliu, Miguel; Bornas, Xavier; Llabres, Jordi

    2008-01-01

    This review introduces the state of the art in computer-assisted treatment for behavioural disorders. The core of the paper is devoted to describe one of these interventions providing computer-assisted exposure for flight phobia treatment, the Computer-Assisted Fear of Flying Treatment (CAFFT). The rationale, contents and structure of the CAFFT…

  8. Video-assisted treatment of thoracolumbar junction fractures using a specific distractor for reduction: prospective study of 50 cases.

    Science.gov (United States)

    Le Huec, Jean-Charles; Tournier, C; Aunoble, S; Madi, K; Leijssen, Ph

    2010-03-01

    Posterior instrumentation allows good osteosynthesis for thoracolumbar junction fractures. However, in approximately 20% of cases, anterior bone defects may persist, leading to pseudoarthrosis and loss of reduction. Anterior approaches can circumvent this drawback, but they are considered aggressive with a high rate of complications. The advent of the endoscopic mini-invasive techniques has led to a reduction in the number of complications while maintaining the same consolidation rate. Nevertheless, poor restitution of anatomic curves is a reproach for this technique. This prospective study reports clinical and radiological result of 50 patients (19 women and 31 men) operated between April 2000 and March 2006 with a video-assisted anterior approach using an endodistractor for reduction and consequent insertion of the implant. There were A3 (n = 44), A2 (n = 2), A1 (n = 3) and C1 (n = 1) fractures (Magerl classification). The specific system for fracture reduction was used in the last 39 cases of this series. A Pyramesh cage (Medtronic, Memphis, USA) was used in 15 patients, a peek cage (Creaspine, Bordeaux, France) in 30 patients and a tricortical graft in 5 patients. Standard X-rays and CT scan were performed pre-operatively. Kyphosis, and angulations were measured pre-, per- and post-operatively. Mean immediate postoperative gain in localized kyphosis was 12.18 degrees and mean gain at last follow-up was 11.71 degrees. Mean immediate postoperative gain in RA was 13.24 degrees and remained identical at last follow-up. Five patients had a transient pulmonary atelectasia and there was one pulmonary infection. No neurological complication occurred. Fracture reduction is comparable to the best thoracotomy series while limiting approach-related complications.

  9. Robotic assisted surgeries for the treatment of spine tumors

    OpenAIRE

    Hu, Xiaobang; Scharschmidt, Thomas J; Ohnmeiss, Donna D.; Lieberman, Isador H.

    2015-01-01

    Background Surgery plays an important role in the treatment of patients with metastatic or primary spine tumors. In recent years, various new techniques, such as robotic assisted spine surgery have been developed which has shown some promising results by improving the accuracy of spinal instrumentation and reducing potential complications. The purpose of this study was to evaluate our early experience using robotic guidance in the treatment of spinal tumors. Methods Data were collected from m...

  10. Assisted outpatient treatment in New York: regional differences in New York's assisted outpatient treatment program.

    Science.gov (United States)

    Robbins, Pamela Clark; Keator, Karli J; Steadman, Henry J; Swanson, Jeffrey W; Wilder, Christine M; Swartz, Marvin S

    2010-10-01

    This study sought to describe the implementation of "Kendra's Law" in New York State and examine regional differences in the application of the program. Between February 2007 and April 2008, interviews were conducted with 50 key informants across New York State. Key informants included assisted outpatient treatment (AOT) county coordinators, county directors of community services, judges, attorneys from the Mental Hygiene Legal Service (MHLS), psychiatrists, treatment providers, peer advocates, family members, and other referred individuals. Additional analyses were conducted using AOT program administrative and evaluation databases and client history data. From program inception in 1999 through 2007, a total of 8,752 initial AOT orders and 5,684 renewals were granted. Notable regional differences were found in the use of two distinct models of AOT: AOT First and Enhanced Voluntary Services First. Regional differences were also found in how the AOT program was implemented and administered. Other variations stemmed from the court proceedings themselves, the continuity and interest of the presiding judge, and the attitudes of the MHLS attorneys. Many regional adaptations of the AOT program were found. Many were the result of lack of guidance in implementing Kendra's Law. Policy makers may want to consider whether the law should change to allow for these differences or whether additional support from a central source is warranted to ensure more uniformity in the implementation of AOT and thus the fairness of its application across the state.

  11. Vacuum-assisted closure system in treatment of postoperative mediastinitis.

    Science.gov (United States)

    Elawadi, Mohamed Ahmed; Oueida, Farouk

    2013-12-01

    Post-cardiac surgery mediastinitis is a serious complication with high morbidity and high financial costs. Using a vacuum-assisted closure system is the established line of treatment for mediastinitis, which improves outcome, especially in the high-risk group of patients. From January 2007 to April 2011, a retrospective study was carried out to evaluate the outcome of vacuum-assisted closure in the treatment of postoperative mediastinitis. There were 34 patients; 27 were male and 7 female. Mean time from infection to vacuum-assisted closure was 3.34 ± 1.10 days. The duration of vacuum-assisted closure was 6.51 ± 1.85 days (3-9 days). The mean amount of discharge was 759.60 ± 175.28 mL (range, 354-990 mL). Of the 34 patients, 21 (61.76%) had direct surgical wound closure and 13 (41.16%) had re-wiring. Two patients had bilateral pectoral flaps. One patient had chronic fistula formation, and one had a tear in the right ventricle. Mean hospital stay was 11.28 ± 2.09 days (range, 6-16 days). Vacuum-assisted closure therapy is a safe, reliable, and cost-effective modality of treatment for postoperative mediastinitis. It improves the outcome and can be combined with other modalities of conventional treatment, especially in high-risk groups such as the elderly or patients with diabetes.

  12. Male and female alcohol consumption and live birth after assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Vittrup, Ida; Petersen, Gitte Lindved; Kamper-Jørgensen, Mads

    2017-01-01

    The objective was to assess the potential association between female and male alcohol consumption and probability of achieving a live birth after assisted reproductive treatment. From a nationwide Danish register-based cohort information on alcohol consumption at assisted reproductive treatment.......99-1.01) and 0.99 (95% CI 0.97-1.01) for every one-unit increase in female and male weekly alcohol consumption at assisted reproductive treatment initiation, respectively. In conclusion, this study did not show significant associations between male or female alcohol consumption and odds of live birth after...... assisted reproductive treatment....

  13. Custom-made radiographic template, computed tomography, and computer-assisted flapless surgery for treatment planning in partial edentulous patients: a prospective 12-month study.

    Science.gov (United States)

    Nikzad, Sakineh; Azari, Abbas

    2010-06-01

    It was proposed that technologies derived from computer-aided design (CAD)/computer-aided manufacturing (CAM) and computed tomography may be useful for flapless implant treatment procedures. However, most of the studies examining the effectiveness of this method were performed in fully edentulous patients, with little or no attention paid to partially edentulous patients. The aims of this study were 1) to evaluate the concept of computer-assisted implant placement including a treatment planning procedure based on computed tomography scan images by use of a flapless surgical approach in partially edentulous cases and 2) to validate the reliability of this concept in a prospective 12-month clinical study. Sixteen patients with partially edentulous areas in their mandibles were included in this study. A total of 57 implants were inserted by use of a CAD/CAM drill template, specially designed for flapless implant surgery. To assess the degree of pain and discomfort, the patients were examined at 2 days and 1 week after surgery. Patient satisfaction and implant functionality were further evaluated at follow-up intervals of 1, 3, 6, and 12 months postoperatively. A specially designed visual analog scale was used for data acquisition. The mean pain score on the visual analog scale at follow-up was within the range for little or no pain. Two implants failed early in 1 patient. All of the other implants were in a good functional state throughout the study. The mean marginal bone loss after 1 year of follow-up was 0.6 mm (SD, 0.2) mesially and 0.5 mm (SD, 0.1) distally. This prospective study showed that the use of CAD/CAM technology and flapless implant surgery may be considered reliable for partial edentulous patients. 2010 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

  14. Effect of deploying community health assistants on appropriate treatment for diarrhoea, malaria and pneumonia: quasi-experimental study in two districts of Zambia.

    Science.gov (United States)

    Biemba, Godfrey; Yeboah-Antwi, Kojo; Vosburg, Kathryn Bradford; Prust, Margaret L; Keller, Brett; Worku, Yekoyesew; Zulu, Happy; White, Emily; Hamer, Davidson H

    2016-08-01

    A critical shortage of human resources for health in Zambia remains a great challenge. In response, the Zambian Ministry of Health developed a national community health assistant (CHA) programme, aiming to create a well-trained and motivated community-based health workforce. This study assessed whether CHAs increased treatment rates for diarrhoea, confirmed malaria or pneumonia in the first programme year. This study used a quasi-experimental difference-in-difference design, comparing changes in the catchment areas of health posts with CHAs to those without. Baseline and end line household surveys were conducted to measure the proportion of children under 5 years treated for diarrhoea, malaria or pneumonia in the 2 weeks before the survey and immunisation rates and malaria rapid diagnostic test rates. We surveyed 2330 women with children under five from the intervention area and 2314 from comparison areas at baseline and end line. Treatment for diarrhoea, malaria or pneumonia increased by 18.0% (P < 0.01) and 23.5% (P < 0.01) in the intervention and comparison groups, respectively, but DID analysis was not significant (P = 0.27). The proportion of fully immunised children grew by 7.5% in the intervention, but shrank by 7.5% in the comparison group (DID: 0.14; 95% CI 0.12-0.16, P < 0.01). Although we observed no significant difference between the intervention and comparison groups in the DID estimates for the primary outcome, there were significant increases after one year in treatment for all three diseases in the intervention group from baseline to end line and in the proportion of fully immunised children. © 2016 John Wiley & Sons Ltd.

  15. Study of two strategies to induce follicular wave emergence for assisted reproductive treatments (ART)-a preliminary trial.

    Science.gov (United States)

    Bianchi, Paulo H M; Viera, Lais M; Gouveia, Gabriela R F C A; Rocha, André M; Baruselli, Pietro S; Baracat, Edmund C; Serafini, Paulo C

    2015-04-01

    This study aimed to induce follicular wave emergence (FWE) using pharmacological (recombinant hCG administration) or mechanical (aspiration of dominant follicle) interventions in infertile women. Sixteen infertile women (≤35 years) with indications for in vitro fertilization due to tubal and/or male factor infertility were randomized into three groups: control (n = 6), pharmacological (n = 5) and mechanical (n = 5) groups. Women in both experimental groups underwent serial transvaginal sonograms (TVS) from menstrual cycle day 10 until identification of a dominant follicle ≥15 mm. Women in the pharmacological group received 250 μg of recombinant-hCG to induce ovulation, and resumed serial TVS 2 days later. In the mechanical group, dominant and subordinate follicles ≥10 mm were aspirated, and daily TVS was resumed on the following day. An increased pool of follicles ≥5 and ≤9 mm after interventions characterized FWE. Women in the control group underwent ovulation induction (OI) with 150 IU/day of recombinant follicle-stimulating hormone started on menstrual cycle day 3 (D3). OI was started on the day of FWE in the experimental groups. Endometrial asynchrony with development of the embryo was expected in the experimental groups. Therefore, all viable embryos were cryopreserved and transferred in an endometrial-stimulated cycle. The number of follicles ≥5 and ≤9 mm increased after the interventions in both experimental groups (p < .001), indicating induction of FWE. OI outcomes were similar among the groups. The pharmacological and mechanical interventions are efficient in inducing FWE; outcomes of OI synchronized with FWE should be further investigated.

  16. The effect of bundling medication-assisted treatment for opioid addiction with mHealth: study protocol for a randomized clinical trial.

    Science.gov (United States)

    Gustafson, David H; Landucci, Gina; McTavish, Fiona; Kornfield, Rachel; Johnson, Roberta A; Mares, Marie-Louise; Westergaard, Ryan P; Quanbeck, Andrew; Alagoz, Esra; Pe-Romashko, Klaren; Thomas, Chantelle; Shah, Dhavan

    2016-12-12

    Opioid dependence has devastating and increasingly widespread consequences and costs, and the most common outcome of treatment is early relapse. People who inject opioids are also at disproportionate risk for contracting the human immunodeficiency virus (HIV) and hepatitis C virus (HCV). This study tests an approach that has been shown to improve recovery rates: medication along with other supportive services (medication-assisted treatment, or MAT) against MAT combined with a smartphone innovation called A-CHESS (MAT + A-CHESS). This unblinded study will randomly assign 440 patients to receive MAT + A-CHESS or MAT alone. Eligible patients will meet criteria for having an opioid use disorder of at least moderate severity and will be taking methadone, injectable naltrexone, or buprenorphine. Patients with A-CHESS will have smartphones for 16 months; all patients will be followed for 24 months. The primary outcome is the difference between patients in the two arms in percentage of days using illicit opioids during the 24-month intervention. Secondary outcomes are differences between patients receiving MAT + A-CHESS versus MAT in other substance use, quality of life, retention in treatment, health service use, and, related to HIV and HCV, screening and testing rates, medication adherence, risk behaviors, and links to care. We will also examine mediators and moderators of the effects of MAT + A-CHESS. We will measure variables at baseline and months 4, 8, 12, 16, 20, and 24. At each point, patients will respond to a 20- to 30-min phone survey; urine screens will be collected at baseline and up to twice a month thereafter. We will use mixed-effects to evaluate the primary and secondary outcomes, with baseline scores functioning as covariates, treatment condition as a between-subject factor, and the outcomes reflecting scores for a given assessment at the six time points. Separate analyses will be conducted for each outcome. A-CHESS has been shown to

  17. Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder

    DEFF Research Database (Denmark)

    Ebdrup, Ninna H; Assens, Maria; Hougaard, Charlotte O

    2014-01-01

    To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders.......To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders....

  18. Treatment of a patient with post-natal chronic calf pain utilizing instrument-assisted soft tissue mobilization: a case study.

    Science.gov (United States)

    Bayliss, Amy J; Klene, Frank J; Gundeck, Evelina L; Loghmani, Mary T

    2011-08-01

    Musculoskeletal pain is commonly reported by pre- and postnatal women, with the most common complaint being low back pain. However, lower leg pain is also frequently reported by women particularly in the third trimester. The purpose of the case study is to illustrate how instrument-assisted soft tissue mobilization (ISTM) can be used to treat a patient with a 2-year history of chronic calf pain. The subject was a 35-year-old female who developed calf pain during the last trimester of her pregnancy following severe lower leg edema. The calf pain was present for the 2 years following delivery and was described as a dull ache, typically aggravated by direct pressure on the calf, prolonged standing, and stairs. An X-ray, magnetic resonance imaging (MRI) with contrast, and ultrasound Doppler study prior to referral ruled out tumors, vascular, lymphatic, or skeletal bone abnormalities. However, her MRI did show a dense superficial venous tissue asymmetry in the same location of her symptoms. Impairments were minimal; the only asymmetrical objective findings were calf length, strength, and soft tissue restrictions detected on palpation. After nine treatments incorporating an ISTM approach, soft tissue mobility, pain, calf strength, and lower extremity functional scale score all improved and her symptoms were abolished.

  19. Patterns of acquisitive crime during methadone maintenance treatment among patients eligible for heroin assisted treatment.

    Science.gov (United States)

    van der Zanden, Bart P; Dijkgraaf, Marcel G W; Blanken, Peter; van Ree, Jan M; van den Brink, Wim

    2007-01-05

    To determine the patterns of acquisitive crime during methadone maintenance treatment among chronic, treatment-resistant heroin users eligible for heroin assisted treatment in the Netherlands. We retrospectively assessed the type and number of illegal activities during 1 month of standard methadone maintenance treatment in 51 patients prior to the start of heroin assisted treatment. Data were collected using a semi-structured interview focussed on crime with special emphasis on property crime. Volume analyses consisted of frequencies and descriptives of mean numbers of offences per day and per type. In a Dutch population of problematic drug users eligible for and prior to commencing heroin assisted treatment, 70% reported criminal activities and 50% reported acquisitive crimes. Offending took place on 20.5 days per month with on average 3.1 offences a day. Acquisitive crime consisted mainly of shoplifting (mean 12.8 days, 2.2 times/day) and theft of bicycles (mean 5.8 days, 2.4 times/day); theft from a vehicle and burglaries were committed less frequently. The majority of these patients (63%) reported to have started offending in order to acquire illicit drugs and alcohol. During methadone maintenance treatment, 50% of criminally active, problematic heroin users eligible for heroin assisted treatment reported acquisitive crime. Shoplifting, thefts and/or other property crimes were committed on average two to three times on a crime day. This study discusses that the detail provided by self-reported crime data can improve cost estimates in economic evaluations of heroin assisted treatment.

  20. Assisted reproductive technology treatment in women with severe eating disorders

    DEFF Research Database (Denmark)

    Assens, Maria; Ebdrup, Ninna H; Pinborg, Anja

    2015-01-01

    INTRODUCTION: This national retrospective cohort study investigates the prevalence of women with severe eating disorders in assisted reproductive technology (ART) treatment compared with an age-matched background population without ART treatment. It assesses the frequency distribution of the first...... and last eating disorder diagnosis before, during, and after ART treatment, and evaluates differences in obstetric outcomes between women with and without a severe eating disorder. MATERIAL AND METHODS: Hospital-diagnosed eating disorders among 42 915 women in the Danish National ART cohort (DANAC......), registered during 1994-2009 in the mandatory Psychiatric Central Research Register, were compared with a non-eating disorder ART cohort of 42 644 women and an age-matched background population of 215 290 women without a history of ART treatment for the main outcome measures prevalence of eating disorders...

  1. Study of sterilization-treatment in pure and N- doped carbon thin films synthesized by inductively coupled plasma assisted pulsed-DC magnetron sputtering

    Energy Technology Data Exchange (ETDEWEB)

    Javid, Amjed [Center for Advanced Plasma Surface Technology (CAPST), NU-SKKU Joint Institute for Plasma Nano-Materials (IPNM), Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of); Department of Textile Processing, National Textile University, Faisalabad 37610 (Pakistan); Kumar, Manish, E-mail: manishk@skku.edu [Center for Advanced Plasma Surface Technology (CAPST), NU-SKKU Joint Institute for Plasma Nano-Materials (IPNM), Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of); Han, Jeon Geon, E-mail: hanjg@skku.edu [Center for Advanced Plasma Surface Technology (CAPST), NU-SKKU Joint Institute for Plasma Nano-Materials (IPNM), Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of)

    2017-01-15

    Highlights: • Pure and N-doped nanocrystallie carbon films are synthesized by ICP assisted pulsed DC plasma process. • ICP power induces the increase in average graphitic crystallite size from 4.86 nm to 6.42 nm. • Beneficial role of ICP source assistance to achieve high sputtering throughput (deposition rate ∼55 nm/min). • Post-sterilization electron-transport study shows N-doped carbon films having promising stability. - Abstract: Electrically-conductive nanocrystalline carbon films, having non-toxic and non-immunogenic characteristics, are promising candidates for reusable medical devices. Here, the pure and N- doped nanocrystalline carbon films are deposited by the assistance of inductively coupled plasma (ICP) in an unbalanced facing target pulsed-DC magnetron sputtering process. Through the optical emission spectroscopy study, the role of ICP assistance and N-doping on the reactive components/radicals during the synthesis is presented. The N-doping enhances the three fold bonding configurations by increasing the ionization and energies of the plasma species. Whereas, the ICP addition increases the plasma density to control the deposition rate and film structure. As a result, sputtering-throughput (deposition rate: 31–55 nm/min), electrical resistivity (4–72 Ωcm) and water contact angle (45.12°–54°) are significantly tailored. Electric transport study across the surface microchannel confirms the superiority of N-doped carbon films for sterilization stability over the undoped carbon films.

  2. Clinical outcome after poststernotomy mediastinitis: vacuum-assisted closure versus conventional treatment.

    Science.gov (United States)

    Sjögren, Johan; Gustafsson, Ronny; Nilsson, Johan; Malmsjö, Malin; Ingemansson, Richard

    2005-06-01

    The conventional treatment for poststernotomy mediastinitis usually involves surgical revision, closed irrigation, or reconstruction with omentum or pectoral muscle flaps. Recently, vacuum-assisted closure has been successfully used in poststernotomy mediastinitis. The aim of the present study was to compare the clinical outcome and survival in 101 patients undergoing vacuum-assisted closure therapy or conventional treatment for poststernotomy mediastinitis. One hundred one consecutive patients underwent treatment for poststernotomy mediastinitis: vacuum-assisted closure therapy (January 1999 through December 2003, n = 61) or conventional treatment (July 1994 through December 1998, n = 40). Follow-up was made in April 2004 and was 100% complete. Actuarial statistics were used to calculate the survival rates. The 90-days mortality was 0% in the vacuum-assisted closure group and 15% in the conventional treatment group (p vacuum-assisted closure and conventional treatment were 0% and 37.5%, respectively (p vacuum-assisted closure therapy or conventional treatment: 6.6% versus 5.0%, respectively. Overall survival in the vacuum-assisted closure group was significantly better (p vacuum-assisted closure therapy is a safe and reliable option in poststernotomy mediastinitis with excellent survival and a very low failure rate compared with conventional treatment.

  3. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

    Science.gov (United States)

    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  4. Male psychological adaptation to unsuccessful medically assisted reproduction treatments

    DEFF Research Database (Denmark)

    Martins, Mariana Veloso; Basto-Pereira, Miguel; Pedro, Juliana

    2016-01-01

    to infertility and related treatments. OBJECTIVE AND RATIONALE: The main research questions addressed in this review were 'Does male psychological adaptation to unsuccessful medically assisted reproduction (MAR) treatment vary over time?' and 'Which psychosocial variables act as protective or risk factors...

  5. Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency.

    Science.gov (United States)

    Mees, Soeren Torge; Palmes, Daniel; Mennigen, Rudolf; Senninger, Norbert; Haier, Joerg; Bruewer, Matthias

    2008-04-01

    Anastomotic insufficiency in patients with colorectal anastomosis is a major complication with high morbidity and mortality. Local treatment with transrectal lavage and drainage can be considered in patient without peritonitis. In order to prevent prolonged wound closure and secondary complications during conservative treatment we investigated the vacuum assisted closure (VAC) in this setting. Ten patients with anastomotic insufficiency after colorectal resections, who did not require transabdominal interventions, were treated with an Endo-vacuum assisted closure dressing (Group A; n = 5) or by transrectal lavage (Group B; n = 5). Time for wound healing, duration of hospitalization and pain assessment were compared in both groups. The Endo-vacuum assisted closure treatment was performed for a median time of 27 days without any vacuum assisted closure associated complications. Wound healing was significantly accelerated in Group A compared to Group B. Time in hospital was slightly shortened in patients with Endo-vacuum assisted closure. Pain assessment in both groups did not show any significant differences. Endo-vacuum assisted closure therapy is a novel approach that can be considered in diverted patients with failed colorectal anastomoses. Larger randomized trials that include complete cost-benefit analyses are needed to establish its role in this setting.

  6. Psychosocial needs of women and their partners after successful assisted reproduction treatment in Barcelona

    Directory of Open Access Journals (Sweden)

    Esther Crespo

    2016-12-01

    Full Text Available It is assumed that pregnancy and parenthood after a period of infertility are unproblematic and gratifying. However, a review of the literature highlights the complexity of the psychological and social consequences of pregnancy, childbirth and parenting after successful treatment with assisted reproductive technology. These experiences, including those following the creation of new forms of non-genetic and/or social parenthood, require investigation in order to understand how women and their partners integrate their journey from infertility to pregnancy and parenthood after successful assisted reproductive treatment. This paper presents results derived from qualitative interviews with 30 pregnant women and 21 couples after assisted reproductive treatment (repeated rounds of individual interviews with the study participants conducted from July 2010 to April 2014 as part of a larger ethnographic study exploring the psychosocial needs of women and partners following assisted reproductive treatment in Barcelona’s. The transcribed text was coded into categories of either predetermined or emergent topics. Prior studies have found that couples who achieve pregnancy after infertility may experience higher levels of anxiety in relation to pregnancy. This anxiety can be linked with a higher risk of complications during pregnancy after assisted reproductive treatment compared with spontaneous conception. However, the evidence concerning adjustment to pregnancy and parenthood is inconclusive. This study highlights the necessity for participants to give meaning to these treatments, given the variability that exists in perceptions of infertility and pregnancy after successful assisted reproductive treatment.

  7. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    Objective. To examine the costs to the public health care system of couples in medically assisted reproduction. Design. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Setting. Specialized public fertility clinics in Denmark. Sample. Seven...... hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic. Methods. Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics...... or not – were estimated at 6607€. Costs per live birth of women assisted reproduction treatment are relatively modest. The results can be generalized...

  8. [Guideline compliance in the treatment of schizophrenic patients. Introduction of a computer-assisted treatment pathway].

    Science.gov (United States)

    Godemann, F; Blittersdorf, K; Poschenrieder, M; Klimitz, H; Hauth, I; Gutzmann, H

    2010-05-01

    The goal of S3 Guidelines for the Treatment of Schizophrenia was to improve the care of patients with schizophrenic psychoses. However, the publication of guidelines alone does not ensure their consistent implementation. The use of treatment pathways represents one possible approach to help implement the complex treatment recommendations contained in the S3 Guidelines. The first computer-assisted treatment pathway for patients with schizophrenic psychoses was successfully incorporated into the everyday routine of psychiatric hospitals. The aim of the present study was to systematically analyse the impact of this measure on guideline compliance. Based on the S3 Guidelines for the Treatment of Schizophrenia developed by the German Association of Psychiatry, Psychotherapy and Neurology (Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde; DGPPN), diagnostic and treatment procedures were defined by a multiprofessional working group with members from five different hospitals and subsequently incorporated into an existing hospital information system. In one of the five hospitals, the impact of this measure was analysed in a pilot study in a systematic manner. In the year 2007, approximately 100 patients in each of two wards in the hospital received in a parallel group design either standard care or care based on a computer-assisted treatment pathway. Based on their place of residence, patients were assigned to the two units consecutively. Both groups were analysed to determine the extent to which the care they received conformed to treatment guidelines. Data available from the years 2004 and 2005 served as a historical comparison to the present results. The differences in guideline compliance between the two wards were heterogeneous and, in certain respects, counterintuitive. As expected, the treatment pathway group showed an increased number of laboratory tests, more frequent drug screening at hospital admission and more appropriate dosing of

  9. Vacuum-assisted close versus conventional treatment for postlaparotomy wound dehiscence.

    Science.gov (United States)

    Ko, Yoon Song; Jung, Sung Won

    2014-11-01

    The conventional treatment for postlaparotomy wound dehiscence usually involves surgical revision. Recently, vacuum-assisted closure has been successfully used in postlaparotomy wound dehiscence. The aim of the present study was to compare the clinical outcome of 207 patients undergoing vacuum-assisted closure therapy or conventional treatment for postlaparotomy wound dehiscence. TWO HUNDRED AND SEVEN CONSECUTIVE PATIENTS UNDERWENT TREATMENT FOR POSTLAPAROTOMY WOUND DEHISCENCE: vacuum-assisted closure therapy (January 2007 through August 2012, n = 25) or conventional treatment (January 2001 through August 2012, n = 182). The failure rate to first-line treatment with vacuum-assisted closure and conventional treatment were 0% and 14.3%, respectively (P = 0.002). There was no statistically significant difference in the enterocutaneous fistulas and hospital stay after vacuum-assisted closure therapy or conventional treatment respectively. Our findings support that vacuum-assisted closure therapy is a safe and reliable option in postlaparotomy wound dehiscence with very low failure rate in surgical revision compared with conventional treatment.

  10. Study of sterilization-treatment in pure and N- doped carbon thin films synthesized by inductively coupled plasma assisted pulsed-DC magnetron sputtering

    Science.gov (United States)

    Javid, Amjed; Kumar, Manish; Han, Jeon Geon

    2017-01-01

    Electrically-conductive nanocrystalline carbon films, having non-toxic and non-immunogenic characteristics, are promising candidates for reusable medical devices. Here, the pure and N- doped nanocrystalline carbon films are deposited by the assistance of inductively coupled plasma (ICP) in an unbalanced facing target pulsed-DC magnetron sputtering process. Through the optical emission spectroscopy study, the role of ICP assistance and N-doping on the reactive components/radicals during the synthesis is presented. The N-doping enhances the three fold bonding configurations by increasing the ionization and energies of the plasma species. Whereas, the ICP addition increases the plasma density to control the deposition rate and film structure. As a result, sputtering-throughput (deposition rate: 31-55 nm/min), electrical resistivity (4-72 Ωcm) and water contact angle (45.12°-54°) are significantly tailored. Electric transport study across the surface microchannel confirms the superiority of N-doped carbon films for sterilization stability over the undoped carbon films.

  11. Plasma assisted surface treatments of biomaterials.

    Science.gov (United States)

    Minati, L; Migliaresi, C; Lunelli, L; Viero, G; Dalla Serra, M; Speranza, G

    2017-10-01

    The biocompatibility of an implant depends upon the material it is composed of, in addition to the prosthetic device's morphology, mechanical and surface properties. Properties as porosity and pore size should allow, when required, cells penetration and proliferation. Stiffness and strength, that depend on the bulk characteristics of the material, should match the mechanical requirements of the prosthetic applications. Surface properties should allow integration in the surrounding tissues by activating proper communication pathways with the surrounding cells. Bulk and surface properties are not interconnected, and for instance a bone prosthesis could possess the necessary stiffness and strength for the application omitting out prerequisite surface properties essential for the osteointegration. In this case, surface treatment is mandatory and can be accomplished using various techniques such as applying coatings to the prosthesis, ion beams, chemical grafting or modification, low temperature plasma, or a combination of the aforementioned. Low temperature plasma-based techniques have gained increasing consensus for the surface modification of biomaterials for being effective and competitive compared to other ways to introduce surface functionalities. In this paper we review plasma processing techniques and describe potentialities and applications of plasma to tailor the interface of biomaterials. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. The effect of assisted reproduction treatment on mental health in fertile women.

    Science.gov (United States)

    Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza

    2016-01-01

    The process of assisted reproductive treatment is a stressful situation in the treatment of infertile couples and it would harm the mental health of women. Fertile women who started infertility treatment due to male factor infertility have reported to experience less stress and depression than other women before the assisted reproductive process but considering the cultural and social factors and also the etiology of the assisted reproductive process, it could affect the metal health of these women. Therefore, this study was conducted to evaluate the mental health of fertile women who undergo assisted reproductive treatment due to male factor infertility. This study was a prospective study on 70 fertile women who underwent assisted reproductive treatment due to male factor infertility. The exclusion criterion was to stop super ovulation induction. To assess mental health, anxiety and depression dimensions of the general health questionnaire were used. Before starting ovulation induction and after oocyte harvesting, the general health questionnaire was filled by women who were under treatment. Data were analyzed using multi-variable linear regression, paired t-test, and Chi-square. The results showed that the mean score of depression and anxiety before ovulation induction and after oocyte harvesting were not significantly different; but the rate of mental health disorder in the depression dimension was significantly decreased after oocytes harvesting (31.7% vs. 39.7%). Also, there was a significant relation between the level of anxiety and depression before ovulation induction and after oocyte harvesting (P assisted reproductive treatment does not affect the mental health in fertile women independently, but these women start assisted reproductive process with high levels of depression and anxiety. Therefore, prior to the assisted reproductive treatment mental health consultation is needed.

  13. Treatment outcome of alcohol use disorder outpatients with or without medically assisted detoxification

    NARCIS (Netherlands)

    Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten W. J.; de Wildt, Wencke A. J. M.; Vedel, Ellen; Goudriaan, Anna E.; van den Brink, Wim

    2014-01-01

    Little is known about the incremental effects of medically assisted detoxification on outpatient treatment for alcohol use disorders. The objective of this study was to compare drinking outcomes in a psychosocial treatment program between two groups of heavy drinking patients who had an alcohol use

  14. Patterns of acquisitive crime during methadone maintenance treatment among patients eligible for heroin assisted treatment

    NARCIS (Netherlands)

    van der Zanden, Bart P.; Dijkgraaf, Marcel G. W.; Blanken, Peter; van Ree, Jan M.; van den Brink, Wim

    2007-01-01

    OBJECTIVE: To determine the patterns of acquisitive crime during methadone maintenance treatment among chronic, treatment-resistant heroin users eligible for heroin assisted treatment in the Netherlands. METHODS: We retrospectively assessed the type and number of illegal activities during 1 month of

  15. Computer-Assisted Instruction on Study Skills.

    Science.gov (United States)

    Gadzella, Bernadette M.

    1982-01-01

    A computer-assisted instruction study skills program was presented to 88 college students, while a control group did not have access to it. Scores for the experimental group on the Survey of Study Habits and Attitudes increased during the semester, while scores for the control group decreased. (Author/BW)

  16. Legal regulation of assisted reproduction treatment in Russia.

    Science.gov (United States)

    Svitnev, Konstantin

    2010-06-01

    Russia remains one of the countries with a most favourable approach towards human reproduction in Europe, allowing almost everybody wanting to have a child of their own through assisted reproduction treatment to fulfill their dream. The legal situation around assisted reproduction treatment in Russia is very favourable; surrogacy, gamete and embryo donation are permitted, even on a commercial level. Gestational surrogacy is an option for heterosexual couples and single women, although a court decision might be needed to register a 'surrogate' child born to a couple who are not officially married or a single woman. However, it is not explicitly allowed nor prohibited for single men. Copyright 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Heroin-assisted treatment (HAT) a decade later : A brief update on science and politics

    NARCIS (Netherlands)

    Fischer, Benedikt; Oviedo-Joekes, Eugenia; Blanken, Peter; Haasen, Christian; Rehm, Juergen; Schechter, Martin T.; Strang, John; van den Brink, Wim

    Since the initial Swiss heroin-assisted treatment (HAT) study conducted in the mid-1990s, several other jurisdictions in Europe and North America have implemented HAT trials. All of these studies embrace the same goal-investigating the utility of medical heroin prescribing for problematic opioid

  18. Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance.

    Directory of Open Access Journals (Sweden)

    Emma Robinson

    Full Text Available BACKGROUND: Internet-based cognitive behavioural therapy (iCBT for generalized anxiety disorder (GAD has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. METHOD: Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Penn State Worry Questionnaire (PSWQ and the Generalized Anxiety Disorder-7 Item (GAD-7. Completion rates were high, and both treatment groups reduced scores on the PSWQ (p<0.001 and GAD-7 (p<0.001 compared to the delayed treatment group, but did not differ from each other. Within group effect sizes on the PSWQ were 1.16 and 1.07 for the clinician- and technician-assisted groups, respectively, and on the GAD-7 were 1.55 and 1.73, respectively. At 3 month follow-up participants in both treatment groups had sustained the gains made at post-treatment. Participants in the clinician-assisted group had made further gains on the PSWQ. Approximately 81 minutes of clinician time and 75 minutes of technician time were required per participant during the 10 week treatment program. CONCLUSIONS: Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment

  19. A novel cupping-assisted plasma treatment for skin disinfection

    Science.gov (United States)

    Xiong, Zilan; Graves, David B.

    2017-02-01

    A novel plasma treatment method/plasma source called cupping-assisted plasma treatment/source for skin disinfection is introduced. The idea combines ancient Chinese ‘cupping’ technology with plasma sources to generate active plasma inside an isolated, pressure-controlled chamber attached to the skin. Advantages of lower pressure include reducing the threshold voltage for plasma ignition and improving the spatial uniformity of the plasma treatment. In addition, with reduced pressure inside the cup, skin pore permeability might be increased and it improves attachment of the plasma device to the skin. Moreover, at a given pressure, plasma-generated active species are restricted inside the cup, raising local reactive species concentration and enhancing the measured surface disinfection rate. A surface micro-discharge (SMD) device is used as an example of a working plasma source. We report discharge characteristics and disinfection efficiency as a function of pressure and applied voltage.

  20. Endoport-Assisted Microsurgical Treatment of a Ruptured Periventricular Aneurysm

    Directory of Open Access Journals (Sweden)

    Ching-Jen Chen

    2016-01-01

    Full Text Available Background and Importance. Ruptured periventricular aneurysms in patients with moyamoya disease represent challenging pathologies. The most common methods of treatment include endovascular embolization and microsurgical clipping. However, rare cases arise in which the location and anatomy of the aneurysm make these treatment modalities particularly challenging. Clinical Presentation. We report a case of a 34-year-old female with moyamoya disease who presented with intraventricular hemorrhage. CT angiography and digital subtraction angiography revealed an aneurysm located in the wall of the atrium of the right lateral ventricle. Distal endovascular access was not possible, and embolization risked the sacrifice of arteries supplying critical brain parenchyma. Using the BrainPath endoport system, the aneurysm was able to be accessed. Since the fusiform architecture of the aneurysm prevented clip placement, the aneurysm was ligated with electrocautery. Conclusion. We demonstrate the feasibility of endoport-assisted approach for minimally invasive access and treatment of uncommon, distally located aneurysms.

  1. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    Science.gov (United States)

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  2. Evaluating Animal-Assisted Therapy in Group Treatment for Child Sexual Abuse

    Science.gov (United States)

    Dietz, Tracy J.; Davis, Diana; Pennings, Jacquelyn

    2012-01-01

    This study evaluates and compares the effectiveness of three group interventions on trauma symptoms for children who have been sexually abused. All of the groups followed the same treatment protocol, with two of them incorporating variations of animal-assisted therapy. A total of 153 children ages 7 to 17 who were in group therapy at a Child…

  3. Comparing the efficacy of a web-assisted calprotectin-based treatment algorithm (IBD-live) with usual practices in teenagers with inflammatory bowel disease: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Heida, Anke; Dijkstra, Alie; Groen, Henk; Muller Kobold, Anneke; Verkade, Henkjan; van Rheenen, Patrick

    2015-06-16

    To prevent clinical relapse in teenagers with inflammatory bowel disease (IBD) there is a need to monitor disease activity continuously. Timely optimisation of medical treatment may nip a preclinical relapse in the bud and change the natural course of IBD. Traditionally, disease monitoring is done during scheduled visits, but this is when most teenagers report full control. IBD care could be more efficient if patients were seen at times of clinical need. This study aims to examine the effectiveness of a web-assisted calprotectin-based treatment algorithm (IBD-live) compared with usual practices in teenagers with IBD. A randomized trial of web-based disease monitoring versus usual care is conducted at 10 Dutch IBD care centers. We plan to recruit 180 patients between 10- and 19-years old with quiescent IBD at baseline. Teenagers assigned to IBD-live will use the flarometer--an automatic cumulation of disease activity and fecal calprotectin measurements- to estimate probability of relapse. In case the flarometer indicates high risk the patient requires treatment intensification in accordance with national guidelines; low risk means that maintenance therapy is unchanged; and intermediate risk requires optimisation of drug adherence. Patients assigned to usual practice get the best accepted medical care with regular health checks. Primary outcome is the frequency of relapse at 52 weeks of follow-up. The diagnosis of relapse is based on a clinical activity index score >10 points necessitating remission induction therapy. Secondary outcomes include quality of life and cost-effectiveness. Web-assisted monitoring of disease activity with rapid access for those with acute relapse may allow teenagers to develop skills that are required of adult patients (including communication and self-determination). Similar monitoring systems have been introduced for teenagers with asthma and diabetes, with a positive effect on disease control, but the intervention has not been evaluated

  4. Altruism or obligation? The motivations and experience of women who donate oocytes to known recipients in assisted conception treatment: an interpretative phenomenological analysis study.

    Science.gov (United States)

    Acharya, Santanu; Bryant, Louise; Twiddy, Maureen

    2017-03-01

    This qualitative study was conducted to explore the motivations and experience of oocyte donors donating to women known to them. Three women who donated oocytes to a close relative were interviewed and data were analysed using an Interpretative Phenomenological Analysis approach. The two key elements noted were "motivations for donation" and "coping with the consequences of oocyte donation". The motivation for donation was influenced by the familial bond that was strengthened by the donation process in some cases. The concept of altruistic oocyte donation stemmed from the narratives of giving the gift of motherhood and gaining a positive self-image and respect from others. Coping with the consequences of oocyte donation tests the donor identity, their wishes for a positive outcome, concerns regarding disclosure of biological motherhood and detachment from the egg and potential child. Motivation is influenced by a combination of factors including the rewards of altruistic behaviour, the existence and potential strengthening of the relationship between donor and recipient, but possibly also, a sense of obligation and societal expectations. Oocyte donation can be variously viewed by donors as a unique way of reproductive empowerment or an example of acceding to subtle coercion and thus disempowerment. The study also highlights the clinical as well as ethical importance of providing support services for oocyte donors and recipients.

  5. Assisted reproductive techniques after fertility-sparing treatments in gynaecological cancers.

    Science.gov (United States)

    Zapardiel, Ignacio; Cruz, Maria; Diestro, Maria D; Requena, Antonio; Garcia-Velasco, Juan A

    2016-04-01

    The trend toward late childbearing has made fertility preservation a major issue for women who face gynecological cancer. New techniques in assisted reproductive medicine enable conception after primary treatment of these cancers. Here, we aimed to review the efficacy and safety of assisted reproductive techniques (ART) after fertility-preserving treatment of gynaecological cancers. We conducted a systematic literature review of both prospective and retrospective studies in the PubMed, EMBASE, CENTRAL and SciSearch databases. In the retrieved studies, we evaluated live births, clinical pregnancies, overall survival and disease-free survival. We identified many prospective and retrospective studies on this topic, but no relevant randomized clinical trials. Fertility-sparing treatments with safe oncological outcomes are feasible in endometrial, cervical and ovarian cancer cases. After cancer treatment, ART seem safe and show variable obstetrical outcomes. After fertility-preserving treatment for gynaecological cancers, ART can enable pregnancy to be achieved with apparent oncological safety. The success of such procedures should directly impact clinical practice and management of those patients who require fertility-sparing treatment. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Minimally Invasive Procedures - Direct and Video-Assisted Forms in the Treatment of Heart Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Josué Viana Neto, E-mail: jvcn@uol.com.br [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Melo, Emanuel Carvalho; Silva, Juliana Fernandes [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Rebouças, Leonardo Lemos; Corrêa, Larissa Chagas; Germano, Amanda de Queiroz [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Machado, João José Aquino [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil)

    2014-03-15

    Minimally invasive cardiovascular procedures have been progressively used in heart surgery. To describe the techniques and immediate results of minimally invasive procedures in 5 years. Prospective and descriptive study in which 102 patients were submitted to minimally invasive procedures in direct and video-assisted forms. Clinical and surgical variables were evaluated as well as the in hospital follow-up of the patients. Fourteen patients were operated through the direct form and 88 through the video-assisted form. Between minimally invasive procedures in direct form, 13 had aortic valve disease. Between minimally invasive procedures in video-assisted forms, 43 had mitral valve disease, 41 atrial septal defect and four tumors. In relation to mitral valve disease, we replaced 26 and reconstructed 17 valves. Aortic clamp, extracorporeal and procedure times were, respectively, 91,6 ± 21,8, 112,7 ± 27,9 e 247,1 ± 20,3 minutes in minimally invasive procedures in direct form. Between minimally invasive procedures in video-assisted forms, 71,6 ± 29, 99,7 ± 32,6 e 226,1 ± 42,7 minutes. Considering intensive care and hospitalization times, these were 41,1 ± 14,7 hours and 4,6 ± 2 days in minimally invasive procedures in direct and 36,8 ± 16,3 hours and 4,3 ± 1,9 days in minimally invasive procedures in video-assisted forms procedures. Minimally invasive procedures were used in two forms - direct and video-assisted - with safety in the surgical treatment of video-assisted, atrial septal defect and tumors of the heart. These procedures seem to result in longer surgical variables. However, hospital recuperation was faster, independent of the access or pathology.

  7. Vacuum-assisted closure in the treatment of poststernotomy mediastinitis

    NARCIS (Netherlands)

    Obdeijn, MC; de Lange, M.Y.; Lichtendahl, DHE; de Boer, Willem

    1999-01-01

    A new technique using vacuum-assist-ed closure was successfully applied in 3 patients with poststernotomy mediastinitis. After surgical debridement, this vacuum-assisted closure technique has made it possible to avoid the need for secondary surgical closure (including direct secondary surgical

  8. Adopting evidence-based medically assisted treatments in substance abuse treatment organizations: roles of leadership socialization and funding streams.

    Science.gov (United States)

    Blum, Terry C; Davis, Carolyn D; Roman, Paul M

    2014-01-01

    This paper examines the organizational adoption of medically assisted treatments (MAT) for substance use disorders (SUDs) in a representative sample of 555 US for-profit and not-for-profit treatment centers. The study examines organizational adoption of these treatments in an institutionally contested environment that traditionally has valued behavioral treatment, using sociological and resource dependence frameworks. The findings indicate that socialization of leadership, measured by formal clinical education, is related to the adoption of MAT. Funding patterns also affect innovation adoption, with greater adoption associated with higher proportions of earned income from third party fees for services, and less adoption associated with funding from criminal justice sources. These findings may generalize to other social mission-oriented organizations where innovation adoption may be linked to private and public benefit values inherent in the type of socialization of leadership and different patterns of funding support.

  9. Assisted bibliotherapy: effective, efficient treatment for moderate anxiety problems.

    Science.gov (United States)

    Kupshik, G A; Fisher, C R

    1999-01-01

    Specific psychological treatments of proven effectiveness for moderate anxiety disorders are not often easily accessible in general practice. In this study, selected patients were supported in learning skills to manage their symptoms. This approach was efficient, acceptable, and led to clinically significant symptom reduction for a high proportion of patients. This improvement was well sustained at three-month follow-up. PMID:10622018

  10. Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders.

    Science.gov (United States)

    Thomas, Kelan; Malcolm, Benjamin; Lastra, Dan

    2017-05-08

    Recent research suggests that functional connectivity changes may be involved in the pathophysiology of psychiatric disorders. Hyperconnectivity in the default mode network has been associated with psychopathology, but psychedelic serotonin agonists like psilocybin may profoundly disrupt these dysfunctional neural network circuits and provide a novel treatment for psychiatric disorders. We have reviewed the current literature to investigate the efficacy and safety of psilocybin-assisted therapy for the treatment of psychiatric disorders. There were seven clinical trials that investigated psilocybin-assisted therapy as a treatment for psychiatric disorders related to anxiety, depression, and substance use. All trials demonstrated reductions in psychiatric rating scale scores or increased response and remission rates. There were large effect sizes related to improved depression and anxiety symptoms. Psilocybin may also potentially reduce alcohol or tobacco use and increase abstinence rates in addiction, but the benefits of these two trials were less clear due to open-label study designs without statistical analysis. Psilocybin-assisted therapy efficacy and safety appear promising, but more robust clinical trials will be required to support FDA approval and identify the potential role in clinical psychiatry.

  11. Investigation of sewage sludge treatment using air plasma assisted gasification.

    Science.gov (United States)

    Striūgas, Nerijus; Valinčius, Vitas; Pedišius, Nerijus; Poškas, Robertas; Zakarauskas, Kęstutis

    2017-06-01

    This study presents an experimental investigation of downdraft gasification process coupled with a secondary thermal plasma reactor in order to perform experimental investigations of sewage sludge gasification, and compare process parameters running the system with and without the secondary thermal plasma reactor. The experimental investigation were performed with non-pelletized mixture of dried sewage sludge and wood pellets. To estimate the process performance, the composition of the producer gas, tars, particle matter, producer gas and char yield were measured at the exit of the gasification and plasma reactor. The research revealed the distribution of selected metals and chlorine in the process products and examined a possible formation of hexachlorobenzene. It determined that the plasma assisted processing of gaseous products changes the composition of the tars and the producer gas, mostly by destruction of hydrocarbon species, such as methane, acetylene, ethane or propane. Plasma processing of the producer gas reduces their calorific value but increases the gas yield and the total produced energy amount. The presented technology demonstrated capability both for applying to reduce the accumulation of the sewage sludge and production of substitute gas for drying of sewage sludge and electrical power. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Intraoperative ultrasound assistance in treatment of intradural spinal tumours.

    Science.gov (United States)

    Zhou, Hongyu; Miller, Dorothea; Schulte, Dirk Michael; Benes, Ludwig; Bozinov, Oliver; Sure, Ulrich; Bertalanffy, Helmut

    2011-09-01

    Currently, the standard practice to treat intradural spinal tumours involves microsurgical resection of the lesions. It is essential to be able to locate the lesion precisely to reduce the risk of neurological morbidity. The purpose of this study was to evaluate intraoperative ultrasonography (IOUS) in visualizing intradural spinal tumours, and assess its potential to improve surgical precision and minimize surgical trauma. Between January 2006 and July 2007, 30 patients with suspected intradural spinal tumours underwent surgery with the aid of IOUS. There were 13 patients with intramedullary tumours (ependymoma=2, astrocytoma=5, hemangioblastoma=2 and metastasis=4); and 14 patients with extramedullary tumours (meningioma=6, neurinoma=6, filum terminale ependymoma=1 and lipoma=1). In 3 patients histopathology did not reveal any neoplasm despite an MRI suggesting tumour. Their sonographic features are analyzed and the advantages of IOUS are discussed. The shape and expansion of intradural tumours could be visualized on IOUS. The sonographic visualization allowed adapting the approach to an appropriate location and size before dura opening. Certain sonographic features can be used for a differential diagnosis of different intradural tumours. In addition, IOUS can inform neurosurgeons about the location of the neoplastic tissue, its relation to the spinal cord and the size of residual tumour following excision. IOUS is a sensitive intraoperative tool. When appropriately applied to assist surgical procedures, it offers additional intraoperative information that helps to improve surgical precision and therefore might reduce the procedure related morbidity. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Patients Undergoing Substance Abuse Treatment and Receiving Financial Assistance for a Physical Disability Respond Well to Contingency Management Treatment.

    Science.gov (United States)

    Burch, Ashley E; Morasco, Benjamin J; Petry, Nancy M

    2015-11-01

    Physical illness and disability are common in individuals with substance use disorders, but little is known about the impact of physical disability status on substance use treatment outcomes. This study examined the main and interactive effects of physical disability payment status on substance use treatment. Participants (N = 1,013) were enrolled in one of six prior randomized clinical trials comparing contingency management (CM) to standard care; 79 (7.8%) participants reported receiving disability payments, CM improved all three primary substance use outcomes: treatment retention, percent negative samples and longest duration of abstinence. There was no significant main effect of physical disability payment status on treatment outcomes; however, a significant treatment condition by physical disability status interaction effect emerged in terms of retention in treatment and duration of abstinence achieved. Patients who were receiving physical disability payments responded particularly well to CM, and their time in treatment and durations of drug and alcohol abstinence increased even more markedly with CM than did that of their counterparts who were not receiving physical disability assistance. These findings suggest an objectively defined cohort of patients receiving substance use treatment who respond particularly well to CM. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Chromosomal abnormalities in spontaneous abortion after assisted reproductive treatment

    Directory of Open Access Journals (Sweden)

    Kim You

    2010-11-01

    Full Text Available Abstract Background We evaluated cytogenetic results occurring with first trimester pregnancy loss, and assessed the type and frequency of chromosomal abnormalities after assisted reproductive treatment (ART and compared them with a control group. We also compared the rate of chromosomal abnormalities according to infertility causes in ICSI group. Methods A retrospective cohort analysis was made of all patients who were referred to the Genetics Laboratory of Fertility Center of CHA Gangnam Medical Center from 2005 to 2009 because of clinical abortion with a subsequent dilation and evacuation (D&E performed, and patients were grouped by type of conception as follows: conventional IVF (in vitro fertilization (n = 114, ICSI (intracytoplasmic sperm injection (n = 140, and control (natural conception or intrauterine insemination [IUI] (n = 128. Statistical analysis was performed using SPSS software. Results A total 406 specimens were referred to laboratory, ten abortuses were excluded, and in 14 cases, we did not get any spontaneous metaphase, chromosomal constitutions of 382 specimens were successfully obtained with conventional cytogenetic methods. Overall, 52.62% of the miscarriages were found to be cytogenetically abnormal among all patients, the frequency was 48.4% in the control group, 54.3% of miscarriages after ICSI and 55.3% after conventional IVF (p = 0.503. The most prevalent abnormalities were autosomal trisomy, however, nine (11.69% sex chromosome aneuploidy were noted in the ICSI group vs. four (6.45% and two (3.23% cases in the conventional IVF group and control group. We compared chromosomal abnormalities of miscarriages after ICSI according to infertility factor. 55.71% underwent ICSI due to male factors, 44.29% due to non-male factors. ICSI group having male factors showed significantly higher risk of chromosomal abnormalities than ICSI group having non-male factors (65.8% vs. 34.2%, p = 0.009, odds ratio = 1.529, 95% CI = 1

  15. Treatment of subcutaneous abdominal wound healing impairment after surgery without fascial dehiscence by vacuum assisted closure™ (SAWHI-V.A.C.®-study) versus standard conventional wound therapy: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Seidel, Dörthe; Lefering, Rolf; Neugebauer, Edmund A M

    2013-11-20

    A decision of the Federal Joint Committee Germany in 2008 stated that negative pressure wound therapy is not accepted as a standard therapy for full reimbursement by the health insurance companies in Germany. This decision is based on the final report of the Institute for Quality and Efficiency in Health Care in 2006, which demonstrated through systematic reviews and meta-analysis of previous study projects, that an insufficient state of evidence regarding the use of negative pressure wound therapy for the treatment of acute and chronic wounds exists. Further studies were therefore indicated. The study is designed as a multinational, multicenter, prospective randomized controlled, adaptive design, clinical superiority trial, with blinded photographic analysis of the primary endpoint. Efficacy and effectiveness of negative pressure wound therapy for wounds in both medical sectors (in- and outpatient care) will be evaluated. The trial compares the treatment outcome of the application of a technical medical device which is based on the principle of negative pressure wound therapy (intervention group) and standard conventional wound therapy (control group) in the treatment of subcutaneous abdominal wounds after surgery. The aim of the SAWHI-VAC® study is to compare the clinical, safety and economic results of both treatment arms. The study project is designed and conducted with the aim of providing solid evidence regarding the efficacy of negative pressure wound therapy. Study results will be provided until the end of 2014 to contribute to the final decision of the Federal Joint Committee Germany regarding the general admission of negative pressure wound therapy as a standard of performance within both medical sectors. Clinical Trials.gov NCT01528033German Clinical Trials Register DRKS00000648.

  16. Single-arm, observational study of the ease of use of a redesigned pen device to deliver recombinant human follicle-stimulating hormone (follitropin alfa for assisted reproductive technology treatment

    Directory of Open Access Journals (Sweden)

    Illingworth PJ

    2014-06-01

    Full Text Available Peter J Illingworth,1 Robert Lahoud,1 Frank Quinn,1 Kendal Chidwick,2 Claire Wilkinson,2 Gavin Sacks1 1IVFAustralia, Greenwich, Sydney, NSW, Australia; 2Scientific Affairs, Merck Serono Australia Pty Ltd, Frenchs Forest, Sydney, NSW, Australia Purpose: Evaluation of patients’ ease of use of the redesigned, disposable, ready-to-use ­follitropin alfa pen during controlled ovarian stimulation for assisted reproductive technology. Methods: This single-center, observational, open-label, single-arm study recruited infertile normo-ovulatory women (aged 18–45 years. Nurses trained patients to self-administer recombinant human follicle-stimulating hormone daily using the follitropin alfa pen (300 IU, 450 IU, and 900 IU. Before treatment, patients completed Questionnaire A. Following self-administered treatment, on stimulation days 5–6 and 7–8 (within a day of receiving recombinant human chorionic gonadotropin, patients completed Questionnaire B. Nurses completed an ease-of-learning/teaching questionnaire. The primary endpoint was proportion of patients rating the pen as “easy/very easy” to use (Questionnaire B on the final visit before recombinant human chorionic gonadotropin. Secondary endpoints included: proportion of patients rating the follitropin alfa pen as easy to learn, use, prepare, deliver, and dispose of (Questionnaires A and B. Proportions (95% confidence intervals [CIs] were provided for primary and secondary endpoints. Adverse events were reported descriptively. Results: Eighty-six patients received recombinant human follicle-stimulating hormone. Of the 72 patients who had completed the overall assessment questions, 66 (91.7%; 95% CI =82.7%–96.9% found the pen “easy” to use. Also, 70/86 (81.4% patients “strongly agreed/agreed” that, overall, it was easy to learn how to use the pen; 72/86 (83.7% “strongly agreed/agreed” that easily understandable, verbal information was provided; and 70/86

  17. Laparoscopic-assisted treatment of pyometra associated with mammary fibroadenomatous hyperplasia in a cat

    Directory of Open Access Journals (Sweden)

    Lucas Marques Colomé

    2014-03-01

    Full Text Available This paper describes a case of laparoscopic-assisted ovariohysterectomy in a female cat presenting pyometra and mammary fibroadenomatous hyperplasia. Using four portals, mesovarium were ligated by titanium ligature clips whereas the uterine vessels were occluded by video-assisted conventional ligatures. There were no postoperative complications. Video-assisted technique can be an alternative method for treatment of pyometra and cystic endometrial hyperplasia in female cats.

  18. [Use of vacuum-assisted closure in the topical treatment of surgical site infections].

    Science.gov (United States)

    Kiliç, Ayhan; Ozkaya, Ufuk; Sökücü, Sami; Basilgan, Seçkin; Kabukçuoğlu, Yavuz

    2009-01-01

    This study was designed to evaluate the results of vacuum-assisted closure in the topical treatment of surgical site infections. Vacuum therapy was performed in 17 patients (10 males, 7 females; mean age 60 + or - 20 years) using the VAC system (Vacuum-Assisted Closure, Kinetic Concept Inc) for the treatment of surgical site infections. Infective wounds were in the hip (n=6), crus (n=5), knee (n=3), sacrum (n=2), and hand (n=1). The causative organism for infections was gram-positive bacteria in 15 patients (88.2%), and six patients (35.3%) had nosocomial infections. The wounds were treated with a negative pressure of 100-125 mmHg applied continuously for the first two days, and then intermittently for the following days. The mean follow-up period was 11 + or - 6 months. The mean duration of vacuum therapy was 16 + or - 4 days and the mean length of hospitalization was 31 + or - 19 days. The patients underwent a mean number of three surgical procedures (range 1 to 6) before vacuum therapy. The mean amount of discharge from the wound was 500 + or - 150 ml. Tissue edema and discharge problems were resolved in all the wounds and a hygienic and dry-looking surgical site was attained. In 11 patients (64.7%), clinical and bacteriologic eradication of infections was achieved at the surgical site through antibiotic use and vacuum therapy. Six patients with nosocomial infections continued to receive antibiotic treatment following resolution of surgical site problems. The mean wound area showed a significant reduction from 36 + or - 14 cm(2) to 11 + or - 10 cm(2) following vacuum therapy (pclosure of wound site. Two patients (11.8%) complained of pain associated with vacuum application. Besides its topical advantages in the care of infected wounds, vacuum-assisted closure provides a more rapid and comfortable treatment opportunity, representing a reliable alternative to conventional wound care methods.

  19. The impact of treatment density and molecular weight for fractional laser-assisted drug delivery

    DEFF Research Database (Denmark)

    Haak, Christina S; Bhayana, Brijesh; Farinelli, William A

    2012-01-01

    Ablative fractional lasers (AFXL) facilitate uptake of topically applied drugs by creating narrow open micro-channels into the skin, but there is limited information on optimal laser settings for delivery of specific molecules. The objective of this study was to investigate the impact of laser...... treatment density (% of skin occupied by channels) and molecular weight (MW) for fractional CO(2) laser-assisted drug delivery. AFXL substantially increased intra- and transcutaneous delivery of polyethylene glycols (PEGs) in a MW range from 240 to 4300 Da (Nuclear Magnetic Resonance, p...

  20. Computer Assisted Diagnosis of Chest Pain. Adjunctive Treatment Protocols

    Science.gov (United States)

    1984-07-30

    physical etiology for chest pain. Disorders that present with epigastric pain such as gastritis , peptic ulcer, pancreatitis, and cholelithiasis may...shaking chills seen in bacterial pneumonia. TREATMENT: The treatment of pneumonia consists of bed rest, hydration, adequate nutrition , an

  1. A study of surfactant-assisted waterflooding

    Energy Technology Data Exchange (ETDEWEB)

    Scamehorn, J F; Harwell, J H

    1990-09-01

    In surfactant-assisted waterflooding, a surfactant slug is injected into a reservoir, followed by a brine spacer, followed by second surfactant slug. The charge on the surfactant in the first slug has opposite sign to that in the second slug. When the two slugs mix in the reservoir, a precipitate or coacervate is formed which plugs the permeable region of the reservoir. Subsequently injected water or brine is forced through the low permeability region of the reservoir, increasing sweep efficiency of the waterflood, compared to a waterflood not using surfactants. In this part of the work, two major tasks are performed. First, core floods are performed with oil present to demonstrate the improvement in incremental oil production, as well as permeability modification. Second, a reservoir simulation model will be proposed to further delineate the optimum strategy for implementation of the surfactant-assisted waterflooding, as well as indicate the reservoir types for which it would be most effective. Surfactants utilized were sodium dodecyl sulfate and dodecyl pyridinium chloride. 44 refs., 17 figs., 3 tabs.

  2. Cannabis and social welfare assistance: a longitudinal study.

    Science.gov (United States)

    Pedersen, Willy

    2011-09-01

    To investigate associations between cannabis use and subsequent receipt of social welfare assistance. The Young in Norway Longitudinal Study. A population-based Norwegian sample (n = 2606) was followed-up from adolescence to late 20s. Self-report data were merged with data from national registers. Data were extracted on the use of alcohol, tobacco and cannabis and other illegal substances. Information was also retrieved on socio-demographic and family factors, academic achievement, conduct problems and mental health. National registers provided data on social welfare assistance, educational level and crime statistics. We observed prospective bivariate associations between increasing levels of cannabis use and subsequent social welfare assistance (P social welfare assistance. At 28 years, those with 50+ times cannabis use during the previous 12 months and had an odds ratio of 9.3 (95% confidence interval: 4.3-20.1) for receiving social welfare assistance in the following 2-year span. Users of cannabis also had longer periods of receiving social welfare assistance than others (P welfare assistance system (P social welfare assistance whether the consequences are related to use of the substance per se, or to cultural factors and the illegal status of the cannabis. Future research should attempt to understand the interactions of factors behind these associations. © 2011 The Author, Addiction © 2011 Society for the Study of Addiction.

  3. Dutch nursing home policies and guidelines on physician-assisted death and decisions to forego treatment.

    Science.gov (United States)

    Haverkate, I; van der Wal, G

    1998-11-01

    The purpose of this study was to describe: (a) the prevalence and content of policies on euthanasia or assisted suicide (EAS) in three different types of nursing homes; (b) specific content items of written guidelines for EAS; and (c) the prevalence of guidelines on withholding or withdrawing treatment from severely demented patients and patients in a persistent vegetative state in the nursing homes. Descriptive, cross-sectional. We have used a postal survey among directors of patient care of all (n = 304) Dutch somatic nursing homes (meant for physically handicapped patients), psychogeriatric nursing homes (meant for patients suffering from dementia) and combined nursing homes. Data were collected from October 1994 through January 1995. Results indicate that psychogeriatric nursing homes less often had a written EAS policy than somatic and combined nursing homes (62, 68 and 80% respectively). The most frequently reported aspects in the EAS guidelines, by the nursing homes with guidelines based on a policy that EAS was accepted under certain conditions; were consultation of another physician (97%), referral to another physician if the attending physician had in-principle objections (82%), and the involvement of the nurse in the decision-making procedure (82%). Of the nursing homes, 9% reported having specific written procedures concerning withholding or withdrawing treatment from severely demented patients. Guidelines in the nursing homes on euthanasia and assisted suicide might be improved. Especially with regard to withholding or withdrawing treatment from incompetent patients, more guidelines should be developed.

  4. Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

    Science.gov (United States)

    Stea, Jonathan N; Yakovenko, Igor; Hodgins, David C

    2015-09-01

    The present study of recovery from cannabis use disorders was undertaken with 2 primary objectives that address gaps in the literature. The first objective was to provide an exploratory portrait of the recovery process from cannabis use disorders, comparing individuals who recovered naturally with those who were involved in treatment. The second objective was to explore systematically the similarities and differences between abstinence and moderation recoveries. Adults who have recovered from a cannabis use disorder were recruited in the community (N = 119). The abstinence and treatment-assisted participants exhibited higher levels of lifetime cannabis problem severity than the moderation and natural recovery participants, respectively. As well, cognitive factors were identified as the most useful strategies for recovery (e.g., thinking about benefits and negative consequences of cannabis), followed by behavioral factors (e.g., avoidance of triggers for use and high-risk situations). Findings lend further support to the effectiveness of cognitive, motivational, and behavioral strategies as helpful actions and maintenance factors involved in the recovery process. The findings also generally support the idea that cannabis use disorders lie on a continuum of problem severity, with moderation and natural recoveries more likely to occur at the lower end of the continuum and abstinence and treatment-assisted recoveries more likely to occur at the upper end. (c) 2015 APA, all rights reserved).

  5. MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults.

    Science.gov (United States)

    Danforth, Alicia L; Struble, Christopher M; Yazar-Klosinski, Berra; Grob, Charles S

    2016-01-04

    The first study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of social anxiety in autistic adults commenced in the spring of 2014. The search for psychotherapeutic options for autistic individuals is imperative considering the lack of effective conventional treatments for mental health diagnoses that are common in this population. Serious Adverse Events (SAEs) involving the administration of MDMA in clinical trials have been rare and non-life threatening. To date, MDMA has been administered to over 1133 individuals for research purposes without the occurrence of unexpected drug-related SAEs that require expedited reporting per FDA regulations. Now that safety parameters for limited use of MDMA in clinical settings have been established, a case can be made to further develop MDMA-assisted therapeutic interventions that could support autistic adults in increasing social adaptability among the typically developing population. As in the case with classic hallucinogens and other psychedelic drugs, MDMA catalyzes shifts toward openness and introspection that do not require ongoing administration to achieve lasting benefits. This infrequent dosing mitigates adverse event frequency and improves the risk/benefit ratio of MDMA, which may provide a significant advantage over medications that require daily dosing. Consequently, clinicians could employ new treatment models for social anxiety or similar types of distress administering MDMA on one to several occasions within the context of a supportive and integrative psychotherapy protocol. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Live birth outcome, spontaneous pregnancy and adoption up to five years after undergoing assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Volgsten, Helena; Schmidt, Lone

    2017-01-01

    INTRODUCTION: This study is part of a longitudinal cohort undertaken in both women and men to describe live birth outcome after undergoing assisted reproductive technology (ART) treatment in a clinical setting. Another objective was to follow women and men living with children from other...

  7. Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center

    DEFF Research Database (Denmark)

    Tan, YueQiu; Gao, Ya; Lin, Ge

    2016-01-01

    Objective: The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART). Method: In two years period, 565 pregnant women with ART twin pregnancies were prospectively tested by NIPT...

  8. Women involved in assisted reproductive treatments: a qualitative study in the medical context / Mujeres castellano-manchegas y reproducción asistida: un estudio cualitativo desde el ámbito sanitario

    Directory of Open Access Journals (Sweden)

    Beatriz Mañas Ramírez

    2014-10-01

    Full Text Available This research emerges from the necessity of facing health problems in a holistic way, able to capture the subjects’ perspective about their situation and context, and the way they are perceived and understood. This paper presents the qualitative research we have developed about women living in Castilla-La Mancha who start or are already involved in Assisted Reproductive Treatments (ART. The implementation and analysis of discussion groups provide a rich understanding of these women’s perceptions and representations about a series of dimensions that structure their own self-concept, their relations and their experience of a process which can provide or frustrate a whole vital project. In this context, where social, cultural, symbolic and biomedical aspects are involved, the cooperative work of social scientists and healthcare professionals can contribute to the advancement of both fields of knowledge, and to their mutual integration.

  9. Endoscope-assisted conservative condylectomy combined with orthognathic surgery in the treatment of mandibular condylar osteochondroma.

    Science.gov (United States)

    Yu, Hongbo; Jiao, Feifei; Li, Biao; Zhang, Lei; Shen, Steve Guofang; Wang, Xudong

    2014-07-01

    Mandibular condylar osteochondroma (OC) results in asymmetric prognathism with facial morphologic and functional disturbance. The aim of this study was to explore the feasibility of endoscope-assisted conservative condylectomy combined with simultaneous orthognathic surgery in the treatment of condylar OC. Thirteen patients with OC of the mandibular condyle were enrolled in this study. With the aid of endoscope, condylar OC resection and conservative condylectomy were carried out via intraoral approach. A direct vision of the magnified and illuminated operative field was realized. Simultaneous orthognathic surgery was used to correct facial asymmetry and malocclusion. All patients healed uneventfully. No facial nerve injury and salivary fistula occurred. Facial symmetry and morphology were greatly improved, and stable occlusion was obtained in all cases. The patients showed no signs of recurrence and temporomandibular joint ankylosis in the 16 to 54 months of follow-up. Endoscope-assisted tumor resection and condylectomy combined with simultaneous orthognathic surgery provide us a valuable option in the treatment of mandibular condylar OC.

  10. Erythropoietic protoporphyria and pretransplantation treatment with nonbiological liver assist devices

    DEFF Research Database (Denmark)

    Eefsen, Martin; Rasmussen, Allan; Wulf, Hans Christian

    2007-01-01

    of patients liver failure is a significant complication and liver transplantation is the only treatment option. Damage to both abdominal skin and organs occurs when exposed to operating light; however, this problem can be ameliorated by the use of filters that block the transmission of light with wavelength...... below 470 nm. A more unusual but very serious complication postoperatively is severe motor neuropathy, with few or no known acute available precautions. An effective treatment option is needed to manage EPP crises and to prevent complications after liver transplantation. We successfully treated...... a patient with EPP-induced liver failure with the molecular adsorbents recirculating system (MARS) and Prometheus in independent sessions. Following treatment with MARS we found a 9.1% reduction of the RBC-PPIX concentration and a 5.9% reduction after treatment with the Prometheus system. Plasmapheresis...

  11. Recurrent varicoceles: causes and treatment using angiography and magnification assisted subinguinal varicocelectomy.

    Science.gov (United States)

    Moon, Kyung Hyun; Cho, Suk Ju; Kim, Kun Suk; Park, Seonghun; Park, Sungchan

    2012-07-01

    To investigate the causes of varicocele recurrence and assess the use of embolization and subinguinal varicocelectomy in its treatment in patients with angiography and subinguinal varicocelectomy. The present study involved 15 patients with recurrent varicoceles. The mean patient age was 21.2 years (range: 12-42 years). Preoperative angiography was performed in 11 patients. Embolization was used in patients with patent internal spermatic veins (ISVs). Patients without patent ISVs or preoperative angiography underwent magnification-assisted subinguinal varicocelectomy which included testicular retrieval and ligation of all collateral veins except arteries and deferential veins. Seven among 11 patients (64%) which had preoperative angiography had patent ISVs and underwent embolization and 8 patients underwent subinguinal varicocelectomy. Of those 8 patients, 6 had dilated ISVs and external spermatic veins (ESVs), one had dilated ISVs and gubernacular veins, and one had dilated ISVs, ESVs and gubernacular veins. No patient experienced recurrence or testis atrophy. Patent ISVs or collateral veins may be the cause of recurrence after varicocelectomy. Angiographic embolization was successful in 64% of recurrent varicoceles patients with patent ISVs. However, microscope-assisted subinguinal varicocelectomy may be the best overall treatment for patients with recurrent varicoceles.

  12. Ovulatory disorders are an independent risk factor for pregnancy complications in women receiving assisted reproduction treatments.

    Science.gov (United States)

    Barua, Sumita; Hng, Tien-Ming; Smith, Howard; Bradford, Jennifer; McLean, Mark

    2017-06-01

    Conception using assisted reproduction treatments (ART) has been associated with an increased risk of pregnancy complications. It is uncertain if this is caused by ART directly, or is an association of the underlying factors causing infertility. We assessed the relationship between assisted conception (AC) and maternal or fetal complications in a large retrospective cohort study. In a nested cohort of women receiving infertility treatment, we determined if such risk rests predominantly with certain causes of infertility. Retrospective database analysis of 50 381 women delivering a singleton pregnancy in four public hospital obstetric units in western Sydney, and a nested cohort of 508 women receiving ART at a single fertility centre, in whom the cause of infertility was known. A total of 1727 pregnancies followed AC; 48 654 were spontaneous conceptions. Adjusted for age, body mass index and smoking, AC was associated with increased risk of preterm delivery (OR 1.73, 95% CI 1.50-2.02), hypertension (OR 1.55, 95% CI 1.34-1.82) and diabetes (OR 1.51, 95% CI 1.30-1.75). In the nested cohort, ovulatory dysfunction was present in 145 women and 336 had infertility despite normal ovulatory function. Ovulatory dysfunction was associated with increased risk of diabetes (OR 2.94, 95% CI 1.72-5.02) and hypertension (OR 2.40, 95% CI 1.15-5.00) compared to women with normal ovulatory function. Assisted conception is associated with increased risk of pregnancy complications. This risk appears greatest for women whose underlying infertility involves ovulatory dysfunction. Such disorders probably predispose towards diabetes and hypertension, which is then exacerbated by pregnancy. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  13. Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?

    DEFF Research Database (Denmark)

    Sejbaek, Camilla S; Pinborg, Anja; Hageman, Ida

    2015-01-01

    INTRODUCTION: Previous studies have shown conflicting results whether unsuccessful medically assisted reproduction is a risk factor for depression among women. This study therefore investigated if women with no live birth after assisted reproductive technology (ART) treatment had a higher risk...... of unipolar depression compared with women with a live birth after ART treatment. MATERIAL AND METHODS: The Danish National ART-Couple (DANAC) Cohort is a national register-based cohort study that consists of women who received ART treatment from 1 January 1994 to 30 September 2009, in Denmark (n = 41 050......). Information on unipolar depression was obtained from the Danish Psychiatric Central Research Register. The analyses were conducted in Cox regression analysis. RESULTS: During the 308 494 person-years of follow up, 552 women were diagnosed with unipolar depression. A Cox proportional hazards model showed...

  14. The Ethical Treatment of Research Assistants: Are We Forsaking Safety for Science?

    Directory of Open Access Journals (Sweden)

    Karen Z. Naufel

    2013-01-01

    Full Text Available Science inevitably involves ethical discussions about how research should be implemented. However such discussions often neglect the potential unethical treatment of a third party: the research assistant. Extensive anecdotal evidence suggests that research assistants can experience unique physical, psychological, and social risks when implementing their typical responsibilities. Moreover, these research assistants, who perhaps engage in research experience to bolster their curricula vitae, may feel coerced to continue to work in unsafe environments out of fear of losing rapport with the research supervisor or letters of recommendation for their future endeavors. In the present article, we address two important issues regarding the ethical treatment of research assistants. First, we present evidence suggesting that research assistants may experience substantive risk when implementing their assigned responsibilities. Second, we propose a document, the “Research Assistant’s Bill of Rights,” as a possible ethics code for people supervising research assistants. This document is independent from typical institutional review board processes, and it has the potential to maximize benefits to research supervisors and research assistants.

  15. Meniscus and discus lesions of triangular fibrocartilage complex (TFCC): treatment by laser-assisted wrist arthroscopy.

    Science.gov (United States)

    Infanger, Manfred; Grimm, Daniela

    2009-04-01

    Meniscus and disc lesions in the triangular fibrocartilage complex (TFCC) are generally caused by falling accidents with pronated, hyperextended wrists, or by distraction injuries that pull the ulnar side of the wrist out of place. Characteristic clinical signs are swelling and pain in the distal radioulnar joint (DRUJ) and a 'clicking' noise in the meniscus lesion. If untreated, loss of mobility and grip strength as well as progressive arthritic changes ensue. We investigated in this study the laser-assisted arthroscopic debridement of the central TFCC and meniscus to compare the advantages and disadvantages of such treatment to conventional arthroscopic debridement. Seventy-two patients underwent laser-assisted arthroscopic debridement of traumatic TFCC tears (meniscus and disc). Patients with TFCC tears that were associated with fractures, significant bone or neurovascular pathology or DRUJ instability were excluded from the study. The mean age was 32.4 years; 28 female and 51 male patients were included in the study. The mean follow up was 25.6 months. First of all, we evaluated the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. We then applied the range of motion of the hand (ROM) as second variable during statistical analysis to identify outcome. There were no complications after surgery. No instabilities or dislocations of the DRUJ were noted. The postoperative DASH score indicated that the laser-assisted arthroscopic repair of traumatic peripheral TFCC tears resulted in a very good functional outcome. All patients with isolated meniscus homologue tears were without pain after the operation. At final follow up, the ROM was equal to or greater than that of the contralateral side. We have demonstrated that the TFCC laser debridement technique is easy and safe to perform. The outcome was excellent with less pain and good ROM. In particular, the laser technique enabled a good intra-articular haemostasis and allowed an exact tear debridement.

  16. Treating tobacco use disorder in pregnant women in medication-assisted treatment for an opioid use disorder: a systematic review.

    Science.gov (United States)

    Akerman, Sarah C; Brunette, Mary F; Green, Alan I; Goodman, Daisy J; Blunt, Heather B; Heil, Sarah H

    2015-05-01

    Smoking is associated with adverse effects on pregnancy and fetal development, yet 88-95% of pregnant women in medication-assisted treatment for an opioid use disorder smoke cigarettes. This review summarizes existing knowledge about smoking cessation treatments for pregnant women on buprenorphine or methadone, the two forms of medication-assisted treatment for opioid use disorder indicated for prenatal use. We performed a systematic review of the literature using indexed terms and key words to capture the concepts of smoking, pregnancy, and opioid substitution and found that only three studies met search criteria. Contingency management, an incentive based treatment, was the most promising intervention: 31% of participants achieved abstinence within the 12-week study period, compared to 0% in a non-contingent behavior incentive group and a group receiving usual care. Two studies of brief behavioral interventions resulted in reductions in smoking but not cessation. Given the growing number of pregnant women in medication-assisted treatment for an opioid use disorder and the negative consequences of smoking on pregnancy, further research is needed to develop and test effective cessation strategies for this group. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Predicting use of assistance when quitting: a longitudinal study of the role of quitting beliefs.

    Science.gov (United States)

    Myers, Mark G; Strong, David R; Linke, Sarah E; Hofstetter, C Richard; Al-Delaimy, Wael K

    2015-04-01

    A growing literature addresses the need to reduce cigarette smoking prevalence by increasing the use of assistance when quitting. A key focus is to identify strategies for enhancing adoption of effective interventions in order to increase utilization of evidence-based treatments. To examine the effect of beliefs regarding ability to quit on utilization of assistance for smoking cessation. A mediation model was hypothesized whereby the relationship between smoking and use of assistance is influenced by beliefs in ability to quit. The present study includes 474 of 1000 respondents to baseline and follow-up California Smokers Cohort surveys conducted from 2011 to 2013. Included were baseline smokers who reported a 24-h quit attempt at follow-up. Baseline variables were used to predict use of assistance when quitting. The hypothesized model was tested using a product of coefficients method, controlling for demographics. Greater heaviness of smoking and lower belief in ability to quit were significantly related to use of assistance. Quitting beliefs significantly mediated the relationship between nicotine dependence and use of assistance. The present data support a mechanism whereby the effect of smoking rate on treatment utilization is mediated by beliefs in ability to quit. Greater belief in one's ability to quit may represent an obstacle to treatment utilization by reducing the likelihood of successful cessation. The present findings suggest the value of targeted messages from health care providers that normalize the need for assistance when attempting to change an addictive behavior and emphasize the difficulty of quitting without assistance. Published by Elsevier Ireland Ltd.

  18. Opportunities for laser-assisted drug delivery in the treatment of cutaneous disorders

    DEFF Research Database (Denmark)

    Wenande, Emily; Erlendsson, Andrés Már; Haedersdal, Merete

    2017-01-01

    lesions, scars, cutaneous infections, and vitiligo as well as for topical anesthetic and aesthetic procedures. Substantiated by randomized controlled clinical trials, strong evidence is available for LADD's usefulness for photodynamic therapy (PDT), for which improved efficacy using laser......-assisted photosensitizer treatment is established for actinic keratosis compared with conventional PDT. Over time, the modality has undergone increasing refinement and offers the potential advantages of reduced treatment durations, shortened incubation times, and the replacement of cumbersome, patient-dependent treatment...

  19. Nanoparticle-Assisted Combinatorial Therapy for Effective Treatment of Endometriosis.

    Science.gov (United States)

    Singh, Abhay Kumar; Chakravarty, Baidyanath; Chaudhury, Koel

    2015-05-01

    Endometriosis is characterized by the presence of endometrial glands and stroma outside the uterine cavity. Conventional treatment modalities for endometriosis are unsatisfactory; therefore, there is a need to treat the underlying causes and mechanism. Oxidative stress, extracellular matrix degradation, and angiogenesis are associated with the pathogenesis of endometriosis. The anti-angiogenic and antioxidant properties of epigallocatechin gallate and the matrix metalloproteinase inhibitory activity of the antibiotic doxycycline are well established. However, epigallocatechin gallate and doxycycline have several limitations when used in their native forms. This motivated us to synthesize dual drug-loaded (epigallocatechin gallate and doxycycline) nanoparticles and check their therapeutic efficacy in mice with induced endometriosis. The synthesized nanoparticles displayed features of a promising drug-delivery system, such as small size, high encapsulation efficiency, controlled drug release, and low toxicity. The serum of endometriosis-induced mice and controls was assessed for various oxidative stress markers, matrix-degrading enzymes, and angiogenic markers before and after nanoparticle administration. Endometrial glands, stroma, and new microvessels were determined using histochemistry and immunohistochemistry. Treatment with dual drug-loaded nanoparticles markedly decreased oxidative stress, matrix metalloproteinase activity, and angiogenesis, as well as endometrial gland presence and microvessel density. Mitigation of endometriosis-related adverse effects further produced an improvement in the quality of oocytes, which is critical for successful pregnancy outcomes. Our observations suggest that owing to their combinatorial effect, poly(lactic-co-glycolic) acid nanoparticles loaded with epigallocatechin gallate and doxycycline in a single vehicle appear to be promising for the treatment of endometriosis.

  20. Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada.

    Science.gov (United States)

    Thomas, Gerald; Lucas, Philippe; Capler, N Rielle; Tupper, Kenneth W; Martin, Gina

    2013-03-01

    This paper reports results from a preliminary observational study of ayahuasca-assisted treatment for problematic substance use and stress delivered in a rural First Nations community in British Columbia, Canada. The "Working with Addiction and Stress" retreats combined four days of group counselling with two expert-led ayahuasca ceremonies. This study collected pre-treatment and six months follow-up data from 12 participants on several psychological and behavioral factors related to problematic substance use, and qualitative data assessing the personal experiences of the participants six months after the retreat. Statistically significant (p ayahuasca-assisted therapy appears to be associated with statistically significant improvements in several factors related to problematic substance use among a rural aboriginal population. These findings suggest participants may have experienced positive psychological and behavioral changes in response to this therapeutic approach, and that more rigorous research of ayahuasca-assisted therapy for problematic substance use is warranted.

  1. [Effects of iASSIST navigation system and personal specific instrument assisted total knee arthroplasty in the treatment of osteoarthritis].

    Science.gov (United States)

    Tian, S C; Yao, Q Q; Yin, X D; Liu, S; Zhou, J; Hu, J; Li, J Y; Shan, R; Jiang, H B; Wang, L M

    2017-06-01

    Objective: To compare the application of iASSIST assisted total knee arthroplasty (TKA) and three-dimentional(3D) printing personal specific instrument (PSI) assist TKA in the treatment of osteoarthritis (OA). Methods: Clinical data of 47 patients with OA admitted at Department of Orthopaedic Surgery in Nanjing Medical University Nanjing Hospital between April and September 2016 were retrospectively reviewed, including 20 males and 27 females, aging from 57 to 77 years with mean age of (63.8±8.2) years. They were randomly divided into iASSIST-TKA group (23 patients) and PSI-TKA group (24 patients). The data such as hip knee ankle (HKA) angle, frontal femoral component (FFC) angle, frontal tibial component (FTC) angle, lateral femoral component (LFC) angle, lateral tibial component (LTC) angle, time of operation, post-operative wound drainage, period of hospitalization, visual analog scale (VAS) and Knee Society Score (KSS) at 1 day, 7 days, 14 days, 1 month and 3 months were recorded and compared between the two groups. T test was used to compare measurement data, Fisher exact test and χ(2) test were applied to enumeration data in comparison among groups, and Kruskal-Wallis test was applied to ranked data. Results: The deviation values of HKA, FFC, LFC, FTC and LTC angles were all below 3°(-2° to 2°), and there were no significant difference between iASSIST-TKA group and PSI-TKA group (Z=-0.610 to 0.000, P=0.542 to 1.000). Compared to PSI-TKA group, the time of operation was long((80.7±8.8) minutes vs.(60.2±7.8) minutes), the amount of post-operative wound drainage was increased((210.7±32.1) ml vs.(185.5±30.2)ml) and the period of hospitalization decreased((5.4±2.4) d vs.(6.7±1.6) d) in iASSIST-TKA group, there were significant difference(t=-2.190 to 8.460, P=0.000 to 0.033). There were no significant difference in intra-operative blood drainage((18.4±5.4) ml vs.(17.3±6.2) ml) between the two groups(t=0.650, P=0.521). PSI-TKA group had a superior VAS

  2. Effects of an Equine Assisted Activities Program on Youth with Emotional Disturbance: A Pilot Study

    Science.gov (United States)

    Stebbins, Tira

    2012-01-01

    This study evaluated the effects of a 10-week Equine Assisted Activities (EAA) program on special education students (aged 9 to 15) identified as Emotionally Disturbed (ED) who were enrolled in an alternative school. A control group of special education students receiving treatment-as-usual was included. The Behavior Assessment Scale for Children,…

  3. Neurological symptoms among dental assistants: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Hollund BE

    2008-05-01

    Full Text Available Abstract Background Dental assistants help the dentist in preparing material for filling teeth. Amalgam was the filling material mostly commonly used in Norway before 1980, and declined to about 5% of all fillings in 2005. Amalgam is usually an alloy of silver, copper, tin and mercury. Copper amalgam, giving particularly high exposure to mercury was used in Norway until 1994. Metallic mercury is neurotoxic. Few studies of the health of dental assistants exist, despite their exposure to mercury. There are questions about the existence of possible chronic neurological symptoms today within this working group, due to this exposure. The aim of this study was to compare the occurrence of neurological symptoms among dental assistants likely to be exposed to mercury from work with dental filling material, compared to similar health personnel with no such exposure. Methods All dental assistants still at work and born before 1970 registered in the archives of a trade union in Hordaland county of Norway were invited to participate (response rate 68%, n = 41, as well as a similar number of randomly selected assistant nurses (response rate 87%, n = 64 in the same age group. The participants completed a self-administered, mailed questionnaire, with questions about demographic variables, life-style factors, musculoskeletal, neurological and psychosomatic symptoms (Euroquest. Results The dental assistants reported significant higher occurrence of neurological symptoms; psychosomatic symptoms, problems with memory, concentration, fatigue and sleep disturbance, but not for mood. This was found by analyses of variance, adjusting for age, education, alcohol consumption, smoking and personality traits. For each specific neurological symptom, adjusted logistic regression analyses were performed, showing that these symptoms were mainly from arms, hands, legs and balance organs. Conclusion There is a possibility that the higher occurrence of neurological symptoms

  4. [Analysis of factors associated with multiple pregnancies in assisted reproduction treatment complex].

    Science.gov (United States)

    Hernández-Nieto, C A; Méndez-Lozano, D H; Fraustro-Ávila, M E; García-Martínez, M R; Soto-Cossio, L E; Basurto-Díaz, D; Flores-Mendoza, H

    2016-01-01

    Today, advances in technology provide the best success rates in the reproductive medicine field. One of the biggest concerns about it, is the high risk of achieving multiple pregnancies, which may carry greater health risks for both; the mother and fetuses. Besides that, multiple pregnancies are considered a complication or an adverse effect of assisted reproduction treatments. To compare the factors associated with multiple pregnancy in patients who underwent complex assisted reproduction techniques. A retrospective and transversal case control study was rolled to compare the factors associated with multiple pregnancy rates, these results were correlated using a logistic regression model. a total of 1063 cases were reviewed, we obtained a pregnancy rate of 35.9%, and a multiple pregnancy rate of 31.5%. We found positive statistical association between patient age, total number of oocytes obtained, total embryos transferred, total vitrified embryos per cycle, total serum cuantitative B-GCH level, endometrial thickness in milimeters, and the Honest of a multiple pregnancy. In the logistic regression model, we found statistical association between the number of embryos transferred, number of embryos obtained, embryo quality, total vitrified embryos and the risk for multiple pregnancies. The total number of embryos transferred in a cycle of a complex assisted reproduction, is the most important factor for the onset of multiple pregnancies. The age of patients, the number of oocytes, total number of embryos obtained, the number of embryos transferred, the quality of embryos transferred and the number of frozen embryos per cycle, correlate significantly with more risk for multiple pregnancies.

  5. Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance.

    Directory of Open Access Journals (Sweden)

    Nickolai Titov

    Full Text Available BACKGROUND: Internet-based cognitive behavioural therapy (iCBT for depression is effective when guided by a clinician, less so if unguided. QUESTION: Would guidance from a technician be as effective as guidance from a clinician? METHOD: Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II and the Patient Health QUESTIONnaire-9 Item (PHQ-9. Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (p<0.001 and PHQ-9 (p<0.001 compared to the delayed treatment group but did not differ from each other. Within group effect sizes on the BDI-II were 1.27 and 1.20 for the clinician- and technician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. CONCLUSIONS: Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large

  6. Identification of Reproductive Education Needs of Infertile Clients Undergoing Assisted Reproduction Treatment Using Assessments of Their Knowledge and Attitude

    OpenAIRE

    Ezabadi Zahra; Mollaahmadi Fahimeh; Mohammadi Maryam; Omani Samani Reza; Vesali Samira

    2017-01-01

    Background In order to empower infertile individuals and provide high quality patient-centered infertility care, it is necessary to recognize and meet infertile individuals? educational needs. This study aims to examine infertility patients? knowledge and subsequently their education needs given their attitudinal approach to infertility education in terms of patients who undergo assisted reproduction treatment. Materials and Methods This descriptive study enrolled 150 subjects by conveni- enc...

  7. Mobile-Assisted Vocabulary Learning: A Review Study

    Science.gov (United States)

    Afzali, Parichehr; Shabani, Somayeh; Basir, Zohreh; Ramazani, Mohammad

    2017-01-01

    Mobile phones are becoming more acceptable toolkits to learn languages. One aspect of English language which has been subject to investigation in mobile-assisted language learning (MALL) is vocabulary. This study reviewed some of the studies conducted in various contexts on the effect of MALL on vocabulary learning. We investigated some of the…

  8. A Student Experience of Peer Assisted Study Sessions in Physiotherapy

    Science.gov (United States)

    Sole, Gisela; Rose, Andrew; Bennet, Tracey; Jaques, Katrina; Rippon, Zoe; van der Meer, Jacques

    2012-01-01

    Peer Assisted Study Sessions (PASS) were introduced as an optional learning experience in a Bachelor of Physiotherapy programme. The aim of this study was to evaluate the use of PASS from the student perspective. Eight third year physiotherapy students who had participated in PASS during their second year of training attended a focus group, at…

  9. [Attitudes towards assisted living inAustria-A qualitative study].

    Science.gov (United States)

    Boggatz, Thomas; Lechner, Cornelia

    2015-08-01

    Surveys in German speaking countries identified motives for choosing assisted living, but their importance in the context of decision making remains unclear. This study aimed to identify types of attitudes towards assisted living among older persons in Austria that result from the interplay of single motives. A comparative qualitative study with semi-structured interviews was conduCted in the land Salzburg among residents of assisted living facilities and home dwelling older adults. Data were analysed by using qualitative content analysis according to Mayring and subsequent construction of types. Among residents types of attitudes were "proactive users" who expected more safety or comfort and persons who "moved m due to external circumstances" like taking the opportunity of available place or feeling forced by functional/imitations or be ing influenced by significant others. Types of attitudes among home dwelling older persons were "conditional acceptance';"rejection" and ;'indecisiveness':Vague ideas about assisted living often prevented an informed decision. Choice of assisted living only depends to some extent on specific expectations. Better information,advice by significant others and availability of a place may favour a decision to move in.

  10. Identification of Reproductive Education Needs of Infertile Clients Undergoing Assisted Reproduction Treatment Using Assessments of Their Knowledge and Attitude

    Directory of Open Access Journals (Sweden)

    Ezabadi Zahra

    2017-01-01

    Full Text Available Background In order to empower infertile individuals and provide high quality patient-centered infertility care, it is necessary to recognize and meet infertile individuals’ educational needs. This study aims to examine infertility patients’ knowledge and subsequently their education needs given their attitudinal approach to infertility education in terms of patients who undergo assisted reproduction treatment. Materials and Methods This descriptive study enrolled 150 subjects by conveni- ence sampling of all patients who received their first assisted reproductive treatment between July and September 2015 at a referral fertility clinic, Royan Institute, Tehran, Iran. We used a questionnaire that measured fertility and infertility information (8 questions as well as attitude toward education on the causes and treatment of infertility (5 questions. Chi-square, independent sample t test, and one way ANOVA analyses were conducted to examine differences by sex. P<0.05 was considered statistically significant. Results Total mean knowledge was 3.08 ± 0.99. Clients’ responses indicated that the highest mean knowledge scores related to knowledge of factors that affected pregnancy (3.97 ± 1.11 and infertility treatment (3.97 ± 1.16. The lowest mean knowledge scores related to knowledge of the natural reproductive cycle (2.96 ± 1.12 and anatomy of the genital organs (2.94 ± 1.16. Most females (92.1% and males (83.3% were of the opinion that infertility education programs should include causes of infertility and types of treatment associated with diagnostic and laboratory procedures. No statistically significant difference existed between male and female participants (P=0.245. Conclusion Most participants in this study expressed awareness of factors that affect pregnancy and infertility treatment. It is imperative to educate and empower infertile individuals who seek reproduction treatment in terms of infertility causes and types of treatment, as

  11. Identification of Reproductive Education Needs of Infertile Clients Undergoing Assisted Reproduction Treatment Using Assessments of Their Knowledge and Attitude

    Science.gov (United States)

    Ezabadi, Zahra; Mollaahmadi, Fahimeh; Mohammadi, Maryam; Omani Samani, Reza; Vesali, Samira

    2017-01-01

    Background In order to empower infertile individuals and provide high quality patient-centered infertility care, it is necessary to recognize and meet infertile individuals’ educational needs. This study aims to examine infertility patients’ knowledge and subsequently their education needs given their attitudinal approach to infertility education in terms of patients who undergo assisted reproduction treatment. Materials and Methods This descriptive study enrolled 150 subjects by conveni- ence sampling of all patients who received their first assisted reproductive treatment between July and September 2015 at a referral fertility clinic, Royan Institute, Tehran, Iran. We used a questionnaire that measured fertility and infertility information (8 questions) as well as attitude toward education on the causes and treatment of infertility (5 questions). Chi-square, independent sample t test, and one way ANOVA analyses were conducted to examine differences by sex. Pinfertility treatment (3.97 ± 1.16). The lowest mean knowledge scores related to knowledge of the natural reproductive cycle (2.96 ± 1.12) and anatomy of the genital organs (2.94 ± 1.16). Most females (92.1%) and males (83.3%) were of the opinion that infertility education programs should include causes of infertility and types of treatment associated with diagnostic and laboratory procedures. No statistically significant difference existed between male and female participants (P=0.245). Conclusion Most participants in this study expressed awareness of factors that affect pregnancy and infertility treatment. It is imperative to educate and empower infertile individuals who seek reproduction treatment in terms of infertility causes and types of treatment, as well as diagnostic and laboratory procedures to enable them to make informed decisions about their assisted reproductive procedures. PMID:28367301

  12. Novel fungal pelletization-assisted technology for algae harvesting and wastewater treatment.

    Science.gov (United States)

    Zhou, Wenguang; Cheng, Yanling; Li, Yun; Wan, Yiqin; Liu, Yuhuan; Lin, Xiangyang; Ruan, Roger

    2012-05-01

    A novel fungi pelletization-assisted bioflocculation technology was developed for efficient algae harvesting and wastewater treatment. Microalga Chlorella vulgaris UMN235 and two locally isolated fungal species Aspergillus sp. UMN F01 and UMN F02 were used to study the effect of various cultural conditions on pelletization process for fungi-algae complex. The results showed that pH was the key factor affecting formation of fungi-algae pellet, and pH could be controlled by adjusting glucose concentration and fungal spore number added. The best pelletization happened when adding 20 g/L glucose and approximately 1.2E8/L spores in BG-11 medium, under which almost 100% of algal cells were captured onto the pellets with shorter retention time. The fungi-algae pellets can be easily harvested by simple filtration due to its large size (2-5 mm). The filtered fungi-algae pellets were reused as immobilized cells for treatment wastewaters and the nutrient removal rates of 100, 58.85, 89.83, and 62.53 % (for centrate) and 23.23, 44.68, 84.70, and 70.34% (for diluted swine manure wastewater) for ammonium, total nitrogen, total phosphorus, and chemical oxygen demand, respectively, under both 1- and 2-day cultivations. The novel technology developed is highly promising compared with current algae harvesting and biological wastewater treatment technologies in the literature.

  13. Psychiatric disorders among women and men in assisted reproductive technology (ART) treatment. The Danish National ART-Couple (DANAC) cohort

    DEFF Research Database (Denmark)

    Schmidt, Lone; Hageman, Ida; Hougaard, Charlotte Ørsted

    2013-01-01

    INTRODUCTION: There are complex causal associations between mental disorders, fertility treatment, fertility treatment outcome and infertility per se. Eating disorders cause endocrine disturbances, anovulation and thereby infertility, and research has shown that infertility as well as unsuccessful...... assisted reproductive technology (ART) treatment are potential risk factors for developing a depression on a long-term basis. Despite the fact that worldwide more than 400 000 ART treatment cycles are performed every year, the causal associations between mental disorders, use of medication for mental...... disorders and ART treatment in both sexes have only been sparsely explored. METHOD AND ANALYSIS: The main objective of this national register-based cohort study is to assess women's and men's mental health before, during, and after ART treatment in comparison with the mental health in an age...

  14. Robotic-Assisted Laparoscopic Treatment of Residual Ectopic Pregnancy in a Previous Cesarean Section Scar: A Case Report.

    Science.gov (United States)

    Schmitt, Andy; Crochet, Patrice; Agostini, Aubert

    To describe a technique of robotic-assisted laparoscopy of residual cesarean scar pregnancy (CSP) and uterine defect repair. Video case report, with step-by-step explanation of the procedure (Canadian Task Force classification III) SETTING: CSP may be treated by different approaches including surgery and methotrexate. Successful methotrexate treatments avoid an emergency surgical treatment. In these cases a residual CSP often remains and should be removed in women who desire to conceive. CSP is often associated with a cesarean section scar defect called an isthmocele. In case of isthmocele with important defect and desire for pregnancy, laparoscopic repair may be proposed. Diagnosis and treatment of isthmocele is usually performed in a second time after a successful treatment of CSP. In this case, a surgical treatment including the removal of the residual CSP and treatment of the isthmocele may be proposed. In this video we describe a technique for the surgical removal of residual CSP and isthmocele treatment by robotic-assisted laparoscopy. A 32-year-old patient developed a CSP treated by 2 in situ injections of methotrexate. A magnetic resonance imaging study performed 1 month after the last methotrexate injection revealed a persistent 4-cm residual CSP, associated with an isthmocele. Preoperative uterine artery embolization was performed to reduce intraoperative bleeding. After localization of the residual CSP on the left side, a temporary left uterine occlusion was performed. Residual CSP was totally removed. The residual defect and isthmocele were closed using delayed absorbable suture. Robotic-assisted laparoscopic removal of residual CSP and isthmocele treatment is a feasible and safe procedure. This procedure may be proposed in patients presenting with this condition after a methotrexate treatment of CSP. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  15. Scientific and political challenges in North America’s first randomized controlled trial of heroin-assisted treatment for severe heroin addiction: Rationale and design of the NAOMI study

    Science.gov (United States)

    Oviedo-Joekes, Eugenia; Nosyk, Bohdan; Marsh, David C; Guh, Daphne; Brissette, Suzanne; Gartry, Candice; Krausz, Michael; Anis, Aslam; Schechter, Martin T

    2016-01-01

    Background Heroin addiction is a chronic relapsing disease, best treated with opioid-agonist substitution therapy such as methadone maintenance. However, a subset of the most severely affected individuals do not benefit sufficiently from this treatment. The North American Opiate Medication Initiative (NAOMI) is a randomized clinical trial (RCT) to evaluate the hypothesis that pharmaceutical-grade heroin, diacetylmorphine (DAM) is more effective in retaining patients and improving their outcomes than Methadone Maintenance Treatment (MMT) among those with chronic, refractory injection opioid dependence. Purpose/Methods The study aimed at randomizing 253 participants to two intervention arms: (1) MMT alone or (2) injectable opioids (DAM or hydromorphone) plus adjunctive MMT if deemed appropriate. The planned study duration was 3 years, with a 1-year intake period, 1 year of treatment, and an additional year of follow-up. The NAOMI trial was initiated in March 2005 at two Canadian sites (Vancouver and Montreal). This was the first multicenter RCT in North America to compare the relative efficacy of these different therapeutic strategies. We discuss the rationale behind the NAOMI study design, as well as the scientific and political issues and methodological challenges arising from the conduct of a trial that involves the prescription of a controlled substance to individuals with dependence on that substance. Limitations Restrictive entry criteria led to the exclusion of many otherwise eligible participants, slowing recruitment into the study. Inability to offer DAM treatment beyond 12 months led to artificial boundary effects in the trial. Conclusions Addiction treatment research navigates between science and politics, and evidence-based medicine is many times confronted by moral beliefs. Political considerations influence study design to a further degree than in RCTs treating less-stigmatized disorders with more-reputable medications. PMID:19528135

  16. Male psychological adaptation to unsuccessful medically assisted reproduction treatments: a systematic review.

    Science.gov (United States)

    Martins, Mariana Veloso; Basto-Pereira, Miguel; Pedro, Juliana; Peterson, Brennan; Almeida, Vasco; Schmidt, Lone; Costa, Maria Emília

    2016-06-01

    Similarly to women, men suffer from engaging in fertility treatments, both physically and psychologically. Although there is a vast body of evidence on the emotional adjustment of women to infertility, there are no systematic reviews focusing on men's psychological adaptation to infertility and related treatments. The main research questions addressed in this review were 'Does male psychological adaptation to unsuccessful medically assisted reproduction (MAR) treatment vary over time?' and 'Which psychosocial variables act as protective or risk factors for psychological maladaptation?' A literature search was conducted from inception to September 2015 on five databases using combinations of MeSH terms and keywords. Eligible studies had to present quantitative prospective designs and samples including men who did not achieve pregnancy or parenthood at follow-up. A narrative synthesis approach was used to conduct the review. Twelve studies from three continents were eligible from 2534 records identified in the search. The results revealed that psychological symptoms of maladjustment significantly increased in men 1 year after the first fertility evaluation. No significant differences were found two or more years after the initial consultation. Evidence was found for anxiety, depression, active-avoidance coping, catastrophizing, difficulties in partner communication and the use of avoidance or religious coping from the wife as risk factors for psychological maladjustment. Protective factors were related to the use of coping strategies that involve seeking information and attribution of a positive meaning to infertility, having the support of others and of one's spouse, and engaging in open communication about the infertility problem. Our findings recommend an active involvement of men during the treatment process by health care professionals, and the inclusion of coping skills training and couple communication enhancement interventions in counselling. Further

  17. From assistive to enhancing technology: should the treatment-enhancement distinction apply to future assistive and augmenting technologies?

    Science.gov (United States)

    Minerva, Francesca; Giubilini, Alberto

    2017-10-14

    The treatment-enhancement distinction is often used to delineate acceptable and unacceptable medical interventions. It is likely that future assistive and augmenting technologies will also soon develop to a level that they might be considered to provide users, in particular those with disabilities, with abilities that go beyond natural human limits, and become in effect an enhancing technology. In this paper, we describe how this process might take place, and discuss the moral implications of such developments. We argue that such developments are morally acceptable and indeed desirable. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Video Assisted Anal Fistula Treatment in a Child with Perianal Fistula

    OpenAIRE

    Naeem Liaqat; Asif Iqbal; Sajid Hameed Dar; Faheem Liaqat

    2016-01-01

    Perianal fistula formation is a rare complication in children after rectal biopsy. Perianal fistula may become difficult to treat; therefore a lot of surgical options are present. One of these options is video assisted anal fistula treatment (VAAFT). We present a 6-year-old female who developed perianal fistula following rectal biopsy for which VAAFT was done successfully.

  19. Towards semi-automated assistance for the treatment of stress disorders

    NARCIS (Netherlands)

    Sluis, F. van der; Broek, E.L. van den; Dijkstra, A.F.J.

    2010-01-01

    People who suffer from a stress disorder have a severe handicap in daily life. In addition, stress disorders are complex and consequently, hard to define and hard to treat. Semi-automatic assistance was envisioned that helps in the treatment of a stress disorder. Speech was considered to provide an

  20. Peer Assisted Study Sessions for Postgraduate International Students in Australia

    Science.gov (United States)

    Zaccagnini, Melissa; Verenikina, Irina

    2013-01-01

    Peer Assisted Study Sessions (PASS), a peer led academic support program that has multiple documented academic, social, and transition benefits, is increasingly being utilised in Australian institutions. Whilst PASS has been evaluated from multiple angles in regard to the undergraduate cohort, there is limited research regarding the benefits of…

  1. Vacuum-assisted closure with a portable system for treatment of poststernotomy mediastinitis.

    Science.gov (United States)

    Dohi, Shizuyuki; Inaba, Hirotaka; Tanbara, Keiichi; Yamamoto, Taira; Kikuchi, Keita; Shimada, Akie; Amano, Atsushi

    2010-08-01

    The patient was a 50-year-old man with diabetes who was on insulin. Complications of mediastinitis developed after coronary bypass surgery, which had been performed for unstable angina. Upon hospital admission, the patient was treated with antibiotics, and the wound was cleaned on a daily basis. However, because the patient's fever persisted, the wound was completely opened surgically and found to be deep and large. Because the patient's condition was relatively stable, minimally invasive vacuum-assisted closure was selected. We fabricated a portable vacuum-assisted closure system that imposed few limitations on individual movement. Vacuum-assisted closure treatment resulted in both rapid abatement of fever and improved granulation. Dressings were changed once a week; the wound was closed 4 weeks after vacuum-assisted closure and healed completely. Vacuum-assisted closure may be an effective therapy for postoperative mediastinitis, and our portable vacuum-assisted closure system may significantly reduce patient distress as well as direct medical care.

  2. STUDY ABOUT THE ROLE OF COMPUTER-ASSISTED INSTRUCTION IN BIOLOGY

    Directory of Open Access Journals (Sweden)

    Mariana FAUR

    2012-01-01

    Full Text Available The computer-assisted instruction play an increasingly important role in providing enhancement to instruction. The purpose of this study was to evaluate the effectiveness of computer assisted instruction in Biology lessons. In this study we compared the differences in retention of information by pupils using the two different instructional modes, CAI or written text. Initial results of the study indicated that pupils in treatment classes with the computer-assisted instruction, and in control classes, all made important gains in knowledge. Further research may be needed to determine whether the students' improved learning performance could be attributed to the use of the computer or to the restructuring of the conventional lesson with interesting informations.

  3. The adverse effect of overweight in assisted reproduction treatment outcomes.

    Science.gov (United States)

    Sampo, Antonella Valeria; Palena, Celina; Ganzer, Luciano; Maccari, Virginia; Estofán, Gustavo; Hernández, Mariana

    2017-09-01

    To assess Body Mass Index (BMI) effects on the results obtained from ICSI cycles. We studied 266 ICSI cycles performed between January 2014 and December 2016. The patients were grouped according to their BMI in: Normal (18.5-24.9), Overweight (25.0-29.9) and Obese (>30). We compared the following variables between the groups: number of antral follicles, ovarian stimulation length, gonadotropin dose used, maximum estradiol level, follicles developed/antral follicles, retrieved oocytes/developed follicles and mature/retrieved oocytes, normal fertilization rate, embryo achieved/normal fertilized oocytes, clinical pregnancy and implantation rates. We used the Kruskal-Wallis and the Chi square tests. p<0.05 was considered significant. Normal, Overweight and Obese patients presented comparable values for number of antral follicles (11.6±5.4, 12.5±5.5, 12.2±5.7), ovarian stimulation length (7.5±1.4, 7.6±1.1, 7.8±1.3) and gonadotropin dose used (2043±489, 1940±536, 2109±605). Obese patients had lower values of estradiol (1560±610, 1511±635, 1190±466; p=0.018), developed follicles (81%, 76%, 70%; p<0.0001), and retrieved oocytes (91%, 90%, 84%; p=0.0017); and not significantly lower values of mature oocytes (82%, 82%, 77%; p=0.26). The groups had comparable fertilization rates (72%, 73%, 69%) and embryo achieved rates (67%, 63%, 72%). The normal group had higher, but not significantly higher pregnancy and implantation rates (43%, 40%, 38%, p=0.53; and 33%, 26%, 23%; p=0.11), and significantly higher ongoing pregnancy rates (37%, 33%, 33%, p=0.042). Increased BMI patients had impaired ovarian response and lower pregnancy rates in ICSI cycles.

  4. Friendship And Study Assistance Ties Of University Students

    OpenAIRE

    Oleg Poldin; Diliara Valeeva; Maria Yudkevich

    2014-01-01

    We analyze the characteristics of the social networks of students studying in the economics department in one Russian university. We focus on student friendship and study assistance ties and demonstrate how these networks are connected with the individual characteristics of students and their peers. We find that the probability of a tie existing is explained by the gender homophily, and initial student assignment to the same exogenously defined study group. Students ask for help and form frie...

  5. Sludge treatment studies

    Energy Technology Data Exchange (ETDEWEB)

    Beahm, E.C.; Weber, C.F.; Dillow, T.A.; Bush, S.A.; Lee, S.Y.; Hunt, R.D.

    1997-06-01

    Solid formation in filtered leachates and wash solutions was seen in five of the six sludges treated by Enhanced Sludge Washing. Solid formation in process solutions takes a variety of forms: very fine particles, larger particulate solids, solids floating in solution like egg whites, gels, crystals, and coatings on sample containers. A gel-like material that formed in a filtered leachate from Enhanced Sludge Washing of Hanford T-104 sludge was identified as natrophosphate, Na{sub 7}(PO{sub 4}){sub 2}F{center_dot}19H{sub 2}O. A particulate material that formed in a filtered caustic leachate from Hanford SX-113 sludge contained sodium and silicon. This could be any of a host of sodium silicates in the NaOH-SiO{sub 2}-H{sub 2}O system. Acidic treatment of Hanford B-202 sludge with 1 M, 3 M, and 6 M HNO{sub 3} sequential leaching resulted in complete dissolution at 75 C, but not at ambient temperature. This treatment resulted in the formation of solids in filtered leachates. Analyses of the solids revealed that a gel material contained silica with some potassium, calcium, iron, and manganese. Two phases were embedded in the gel. One was barium sulfate. The other could not be identified, but it was determined that the only metal it contained was bismuth.

  6. Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

    Science.gov (United States)

    McClellan, Sean R.

    2013-01-01

    Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

  7. Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

    Science.gov (United States)

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

  8. Life-sustaining treatment and assisted death choices in depressed older patients.

    Science.gov (United States)

    Blank, K; Robison, J; Doherty, E; Prigerson, H; Duffy, J; Schwartz, H I

    2001-02-01

    The major purpose of this study was to examine the effect of depressed mood in older, medically ill, hospitalized patients on their preferences regarding life-sustaining treatments, physician-assisted suicide (PAS), and euthanasia and to determine the degree to which financial constraints affected their choices. Cross-sectional study. General medical hospital. One hundred fifty-eight medically hospitalized, nondemented patients age 60 or older, mean age 74.1 (range 60-94). The sample was divided, based on Center for Epidemiologic Studies-Depression (CES-D) scores, into a depressed group (n = 71) and a nondepressed control group. Subjects underwent a structured interview evaluating their life-sustaining treatment choices and whether they would accept or refuse PAS or euthanasia under a variety of hypothetical conditions. These choices were reevaluated with the introduction of financial impact. In addition, assessment included measures of depression, suicide, cognition, social support, functioning, and religiosity. Depression was found to be highly associated with acceptance of PAS and euthanasia in most hypothetical clinical scenarios in addition to patients' current condition. Compared with nondepressed people, depressed respondents were 13 times as likely to accept PAS when considering their current condition (95% confidence interval [CI] 1.68-110.98), and over twice as likely to accept PAS when facing a hypothetical terminal illness or coma. Depression alone was weakly associated with life-sustaining treatment choices but, when financial impact was introduced, significantly more depressed subjects refused treatment options they had previously desired than did nondepressed subjects. The presence of suicidal ideation, even passive ideation, was strongly predictive of life-sustaining treatment refusals and increased interest in PAS and euthanasia. Depression's effect on acceptance of PAS was confirmed by logistic regression, which also showed that religious coping

  9. HLA-G regulatory haplotypes and implantation outcome in couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Wowk, Pryscilla Fanini; Mattar, Sibelle Botogosque; Vargas, Rafael Gustavo; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; Bicalho, Maria da Graça

    2012-09-01

    The role of HLA-G in several clinical conditions related to reproduction has been investigated. Important polymorphisms have been found within the 5'URR and 3'UTR regions of the HLA-G promoter. The aim of the present study was to investigate 16 SNPs in the 5'URR and 14-bp insertion/deletion (ins/del) polymorphism located in the 3'UTR region of the HLA-G gene and its possible association with the implantation outcome in couples who underwent assisted reproduction treatments (ART). The case group was composed of 25 ART couples. Ninety-four couples with two or more term pregnancies composed the control group. Polymorphism haplotype frequencies of the HLA-G were determined for both groups. The Haplotype 5, Haplotype 8 and Haplotype 11 were absolute absence in ART couples. The HLA-G*01:01:02a, HLA-G*01:01:02b alleles and the 14-bp ins polymorphism, Haplotype 2, showed an increased frequency in case women and similar distribution between case and control men. However, this susceptibility haplotype is significantly presented in case women and in couple with failure implantation after treatment, which led us to suggest a maternal effect, associated with this haplotype, once their presence in women is related to a higher number of couples who underwent ART. Copyright © 2012. Published by Elsevier Inc.

  10. Heroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification.

    Science.gov (United States)

    Kenney, Shannon R; Bailey, Genie L; Anderson, Bradley J; Stein, Michael D

    2017-10-01

    An individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification. Participants (N=397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT. Controlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT). Perceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery. Copyright © 2017. Published by Elsevier Ltd.

  11. Flame-assisted laser surface treatment of refractory materials for crack-free densification

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, L.; Li, L. [University of Manchester Inst. of Science and Technology (UMIST) (United Kingdom). Dept. of Mechanical Engineering; Stott, F.H. [Univ. of Manchester Inst. of Science and Technology (UMIST) (United Kingdom). Inst. of Sci. and Technol.

    2000-02-15

    A study to improve the integrity and reliability of alumina-based refractory bricks, installed as linings in furnaces and incinerators, is being conducted. Owing to the inherent porosity of such heat-insulating materials, problems associated with molten slag penetration and chemical degradation are often encountered. It is known that denser refractories degrade less rapidly since such penetration is hindered. One aim for the current research is to seal the surfaces of these refractory materials by laser surface processing. In this way the bulk properties of the brick are retained, while the surface properties are improved. This paper reports on the results of an investigation to determine the optimum laser processing parameters that produce a zone of densified material containing few defects at the refractory surface. The high thermal stresses usually associated with laser treatment are often relieved by fracture of the laser-treated zone. However, by using a novel flame-assisted laser surface treatment, a reduction in thermal stress has been achieved, resulting in a crack-free, dense laser-treated zone. This treated zone should reduce or even eliminate the ingress of molten slags and gases, thus providing a reduced area for attack by corrosive species. (orig.)

  12. Gold nanoclusters-assisted delivery of NGF siRNA for effective treatment of pancreatic cancer

    Science.gov (United States)

    Lei, Yifeng; Tang, Lixue; Xie, Yangzhouyun; Xianyu, Yunlei; Zhang, Lingmin; Wang, Peng; Hamada, Yoh; Jiang, Kai; Zheng, Wenfu; Jiang, Xingyu

    2017-04-01

    Pancreatic cancer is one of the deadliest human cancers, whose progression is highly dependent on the nervous microenvironment. The suppression of gene expression of nerve growth factor (NGF) may have great potential in pancreatic cancer treatment. Here we show that gold nanocluster-assisted delivery of siRNA of NGF (GNC-siRNA) allows efficient NGF gene silencing and pancreatic cancer treatment. The GNC-siRNA complex increases the stability of siRNA in serum, prolongs the circulation lifetime of siRNA in blood and enhances the cellular uptake and tumour accumulation of siRNA. The GNC-siRNA complex potently downregulates the NGF expression in Panc-1 cells and in pancreatic tumours, and effectively inhibits the tumour progression in three pancreatic tumour models (subcutaneous model, orthotopic model and patient-derived xenograft model) without adverse effects. Our study constitutes a straightforward but effective approach to inhibit pancreatic cancer via NGF knockdown, suggesting a promising therapeutic direction for pancreatic cancer.

  13. The role of steroid hormone supplementation in non-assisted reproductive technology treatments for unexplained infertility.

    Science.gov (United States)

    Quaas, Alexander M; Hansen, Karl R

    2016-12-01

    Fertility treatment strategies are evolving, with a more rapid transition to assisted reproductive technology (ART) treatments after unsuccessful non-ART treatments. This trend increases the potential importance of adjuvant treatments in non-ART cycles, such as steroid hormone supplementation. It has been established that success rates of ART treatments are increased with the use of luteal support with progesterone. In the setting of non-ART cycles, however, the evidence is less clear, and clinical practices vary widely between providers and clinics. In this review, we aimed to provide an overview of the current evidence for the use of steroid hormone supplementation, including progesterone for luteal support, estrogens, androgens, and mineralocorticoids, in the setting of non-ART treatments for ovulatory women. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Telling our stories: heroin-assisted treatment and SNAP activism in the Downtown Eastside of Vancouver.

    Science.gov (United States)

    Boyd, Susan; Murray, Dave; MacPherson, Donald

    2017-05-18

    This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver. This article highlights SNAP members' experiences as research subjects in Canada's second clinical trial conducted in Vancouver, Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), that began recruitment of research participants in 2011. This paper draws on one brainstorming session, three focus groups, and field notes, with the SALOME/NAOMI Association of Patients (SNAP) in late 2013 about their experiences as research subjects in Canada's second clinical trial, SALOME in the DTES of Vancouver, and fieldwork from a 6-year period (March 2011 to February 2017) with SNAP members. SNAP's research draws on research principles developed by drug user groups and critical methodological frameworks on community-based research for social justice. The results illuminate how participating in the SALOME clinical trial impacted the lives of SNAP members. In addition, the findings reveal how SNAP member's advocacy for HAT impacts the group in positive ways. Seven major themes emerged from the analysis of the brainstorming and focus groups: life prior to SALOME, the clinic setting and routine, stability, 6-month transition, support, exiting the trial and ethics, and collective action, including their participation in a constitutional challenge in the Supreme Court of BC to continue receiving HAT once the SALOME trial ended. HAT benefits SNAP members. They argue that permanent HAT programs should be established in Canada because they are an effective harm reduction

  15. The clinical application of laparoscope-assisted peritoneal vaginoplasty for the treatment of congenital absence of vagina.

    Science.gov (United States)

    Qin, Chenglu; Luo, Guangnan; Du, Min; Liao, Shi; Wang, Chunping; Xu, Keke; Tang, Jie; Li, Baoyan; Zhang, Juanjuan; Pan, Hongxin; Ball, Tyler W; Fang, Yujiang

    2016-06-01

    To evaluate the outcomes of laparoscope-assisted peritoneal vaginoplasty for the treatment of congenital vaginal atresia. A retrospective study enrolled patients diagnosed with congenital vaginal atresia who were treated with one of two different laparoscope-assisted peritoneal vaginoplasty techniques (named Luohu-one and Luohu-two) between October 31, 2001 and December 31, 2014. Operative time, intraoperative bleeding volume, surgical difficulty, complications, and post-procedure sexual satisfaction were reported. Data were collected for 620 patients. The Luohu-one procedure was used in the treatment of 145 patients, while 475 patients were treated with the Luohu-two procedure. In 5 (0.8%) patients, it was necessary to perform a sigmoid colon vaginoplasty. During surgery, 16 patients experienced a rectal injury, among whom, 9 patients experienced a rectal-vaginal fistula. Follow-up data extending to 7years were available for 285 patients. Of these 285 patients, 231 agreed to report details of their sexual experiences. In total, 222 (96.1%) patients reported being very satisfied with their vaginal conditions and sex life. The Luohu-two procedure demonstrated shorter operative and recovery time, and reduced intraoperative bleeding. However, both procedures demonstrated satisfactory results. Laparoscope-assisted peritoneal vaginoplasty demonstrated good safety and effectiveness in the treatment of patients with congenital vaginal atresia. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Antioxidative Peptides Derived from Enzyme Hydrolysis of Bone Collagen after Microwave Assisted Acid Pre-Treatment and Nitrogen Protection

    Directory of Open Access Journals (Sweden)

    Jin Sun

    2010-11-01

    Full Text Available This study focused on the preparation method of antioxidant peptides by enzymatic hydrolysis of bone collagen after microwave assisted acid pre-treatment and nitrogen protection. Phosphoric acid showed the highest ability of hydrolysis among the four other acids tested (hydrochloric acid, sulfuric acid and/or citric acid. The highest degree of hydrolysis (DH was 9.5% using 4 mol/L phosphoric acid with a ratio of 1:6 under a microwave intensity of 510 W for 240 s. Neutral proteinase gave higher DH among the four protease tested (Acid protease, neutral protease, Alcalase and papain, with an optimum condition of: (1 ratio of enzyme and substrate, 4760 U/g; (2 concentration of substrate, 4%; (3 reaction temperature, 55 °C and (4 pH 7.0. At 4 h, DH increased significantly (P < 0.01 under nitrogen protection compared with normal microwave assisted acid pre-treatment hydrolysis conditions. The antioxidant ability of the hydrolysate increased and reached its maximum value at 3 h; however DH decreased dramatically after 3 h. Microwave assisted acid pre-treatment and nitrogen protection could be a quick preparatory method for hydrolyzing bone collagen.

  17. Integrated nonthermal treatment system study

    Energy Technology Data Exchange (ETDEWEB)

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J. [Morrison Knudsen Corp. (United States); Quapp, W.J. [Nuclear Metals (United States); Bechtold, T.; Brown, B.; Schwinkendorf, W. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States); Swartz, G. [Swartz and Associates (United States)

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

  18. Flow behavior and plasticity of Ti-6Al-4V under different electrically assisted treatments

    Science.gov (United States)

    Jiang, Tianhao; Peng, Linfa; Yi, Peiyun; Lai, Xinmin

    2016-12-01

    Both electrically assisted tension (EAT) and electrically assisted pre-treatment tension (EAPT) were conducted to compare different effects on improving deformation resistance and ductility of Ti-6Al-4V. It is found EAPT obviously enhanced the ductility of Ti-6Al-4V compared with that obtained in EAT. In order to decouple the thermal effect from electro-plastic effect, thermally assisted tension (TAT) as well as thermally assisted pre-treatment tension (TAPT) were also conducted. The result indicates deformation mechanism of alpha phase with h.c.p crystal structure in Ti-6Al-4V was insensitive to electric current when current duty is less than 20%. However, the elevated temperature alone is insufficient to account for additional stress drop in the initial yielding stress observed in EAT and EAPT when current duty is higher than 20%. According to XRD investigation on specimens treated in original state, TAPT and EAPT, it is found electric current accelerates the annihilation of alpha phase and formation of beta phase in Ti-6Al-4V more effectively than the rising temperature does and such microstructure evolution also throws light on the improvement of flow stress and ductility observed in EAPT both experimentally and theoretically.

  19. Psychiatric Comorbidity in Patients from the Addictive Disorders Assistance Units of Galicia: The COPSIAD Study.

    Directory of Open Access Journals (Sweden)

    César Pereiro

    Full Text Available The objective of this study is to assess the prevalence of psychiatric comorbidity in patients under treatment within the addictive disorders assistance units of Galicia (Spain.A total of 64 healthcare professionals performed clinical diagnosis of mental disorders (on DSM IV-TR criteria in 2300 patients treated throughout March 2010 in 21 addictive disorders assistance units.56.3% of patients with substance abuse/dependency also showed some other mental disorder, 42.2% of patients suffering from at least an Axis I condition and 20.2% from some Axis II condition. Mood and anxiety disorders and borderline and antisocial personality disorders were the most frequent disorders in both axes.A high comorbidity was found between mental and substance use disorders (SUD in patients seen at the addictive disorders assistance units of Galicia.

  20. Psychiatric Comorbidity in Patients from the Addictive Disorders Assistance Units of Galicia: The COPSIAD Study.

    Science.gov (United States)

    Pereiro, César; Pino, Carlos; Flórez, Gerardo; Arrojo, Manuel; Becoña, Elisardo

    2013-01-01

    The objective of this study is to assess the prevalence of psychiatric comorbidity in patients under treatment within the addictive disorders assistance units of Galicia (Spain). A total of 64 healthcare professionals performed clinical diagnosis of mental disorders (on DSM IV-TR criteria) in 2300 patients treated throughout March 2010 in 21 addictive disorders assistance units. 56.3% of patients with substance abuse/dependency also showed some other mental disorder, 42.2% of patients suffering from at least an Axis I condition and 20.2% from some Axis II condition. Mood and anxiety disorders and borderline and antisocial personality disorders were the most frequent disorders in both axes. A high comorbidity was found between mental and substance use disorders (SUD) in patients seen at the addictive disorders assistance units of Galicia.

  1. Psychiatric Comorbidity in Patients from the Addictive Disorders Assistance Units of Galicia: The COPSIAD Study

    Science.gov (United States)

    Pereiro, César; Pino, Carlos; Flórez, Gerardo; Arrojo, Manuel; Becoña, Elisardo

    2013-01-01

    The objective of this study is to assess the prevalence of psychiatric comorbidity in patients under treatment within the addictive disorders assistance units of Galicia (Spain). Material and Methods A total of 64 healthcare professionals performed clinical diagnosis of mental disorders (on DSM IV-TR criteria) in 2300 patients treated throughout March 2010 in 21 addictive disorders assistance units. Results 56.3% of patients with substance abuse/dependency also showed some other mental disorder, 42.2% of patients suffering from at least an Axis I condition and 20.2% from some Axis II condition. Mood and anxiety disorders and borderline and antisocial personality disorders were the most frequent disorders in both axes. Conclusions A high comorbidity was found between mental and substance use disorders (SUD) in patients seen at the addictive disorders assistance units of Galicia. PMID:23823135

  2. Topography-guided customized laser-assisted subepithelial keratectomy for the treatment of postkeratoplasty astigmatism.

    Science.gov (United States)

    Rajan, Madhavan S; O'Brart, David P S; Patel, Parul; Falcon, Mike G; Marshall, John

    2006-06-01

    To assess topography-assisted corneal wavefront excimer laser surface ablation for the correction of ametropia and irregular astigmatism after keratoplasty. Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom. In this pilot study, 15 patients (16 eyes) who were intolerant of spectacle and contact lens correction due to astigmatic anisometropia after keratoplasty (15 penetrating and 1 lamellar) had topography-assisted customized excimer laser treatments. Corneal topographic data using a Keratron Scout, Placido disk system allowed for preoperative analysis of wavefront anomalies of the anterior corneal surface from which a customized excimer laser correction of both lower-order aberrations (LOAs) and higher-order aberrations (HOAs) was prepared (ORK software) for treatment with a Schwind Esiris flying-spot laser. All eyes had laser-assisted subepithelial keratectomy (LASEK) using 15% alcohol with a 20-second to 30-second application. Four eyes received an application of mitomycin-C (MMC) 0.2 mg/mL for 1 minute after stromal ablation. The mean preoperative spherical equivalent (SE) was -3.50 diopters (D) +/- 3.97 (SD) (range +1.625 to -9.25 D). The preoperative cylindrical error was -7.2 D (range -2.75 to -13.5 D). The programmed laser correction was -3.14 D (range +1.62 to -9 D) with a maximum attempted cylindrical correction of -7 D. Adherent LASEK epithelial flaps along suture lines and the graft-host junction were noted in 9 eyes (56%), although it was possible to obtain and replace a partial flap. A follow-up of 18 months was achieved in all eyes. At the final follow-up visit, the mean postoperative SE was -1.08 +/- 1.85 D (range +3 to -4.78 D) (P<.01, F<.01). Ten eyes (62.5%) were within +/-1 D of the intended correction. The mean postoperative cylindrical error was -2.72 D (range -0.5 to -6.5 D) (P<.001), with vector analysis demonstrating a mean 6.23 D correction. Analysis of HOAs using a 6.0 mm pupil size demonstrated a significant

  3. Cross-sectional study of morbidity, morbidity-associated factors and cost of treatment in Ngaoundere, Cameroon, with implications for health policy in developing countries and development assistance policy

    Directory of Open Access Journals (Sweden)

    Holtedahl Knut

    2002-04-01

    Full Text Available Abstract Background In a population-based epidemiological study in Ngaoundere, Cameroon, we studied cross-sectional child morbidity and the cost of necessary investigation and treatment. Methods Three teams of two to three health workers visited haphazardly selected households in all major housing quarters. We asked permission to enter for a health survey. Children with cough, fever or weight loss as well as sick adults were offered free-of-charge local hospital examination and treatment. Results From 177 households with 1777 persons, 51 (2.9% persons were referred. Thirty-five of them had an undiagnosed disease threatening individual health and in many cases also public health. Seven were hospitalised, including three adults with tuberculosis. Malnutrition was diagnosed in nine small children. Four patients had AIDS, seven had malaria. Average total cost for ambulant patients was 15 USD, for hospitalised patients 110 USD. In the households, almost half of the women 16–50 years of age had no schooling. Two per cent of women and nine per cent of men were daily smokers. Coughing children were more likely than non-coughing children to live in a household with at least one smoker (OR = 3.58, 95% CI 1.72 to 7.46, and they generally lived in more poor households (P = 0.018. Twelve of 16 children with weight loss were referred from households with a high poverty score. Conclusions Adult smoking and poverty affect children's health. The cost of hospitalisation or long-lasting therapy is beyond the means of most ordinary families. Diseases with severe consequences for public health, like tuberculosis, AIDS and malaria should have national programs with free, decentralised examination and treatment. Access to generic drugs is important. A major educational effort is needed to improve public health.

  4. Effects of Surgical Assistant's Level of Resident Training on Surgical Treatment of Intermittent Exotropia: Operation Time and Surgical Outcomes.

    Science.gov (United States)

    Kim, Moo Hyun; Chung, Hyunuk; Kim, Won Jae; Kim, Myung Mi

    2018-02-01

    To evaluate the effects of the surgical assistant's level of resident training on operation time and surgical outcome in the surgical treatment of intermittent exotropia. This study included 456 patients with intermittent exotropia who underwent lateral rectus recession and medial rectus resection and were followed up for 24 months after surgery. The patients were divided into two groups according to the surgical assistant's level of resident training: group F (surgery assisted by a first-year resident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwent a second operation) were compared between the two groups. The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively (p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than in group S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significant difference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A second operation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those in group S (p = 0.51). No significant difference in operation time was observed when we compared the effects of the level of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperative exodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgical outcome during the 24-month follow-up was not significantly different.

  5. Implant-assisted removable partial dentures as an alternative treatment for partial edentulism: a review of the literature.

    Science.gov (United States)

    Chatzivasileiou, Konstantinos; Kotsiomiti, Eleni; Emmanouil, Ioannis

    2015-01-01

    This study reviewed the current literature concerning implant-assisted removable partial dentures (RPDs) in order to present the existing knowledge about performance issues. An electronic search was conducted on the PubMed database for published English-language articles that contained information about implant-assisted RPDs. A review of these articles indicated that the combination of dental implants with RPDs constitutes a cost-efficient prosthetic protocol that can offer solutions to problematic aspects of treatment with removable partial dentures. Well-designed studies are still needed to provide robust evidence on critical issues, such as design guidelines, long-term survival of implants associated with RPDs, and their effect on patients' quality of life.

  6. Psychosocial needs of women and their partners after successful assisted reproduction treatment in Barcelona

    OpenAIRE

    Esther Crespo; Joan Bestard

    2016-01-01

    It is assumed that pregnancy and parenthood after a period of infertility are unproblematic and gratifying. However, a review of the literature highlights the complexity of the psychological and social consequences of pregnancy, childbirth and parenting after successful treatment with assisted reproductive technology. These experiences, including those following the creation of new forms of non-genetic and/or social parenthood, require investigation in order to understand how women and their ...

  7. ANIMAL-ASSISTED THERAPY – A NEW TREND IN THE TREATMENT OF CHILDREN AND ADDULTS

    OpenAIRE

    Dimitrijević, Ivan

    2009-01-01

    Animal-assisted therapy is a familiar method of treatment in the rehabilitation of many illnesses and conditions, but is still not applied sufficiently in our milieu. This paper gives an overview of the available literature and some of the research which demonstrates that the interaction between the patient, animal and therapist provides a context which improves communication, elevates self-confidence, reduces the symptoms of diseases, and improves the quality of life. The dog, cat, horse,...

  8. HLA-G profile of infertile couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Nardi, Fabiola Silva; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; da Graça Bicalho, Maria

    2016-12-01

    HLA-G codes for a non-classical class I (Ib) protein which is mainly expressed in trophoblast cells. Many pieces of evidence pointed out its essential role conferring immunological tolerance to the fetus. Some HLA-G alleles have been linked to enhanced or reduced HLA-G protein levels expression, which have been associated with reproductive failure. In this study 33 couples undergoing ART (assisted reproduction treatment; n=66) and 120 couples who conceived naturally (controls; n=240) were enrolled in the study. Genotyping was performed by SBT and tagged an 1837bp at 5'URR as well as exons 2, 3 and4 of HLA-G. Alleles, genotypes and haplotypes were compared between infertile and control groups using Fisher Exact Test. The haplotype HLA-G ∗ 010101b/HLA-G ∗ 01:01:01 showed statistically significant higher frequency in control groups. The immunogenetics of infertility is complex and might be dependent on different genes involved in the establishment of a successful pregnancy. A better understanding of HLA-G alleles and haplotypes structure and how the genetic diversity at their regulatory sites could impact on their level of expression and build up the susceptibility or protection conditions may shed light on the comprehension of immunogenetics mechanisms acting at the fetus-maternal interface. Copyright © 2016 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  9. Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil.

    Science.gov (United States)

    Miyada, Simone; Garbin, Artênio José Ísper; Gatto, Renata Colturato Joaquim; Garbin, Cléa Adas Saliba

    2017-01-01

    In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. This was a cross-sectional, exploratory study with a quantitative approach that was conducted over 8 months. The target population contained patients who were assisted at the ambulatory care facility specialized in STD/AIDS of a medium-size city located in Northwest São Paulo. In order to verify the level of adherence to ART, a validated CEAT-VIH (Assessment of Adherence to Antiretroviral Therapy Questionnaire) questionnaire was used. Sociodemographic aspects and clinical/laboratory data were obtained from the medical records. The results were analyzed using the Student's t-test and Pearson's coefficient. Herein, 109 patients were interviewed, 56% of whom were male. The age of the population ranged 18-74 years (mean 45.67 years). Adherence to ART was classified as insufficient in 80.7% of cases. There was an association between ART adherence and presence of symptoms and/or opportunistic infection (p=0.008) and economic status (ptreatment adherence than those who needed to take more than 3 pills a day.

  10. Donkey-assisted rehabilitation program for children: a pilot study

    Directory of Open Access Journals (Sweden)

    Paola De Rose

    2011-12-01

    Full Text Available Bonding with animals grants access to the sphere of affectivity and facilitates therapeutic engagement. The methodological approach of donkey-assisted programs is based on mediation, which is characterized by multidirectional relationships (patient-donkey-therapist. The donkey is an excellent facilitator in the motivation-building process, being able to stimulate the child's development by way of active and positive forces that foster psycho-affective and psycho-cognitive development processes. Results of this study, which focused on the child's approach to the donkey, indicate that while communicating with the animal, children rely more on physical expressions than on verbal language. Donkey-assisted rehabilitative sessions can help in identifying children's strong points, on which motivation could be built.

  11. The Role of Human Web Assistants in E-Commerce: An Analysis and a Usability Study.

    Science.gov (United States)

    Aberg, Johan; Shahmehri, Nahid

    2000-01-01

    Discusses electronic commerce and presents the concept of Web assistants, human assistants working in an electronic Web shop. Presents results of a usability study of a prototype adaptive Web assistant system that show users were enthusiastic about the concept of Web assistants and its implications. (Author/LRW)

  12. Successful treatment of a continuous flow left ventricular assist device thrombosis with eptifibatide.

    Science.gov (United States)

    Jennings, Douglas L; Cabrera, Rafael; Wang, Dee Dee; Tita, Cristina

    2012-01-01

    Left ventricular assist device thrombosis is a rare but potentially lethal complication of mechanical circulatory support. Here, we present a case of successful treatment of a suspected HeartMate II thrombosis with the glycoprotein IIb/IIIa inhibitor, eptifibatide. The patient presented with signs and symptoms of heart failure, along with acute kidney injury and hemolytic anemia that did not respond to diuresis, inotrope support, or anticoagulation. Treatment with eptifibatide resulted in marked clinical and hemodynamic improvement within 24 hrs. The patient was transitioned to clopidogrel and discharged without further incident. Eptifibatide may represent a potential therapeutic option for patients with device thrombosis.

  13. Meta-analysis of scientific studies related to pesticide application techniques - air assistance and adjuvant addition

    Directory of Open Access Journals (Sweden)

    Gustavo Migliorini de Oliveira

    Full Text Available ABSTRACT: The aim of this study was to investigate the effects of air-assisted boom sprayers and addition of adjuvants in the spray solution on control levels of pesticide sprays against weeds and pathogenic fungi by meta-analysis of scientific literature. To perform the meta-analysis, data were collected from the results presented in scientific papers. By these data, a variable was created, denominated as relative control that was used to quantify and test whether the use of air assistance or adjuvants affects the effectiveness of pesticide sprays. This variable was calculated as a difference between percentage of pesticide control in treatments with air assistance or adjuvants and treatments without these spray techniques. Data were analyzed statistically using the Comprehensive Meta-Analysis software. Results showed that the use of air assistance did not have any effect on the control levels of weeds and pathogenic fungi; whereas, the addition of adjuvants increased these levels by 6.45%.

  14. Increased incidence of gestational hypertension and preeclampsia after assisted reproductive technology treatment.

    Science.gov (United States)

    Wang, Yueping A; Chughtai, Abrar A; Farquhar, Cynthia M; Pollock, Wendy; Lui, Kei; Sullivan, Elizabeth A

    2016-04-01

    To determine the association between assisted reproductive technology (ART) treatment and the rate of combined gestational hypertension (GH), preeclampsia (PE). Retrospective population study. Not applicable. A total of 596,520 mothers (3.6% ART mothers) who gave birth between 2007 and 2011. Not applicable. Comparison of the rate of GH/PE for ART and non-ART mothers, with odds ratio (OR), adjusted odds ratio (AOR), and 95% confidence interval (CI) used to assess the association between ART and GH/PE. The overall rate of GH/PE was 4.3%, with 6.4% for ART mothers and 4.3% for non-ART mothers. The rate of GH/PE was higher for mothers of twins than singletons (12.4% vs. 5.7% for ART mothers; 8.6% vs. 4.2% for non-ART mothers). The ART mothers had a 17% increased odds of GH/PE compared with the non-ART mothers (AOR 1.17; 95% CI, 1.10-1.24). After stratification by plurality, the difference in GH/PE rates between ART and non-ART mothers was not statistically significant, with AOR 1.05 (95% CI, 0.98-1.12) for mothers of singletons and AOR 1.10 (95% CI, 0.94-1.30) for mothers of twins. The changes in AOR after stratification indicated that multiple pregnancies after ART are the single most likely explanation for the increased rate of GH/PE among ART mothers. The lower rate of GH/PE among mothers of singletons compared with mothers of twins suggests that a policy to minimize multiple pregnancies after ART may reduce the excess risk of GH/PE due to ART treatment. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. [Treatment of septic olecranon and patellar bursitis by excision and vacuum-assisted closure therapy].

    Science.gov (United States)

    Walter, G; Kemmerer, M; Hoffmann, R

    2013-08-01

    Treatment of septic olecranon and patellar bursitis differs considerably and is currently under discussion. We therefore performed a retrospective study of our patients with septic bursitis in the past 5 years. Between March 2007 and February 2012 we treated 79 patients with septic olecranon (n = 43) and patellar (n = 36) bursitis surgically: 61-males, 18 females, age 51 (range: 11-91) years. Four patients had not been treated before, 25 had suffered recurrences after 1-10 previous procedures, and 9 patients had not improved after conservative therapy. 34 patients presented with traumatic rupture or fistula of their bursae. In all cases we performed a radical bursectomy and vacuum-assisted therapy for 4 to 5 days. In addition, patients received systemic antibiotics. We phoned all patients and were successful in 57 cases (72 %). We questioned these patients for range of movement, limitations at work, pain, sensibility disorder, satisfaction with the result and further surgical procedures. In all cases we took tissue specimens for cultures, in 48 preparations histological examination was performed. Microbiological and histological results are discussed in detail. 40 patients were free of complaints, 15 complained of mild pain, 54 of 57 had unlimited range of motion. Minor discomforts at desk work were reported by 5 of 43 patients, 12 out of 36 patient reported discomfort when performing on their knees. There was no recurrence in the period of investigation. We recommend our treatment concept for septic olecranon and patellar bursitis because patient satisfaction is high and recurrences are reliably avoided. The soft tissue is spared, so that plastic covering procedures are seldom necessary. Georg Thieme Verlag KG Stuttgart · New York.

  16. Clinical assessment of diode laser-assisted endoscopic intrasphenoidal vidian neurectomy in the treatment of refractory rhinitis.

    Science.gov (United States)

    Lai, Wen-Sen; Cheng, Sheng-Yao; Lin, Yuan-Yung; Yang, Pei-Lin; Lin, Hung-Che; Cheng, Li-Hsiang; Yang, Jinn-Moon; Lee, Jih-Chin

    2017-12-01

    For chronic rhinitis that is refractory to medical therapy, surgical intervention such as endoscopic vidian neurectomy (VN) can be used to control the intractable symptoms. Lasers can contribute to minimizing the invasiveness of ENT surgery. The aim of this retrospective study is to compare in patients who underwent diode laser-assisted versus traditional VN in terms of operative time, surgical field, quality of life, and postoperative complications. All patients had refractory rhinitis with a poor treatment response to a 6-month trial of corticosteroid nasal sprays and underwent endoscopic VN between November 2006 and September 2015. They were non-randomly allocated into either a cold instrument group or a diode laser-assisted group. Vidian nerve was excised with a 940-nm continuous wave diode laser through a 600-μm silica optical fiber, utilizing a contact mode with the power set at 5 W. A visual analog scale (VAS) was used to grade the severity of the rhinitis symptoms for quality of life assessment before the surgery and 6 months after. Of the 118 patients enrolled in the study, 75 patients underwent cold instrument VN and 43 patients underwent diode laser-assisted VN. Patients in the laser-assisted group had a significantly lower surgical field score and a lower postoperative bleeding rate than those in the cold instrument group. Changes in the VAS were significant in preoperative and postoperative nasal symptoms in each group. The application of diode lasers for vidian nerve transection showed a better surgical field and a lower incidence of postoperative hemorrhage. Recent advancements in laser application and endoscopic technique has made VN safer and more effective. We recommend this surgical approach as a reliable and effective treatment for patients with refractory rhinitis.

  17. Applications of Video-assisted Thoracic Surgery for the Diagnosis and Treatment 
of Patients with Small Pulmonary Nodules

    Directory of Open Access Journals (Sweden)

    Liqun SHAN

    2013-07-01

    Full Text Available Background and objective Chest computed tomography (CT, particularly thin-slice high resolution CT, has low sensitivity and specificity for detecting pulmonary nodules <10 mm in size. This limitation leads to challenges in clinical diagnosis and treatment of small pulmonary nodules. This study introduces the use of video-assisted thoracoscopic surgery (VATS for the diagnosis and treatment of small pulmonary nodules. Methods From November 2009 to May 2012, 64 patients with small pulmonary nodules without prior preoperative pathologic diagnosis were treated by pulmonary wedge resection through VATS. The diagnosis of small pulmonary nodules was established from rapid frozen section. The type of operation depends on the pathology and the condition of the patients. Twenty patients with primary lung cancer were subjected to lobectomy and radical resection of the lymph nodes by complete thoracospic lobectomy or video-assisted thoracoscopic invasive lobectomy. Pulmonary wedge resection was performed in 44 patients, among whom 21 have benign nodule, 18 have precancerous lesion, 3 have metastatic nodule, and 2 have primary lung cancer for which lobectomy was not fit. Results Confirmative diagnosis is difficult to obtain among patients with small pulmonary nodules. VATS is effective in the diagnosis and treatment of small pulmonary nodules. With VATS, patients with benign small pulmonary nodules can be cured, and patients with primary lung cancer can receive definite diagnosis and effective treatment in time. Conclusion CT-guided hook-wire fixation is useful in precise lesion localization for surgical resection.

  18. Mobile-Assisted Vocabulary Learning: A Review Study

    Directory of Open Access Journals (Sweden)

    Parichehr Afzali

    2017-04-01

    Full Text Available Mobile phones are becoming more acceptable toolkits to learn languages. One aspect of English language which has been subject to investigation in mobile assisted language learning (MALL is vocabulary. This study reviewed some of the studies conducted in various contexts on the effect of MALL on vocabulary learning. We investigated some of the most prominent databases such as Science Direct, Wiley, Scopus and Oxford to find these studies; believing that this study can have pedagogical implications for future researchers and language teachers. We selected studies done in different countries such as Malaysia, Taiwan, Korea, China, Japan, Iran, Saudi Arabia, Turkey. Thirty studies were selected purposively in this way. Some of the main features of these studies are elaborated on in the discussion section. Pedagogical implications are discussed.

  19. Robot-assisted rectopexy is a safe and feasible option for treatment of rectal prolapse

    DEFF Research Database (Denmark)

    Haahr Raunkjær, Camilla; Jakobsen, Henrik Loft; Gögenur, Ismail

    2014-01-01

    and satisfaction. RESULTS: A total of 24 consecutive patients underwent robot-assisted rectopexy from October 2010 to July 2012. Data regarding their long-term outcome was available for 18 patients at follow-up (average ten months). 50% of the patients suffered from faecal incontinence before surgery (n = 9/18, 50......INTRODUCTION: Rectal prolapse is seen in up to one in 100 elderly women and results in symptoms such as incontinence, mucus secretion and constipation. The aim of this study was to present short- and longterm outcomes after robot-assisted rectopexy in patients with rectal prolapse. MATERIAL...... AND METHODS: All patients diagnosed with rectal prolapse at our institution underwent robot-assisted rectopexy. Data regarding the surgical procedure and post-operative morbidity were collected retrospectively. Patients were contacted to register long-term results regarding recurrence, incontinence...

  20. TREATMENT OF OSTEOCHONDRAL LESIONS OF THE TALUS BY MEANS OF THEARTHROSCOPY-ASSISTED MICROPERFORATION TECHNIQUE

    Science.gov (United States)

    de Lima, Everton; de Queiroz, Felipe; Lopes, Osmar Valadão; Spinelli, Leandro de Freitas

    2015-01-01

    Objective: To evaluate patients affected by osteochondral fractures of the talus who were treated surgically by means of arthroscopy-assisted microperforation. Methods: A retrospective study was carried out on 24 patients with osteochondral lesions of the talus who underwent microperforation assisted by videoarthroscopy of the ankle. They were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score system before and after the operation. Results: There were 19 men and 5 women, with a mean age of 35.3 years (minimum of 17 years and maximum of 54 years). The minimum follow-up was two years (maximum of 39 months). All the patients showed an improvement in AOFAS score after surgery, with an average improvement of around 22.5 points. Conclusion: Videoarthroscopy-assisted microperforation is a good option for treating osteochondral lesions of the talus and provides good functional results. PMID:27027076

  1. Osteopathic treatment in a patient with left-ventricular assist device with left brachialgia: a case report.

    Science.gov (United States)

    Bordoni, Bruno; Marelli, Fabiola; Morabito, Bruno; Sacconi, Beatrice

    2017-01-01

    This study deals with an osteopathic approach used for a patient with left-ventricular assist device (L-VAD) affected by left brachialgia. Clinical examination revealed the presence of thoracic outlet syndrome and pectoralis minor syndrome, with compression of the left proximal ulnar nerve, related to the surgical sternotomy performed. The osteopathic techniques used can be classified as indirect and direct, addressed to the pectoralis minor and the first left rib, respectively. To our knowledge, this is the first text in literature with an osteopathic treatment in a patient with L-VAD.

  2. Medication-Assisted Treatment for Opioid Addiction in the United States: Critique and Commentary.

    Science.gov (United States)

    McElrath, Karen

    2018-01-28

    In the United States, buprenorphine products (namely buprenorphine/naloxone combination) and methadone are the primary forms of medication-assisted treatment (MAT) that are authorized for addressing opioid addiction. Although treatment ideologies differentiate MAT programs, much of the provision in the US reflects a model of "high threshold, low tolerance." This model is discussed with a focus on structural and programmatic barriers that shape access to and retention in MAT. The critique continues with a discussion of multifaceted stigma that reinforces spoiled identities and diffuses into treatment settings. The social control mechanisms that are imposed in MAT are strikingly similar to those reflected in criminal justice settings, namely probation, parole and community corrections more generally. Parallels are drawn between the "addict" and the "felon" and how they are monitored, tracked, and controlled. These factors have major implications for recovery.

  3. Animal-Assisted Therapy for Patients Undergoing Treatment at NIH Clinical Center | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Therapy Dogs Animal-Assisted Therapy for Patients Undergoing Treatment at NIH ... is unlike any other." A self-described "huge animal lover," she coordinates 14 teams of trained and ...

  4. Authors' reply to comment on "Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?"

    DEFF Research Database (Denmark)

    Sejbaek, Camilla S.; Pinborg, Anja; Hageman, Ida

    2016-01-01

    . Hence, we did not aim to compare unipolar depression in women who received ART treatment with women who did not. However, a systematic review and meta-analysis (2) was published recently which shows no increased risk of post-partum depressive symptoms in women after medically assisted reproduction......The aim of our national register-based study (1) was to investigate the risk of a new episode of unipolar depression among women treated with assisted reproductive technology (ART) in regards to whether they had achieved a live birth (as a result of treatment or spontaneous conception) or not...

  5. Natural healers: a review of animal assisted therapy and activities as complementary treatment for chronic conditions.

    Science.gov (United States)

    Reed, Reiley; Ferrer, Lilian; Villegas, Natalia

    2012-01-01

    The primary objective of this review is to synthesize the existing literature on the use of animal-assisted therapy and activity (AAT/A) as complementary treatment among people living with chronic disease and to discuss the possible application of this practice among children living with HIV. Relevant databases were searched between March 10 and April 11, 2011, using the words: animal assisted therapy or treatment and chronic conditions or diseases. Thirty-one articles were found and 18 followed the inclusion and exclusion criteria. Research suggests that AAT/A is effective for different patient profiles, particularly children. Interaction with dogs has been found to increase positive behaviors, such as sensitivity and focus, in children with social disabilities. Decreased levels of pain have also been reported among child patients as a result of AAT/A. More research should be done in the area of children living with chronic diseases that require strict adherence to treatment, such as HIV, and on AAT/A's prospective use as an educational tool to teach children about the importance of self-care for their medical conditions.

  6. Effect of intestinal pressure on fistula closure during vacuum assisted treatment: a computational approach.

    Science.gov (United States)

    Cattoni, Diego I; Ravazzola, Constanza; Tüngler, Victoria; Wainstein, Daniel E; Chara, Osvaldo

    2011-01-01

    Enterocutaneous fistulae, pathological communications between the intestinal lumen and the abdominal skin, can arise as serious complication of gastrointestinal surgery. A current non-surgical treatment for this pathology involves topical application of sub-atmospheric pressure, also known as vacuum assisted closure (VAC). While this technique appears to be promising, surgeons report a number of cases in which its application fails to achieve fistula closure. Here, we evaluate the fistula's physical properties during the vacuum assisted closure process in a computational approach exploring the relevance of intraluminal intestinal pressure. A mathematical model formulated by differential equations based on tissue elasticity properties and principles of fluid mechanics was created and forcing functions were integrated to mimic intestinal pressure dynamics. A software to solve equations and to fit the model to experimentally obtained data was developed. This enabled simulations of vacuum assisted fistula closure under different intestinal pressure. The simulation output indicates conditions, in which fistula closure can or cannot be expected suggesting favoured or impeded healing, respectively. When modifications of intestinal pressure, as observed in fistula accompanying pathologies, are integrated, the outcome of fistula closure changes considerably. Rise of intestinal pressure is associated with delay of fistula closure and temporary fistula radius augmentation, while reduction of intestinal pressure during sub-atmospheric pressure treatment contributes to a faster and direct fistula closure. From the model predictions, we conclude that administration of intestinal pressure decreasing compounds (e.g. butylscopolamine, glucagon) may improve VAC treatment, while intestinal pressure increasing drugs should be avoided. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Effects of ultrasound-assisted α-amylase degradation treatment with multiple modes on the extraction of rice protein.

    Science.gov (United States)

    Yang, Xue; Li, Yunliang; Li, Suyun; Oladejo, Ayobami Olayemi; Wang, Yucheng; Huang, Shanfen; Zhou, Cunshan; Ye, Xiaofei; Ma, Haile; Duan, Yuqing

    2018-01-01

    The effects of ultrasound-assisted α-amylase degradation (UAD) treatment with multiple modes on the extraction of rice protein (RP) from rice dreg powder were studied. The results showed that UAD treatment increased protein extraction rate significantly (pextraction rate compared to that of simultaneous or single frequency ultrasound treatment. The highest protein extraction rate was obtained under 20/35kHz of sequential frequency UAD treatment with the protein extraction rate of 89.58% and protein purity of 92.99%. The test and analysis of fourier transform infrared spectroscopy, ultraviolet-visible spectroscopy, starch content, non-protein nitrogen content, SH and SS content, surface hydrophobicity, amino acids content and proteins characteristics were studied to reveal the mechanism of UAD on the protein extraction effect. After treated with UAD, the starch-protein agglomerates disintegrated completely, moreover, protein advanced structure was changed to some extent and the disulfide bond was partially broken, but the main chain structure (peptide chain), specificity of protein and amino acid composition were not obviously changed. Consequently, the structure modified RP extracted by UAD treatment presented higher solubility, emulsifying activity and foaming capacity, which was beneficial for the application of RP. In conclusion, UAD treatment is an effective method for maximizing extraction rate, purity and modifying properties of extracted protein. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Trans people's experiences with assisted reproduction services: a qualitative study.

    Science.gov (United States)

    James-Abra, S; Tarasoff, L A; Green, D; Epstein, R; Anderson, S; Marvel, S; Steele, L S; Ross, L E

    2015-06-01

    What are the experiences of trans persons (i.e. those whose gender identity does not match the gender assigned to them at birth) who sought or accessed assisted reproduction (AR) services in Ontario, Canada, between 2007 and 2010? The majority of trans persons report negative experiences with AR service providers. Apart from research examining desire to have children among trans people, most of the literature on this topic has debated the ethics of assisting trans persons to become parents. To-date, all of the published research concerning trans persons' experiences with AR services is solely from the perspective of service providers; no studies have examined the experiences of trans people themselves. Secondary qualitative research study of data from nine trans-identified people and their partners (total n = 11) collected as part of a community-based study of access to AR services for sexual and gender minority people between 2010 and 2012. Trans-identified volunteers (and their partners, when applicable) who had used or attempted to access AR services since 2007 from across Ontario, Canada, participated in a 60-90 minute, semi-structured qualitative interview. Qualitative analysis was performed using a descriptive phenomenological approach. Emerging themes were continually checked against the data as part of an iterative process. The data highlight barriers to accessing AR services for trans people. Participant recommendations for improving AR service provision to better meet the needs of this population are presented. These recommendations address the following areas: (i) AR service provider education and training; (ii) service provider and clinic practices and (iii) clinic environment. The majority of study participants were trans people who identified as men and who resided in major urban areas; those living in smaller communities may have different experiences that were not adequately captured in this analysis. While existing literature debates the ethics of

  9. Endoscope-assisted treatment of scaphocephaly: report of a case and new surgical technique

    Directory of Open Access Journals (Sweden)

    Domagoj Jugović

    2015-10-01

    Full Text Available The most common craniosynostosis, scaphocephaly, is the consequence of premature closure of the sagittal suture. Craniosynostosis does not just pose a cosmetic problem, but it can also lead to the permanent neurological deficits. Therefore early diagnosis and treatment are crucial for good outcome. Open surgery with large skin incision is currently the standard procedure. We present our first endoscope-assisted surgical procedure for scaphocephaly. The infant did not need transfusion or intensive therapy after the surgery and skin incision was minimal. This minimal invasive, new surgical technique and its development were described.  

  10. Overcoming the Recalcitrance for the Conversion of Kenaf Pulp to Glucose via Microwave-Assisted Pre-Treatment Processes

    Directory of Open Access Journals (Sweden)

    Miguel A. Hurtado

    2011-02-01

    Full Text Available This study evaluates the pre-treatment of cellulose from kenaf plant to yield sugar precursors for the production of ethanol or butanol for use as biofuel additives. In order to convert the crystalline cellulosic form to the amorphous form that can undergo enzymatic hydrolysis of the glycosidic bond to yield sugars, kenaf pulp samples were subjected to two different pre-treatment processes. In the acid pre-treatment, the pulp samples were treated with 37.5% hydrochloric acid in the presence of FeCl3 at 50 °C or 90 °C whereas in the alkaline method, the pulp samples were treated with 25% sodium hydroxide at room temperature and with 2% or 5% sodium hydroxide at 50 °C. Microwave-assisted NaOH-treatment of the cellulose was also investigated and demonstrated to be capable of producing high glucose yield without adverse environmental impact by circumventing the use of large amounts of concentrated acids i.e., 83–85% phosphoric acid employed in most digestion processes. The treated samples were digested with the cellulase enzyme from Trichoderma reesei. The amount of glucose produced was quantified using the QuantichromTM glucose bioassay for assessing the efficiency of glucose production for each of the treatment processes. The microwave-assisted alkaline pre-treatment processes conducted at 50 °C were found to be the most effective in the conversion of the crystalline cellulose to the amorphous form based on the significantly higher yields of sugar produced by enzymatic hydrolysis compared to the untreated sample.

  11. Family Assisted Contingency Management within the Context of Evidence-Supported Treatment for Child Neglect and Drug Abuse.

    Science.gov (United States)

    Donohue, Brad; Plant, Christopher P; Loughran, Travis A; Torres, Anali

    2017-08-01

    Contingency management (CM) has extensively been shown to be effective in reducing substance use disorders, but its effects in reducing child maltreatment have yet to be determined. The current study provides preliminary support for the utilization of an innovative family-assisted CM component in 18 mothers who were referred to an evidence-supported behavioral treatment for concurrent child neglect and drug abuse by Child Protective Service caseworkers. In the examined CM, participants were invited to indicate from a list of common actions incompatible with child neglect (i.e. positive parenting actions), the extent to which these actions had been experienced utilizing a 3-point scale (almost never, sometimes, almost always). For each item that was indicated to be almost never or sometimes experienced, the participants were queried to indicate if the neglect incompatible action should be targeted as a therapeutic goal. Contingencies were subsequently established in which the participants were rewarded by involved family members for their completion of therapeutic goals. At baseline, results indicated that there was a negative association between the number of neglect incompatible parenting actions that were infrequently experienced and child abuse potential. A hierarchical multiple regression analysis showed that the number of neglect incompatible actions targeted as therapeutic goals at baseline, but not the number of positive parenting actions experienced infrequently at baseline, predicted reduced child maltreatment potential following treatment. These findings suggest the examined CM may assist evidence supported behavioral treatment specific to child neglect and drug abuse.

  12. High-intensity focused ultrasound ablation assisted using color Doppler imaging for the treatment of hepatocellular carcinomas.

    Science.gov (United States)

    Fukuda, Hiroyuki; Numata, Kazushi; Nozaki, Akito; Kondo, Masaaki; Morimoto, Manabu; Maeda, Shin; Tanaka, Katsuaki; Ohto, Masao; Ito, Ryu; Ishibashi, Yoshiharu; Oshima, Noriyoshi; Ito, Ayao; Zhu, Hui; Wang, Zhi-Biao

    2013-12-01

    We evaluated the usefulness of color Doppler flow imaging to compensate for the inadequate resolution of the ultrasound (US) monitoring during high-intensity focused ultrasound (HIFU) for the treatment of hepatocellular carcinoma (HCC). US-guided HIFU ablation assisted using color Doppler flow imaging was performed in 11 patients with small HCC (<3 lesions, <3 cm in diameter). The HIFU system (Chongqing Haifu Tech) was used under US guidance. Color Doppler sonographic studies were performed using an HIFU 6150S US imaging unit system and a 2.7-MHz electronic convex probe. The color Doppler images were used because of the influence of multi-reflections and the emergence of hyperecho. In 1 of the 11 patients, multi-reflections were responsible for the poor visualization of the tumor. In 10 cases, the tumor was poorly visualized because of the emergence of a hyperecho. In these cases, the ability to identify the original tumor location on the monitor by referencing the color Doppler images of the portal vein and the hepatic vein was very useful. HIFU treatments were successfully performed in all 11 patients with the assistance of color Doppler imaging. Color Doppler imaging is useful for the treatment of HCC using HIFU, compensating for the occasionally poor visualization provided by B-mode conventional US imaging.

  13. [Comparative analysis of neuroendoscope-assisted microsurgery and microscope treatment for small acoustic neuroma].

    Science.gov (United States)

    Yao, Xiaohui; Ji, Hongming; Zhang, Shiyuan; Ding, Xinmin; Zhang, Gangli; Zhang, Yan

    2014-09-23

    To explore the outcomes of surgery for the treatment of small acoustic neuroma by the neuroendoscope-assisted microsurgery and microscope. From 2008 to 2013, 42 patients with small acoustic neuroma underwent neuroendoscope-assisted microsurgery (n = 20) and microscopic tumoural resection (n = 22). Neurophysiological monitoring, 30-degree rigid neuroendoscope and microscope were employed intra-operatively. For the endoscope group, facial nerve and inner acoustic meatus could be visualized distinctly in each aspect, as for the microscope group, microscopic operation could be accomplished directly. The damage extents of facial nerve and inner acoustic meatus were compared between two groups. Total removal of acoustic neuroma and conservation of facial nerve were achieved in all patients. For the neuroendoscope-assisted group, the postoperative facial functions were Grade I (n = 6), Grade II (n = 10) and Grade III (n = 4). Internal acoustic canal was drilled 2-3 mm in 4 patients and no drilling in others. For the microscope group, Grade I (n = 5), Grade II (n = 6), Grade III (n = 8) and Grade III-IV (n = 3). Internal acoustic canal was drilled at least 3 mm in 12 patients and no drilling in others. No complication such as cerebrospinal fluid leakage occurred during the follow-ups. Endosocopic operation of acoustic neuroma surgery is superior to microscopic operation in terms of magnification, illumination, wide-angel and angulation. And the former procedure may yield better outcomes through alleviating the damage of facial nerve and decreasing the drilling degree of inner acoustic meatus.

  14. High-efficiency treatment of PTA wastewater using a biogas jet assisted anaerobic fluidized bed reactor.

    Science.gov (United States)

    Zhang, Wei; Feng, Yangyang; Chen, Yingwen; Li, Peiwen; Zhu, Shemin; Shen, Shubao

    2018-01-15

    In this paper, a new type of biogas jet assisted anaerobic fluidized bed reactor loaded with a polypropylene (PP) carrier, has been proposed. There was a clear improvement in the fluidized state due to the biogas assisted input when the gas/water ratio was set at 1:3 with a suitable carrier loading of 60%. When the circulating water flow is 30 L/min assisted with biogas 10 L/min, the mixing time shortens from 26 s to 18 s. The performance of anaerobic biodegradation on wastewater treatment was improved largely. The chemical oxygen demand (COD) and terepthallic acid (TA) removal efficiencies were at 85.4% and 84% respectively at HRT of 20h, even when the influent COD concentration was as high as 4224 mg/L. In addition, plenty of microorganisms, attached to the carriers and assumed to be the reason behind the organic biodegradation efficiency of the proposed system, were observed using scanning electron microscopy (SEM).

  15. The CAMERA (Computer-Assisted Management in Early Rheumatoid Arthritis) studies.

    Science.gov (United States)

    Jacobs, Johannes W G

    2012-01-01

    The history, main issues and results of the two tight control CAMERA (Computer-Assisted Management in Early Rheumatoid Arthritis) studies are described. The first CAMERA study showed favourable and superior effects of a tight control methotrexate-based strategy, compared to that of a conventional methotrexate-based strategy. In CAMERA-II, the results were even better when adding 10 mg prednisone daily for 2 years to the methotrexate-based, tight control strategy. In all, the CAMERA studies have shown good results in the treatment of early RA patients with conventional anchor drugs, aiming for remission, making use of a feasible and simple computer decision program.

  16. Should obese women's access to assisted fertility treatment be limited? A scientific and ethical analysis.

    Science.gov (United States)

    Tremellen, Kelton; Wilkinson, Dominic; Savulescu, Julian

    2017-10-01

    Obesity is associated with a reduction in fertility treatment success and increased risks to mother and child. Therefore guidelines of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) suggest that a body mass index exceeding 35 kg/m2 should be an absolute contraindication to assisted fertility treatment such as in vitro fertilisation IVF. In this paper we challenge the ethical and scientific basis for such a ban. Livebirth rates for severely obese women are reduced by up to 30%, but this result is still far better than that observed for many older women who are allowed access to IVF. This prohibition is particularly unjust when IVF is the only treatment capable of producing a pregnancy, such as bilateral tubal blockage or severe male factor infertility. Furthermore, the absolute magnitude of risks to mother or child is relatively small, and while a woman has a right to be educated about these risks, she alone should be allowed to make a decision on proceeding with treatment. We do not prohibit adults from engaging in dangerous sports, nor do we force parents to vaccinate their children, despite the risks. Similarly, we should not prohibit obese women from becoming parents because of increased risk to themselves or their child. Finally, prohibiting obese women's access to IVF to prevent potential harms such as 'fetal programing' is questionable, especially when compared to that child never being born at all. As such, we believe the RANZCOG ban on severely obese women's access to assisted reproductive treatment is unwarranted and should be revised. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  17. Comparing the efficacy of a web-assisted calprotectin-based treatment algorithm (IBD-live) with usual practices in teenagers with inflammatory bowel disease : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Heida, Anke; Dijkstra, Alie; Groen, Henk; Muller Kobold, Alie; Verkade, Henkjan; van Rheenen, Patrick

    2015-01-01

    Background: To prevent clinical relapse in teenagers with inflammatory bowel disease (IBD) there is a need to monitor disease activity continuously. Timely optimisation of medical treatment may nip a preclinical relapse in the bud and change the natural course of IBD. Traditionally, disease

  18. Kinetic Study of Nonequilibrium Plasma-Assisted Methane Steam Reforming

    Directory of Open Access Journals (Sweden)

    Hongtao Zheng

    2014-01-01

    Full Text Available To develop a detailed reaction mechanism for plasma-assisted methane steam reforming, a comprehensive numerical and experimental study of effect laws on methane conversion and products yield is performed at different steam to methane molar ratio (S/C, residence time s, and reaction temperatures. A CHEMKIN-PRO software with sensitivity analysis module and path flux analysis module was used for simulations. A set of comparisons show that the developed reaction mechanism can accurately predict methane conversion and the trend of products yield in different operating conditions. Using the developed reaction mechanism in plasma-assisted kinetic model, the reaction path flux analysis was carried out. The result shows that CH3 recombination is the limiting reaction for CO production and O is the critical species for CO production. Adding 40 wt.% Ni/SiO2 in discharge region has significantly promoted the yield of H2, CO, or CO2 in dielectric packed bed (DPB reactor. Plasma catalytic hybrid reforming experiment verifies the reaction path flux analysis tentatively.

  19. Trends in Global Assisted Reproductive Technologies Research: a Scientometrics study.

    Science.gov (United States)

    Okhovati, Maryam; Zare, Morteza; Zare, Fatemeh; Bazrafshan, Maliheh Sadat; Bazrafshan, Azam

    2015-12-01

    This study illustrated the global contribution to assisted reproductive technologies (ARTs) research in MEDLINE database from 1998 to 2014. In March 2015, the MEDLINE database was searched for research publications indexed under 'reproductive techniques, assisted' (including the following MeSH headings: in vitro fertilization [IVF]; intracytoplasmic sperm injections; cryopreservation; and ovulation induction), with the following expressions in the fields of title or abstract: intrauterine insemination; sperm donation; embryo/egg donation and surrogate mothers. The number of publications in MEDLINE database was recorded for each individual year, 1998-2014, and for each country. The following countries were arbitrarily selected for data retrieval: United States, United Kingdom, France, Germany, Canada, Italy, Japan (G7 countries), Brazil, Russia, India, China (BRIC countries), Egypt, Turkey, Israel and Iran. The absolute number of publications for each country from 1998 to 2014 ranged from 75 to 16453, with a median of 2024. The top five countries were the US (16453 publications), the UK (5427 publications), Japan (4805), China (4660) and France (3795). ART (20277), cryopreservation (11623) and IVF (11209) were the most researched areas. Global research on ARTs were geographically distributed and highly concentrated among the world's richest countries. Cryopreservation and IVF were the most productive research domains among ARTs.

  20. Temperature evolution on human teeth root surface after diode laser assisted endodontic treatment.

    Science.gov (United States)

    Gutknecht, Norbert; Franzen, Rene; Meister, Jörg; Vanweersch, Leon; Mir, Maziar

    2005-09-01

    The thermal rise threshold of an 810-nm semi-conductor diode laser on the root surface when used in root canals in vitro for laser assisted root canal treatment is investigated in this study. A total of 50 human single-rooted extracted teeth were included. For this study, the canals were enlarged up to an apical size of ISO#50 file. Laser irradiation was performed with six different settings. Specimens were irradiated at 0.6-1 W output power at the distal end of the fiber and about 1-1.5 W output power in the continuous mode (CW) as two groups. In the third group, 0.6-1 W output power, 10 ms pulse length (PL) and 10 ms interval duration (ID) were selected. In three other groups 1-1.5 W output power were used with different PL and ID as following: PL 10 and ID 10 ms, PL 10 and ID 20 ms and PL 20 and ID 20 ms. The total irradiation time was from 5 to 20 s per canal with a 200 mum in diameter and 25 mm long tip. After laser treatment, the temperature changes at the outer root surface were registered by means of NiCr-Ni measuring sensors and a T 202 thermometer. The safe temperature threshold for applying this diode laser in root canal is considered as 7 degrees C increase. To avoid increasing the temperature changes at the outer root surface related to this threshold, following total irradiation times were found: 0.6-1 W output power (10 ms PL/10 ms ID): 20 s (s), 1-1.5 W output power (10 ms/10 ms and 20 ms/20 ms): 15 s, 0.6-1 W output power CW and 1-1.5 W output power (20 ms PL/10 ms ID): 10 s and 1-1.5 W output power CW: 5 s. In the first three groups, 5 s irradiation and 5 s rest period avoided a temperature increase above the threshold of 7 degrees C).

  1. Application of 3D printing rapid prototyping-assisted percutaneous fixation in the treatment of intertrochanteric fracture.

    Science.gov (United States)

    Zheng, Sheng-Nai; Yao, Qing-Qiang; Mao, Feng-Yong; Zheng, Peng-Fei; Tian, Shu-Chang; Li, Jia-Yi; Yu, Yi-Fan; Liu, Shuai; Zhou, Jin; Hu, Jun; Xu, Yan; Tang, Kai; Lou, Yue; Wang, Li-Ming

    2017-10-01

    The aim of the present study was to investigate the application of 3D printing (3DP) rapid prototyping (RP) technique-assisted percutaneous fixation in the treatment of femoral intertrochanteric fracture (ITF) using proximal femoral nail anti-rotation (PFNA). A total of 39 patients with unstable ITF were included in the current study. Patients were divided into two groups: 19 patients were examined using computed tomography scanning and underwent PFNA with SDP-RP whereas the other 20 patients underwent conventional PFNA treatment. Anatomical data were converted from the Digital Imaging and Communications in Medicine format to the stereolithography format using M3D software. The 3DP-RP model was established using the fused deposition modeling technique and the length and diameter of the main screw blade was measured during the simulation. The postoperative femoral neck-shaft angle (NSA), surgery duration, intraoperative and postoperative blood loss, and the duration of hospital stay were recorded and compared with the corresponding values in conventional surgery. No significant differences were observed in mean PFNA size between the implants used and the preoperative planning estimates. It was demonstrated that the 3DP-RP assisted procedure resulted in more effective reduction of the NSA. Furthermore, patients undergoing 3DP-RP experienced a significant reduction in duration of surgery (P<0.01), as well as reductions in intraoperative (P=0.02) and postoperative (P=0.03) blood loss, compared with conventional surgery. At 6 months post-surgery, no cases of hip varus/vague deformities or implant failure were observed in patients that underwent either the 3DP-RP-assisted or conventional procedure. The results of the present study suggest that the 3DP-RP technique is able to create an accurate model of the ITF, which facilitates surgical planning and fracture reduction, thus improving the efficiency of PFNA surgery for ITFs.

  2. Learning Assistant Supported Student Outcomes (LASSO) study initial findings

    CERN Document Server

    Van Dusen, Ben; Otero, Valerie

    2015-01-01

    This study investigates how faculty, student, and course features are linked to student outcomes in Learning Assistant (LA) supported courses. Over 4,500 students and 17 instructors from 13 LA Alliance member institutions participated in the study. Each participating student completed an online concept inventory at the start (pre) and end (post) of their term. The physics concept inventories included Force and Motion Concept Evaluation (FMCE) and the Brief Electricity and Magnetism Assessment (BEMA). Concepts inventories from the fields of biology and chemistry were also included. Our analyses utilize hierarchical linear models that nest student level data (e.g. pre/post scores and gender) within course level data (e.g. discipline and course enrollment) to build models that examine student outcomes across institutions and disciplines. We report findings on the connections between students' outcomes and their gender, race, and time spent working with LAs as well as instructors' experiences with LAs.

  3. Adaptive Workflows for Diabetes Management: Self-Management Assistant and Remote Treatment for Diabetes.

    Science.gov (United States)

    Contreras, Iván; Kiefer, Stephan; Vehi, Josep

    2017-01-01

    Diabetes self-management is a crucial element for all people with diabetes and those at risk for developing the disease. Diabetic patients should be empowered to increase their self-management skills in order to prevent or delay the complications of diabetes. This work presents the proposal and first development stages of a smartphone application focused on the empowerment of the patients with diabetes. The concept of this interventional tool is based on the personalization of the user experience from an adaptive and dynamic perspective. The segmentation of the population and the dynamical treatment of user profiles among the different experience levels is the main challenge of the implementation. The self-management assistant and remote treatment for diabetes aims to develop a platform to integrate a series of innovative models and tools rigorously tested and supported by the research literature in diabetes together the use of a proved engine to manage workflows for healthcare.

  4. Comparison of Laparoscopic-Assisted Operations and Laparotomy Operations for the Treatment of Hirschsprung Disease

    Science.gov (United States)

    Zhang, Shisong; Li, Juan; Wu, Yurui; Hu, Yuanjun; Duan, Chunhong; Wang, Meiyun; Gai, Zhongtao

    2015-01-01

    Abstract The purpose of this meta-analysis is to compare the relative merits among laparoscopic-assisted operations and laparotomy operations for patients with Hirschsprung disease. PubMed, Web of Science, and Wanfang databases were searched for the related articles. We analyzed dichotomous variables by estimating odds ratios (ORs) with their 95% confidence intervals (CIs) and continuous variables using the weighted mean difference (WMD) with the 95% CI. The random-effects model (REM) was used to combine the results. The outcome measures included operating time (OT), estimated blood loss (EBL), length of hospital stay (LOHS), mean first bowel movement (MFBM), and number of complications. Sixteen articles were included in the meta-analysis. These studies involved a total of 774 patients, 396 of whom underwent laparoscopic-assisted operations and 378 of whom underwent laparotomy operations. The EBL (WMD = −1.48, 95% CI = −1.82, −1.13), LOHS (WMD = −0.67, 95% CI = −0.86, −0.49), MFBM (WMD = −0.83, 95% CI = −1.05, −0.61), and number of complications (OR = 0.60, 95% CI = 0.40, 0.89) were significantly lower in laparoscopic-assisted operations than in laparotomy operations. The OT (WMD = 0.12, 95% CI = −0.05, 0.28) showed no significant differences between laparoscopic-assisted operations and laparotomy operations. Compared with laparotomy operations, laparoscopic-assisted operations are generally safer and more reliable for patients with Hirschsprung disease. PMID:26426651

  5. Application of computer assisted three-dimensional simulation operation and biomechanics analysis in the treatment of sagittal craniosynostosis.

    Science.gov (United States)

    Li, Xiang; Zhu, Wanchun; He, Jintao; Di, Fei; Wang, Lei; Li, Xin; Liu, Wei; Li, Chunde; Gong, Jian

    2017-10-01

    As a surgical method to treat children with sagittal craniosynostosis, calvarial vault reconstruction is subjected to some limitations. In traditional surgical method to treat children with sagittal craniosynostosis, surgical resection and fixation are performed all by the experience of surgical doctor, which is likely to cause individual differences, insecure fixation, configurational asymmetry, and waste of unnecessary fixtures materials. This study aims to provide surgical doctor with objective indicators via 3D simulation combined with biomechanical calculation, so as to improve the surgical efficiency. The aim of this study is to compare preoperative strategy integrating computer-assisted 3D simulation and biomechanical calculation and traditional strategy. A retrospective method was used to compare the effect and difference between these 2 strategies. The clinical data of 18 patients with sagittal synostosis were collected and compared. Among them, 10 patients were enrolled in Group A applied with traditional treatment method, while 8 were enrolled in Group B applied with preoperative strategy integrating computer-assisted 3D simulation and biomechanical calculation. The aim of this study is to evaluate two treatment methods by investigating indexes between two groups, such as length of operation, blood loss, operation cost, and postoperative complications. Through comparing the cranial index, head circumference, and cranial vault asymmetry index of two groups before and after treatment, the surgical effects of two groups can be evaluated. Moreover, biomechanical analyses for two groups were conducted. Regarding group B, the length of operation was (217±29.3min), blood loss was (70±11.7ml), operation cost was (34,495±8662¥); while for group A, the length of operation was (276±23.5min), blood loss was (90±15.5ml), operation cost was (25,149±4133¥). No postoperative complication was observed for group B, while there was 1 case of central nervous system

  6. [The treatment of otosclerosis using laser assisted stapedotomy with mini incision in external auditory meatus].

    Science.gov (United States)

    Hao, Xinping; Chen, Shubin; Yu, Zilong; Liang, Fenghe; Li, Yongxin

    2016-03-01

    To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.

  7. Computer Assisted Language Learning. Routledge Studies in Computer Assisted Language Learning

    Science.gov (United States)

    Pennington, Martha

    2011-01-01

    Computer-assisted language learning (CALL) is an approach to language teaching and learning in which computer technology is used as an aid to the presentation, reinforcement and assessment of material to be learned, usually including a substantial interactive element. This books provides an up-to date and comprehensive overview of…

  8. Retroperitoneoscopic Anatomical Necrosectomy: A Modified Single-Stage Video-Assisted Retroperitoneal Approach for Treatment of Infected Necrotizing Pancreatitis.

    Science.gov (United States)

    Zhao, Guodong; Hu, Minggen; Liu, Rong; Xu, Yong

    2015-08-01

    Video-assisted retroperitoneal necrosectomy is a minimally invasive surgical technique for the treatment of severe acute pancreatitis. This study evaluated the safety and feasibility of a modified single-stage video-assisted retroperitoneal necrosectomy, retroperitoneoscopic anatomical necrosectomy (REAN). Between September 2010 and May 2012, a total of 17 patients with infected necrotizing pancreatitis underwent REAN. The surgical procedures were similar to retroperitoneoscopic pancreatectomy, in which 3 trocars are utilized. Briefly, the perirenal space was entered through the posterior pararenal space. Dissection proceeded from posterior to anterior direction to expose the dorsal side of the perirenal fascia. This was opened to reach the anterior perirenal space, where the peripancreatic abscess was located. Necrotic tissue was then debrided and catheter drainage was performed in a single stage. Operating time ranged from 45 to 100 minutes with minimal blood loss. All patients recovered except for one who died. Major perisurgical complications included peritoneal injury (1 patient), splenic vein injury (1 patient), retroperitoneal infection with paralytic ileus (1 patient), hydrothorax and atelectasis (2 patients), and subcutaneous cellulitis beneath the incision (3 patients). Two patients required additional percutaneous catheter drainage, and 1 patient required a laparotomy to debride the remaining necrotic tissue. Postoperative hospital stay ranged from 21 to 64 days. This study demonstrates that REAN, a modified single-stage video-assisted retroperitoneal approach, was safe and feasible for the treatment of infected necrotizing pancreatitis. The advantages of this procedure include direct access with shorter operating time, complete necrotic tissue debridement, easy hemostasis, simple manipulation, and easy drainage. © The Author(s) 2014.

  9. Robot-assisted arm training in patients with Parkinson's disease: a pilot study.

    Science.gov (United States)

    Picelli, Alessandro; Tamburin, Stefano; Passuello, Michele; Waldner, Andreas; Smania, Nicola

    2014-03-05

    Despite the growing diffusion of robotic devices in neurorehabilitation, no previous study investigated the effects of robotic training on arm impairment due to Parkinson's disease. The aim of this pilot study was to evaluate whether robot-assisted arm training might improve upper limb function in patients with Parkinson's disease. Ten patients with Parkinson's disease (Hoehn and Yahr stage 2.5-3) received ten, 45-minute, treatment sessions, five days a week, for two consecutive weeks. Robot-assisted arm training was performed with the Bi-Manu-Track (Reha-Stim, Berlin, Germany) that provides a computer-controlled, repetitive, bilateral, mirror-like practice of forearm pronation/supination and wrist extension/flexion. Patients were trained according to the following modalities: passive-passive (both arms moved by the machine) and active-active (both arms actively moving against resistance). The dominant upper limb was evaluated before and immediately after treatment as well as at two weeks of follow-up. Outcomes were the nine-hole peg test, the Fugl-Meyer assessment (upper limb section) and the Unified Parkinson's Disease Rating Scale. After treatment, a significant improvement was found in the nine-hole peg test (P = 0.007) as well as in the upper limb section of the Fugl-Meyer assessment (P = 0.012). Findings were confirmed at the 2-week follow-up evaluation only for the nine-hole peg test (P = 0.007). No significant improvement was found in the Unified Parkinson's Disease Rating Scale at both post-treatment and follow-up evaluations. Our findings support the hypothesis that robot-assisted arm training might be a promising tool in order to improve upper limb function in patients with Parkinson's disease.

  10. 18F-FDG PET/CT-based early treatment response evaluation of nanoparticle-assisted photothermal cancer therapy

    DEFF Research Database (Denmark)

    Norregaard, Kamilla; Jørgensen, Jesper T.; Simón, Marina

    2017-01-01

    Within the field of nanoparticle-assisted photothermal cancer therapy, focus has mostly been on developing novel heat-generating nanoparticles with the right optical and dimensional properties. Comparison and evaluation of their performance in tumor-bearing animals are commonly assessed by changes......-[F-18]fluoro-D-glucose is found already one day after therapy in the group receiving NS and laser treatment compared to control animals. At this time point no change in tumor volume can be detected. Moreover, the change in tumor uptake, is used to stratify the animals into responders and non...... in tumor volume; however, this is usually a late-occurring event. This study implements 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography imaging to perform early evaluation of the treatment outcome of photothermal therapy. Silica-gold nanoshells (NS) are administered intravenously to nude mice...

  11. Treatment of petroleum refinery wastewater by distillation-assisted catalytic oxidation under low temperature and low pressure.

    Science.gov (United States)

    Gao, Xiaoming; Li, Wenhong; Fu, Feng; Li, Dong; Cao, Zhenheng; Wang, Jiwu

    2011-01-01

    A distillation-assisted catalytic oxidation (DACO) process under low temperature (100 degrees C) and atmospheric pressure was investigated to treat heavily contaminated wastewater from oil refining industry. The DACO experiments were carried out in a distillation batch reactor, using CuO/gamma-A1(2)O3 as catalyst. The experimental temperature was kept at 100 degrees C and H2O2 oxidant was supplied into the reactive system with 200 mL/L. The results demonstrated that more than 92.2% of chemical oxygen demand removal was obtained and the absorbance of the refinery wastewater after treatment was zero, indicating significant decolorization efficiency for the solution. The research of life and stability showed that the catalyst had a good stability. The present study indicates that this DACO approach may have a significant application potential for industrial wastewater treatment.

  12. Robot-assisted endoscopic intrauterine myelomeningocele repair: a feasibility study.

    Science.gov (United States)

    Aaronson, Oran S; Tulipan, Noel B; Cywes, Robert; Sundell, Håkan W; Davis, Georges H; Bruner, Joseph P; Richards, William O

    2002-02-01

    Animal experiments have suggested that the intrauterine environment causes secondary injury to the congenitally dysplastic spinal cord. This in turn suggests that early closure of the myelomeningocele sac might prevent secondary injury and therefore improve neurologic outcome. This study was designed to examine the technical feasibility of performing intrauterine myelomeningocele repair using a robot-assisted endoscopic system in an animal model. Six fetal sheep underwent creation and repair of a full-thickness skin lesion using the da Vinci system. With the device's advanced articulated instruments and three-dimensional optics, it was possible to endoscopically repair the induced skin defects. We conclude that, with the recent evolution in robotics and minimally invasive techniques, intrauterine endoscopic surgery has become a realistic goal that promises to reduce the associated risks of fetal surgery and extend the indications for its use. Copyright 2002 S. Karger AG, Basel

  13. Development of a Quality Improvement Curriculum in Physician Assistant Studies.

    Science.gov (United States)

    Kindratt, Tiffany B; Orcutt, Venetia L

    2017-06-01

    The purpose of this project was to develop and evaluate a curriculum for physician assistant (PA) students addressing knowledge, skills, and attitudes (KSA) toward quality improvement (QI). Students (N = 77) completed a pretest rating their KSA. A curriculum was developed to improve KSA among didactic and clinical students. Two department-wide QI projects were developed for student participation. Students completed a posttest after completing curriculum components and changes in KSA had been measured. Postcurriculum implementation, QI knowledge, and skills increased significantly in most areas. Large improvements were seen in knowledge of Plan, Do, Study, Act models and life cycles of QI projects (p curriculum model (1) was effective at improving students' QI knowledge and skills; (2) allowed students to participate in community-based QI projects; and (3) can be used by other PA programs looking to enhance their QI curriculum.

  14. Burnout in Rural Physician Assistants: An Initial Study.

    Science.gov (United States)

    Benson, Marc A; Peterson, Teri; Salazar, Lisa; Morris, Wesley; Hall, Rebecca; Howlett, Bernadette; Phelps, Paula

    2016-06-01

    To assess the prevalence and causes of burnout in rural physician assistants. (PA in this article refers to personal accomplishment. To avoid confusion, we will spell out physician assistant throughout the article, instead of using PA to refer to both physician assistant and personal accomplishment.) Physician assistants who practice in rural communities were asked to complete the Maslach Burnout Inventory. A preliminary assessment of burnout was determined using the 3 Maslach Burnout Inventory subscale scores: emotional exhaustion, depersonalization, and personal accomplishment, as well as causes of burnout assessed for a correlation to personal and professional factors. Burnout within the rural physician assistant population responding to this survey (response rate = 11.3%) was measured to have high to moderate emotional exhaustion and depersonalization subscores (64% each) and a low to moderate personal accomplishment subscore (46%). The rural physician assistant population who responded to this survey exhibited burnout correlating to feelings of professional isolation and various workplace conditions such as the adequacy of administrative support and control over workload. To begin addressing burnout within this community, we suggest adjusting rural physician assistant workload and support, enhancing professional communications, and addressing burnout prevention techniques within physician assistant training programs.

  15. Bioethical dilemmas of assisted reproduction in the opinions of Polish women in infertility treatment: a research report.

    Science.gov (United States)

    Dembinska, Aleksandra

    2012-12-01

    Infertility Accepted treatment is replete with bioethical dilemmas regarding the limits of available medical therapies. Poland has no legal acts regulating the ethical problems associated with infertility treatment and work on such legislation has been in progress for a long time, arousing very intense emotions in Polish society. The purpose of the present study was to find out what Polish women undergoing infertility treatment think about the most disputable and controversial bioethical problems of assisted reproduction. An Attitudes towards Bioethical Problems of Infertility Scale was constructed specifically for this study. Items were taken from the Bioethics Bills currently under discussion in Polish Parliament (Seym). 312 women were enrolled in the study. Women experiencing infertility favoured more liberal legislation. Participants disagreed, for example, with the following regulations: prohibition of embryo freezing, prohibition of preimplantation genetic diagnosis of embryos, age limits for women using in vitro fertilisation and prohibition of in vitro fertilisation for single women. The opinions of patients undergoing infertility treatment are an important voice in the Polish debate on the Bioethics Bills.

  16. Application of a Computer-Assisted Navigation System (CANS) in the Delayed Treatment of Zygomatic Fractures: A Randomized Controlled Trial.

    Science.gov (United States)

    Gong, Xi; He, Yang; An, Jingang; Yang, Yao; Huang, Xiuling; Liu, Meng; Zhao, Yangyang; Zhang, Yi

    2017-07-01

    The delayed treatment of zygomatic complex (ZMC) fracture presents a difficult challenge to surgeons. The aim of this study was to compare the treatment effects of delayed surgery of ZMC fractures with and without a computer-assisted navigation system (CANS). In this observer-blinded single-site randomized clinical trial, patients with unilateral ZMC fracture were included and randomized 1:1 to delayed treatment with or without CANS. The primary outcome measurement was the absolute bilateral differences of the ZMC eminence and width based on computed tomographic (CT) measurements 48 to 72 hours after surgery. One hundred three patients with unilateral ZMC fracture without immediate treatment were enrolled, and 78 were randomized to each group. Postoperative CT measurements showed that the bilateral difference in ZMC eminence was significantly less for the navigation group than for the control group (1.24 vs 2.22 mm; P CANS improved ZMC symmetry in patients with unilateral ZMC fracture who had delayed treatment by allowing for more accurate implementation of the preoperative plan. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Therapeutic efficacy of vacuum-assisted-closure therapy in the treatment of lymphatic complications following peripheral vascular interventions and surgeries.

    Science.gov (United States)

    Aydin, Ufuk; Gorur, Alper; Findik, Orhan; Yildirim, Abdullah; Kocogullari, Cevdet Ugur

    2015-02-01

    Lymphatic complications, lymphocele and lymphorrhea being the leading, are generally encountered after vascular interventions and surgeries. The present study aimed to evaluate the outcomes of vacuum-assisted-closure (VAC) therapy, which we frequently prefer as the first-choice treatment for such complications. Among patients undergoing peripheral vascular intervention or surgery between January 2008 and February 2012, the medical files of 21 patients who received VAC therapy or other treatment due to symptomatic lymphatic complications were retrospectively analyzed and the results were discussed. Group I consisted of 10 patients (three with lymphocele and seven with lymphorrhea) who underwent VAC therapy as the first-choice treatment, Group II consisted of 11 patients of which 7 patients received various therapies before VAC therapy and 4 patients received other treatments alone. The patients who received VAC therapy as the primary therapy demonstrated more rapid wound healing, early drainage control, and shorter hospital stay. The mean hospital medical cost was €1038 (range, €739-1826) for the patients who primarily underwent VAC therapy; it was calculated to be €2137 (range, €1610-3130) for the other patients (p=0.001). In addition to its safety and good clinical outcomes, VAC therapy also has economic advantages and should be the primary method for the treatment of lymphatic complications. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Clinical outcomes of endoscope-assisted vitrectomy for treatment of rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Yokoyama S

    2017-11-01

    cases (3.1% of using PFCL to suppress movement of the detached retina, but there were no cases of creation of a posterior drainage retinotomy or using PFCL for subretinal fluid drainage. There was 1 case of presumed endophthalmitis after surgery. There were 12 hypotonous cases at postoperative day 1 and one of them needed additional scleral sutures at postoperative day 4 for prolonged hypotony.Conclusion: The present study demonstrated the efficacy of endoscope-assisted vitrectomy for patients with uncomplicated RRD. To perform endoscope-assisted vitrectomy safely, sufficient closure of sclerotomies is necessary at the end of surgery. Keywords: endoscope-assisted vitrectomy, endoscopic vitrectomy, ophthalmic endoscope, retinal detachment, rhegmatogenous retinal detachment

  19. Robotic system-assisted endovascular treatment of a dissection-related pseudoaneurysm of the celiac axis secondary to fibromuscular dysplasia

    Directory of Open Access Journals (Sweden)

    Wonho Kim, MD

    2016-09-01

    Full Text Available Spontaneous celiac artery dissection caused by fibromuscular dysplasia is rare. Subsequent thrombosis and occlusion of the celiac trunk can result in intestinal ischemia and hepatic failure. We describe a case of spontaneous celiac artery dissection with an associated pseudoaneurysm caused by fibromuscular dysplasia, extending into the common hepatic artery. An endovascular intervention featuring robotic-assisted celiac artery cannulation with stent-assisted coil embolization resulted in successful treatment.

  20. Robot-assisted rectopexy is a safe and feasible option for treatment of rectal prolapse.

    Science.gov (United States)

    Haahr, Camilla; Jakobsen, Henrik Loft; Gögenur, Ismail

    2014-05-01

    Rectal prolapse is seen in up to one in 100 elderly women and results in symptoms such as incontinence, mucus secretion and constipation. The aim of this study was to present short- and longterm outcomes after robot-assisted rectopexy in patients with rectal prolapse. All patients diagnosed with rectal prolapse at our institution underwent robot-assisted rectopexy. Data regarding the surgical procedure and post-operative morbidity were collected retrospectively. Patients were contacted to register long-term results regarding recurrence, incontinence and satisfaction. A total of 24 consecutive patients underwent robot-assisted rectopexy from October 2010 to July 2012. Data regarding their long-term outcome was available for 18 patients at follow-up (average ten months). 50% of the patients suffered from faecal incontinence before surgery (n = 9/18, 50%). The mean age at surgery was 72 years (28-93 years). The mean duration of surgery was 123 min. (70-245 min.). The median length of stay in hospital was 4.1 days (0-15 days). There was one procedure-related complication (small-bowel obstruction) resulting in reoperation. At the time of follow-up, two patients (11%) had a subjective recurrence of rectal prolapse, and three patients (17%) had faecal incontinence. 89% were satisfied with the operation, and 94% would recommend this operation to other patients with the same condition. Robot-assisted rectopexy is a safe procedure for patients with rectal prolapse and is associated with acceptable functional outcomes and recurrence rates. There is no evidence in the literature of advantages compared with the corresponding laparoscopic procedure. not relevant. not relevant.

  1. Comparative study on a single treatment response to long pulse Nd:YAG lasers and intense pulse light therapy for hair removal on skin type IV to VI--is longer wavelengths lasers preferred over shorter wavelengths lights for assisted hair removal.

    Science.gov (United States)

    Goh, C L

    2003-12-01

    To investigate the safety and effectiveness of a long pulsed Nd:YAG (1064nm) laser compared to a shorter wavelength intense pulse light system for assisted hair removal in volunteers with skin type 1V, V and VI. Eleven patients of Fitzpatrick skin type IV-VI were recruited into the study. The area treated included the face (upper lips, chin and jaw area), axillae and legs. One half of the body was treated with the long pulse Nd:YAG laser and the other half was treated with the IPL system randomly under topical anesthesia. Degree of pain experienced during treatment, the treatment outcome and any complications were observed. Patients were reviewed at 2 weeks and 6 weeks post-treatment. Volunteers generally described pain from the IPL system as "prolonged burning sensation" but tolerable. Pain from Nd:YAG laser treatment was described as "pinprick" and more intense but tolerable. "Slowing of hair growth"was reported with IPL and Nd:YAG, but with a greater effect from Nd:YAG. Sixty-four percent and 73%(8/11) noticed hair reduction IPL and Nd:YAG treated side respectively (ns). Post-inflammatory pigmentation occurred in some volunteers on the IPL treated sides whereas this was not seen on any Nd:YAG treated side, and three of these patients experienced blistering, followed by post-inflammatory pigmentation. In our experience the long pulse width 1064 nm Nd:YAG laser, which can penetrate 5-7 mm into the dermis depths to reach the whole length of the hair follicle, would be expected to produce sufficient follicular injury with less epidermal damage in patients with darker skin type compared to shorter wavelength laser and light system.

  2. [Rehabilitation standards for follow-up treatment and rehabilitation of patients with ventricular assist device (VAD)].

    Science.gov (United States)

    Willemsen, Detlev; Cordes, C; Bjarnason-Wehrens, B; Knoglinger, E; Langheim, E; Marx, R; Reiss, N; Schmidt, T; Workowski, A; Bartsch, P; Baumbach, C; Bongarth, C; Phillips, H; Radke, R; Riedel, M; Schmidt, S; Skobel, E; Toussaint, C; Glatz, J

    2016-03-01

    The increasing use of ventricular assist devices (VADs) in terminal heart failure patients provides new challenges to cardiac rehabilitation physicians. Structured cardiac rehabilitation strategies are still poorly implemented for this special patient group. Clear guidance and more evidence for optimal modalities are needed. Thereby, attention has to be paid to specific aspects, such as psychological and social support and education (e.g., device management, INR self-management, drive-line care, and medication).In Germany, the post-implant treatment and rehabilitation of VAD Patients working group was founded in 2012. This working group has developed clear recommendations for the rehabilitation of VAD patients according to the available literature. All facets of VAD patients' rehabilitation are covered. The present paper is unique in Europe and represents a milestone to overcome the heterogeneity of VAD patient rehabilitation.

  3. Achilles tendon rupture: physiotherapy and endoscopy-assisted surgical treatment of a common sports injury.

    Science.gov (United States)

    Doral, Mahmut Nedim; Bozkurt, Murat; Turhan, Egemen; Dönmez, Gürhan; Demirel, Murat; Kaya, Defne; Ateşok, Kıvanç; Atay, Ozgür Ahmet; Maffulli, Nicola

    2010-12-13

    Although the Achilles tendon (AT) is the strongest tendon in the human body, rupture of this tendon is one of the most common sports injuries in the athletic population. Despite numerous nonoperative and operative methods that have been described, there is no universal agreement about the optimal management strategy of acute total AT ruptures. The management of AT ruptures should aim to minimize the morbidity of the injury, optimize rapid return to full function, and prevent complications. Since endoscopy-assisted percutaneous AT repair allows direct visualization of the synovia and protects the paratenon that is important in biological healing of the AT, this technique becomes a reasonable treatment option in AT ruptures. Furthermore, Achilles tendoscopy technique may decrease the complications about the sural nerve. Also, early functional postoperative physiotherapy following surgery may improve the surgical outcomes.

  4. Laser-assisted gingivectomy in pediatric patients: A novel alternative treatment

    Directory of Open Access Journals (Sweden)

    G Gontiya

    2011-01-01

    Full Text Available Gingival enlargement is quite a common pathology in pediatric patients and may be inflammatory, noninflammatory, or a combination of both. Idiopathic gingival fibromatosis, although rare, is a slowly progressive benign enlargement that affects the marginal gingiva, attached gingival, and interdental papilla. The fibromatosis may potentially cover the exposed tooth surfaces, causing esthetic and functional problems. The treatment of gingival fibromatosis is essential because it causes difficulties with mastication, speech problems, mispositioning of teeth, esthetic effects, and psychological difficulties for the patient. Traditional gingivectomy procedures have been a challenge for dentists who confront issues of patient cooperation and discomfort. In the last decade, laser procedures in oral cavity had shown many optimum effects in both hard and soft tissue procedures. Laser soft-tissue surgery has been shown to be well accepted by children. The following case report describes a laser-assisted gingivectomy procedure performed on a 13-year-old female.

  5. Laser gas assisted treatment of steel 309: Corrosion and scratch resistance of treated surface

    Science.gov (United States)

    Toor, Ihsan-ul-Haq; Yilbas, B. S.; Ahmed, Junaid; Karatas, C.

    2017-10-01

    Laser gas assisted surface treatment of steel 309 is carried out and the characteristics of the resulting surface are analyzed using the analytical tools. Scanning electron and 3-D optical microscopes are used to assess the morphological and metallurgical changes in the laser treated layer. Energy spectroscopy and X-ray diffraction are carried out to determine the elemental composition and compounds formed on the laser treated surface. The friction coefficient of the laser treated surface is measured using the micro-tribometer and compared to that of the as received surface. The corrosion resistance of the laser treated and as received surfaces is measured incorporating the electrochemical tests. It is found that laser treatment results in a dense layer and formation of nitride compounds at the surface. This enhances the microhardness at the laser treated surface. The friction coefficient attains lower values at the laser treated surface than that corresponding to the as received surface. The corrosion rate of the surface reduces significantly after the laser treatment process, which can be attributed to the passive layer at the surface via formation of a dense layer and nitride compounds in the surface vicinity. In addition, the number of pit sites decreased for the laser treated surface than that of as received surface.

  6. Mobile-Assisted Vocabulary Learning: A Review Study

    National Research Council Canada - National Science Library

    Parichehr Afzali; Somayeh Shabani; Zohreh Basir; Mohammad Ramazani

    2017-01-01

    Mobile phones are becoming more acceptable toolkits to learn languages. One aspect of English language which has been subject to investigation in mobile assisted language learning (MALL) is vocabulary...

  7. Ethics and Computer-Assisted Assessment: Three Case Studies.

    Science.gov (United States)

    Jacob, Susan; Brantley, John C.

    1989-01-01

    Three ethical-legal case incidents involving computer-assisted psychodiagnostic assessment in the schools are presented. Each case is analyzed in terms of applicable laws, ethical codes, and standards for professional practice. (Author)

  8. Center for Advanced Energy Studies: Computer Assisted Virtual Environment (CAVE)

    Data.gov (United States)

    Federal Laboratory Consortium — The laboratory contains a four-walled 3D computer assisted virtual environment - or CAVE TM — that allows scientists and engineers to literally walk into their data...

  9. Usability testing of a developed assistive robotic system with virtual assistance for individuals with cerebral palsy: a case study.

    Science.gov (United States)

    Jafari, Nooshin; Adams, Kim; Tavakoli, Mahdi; Wiebe, Sandra; Janz, Heidi

    2017-07-04

    This paper presents a novel application of an assistive robotic system with virtual assistance to enhance manual performance of individuals with cerebral palsy. Cerebral palsy affects one's voluntary motor movements resulting in limited opportunities to actively engage in physical manipulative activities that require fine motor movements and coordination. Lack of object manipulation and environmental exploration can result in further impairments such as cognitive and social delays. The proposed assistive robotic system has been developed to enhance hand movements of people with disabilities when performing a functional task colouring. This paper presents the usability testing of the effectiveness of the developed system with an individual with cerebral palsy in a set of colouring tasks. Assisted and unassisted approaches were compared and analysed through quantitative and qualitative measures. The robotic-based approach was further compared with the participant's typical alternate access method to perform the same proposed tasks. The robotic system with virtual assistance was clinically validated to be significantly more effective, compared to both unassisted and typical approaches, by increasing the hand controllability, reducing the physical load and increasing the easiness of maintaining movements within the lines. Future studies will inform the use of the system for children with disabilities to provide them with assisted play for functional and playful activities. Implications for rehabilitation Robotic system can enhance manual performance in individuals with disabilities. Participating in a robot-mediated play activity could increase children's motivation and engagement. The developed robotic system can contribute to a basis for clinical and home-based implementation of the technology to promote manual play activities for children with disabilities.

  10. Quantum Mechanical Studies of Charge Assisted Hydrogen and Halogen Bonds

    OpenAIRE

    Nepal, Binod

    2016-01-01

    This dissertation is mainly focused on charge assisted noncovalent interactions specially hydrogen and halogen bonds. Generally, noncovalent interactions are only weak forces of interaction but an introduction of suitable charge on binding units increases the strength of the noncovalent bonds by a several orders of magnitude. These charge assisted noncovalent interactions have wide ranges of applications from crystal engineering to drug design. Not only that, nature accomplishes a number of i...

  11. Improving Public Health Through Access to and Utilization of Medication Assisted Treatment

    Directory of Open Access Journals (Sweden)

    Thomas F. Kresina

    2011-10-01

    Full Text Available Providing access to and utilization of medication assisted treatment (MAT for the treatment of opioid abuse and dependence provides an important opportunity to improve public health. Access to health services comprising MAT in the community is fundamental to achieve broad service coverage. The type and placement of the health services comprising MAT and integration with primary medical care including human immunodeficiency virus (HIV prevention, care and treatment services are optimal for addressing both substance abuse and co-occurring infectious diseases. As an HIV prevention intervention, integrated (same medical record for HIV services and MAT services MAT with HIV prevention, care and treatment programs provides the best “one stop shopping” approach for health service utilization. Alternatively, MAT, medical and HIV services can be separately managed but co-located to allow convenient utilization of primary care, MAT and HIV services. A third approach is coordinated care and treatment, where primary care, MAT and HIV services are provided at distinct locations and case managers, peer facilitators, or others promote direct service utilization at the various locations. Developing a continuum of care for patients with opioid dependence throughout the stages MAT enhances the public health and Recovery from opioid dependence. As a stigmatized and medical disenfranchised population with multiple medical, psychological and social needs, people who inject drugs and are opioid dependent have difficulty accessing services and navigating medical systems of coordinated care. MAT programs that offer comprehensive services and medical care options can best contribute to improving the health of these individuals thereby enhancing the health of the community.

  12. FES-Assisted Walking with Spring Brake Orthosis: Simulation Studies

    Directory of Open Access Journals (Sweden)

    R. Jailani

    2011-01-01

    Full Text Available This paper presents a simulation of bipedal locomotion to generate stimulation pulses for activating muscles for paraplegic walking with wheel walker using functional electrical stimulation (FES with spring brake orthosis (SBO. A new methodology for paraplegic gait, based on exploiting natural dynamics of human gait, is introduced. The work is a first effort towards restoring natural like swing phase in paraplegic gait through a new hybrid orthosis, referred to as spring brake orthosis (SBO. This mechanism simplifies the control task and results in smooth motion and more-natural like trajectory produced by the flexion reflex for gait in spinal cord injured subjects. SBO can eliminate reliance on the withdrawal reflex and foot-ground clearance without extra upper body effort. The stored energy in the spring of SBO is used to replace stimulation pulses in knee flexion and reduce total required torque for the paraplegic walking with wheel walker. The study is carried out with a model of humanoid with wheel walker using the Visual Nastran (Vn4D dynamic simulation software. Stimulated muscle model of quadriceps is developed for knee extension. Fuzzy logic control (FLC is developed in Matlab/Simulink to regulate the muscle stimulation pulse-width required to drive FES-assisted walking gait and the computed motion is visualised in graphic animation from Vn4D. The simulation results show that SBO can be successfully used with FES for paraplegic walking with wheel walker with all the advantages discussed over the current hybrid orthoses available.

  13. Religion and assisted and non-assisted suicide in Switzerland: National Cohort Study.

    Science.gov (United States)

    Spoerri, Adrian; Zwahlen, Marcel; Bopp, Matthias; Gutzwiller, Felix; Egger, Matthias

    2010-12-01

    In the 19th century, eminent French sociologist Emile Durkheim found suicide rates to be higher in the Protestant compared with the Catholic cantons of Switzerland. We examined religious affiliation and suicide in modern Switzerland, where assisted suicide is legal. The 2000 census records of 1,722,456 (46.0%) Catholics, 1,565,452 (41.8%) Protestants and 454,397 (12.2%) individuals with no affiliation were linked to mortality records up to December 2005. The association between religious affiliation and suicide, with the Protestant faith serving as the reference category, was examined in Cox regression models. Hazard ratios (HRs) with 95% confidence intervals (CIs) were adjusted for age, marital status, education, type of household, language and degree of urbanization. Suicide rates per 100,000 inhabitants were 19.7 in Catholics (1664 suicides), 28.5 in Protestants (2158 suicides) and 39.0 in those with no affiliation (882 suicides). Associations with religion were modified by age and gender (P < 0.0001). Compared with Protestant men aged 35-64 years, HRs (95% CI) for all suicides were 0.80 (0.73-0.88) in Catholic men and 1.09 (0.98-1.22) in men with no affiliation; and 0.60 (0.53-0.67) and 1.96 (1.69-2.27), respectively, in men aged 65-94 years. Corresponding HRs in women aged 35-64 years were 0.90 (0.80-1.03) and 1.46 (1.25-1.72); and 0.67 (0.59-0.77) and 2.63 (2.22-3.12) in women aged 65-94 years. The association was strongest for suicides by poisoning in the 65-94-year-old age group, the majority of which was assisted: HRs were 0.45 (0.35-0.59) for Catholic men and 3.01 (2.37-3.82) for men with no affiliation; 0.44 (0.36-0.55) for Catholic women and 3.14 (2.51-3.94) for women with no affiliation. In Switzerland, the protective effect of a religious affiliation appears to be stronger in Catholics than in Protestants, stronger in older than in younger people, stronger in women than in men, and particularly strong for assisted suicides.

  14. Motivation of health surveillance assistants in Malawi: A qualitative study.

    Science.gov (United States)

    Chikaphupha, Kingsley R; Kok, Maryse C; Nyirenda, Lot; Namakhoma, Ireen; Theobald, Sally

    2016-06-01

    Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of HSAs. A qualitative study capturing the perspectives of purposively selected participants was conducted in two districts: Salima and Mchinji. Participants included HSAs, health managers, and various community members. Data were collected through focus group discussions (n = 16) and in-depth interviews (n = 44). The study sample was comprised of 112 women and 65 men. Qualitative data analysis was informed by existing frameworks on factors influencing health worker motivation. Our analysis identified five key themes shaping HSA motivation: salary, accommodation, human resource management, supplies and logistics, and community links. Each of these played out at different levels-individual, family, community, and organisational-with either positive or negative effects. Demotivating factors related primarily to the organisational level, while motivating factors were more often related to individual, family, and community levels. A lack of financial incentives and shortages of basic supplies and materials were key factors demotivating HSAs. Supervision was generally perceived as unsupportive, uncoordinated, and top-down. Most HSAs complained of heavy workload. Many HSAs felt further recognition and support from the Ministry of Health, and the development of a clear career pathway would improve their motivation. Factors shaping motivation of HSAs are complex and multilayered; experiences at one level will impact other levels. Interventions are required to enhance HSA motivation, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. HSAs have unique experiences, and there is need to hear

  15. 25 CFR 166.905 - Who can get assistance for postgraduate studies?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Who can get assistance for postgraduate studies? 166.905... assistance for postgraduate studies? (a) The purpose of the postgraduate studies program is to enhance the... agriculture-related field. Requirements of the postgraduate study program are: (1) The duration of course work...

  16. Medication-Assisted Treatment Improves Child Permanency Outcomes for Opioid-Using Families in the Child Welfare System.

    Science.gov (United States)

    Hall, Martin T; Wilfong, Jordan; Huebner, Ruth A; Posze, Lynn; Willauer, Tina

    2016-12-01

    Parents who use opioids and are involved in the child welfare system are less likely to retain custody of their children than parents who use other drugs. No previous studies have described medication-assisted treatment (MAT) utilization and child permanency outcomes for this population. The Sobriety Treatment and Recovery Team (START) model is a child welfare-based intervention focused on families with co-occurring substance use and child abuse / neglect issues. This study examined the prevalence and correlates of MAT utilization among parents in the START program with a history of opioid use, and compared child outcomes for families who received MAT services to those who did not. Of the 596 individuals with a history of opioid use in the START program, 55 (9.2%) received MAT. Receipt of MAT services did not differ by gender, age, county of residence, or drug use, though individuals who identified as White were more likely to participate in MAT. In a multiple logistic regression model, additional months of MAT increased the odds of parents retaining custody of their children. To address barriers to MAT, results-focused educational interventions may be needed for the child welfare workforce, as well as programs to improve collaboration and decision-making between the child welfare workforce, court personnel, and drug addiction treatment providers. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Endoscopy-assisted subfascial anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome.

    Science.gov (United States)

    Wong, J K F; Hsu, C C; Lin, C H; Lien, S H; Lin, Y T

    2016-12-01

    Many techniques have been described to relieve the compression and reduce subluxation of the ulnar nerve following surgery. The subfascial anterior transposition of the ulnar nerve (SfATUN) is one described technique, but involves a long scar, risk of injury to the medial antebrachial cutaneous nerve, and possible nerve ischemia from anterior transposition. We assessed a more refined approach of endoscopy-assisted SfATUN for the treatment of cubital tunnel syndrome. A consecutive case series of 21 patients (15 males and 6 females) with evidence of nerve subluxation after ulnar nerve decompression were operated using an endoscopy-assisted SfATUN. Each patient was assessed with pre- and postoperative nerve conduction studies, McGowan grading, and recovery of grip strength. The average age of patients was 54 years (range 23-74 years), and they were followed up for a mean of 9 months (range 3-22 months). Preoperative McGowan grades were eight grade II and 13 grade III. Eighteen of the 21 patients showed improvement, including improvement by two McGowen grades in 8 patients and improvement by one grade in 10 patients. Three grade III patients did not show improvement in grading after surgery. A proportion of 90% of patients showed significant improvements in motor nerve conduction velocity of the ulnar nerve across the elbow (p cubital tunnel syndrome and the "unstable" nerve. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Preparation of sago starch-based biocomposite reinforced microfibrillated cellulose of bamboo assisted by mechanical treatment

    Science.gov (United States)

    Silviana, S.; Hadiyanto, H.

    2017-06-01

    The utilization of green composites by using natural fibres is developed due to their availability, ecological benefits, and good properties in mechanical and thermal. One of the potential sources is bamboo that has relative high cellulose content. This paper was focused on the preparation of sago starch-based reinforced microfribrillated cellulose of bamboo that was assisted by mechanical treatment. Microfibrillated cellulose of bamboo was prepared by isolation of cellulose with chemical treatment. Preparation of bamboo microfibrillated cellulose was conducted by homogenizers for dispersing bamboo cellulose, i.e. high pressure homogenizer and ultrasonic homogenizer. Experiments were elaborated on several variables such as the concentration of bamboo microfibrillated cellulose dispersed in water (1-3 %w) and the volume of microfibrillated cellulose (37.5-75%v). Four %w of sago starch solution was mixed with bamboo microfibrillated cellulose and glycerol with plasticizer and citric acid as cross linker. This paper provided the analysis of tensile strength as well as SEM for mechanical and morphology properties of the biocomposite. The results showed that the preparation of sago starch-based biocomposite reinforced bamboo microfibrillated cellulose by using ultrasonic homogenizer yielded the highest tensile strength and well dispersed in the biocomposite.

  19. Animal-assisted therapy--a new trend in the treatment of children and adults.

    Science.gov (United States)

    Dimitrijević, Ivan

    2009-06-01

    Animal-assisted therapy is a familiar method of treatment in the rehabilitation of many illnesses and conditions, but is still not applied sufficiently in our milieu. This paper gives an overview of the available literature and some of the research which demonstrates that the interaction between the patient, animal and therapist provides a context which improves communication, elevates self-confidence, reduces the symptoms of diseases, and improves the quality of life. The dog, cat, horse, birds and toy animals are most often used in therapy. Short-term contacts with animals are used, as well as long term keeping of animals, which are looked after by patients following a particular methodology. The therapy is used in the treatment of psychiatric patients afflicted with depression, schizophrenia, phobias and addiction problems. Loneliness is easier to endure in the company of animals. It is also applied in cardiovascular diseases, dementia, Alzheimer's disease, child cerebral paralysis, rheumatoid arthritis, AIDS, and other diseases. Research shows a more rapid reduction of symptoms of many diseases when animals are included in the therapeutic process.

  20. Housing assistance and case management: improving access to substance use disorder treatment for homeless veterans.

    Science.gov (United States)

    Winn, Jaime L; Shealy, Suzanne E; Kropp, Gary J; Felkins-Dohm, Donna; Gonzales-Nolas, Cheryl; Francis, Elie

    2013-05-01

    The problem of waiting list attrition in addiction treatment programs is widespread, and homeless and marginally housed individuals are particularly susceptible. This naturalistic, retrospective study describes an intervention (Transitional Supportive Housing and Case Management) that effectively promoted treatment admission for this high-risk group above and beyond that which could be explained by certain pretreatment factors. The clinical records of 211 military veterans referred to intensive outpatient addiction treatment were reviewed for factors related to treatment program admission, including 3 interventions designed to prevent waiting list attrition. Chi-square tests evaluated univariate predictors of treatment entry, and a hierarchical binary logistic regression evaluated several variables simultaneously. Results showed that fewer than 50% of wait-listed patients achieved treatment admission. Univariate predictors of treatment entry were not having a current partner, having a legal problem, and having had past substance use disorder treatment. The logistic regression showed that patients who received the intervention were 4.5 times more likely to enter the treatment program, and individuals with a current legal problem were 2.5 times more likely to enter treatment. Participation in a weekly support group and/or contact with a psychiatric nurse practitioner did not increase the likelihood of program admission. It may be possible to enhance treatment entry for the homeless and marginally housed by providing case management and housing services. Future research is needed to determine how the individual-level factors predicting treatment entry in this study can be used to tailor other interventions to further address the problem of waiting list attrition. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  1. Assistive technologies after stroke: self-management or fending for yourself? A focus group study.

    Science.gov (United States)

    Demain, Sara; Burridge, Jane; Ellis-Hill, Caroline; Hughes, Ann-Marie; Yardley, Lucy; Tedesco-Triccas, Lisa; Swain, Ian

    2013-08-22

    Assistive Technologies, defined as "electrical or mechanical devices designed to help people recover movement" have demonstrated clinical benefits in upper-limb stroke rehabilitation. Stroke services are becoming community-based and more reliant on self-management approaches. Assistive technologies could become important tools within self-management, however, in practice, few people currently use assistive technologies. This study investigated patients', family caregivers and health professionals' experiences and perceptions of stroke upper-limb rehabilitation and assistive technology use and identified the barriers and facilitators to their use in supporting stroke self-management. A three-day exhibition of assistive technologies was attended by 204 patients, family caregivers/friends and health professionals. Four focus groups were conducted with people purposively sampled from exhibition attendees. They included i) people with stroke who had used assistive technologies (n = 5), ii) people with stroke who had not used assistive technologies (n = 6), iii) family caregivers (n = 5) and iv) health professionals (n = 6). The audio-taped focus groups were facilitated by a moderator and observer. All participants were asked to discuss experiences, strengths, weaknesses, barriers and facilitators to using assistive technologies. Following transcription, data were analysed using thematic analysis. All respondents thought assistive technologies had the potential to support self-management but that this opportunity was currently unrealised. All respondents considered assistive technologies could provide a home-based solution to the need for high intensity upper-limb rehabilitation. All stakeholders also reported significant barriers to assistive technology use, related to i) device design ii) access to assistive technology information and iii) access to assistive technology provision. The lack of and need for a coordinated system for assistive technology

  2. Influence of medical insurance schemes and charity assistance projects on regular prophylaxis treatment of the boys with severe haemophilia A in China.

    Science.gov (United States)

    Li, Z; Wu, J; Zhao, Y; Liu, R; Li, K; Zhou, Y; Wu, R; Yang, R; Zhang, X; Lian, S; Hu, Q; Li, X; Gu, J; Zhou, R; Sun, J; Li, C; Xu, W; Poon, M-C; Xiao, J

    2017-11-17

    To explore the influence of medical insurance policy and charity assistance projects on the uptake and discontinuation of regular prophylaxis treatment in Chinese severe haemophilia A children. This retrospective study was conducted on children with severe haemophilia A, who received FVIII prophylaxis treatment at 12 haemophilia centres in China from 1 November 2007 to 31 May 2013. The average duration of prophylaxis treatment received by haemophilia children significantly increased from 16.7 weeks in 2008 to 32.8 weeks in 2012 (P risk for poor adherence to regular prophylaxis. In about two third of the patients, the annual out-of-pocket copayment cost amounted to >50% of their average annual disposable income. Many patients therefore required assistance from the charity assistance projects, but nonadherence remained prevalent. Medical insurance policy and charity assistance projects helped haemophilia children to accept and continue prophylaxis regimens. It was the proportion of the out-of-pocket copayment cost rather than the upper limit of insurance reimbursement that restricted long-term regular low-dose prophylaxis in China. © 2017 John Wiley & Sons Ltd.

  3. The Helping Horse: How Equine Assisted Learning Contributes to the Wellbeing of First Nations Youth in Treatment for Volatile Substance Misuse

    Science.gov (United States)

    Adams, Cindy; Arratoon, Cheryl; Boucher, Janice; Cartier, Gail; Chalmers, Darlene; Dell, Colleen Anne; Dell, Debra; Dryka, Dominique; Duncan, Randy; Dunn, Kathryn; Hopkins, Carol; Longclaws, Loni; MacKinnon, Tamara; Sauve, Ernie; Spence, Serene; Wuttunee, Mallory

    2015-01-01

    There has been recent interest in Canada exploring the benefits of equine assisted interventions in the treatment of First Nations youth who misuse volatile substances. Using the richness of an exploratory case study involving the White Buffalo Youth Inhalant Treatment Centre and the Cartier Equine Learning Center, our community-based study examined the question of how an Equine Assisted Learning (EAL) program contributes to the wellbeing of First Nations female youth who misuse volatile substances. Both programs are grounded in a holistic bio-psycho-social-spiritual framework of healing. Our study shares how the EAL horses, facilitators and program content contributed to youths’ wellbeing in each area of the healing framework (bio-psycho-social-spiritual), with emphasis on the cultural significance of the horse and its helping role. The horse is a helper in the girls’ journeys toward improved wellbeing—the horse helps through its very nature as a highly instinctive animal, it helps the facilitators do their jobs, and it also helps put the treatment program activities into practice. In addition, the role of First Nations culture in the girls’ lives was enhanced through their encounters with the horses. The findings support the limited literature on equine assisted interventions and add important insights to the youth addictions treatment literature. Key implications to consider for EAL and volatile substance misuse policy, practice and research are identified. PMID:26793794

  4. Treatment of postoperative keratoplasty astigmatism using femtosecond laser-assisted intrastromal relaxing incisions.

    Science.gov (United States)

    Wetterstrand, Olli; Holopainen, Juha M; Krootila, Kari

    2013-06-01

    To investigate the effectiveness of femtosecond laser-assisted intrastromal relaxing incisions for astigmatism management and establish laser treatment parameters. Sixteen eyes of 16 patients had regular astigmatism after penetrating keratoplasty. All sutures had been removed and the refraction was stabilized. Paired arcuate intrastromal incisions were made 180° apart within the graft stroma with a femtosecond laser preserving the epithelium. Follow-up examinations were performed at 1 week, 2 weeks, 1 month, and 3 months. The logMAR corrected distance visual acuity (CDVA) improved from 0.50 ± 0.29 to 0.32 ± 0.23 (Snellen 20/63 to 20/40). Refractive and topographic anterior cylinders decreased from 6.8 ± 2.2 diopters (D) to 3.7 ± 1.7 D and from 9.5 ± 4.8 D to 4.4 ± 2.1 D, respectively. Stabilization of topographic cylinder was observed 1 month postoperatively. The worse the preoperative CDVA was and the higher the preoperative values for the refractive and topographic cylinders were, the higher the surgically induced changes were. Anterior side cut angles at 90° and 120° produced similar results. A bulge of incision occurred in one eye requiring compression sutures. Significant improvement in CDVA and refractive and topographic cylinders indicated a good effect of femtosecond laser-assisted intrastromal relaxing incisions in reducing astigmatism. No advantage between 90° and 120° anterior side cut angles was found. No infections were recorded and no patient expressed discomfort. Copyright 2013, SLACK Incorporated.

  5. Fibrin glue-assisted for the treatment of corneal perforationsusing glycerin-cryopreserved corneal tissue

    Directory of Open Access Journals (Sweden)

    Nuo Dong

    2014-04-01

    Full Text Available AIM: To evaluate the outcomes and safety of lamellar keratoplasty (LK assisted by fibrin glue in corneal perforations.METHODS: Six eyes of 6 patients affected by different corneal pathologies (2 posttraumatic corneal scar and 3 bacterial keratitis underwent LK procedures by using fibrin glue. The mean corneal perforation diameter was 1.35±0.64mm (range, 0.7-2.5mm, and the greatest diameter of the ulcerative stromal defect was 2.47±0.77mm in average (range, 1.5-3.5mm. The donor corneal lamella diameters were 0.20-mm larger and thicker than the recipient to restore a physiologic corneal thickness and shape:mean donor diameter was 8.34±0.28mm (range, 8.2-8.7mm and mean thickness was 352±40.27mm (range, 220-400mm. Mean follow-up was 7.33±1.97 months (range, 6-11 months. Postoperatively, the graft status, graft clarity, anterior chamber response, the visual prognosis, intraocular pressures, and postoperative complications were recorded.RESULTS: All the corneal perforations were successfully healed after the procedure. The best-corrected visual acuity (BCVA ranged from 20/1 000 to 20/50 in their initial presentation, and from 20/100 to 20/20 in their last visit, showed increase in all the patients. No major complications such as graft dislocation and graft failure were noted. Neovascularization developed in the superficial stroma of donor graft in 1 case. High intraocular pressure developed on day 2 after surgery, while was remained in normal range after application of anti-glaucomatous eyedrops for 1 week in 1 case.CONCLUSION: Fibrin glue-assisted sutureless LK is valuable for maintaining the ocular integrity in the treatment of corneal perforations.

  6. Laser welding to assist penetrating keratoplasty: in vivo studies

    Science.gov (United States)

    Menabuoni, Luca; Mincione, F.; Mincione, G. P.; Pini, Roberto

    1998-01-01

    Laser-induced corneal welding has been tested in vivo to perform experimental trials of penetrating keratoplasty (corneal transplantation). Twenty rabbits of 2500 - 3500 g in weight were selected to undergo laser-assisted corneal transplantation and then subjected to follow up on 2 - 15 postoperative days. Good sealing along the entire cut length was obtained soon after the surgical operation. Histology examinations evidenced that the laser-assisted surgical procedure provides a satisfactory healing process of corneal tissue in times that are substantially shorter than those of the conventional procedure.

  7. Open abdomen treatment after aortic aneurysm repair with vacuum-assisted wound closure and mesh-mediated fascial traction.

    Science.gov (United States)

    Sörelius, K; Wanhainen, A; Acosta, S; Svensson, M; Djavani-Gidlund, K; Björck, M

    2013-06-01

    Open abdomen (OA) treatment is sometimes necessary after surgery for aortic aneurysm (AA), to prevent or treat abdominal compartment syndrome (ACS). A multicentre study evaluating vacuum-assisted wound closure (100-150 mmHg) and mesh-mediated fascial traction (VAWCM) was performed. All patients treated with OA after AA repair (2006-2009) were prospectively registered at four centres; those treated closure; primary delayed fascial closure was achieved in all survivors. One-year mortality was 50%. Ten (33%) had bowel ischaemia requiring bowel resection. Late potential OA-related infectious complications occurred in five (17%), all of whom first developed intestinal ischaemia: entero-atmospheric fistulae (two), graft infections (two), aorto-enteric fistula (one). One year follow-up with clinical evaluation and CT showed no signs of graft infection. Incisional hernias occurred in 9 of 15 patients (60%); only three were symptomatic. VAWCM provided high fascial closure rate after AA repair and long-term OA treatment. Infectious complications occur after intestinal ischaemia and prolonged OA treatment, and are often fatal. The poor prognosis among patients needing OA after AA surgery may be improved by using VAWCM, permitting earlier closure. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Ultrasound assisted synthesis of PMMA/clay nanocomposites: Study ...

    Indian Academy of Sciences (India)

    Abstract. PMMA/clay nanocomposites were synthesized by ultrasound assisted emulsifier-free emulsion polymeri- zation technique. Ultrasound waves of different power and frequencies were applied to enhance the dispersion of the clay layers with polymer matrix. The structural information of the synthesized materials was ...

  9. [Treatment of FAI via a minimally invasive ventral approach with arthroscopic assistance. Technique and midterm results].

    Science.gov (United States)

    Laude, F; Sariali, E

    2009-05-01

    Femoroacetabular impingement (FAI) may be considered as an important cause of hip pain among young patients. A new surgical technique using a mini open anterior Hueter approach with arthroscopic assistance was developed in our department in 1999. The goal of our study was to evaluate the midterm clinical results and the quality of life after cam resection, rim trimming, and labrum refixation using this technique. The first 100 hips operated on using this technique were evaluated with the Nonarthritic Hip Score (NAHS) at a mean follow-up of 54 months. The mean age of the patients was 33.4 years, with 50 men and 47 women. At the last follow-up, the mean NAHS score increased significantly from 54.5+/-12 by 29.6 points to 84.3+/-16 (pFAI of the femoral head-neck junction using a mini anterior Hueter approach with arthroscopic assistance is a safe and effective technique in treating young adults with femoroacetabular impingement. This technique offers direct visualization of the anterior femoral head-neck junction and is less invasive than the surgical dislocation approach.

  10. Computer-Assisted Distraction Osteogenesis in the Treatment of Hemifacial Microsomia.

    Science.gov (United States)

    Yu, Hongbo; Wang, Bo; Wang, Minjiao; Wang, Xudong; Shen, Steve Guofang

    2016-09-01

    To investigate the application of computer-assisted surgical planning and virtual guide in distraction osteogenesis for patients with hemifacial microsomia. Eight patients diagnosed with unilateral hemifacial microsomia were enrolled in this study. Preoperative surgical planning and simulation were performed on three-dimensional model. Distraction was simulated on virtual model and the new morphology of the mandible was predicted. Mandibular ramus osteotomy and distractor implant was performed under the guidance of tooth-borne virtual guide. Postoperative evaluation of the intervention was performed by comparison of surgical planning and actual result. Preoperative planning, simulation, osteotomy and distractor implant under the guidance of virtual guide were performed successfully on all patients. Tooth-borne guide defined the osteotomy line and accurate position of distractor. Facial symmetry was greatly improved. The osteogenesis and neomandible contour was checked by postoperative computed tomography, and a good matching with the preoperative planning was achieved. Computer-assisted surgical planning and intraoperative virtual guide shows its great value in improving the accuracy of distraction osteogenesis and restoring facial symmetry. It is regarded as a valuable technique in this potentially complicated procedure.

  11. Swiss physicians' attitudes to assisted suicide: A qualitative and quantitative empirical study.

    Science.gov (United States)

    Brauer, Susanne; Bolliger, Christian; Strub, Jean-Daniel

    2015-01-01

    In Switzerland, assisted suicide is legal as long as it does not involve self-serving motives. Physician-assisted suicide is regulated by specific guidelines issued by the Swiss Academy of Medical Sciences (SAMS). This article summarises the results of an empirical study of physicians' attitudes to assisted suicide in Switzerland, which was commissioned by the SAMS. The study (in German) is available online at: www.samw.ch. Twelve qualitative interviews and a written survey were conducted, involving a disproportional, stratified random sample of Swiss physicians (4,837 contacted, 1,318 respondents, response rate 27%). Due to the response rate and the wide variation of respondents from one professional speciality to another, the findings and interpretations presented should be regarded as applying only to the group of physicians who are interested in or are particularly affected by the issue of assisted suicide. They cannot be generalised to the whole body of physicians in Switzerland. Of the respondents, 77% considered physician-assisted suicide to be justifiable in principle, while 22% were fundamentally opposed to it. Although 43% could imagine situations where they would personally be prepared to perform assisted suicide, it is clear from the study that this potential readiness does not mean that all respondents would automatically be prepared to perform it in practice as soon as the legal criteria are met. The vast majority of respondents emphasised that there should be no obligation to perform physician-assisted suicide. Opinions differed as to whether physician-assisted suicide should remain restricted to cases where the person concerned is approaching the end of life. While a large majority of respondents considered physician-assisted suicide also to be justifiable in principle in non-end-of-life situations, 74% supported the maintenance of the end-of-life criterion in the SAMS Guidelines as a necessary condition for physician-assisted suicide. Over 50% of

  12. Innovative Technology for the Assisted Delivery of Intensive Voice Treatment (LSVT[R]LOUD) for Parkinson Disease

    Science.gov (United States)

    Halpern, Angela E.; Ramig, Lorraine O.; Matos, Carlos E. C.; Petska-Cable, Jill A.; Spielman, Jennifer L.; Pogoda, Janice M.; Gilley, Phillip M.; Sapir, Shimon; Bennett, John K.; McFarland, David H.

    2012-01-01

    Purpose: To assess the feasibility and effectiveness of a newly developed assistive technology system, Lee Silverman Voice Treatment Companion (LSVT[R] Companion[TM], hereafter referred to as "Companion"), to support the delivery of LSVT[R]LOUD, an efficacious speech intervention for individuals with Parkinson disease (PD). Method: Sixteen…

  13. Single-incision versus multiport video-assisted thoracoscopic surgery in the treatment of lung cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Zhang; Shen, Zhenghai; Zhou, Qinghua; Huang, Yunchao

    2017-09-21

    Recent studies compared single-incision thoracoscopic surgery (SITS) with more widely used conventional multiport video-assisted thoracoscopic surgery in the treatment of lung cancer. To establish the safety and feasible of SITS in the treatment of lung cancer, we conducted this systematic review and meta-analysis. Eleven studies were identified from the databases of PubMed, Cochrane Library, SpringerLink, and ScienceDirect. The randomized controlled trials (RCTs) and non-randomized studies evaluated the outcomes of SITS compared with multiport video-assisted thoracoscopic surgery in the treatment of lung cancer were included for analysis. Odds ratio (OR, used to compare dichotomous variables) and weight mean difference (WMD, used to compare continuous variables) were calculated with 95% confidence intervals (CIs) based on intention-to-treat analysis. Eleven studies including 1314 patients were included for analysis. Our analysis showed that the operative time, blood loss amount, mean duration of chest tube, lymph nodes retrieved were similar between two approaches, the SITS pulmonary resection might be associated with shorter hospital stay (p = .008) and lower complication rate (p = .009) when compared with conventional multiport video-assisted thoracoscopic surgery approaches. In selected patients SITS is safe, feasible and may be considered an alternative to multiport VATS.

  14. Predicting use of assistance when quitting: A longitudinal study of the role of quitting beliefs

    OpenAIRE

    Myers, MG; Strong, DR; Linke, SE; Hofstetter, CR; Al-Delaimy, WK

    2015-01-01

    © 2015. Background: A growing literature addresses the need to reduce cigarette smoking prevalence by increasing the use of assistance when quitting. A key focus is to identify strategies for enhancing adoption of effective interventions in order to increase utilization of evidence-based treatments. Purpose: To examine the effect of beliefs regarding ability to quit on utilization of assistance for smoking cessation. A mediation model was hypothesized whereby the relationship between smoking ...

  15. Predictors for failure of vacuum-assisted vaginal delivery : A case-control study

    NARCIS (Netherlands)

    Verhoeven, Corine J M; Nuij, Chelly; Janssen-Rolf, Christel R M; Schuit, Ewoud; Bais, Joke M J; Oei, S. Guid; Mol, Ben Willem J

    2016-01-01

    Objective To identify potential predictors for failed vacuum-assisted delivery. Study design Retrospective case-control study conducted in two perinatal centers in the Netherlands. Cases were women who underwent a failed vacuum-assisted delivery between 1997 and 2011. A failed vacuum extraction was

  16. A Study of Research Assistants' Perceptions about Academic Adviser and Academic Life through Metaphors

    Science.gov (United States)

    Gulmez, Deniz; Kozan, Hatice Irem Ozteke

    2017-01-01

    In current study research assistants' perceptions about the concepts of "Academic adviser" and "Academic life" via metaphors were aimed which is conducted with qualitative research method. Participants of study consist of 82 research assistant (45 of them women) work in Educational Faculties in Turkey. In data collection, for…

  17. 34 CFR 477.1 - What is the State Program Analysis Assistance and Policy Studies Program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What is the State Program Analysis Assistance and Policy Studies Program? 477.1 Section 477.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE PROGRAM ANALYSIS ASSISTANCE AND POLICY STUDIES PROGRAM...

  18. More than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy

    Directory of Open Access Journals (Sweden)

    Ann Kern-Godal

    2016-01-01

    Full Text Available Inclusion of horse-assisted therapy (HAT in substance use disorder (SUD treatment is rarely reported. Our previous studies show improved treatment retention and the importance of the patient–horse relationship. This qualitative study used thematic analysis, within a social constructionist framework, to explore how eight patients experienced contextual aspects of HAT's contribution to their SUD treatment. Participants described HAT as a “break from usual treatment”. However, four interrelated aspects of this experience, namely “change of focus”, “activity”, “identity”, and “motivation,” suggest HAT is more than just a break from usual SUD treatment. The stable environment is portrayed as a context where participants could construct a positive self: one which is useful, responsible, and accepted; more fundamentally, a different self from the “patient/self” receiving treatment for a problem. The implications extend well beyond animal-assisted or other adjunct therapies. Their relevance to broader SUD policy and treatment practices warrants further study.

  19. Microwave-Assisted Alkali Pre-Treatment, Densification and Enzymatic Saccharification of Canola Straw and Oat Hull.

    Science.gov (United States)

    Agu, Obiora S; Tabil, Lope G; Dumonceaux, Tim

    2017-03-26

    The effects of microwave-assisted alkali pre-treatment on pellets' characteristics and enzymatic saccharification for bioethanol production using lignocellulosic biomass of canola straw and oat hull were investigated. The ground canola straw and oat hull were immersed in distilled water, sodium hydroxide and potassium hydroxide solutions at two concentrations (0.75% and 1.5% w/v) and exposed to microwave radiation at power level 713 W and three residence times (6, 12 and 18 min). Bulk and particle densities of ground biomass samples were determined. Alkaline-microwave pre-treated and untreated samples were subjected to single pelleting test in an Instron universal machine, pre-set to a load of 4000 N. The measured parameters, pellet density, tensile strength and dimensional stability were evaluated and the results showed that the microwave-assisted alkali pre-treated pellets had a significantly higher density and tensile strength compared to samples that were untreated or pre-treated by microwave alone. The chemical composition analysis showed that microwave-assisted alkali pre-treatment was able to disrupt and break down the lignocellulosic structure of the samples, creating an area of cellulose accessible to cellulase reactivity. The best enzymatic saccharification results gave a high glucose yield of 110.05 mg/g dry sample for canola straw ground in a 1.6 mm screen hammer mill and pre-treated with 1.5% NaOH for 18 min, and a 99.10 mg/g dry sample for oat hull ground in a 1.6 mm screen hammer mill and pre-treated with 0.75% NaOH for 18 min microwave-assisted alkali pre-treatments. The effects of pre-treatment results were supported by SEM analysis. Overall, it was found that microwave-assisted alkali pre-treatment of canola straw and oat hull at a short residence time enhanced glucose yield.

  20. Remediation of sewage and industrial effluent using bacterially assisted floating treatment wetlands vegetated with Typha domingensis.

    Science.gov (United States)

    Ijaz, Amna; Iqbal, Zafar; Afzal, Muhammad

    2016-11-01

    This investigation reports the quantitative assessment of endophyte-assisted floating treatment wetlands (FTWs) for the remediation of sewage and industrial wastewater. Typha domingensis was used to vegetate FTWs that were subsequently inoculated with a consortium of pollutant-degrading and plant growth-promoting endophytic bacteria. T. domingensis, being an aquatic species, holds excellent potential to remediate polluted water. Nonetheless, investigation conducted on Madhuana drain carrying industrial and sewage water from Faisalabad City revealed the percentage reduction in chemical oxygen demand (COD) and biochemical oxygen demand (BOD5) to be 87% and 87.5%, respectively, within 96 h on coupling the plant species with a consortium of bacterial endophytes. With the endophytes surviving in plant tissue, maximal reduction was obtained in not only the aforementioned pollution parameters but for other major environmental quality parameters including nutrients (N and P), ions (Na+ and K+), Cl-, and SO42- as well, which showed percentage reductions up to 90%, 39%, 77%, 91.8%, 40%, and 60%, respectively. This significant improvement in polluted wastewater quality treated with the proposed method render it safe to be discharged freely in larger water bodies as per the National Environmental Quality Standards (NEQS) of Pakistan or to be reused safely for irrigation purposes; thus, FTWs provide a sustainable and affordable approach for in situ remediation of sewage and industrial wastewater.

  1. Electroejaculation and assisted reproductive technologies in the treatment of anejaculatory infertility.

    Science.gov (United States)

    Ohl, D A; Wolf, L J; Menge, A C; Christman, G M; Hurd, W W; Ansbacher, R; Smith, Y R; Randolph, J F

    2001-12-01

    To determine the efficacy of electroejaculation in combination with assisted reproductive technology (ART). Case series. University fertility program. One hundred twenty-one consecutive couples seeking treatment of anejaculatory infertility. Electroejaculation with IUI, or gamete intrafallopian transfer or IVF. Pregnancy and pregnancy outcome. Fifty-two couples became pregnant (43%), 39 by IUI alone (32.2%). Cycle fecundity for IUI was 8.7%. No difference in cycle fecundity was seen among ovarian stimulation protocols (clomiphene citrate, 7.6%, hMG, 13.2%, and natural cycle, 11.2%). Pregnancy was unlikely when the inseminated motile sperm count was Electroejaculation with stepwise application of ART is effective in treating anejaculatory infertility. Intrauterine insemination with the least expensive monitoring protocol should be used for most couples, because use of more expensive monitoring did not improve results. It is cost-effective to bypass IUI and proceed directly to IVF in men who require anesthesia for electroejaculation and in those with a total inseminated motile sperm count < 4 million.

  2. Multimodal analgesic treatment in video-assisted thoracic surgery lobectomy using an intraoperative intercostal catheter

    DEFF Research Database (Denmark)

    Wildgaard, Kim; Petersen, Rene H; Hansen, Henrik J

    2012-01-01

    OBJECTIVES: No golden standard for analgesia in video-assisted thoracic surgery (VATS) lobectomy exists. A simple multimodal approach using an intercostal catheter (ICC) may be of benefit since acute post-operative pain following VATS lobectomy primarily originates from the chest drain area...... for the PVB and ICC placement was 5 min (CI: 4.7-5.9). The mean pain score at rest using a numerical rating scale (NRS, 0-10) was 85% of patients reporting satisfactory or very satisfactory pain treatment all days. CONCLUSIONS: Acute pain after VATS lobectomy may be adequately controlled using a multimodal......) and inserted an ICC at the drain site level for continuous delivery of 6 ml of 0.25% bupivacaine h(-1). Pain scores at rest, mobilization and with the extended arms were followed until discharge or for 4 days. RESULTS: Forty-eight patients, mean age 64 years (CI: 61-68), were included. The mean time...

  3. Successful treatment of cervical esophageal leakage by endoscopic-vacuum assisted closure therapy.

    Science.gov (United States)

    Lenzen, Henrike; Negm, Ahmed A; Erichsen, Thomas J; Manns, Michael P; Wedemeyer, Jochen; Lankisch, Tim O

    2013-07-16

    To evaluate the efficacy and safety of endoscopic-vacuum assisted closure (E-VAC) therapy in the treatment of cervical esophageal leakage. Between May and November 2012, three male patients who developed post-operative cervical esophageal leakage were treated with E-VAC therapy. One patient had undergone surgical excision of a pharyngo-cervical liposarcoma with partial esophageal resection, and the other two patients had received surgical treatment for symptomatic Zenker's diverticulum. Following endoscopic verification of the leakage, a trimmed polyurethane sponge was fixed to the distal end of a nasogastric silicone tube and endoscopically positioned into the wound cavity, and with decreasing cavity size the sponge was positioned intraluminally to cover the leak. Continuous suction was applied, and the vacuum drainage system was changed twice a week. The initial E-VAC placement was technically successful for all three patients, and complete closure of the esophageal leak was achieved without any procedure-related complications. In all three patients, the insufficiencies were located either above or slightly below the upper esophageal sphincter. The median duration of the E-VAC drainage was 29 d (range: 19-49 d), with a median of seven sponge exchanges (range: 5-12 sponge exchanges). In addition, the E-VAC therapy reduced inflammatory markers to within normal range for all three patients. Two of the patients were immediately fitted with a percutaneous enteral gastric feeding tube with jejunal extension, and the third patient received parenteral feeding. All three patients showed normal swallow function and no evidence of stricture after completion of the E-VAC therapy. E-VAC therapy for cervical esophageal leakage was well tolerated by patients. This safe and effective procedure may significantly reduce morbidity and mortality following cervical esophageal leakage.

  4. Treatment outcome of immediately loaded implants installed in edentulous jaws following computer-assisted virtual treatment planning and flapless surgery.

    Science.gov (United States)

    Komiyama, Ai; Klinge, Björn; Hultin, Margareta

    2008-07-01

    The objective was to evaluate the outcome of immediately loaded implants installed in edentulous jaws following computer-assisted virtual treatment planning combined with flapless surgery. Twenty-nine edentulous patients (9 females, 20 males, mean age of 71.5 years) were treated using the Nobel Guide protocol for surgical planning, fixture installation and immediate functioning of a prefabricated fixed implant prosthesis. One hundred and seventy-six fixtures were installed to support 21 maxillary and 10 mandibular reconstructions. Patients were followed for up to 44 months. Nineteen out of 176 fixtures were lost between 2 and 18 months after installation. Fixture survival rate was 89% (92% maxilla, 83% mandible). Implant-supported suprastructures remained stable during the follow-up period in 26 out of 31 jaws (90% maxilla, 70% mandible). Surgical or technical complications occurred in 42% of treated cases. Misfit of abutment-bridge appeared in five cases, resulting in disconnection of the bridge in two patients where fixtures were left for unloaded healing. Fixture losses resulted in the removal of the suprastructure in three patients, who returned to removable dentures. Extensive adjustments of occlusion were made in 10% of the immediately connected bridges. Radiographic bone defects developed in three patients after drilling, which appeared in two cases after anchor-pin drilling in the maxilla and another in a severely resorbed mandible. The patient's post-operative discomfort such as swelling and pain was almost negligible. However, compared to conventional protocols, the occurrences of surgical and technical complications were higher, and thus this method must still be regarded to be in an exploratory phase.

  5. Anxiety and depression after failure of assisted reproductive treatment among patients experiencing infertility.

    Science.gov (United States)

    Maroufizadeh, Saman; Karimi, Elaheh; Vesali, Samira; Omani Samani, Reza

    2015-09-01

    To investigate the impact of the number of previous infertility treatment failures on anxiety and depression. In a cross-sectional study, individuals (men and women, but not couples) aged at least 18 years who had a history of infertility and could read and write in Persian were enrolled at the Royan Institute, Tehran, Iran, between November 1, 2013, and February 28, 2014. Participants provided demographic and infertility information and completed the Persian version of the Hospital Anxiety and Depression Scale (HADS). Overall, 330 patients (122 men, 208 women) were included. Mean scores on the HADS anxiety and depression subscales (HADS-A and HADS-D) were 8.40±4.51 and 5.95±3.54, respectively. In multiple regression analysis, mean HADS-A scores were significantly higher for patients with one treatment failure (9.57±4.58) than for those without a history of treatment (7.79±4.13; P=0.003). HADS-D scores were significantly higher for patients with two failures (6.92±3.69) than for those with no previous treatment (5.59±3.79; P=0.019). Patients with infertility have increased depression and anxiety after infertility treatment failure. Counseling or treatment for these potential psychological effects should be considered after infertility treatment failure. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Role of video-assisted thoracoscopic sympathectomy in the treatment of primary hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Villaça Leão

    Full Text Available CONTEXT: Essential hyperhidrosis is a frequent disorder causing significant functional impairment. The advent and development of video-assisted thoracoscopic techniques now allows thoracic sympathectomy to be carried out precisely and safety with good results and minimal morbidity. OBJECTIVE: To assess the impact of video-assisted thoracic sympathectomy in patients diagnosed as presenting severe and disabling hyperhidrosis. TYPE OF STUDY: This was a longitudinal study of the clinical course of all hyperhidrosis cases selected for surgery between May 1999 and January 2003. SETTING: Division of Thoracic Surgery, Universidade Federal de São Paulo (UNIFESP. PARTICIPANTS: 743 patients with surgery indicated due to palmar hyperhidrosis (49.8%, palmar-axillary hyperhidrosis (38.1%, craniofacial hyperhidrosis (8.9% or isolated axillary hyperhidrosis (2.8%. PROCEDURES: Video-thoracoscopic sympathectomy was performed, isolating the second thoracic ganglion (T2 in all patients, with additional sympathectomy of T3 and T4 if necessary. MAIN MEASUREMENTS:The clinical course was followed up via questionnaires, phone calls, letters and statements. Simple questions were asked regarding the disappearance of symptoms and presence and intensity of compensatory sweating. RESULTS: The surgery was regarded as efficient in all cases of palmar hyperhidrosis. In the craniofacial hyperhidrosis cases, partial recurrence of the symptoms occurred in 2 cases (3.0%. Partial recurrence or persistence of symptoms occurred in 20% of the patients with predominantly axillary symptomatology. The compensatory sweating was considered disagreeable or uncomfortable by about 30% of the patients, but it only reached the level of regretting the operation for 3% of them. This occurred more frequently in patients with axillary hyperhidrosis. Ten cases of complications occurred. CONCLUSION: Thoracoscopic sympathectomy provides very good results in most patients, with a very low complication

  7. Ultrasound assisted acid catalyzed lactose hydrolysis: Understanding into effect of operating parameters and scale up studies.

    Science.gov (United States)

    Gajendragadkar, Chinmay N; Gogate, Parag R

    2017-07-01

    The current work deals with the value addition of lactose by transforming into hydrolyzed lactose syrup containing glucose and galactose in major proportion using the novel approach of ultrasound assisted acid catalyzed lactose hydrolysis. The hydrolysis of lactose was performed in ultrasonic bath (33kHz) at 50% duty cycle at different temperatures as 65°C and 70°C and two different hydrochloric acid (HCl) concentrations as 2.5N and 3N. It was observed that acid concentration, temperature and ultrasonic treatment were the major factors in deciding the time required to achieve ∼90% hydrolysis. The ultrasonic assisted approach resulted in reduction in the reaction time and the extent of intensification was established to be dependent on the temperature, acid concentration and time of ultrasonic exposure. It was observed that the maximum process intensification obtained by introduction of ultrasound in the lactose hydrolysis process performed at 70°C and 3N HCl was reduction in the required time for ∼90% hydrolysis from 4h (without the presence of ultrasound) to 3h. The scale-up study was also performed using an ultrasonic bath with longitudinal horn (36kHz as operating frequency) at 50% duty cycle, optimized temperature of 70°C and acid concentration of 3N. It was observed that the reaction was faster in the presence of ultrasound and stirring by axial impeller at rpm of 225±25. The time required to complete ∼90% of hydrolysis remained almost the same as observed for small scale study on ultrasonic bath (33kHz) at 50% duty cycle. The use of recovered lactose from whey samples instead of pure lactose did not result in any significant changes in the progress of hydrolysis, confirming the efficacy of the selected approach. Overall, the work has presented a novel ultrasound assisted approach for intensified lactose hydrolysis. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes

    Directory of Open Access Journals (Sweden)

    Lund IO

    2012-02-01

    Full Text Available Ingunn O Lund1, Heather Fitzsimons2, Michelle Tuten2, Margaret S Chisolm2, Kevin E O’Grady3, Hendrée E Jones2,41SERAF-Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway; 2Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; 3Department of Psychology, University of Maryland, College Park, MD; 4Substance Abuse Treatment Evaluations and Interventions Research Program, RTI International, Research Triangle Park, NC, USAAbstract: Pregnancy can motivate opioid-dependent women to seek substance abuse treatment. Research has demonstrated that although prenatal exposure to buprenorphine results in less severe neonatal abstinence syndrome (NAS relative to prenatal methadone exposure, the maternal and other neonatal outcomes are similar for the two medications. Maternal and neonatal outcomes for opioid-dependent pregnant women receiving these medications have not been systematically compared with methadone-assisted withdrawal. The present study provides an initial assessment of the relative efficacy of both methadone and buprenorphine maintenance versus methadone-assisted withdrawal in terms of neonatal and maternal delivery outcomes. Data were derived from (1 the MOTHER (Maternal Opioid Treatment: Human Experimental Research study at the Johns Hopkins University Bayview Medical Center (JHBMC, or (2 retrospective records review of women who underwent methadone-assisted withdrawal at the JHBMC during the time period in which participants were enrolled in the MOTHER study. Compared with the methadone maintenance group, the methadone-assisted withdrawal group had a significantly lower mean NAS peak score (Means = 13.7 vs 7.0; P = 0.002, required a significantly lower mean amount of morphine to treat NAS (Means = 82.8 vs 0.2; P < 0.001, had significantly fewer days medicated for NAS (Means = 31.5 vs 3.9; P < 0.001, and remained in the hospital for a significantly fewer number of

  9. The Psychosexual Profile of Sexual Assistants: An Internet-Based Explorative Study

    Science.gov (United States)

    Limoncin, Erika; Galli, Debora; Ciocca, Giacomo; Gravina, Giovanni Luca; Carosa, Eleonora; Mollaioli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A.

    2014-01-01

    Introduction Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees). In this study, we investigate whether a rigorous selection and training process on the part of specialised organisations may reduce the risk of training subjects with an atypical sexual interest and behaviours resembling prostitution. Materials and Methods The study population consisted of 152 subjects defining themselves as sexual assistants. Subjects were initially contacted on websites specifically dedicated to sexual assistants and prostitutes. One hundred and twenty subjects were selected, by propensity score analysis, and studied by means of a modified version of a semi-structured questionnaire previously developed to investigate a population of subjects attracted by disability. Results The study group was composed of 80 trained and 40 untrained sexual assistants, with mean ages of 41.5 (SD +/−12.58) and 44.5 (SD +/−11.62), respectively. A significant number of untrained subjects affirmed that their motivation in carrying out sexual assistance was of a remunerative nature, while this number was lower among the trained assistants (p = 0.001). Nearly all untrained subjects claimed to do one or more of the following activities during sexual assistance: sexual intercourse, oral sex, and masturbation. Among the trained subjects, however, only 47.5% claimed to do one or more of these activities, which means that there is a significant gap between trained and untrained assistants (p<0.0001). The existence of an atypical sexual interest was more evident between untrained rather than between trained subjects (p<0.0001). Conclusions Sexual assistance represents a way through which people affected by disabilities may attain the right to explore their sexuality in a safe setting. This can be guaranteed only if sexual assistants are trained and

  10. The psychosexual profile of sexual assistants: an internet-based explorative study.

    Directory of Open Access Journals (Sweden)

    Erika Limoncin

    Full Text Available Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees. In this study, we investigate whether a rigorous selection and training process on the part of specialised organisations may reduce the risk of training subjects with an atypical sexual interest and behaviours resembling prostitution.The study population consisted of 152 subjects defining themselves as sexual assistants. Subjects were initially contacted on websites specifically dedicated to sexual assistants and prostitutes. One hundred and twenty subjects were selected, by propensity score analysis, and studied by means of a modified version of a semi-structured questionnaire previously developed to investigate a population of subjects attracted by disability.The study group was composed of 80 trained and 40 untrained sexual assistants, with mean ages of 41.5 (SD +/-12.58 and 44.5 (SD +/-11.62, respectively. A significant number of untrained subjects affirmed that their motivation in carrying out sexual assistance was of a remunerative nature, while this number was lower among the trained assistants (p = 0.001. Nearly all untrained subjects claimed to do one or more of the following activities during sexual assistance: sexual intercourse, oral sex, and masturbation. Among the trained subjects, however, only 47.5% claimed to do one or more of these activities, which means that there is a significant gap between trained and untrained assistants (p<0.0001. The existence of an atypical sexual interest was more evident between untrained rather than between trained subjects (p<0.0001.Sexual assistance represents a way through which people affected by disabilities may attain the right to explore their sexuality in a safe setting. This can be guaranteed only if sexual assistants are trained and carefully selected by specialised organisations.

  11. The psychosexual profile of sexual assistants: an internet-based explorative study.

    Science.gov (United States)

    Limoncin, Erika; Galli, Debora; Ciocca, Giacomo; Gravina, Giovanni Luca; Carosa, Eleonora; Mollaioli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A

    2014-01-01

    Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees). In this study, we investigate whether a rigorous selection and training process on the part of specialised organisations may reduce the risk of training subjects with an atypical sexual interest and behaviours resembling prostitution. The study population consisted of 152 subjects defining themselves as sexual assistants. Subjects were initially contacted on websites specifically dedicated to sexual assistants and prostitutes. One hundred and twenty subjects were selected, by propensity score analysis, and studied by means of a modified version of a semi-structured questionnaire previously developed to investigate a population of subjects attracted by disability. The study group was composed of 80 trained and 40 untrained sexual assistants, with mean ages of 41.5 (SD +/-12.58) and 44.5 (SD +/-11.62), respectively. A significant number of untrained subjects affirmed that their motivation in carrying out sexual assistance was of a remunerative nature, while this number was lower among the trained assistants (p = 0.001). Nearly all untrained subjects claimed to do one or more of the following activities during sexual assistance: sexual intercourse, oral sex, and masturbation. Among the trained subjects, however, only 47.5% claimed to do one or more of these activities, which means that there is a significant gap between trained and untrained assistants (psexual interest was more evident between untrained rather than between trained subjects (pSexual assistance represents a way through which people affected by disabilities may attain the right to explore their sexuality in a safe setting. This can be guaranteed only if sexual assistants are trained and carefully selected by specialised organisations.

  12. Preferences for treatment of lobectomy in Chinese lung cancer patients: video-assisted thoracoscopic surgery or open thoracotomy?

    Directory of Open Access Journals (Sweden)

    Yang B

    2014-10-01

    Full Text Available Bo Yang,1 Fang Zhao,1 Zhenfeng Zong,1 Jun Yuan,1 Xiang Song,1 Mingming Ren,1 Qingjun Meng,1 Guoguang Dai,1 Fanyi Kong,1 Shumin Xie,2 Siying Cheng,2 Tianwen Gao2 1Hebei Cangzhou Central Hospital, Department of Thoracic Surgery, Hebei, 2Xiangya Medical School of Central-South University, Changsha, People’s Republic of China Background: This study was designed to investigate the preferences for treatment of lobectomy in Chinese lung cancer patients and differences in the psychological and social factors that influence treatment decision-making.Methods: One hundred and forty patients with stage I lung cancer were recruited from Hebei Cangzhou Central Hospital. Before surgery, the patients completed a questionnaire that surveyed their preferences for treatment and the relevant influencing factors. Differences in psychological and social characteristics were compared between lung cancer patients who chose video-assisted thoracoscopic surgery (VATS and those who opted for open thoracotomy.Results: Among the 135 valid questionnaires, 79 patients preferred VATS and 56 patients chose open thoracotomy. Potential side effects, doctors’ recommendation, the prognosticated chance for cure, cosmesis, and financial burden influenced the patients’ decisions.Conclusion: The minimally invasive advantages of VATS, including lesser trauma to the chest wall, earlier remission of postoperative pain, faster recovery, less bleeding, and improved cardiopulmonary function made VATS more attractive to patients needing lobectomy for lung cancer. However, the choice of VATS over open thoracotomy is still influenced by the degree of prognosticated cure and the feasibility of surgery. Keywords: lobectomy, treatment decision-making, Chinese, oncologists

  13. Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy: A prospective single surgeon randomized comparative study.

    Science.gov (United States)

    Akand, Murat; Erdogru, Tibet; Avci, Egemen; Ates, Mutlu

    2015-10-01

    To compare operative, pathological, and functional results of transperitoneal and extraperitoneal robot-assisted laparoscopic radical prostatectomy carried out by a single surgeon. After having experience with 32 transperitoneal laparoscopic radical prostatectomies, 317 extraperitoneal laparoscopic radical prostatectomies, 30 transperitoneal robot-assisted laparoscopic radical prostatectomies and 10 extraperitoneal robot-assisted laparoscopic radical prostatectomies, 120 patients with prostate cancer were enrolled in this prospective randomized study and underwent either transperitoneal or extraperitoneal robot-assisted laparoscopic radical prostatectomy. The main outcome parameters between the two study groups were compared. No significant difference was found for age, body mass index, preoperative prostate-specific antigen, clinical and pathological stage, Gleason score on biopsy and prostatectomy specimen, tumor volume, positive surgical margin, and lymph node status. Transperitoneal robot-assisted laparoscopic radical prostatectomy had shorter trocar insertion time (16.0 vs 25.9 min for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, P robot-assisted laparoscopic radical prostatectomy had shorter console time (101.5 vs 118.3 min, respectively, P robot-assisted laparoscopic radical prostatectomy, without statistical significance (200.9 vs 193.2 min; 221.8 vs 213.3 min, respectively). Estimated blood loss was found to be lower for extraperitoneal robot-assisted laparoscopic radical prostatectomy (P = 0.001). Catheterization and hospitalization times were observed to be shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy (7.3 vs 5.8 days and 3.1 vs 2.3 days for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, respectively, P robot-assisted laparoscopic

  14. An Exploratory Study of Animal-Assisted Interventions Utilized by Mental Health Professionals

    Science.gov (United States)

    O'Callaghan, Dana M.; Chandler, Cynthia K.

    2011-01-01

    This study implemented an exploratory analysis to examine how a sample of mental health professionals incorporates specific animal-assisted techniques into the therapeutic process. An extensive review of literature related to animal-assisted therapy (AAT) resulted in the identification of 18 techniques and 10 intentions for the practice of AAT in…

  15. Dolphin-Assisted Therapy for Children with Special Needs: A Pilot Study

    Science.gov (United States)

    Dilts, Rachel; Trompisch, Norbert; Bergquist, Timothy M.

    2011-01-01

    Dolphin-assisted therapy (DAT), as a part of animal-assisted therapy and complementary and alternative medicine, yields several positive results. This study intended to add to DAT effectiveness research while using a standardized assessment. In the Ukraine, a DAT program called DolphinSwim agreed to take part in research with 37 voluntary…

  16. Failure Modes and Effects Analysis (FMEA) Assistant Tool Feasibility Study

    Science.gov (United States)

    Flores, Melissa D.; Malin, Jane T.; Fleming, Land D.

    2013-09-01

    An effort to determine the feasibility of a software tool to assist in Failure Modes and Effects Analysis (FMEA) has been completed. This new and unique approach to FMEA uses model based systems engineering concepts to recommend failure modes, causes, and effects to the user after they have made several selections from pick lists about a component's functions and inputs/outputs. Recommendations are made based on a library using common failure modes identified over the course of several major human spaceflight programs. However, the tool could be adapted for use in a wide range of applications from NASA to the energy industry.

  17. Achilles tendon rupture: physiotherapy and endoscopy-assisted surgical treatment of a common sports injury

    Directory of Open Access Journals (Sweden)

    Mahmut Nedim Doral

    2010-12-01

    Full Text Available Mahmut Nedim Doral1,2, Murat Bozkurt3, Egemen Turhan4, Gürhan Dönmez2, Murat Demirel5, Defne Kaya2, Kivanç Atesok7, Özgür Ahmet Atay1, Nicola Maffulli61Department of Orthopedics and Traumatology, 2Department of Sports Medicine, Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey; 3Department of Orthopedics and Traumatology, Ankara Etlik Ihtisas Training and Research Hospital, Ankara, Turkey; 4Department of Orthopedics and Traumatology, Zonguldak Karaelmas University School of Medicine, Zonguldak, Turkey; 5Department of Orthopedics and Traumatology, Ankara Bayindir Medical Center, Ankara, Turkey; 6Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; 7St. Michael's Hospital Division of Orthopaedics Musculoskeletal Research Lab, Toronto, Ontario, CanadaAbstract: Although the Achilles tendon (AT is the strongest tendon in the human body, rupture of this tendon is one of the most common sports injuries in the athletic population. Despite numerous nonoperative and operative methods that have been described, there is no universal agreement about the optimal management strategy of acute total AT ruptures. The management of AT ruptures should aim to minimize the morbidity of the injury, optimize rapid return to full function, and prevent complications. Since endoscopy-assisted percutaneous AT repair allows direct visualization of the synovia and protects the paratenon that is important in biological healing of the AT, this technique becomes a reasonable treatment option in AT ruptures. Furthermore, Achilles tendoscopy technique may decrease the complications about the sural nerve. Also, early functional postoperative physiotherapy following surgery may improve the surgical outcomes.Keywords: Achilles tendon rupture, percutaneous repair, endoscopic control, growth factors

  18. Study of a fiber laser assisted friction stir welding process

    Science.gov (United States)

    Casalino, G.; Campanelli, S.; Ludovico, A. D.; Contuzzi, N.; Angelastro, A.

    2012-03-01

    Friction stir welding is a relatively new joining technique. This technique, which is considered a derivative of the more common friction welding method, was developed mainly for aluminum and its alloys. In recent years, this method has been used to join various other alloys. FSW has many advantages, including the following: the welding procedure is relatively simple with no consumables or filler metal; joint edge preparation is not needed; oxide removal prior to welding is unnecessary; high joint strength has been achieved in aluminum and magnesium alloys; FSW can be used with alloys that cannot be fusion welded due to crack sensitivity. The drawbacks of FSW include the need for powerful fixtures to clamp the workpiece to the welding table, the high force needed to move the welding tool forward, the relatively high wear rate of the welding tool, and weld speeds in FSW are slower, which can lead to longer process times. To overcome these drawbacks, a fiber laser-assisted friction stir welding system was designed (FLAFSW). The system combined a conventional commercial friction machine and a fiber pumped laser system. The scope is to investigate the influence of the laser assistance on the weld quality. A number of different aluminum plates, which are still mentioned to be difficult to be joint as intermetallic phases appear during melting welding techniques, were used. The evaluation of quality was performed through analysis of appearance, mechanical and microstructure characterization of the weld.

  19. Efficacy evaluation of bifidobacterium tetragenous viable bacteria tablets-assisted blu-ray irradiation in treatment of neonatal jaundice

    Directory of Open Access Journals (Sweden)

    Qun-Ying Ma

    2016-02-01

    Full Text Available Objective: To investigate the efficacy of bifidobacterium tetragenous viable bacteria tabletsassisted blu-ray irradiation in treatment of neonatal jaundice. Methods: A total of 118 cases of children with neonatal jaundice were randomly divided into observation group (n=59 and control group (n=59, control group received blu-ray irradiation treatment alone, observation group received bifidobacterium tetragenous viable bacteria tablets-assisted blu-ray irradiation treatment and then levels of bilirubin-related indicators, nerve damage indexes and liver function indexes of two groups were compared. Results: 3 d after treatment, total serum bilirubin (TSB, direct bilirubin (DB and transcutaneous bilirubin (TCB levels of observation group were lower than those of control group and differences were statistically significant; 3 d after treatment, serum neuron specific enolase (NSE, amyloid β-protein (A β and astrocytederived protein (S100 β levels of observation group were lower than those of control group and differences were statistically significant; 3 d after treatment, alanine aminotransferase (ALT and aspartate aminotransferase (AST levels of observation group were lower than those of control group and differences were statistically significant. Conclusion: Bifidobacterium tetragenous viable bacteria tablets-assisted blu-ray irradiation has better effect in treatment of neonatal jaundice and has advantages in reducing bilirubin level, protecting nerve function and liver function and other aspects.

  20. Vacuum-assisted early transanal closure of leaking low colorectal anastomoses: the CLEAN study.

    Science.gov (United States)

    Borstlap, W A A; Musters, G D; Stassen, L P S; van Westreenen, H L; Hess, D; van Dieren, S; Festen, S; van der Zaag, E J; Tanis, P J; Bemelman, W A

    2017-06-29

    Non-healing of anastomotic leakage can be observed in up to 50% after total mesorectal excision for rectal cancer. This study investigates the efficacy of early transanal closure of anastomotic leakage after pre-treatment with the Endosponge(®) therapy. In this prospective, multicentre, feasibility study, transanal suturing of the anastomotic defect was performed after vacuum-assisted cleaning of the presacral cavity. Primary outcome was the proportion of patients with a healed anastomosis at 6 months after transanal closure. Secondary, healing at last follow-up, continuity, direct medical costs, functionality and quality of life were analysed. Between July 2013 and July 2015, 30 rectal cancer patients with a leaking low colorectal anastomosis were included, of whom 22 underwent neoadjuvant radiotherapy. Median follow-up was 14 (7-29) months. At 6 months, the anastomosis had healed in 16 (53%) patients. At last follow-up, anastomotic integrity was found in 21 (70%) and continuity was restored in 20 (67%) patients. Non-healing at 12 months was observed in 10/29 (34%) patients overall, and in 3/14 (21%) when therapy started within three weeks following the index operation. Major LARS was reported in 12/15 (80%) patients. The direct medical costs were €8933 (95% CI 7268-10,707) per patient. Vacuum-assisted early transanal closure of a leaking anastomosis after total mesorectal excision with 73% preoperative radiotherapy showed that acceptable anastomotic healing rates and stoma reversal rates can be achieved. Early diagnosis and start of treatment seems crucial.

  1. Osteopathic treatment in a patient with left-ventricular assist device with left brachialgia: a case report

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2017-01-01

    Full Text Available Bruno Bordoni,1–3 Fabiola Marelli,2,3 Bruno Morabito,2–4 Beatrice Sacconi5 1Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization and Care with Scientific Address, Milan, 2CRESO, School of Osteopathic Centre for Research and Studies, Gorla Minore, 3CRESO, School of Osteopathic Centre for Research and Studies, Falconara Marittima, 4Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, 5Center for Life Nano Science, CLNS@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy Abstract: This study deals with an osteopathic approach used for a patient with left-ventricular assist device (L-VAD affected by left brachialgia. Clinical examination revealed the presence of thoracic outlet syndrome and pectoralis minor syndrome, with compression of the left proximal ulnar nerve, related to the surgical sternotomy performed. The osteopathic techniques used can be classified as indirect and direct, addressed to the pectoralis minor and the first left rib, respectively. To our knowledge, this is the first text in literature with an osteopathic treatment in a patient with L-VAD. Keywords: osteopathic, L-VAD, thoracic outlet syndrome, TOS, myofascial, fascia

  2. En-face OCT microleakage investigation after laser-assisted dental hard tissue treatment

    Science.gov (United States)

    Todea, Carmen; Balabuc, Cosmin; Sinescu, Cosmin; Negrutiu, Meda; Filip, Laura; Bradu, Adrian; Podoleanu, Adrian Gh.

    2008-09-01

    Purpose: To investigate using en-face Optical Coherence Tomography (OCT) the microleakage after Er:YAG laser cavity preparation. Material and Methods: Thirty single- and multi-rooted freshly extracted human teeth divided into two study groups, group I (laser) and group II (control), were used in this study. In group I, Class V cavities were prepared using laser on the buccal surface of each tooth. The laser device used was an Er:YAG laser (2940 nm, VSP, 250-320 mJ, 10-20 Hz). In group II, cavities were prepared conventionally and acid etched on the oral surface of the same tooth. All cavities were filled with composite resin. The cavity microleakage was investigated using en-face Optical Coherence Tomography prototype, based on transverse scanning and operating at 1300 nm. Results: The investigation demonstrated qualitatively the reduction of microleakage in cavities prepared with Er:YAG laser as compared to the control group, in which cavities were prepared conventionally. Conclusion: The en-face OCT method provided a superior non-invasive and real time investigation method, thus reducing the occurrence of secondary caries by early detection. Moreover, based on the results of this investigation, it may be concluded that Er:YAG laser-assisted cavity preparation leads to reduction of microleakage.

  3. A Study To Evaluate Skills Of Ophthalmic Assistants For Assessment Of Cup Disc Ratio

    Directory of Open Access Journals (Sweden)

    Malik J.S

    1999-01-01

    Full Text Available Research question: 1. Whether paramedical ophthalmic assistants can be trained to examine vertical cup disc ratio? 2. Can the PMO As detect abnormal cup disc ratio after training? Objectives: 1. T o train ophthalmic assistants in cup disc ratio examination 2. To evaluate skills of trained ophthalmic assistants in cup disc ratio examination Study design: Cross sectional Setting: OPD of Ophthalmology department, Pt. B.D. Sharma PGIMS, Rohtak Participants: Five paramedical ophthalmic assistants, one ophthalmologist and 322 patients above 40 years of age. Statistical analysis: Sensitivity, specificity, Kappa values. Results: Data analysis of 322 cases was found by PMO As and ophthalmologist revealed sensitivity between 50-65% and specificity between 84.5-92.62%. A good agreement was found among all the examiners on computation of Kappa Values. It was concluded that ophthalmic assistants can examine vertical cup disc ratio after five days training.

  4. Alkaline assisted thermal oil recovery: Kinetic and displacement studies

    Energy Technology Data Exchange (ETDEWEB)

    Saneie, S.; Yortsos, Y.C.

    1993-06-01

    This report deals with two major issues of chemical assisted flooding - the interaction of caustic, one of the proposed additives to steam flood, with the reservoir rock, and the displacement of oil by a chemical flood at elevated temperatures. A mathematical model simulating the kinetics of silica dissolution and hydroxyl ion consumption in a typical alkaline flooding environment is first developed. The model is based on the premise that dissolution occurs via hydrolysis of active sites through the formation of an intermediate complex, which is in equilibrium with the silicic acid in solution. Both static (batch) and dynamic (core flood) processes are simulated to examine the sensitivity of caustic consumption and silica dissolution to process parameters, and to determine rates of propagation of pH values. The model presented provides a quantitative description of the quartz-alkali interaction in terms of pH, salinity, ion exchange properties, temperature and contact time, which are of significant importance in the design of soluble silicate flooding processes. The modeling of an adiabatic hot waterflood assisted by the simultaneous injection of a chemical additive is next presented. The model is also applicable to the hot alkaline flooding under conditions of negligible adsorption of the generated anionic surfactant and of hydroxide adsorption being Langmuirian. The theory of generalized simple waves (coherence ) is used to develop solutions for the temperature, concentration, and oil saturation profiles, as well as the oil recovery curves. It is shown that, for Langmuir adsorption kinetics, the chemical resides in the heated region of the reservoir if its injection concentration is below a critical value, and in the unheated region if its concentration exceeds this critical value. Results for a chemical slug injection in a tertiary recovery process indicate recovery performance is maximized when chemical resides in the heated region of the reservior.

  5. Cycle 1 as predictor of assisted reproductive technology treatment outcome over multiple cycles: an analysis of linked cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System online database.

    Science.gov (United States)

    Stern, Judy E; Brown, Morton B; Luke, Barbara; Wantman, Ethan; Lederman, Avi; Hornstein, Mark D

    2011-02-01

    To determine whether the first cycle of assisted reproductive technology (ART) predicts treatment course and outcome. Retrospective study of linked cycles. Society for Assisted Reproductive Technology Clinic Outcome Reporting System database. A total of 6,352 ART patients residing or treated in Massachusetts with first treatment cycle in 2004-2005 using fresh, autologous oocytes and no prior ART. Women were categorized by first cycle as follows: Group I, no retrieval; Group II, retrieval, no transfer; Group III, transfer, no embryo cryopreservation; Group IV, transfer plus cryopreservation; and Group V, all embryos cryopreserved. None. Cumulative live-birth delivery per woman, use of donor eggs, intracytoplasmic sperm injection (ICSI), or frozen embryo transfers (FET). Groups differed in age, baseline FSH level, prior gravidity, diagnosis, and failure to return for Cycle 2. Live-birth delivery per woman for groups I through V for women with no delivery in Cycle I were 32.1%, 35.9%, 40.1%, 53.4%, and 51.3%, respectively. Groups I and II were more likely to subsequently use donor eggs (14.5% and 10.9%). Group II had the highest use of ICSI (73.3%); Group III had the lowest use of FET (8.9%). Course of treatment in the first ART cycle is related to different cumulative live-birth delivery rates and eventual use of donor egg, ICSI, and FET. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Effects of microwave-assisted hot water treatments designed against Mexican fruit fly (Anastrepha ludens) on grapefruit (Citrus paradisi) quality.

    Science.gov (United States)

    Soto-Reyes, Nohemi; Lopez-Malo, Aurelio; Rojas-Laguna, Roberto; Gómez-Salazar, Julián Andrés; Sosa-Morales, María Elena

    2017-12-18

    Hot water treatment (HWT) against Anastrepha ludens were developed achieving 48°C in the core of grapefruits and holding it for 6 min. After heating, the grapefruits were hydro-cooled and stored at 23°C and analyzed for 16 days. The effect of microwave-assisted hot water treatment (MW-HWT) on grapefruit quality was analyzed and compared with the quality of fruits treated with HWT and control fruits (without treatment). The physico-chemical properties and chemical composition of essential oil were analyzed. MW-HWT was equivalent to HWT according to accumulated heat calculations, with the advantage of being shorter. Treatments significantly affected the weight, color, maturity index, juice content, firmness, titratable acidity, pH and ascorbic acid content of the grapefruits (P 0.05). The major components identified in the essential oil were D-limonene and β-myrcene, compounds responsible of the scent of the grapefruits. Microwave-assisted hot water treatment (MW-HWT) was shorter (130 min) and had a lesser effect on the quality of the grapefruit when compared to fruits under HWT (188 min duration). Thus, this treatment could be considered as an alternative method against the Mexican fruit fly in grapefruit. This article is protected by copyright. All rights reserved.

  7. Effect of Prometheus liver assist system on systemic hemodynamics in patients with cirrhosis: a randomized controlled study

    DEFF Research Database (Denmark)

    Dethloff, T.; Tofteng, F.; Frederiksen, H.J.

    2008-01-01

    Adsorption and Dialysis, Prometheus system (Study group; n = 8); Molecular Adsorbent Recirculation System (MARS) (Control group 1, n = 8); or hemodialysis (Control group 2; n = 8). All patients included in the study had decompensated cirrhosis at the time of the inclusion into the study. Circulatory changes......AIM: To evaluate treatment safety and hemodynamic changes during a single 6-h treatment with the Prometheus liver assist system in a randomized, controlled study. METHODS: Twenty-four patients were randomized to either the study group or to one of two control groups: Fractionated Plasma Separation...... were monitored with a Swan-Ganz catheter and bilirubin and creatinine were monitored as measures of protein-bound and water-soluble toxins. RESULTS: Systemic hemodynamics did not differ between treatment and control groups apart from an increase in arterial pressure in the MARS group (P = 0...

  8. Vacuum-Assisted Abdominal Closure Is Safe and Effective: A Cohort Study in 74 Consecutive Patients.

    Science.gov (United States)

    Jensen, R O; Buchbjerg, T; Simonsen, R M; Eckardt, R; Qvist, N

    2017-01-01

    Vacuum-assisted closure (VAC) has, in many instances, become the treatment of choice in patients with abdominal catastrophes. This study describes the use and outcome of ABThera KCI® VAC in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants. A prospective multicenter study including all patients treated with VAC during an eleven-month period. A total of 74 consecutive patients were included. Median age was 64.4 (9-89) years, 64% were men, and median body mass index was 25 (17-42). Duration of VAC treatment was median 4.5 (0-39) days with median 1 (0-16) dressing changes. Seventy per cent of the patients attended the intensive care unit. The 90-day mortality was 15%. A secondary closure of the fascia was obtained in 84% of the surviving patients. Only one patient developed an enteroatmospheric fistula. Patients with secondary closure were less likely to develop large hernias and had better self-evaluated physical health score (p closure when possible has yet to be proven in a randomized study.

  9. A cross-sectional survey comparing a free treatment program for advanced schistosomiasis japonica to a general assistance program.

    Science.gov (United States)

    Song, Langui; Wu, Xiaoying; Zhang, Beibei; Liu, Jiahua; Ning, An; Wu, Zhongdao

    2017-11-01

    The prevalence and intensity of schistosomiasis has dropped dramatically in China due to an effective integrated control program. However, advanced schistosomiasis is becoming a key challenge on the road to elimination. The aims of this study were to compare the disease condition between advanced cases under the general assistance program (GAP) and free treatment program (FTP) and to determine whether the FTP should be popularized to provide an objective reference for policymakers in China's advanced schistosomiasis control program. One hundred and ninety-four patients with schistosomiasis japonica who were enrolled in the GAP or FTP participated in this study. Little significant difference was observed in the potential confounders, including general characteristics, comorbidities, and lifestyle, indicating a similar effect on the pathology of liver damage caused by schistosome infection. There was no apparent difference in the incidence of common clinical symptoms. Furthermore, no significant difference was observed in the ultrasound findings, implying that the GAP and FTP groups shared a similar degree of liver lesion. With the exception of the abnormal rates of aspartate aminotransferase (AST), alkaline phosphatase (ALP), and hyaluronic acid (HA), the other serological indicators were comparable between the groups. Overall, the FTP is not a better option for controlling advanced schistosomiasis in China. It is important to reveal the precise mechanism underlying the pathogenesis of advanced schistosomiasis so that specific approaches to treating and preventing the development of advanced schistosomiasis can be developed and schistosomiasis can be eliminated in China.

  10. Post-operative benefits of animal-assisted therapy in pediatric surgery: a randomised study.

    Science.gov (United States)

    Calcaterra, Valeria; Veggiotti, Pierangelo; Palestrini, Clara; De Giorgis, Valentina; Raschetti, Roberto; Tumminelli, Massimiliano; Mencherini, Simonetta; Papotti, Francesca; Klersy, Catherine; Albertini, Riccardo; Ostuni, Selene; Pelizzo, Gloria

    2015-01-01

    Interest in animal-assisted therapy has been fuelled by studies supporting the many health benefits. The purpose of this study was to better understand the impact of an animal-assisted therapy program on children response to stress and pain in the immediate post-surgical period. Forty children (3-17 years) were enrolled in the randomised open-label, controlled, pilot study. Patients were randomly assigned to the animal-assisted therapy-group (n = 20, who underwent a 20 min session with an animal-assisted therapy dog, after surgery) or the standard-group (n = 20, standard postoperative care). The study variables were determined in each patient, independently of the assigned group, by a researcher unblinded to the patient's group. The outcomes of the study were to define the neurological, cardiovascular and endocrinological impact of animal-assisted therapy in response to stress and pain. Electroencephalogram activity, heart rate, blood pressure, oxygen saturation, cerebral prefrontal oxygenation, salivary cortisol levels and the faces pain scale were considered as outcome measures. After entrance of the dog faster electroencephalogram diffuse beta-activity (> 14 Hz) was reported in all children of the animal-assisted therapy group; in the standard-group no beta-activity was recorded (100% vs 0%, panimal-assisted therapy, though a higher variability in diastolic pressure was observed. Salivary cortisol levels did not show different behaviours over time between groups (p=0.70). Lower pain perception was noted in the animal-assisted group in comparison with the standard-group (p = 0.01). Animal-assisted therapy facilitated rapid recovery in vigilance and activity after anaesthesia, modified pain perception and induced emotional prefrontal responses. An adaptative cardiovascular response was also present. ClinicalTrials.gov NCT02284100.

  11. Nursing Assistants' Satisfaction or Dissatisfaction with Their Jobs in Long-Term Care: An Exploratory Study of Data from the First National Nursing Assistant Survey

    Science.gov (United States)

    Adams, Carmen Ann

    2010-01-01

    The purpose of this study was to explore some of the issues posed by the developers of the first National Nursing Assistant Survey (NNAS). One of the central issues was what factors influence job satisfaction among long-term care nursing assistants. Four areas that are more specific were investigated--initial employment decisions, initial training…

  12. Video-assisted thoracoscopic surgery under O-arm navigation system guidance for the treatment of thoracic disk herniations: surgical techniques and early clinical results.

    Science.gov (United States)

    Hur, Jung-Woo; Kim, Jin-Sung; Cho, Dong-Young; Shin, Jong-Mok; Lee, Jun-Ho; Lee, Sang-Ho

    2014-11-01

    This study describes the surgical technique and clinical results of video-assisted thoracoscopic surgery (VATS) assisted by an O-arm-based navigation system, used for the treatment of thoracic disk herniation (TDH). The trend toward the use of minimally invasive procedures with endoscopic visualization of the thoracic cavity in thoracic spine surgery has evolved. It is difficult to develop a new set of visuomotor skills unique to endoscopic procedures and understand the three-dimensional (3D) anatomy while performing a two-dimensional (2D) imaging procedure. Adding image guidance would have a positive impact on these procedures, making them safer and more precise. We report the results of 10 patients who underwent diskectomy for TDH using VATS assisted by an O-arm-based navigation system and describe the surgical technique. The average duration of the symptoms was 2.8 years; average operation time, 326.9 minutes; and average additional time required for the image guidance surgery using the O-arm-based navigation, ∼ 29.4 minutes. No complications occurred during the surgical procedure or the immediate postoperative period. The advantages of using navigational assistance during the surgical procedure include better visualization of the operative field, more accurate surgical planning, and optimization of the surgical approach involving the establishment of the correct drilling trajectory and safe decompression of the spinal cord, as well as the possibility of intraoperative control of bone resection. Georg Thieme Verlag KG Stuttgart · New York.

  13. Enhancing decomposition rate of perfluorooctanoic acid by carbonate radical assisted sonochemical treatment.

    Science.gov (United States)

    Phan Thi, Lan-Anh; Do, Huu-Tuan; Lo, Shang-Lien

    2014-09-01

    Perfluorooctanoic acid (PFOA) is a recalcitrant organic pollutant in wastewater because of its wide range of applications. Technologies for PFOA treatment have recently been developed. In this study, PFOA decomposition by sonochemical treatment was investigated to determine the effects of NaHCO3 concentrations, N2 saturation, and pH on decomposition rates and defluorination efficiencies. The results showed that PFOA decomposition by ultrasound treatment only (150 W, 40 kHz), with or without saturated N2, was decomposition and defluorination efficiencies of PFOA, however, greatly increased with the addition of carbonate radical reagents. PFOA was completely decomposed after 4h of sonochemical treatment with a carbonate radical oxidant and saturated N2. Without saturated N2, PFOA was also decomposed to a high (98.81%) degree. The highest PFOA decomposition and defluorination efficiencies occurred in N2 saturated solution containing an initial NaHCO3 concentration of 30 mM. Sonodecomposition of PFOA with CO3(-) radical was most favorable in a slightly alkaline environment (pH=8.65). There isn't any shorter-chain perfluorinated carboxylic acids detected except fluorine ions in final reaction solution. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Robot-assisted laparoscopic rectovaginopexy for rectal prolapse: a prospective cohort study on feasibility and safety

    NARCIS (Netherlands)

    Draaisma, W.A.; Nieuwenhuis, D.H.; Janssen, L.W.M.; Broeders, I.A.M.J.

    Robotic systems may be particularly supportive for procedures requiring careful pelvic dissection and suturing in the Douglas pouch, as in surgery for rectal prolapse. Studies reporting robot-assisted laparoscopic rectovaginopexy for rectal prolapse, however, are scarce. This prospective cohort

  15. Assessing observational studies of medical treatments

    Directory of Open Access Journals (Sweden)

    Butani Yogita

    2005-09-01

    Full Text Available Abstract Background Previous studies have assessed the validity of the observational study design by comparing results of studies using this design to results from randomized controlled trials. The present study examined design features of observational studies that could have influenced these comparisons. Methods To find at least 4 observational studies that evaluated the same treatment, we reviewed meta-analyses comparing observational studies and randomized controlled trials for the assessment of medical treatments. Details critical for interpretation of these studies were abstracted and analyzed qualitatively. Results Individual articles reviewed included 61 observational studies that assessed 10 treatment comparisons evaluated in two studies comparing randomized controlled trials and observational studies. The majority of studies did not report the following information: details of primary and ancillary treatments, outcome definitions, length of follow-up, inclusion/exclusion criteria, patient characteristics relevant to prognosis or treatment response, or assessment of possible confounding. When information was reported, variations in treatment specifics, outcome definition or confounding were identified as possible causes of differences between observational studies and randomized controlled trials, and of heterogeneity in observational studies. Conclusion Reporting of observational studies of medical treatments was often inadequate to compare study designs or allow other meaningful interpretation of results. All observational studies should report details of treatment, outcome assessment, patient characteristics, and confounding assessment.

  16. Responses to assisted suicide requests: an interview study with Swiss palliative care physicians.

    Science.gov (United States)

    Gamondi, Claudia; Borasio, Gian Domenico; Oliver, Pam; Preston, Nancy; Payne, Sheila

    2017-08-11

    Assisted suicide in Switzerland is mainly performed by right-to-die societies. Medical involvement is limited to the prescription of the drug and certification of eligibility. Palliative care has traditionally been perceived as generally opposed to assisted suicide, but little is known about palliative care physicians' involvement in assisted suicide practices. This paper aims to describe their perspectives and involvement in assisted suicide practices. A qualitative interview study was conducted with 23 palliative care physicians across Switzerland. Thematic analysis was used to interpret data. Swiss palliative care physicians regularly receive assisted suicide requests while none reported having received specific training in managing these requests. Participants reported being involved in assisted suicide decision making most were not willing to prescribe the lethal drug. After advising patients of the limits on their involvement in assisted suicide, the majority explored the origins of the patient's request and offered alternatives. Many participants struggled to reconcile their understanding of palliative care principles with patients' wishes to exercise their autonomy. The majority of participants had no direct contact with right-to-die societies, many desired better collaboration. A desire was voiced for a more structured debate on assisted suicide availability in hospitals and clearer legal and institutional frameworks. The Swiss model of assisted suicide gives palliative care physicians opportunities to develop roles which are compatible with each practitioner's values, but may not correspond to patients' expectations. Specific education for all palliative care professionals and more structured ways to manage communication about assisted suicide are warranted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Comparison of the Conventional Surgery and the Surgery Assisted by 3d Printing Technology in the Treatment of Calcaneal Fractures.

    Science.gov (United States)

    Zheng, Wenhao; Tao, Zhenyu; Lou, Yiting; Feng, Zhenhua; Li, Hang; Cheng, Liang; Zhang, Hui; Wang, Jianshun; Guo, Xiaoshan; Chen, Hua

    2017-09-19

    This study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of calcaneal fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients. we enrolled 75 patients with calcaneal fracture from April 2014 to August 2016. They were divided randomly into two groups: 35 cases of 3D printing group, 40 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan in 3D printing group. Operation duration, blood loss volume during the surgery, number of intraoperative fluoroscopy and fracture union time were recorded. The radiographic outcomes Böhler angle, Gissane angle, calcaneal width and calcaneal height and final functional outcomes including VAS and AOFAS score as well as the complications were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. The operation duration, blood loss volume and number of intraoperative fluoroscopy for 3D printing group was 71.4 ± 6.8 minutes, 226.1 ± 22.6 ml and 5.6 ± 1.9 times, and for conventional group was 91.3 ± 11.2 minutes, 288.7 ± 34.8 ml and 8.6 ± 2.7 times respectively. There was statistically significant difference between the conventional group and 3D printing group (p 3D printing group achieved significantly better radiographic results than conventional group both postoperatively and at the final follow-up (p 3D printing model. This study suggested the clinical feasibility of 3D printing technology in treatment of calcaneal fractures.

  18. Killing Bugs at the Bedside: A prospective hospital survey of how frequently personal digital assistants provide expert recommendations in the treatment of infectious diseases

    Directory of Open Access Journals (Sweden)

    Richardson W Scott

    2004-10-01

    Full Text Available Abstract Background Personal Digital Assistants (PDAS are rapidly becoming popular tools in the assistance of managing hospitalized patients, but little is known about how often expert recommendations are available for the treatment of infectious diseases in hospitalized patients. Objective To determine how often PDAs could provide expert recommendations for the management of infectious diseases in patients admitted to a general medicine teaching service. Design Prospective observational cohort study Setting Internal medicine resident teaching service at an urban hospital in Dayton, Ohio Patients 212 patients (out of 883 patients screened were identified with possible infectious etiologies as the cause for admission to the hospital. Measurements Patients were screened prospectively from July 2002 until October 2002 for infectious conditions as the cause of their admissions. 5 PDA programs were assessed in October 2002 to see if treatment recommendations were available for managing these patients. The programs were then reassessed in January 2004 to evaluate how the latest editions of the software would perform under the same context as the previous year. Results PDAs provided treatment recommendations in at least one of the programs for 100% of the patients admitted over the 4 month period in the 2004 evaluation. Each of the programs reviewed improved from 2002 to 2004, with five of the six programs offering treatment recommendations for over 90% of patients in the study. Conclusion Current PDA software provides expert recommendations for a great majority of general internal medicine patients presenting to the hospital with infectious conditions.

  19. Joint Forces Command - Operation United Assistance Case Study: Lessons and Best Practices

    Science.gov (United States)

    2016-07-01

    team (HAST) concept. (JP 3-29, Foreign Humanitarian Assistance , and ATP 3-57.20, Multi-Service Techniques for Civil Affairs Support to Foreign...version of this CALL publication is available to view, download, or reproduce from the CALL public website at http://call.army.mil. Reproduction of...this publication is welcomed and highly encouraged. Joint Forces Command – Operation United Assistance Case Study JFC-OUA CASE STUDY iii Foreword

  20. Enzyme-assisted hydrothermal treatment of food waste for co-production of hydrochar and bio-oil.

    Science.gov (United States)

    Kaushik, Rajni; Parshetti, Ganesh K; Liu, Zhengang; Balasubramanian, Rajasekhar

    2014-09-01

    Food waste was subjected to enzymatic hydrolysis prior to hydrothermal treatment to produce hydrochars and bio-oil. Pre-treatment of food waste with an enzyme ratio of 1:2:1 (carbohydrase:protease:lipase) proved to be effective in converting food waste to the two products with improved yields. The carbon contents and calorific values ranged from 43.7% to 65.4% and 17.4 to 26.9 MJ/kg for the hydrochars obtained with the enzyme-assisted pre-treatment, respectively while they varied from 38.2% to 53.5% and 15.0 to 21.7 MJ/kg, respectively for the hydrochars obtained with no pre-treatment. Moreover, the formation of carbonaceous microspheres with low concentrations of inorganic elements and diverse surface functional groups was observed in the case of enzyme-assisted food waste hydrochars. The enzymatic pre-treatment also facilitated the formation of the bio-oil with a narrow distribution of organic compounds and with the highest yield obtained at 350 °C. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. EFFICACY OF VACUUM ASSISTED CLOSURE DRESSINGS WHEN COMPARED TO MOIST WOUND DRESSINGS IN THE MANAGEMENT OF DIABETIC FOOT ULCERS : A PROSPECTIVE COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ballapalli Hari

    2015-10-01

    Full Text Available INTRODUCTION: F oot ulceration is mainly responsible for the morbidity of diabetes mellitus. They deprive the patient of quality working days and add to his financial burden. Several novel methods of wound healing came to vogue among which vacuum assisted dressing is becoming quite popular. Present study aim s to evaluate its efficacy when compared to regular moist wound dressings. OBJECTIVES: To study the effectiveness of vacuum assisted dressings in terms of Rate of wound healing. MATERIALS AND METHODS: we carried out a prospective study at Narayana medical college hospital on two groups (group A and group B of diabetic foot ulcer patients, whom we selected randomly after considering inclusion and exclusion criteria . Vacuum assisted dressings were done in group A patients and normal moist wound dressings in group B. At the start of the treatment and every week thereafter, size and depth of ulcers were recorded and results were compared at complete wound healing or at the end of 12 weeks of treatment whichever is earlier. S trict glycaemic control was maintaine d throughout the treatment period. RESULTS : significant healing was noticed in group A patients (vacuum assisted dressings group both in terms of ulcer size and depth. Wounds appeared more - healthy i.e. with less slough and more red granulation tissue in g roup A patients. CONCLUSION: vacuum assisted dressing is an efficacious method in the treatment of diabetic foot ulcers with significantly reduced hospital stay

  2. How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada

    Science.gov (United States)

    2013-01-01

    Background In Canada, the prevalence of oral diseases is very high among people on social assistance. Despite great need for dental treatment, many are reluctant to consult dental professionals, arguing that dentists do not welcome or value poor patients. The objective of this research was thus to better understand how dentists perceived and experienced treating people on social assistance. Methods This descriptive qualitative research was based on in-depth semi-structured interviews with 33 dentists practicing in Montreal, Canada. Generally organized in dentists’ offices, the interviews lasted 60 to 120 minutes; they were digitally recorded and later transcribed verbatim. The interview transcripts were coded with NVivo software, and data was displayed in analytic matrices. Three members of the research team interpreted the data displayed and wrote the results of this study. Results Dentists express high levels of frustration with people on social assistance as a consequence of negative experiences that fall into 3 categories: 1) Organizational issues (people on social assistance ostensibly make the organization of appointments and scheduling difficult); 2) Biomedical issues (dentists feel unable to provide them with adequate treatment and fail to improve their oral health); 3) Financial issues (they are not lucrative patients). To explain their stance, dentists blame people on social assistance for neglecting themselves, and the health care system for not providing adequate coverage and fees. Despite dentists’ willingness to treat all members of society, an accumulation of frustration leads to feelings of powerlessness and discouragement. Conclusions The current situation is unacceptable; we urge public health planners and governmental health agencies to ally themselves with the dental profession in order to implement concrete solutions. PMID:24192504

  3. Ultrasound-assisted synthesis of nanosized zero-valent iron for metal cations extraction and wastewater treatment applications

    Science.gov (United States)

    Mikhailov, I. Yu; Lysov, D. V.; Levina, V. V.; Mazov, I. N.; Gusev, A. A.; Yudintseva, T. I.; Kuznetsov, D. V.

    2016-01-01

    Nanosized zero-valent iron has shown good results in wastewater treatment and activation of physicochemical processes. Its applications in modern industry are complicated by high production costs of nanomaterials produced via existing synthesis routes. Therefore there is a need of cheap and high-productive methods of nanosized zero-valent iron with advanced functional properties. Improvement of oxidative conditions with additions may find its place in extraction of rare-earth metals, where high cost of nanomaterials could be viable. In this paper we studied an effect of ultrasonic irradiation on specific surface area and particle size of nanosized zero-valent iron synthesized by methods of chemical precipitation with high- temperature reduction in hydrogen flow and sodium borohydride reduction. Obtained results showed significant decrease of particle size and differences in particles morphology depending on presence of ultrasonication during synthesis and on chosen method. For ultrasonic-assisted synthesis with 100% amplitude, particle size calculated from specific surface area was 70 nm for sample synthesized by chemical precipitation with high-temperature reduction and 35 nm for borohydide reduction method compared to 63 nm for reference sample without ultrasonication.

  4. Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center.

    Science.gov (United States)

    Tan, Yueqiu; Gao, Ya; Lin, Ge; Fu, Meili; Li, Xihong; Yin, Xuyang; Du, Juan; Li, Jing; Li, Wen; Peng, Huanhuan; Yuan, Yuying; Chen, Fang; Jiang, Fuman; Zhang, Hongyun; Lu, Guangxiu; Gong, Fei; Wang, Wei

    2016-07-01

    The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART). In two years period, 565 pregnant women with ART twin pregnancies were prospectively tested by NIPT for screening for trisomy 21 (T21), 18 (T18), and 13 (T13) by sequencing cell-free DNA in maternal plasma. Positive NIPT results were confirmed by karyotyping, while negative results were interviewed after delivery. Pregnant decision based on NIPT and confirmation results was discussed during post-test counseling. In total of 565 cases, NIPT had a failure rate of 0.9% (5/565). Four cases of T21 were identified by NIPT and confirmed by karyotyping, resulting in 100% (95%CI 39.8%-100%) positive predictive value. Among 556 cases with NIPT negative results, 506 cases (91.0%) were confirmed by follow-up of postnatal phenotypes, while 33 cases (5.9%) had adverse pregnant outcomes with unconfirmed reasons because of the lack of cytogenetic samples. The remaining 17 cases (3.1%) refused follow-up. No false negative result was reported. With apparently high positive predictive value and low false positive rate, NIPT has the potential to be used as a good alternative approach of conventional prenatal screening at the first trimester in ART twin pregnancy. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  5. Patient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma.

    Science.gov (United States)

    Jenson, Alexander; Roter, Debra L; Mkocha, Harran; Munoz, Beatriz; West, Sheila

    2018-01-06

    Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA - villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012. 58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009). Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA. Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers. Copyright © 2018. Published by Elsevier B.V.

  6. In Vitro Antioxidant Treatment of Semen Samples in Assisted Reproductive Technology: Effects of Myo-Inositol on Nemaspermic Parameters

    Directory of Open Access Journals (Sweden)

    Mariangela Palmieri

    2016-01-01

    Full Text Available Male infertility and the poor quality of sperm seem to be influenced by oxidative stress. In particular, the reactive oxygen species (ROS mainly produced by morphologically altered spermatozoa affect sperm motility, morphology, and integrity. The aim of this study was to evaluate the efficacy of Myo-Inositol (Myo-Ins on a number of parameters such as viscosity and total and progressive motility of spermatozoa, in order to better validate its possible practical application in vitro, in order to improve the capacitation protocols commonly used in Assisted Reproductive Technology (ART. A total of 100 fresh and 25 thawed semen samples were analyzed in vitro prior to and after addition of Myo-Ins. Treatment of samples with Myo-Ins showed an increase in the sperm total and progressive motility in both fresh and thawed samples. Furthermore, Myo-Ins proved to be well tolerated by spermatozoa in vitro, demonstrating that it can be efficiently and safely used as antioxidant in the laboratory practice and for preparation of semen samples in ART.

  7. Efficacy evaluation of laparoscopy assisted ultrasound guided radiofrequency ablation in the treatment of hepatocellular carcinoma beneath the diaphragm

    Directory of Open Access Journals (Sweden)

    Song WANG

    2017-06-01

    Full Text Available Objective To explore the feasibility, safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA in the treatment of hepatocellular carcinoma (HCC beneath the diaphragm. Methods Twenty- three consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016. We observed the perioperative complications and followed- up long-term effect. Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation. No serious complications such as massive hemorrhage, biliary fistula and severe pleural effusion, hemopneumothorax occurred in the patients during perioperative period. CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area. Besides, the survival condition was satisfactory during follow-up period of 9-38 months. Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm. DOI: 10.11855/j.issn.0577-7402.2017.05.16

  8. [Qualitative and quantitative evaluation of an internal medicine assistance line dedicated to the diagnosis and treatment of diseases for general practice].

    Science.gov (United States)

    Castillo, J-M; Agard, C; Artifoni, M; Brisseau, J-M; Connault, J; Durant, C; Espitia, O; Masseau, A; Neel, A; Perrin, F; Pistorius, M-A; Planchon, B; Ponge, T; Hamidou, M; Pottier, P

    2016-05-01

    Clinical reasoning and treatment challenges within the scope of general practice led to the development of an internal medicine assistance line provided by Nantes University Hospital. The primary outcome of this study was to describe callers' profile, their requests and answers provided. A prospective, cross-sectional, observational, descriptive study was undertaken. For each call were identified the calling physician, her/his specialty and work setting, the call's object and adequacy, the answer provided, the time needed to connect with the assistance line, the time devoted by the internal medicine physician to provide an answer to the request, and whether the assistance line prevented a visit to the emergency room. Each calling physician was then called back to obtain demographic and professional characteristics, and data relating to the call and to the assistance line. Sixty-three days were analyzed and 276 calls identified. The 237 identified calling physicians were mainly females (54%, n=93), with a mean age of 46 years, graduated from Nantes University (65%, n=86), practicing ambulatory general medicine (69%, n=164) in Loire-Atlantique department area (82%, n=176) for a mean duration of 15 years. Calls were mostly associated with diagnostic challenges (61%, n=166) concerning clinical issues (57%, n=155). A sole telephone advice was the main type of answer provided (56%, n=147) and a visit to the emergency room was prevented for 17% of calls. The assistance line activity is adequate with its missions and seems to facilitate patients' healthcare delivery advocating for the development of similar structures in other units. Improvements relating to the information, availability and physicians' training should be considered. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  9. Therapeutic value of 3-D printing template-assisted 125I-seed implantation in the treatment of malignant liver tumors

    Directory of Open Access Journals (Sweden)

    Han T

    2017-07-01

    Full Text Available Tao Han,1,* Xiaodan Yang,1,* Ying Xu,2,* Zhendong Zheng,1,* Ying Yan,2 Ning Wang2 1Department of Oncology, 2Department of Radiotherapy, General Hospital of Shenyang Military Region, Shenyang, China *These authors contributed equally to this work Objective: To explore the therapeutic value of 3-D printing template-assisted 125I-seed implantation in the treatment of malignant liver tumors.Materials and methods: Fifteen liver cancer patients with 47 total lesions were treated with 3-D printing template-assisted radioactive seed implantation (group A, and 25 liver-tumor patients with 66 total lesions were treated with 125I-seed implantation without a template auxiliary (group B. Operation time, in-hospital time, operation complications, dose distribution, and response rate (number were compared between the two groups. Results: Shorter operation times and better dose distribution were observed in group A than in group B, and the differences were statistically significant. The response rate after 2 months was 86.7% (13 of 15 in group A and 84% (21 of 25 in group B; differences between the two groups were not significant.Conclusion: Application of 3-D printing template-assisted radioactive seed implantation in the treatment of malignant liver tumors can help shorten operation time and optimize radiation-dose distribution, is worthy of further study, and has clinical significance. Keywords: brachytherapy, stereotactic techniques, iodine isotopes, liver, carcinoma 

  10. Treatment of steam-assisted gravity drainage water using low coagulant dose and Fenton oxidation.

    Science.gov (United States)

    Al-As'ad, Ahmad; Husein, Maen M

    2014-08-01

    The use of coagulation and Fenton oxidation was studied for total organic carbon (TOC) and silica removal from steam-assisted gravity drainage (SAGD) water at 800C and two different concentrations replicating the stream feeding the warm lime softening unit having 675 mg/L TOC and 350 mg/L silica and the blowdown of the once through steam generator having 3700mg/L TOC and 2585 mg/L silica. Coagulation was carried out by the addition of FeCl3, Al(NO3)3 or Ca(NO3)2. The results showed that Fe(III) salt outperformed Al(III) and Ca(II) salts. A two-stage addition of 2.5 g FeCl3 per g TOC intermediated by a filtration unit resulted in approximately 72% TOC removal and more than 80% silica removal while maintaining low solid waste. Comparing results pertaining to coagulant concentration and final pH, it can be easily concluded that silica removal is governed by the resultant pH, whereas TOC removal was accomplished through surface neutralization and localized enmeshment coagulation. Fenton oxidation is proposed to further treat the filtrate obtained from the second stage Fe(III) coagulation. An additional 10% TOC removal could be achieved; at seven times lower H202 dose in the presence of Fe2+ or Fe0 reagent. Moreover, the advanced Fenton process resulted in high silica removal as a result of adsorption onto Fe(OH)3 precipitate, which formed at the equilibrium pH of the system.

  11. Percutaneous treatment of extrahepatic bile duct stones assisted by balloon sphincteroplasty and occlusion balloon

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong Sung; Kim, Ji Hyung; Choi, Young Woo; Lee, Tae Hee; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keum Won [Konyang University Hospital, Daejeon (Korea, Republic of)

    2005-12-15

    To describe the technical feasibility and usefulness of extrahepatic biliary stone removal by balloon sphincteroplasty and occlusion balloon pushing. Fifteen patients with extrahepatic bile duct stones were included in this study. Endoscopic stone removal was not successful in 13 patients, and two patients refused the procedure due to endoscopy phobia. At first, all patients underwent percutaneous transhepatic biliary drainage (PTBD). A few days later, through the PTBD route, balloon assisted dilatation for common bile duct (CBD) sphincter was performed, and then the stones were pushed into the duodenum using an 11.5 mm occlusion balloon. Success rate, reason for failure, and complications associated with the procedure were evaluated. Eight patients had one stone, five patients had two stones, and two patients had more than five stones. The procedure was successful in 13 patients (13/15). In 12 of the patients, all stones were removed in the first trial. In one patients, residual stones were discovered on follow-up cholangiography, and were subsequently removed in the second trial. Technical failure occurred in two patients. Both of these patients had severely dilated CBD and multiple stones with various sizes. Ten patients complained of pain in the right upper quadrant and epigastrium of the abdomen immediately following the procedure, but there were no significant procedure-related complications such as bleeding or pancreatitis. Percutaneous extrahepatic biliary stone removal by balloon sphincteroplasty and subsequent stone pushing with occlusion balloon is an effective, safe, and technically feasible procedure which can be used as an alternative method in patients when endoscopic extrahepatic biliary stone removal was not successful.

  12. Employee assistance program services for alcohol and other drug problems: implications for increased identification and engagement in treatment.

    Science.gov (United States)

    Jacobson, Jodi M; Sacco, Paul

    2012-01-01

    Fourteen million U.S. workers meet the diagnostic criteria for substance dependence, costing millions in lost productivity. Prior research suggests that employees who follow through with their Employee Assistance Program's (EAP) recommendations are more likely to participate and remain engaged in alcohol and other drug (AOD) treatment programs. This study identified rates of lifetime EAP service use for AOD problems and compared adults who reported using EAP services for AOD problems with those who used services other than EAP. Researchers analyzed a subset of participants from the National Epidemiologic Survey of Alcohol and Related Conditions who reported having received help for an AOD problem (NESARC, 2001-2002). Statistical analyses tested for differences in sociodemographic variables, lifetime mental health and substance abuse disorders, and health disability between EAP services users and users of other types of services. Among adults who sought services for AOD problems (n= 2,272), 7.58% (n= 166) reported using EAP services for these problems at some point during their lives. Major depressive disorder (lifetime), a drug use disorder (lifetime), and Black race/ethnicity were associated with a greater likelihood that someone would seek EAP services for help with their AOD problem. Results provide a foundation for researchers to understand who uses EAP services for AOD problems. Health and mental health professionals should increase their knowledge of EAP services to improve continuity of care for employees with AOD problems. EAPs are in a unique position to reach out to vulnerable employees in the workplace and engage them in treatment. Copyright © American Academy of Addiction Psychiatry.

  13. Male factor infertility and lack of openness about infertility as risk factors for depressive symptoms in males undergoing assisted reproductive technology treatment in Italy.

    Science.gov (United States)

    Babore, Alessandra; Stuppia, Liborio; Trumello, Carmen; Candelori, Carla; Antonucci, Ivana

    2017-04-01

    To investigate the association between male factor infertility and openness to discussing assisted reproductive technology (ART) treatment with levels of depression among men undergoing infertility treatment. Cross-sectional. Not applicable. Three hundred forty participants (170 men and their partners) undergoing ART treatments. Administration of a set of questionnaires. Depressive symptoms were detected by means of the Zung Depression Self-Rating Scale. Participants' willingness to share their infertility treatment experience with other people was assessed by means of self-report questionnaires. In this study, 51.8% of males chose not to discuss their ART treatments with people other than their partner. In addition, the decision to discuss or not discuss the ART treatments with others was significantly associated with men's depressive symptoms. Male factor infertility was significantly associated with depression when considered together with the decision not to discuss ART treatments with others. A general disposition characterized by a lack of openness with others seemed to be a significant predictor of depression. There is a need for routine fertility care to pay greater attention to men's emotional needs. Before commencing reproductive treatment, male patients may benefit from undergoing routine screening for variables (i.e., male factor infertility and openness to others about ART) that may affect their risk of depression. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Animal-assisted therapy used for anxiety disorders in patients with learning disabilities: An observational study

    OpenAIRE

    Giuliani, F; Jacquemettaz, M.

    2017-01-01

    Introduction: Animal-assisted therapy is defined as the positive interaction between an animal and a patient within a therapeutic framework. Previous studies have reported on the beneficial effects of animal-assisted therapy with patients suffering from anxiety, a major challenge for professionals caring for patients with intellectual disability. The presence of psychiatric comorbidities such as depression or anxiety within this population is two to four times higher than in the general popul...

  15. Perspectives on Transitioning to the Assistant Principalship among Peers: A Qualitative Study of Six New School Administrators

    Science.gov (United States)

    Workman, Everette H.

    2013-01-01

    The role of the assistant principal in the public schools is under studied and undervalued. As the largest group of school administrators and as future principals in training, the assistant principals' socialization process begs understanding. This study questions the transition from teacher to assistant principal, accounting for the setting and…

  16. 20 kHz ultrasound assisted treatment of chronic wounds with concurrent optic monitoring

    Science.gov (United States)

    Bawiec, Christopher R.; Sunny, Youhan; Diaz, David; Nadkarni, Sumati; Weingarten, Michael S.; Neidrauer, Michael; Margolis, David J.; Zubkov, Leonid; Lewin, Peter A.

    2015-05-01

    This paper describes a novel, wearable, battery powered ultrasound applicator that was evaluated as a therapeutic tool for healing of chronic wounds, such as venous ulcers. The low frequency and low intensity (~100mW/cm2) applicator works by generating ultrasound waves with peak-to-peak pressure amplitudes of 55 kPa at 20 kHz. The device was used in a pilot human study (n=25) concurrently with remote optical (diffuse correlation spectroscopy - DCS) monitoring to assess the healing outcome. More specifically, the ulcers' healing status was determined by measuring tissue oxygenation and blood flow in the capillary network. This procedure facilitated an early prognosis of the treatment outcome and - once verified - may eventually enable customization of wound management. The outcome of the study shows that the healing patients of the ultrasound treated group had a statistically improved (pulcers accelerates healing when combined with the current standard clinical care. The ultrasound applicator described here provides a user-friendly, fully wearable system that has the potential for becoming the first device suitable for treatment of chronic wounds in patient's homes, which - in turn - would increase patients' compliance and improve quality of life.

  17. The meaning of assisted feeding for people living with spinal cord injury: a phenomenological study

    DEFF Research Database (Denmark)

    Martinsen, B.; Harder, I.; Biering-Sørensen, Fin

    2008-01-01

    AIM: This paper is a report of a study to explore the meaning of assisted feeding through the experiences of people with high cervical spinal cord injury. Background. Eating difficulties are known to affect a person's self-image and transform social lives. Little is known about the experience...... the phenomenological guidelines by Dahlberg and colleagues. FINDINGS: The essence of the phenomenon assisted feeding was described as a constructed pattern based on coordinated attention between the person with high cervical spinal cord injury and the helper. The constituents of the essence were: paralysis...... to each individual person. Fixed procedures or routines should be avoided and assistive devices used with care. We recommend that continuity in the cooperation between the parties involved in assisted feeding is given priority, and that personal standard and social norms around meals are acknowledged...

  18. Effects of assistance dogs on persons with mobility or hearing impairments: a pilot study.

    Science.gov (United States)

    Rintala, Diana H; Matamoros, Rebeca; Seitz, Laura L

    2008-01-01

    Service dogs help persons with mobility impairments by retrieving items and performing other tasks. Hearing dogs alert persons with hearing impairments to environmental sounds. We conducted a pre-post, wait list-controlled pilot study to assess the impact of the dogs on the lives of recipients. Participants were recruited through two assistance dog training organizations and completed an initial questionnaire packet. The Experimental group completed another packet 6 months after receiving a dog. The Control group completed a second packet 6 months after the initial data collection. On average, dog recipients were very satisfied with their assistance dogs. Both service and hearing dog recipients reduced their dependence on other persons. Service dog recipients reduced hours of paid assistance. No other significant change occurred in various standardized outcome measures. Assistance dogs had a major positive impact on the lives of recipients. More appropriate measurement instruments are needed to capture the impact of these dogs.

  19. The use of Animal-Assisted Therapy in adolescents with acute mental disorders: A randomized controlled study.

    Science.gov (United States)

    Stefanini, M C; Martino, A; Allori, P; Galeotti, F; Tani, F

    2015-02-01

    The aim of this study was to compare the effects of Animal-Assisted Therapy (AAT) with a standard treatment protocol in children and adolescents admitted to the psychiatry hospital for acute mental disorders. We used a methodology involving high quality standards for AAT research. A pre-post experimental design with a randomized controlled trial (RCT) in 34 hospitalized patients (17 treatment, 17 control) was carried out. The study focused on improvement in clinical status including, global functioning measured by the Children Global Assessment Scale (C GAS), format of care and ordinary school attendance measured by a rating scale. Our results indicate a statistically significant improvement in global functioning, reduction in format of care and increased ordinary school attendance in the treatment group, but not in the control group. Our results verify that AAT can have significant positive effects on therapeutic progress and the recovery process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    Science.gov (United States)

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Exploring the experiences of bereaved families involved in assisted suicide in Southern Switzerland: a qualitative study.

    Science.gov (United States)

    Gamondi, Claudia; Pott, Murielle; Forbes, Karen; Payne, Sheila

    2015-06-01

    In Switzerland, helping with assisted suicide under certain conditions is not prosecuted. With approximately 300 cases annually, this leaves behind a large group of bereaved people where its consequences are mostly unknown. The study aimed to explore family involvement in decision making prior to assisted suicide, and to examine their ways of coping during the bereavement period. A qualitative interview study used the principles of Grounded Theory analysis. Eleven relatives of eight patients, who died in Southern Switzerland after assisted suicide, participated in semistructured interviews. The large majority of family members faced moral dilemmas during the decision-making phase. Their respect for patient's autonomy was a key justification to resolve dilemmas. Two types of involvement were identified: categorised as 'passive' when the decision making was located with the patient, and 'active' when assisted suicide was proposed by the family member and/or the relative was involved in some way. The relatives reported feelings of isolation during and after assisted suicide. Family members reported fear of social stigma and did not openly disclose assisted suicide as the cause of death. None of those interviewed received formal psychological support. Bereaved families express moral dilemmas, feelings of isolation and secrecy in the management of assisted suicide in Southern Switzerland. These features seem underestimated and not sufficiently recognised by the healthcare professionals. Management of assisted suicide requests should include consideration of family members' needs, in addition to those of the patient. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. [Preparation for assisted reproductive technology in the course of infertility treatment in the female soldiers].

    Science.gov (United States)

    Shmidt, A A; Molchanov, O L; Abashin, V G; Yarman, S A; Beskrovnyi, S V

    2016-04-01

    The level of obstetric morbidity in servicewomen remains high. Infertility occurs more often among the families of servicemen, than among the other families. The leading causative factor among the families suffering from infertility is tuboperitoneal or tubal (up to 85%). Assisted reproductive technologies are often the only possible mean to solve the problem of infertility in case of these forms of infertility.. The families of servicemen suffering from infertility were suggested the echelon principle of health care in military-medical institutions of the Ministry of Defence of the Russian Federation. Defined selection rules and directions, requiring the separation of the assisted reproductive technologies Clinic of Obstetrics and Gynaecology of the Kirov Military Medical Academy to carry out in vitro fertilization procedures.

  3. Treatment of Sagittal Fracture of the Zygomatic Arch Root Assisted by Surgical Navigation Technology.

    Science.gov (United States)

    Dai, Jin-Hong; Xu, Dong-Dong; Yang, Chang-Yuan; Li, Zu-Bing; Li, Zhi

    2018-01-29

    Sagittal fracture at the temporal root of the zygomatic arch often occurs as a part of zygomaticomaxillary fractures. The authors described the application of computer-assisted navigation in the lag screw insertion for the fixation of sagittal fracture at the temporal root of zygomatic arch. Using the presurgical planning of the computer-assisted navigation system, the trajectory of lag screw insertion was designed, and the insertion depth was calculated. In the presurgical planning, the trajectory of screw insertion was placed with an anterior inclination of 10° to 15° (mean: 12.24°), and the screw insertion depth was 9.0 to 12.0 mm (mean: 10.65 mm). In the operation, the screw insertion in the fixation of the sagittal fracture was performed under the guidance of navigation system according to the presurgical planning. The postoperative CT scan showed exact reduction and fixation of the sagittal fracture in all cases. Computer-assisted navigation is a useful tool for the lag screw insertion in the precise fixation of sagittal fracture at the temporal root of the zygomatic arch in complex zygomaticomaxillary fractures.

  4. A study: Effect of Students Peer Assisted Learning on Magnetic Field Achievement

    Science.gov (United States)

    Mueanploy, Wannapa

    2016-04-01

    This study is the case study of Physic II Course for students of Pathumwan Institute of Technology. The purpose of this study is: 1) to develop cooperative learning method of peer assisted learning (PAL), 2) to compare the learning achievement before and after studied magnetic field lesson by cooperative learning method of peer assisted learning. The population was engineering students of Pathumwan Institute of Technology (PIT’s students) who registered Physic II Course during year 2014. The sample used in this study was selected from the 72 students who passed in Physic I Course. The control groups learning magnetic fields by Traditional Method (TM) and experimental groups learning magnetic field by method of peers assisted learning. The students do pretest before the lesson and do post-test after the lesson by 20 items achievement tests of magnetic field. The post-test higher than pretest achievement significantly at 0.01 level.

  5. Breast reconstruction de novo by water-jet assisted autologous fat grafting – a retrospective study

    Directory of Open Access Journals (Sweden)

    Hoppe, Delia Letizia

    2013-12-01

    Full Text Available [english] Background: Autologous fat grafting has become a frequent, simple, reproducible and low-risk technique for revisional or partial breast reconstruction. The presented European multicenter study describes an optimized treatment and follow-up protocol for the de novo breast reconstruction after total mastectomy by lipotransfer alone.Methods: A retrospective European multicenter trial included 135 procedures on 28 (35 breasts postmastectomy patients (mean 52.4 years. All women were treated with the water-jet assisted fat grafting method (BEAULI™ combined with additional procedures (NAC reconstruction, contralateral mastoplasty and evaluated with at least 6 months follow-up (mean 2.6 years. Sonography or mammography, clinical examination, patient questionnaire (10-point Likert scale and digital photographs were carried out.Results: On average the patients received 4 to 6 procedures each with a single volume of 159 ml (±61 ml over 21 months (range 9 months to 2.5 years. In total 1,020 ml (±515 ml fat were grafted till a complete breast reconstruction was achieved. Irradiated patients needed a significantly higher volume than non-irradiated (p<0.041. Main treatment complications were liponecrosis (2.59%, infection (0.74% and granuloma (0.74%. Patient satisfaction was overall high to very high (96% and confirmed the good aesthetic results (68% and the natural softness, contour and shape of the reconstructed breast.Conclusions: A complete breast reconstruction with large volume fat grafting is alternatively possible to standard techniques in selected cases. It takes at least 4 to 6 lipotransfers in the course of 2 years. Patients with prior radiotherapy may require even up to 8 sessions over nearly 3 years of treatment.

  6. Microwave assisted thermal treatment of defective coffee beans press cake for the production of adsorbents.

    Science.gov (United States)

    Franca, Adriana S; Oliveira, Leandro S; Nunes, Anne A; Alves, Cibele C O

    2010-02-01

    Defective coffee press cake, a residue from coffee oil biodiesel production, was evaluated as an adsorbent for removal of basic dyes (methylene blue--MB) from aqueous solutions. The adsorbent was prepared by microwave treatment, providing a significant reduction in processing time coupled to an increase in adsorption capacity in comparison to conventional carbonization in a muffle furnace. Batch adsorption tests were performed at 25 degrees C and the effects of particle size, contact time, adsorbent dosage and initial solution pH were investigated. Adsorption kinetics was better described by a second-order model. The experimental adsorption equilibrium data were fitted to Langmuir, Freundlich and Tempkin adsorption models, with Langmuir providing the best fit. The results presented in this study show that microwave activation presents great potential as an alternative method in the production of adsorbents.

  7. Laser assisted periodontal treatment: from bactericidal effect to local modification of the host response

    Science.gov (United States)

    Ciurescu, Codruţa.; Teslaru, Silvia; Zetu, Liviu; Ciurescu, Daniel

    2016-03-01

    The aim of the present short-term study is to investigate efficiency of laser therapy as adjunct to conventional periodontal therapy in patients with chronic periodontitis. Methods. The study protocol included 44 patients (20 males, 24 females; age 45-60) with moderate and advanced chronic periodontitis, recruited in Private Clinic Krondent (Brasov, Romania). The patients were randomly assigned in two groups, one group (test-sites group, 22 patients) treated by ultrasonic scaling and root planning followed by laser therapy (940 nm diode laser and 2780 nm Er:Cr:YAG laser) and second group (control-sites group, 22 patients) treated only by ultrasonic scaling and root planning. All patients were submitted to initial evaluation, recording of bleeding on probing (BOP) and probing of pockets depth (PPD), oral hygiene instruction and motivation. Indices BOP and PPD for the assessed periodontal sites were also recorded at 8 weeks, 16 weeks and 24 weeks after treatment. Results. Periodontal inflammatory parameters PPD (PPD>=4mm) were significantly lower in test-sites group as compared with control-sites group at 2 months (82% vs. 90%), 4 months (42% vs. 62%), and 6 months (11% vs. 30%).Periodontal parameters BOP were lower among patients in control-sites group and test-sites group at 2 months (38% vs. 32%), and significantly lower in test-sites group at 4 months (42% vs.26%), and 6 months (44% vs. 24%). Conclusions. The additional use of laser therapy increases significantly the efficiency of periodontal treatment comparing with conventional periodontal therapy.

  8. Global computer-assisted appraisal of osteoporosis risk in Asian women: an innovative study.

    Science.gov (United States)

    Chang, Shu F; Hong, Chin M; Yang, Rong S

    2011-05-01

    To develop a computer-assisted appraisal system of osteoporosis that can predict osteoporosis health risk in community-dwelling women and to use it in an empirical analysis of the risk in Asian women. As the literature indicates, health risk assessment tools are generally applied in clinical practice for patient diagnosis. However, few studies have explored how to assist community-dwelling women to understand the risk of osteoporosis without invasive data. A longitudinal, evidence-based study. The first stage of this study is to establish a system that combines expertise in nursing, medicine and information technology. This part includes information from random samples (n = 700), including data on bone mineral density, osteoporosis risk factors, knowledge, beliefs and behaviour, which are used as the health risk appraisal system database. The second stage is to apply an empirical study. The relative risks of osteoporosis of the participants (n = 300) were determined with the system. The participants that were classified as at-risk were randomly grouped into experimental and control groups. Each group was treated using different nursing intervention methods. The sensitivity and specificity of the analytical tools was 75%. In empirical study, analysis results indicate that the prevalence of osteoporosis was 14.0%. Data indicate that strategic application of multiple nursing interventions can promote osteoporosis prevention knowledge in high-risk women and enhance the effectiveness of preventive action. The system can also provide people in remote areas or with insufficient medical resources a simple and effective means of managing health risk and implement the idea of self-evaluation and self-caring among community-dwelling women at home to achieve the final goal of early detection and early treatment of osteoporosis. This study developed a useful approach for providing Asia women with a reliable, valid, convenient and economical self-health management model. Health

  9. Ultrasound assisted synthesis of PMMA/clay nanocomposites: Study ...

    Indian Academy of Sciences (India)

    free emulsion polymerization technique. Ultrasound waves of different power and frequencies were applied to enhance the dispersion of the clay layers with polymer matrix. The structural information of the synthesized materials was studied by ...

  10. DLI-IBM Joint Feasibility Study in Computer-Assisted Foreign Language Instruction. Final Report.

    Science.gov (United States)

    Adams, Edward N.; Rosenbaum, Peter S.

    This document is the final report on a study of the use of computer assisted instruction (CAI). The objective of the study was to evaluate the potential applicability and usefulness of CAI in the instructional environment of the Defense Language Institute (DLI). The operational phases of the study were implemented in the Russian Aural…

  11. Robot-assisted end-effector-based gait training in chronic stroke patients: A multicentric uncontrolled observational retrospective clinical study.

    Science.gov (United States)

    Mazzoleni, Stefano; Focacci, Antonella; Franceschini, Marco; Waldner, Andreas; Spagnuolo, Chiara; Battini, Elena; Bonaiuti, Donatella

    2017-01-01

    Until now studies report inconclusive results as regards the effectiveness of exclusive use of robot-assisted training and clinical indications in stroke patients. To evaluate if the only robot-assisted end-effector-based gait training can be feasible in chronic stroke subjects in terms of gait recovery. Five rehabilitation centers participated and one hundred chronic post-stroke patients were recruited. Patients underwent a robot-assisted end-effector-based gait training as only rehabilitation treatment.6 Minute Walk Test, 10 Meter Walk Test, Timed Up and Go test, Modified Ashworth Scale, Motricity Index, Functional Ambulation Classification (FAC) and Walking Handicap Scale were used as outcome clinical measure. Patients were divided into two groups: those assessed as FAC robot-assisted end-effector-based gait training showed significant improvements in global motor performances, gait endurance, balance and coordination, lower limbs strength and even spasticity.

  12. Obstetric outcomes of monochorionic pregnancies conceived following assisted reproductive technology: A retrospective study

    Directory of Open Access Journals (Sweden)

    Mariano Mascarenhas

    2014-01-01

    Full Text Available Objectives : The overwhelming numbers of twins following assisted reproductive technology (ART are dichorionic twins, but monochorionic twins account for around 0.9% of post ART pregnancies. The data for post ART-monochorionic pregnancy outcomes are scarce due to the rarity of this condition. Hence, we evaluated the obstetric outcomes of monochorionic and dichorionic pregnancies conceived on ART. Settings : University teaching hospital. Study Design : A case-control study of monochorionic diamniotic (MCDA and dichorionic diamniotic (DCDA pregnancies conceived following ART treatment. Charts of all women who conceived following ART from 2008 to 2013 were screened. Among them, the monochorionic twins diagnosed in the first trimester were included and their obstetric outcome was followed-up. For comparison, an equal number of dichorionic twin pregnancies from age and body mass index matched mothers was selected. Results : The baseline clinical characteristics were similar between the two groups. MCDA group had a higher miscarriage rate (50% than the DCDA group (10%, with three seconds trimester miscarriages in the MCDA group. The live birth rates were lower in the MCDA versus DCDA group (40% vs. 90%. Among triplet pregnancies with a monochorionic component, the live birth rate was only 25%. Conclusions : Monochorionic pregnancies following ART have poorer obstetric outcomes when compared to dichorionic pregnancies. For monochorionic pregnancies following ART, intensive antenatal surveillance at a tertiary level obstetric and neonatal center may help optimize the outcome.

  13. Association of assisted reproductive technology (ART) treatment and parental infertility diagnosis with autism in ART-conceived children.

    Science.gov (United States)

    Kissin, D M; Zhang, Y; Boulet, S L; Fountain, C; Bearman, P; Schieve, L; Yeargin-Allsopp, M; Jamieson, D J

    2015-02-01

    Are assisted reproductive technology (ART) treatment factors or infertility diagnoses associated with autism among ART-conceived children? Our study suggests that the incidence of autism diagnosis in ART-conceived children during the first 5 years of life was higher when intracytoplasmic sperm injection (ICSI) was used compared with conventional IVF, and lower when parents had unexplained infertility (among singletons) or tubal factor infertility (among multiples) compared with other types of infertility. Some studies found an increased risk of autism among ART-conceived infants compared with spontaneously-conceived infants. However, few studies, and none in the USA, have examined the associations between types of ART procedures and parental infertility diagnoses with autism among ART-conceived children. Population-based retrospective cohort study using linkages between National ART Surveillance System (NASS) data for 1996-2006, California Birth Certificate data for 1997-2006, and California Department of Developmental Services (DDS) Autism Caseload data for 1997-2011. All live born ART-conceived infants born in California in 1997-2006 (n = 42 383) with 5-year observation period were included in the study. We assessed the annual incidence of autism diagnosis documented in DDS, which includes information on the vast majority of persons with autism in California, and the association of autism diagnosis with ART treatment factors and infertility diagnoses. Among ART-conceived singletons born in California between 1997 and 2006, the incidence of autism diagnosis remained at ∼0.8% (P for trend 0.19) and was lower with parental diagnosis of unexplained infertility (adjusted hazard risk ratio [aHRR]; 95% confidence interval: 0.38; 0.15-0.94) and higher when ICSI was used (aHRR 1.65; 1.08-2.52), when compared with cases without these patient and treatment characteristics. Among ART-conceived multiples, the incidence of autism diagnosis between 1997 and 2006 remained at

  14. Computer Assisted Instruction in Special Education Three Case Studies

    Directory of Open Access Journals (Sweden)

    İbrahim DOĞAN

    2015-09-01

    Full Text Available The purpose of this study is to investigate the computer use of three students attending the special education center. Students have mental retardation, hearing problem and physical handicap respectively. The maximum variation sampling is used to select the type of handicap while the convenience sampling is used to select the participants. Three widely encountered handicap types in special education are chosen to select the study participants. The multiple holistic case study design is used in the study. Results of the study indicate that teachers in special education prefer to use educational games and drill and practice type of computers programs. Also it is found that over use of the animation, text and symbols cause cognitive overload on the student with mental retardation. Additionally, it is also discovered that the student with hearing problem learn words better when the computers are used in education as compared to the traditional method. Furthermore the student with physical handicap improved his fine muscle control abilities besides planned course objectives when computers are used in special education.

  15. Curative effect of minimally invasive puncture and drainage assisted with alteplase on treatment of acute intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Jun-Lin Hu

    2017-01-01

    Full Text Available Objective: To investigate the different effects on evacuation of hematoma, the severity of nerve injury, inflammatory reaction and oxidative stress response in the treatment of acute intracerebral hemorrhage by using minimally invasive puncture and drainage assisted with alteplase or urokinase. Methods: A total of 114 patients with acute intracerebral hemorrhage treated with minimally invasive puncture and drainage in our hospital from May 2012 to October 2015 were retrospectively analyzed and divided into alteplase group and urokinase group, which received adjuvant therapy with alteplase and urokinase, respectively. Before and after treatment, CT was used for scanning, and the volume of hematoma and edema and the distance of midline shift were examined. After treatment, serum was collected for detecting the contents of molecular markers of nerve injury, inflammatory reaction and oxidative stress response. Results: On the 3rd day after treatment, the volume of hematoma and edema and the distance of midline shift in minimally invasive group were significantly lower than those of craniotomy group, and incidence of intracranial infection was lower than that of craniotomy group. There was no significant difference of rebleeding incidence compared to craniotomy group. The serum contents of osteopontin, S100β, glial fibrillary acidic protein, neuron-specific enolase, myelin basic protein, neuropeptide Y, ischemia modified albumin, tumor necrosis factor alpha, interleukin-1β, interleukin-6, interleukin-8, soluble intercellular adhesion molecule-1, highmobility group protein 1, malonaldehyde, advanced oxidation protein products and 8-hydroxy- 2'-deoxyguanosine urine of patients from alteplase group were significantly lower than those of urokinase group. The content of total antioxidant capacity was obviously higher than that of urokinase group. Conclusions: As for the effect on evacuation of hematoma and also the ameliorative effect on nerve injury

  16. Live birth outcome, spontaneous pregnancy and adoption up to five years after undergoing assisted reproductive technology treatment.

    Science.gov (United States)

    Volgsten, Helena; Schmidt, Lone

    2017-08-01

    This study is part of a longitudinal cohort undertaken in both women and men to describe live birth outcome after undergoing assisted reproductive technology (ART) treatment in a clinical setting. Another objective was to follow women and men living with children from other alternatives after ART, such as adoption. A total of 439 (80.5%) women and 423 (77.6%) men were included in the baseline cohort (2005-2007). Live birth rate after ART was 24.8% at baseline. Up to 5 years later (2010-2011) the same participants were sent individual postal questionnaires (n = 439). Overall, 278 (63.3%) women and 183 (41.7%) men filled in and returned the questionnaire at follow up. The majority of women (91.7%) and men (93.4%) were living with children. A total of 225 (80.9%) women had a live birth at follow up. Of these, almost three of four (71.6%) had a live birth after ART and more than one of four (28.0%) after spontaneous pregnancies or both. Of these, 52 (26.1%) women had a subsequent live birth after successful ART and 26 (32.9%) women after unsuccessful ART. Nineteen (6.8%) women and 13 (7.1%) men had a child after adoption. Almost one of five (19.1%) women had no live birth at follow up. The majority of women and men were living with children, resulting from a live birth after ART, spontaneous pregnancy and/or adoption up to 5 years later. However, almost one of five had no live birth at follow up. © 2017 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

  17. Successful Treatment of Anterior Tracheal Necrosis after Total Thyroidectomy Using Vacuum-Assisted Closure Therapy

    Science.gov (United States)

    Philippe, Grégory; Pichon, Nicolas; Lerat, Justine; Amiel, Jean Bernard; Clavel, Marc; Mathonnet, Muriel

    2012-01-01

    Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following total thyroidectomy treated using vacuum-assisted closure device. After two weeks of VAC  therapy, there was no evidence of ongoing infection and the trachea was partially closed around a tracheotomy cannula, removed after 3 months. The use of a VAC  therapy to reduce and close the tracheal rent and to create a rapid granulation tissue over tracheal structure appeared as a good opportunity after anterior tracheal necrosis. PMID:21808730

  18. Successful Treatment of Anterior Tracheal Necrosis after Total Thyroidectomy Using Vacuum-Assisted Closure Therapy

    Directory of Open Access Journals (Sweden)

    Grégory Philippe

    2012-01-01

    Full Text Available Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following total thyroidectomy treated using vacuum-assisted closure device. After two weeks of VAC  therapy, there was no evidence of ongoing infection and the trachea was partially closed around a tracheotomy cannula, removed after 3 months. The use of a VAC  therapy to reduce and close the tracheal rent and to create a rapid granulation tissue over tracheal structure appeared as a good opportunity after anterior tracheal necrosis.

  19. Post-operative benefits of animal-assisted therapy in pediatric surgery: a randomised study.

    Directory of Open Access Journals (Sweden)

    Valeria Calcaterra

    Full Text Available Interest in animal-assisted therapy has been fuelled by studies supporting the many health benefits. The purpose of this study was to better understand the impact of an animal-assisted therapy program on children response to stress and pain in the immediate post-surgical period.Forty children (3-17 years were enrolled in the randomised open-label, controlled, pilot study. Patients were randomly assigned to the animal-assisted therapy-group (n = 20, who underwent a 20 min session with an animal-assisted therapy dog, after surgery or the standard-group (n = 20, standard postoperative care. The study variables were determined in each patient, independently of the assigned group, by a researcher unblinded to the patient's group. The outcomes of the study were to define the neurological, cardiovascular and endocrinological impact of animal-assisted therapy in response to stress and pain. Electroencephalogram activity, heart rate, blood pressure, oxygen saturation, cerebral prefrontal oxygenation, salivary cortisol levels and the faces pain scale were considered as outcome measures.After entrance of the dog faster electroencephalogram diffuse beta-activity (> 14 Hz was reported in all children of the animal-assisted therapy group; in the standard-group no beta-activity was recorded (100% vs 0%, p<0.001. During observation, some differences in the time profile between groups were observed for heart rate (test for interaction p = 0.018, oxygen saturation (test for interaction p = 0.06 and cerebral oxygenation (test for interaction p = 0.09. Systolic and diastolic blood pressure were influenced by animal-assisted therapy, though a higher variability in diastolic pressure was observed. Salivary cortisol levels did not show different behaviours over time between groups (p=0.70. Lower pain perception was noted in the animal-assisted group in comparison with the standard-group (p = 0.01.Animal-assisted therapy facilitated rapid recovery in vigilance and

  20. Comparing the Efficacy of Biofeedback and Balloon-Assisted Training in the Treatment of Dyssynergic Defecation

    Directory of Open Access Journals (Sweden)

    Abbs Ali Pourmomeny

    2011-01-01

    Full Text Available BACKGROUND: Dyssynergic defecation does not respond appropriately to routine treatments for constipation. Recently, research has shown that biofeedback therapy is useful in anorectal dyssynergia.

  1. A Comparative Study of Single-Port Laparoscopic Surgery Versus Robotic-Assisted Laparoscopic Surgery for Rectal Cancer

    DEFF Research Database (Denmark)

    Levic, Katarina; Donatsky, Anders Meller; Bulut, Orhan

    2015-01-01

    INTRODUCTION: Conventional laparoscopic surgery is the treatment of choice for many abdominal procedures. To further reduce surgical trauma, new minimal invasive procedures such as single-port laparoscopic surgery (SPLS) and robotic assisted laparoscopic surgery (RALS) have emerged. The aim...

  2. Surgically assisted maxillary expansion in adults: prospective study.

    Science.gov (United States)

    de Freitas, R R; Gonçalves, A J; Moniz, N J; Maciel, F A

    2008-09-01

    The purpose of this research was to carry out a prospective clinical study of patients with transverse maxillary deficiency, orthopaedically expanded after minimum osteotomies of the zygomatic pillars and the median palatine suture, with quantitative assessment of the stability of the transverse dimensions of the maxilla. The distance between the superior canines and the first superior molars was measured six times during the clinical experiment. The desired expansion was achieved by 15 days postoperatively for all patients. After one year of follow-up, clinical measurements showed a relapse rate of 23% in the superior canine area and 18% in the superior first molar area.

  3. Exploring the outcomes of a novel computer-assisted treatment program targeting expressive-grammar deficits in preschoolers with SLI.

    Science.gov (United States)

    Washington, Karla N; Warr-Leeper, Genese; Thomas-Stonell, Nancy

    2011-01-01

    The impact of a newly designed computer-assisted treatment (C-AT) program, My Sentence Builder, for the remediation of expressive-grammar deficits in children with specific language impairment (SLI) was explored. This program was specifically designed with features to directly address expressive-grammar difficulties, thought to be associated with hypothesized deficits in verbal working memory (VWM). Thirty-four preschoolers with deficits in expressive-grammar morphology participated. Using the randomization procedure of consecutive sampling, participants were recruited. Twenty-two participants were consecutively assigned to one of two treatment groups, C-AT or non C-AT (nC-AT). The nC-AT utilized conventional language stimulation procedures containing features which have been traditionally used to address expressive-grammar deficits. A group of equivalent children awaiting treatment and chosen from the same sample of children as the treatment participants served as a control group. Blind assessments of outcomes were completed pre-, post-, and 3-months post-treatment in a formal and informal context. C-AT and nC-AT participants significantly outperformed controls pre-to-post to 3-months post-treatment in both assessment contexts. No significant differences in treatment gains were found between C-AT and nC-AT. Results suggested that treatments designed to directly address expressive-grammar deficits were better than no treatment for preschool SLI. Further, use of a C-AT program may be another feasible treatment method for this disorder population. As a result of this activity, the reader will recognize that: (1) expressive-grammar treatment is better than no treatment for immediate and continued language growth, (2) use of a C-AT program containing specific features designed to directly address expressive-grammar deficits is another viable, but not necessarily a better treatment option for the remediation of expressive-grammar deficits in preschool children with SLI

  4. Computer Assisted English Language Learning in Costa Rican Elementary Schools: An Experimental Study

    Science.gov (United States)

    Alvarez-Marinelli, Horacio; Blanco, Marta; Lara-Alecio, Rafael; Irby, Beverly J.; Tong, Fuhui; Stanley, Katherine; Fan, Yinan

    2016-01-01

    This study presents first-year findings of a 25-week longitudinal project derived from a two-year longitudinal randomized trial study at the elementary school level in Costa Rica on effective computer-assisted language learning (CALL) approaches in an English as a foreign language (EFL) setting. A pre-test-post-test experimental group design was…

  5. Our Life Depends on This Drug: Competence, Inequity, and Voluntary Consent in Clinical Trials on Supervised Injectable Opioid Assisted Treatment.

    Science.gov (United States)

    Steel, Daniel; Marchand, Kirsten; Oviedo-Joekes, Eugenia

    2017-12-01

    Supervised injectable opioid assisted treament (siOAT) prescribes injectable opioids to individuals for whom other forms of addiction treatment have been ineffective. In this article, we examine arguments that opioid-dependent people should be assumed incompetent to voluntarily consent to clinical research on siOAT unless proven otherwise. We agree that concerns about competence and voluntary consent deserve careful attention in this context. But we oppose framing the issue solely as a matter of the competence of opioid-dependent people and emphasize that it should be considered in the context of inequities in access to siOAT as a medical treatment. Consequently, we suggest that bioethics literature on nonexploitation, which focuses on clinical research in low-income countries, is helpful due to locating ethical issues within systemic social conditions. Finally, we consider the implications of our argument for the ethics of clinical research on siOAT.

  6. Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study.

    Science.gov (United States)

    Vedana, Kelly Graziani Giacchero; Magrini, Daniel Fernando; Miasso, Adriana Inocenti; Zanetti, Ana Carolina Guidorizzi; de Souza, Jacqueline; Borges, Tatiana Longo

    2017-08-01

    To understand emergency nursing experiences in assisting people with suicidal behavior. Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Obstetric outcomes of monochorionic pregnancies conceived following assisted reproductive technology: A retrospective study.

    Science.gov (United States)

    Mascarenhas, Mariano; Kamath, Mohan S; Muthukumar, K; Mangalaraj, Ann M; Chandy, Achamma; Aleyamma, Tk

    2014-04-01

    The overwhelming numbers of twins following assisted reproductive technology (ART) are dichorionic twins, but monochorionic twins account for around 0.9% of post ART pregnancies. The data for post ART-monochorionic pregnancy outcomes are scarce due to the rarity of this condition. Hence, we evaluated the obstetric outcomes of monochorionic and dichorionic pregnancies conceived on ART. University teaching hospital. A case-control study of monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) pregnancies conceived following ART treatment. Charts of all women who conceived following ART from 2008 to 2013 were screened. Among them, the monochorionic twins diagnosed in the first trimester were included and their obstetric outcome was followed-up. For comparison, an equal number of dichorionic twin pregnancies from age and body mass index matched mothers was selected. The baseline clinical characteristics were similar between the two groups. MCDA group had a higher miscarriage rate (50%) than the DCDA group (10%), with three seconds trimester miscarriages in the MCDA group. The live birth rates were lower in the MCDA versus DCDA group (40% vs. 90%). Among triplet pregnancies with a monochorionic component, the live birth rate was only 25%. Monochorionic pregnancies following ART have poorer obstetric outcomes when compared to dichorionic pregnancies. For monochorionic pregnancies following ART, intensive antenatal surveillance at a tertiary level obstetric and neonatal center may help optimize the outcome.

  8. Periodontal and dental effects of surgically assisted rapid maxillary expansion, assessed by using digital study models

    Directory of Open Access Journals (Sweden)

    Danilo Furquim Siqueira

    2015-06-01

    Full Text Available OBJECTIVE: The present study assessed the maxillary dental arch changes produced by surgically assisted rapid maxillary expansion (SARME. METHODS: Dental casts from 18 patients (mean age of 23.3 years were obtained at treatment onset (T1, three months after SARME (T2 and 6 months after expansion (T3. The casts were scanned in a 3D scanner (D-250, 3Shape, Copenhagen, Denmark. Maxillary dental arch width, dental crown tipping and height were measured and assessed by ANOVA and Tukey's test. RESULTS: Increased transversal widths from T1 and T2 and the maintenance of these values from T2 and T3 were observed. Buccal teeth tipping also showed statistically significant differences, with an increase in all teeth from T1 to T2 and a decrease from T2 to T3. No statistically significant difference was found for dental crown height, except for left first and second molars, although clinically irrelevant. CONCLUSION: SARME proved to be an effective and stable procedure, with minimum periodontal hazards.

  9. Comparative analysis of three sperm DNA damage assays and sperm nuclear protein content in couples undergoing assisted reproduction treatment.

    Science.gov (United States)

    Simon, L; Liu, L; Murphy, K; Ge, S; Hotaling, J; Aston, K I; Emery, B; Carrell, D T

    2014-05-01

    Is there an association between sperm DNA damage, measured by three different assays, sperm nuclear protein content and clinical outcomes in assisted reproduction treatment (ART)? Sperm DNA damage measured by terminal deoxynucleotidyltransferase-mediated dUTP nick-end labelling (TUNEL) and the Comet assay were significantly associated with ART outcomes in our single institution study. Abnormal protamine expression is known to be associated with sperm DNA damage and male infertility. A number of studies have shown a significant relationship between sperm DNA damage and ART outcomes. To date, there are no large studies providing direct comparisons of DNA damage tests within the same study population. Thus, the prognostic value for each method remains unknown. Cross-sectional study of 238 men from infertile couples undergoing ART at the University Center for Reproductive Medicine, Utah, USA, between April 2011 and March 2013. Sperm from men undergoing ART were tested for DNA damage using the alkaline Comet assay, TUNEL and flow cytometric chromatin evaluation (FCCE) assays. Histone retention was analysed using the aniline blue staining method, whereas protamine content (proteins P1 and P2) and ratio were analysed using acid urea gel electrophoresis. The prognostic value of each sperm DNA test to predict clinical pregnancy was calculated. Histone retention was associated with sperm DNA damage (P sperm with DNA damage was significantly higher in sperm from non-pregnant couples compared with that from pregnant couples, as measured by TUNEL assay (15.04 ± 1.16% versus 8.79 ± 0.56%; P Comet assay (72.79 ± 2.49% versus 55.86 ± 2.29%; P sperm count (P = 0.013), men's age (P = 0.037), maturity (P = 0.049) and blastocyst quality (P = 0.012). Histone retention and sperm DNA damage measured by Comet and TUNEL assays were associated with fertilization rate (P sperm is one part of the equation; there are also a number of female factors that have the potential to influence ART

  10. Nursing assistants matters-An ethnographic study of knowledge sharing in interprofessional practice.

    Science.gov (United States)

    Lindh Falk, Annika; Hult, Håkan; Hammar, Mats; Hopwood, Nick; Abrandt Dahlgren, Madeleine

    2017-08-03

    Interprofessional collaboration involves some kind of knowledge sharing, which is essential and will be important in the future in regard to the opportunities and challenges in practices for delivering safe and effective health care. Nursing assistants are seldom mentioned as a group of health care workers that contribute to interprofessional collaboration in health care practice. The aim of this ethnographic study was to explore how the nursing assistants' knowledge can be shared in a team on a spinal cord injury rehabilitation ward. Using a sociomaterial perspective on practice, we captured different aspects of interprofessional collaboration in health care. The findings reveal how knowledge was shared between professionals, depending on different kinds of practice architecture. These specific cultural-discursive, material-economic, and social-political arrangements enabled possibilities through which nursing assistants' knowledge informed other practices, and others' knowledge informed the practice of nursing assistants. By studying what health care professionals actually do and say in practice, we found that the nursing assistants could make a valuable contribution of knowledge to the team. © 2017 John Wiley & Sons Ltd.

  11. Minimally Invasive Sinus Tarsi Approach With Cannulated Screw Fixation Combined With Vacuum-Assisted Closure for Treatment of Severe Open Calcaneal Fractures With Medial Wounds.

    Science.gov (United States)

    Zhang, Taiyuan; Yan, Yan; Xie, Xinmin; Mu, Weidong

    2016-01-01

    The aim of our prospective study was to investigate the clinical results and advantages of a minimally invasive sinus tarsi approach with cannulated screw fixation combined with vacuum-assisted closure for the treatment of severe open calcaneal fractures with medial wounds. A total of 31 patients (32 feet) with open calcaneal fractures who were admitted to our hospital from January 2008 to May 2013 were selected for the study and randomly divided into 2 groups: the cannulated screw group (n = 16 patients, 16 feet) and the plate group (n = 15 patients, 16 feet). The Böhler and Gissane angles were compared before and after surgery. The clinical results were evaluated using according to the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale and the rate of infection. The follow-up duration for all patients ranged from 10 to 36 (mean 24) months. No statistically significant differences were found in the radiologic indicators, incidence of early postoperative complications, or American Orthopaedic Foot and Ankle Society ankle-hindfoot scores (p > .05) between the 2 groups. However, a statistically significant difference was seen in the duration of hospitalization (p vacuum-assisted closure is an effective method for the treatment of severe open calcaneal fractures with medial wounds. It provides good reduction and requires fewer days of hospitalization. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Nonextraction Treatment of Severe Crowding with the Aid of Corticotomy-Assisted Orthodontics

    Directory of Open Access Journals (Sweden)

    Ali S. Aljhani

    2012-01-01

    Full Text Available This paper illustrates the combined nonextraction orthodontic treatment with the corticotomy technique in an adult patient (age: 25 years and 3 months with severely crowded arches to accelerate tooth movement and shorten the treatment time. Both her upper lateral incisors were congenitally absent and both upper central incisors’ roots were short. Initial fixed orthodontic appliances (bidimensional were bonded and one week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxilla and mandible was performed. Orthodontic activation to level and align and unravel the crowding was performed every two weeks. The total treatment time was 8 months with no adverse effects observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful alignment of both arches with ideal overbite and overjet as well as adequate occlusion was achieved.

  13. Corticotomy assisted treatment of anterior open bite in an adult patient

    Directory of Open Access Journals (Sweden)

    Eshan Awasthi

    2016-01-01

    Full Text Available This case report discusses orthodontic treatment combined with the corticotomy technique to accelerate tooth movement and shorten the treatment time in a 34-year-old female patient with an anterior open bite and flared and spaced upper and lower incisors. Fixed orthodontic appliances (MBT 0.018″ edgewise brackets were bonded, and 4 months later, buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from canine to canine was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 10 months with an active period of 4 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth was achieved.

  14. Feasibility study of a computer-assisted radioguided surgery system

    Science.gov (United States)

    Massari, R.; Trotta, C.; Trinci, G.; Sala, R.; Basso, A.; Zappa, E.; Scopinaro, F.; Soluri, A.

    2007-12-01

    This paper deals with the study of a system prototype that can be used as an auxiliary tool in radioguided surgery methods. The use of new technologies in radioguided surgery concern the exact positioning of the lesion to be exerted. This is possible, in operation theatre, thanks to portable scintigraphics devices or to radiation counters. Due to lack of a coordinate system in the operation field, it is difficult for the surgeon to localize the pathology after removing the detection instrument. The system proposed in this paper is composed mainly of three elements: a handheld, high-resolution gamma camera with a small Field Of View (FOV) based on Hamamatsu R8900-00-C12 Position Sensitive Photomultiplier Tube (PSPMT), a laser scanner for the reconstruction of the body district and a stereoscopic system for contactless surgical tool tracking. Analyzing a set of scintigraphic images, taken from different projections, it is possible to localize the three-dimensional position of the lesion. Thanks to the use of the scanner and image fusion techniques, the pathology is shown on a PC monitor correctly positioned with respect to the body surface. Using a couple of stereoscopic cameras, the surgical tool can be tracked and shown on the same monitor, so that the surgeon can know the instantaneous relative position between the tool and the pathology. Exploiting these systems, a navigation system prototype has been developed that is suitable for radioguided surgical application.

  15. Feasibility study of a computer-assisted radioguided surgery system

    Energy Technology Data Exchange (ETDEWEB)

    Massari, R.; Trotta, C. [Institute of Biomedical Engineering, CNR, Via Salaria Km 29.300, C.P. 10 00016 Monterotondo, Rome (Italy); Li-tech srl, Lauzacco Pavia di Udine (UD) (Italy); Trinci, G. [Institute of Biomedical Engineering, CNR, Via Salaria Km 29.300, C.P. 10 00016 Monterotondo, Rome (Italy); Sala, R.; Basso, A.; Zappa, E. [Politecnico di Milano, IV Facolta di Ingegneria, Dipartimento di Meccanica, Milan (Italy); Scopinaro, F. [Institute of Biomedical Engineering, CNR, Via Salaria Km 29.300, C.P. 10 00016 Monterotondo, Rome (Italy); Department of Radiological Sciences, University ' La Sapienza' Rome (Italy); Soluri, A. [Institute of Biomedical Engineering, CNR, Via Salaria Km 29.300, C.P. 10 00016 Monterotondo, Rome (Italy); Li-tech srl, Lauzacco Pavia di Udine (Italy)], E-mail: soluri@isib.cnr.it

    2007-12-21

    This paper deals with the study of a system prototype that can be used as an auxiliary tool in radioguided surgery methods. The use of new technologies in radioguided surgery concern the exact positioning of the lesion to be exerted. This is possible, in operation theatre, thanks to portable scintigraphics devices or to radiation counters. Due to lack of a coordinate system in the operation field, it is difficult for the surgeon to localize the pathology after removing the detection instrument. The system proposed in this paper is composed mainly of three elements: a handheld, high-resolution gamma camera with a small Field Of View (FOV) based on Hamamatsu R8900-00-C12 Position Sensitive Photomultiplier Tube (PSPMT), a laser scanner for the reconstruction of the body district and a stereoscopic system for contactless surgical tool tracking. Analyzing a set of scintigraphic images, taken from different projections, it is possible to localize the three-dimensional position of the lesion. Thanks to the use of the scanner and image fusion techniques, the pathology is shown on a PC monitor correctly positioned with respect to the body surface. Using a couple of stereoscopic cameras, the surgical tool can be tracked and shown on the same monitor, so that the surgeon can know the instantaneous relative position between the tool and the pathology. Exploiting these systems, a navigation system prototype has been developed that is suitable for radioguided surgical application.

  16. Accuracy study of new computer-assisted orthopedic surgery software

    Energy Technology Data Exchange (ETDEWEB)

    Sidon, Eli [Department of Orthopaedic Surgery, Beilinson-Rabin Medical Center, Petach Tikva (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Steinberg, Ely L., E-mail: steinberge@tasmc.health.gov.il [Department of Orthopaedic Surgery, Tel-Aviv Medical Center, Tel Aviv (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2012-12-15

    Purpose: The new computerized system is based on image analysis and designed to aid in orthopedic surgeries by virtual trajectory of the guide wire, intra-operative planning and various measurements. Validation of the accuracy and safety of any computer-aided surgery system is essential before implementing it clinically. We examined the accuracy of guide-wire length and angle measurements and fusion of multiple adjacent images (panoramic view image, PVI{sup ®}) of the new software. Methods: This is a 2-part study. Part I: twenty guide wires were drilled to various depths in a synthetic femur model and the results obtained by the software measurements were compared with manual measurements by a caliper and a depth gauge. Part II: a sawbone femur shaft was osteotomized and various inclinations of >10° to the varus or valgus angles were tested. The manually obtained measurements of angles and lengths were compared to the new computerized system software PVI. Results: There was a significant positive linear correlation between all groups of the computerized length and the control measurements (r > 0.983, p < 0.01). There was no significant difference among different distances, angles or positions from the image intensifier. There was a significant positive linear correlation between the angle and length measurement on the PVI and the control measurement (r > 0.993, p < 0.01). Conclusions: The new computerized software has high reliability in performing measurements of length using an aiming, positioning and referring device intra-operatively.

  17. Capillary refill time: a study of interobserver reliability among nurses and nurse assistants

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Hosbond, Susanne; Folkestad, Lars

    2011-01-01

    OBJECTIVES: The interobserver variability of capillary refill time (CRT) has been questioned. Earlier studies of interobserver variability of CRT have been on a large number of patients but with few observers. The objective of our study was to investigate how a large group of nurses and nurse...... assistants would grade CRT. METHODS: We recorded a video of the index finger of six medical patients and these were shown to nurses and nurse assistants. They were asked to record the CRT and whether they found this value to be normal. The data were analyzed using the Fleiss Kappa Coefficient Analysis...... and graded according to the Landis and Koch correlation. Correlation between the exact numbers was evaluated using interclass correlation. RESULTS: Nine nurse assistants and 37 nurses participated. The patients were aged between 44 and 87 years. All but one patient had a systolic blood pressure reading above...

  18. Screening for homelessness among individuals initiating medication-assisted treatment for opioid use disorder in the Veterans Health Administration.

    Science.gov (United States)

    Bachhuber, Marcus A; Roberts, Christopher B; Metraux, Stephen; Montgomery, Ann Elizabeth

    2015-01-01

    To determine the prevalence of homelessness and risk for homelessness among veterans with opioid use disorder initiating treatment. Addiction treatment programs operated by the US Department of Veterans Affairs (VA). All veterans initiating treatment with methadone or buprenorphine for opioid use disorder between October 1, 2013 and September 30, 2014 (n = 2,699) who were administered the VA's national homelessness screener. Self-reported homelessness or imminent risk of homelessness. The prevalence of homelessness was 10.2 percent and 5.3 percent were at risk for homelessness. Compared to male veterans, women veterans were less likely to report homelessness (8.9 percent vs 10.3 percent) but more likely to be at risk (11.8 percent vs 4.9 percent). By age group, veterans aged 18-34 and 45-54 years most frequently reported homelessness (12.0 and 11.7 percent, respectively) and veterans aged 45-54 and 55-64 years most frequently reported risk for homelessness (6.5 and 6.8 percent, respectively). The prevalence of homelessness in this population is approximately 10 times that of the general veteran population accessing care at VA. Screening identified a substantial number of veterans who could benefit from VA housing assistance and had not received it recently. Programs to address veteran homelessness should engage with veterans seeking addiction treatment. Integration of homelessness services into addiction treatment settings may, in turn, improve outcomes.

  19. Two-steps microwave-assisted treatment on acid hydrolysis of sago pith for bioethanol production

    Science.gov (United States)

    Sunarti, T. C.; Yanti, S. D.; Ruriani, E.

    2017-05-01

    Sago is a genus of palm that can be utilized to produce fermentable sugars as substrate for bioethanol. Sago pith is a heterogeneous substrate consists of starch and fiber. Acid hydrolysis by microwave heating radiation can break down starch and fibers together in a very short time, so it is considered to be very efficient process. The use of microwave energy (as power level) and variation of heating time can produce fermentable sugar with certain characteristics. This study included the preparation and analysis of sago pith flour; process of acid hydrolysis (0.3 M and 0.5 M H2SO4) using two steps microwave heating, first with power level 30% (1, 2 and 3 min) and second with power level 70% (3 min); and ethanol production. The conventional treatment (autoclaving at 121°C for 15 min) was carried for the comparison. The highest fermentable sugar (105.7 g/l) was resulted from microwave heating with power level 30% for 2 min followed by the power level 70% for 3 min. This hydrolyzate then used as substrate for bioethanol fermentation and partially neutralized (pH 3, 4, 5) by using yeast Issatchenkia orientalis, and the highest ethanol (2.8 g/l) was produced in pH 5.

  20. Morpho-structural variations of bacterial spores after treatment in steam vacuum assisted autoclave.

    Science.gov (United States)

    Fonzi, M; Montomoli, E; Gasparini, R; Devanna, D; Fonzi, L

    1999-01-01

    This study intended to verify, through microbiological techniques and TEM investigations, the killing of bacterial spores after treatment in steam autoclave, and to propose strictly morphological considerations about the target of this sterilisation process. Autoclave is the most common device for sterilising instruments in order to prevent cross infections in dental offices. The autoclave efficiency has been improved in the last years and part of this improvement is related to both a better and more correct use of the autoclave system and to the technological innovations introduced in the last generation of devices. However, associations as ADA or CDC suggest to regularly verify the process of 'autoclaving' through biological indicators (BI). The most commonly used BI are made of spores strips or suspensions of Bacillus Subtilis (pb 168) and Bacillus Stearothermophilus (ATCC 10149). They visually prove, changing colours on enzymatic base, the death of micro-organism and if the physical parameters, necessary for sterilisation, have been achieved. These two strains of endospore-forming bacteria were processed and prepared following two different techniques: Karnovsky fixed and epon embedded--phosphotungstic acid fixed for direct observation. The kind and the extent of analysed modifications are extremely various: from deep lacerations, which changed the spore structure, to little clefts which let the cytoplasm go out.

  1. Investigating the Problems and Needs of Infertile Patients Referring to Assisted Reproduction Centers: A Review Study

    Directory of Open Access Journals (Sweden)

    Fahimeh Hasanbeigi

    2017-10-01

    Full Text Available Background: The provision of optimal care is the most important goal in nursing, the fulfillment of which requires the identification of clients’ problems and needs. However, based on the review of the literature, no review study has investigated the problems and needs of the infertile patients in Iran. Aim: The purpose of the present study was to investigate the problems and needs of the infertile patients referring to the assisted reproduction centers. Method: This review study was based on the traditional review procedure developed by Cronin et al., which entails five steps including: 1 choosing the topic of the review, 2 searching the manuscripts, 3 collecting, reading, and analyzing the texts, 4 writing the review, and 5 providing references. The articles published within 2003-2017 were searched in such valid databases as Google Scholar, Pub Med, Science Direct, Ovid, and Cochran. The inclusion criteria in this study were articles in Persian and English with the keywords referring to problems and needs of clients. Out of the 350 original articles, 31 cases were finally selected for this review study. Results: In general, the infertile patients’ problems were placed under four domains of mental-psychological, social, marital, and financial factors. The needs of the infertile individuals were grouped into six domains of physical, care, informational, financial, mental-psychological, and spiritual factors. Implications for Practice: The identification of the patients’ problems and needs can lead to the conceptualization of strategic points targeted toward the delivery of effective interventions facilitating the provision of patient-centered infertility care. This can enhance the quality of life and lower the levels of stress during the course of treatment.

  2. Relationship satisfaction in lesbian and heterosexual couples before and after assisted reproduction: a longitudinal follow-up study.

    Science.gov (United States)

    Borneskog, Catrin; Lampic, Claudia; Sydsjö, Gunilla; Bladh, Marie; Svanberg, Agneta Skoog

    2014-12-12

    More and more lesbian couples are planning parenthood through donor insemination and IVF and the number of planned lesbian families is growing in Sweden and other western countries. Research has shown that lesbian couples report as much overall satisfaction in their relationships as do heterosexual couples. However, although parenthood is highly desired, many parents are unaware of the demands of parenthood and the strain on their relationship that the arrival of the baby might bring. The aim of this study was to compare lesbian and heterosexual couples' perceptions of relationship satisfaction at a three-year follow up after assisted reproduction. The present study is a part of the Swedish study on gamete donation, a prospective longitudinal cohort study. The present study constitutes a three-year follow up assessment of lesbian and heterosexual couples after assisted reproduction. Participants requesting assisted reproduction at all fertility clinics performing gamete donation in Sweden, were recruited consecutively during 2005-2008. A total of 114 lesbian women (57 treated women and 57 partners) and 126 heterosexual women and men (63 women and 63 men) participated. Participants responded to the ENRICH inventory at two time points during 2005-2011; at the commencement of treatment (time point 1) and about three years after treatment termination (time point 3). To evaluate the bivariate relationships between the groups (heterosexual and lesbian) and socio-demographic factors Pearson's Chi- square test was used. Kolmogorov-Smirnov test was used for testing of normality, Mann-Whitney U- test to examine differences in ENRICH between the groups and paired samples t-test to examine scores over time. Lesbian couples reported higher relationship satisfaction than heterosexual couples, however the heterosexual couples satisfaction with relationship quality was not low. Both lesbian and heterosexual couples would be classified accordingly to ENRICH-typology as vitalized or

  3. Serum omega-3 fatty acids and treatment outcomes among women undergoing assisted reproduction.

    Science.gov (United States)

    Chiu, Y-H; Karmon, A E; Gaskins, A J; Arvizu, M; Williams, P L; Souter, I; Rueda, B R; Hauser, R; Chavarro, J E

    2018-01-01

    Are serum polyunsaturated fatty acids (PUFA) concentrations, including omega-3 (ω3-PUFA) and omega-6 (ω6-PUFA), related to ART outcomes? Serum levels of long-chain ω3-PUFA were positively associated with probability of live birth among women undergoing ART. Intake of ω3-PUFA improves oocyte and embryo quality in animal and human studies. However, a recent cohort study found no relation between circulating ω3-PUFA levels and pregnancy rates after ART. This analysis included a random sample of 100 women from a prospective cohort study (EARTH) at the Massachusetts General Hospital Fertility Center who underwent 136 ART cycles within one year of blood collection. Serum fatty acids (expressed as percentage of total fatty acids) were measured by gas chromatography in samples taken between Days 3 and 9 of a stimulated cycle. Primary outcomes included the probability of implantation, clinical pregnancy and live birth per initiated cycle. Cluster-weighted generalized estimating equation (GEE) models were used to analyze the association of total and specific PUFAs with ART outcomes adjusting for age, body mass index, smoking status, physical activity, use of multivitamins and history of live birth. The median [25th, 75th percentile] serum level of ω3-PUFA was 4.7% [3.8%, 5.8%] of total fatty acids. Higher levels of serum long-chain ω3-PUFA were associated with higher probability of clinical pregnancy and live birth. Specifically, after multivariable adjustment, the probability of clinical pregnancy and live birth increased by 8% (4%, 11%) and 8% (95% CI: 1%, 16%), respectively, for every 1% increase in serum long-chain ω3-PUFA levels. Intake of long-chain ω3-PUFA was also associated with a higher probability of life birth in these women, with RR of 2.37 (95% CI: 1.02, 5.51) when replacing 1% energy of long-chain ω3-PUFA for 1% energy of saturated fatty acids. Serum ω6-PUFA, ratios of ω6 and ω3-PUFA, and total PUFA were not associated with ART outcomes. The

  4. What people close to death say about euthanasia and assisted suicide: a qualitative study

    Science.gov (United States)

    Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

    2006-01-01

    Objective To explore the experiences of people with a “terminal illness”, focusing on the patients' perspective of euthanasia and assisted suicide. Method A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a “terminal” illness, malignant or non‐malignant. Results That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Conclusion Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death. PMID:17145910

  5. What people close to death say about euthanasia and assisted suicide: a qualitative study.

    Science.gov (United States)

    Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

    2006-12-01

    To explore the experiences of people with a "terminal illness", focusing on the patients' perspective of euthanasia and assisted suicide. A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a "terminal" illness, malignant or non-malignant. That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death.

  6. Male psychological adaptation to unsuccessful medically assisted reproduction treatments: a systematic review

    National Research Council Canada - National Science Library

    Martins, Mariana Veloso; Basto-Pereira, Miguel; Pedro, Juliana; Peterson, Brennan; Almeida, Vasco; Schmidt, Lone; Costa, Maria Emília

    2016-01-01

    .... Although there is a vast body of evidence on the emotional adjustment of women to infertility, there are no systematic reviews focusing on men's psychological adaptation to infertility and related treatments...

  7. Mia-assisted orthodontic treatment for dental malocclusion secondary to periodontal disease.

    Science.gov (United States)

    Feng, Yi-miao; Fang, Bing; Xia, Yun hui; Shu, Rong; Hans, Mark Guenther

    2009-01-01

    In contemporary dental care, an increasing number of adult patients with periodontal disease are seeking orthodontic treatment. Achieving optimal results in such adult patients is difficult because decreased posterior tooth anchorage is risky. This case report demonstrates the use of miniscrew implant anchorage (MIA) in a Chinese male 21 years 5 months of age with maxillary and mandibular anterior dental spacing, bimaxillary protrusion, and severe bone loss caused by periodontal disease. Prior to orthodontic treatment, the patient underwent treatment to control his periodontitis. The patient was treated with 0.022-in straight-wire orthodontic appliances. After 17 months of active orthodontic treatment, the patient had healthier periodontal tissue with increased bone support, as well as improved facial esthetics and a functional occlusion. The results demonstrate that MIA is useful in enhancing anchorage in patients with bone loss associated with severe periodontal disease.

  8. Robust Computer-Assisted Laser Treatment Using Real-Time Retinal Tracking

    National Research Council Canada - National Science Library

    Soluma, Nahed

    2001-01-01

    ... interfaced to a computer that allows real-time capturing and processing of a sequence of images at video frame rates, The first image in the sequence is used as a reference for manual treatment...

  9. [Effectiveness of dog-assisted therapy in the elderly. A preliminary study].

    Science.gov (United States)

    Folch, Anabel; Torrente, Margarita; Heredia, Luis; Vicens, Paloma

    2016-01-01

    Animal-assisted therapy is increasingly present in several educational and health areas. The aim of this study is to assess the effectiveness of such interventions in the elderly population living in residential settings. A 12-week dog-assisted intervention program was designed, with 16 participants from a nursing home divided into an experimental group and a control group. Several physical and psychological variables were assessed before and after the intervention. While there were no significant differences in the control group, the experimental group improved significantly after participating in the program. The results support the hypothesis that animal-assisted interventions may be beneficial for residents in elderly care homes. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Comparative Studies between Conventional and Microwave Assisted Extraction for Rice Bran Oil.

    Science.gov (United States)

    Shukla, Himanshu S; Pratap, Amit

    2017-09-01

    The present work deals with comparison of microwave assisted extraction to that of conventional solvent extraction for the extraction of rice bran oil (RBO); focusing on extraction yield and oil composition. Microwave assisted extraction act as a green process over other method and proved that it is effective method for extraction of oil. The investigation also focuses on the study of functional group and component present in oil. Natural antioxidant component; its activity was confirmed by DPPH assay. The oryzanol content was also determined by measuring the optical density of the sample at 315 nm in n-heptane using UV visible spectrophotometer.

  11. Study on the effect of thermal property of metals in ultrasonic-assisted laser machining

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hu Seung; Kim, Gun Woo; Park, Jong Eun [Dept. of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Cho, Sung Hak; Yang, Min Yang; Park, Jong Kweon [Korea Institute of Machinery and Materials, Deajeon (Korea, Republic of)

    2015-08-15

    The laser machining process has been proposed as an advanced process for the selective fabrication of electrodes without a mask. In this study, we adapt laser machining to metals that have different thermal properties. Based on the results, the metals exhibit a different surface morphology, heat-affected zone (HAZ), and a recast layer around the machined surface according to their thermal conductivity, boiling point, and thermal diffusivity. Then, we apply ultrasonic-assisted laser machining to remove the recast layer. The ultrasonic-assisted laser machining exhibits a better surface quality in metals with higher diffusivity than those having lower diffusivity.

  12. Predictors for good therapeutic outcome and drop-out in technology assisted guided self-help in the treatment of bulimia nervosa and bulimia like phenotype.

    Science.gov (United States)

    Wagner, Gudrun; Penelo, Eva; Nobis, Gerald; Mayrhofer, Anna; Wanner, Christian; Schau, Johanna; Spitzer, Marion; Gwinner, Paulina; Trofaier, Marie-Louise; Imgart, Hartmut; Fernandez-Aranda, Fernando; Karwautz, Andreas

    2015-03-01

    Technology assisted guided self-help has been proven to be effective in the treatment of bulimia nervosa (BN). The aim of this study was to determine predictors of good long-term outcome as well as drop-out, in order to identify patients for whom these interventions are most suitable. One hundred and fifty six patients with BN were assigned to either 7 months internet-based guided self-help (INT-GSH) or to conventional guided bibliotherapy (BIB-GSH), both guided by e-mail support. Evaluations were taken at baseline, after 4, 7, and 18 months. As potential predictors, psychiatric comorbidity, personality features, and eating disorder psychopathology were considered. Higher motivation, lower frequency of binge eating, and lower body dissatisfaction at baseline predicted good outcome after the end of treatment. Lower frequency of binge eating predicted good outcome at long-term follow-up. Factors prediciting drop-out were higher depression and lower self-directedness at baseline. Technology assisted self-help can be recommended for patients with a high motivation to change, lower binge-eating frequency and lower depression scores. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

  13. Stability of Retained Austenite in High-Al, Low-Si TRIP-Assisted Steels Processed via Continuous Galvanizing Heat Treatments

    Science.gov (United States)

    McDermid, J. R.; Zurob, H. S.; Bian, Y.

    2011-12-01

    Two galvanizable high-Al, low-Si transformation-induced plasticity (TRIP)-assisted steels were subjected to isothermal bainitic transformation (IBT) temperatures compatible with the continuous galvanizing (CGL) process and the kinetics of the retained austenite (RA) to martensite transformation during room temperature deformation studied as a function of heat treatment parameters. It was determined that there was a direct relationship between the rate of strain-induced transformation and optimal mechanical properties, with more gradual transformation rates being favored. The RA to martensite transformation kinetics were successfully modeled using two methodologies: (1) the strain-based model of Olsen and Cohen and (2) a simple relationship with the normalized flow stress, ( {{{σ_{{flow}} - σ_{YS} }/{σ_{YS }}}} ) . For the strain-based model, it was determined that the model parameters were a strong function of strain and alloy thermal processing history and a weak function of alloy chemistry. It was verified that the strain-based model in the present work agrees well with those derived by previous workers using TRIP-assisted steels of similar composition. It was further determined that the RA to martensite transformation kinetics for all alloys and heat treatments could be described using a simple model vs the normalized flow stress, indicating that the RA to martensite transformation is stress-induced rather than strain-induced for temperatures above the Ms^{σ }.

  14. AMH and AMHR2 polymorphisms and AMH serum level can predict assisted reproduction outcomes: a cross-sectional study.

    Science.gov (United States)

    Peluso, Carla; Fonseca, Fernando L A; Gastaldo, Guilherme G; Christofolini, Denise M; Cordts, Emerson Barchi; Barbosa, Caio P; Bianco, Bianca

    2015-01-01

    In human assisted reproduction, the ovarian response to exogenous recombinant Follicle-stimulating Hormone (FSH) therapy is variable and difficult to predict. The standard protocol of ovarian hyperstimulation can result in satisfactory response; however, an unsatisfactory response necessitates FSH dose adjustment or results in ovarian hyperstimulation syndrome (OHSS). Polymorphisms in AMH and AMHR2 genes appear to affect hormone biological activities, thus affecting follicle recruitment and development, leading to infertility. We aimed to evaluate AMH and AMHR2 polymorphisms in infertile women, and correlate those findings with AMH, FSH and estradiol serum level response to controlled ovarian hyperstimulation (COH), as well as assisted reproduction outcomes. A cross-sectional study comprising 186 infertile women that underwent one cycle of high complexity assisted reproductive treatment. Blood samples were collected and a TaqMan assay was used for AMH G146T/rs10407022 and AMHR2 A-482G/rs2002555, A10G/rs11170555, C1749G/rs2071558 and G4952A/rs3741664 genotyping, and FSH, estradiol and AMH levels were measured. The findings were correlated to human reproduction outcomes. AMH rs10407022 and AMHR2 rs2002555 polymorphisms were not associated with hormonal measurements, whereas AMHR2 rs11170555 and rs3741664 were positively associated with AMH, estradiol and FSH levels. The genotype distribution of AMH and AMHR2 genes according to Controlled Ovarian Hyperstimulation did not show a positive association. However, an association with AFC, degree of oocyte maturation (allele G of AMHR2 rs2071558) the number of embryos produced (alleles T and G of AMH rs10407022 and AMHR2 rs2002555, respectively) and frozen embryo (allele G of AMHR2 rs11170555) were found to be statistically associated. Considering COH, serum AMH and AFC were a positive predictor to OHSS. Regarding serum AMH and assisted reproduction outcomes, a positive correlation with all variables studied was found

  15. AMH and AMHR2 Polymorphisms and AMH Serum Level Can Predict Assisted Reproduction Outcomes: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Carla Peluso

    2015-03-01

    Full Text Available Background: In human assisted reproduction, the ovarian response to exogenous recombinant Follicle-stimulating Hormone (FSH therapy is variable and difficult to predict. The standard protocol of ovarian hyperstimulation can result in satisfactory response; however, an unsatisfactory response necessitates FSH dose adjustment or results in ovarian hyperstimulation syndrome (OHSS. Polymorphisms in AMH and AMHR2 genes appear to affect hormone biological activities, thus affecting follicle recruitment and development, leading to infertility. We aimed to evaluate AMH and AMHR2 polymorphisms in infertile women, and correlate those findings with AMH, FSH and estradiol serum level response to controlled ovarian hyperstimulation (COH, as well as assisted reproduction outcomes. Methods: A cross-sectional study comprising 186 infertile women that underwent one cycle of high complexity assisted reproductive treatment. Blood samples were collected and a TaqMan assay was used for AMH G146T/rs10407022 and AMHR2 A-482G/rs2002555, A10G/rs11170555, C1749G/rs2071558 and G4952A/rs3741664 genotyping, and FSH, estradiol and AMH levels were measured. The findings were correlated to human reproduction outcomes. Results: AMH rs10407022 and AMHR2 rs2002555 polymorphisms were not associated with hormonal measurements, whereas AMHR2 rs11170555 and rs3741664 were positively associated with AMH, estradiol and FSH levels. The genotype distribution of AMH and AMHR2 genes according to Controlled Ovarian Hyperstimulation did not show a positive association. However, an association with AFC, degree of oocyte maturation (allele G of AMHR2 rs2071558 the number of embryos produced (alleles T and G of AMH rs10407022 and AMHR2 rs2002555, respectively and frozen embryo (allele G of AMHR2 rs11170555 were found to be statistically associated. Considering COH, serum AMH and AFC were a positive predictor to OHSS. Regarding serum AMH and assisted reproduction outcomes, a positive correlation

  16. Assessment and Treatment of Tic Behavior: A Review and Case Study.

    Science.gov (United States)

    Pray, Bruce, Jr.; And Others

    1986-01-01

    A discussion of the classification, differential diagnosis, etiology, assessment, and treatment of tic disorders is presented. A case study is included in which a school psychologist utilized behavioral consultation to assist a 9-year-old girl's parent and teacher in implementing a habit reversal program. (Author/LMO)

  17. Using Computer-Assisted Interviewing to Consult with Children with Autism Spectrum Disorders: An Exploratory Study

    Science.gov (United States)

    Barrow, Wilma; Hannah, Elizabeth F.

    2012-01-01

    This article explores the use of computer-assisted interviewing (CAI) as a tool for consulting with children with autism spectrum disorders (ASD). This is considered within the context of a research study which utilized one CAI programme, "In My Shoes", to investigate children and young people's views of provision, support, and participation in…

  18. Experimental study into plasma-assisted PM removal for diesel engines

    NARCIS (Netherlands)

    Willems, F.P.T.; Creyghton, Y.; Gulijk, C. van; Oonk, H; Maisuls, S.

    2003-01-01

    Plasma-assisted PM removal is examined in a packed-bed plasma system. This study focuses on the effect of plasma power, space velocity and exhaust gas composition on PM filtration. Experiments are done on an engine dynamometer with a VW 1.2l TDI engine. During these experiments, the airflow is

  19. Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro

    Directory of Open Access Journals (Sweden)

    Jia Ke

    2016-01-01

    Conclusions: This exploratory study demonstrated the safety of the newly developed image-guided minimally invasive cochlear implantation assisted by the bi-planar device and established the operational procedures. Further, more in vitro experiments are needed to improve the system operation and its safety.

  20. A Study of Chinese Engineering Students' Communication Strategies in a Mobile-Assisted Professional Development Course

    Science.gov (United States)

    Cheng, Li

    2016-01-01

    The development of students' professional skills is an important issue in higher education in China. This research reports a 3-month study investigating engineering students' communication strategies (CSs) while they were interacting to do a 12-week mobile-assisted learning project, i.e., "Organizing and Attending a Model International…

  1. Autistic Spectrum Disorder and Assistive Technology: Action Research Case Study of Reading Supports

    Science.gov (United States)

    Lindsey, Pam

    2012-01-01

    This descriptive action research experience with case study procedures examined the use of best practices paired with assistive technologies as interventions to individualize fiction reading instruction for a high-functioning elementary student, JB (pseudonym), diagnosed with autistic spectrum disorder. JB's instructional, reading goals were to…

  2. Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study

    Directory of Open Access Journals (Sweden)

    Hongwei Wang

    2015-01-01

    Conclusions: The preliminary study supports the view that computer assisted pedicle screw fixation using spinal robot is feasible and the robot can decrease the intraoperative fluoroscopy time during the minimally invasive pedicle screw fixation surgery. As spine robotic surgery is still in its infancy, further research in this field is worthwhile especially the accuracy of spine robot system should be improved.

  3. Experimental study of the thermal performance of an assisted-gravity ...

    African Journals Online (AJOL)

    In this work, an assisted-gravity heat pipe has been designed and built to study the performance of a thermosyphon of 680 mm overall length of which the lengths of the evaporator and condenser zones are respectively of 41 and 190 mm. The parameters affecting the thermal hydraulic characteristics are the input power (10 ...

  4. Examination of Studies on Technology-Assisted Collaborative Learning Published between 2010-2014

    Science.gov (United States)

    Arnavut, Ahmet; Özdamli, Fezile

    2016-01-01

    This study is a content analysis of the articles about technology-assisted collaborative learning published in Science Direct database between the years of 2010 and 2014. Developing technology has become a topic that we encounter in every aspect of our lives. Educators deal with the contribution and integration of technology into education.…

  5. 49 CFR 390.15 - Assistance in investigations and special studies.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Assistance in investigations and special studies. 390.15 Section 390.15 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS FEDERAL MOTOR CARRIER SAFETY REGULATIONS...

  6. 49 CFR 171.21 - Assistance in investigations and special studies.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Assistance in investigations and special studies. 171.21 Section 171.21 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS GENERAL INFORMATION, REGULATIONS, AND DEFINITIONS...

  7. Physician assistants in medical ward care: a descriptive study of the situation in the Netherlands

    NARCIS (Netherlands)

    Timmermans, M.J.C.; Vught, A.J. van; Berg, M. van den; Ponfoort, E.D.; Riemens, F.; Unen, J. van; Wobbes, Th.; Wensing, M.; Laurant, M.G.H.

    2016-01-01

    RATIONALE, AIMS AND OBJECTIVES: Medical ward care has been increasingly reallocated from medical doctors (MDs) to physician assistants (PAs). Insight into their roles and tasks is limited. This study aims to provide insight into different organizational models of medical ward care, focusing on the

  8. Vacuum-assisted closure therapy for infected perineal wounds after abdominoperineal resection. A retrospective cohort study

    NARCIS (Netherlands)

    Walma, M S; Burbach, J P M; Verheijen, P M; Pronk, A; van Grevenstein, W M U

    INTRODUCTION: Perineal wound complications are a main problem after abdominoperineal resection (APR). There is little evidence concerning perineal wound management. This study describes and evaluates the role of vacuum-assisted closure (VAC) therapy in wound management strategies of perineal wound

  9. Using Assistive Technology to Teach Emotion Recognition to Students With Asperger Syndrome: A Pilot Study

    Science.gov (United States)

    Lacava, Paul G.; Golan, Ofer; Baron-Cohen, Simon; Myles, Brenda Smith

    2007-01-01

    Many individuals with autism spectrum conditions (ASC) have difficulty recognizing emotions in themselves and others. The present pilot study explored the use of assistive technology to teach emotion recognition (ER) to eight children with ASC. Participants were between the ages of 8 and 11 years and had a diagnosis of Asperger syndrome (AS). ER…

  10. Laparoscopic assistance by operating room nurses: Results of a virtual-reality study.

    Science.gov (United States)

    Paschold, M; Huber, T; Maedge, S; Zeissig, S R; Lang, H; Kneist, W

    2017-04-01

    Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available. The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure. The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance. The study subjects were operating room nurses, medical students, and first year residents. Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course. Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05). The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Death and Dying Attitudes, Anxieties, and Fears of Certified Nursing Assistants: A Descriptive Study

    Science.gov (United States)

    Hamilton, Josephine A.

    2010-01-01

    The critical role of Certified Nursing Assistants (CNAs) to help elderly nursing home residents' move through declining conditions or diseases to death is salient. It is important for CNAs and nursing home leaders to understand CNAs' attitudes, fears, and anxieties toward death and dying. The quantitative study investigated CNA's…

  12. EPEC-O Self-Study - Module 14 - Physician-Assisted Suicide

    Science.gov (United States)

    Module fourteen of the EPEC-O Self-Study Original Version focuses on the skills that the physician can use to respond both compassionately and confidently to a request, not on the merits of arguments for or against legalizing physician-assisted suicide (PAS) or euthanasia.

  13. An Ethnographic Study of Stigma and Ageism in Residential Care or Assisted Living

    Science.gov (United States)

    Dobbs, Debra; Eckert, J. Kevin; Rubinstein, Bob; Keimig, Lynn; Clark, Leanne; Frankowski, Ann Christine; Zimmerman, Sheryl

    2008-01-01

    Purpose: This study explored aspects of stigmatization for older adults who live in residential care or assisted living (RC-AL) communities and what these settings have done to address stigma. Design and Methods: We used ethnography and other qualitative data-gathering and analytic techniques to gather data from 309 participants (residents, family…

  14. Hydrogen-assisted versus hydroxyl-assisted CO dissociation over Co-doped Cu(111): A DFT study

    Science.gov (United States)

    Zha, Hao; Dong, Xiuqin; Yu, Yingzhe; Zhang, Minhua

    2018-03-01

    First principle based density functional theory (DFT) was used to calculate the step-by-step hydrogenation and dissociation reaction network of carbon monoxide (CO) over Co-doped Cu(111) surface as a model for understanding the lateral interaction of surface hydroxyl species (OH) on these reactions. We discussed the Csbnd O bond length and the adsorption energy changes of reaction intermediates under different adsorption circumstances for purpose of making out the effect of surface hydroxyl on the reaction selectivity. Reaction intermediates co-adsorbed with H atom and hydroxyl could undergo H-assisted or OH-assisted routes. The calculations show that the OH-assisted route prefers with the formation of COH, CHOH and CH2OH while general H-assisted route prefers with the formation of HCO, CH2O and CH3O. Considering the rather low activation barrier of COH, CHOH and CH2OH to form CHX, the existence of hydroxyl on the surface is in favor of boosting the CHX and suppressing the methanol.

  15. Errors and Intelligence in Computer-Assisted Language Learning: Parsers and Pedagogues. Routledge Studies in Computer Assisted Language Learning

    Science.gov (United States)

    Heift, Trude; Schulze, Mathias

    2012-01-01

    This book provides the first comprehensive overview of theoretical issues, historical developments and current trends in ICALL (Intelligent Computer-Assisted Language Learning). It assumes a basic familiarity with Second Language Acquisition (SLA) theory and teaching, CALL and linguistics. It is of interest to upper undergraduate and/or graduate…

  16. Comparison between peroral traction-assisted ESD and traditional ESD treatment for early gastric cancer and precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    Xiao-Gang Bi; Peng-Zhen Shen; Wen-Xiong Zhou; Shu-Lan Mao

    2017-01-01

    Objective:To explore the differences in the effect of peroral traction-assisted endoscopic submucosal dissection (ESD) and traditional ESD for the treatment of early gastric cancer and precancerous lesions. Methods:112 patients with early gastric cancer and precancerous lesions treated in our hospital between May 2013 and May 2016 were collected and divided into control group and observation group according to the random number table (n=56). Observation group of patients received peroral traction-assisted ESD, and the control group of patients only received traditional ESD. The intraoperative dissected lesion diameter, mean operation time and intraoperative blood loss of two groups of patients were recorded, enzyme-linked immunosorbent assay was used to detect serum inflammatory factor levels, and RIA was used to detect serum stress hormone levels. Results:Dissected lesion diameter of observation group was greater than that of control group (P<0.05) while mean operation time and intraoperative blood loss were less than those of control group (P<0.05);1 d after operation, serum inflammatory factors interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-12 (IL-12) and tumor necrosis factor-α(TNF-α) levels of observation group were lower than those of control group (P<0.05), and serum stress hormones cortisol (Cor),β-endorphin (β-EP), epinephrine (E), norepinephrine (NE) and angiotensin II (ATII) levels were lower than those of control group (P<0.05). Conclusions:Peroral traction-assisted ESD can effectively increase the lesion dissection effect and reduce the postoperative inflammatory response and stress response in patients with early gastric cancer and precancerous lesions.

  17. Wastewater treatment of chemical laboratory using electro assisted-phytoremediation (EAPR)

    Science.gov (United States)

    Putra, Rudy Syah; Trahadinata, Gilang Ahmad; Latif, Arif; Solehudin, Mochamad

    2017-03-01

    The EAPR process using water hyacinth (Eichornia crassipes) on the wastewater treatment of chemical laboratory had been evaluated. The purpose of the EAPR process was to decrease the BOD, COD and heavy metal concentration in the wastewater. The effectiveness of the process on the wastewater treatment was evaluated using COD, BOD, and heavy metal (Pb, Cu) concentration, respectively. The result showed that the EAPR process decrease the COD, BOD, Pb and Cu in the 4 h of EAPR process. Those concentrations were met the water quality standard of class IV according to government regulation No. 82/2001 regarding the water quality management and water pollution control of the Republic of Indonesia.

  18. Cell-Assisted Lipotransfer for the Treatment of Parry-Romberg Syndrome

    Directory of Open Access Journals (Sweden)

    Yanko Castro-Govea

    2012-11-01

    Full Text Available Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive andself-limited deformation of the subcutaneous tissue volume on one side of the face thatcreates craniofacial asymmetry. We present the case of a patient with a five-year historyof progressive right facial hemiatrophy, who underwent facial volumetric restoration usingcell-assisted lipotransfer (CAL, which consists of an autologous fat graft enriched withadipose-derived stem cells (ASCs extracted from the same patient. ASCs have the capacityto differentiate into adipocytes. They also promote angiogenesis, release angiogenic growthfactors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissueatrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome.Currently, CAL has showed promising results in the long term by decreasing the rate of fatreabsorption. The permanence and stability of the graft in all the injected areas has showedthat autologous fat grafts enriched with stem cells could be a promising technique for thecorrection of defects caused by this syndrome.

  19. Cell-Assisted Lipotransfer for the Treatment of Parry-Romberg Syndrome

    Directory of Open Access Journals (Sweden)

    Yanko Castro-Govea

    2012-11-01

    Full Text Available Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL, which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.

  20. Barriers in the social and healthcare assistance for transgender persons: A systematic review of qualitative studies.

    Science.gov (United States)

    Aylagas-Crespillo, Marina; García-Barbero, Óscar; Rodríguez-Martín, Beatriz

    2017-11-01

    To explore the barriers to requesting social and healthcare assistance perceived by transgender persons and professionals involved in the assistance. A meta-study, qualitative systematic review, of studies published in English or Spanish, exploring the barriers, perceived by transgender persons and social and healthcare professionals, that transgender persons have when they seek social and healthcare assistance was carried out in the following databases Medline (PubMed), Scopus, Web of Science, Spanish National Research Council, CUIDEN, ProQuest, PsycINFO and CINAHL. Two thousand two hundred and sixty-one articles were found in the databases searched. Seven articles met all inclusion criteria and were included in this review. The professionals highlight the uncertainty when treating transgender persons and their lack of training. Transgender persons highlight the lack of information and the sense of helplessness it creates. Perceptions of transphobia, the fragmentation of services, administrative barriers, the lack of cultural sensitivity and professional training are also considered barriers to assistance. The findings of this study provide key information for the design of plans and programmes to improve the quality of social and health care for transgender persons. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  1. A volunteer feeding assistance program can improve dietary intakes of elderly patients--a pilot study.

    Science.gov (United States)

    Walton, Karen; Williams, Peter; Bracks, Julie; Zhang, Qingsheng; Pond, Leanne; Smoothy, Rebecca; Tapsell, Linda; Batterham, Marijka; Vari, Linda

    2008-09-01

    Malnutrition is prevalent in elderly hospitalized patients and has been associated with longer lengths of stay (LOS), higher rates of complications and increased hospital costs. Feeding assistance has traditionally been the role of nurses, however with an ageing population and an ever-increasing workload there may not be sufficient time to ensure the nutritional care of all patients. A program in which trained volunteers assist, socialize and feed nutritionally vulnerable patients at lunch on weekdays has been initiated in a major suburban hospital in Sydney. The pilot study reported here aimed to evaluate the lunchtime assistance program in terms of dietary intakes by comparing data from weekdays (with volunteers) and that from weekends (no volunteers). Nine patients (mean age+/-S.D.: 89+/-4.6 years) participated in the study. Observations and weighed plate waste were recorded for each patient at lunch on two weekdays and the following two weekend days. When volunteers were present, the average protein intake increased by 10.1g at lunch (pnurses, socialized more with patients, encouraged them to eat more often and spent more time feeding them. Trialing volunteer assistance in a larger study would be useful.

  2. Experiences of Infertile Women Seeking Assisted Pregnancy in Iran: A Qualitative Study

    Science.gov (United States)

    Ranjbar, Fahimeh; Behboodi-Moghadam, Zahra; Borimnejad, Leili; Ghaffari, Saeed Reza; Akhondi, Mohammad Mehdi

    2015-01-01

    Background: Assisted reproductive technologies (ARTs) are complicated and stressful techniques and the social and cultural norms are major obstacles against their use. Many qualitative studies have been done in the field of women’s experiences of infertility, but less is known about the experiences of infertile women seeking assisted pregnancy. The aim of this study was to understand and describe the experience of women who have used assisted reproductive technologies for their current pregnancy. Methods: This qualitative study was conducted based on a content analysis approach. With purposive sampling, 12 pregnant women who were using ART were recruited from Avicenna Fertility Center in Tehran. Women were selected purposefully and with maximum variation. Interviews were performed after a positive test of pregnancy and women were introduced to researchers in their first visit of pregnancy in the prenatal clinic. Interviews were recorded, transcribed verbatim and analyzed concurrently. Semi-structured interviews were coded, categorized and the themes were also identified. Results: Four main themes were uncovered which included struggle to achieve pregnancy, fear and uncertainty, escape from stigma and the pursuit to achieve husband satisfaction. Conclusion: It is essential for these women to be counseled and prepared by their health care providers after the use of ARTs. Distress can be reduced for infertile women seeking assisted pregnancy when they are prepared for possible failures, empowered to deal with stigma, and have their partners’ involvement in counseling sessions. PMID:27110521

  3. Maternal and Paternal Infertility Disorders and Treatments and Autism Spectrum Disorder: Findings from the Study to Explore Early Development

    Science.gov (United States)

    Schieve, Laura A.; Drews-Botsch, Carolyn; Harris, Shericka; Newschaffer, Craig; Daniels, Julie; DiGuiseppi, Carolyn; Croen, Lisa A.; Windham, Gayle C.

    2017-01-01

    Previous studies of associations between ASD and conception using assisted reproductive technology (ART) are inconsistent and few studies have examined associations with other infertility treatments or infertility disorders. We examined associations between ASD and maternal/paternal infertility disorders and numerous maternal treatments among 1538…

  4. Hospice Care in Assisted Living Facilities Versus at Home: Results of a Multisite Cohort Study.

    Science.gov (United States)

    Dougherty, Meredith; Harris, Pamela S; Teno, Joan; Corcoran, Amy M; Douglas, Cindy; Nelson, Jackie; Way, Deborah; Harrold, Joan E; Casarett, David J

    2015-06-01

    To compare residents of assisted living facilities receiving hospice with people receiving hospice care at home. Electronic health record-based retrospective cohort study. Nonprofit hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network. Individuals admitted to hospice between January 1, 2008, and May 15, 2012 (N = 85,581; 7,451 (8.7%) assisted living facility, 78,130 (91.3%) home). Hospice length of stay, use of opioids for pain, and site of death. The assisted living population was more likely than the home hospice population to have a diagnosis of dementia (23.5% vs 4.7%; odds ratio (OR) = 13.3, 95% confidence interval (CI) = 12.3-14.4; P < .001) and enroll in hospice closer to death (median length of stay 24 vs 29 days). Assisted living residents were less likely to receive opioids for pain (18.1% vs 39.7%; OR = 0.33, 95% CI = 0.29-0.39, P < .001) and less likely to die in an inpatient hospice unit (9.3% vs 16.1%; OR = 0.53, 95% CI = 0.49-0.58, P < .001) or a hospital (1.3% vs 7.6%; OR = 0.16, 95% CI = 0.13-0.19, P < .001). Three are several differences between residents of assisted living receiving hospice care and individuals living at home receiving hospice care. A better understanding of these differences could allow hospices to develop guidelines for better coordination of end-of-life care for the assisted living population. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  5. Arthroscopic Synovectomy and Postoperative Assisted Radiotherapy for Treating Diffuse Pigmented Villonodular Synovitis of the Knee: An observational retrospective study

    Science.gov (United States)

    Li, Wei; Sun, Xiaofei; Lin, Jianning; Ji, Wei; Ruan, Dike

    2015-01-01

    Objective: This retrospective observational study aims to explore the treatment procedure and outcomes of arthroscopically assisted radiotherapy for diffuse pigmented villonodular synovitis (PVNS) of the knee joint. Methods: From September 2006 to August 2011, 28 diffuse PVNS patients were diagnosed and treated under arthroscopy. Twenty six underwent post-operative radiotherapy. All patients were followed up, and the average follow-up period was 54 months (range: 24 to 72 months). Results: All 26 patients who received external radiotherapy showed no recurrence at post-operative follow-up; The Lysholm knee joint function score increased from 54.3±9.0 at pre-operation to 71.2±6.7 at post-operation (paired t-test, t = −13.35, P< 0.01). Conclusions: Arthroscopic synovectomy is an ideal treatment for PVNS of the knee. Adjuvant post-operative external radiotherapy prevents the recurrence of diffuse PVNS. PMID:26430437

  6. ANALYSIS OF TREATMENT OF WOUNDS IN PATIENTS WITH GRADE IIIB COMPOUND FRACTURE WITH VACUUM-ASSISTED WOUND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ashish R. Agarwal

    2017-08-01

    Full Text Available BACKGROUND Delayed wound healing is a significant health problem, particularly in patients with compound fractures. It still remains a challenging task in orthopaedic surgery, which in addition to the pain and suffering, failure of the wound to heal, also imposes social and financial burdens. The aim of the study is to evaluate the results of vacuum-assisted wound therapy in patients with open musculoskeletal injuries. MATERIALS AND METHODS 30 patients of open musculoskeletal injuries underwent randomised trial of vacuum-assisted closure therapy versus standard wound therapy around the upper limb and lower limb. Mean patient age was 39 ± 18 years necrotic tissues were debrided before applying VAC therapy. Dressings were changed every 3 or 4 days. For standard wound therapy, debridement followed by daily dressings was done. Data Management and Statistical Analysis- The results obtained were subjected to statistical analysis. RESULTS Granulation tissue status and skin healing is better in patients undergoing VAC therapy. Hospital stay of patients undergoing VAC therapy was also less. CONCLUSION Vacuum-assisted wound therapy was better method of wound management.

  7. Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction) treatment manual for temporary abdominal wall closure - results of 58 consecutive patients.

    Science.gov (United States)

    Beltzer, Christian; Eisenächer, Alexander; Badendieck, Steffen; Doll, Dietrich; Küper, Markus; Lenz, Stefan; Krapohl, Björn Dirk

    2016-01-01

    The optimal treatment concept for temporary abdominal closure (TAC) in critically ill visceral surgery patients with open abdomen (OA) continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction) therapy seems to permit higher delayed primary fascial closure rates (FCR) than other TAC procedures. Patients of our clinic (n=58) who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed. The overall FCR of all patients was 48.3% (95% confidence interval: 34.95-61.78). An FCR of 61.3% was achieved in patients who had a vicryl mesh implanted at the fascial level (VACM therapy) in the course of treatment. Mortality among patients treated with VACM therapy was 45.2% (95% CI: 27.32-63.97). The results of our own study confirm the results of previous studies which showed an acceptable FCR among non-trauma patients who were treated with VACM therapy. VACM therapy currently appears to be the treatment regime of choice for patients with OA requiring TAC.

  8. Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction) treatment manual for temporary abdominal wall closure – results of 58 consecutive patients

    Science.gov (United States)

    Beltzer, Christian; Eisenächer, Alexander; Badendieck, Steffen; Doll, Dietrich; Küper, Markus; Lenz, Stefan; Krapohl, Björn Dirk

    2016-01-01

    Introduction: The optimal treatment concept for temporary abdominal closure (TAC) in critically ill visceral surgery patients with open abdomen (OA) continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction) therapy seems to permit higher delayed primary fascial closure rates (FCR) than other TAC procedures. Material and methods: Patients of our clinic (n=58) who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed. Results: The overall FCR of all patients was 48.3% (95% confidence interval: 34.95–61.78). An FCR of 61.3% was achieved in patients who had a vicryl mesh implanted at the fascial level (VACM therapy) in the course of treatment. Mortality among patients treated with VACM therapy was 45.2% (95% CI: 27.32–63.97). Conclusions: The results of our own study confirm the results of previous studies which showed an acceptable FCR among non-trauma patients who were treated with VACM therapy. VACM therapy currently appears to be the treatment regime of choice for patients with OA requiring TAC. PMID:27547691

  9. Retrospective analysis of a VACM (vacuum-assisted closure and mesh-mediated fascial traction treatment manual for temporary abdominal wall closure – results of 58 consecutive patients

    Directory of Open Access Journals (Sweden)

    Beltzer, Christian

    2016-07-01

    Full Text Available Introduction: The optimal treatment concept for temporary abdominal closure (TAC in critically ill visceral surgery patients with open abdomen (OA continues to be unclear. The VACM (vacuum-assisted closure and mesh-mediated fascial traction therapy seems to permit higher delayed primary fascial closure rates (FCR than other TAC procedures. Material and methods: Patients of our clinic (n=58 who were treated by application of a VAC/VACM treatment manual in the period from 2005 to 2008 were retrospectively analysed. Results: The overall FCR of all patients was 48.3% (95% confidence interval: 34.95–61.78. An FCR of 61.3% was achieved in patients who had a vicryl mesh implanted at the fascial level (VACM therapy in the course of treatment. Mortality among patients treated with VACM therapy was 45.2% (95% CI: 27.32–63.97.Conclusions: The results of our own study confirm the results of previous studies which showed an acceptable FCR among non-trauma patients who were treated with VACM therapy. VACM therapy currently appears to be the treatment regime of choice for patients with OA requiring TAC.

  10. Effect of Pressure-Assisted Heat Treatment on Photoluminescence Emission of α-Bi2O3 Needles.

    Science.gov (United States)

    Schmidt, Samara; Kubaski, Evaldo T; Volanti, Diogo P; Sequinel, Thiago; Bezzon, Vinicius Danilo N; Beltrán, Armando; Tebcherani, Sergio M; Varela, José A

    2015-11-02

    Materials with high photoluminescence (PL) intensity can potentially be used in optical and electronic devices. Although the PL properties of bismuth(III) oxide with a monoclinic crystal structure (α-Bi2O3) have been explored in the past few years, methods of increasing PL emission intensity and information relating PL emission to structural defects are scarce. This research evaluated the effect of a pressure-assisted heat treatment (PAHT) on the PL properties of α-Bi2O3 with a needlelike morphology, which was synthesized via a microwave-assisted hydrothermal (MAH) method. PAHT caused an angular increase between the [BiO6]-[BiO6] clusters of α-Bi2O3, resulting in a significant increase in the PL emission intensity. The Raman and XPS spectra also showed that the α-Bi2O3 PL emissions in the low-energy region (below ∼2.1 eV) are attributed to oxygen vacancies that form defect donor states. The experimental results are in good agreement with first-principles total-energy calculations that were carried out within periodic density functional theory (DFT).

  11. Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE).

    Science.gov (United States)

    Brunetto, Daniel Paludo; Sant'Anna, Eduardo Franzzotti; Machado, Andre Wilson; Moon, Won

    2017-02-01

    Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE). The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA). All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained. It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.

  12. Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE

    Directory of Open Access Journals (Sweden)

    Daniel Paludo Brunetto

    Full Text Available ABSTRACT Introduction: Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE. More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE. Objective: The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA. Methods: All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained. Conclusion: It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.

  13. Patient safety subcultures among registered nurses and nurse assistants in Swedish hospital care: a qualitative study.

    Science.gov (United States)

    Danielsson, Marita; Nilsen, Per; Ohrn, Annica; Rutberg, Hans; Fock, Jenni; Carlfjord, Siw

    2014-01-01

    Patient safety culture emerges from the shared assumptions, values and norms of members of a health care organization, unit, team or other group with regard to practices that directly or indirectly influence patient safety. It has been argued that organizational culture is an amalgamation of many cultures, and that subcultures should be studied to develop a deeper understanding of an organization's culture. The aim of this study was to explore subcultures among registered nurses and nurse assistants in Sweden in terms of their assumptions, values and norms with regard to practices associated with patient safety. The study employed an exploratory design using a qualitative method, and was conducted at two hospitals in southeast Sweden. Seven focus group interviews and two individual interviews were conducted with registered nurses and seven focus group interviews and one individual interview were conducted with nurse assistants. Manifest content analysis was used for the analysis. Seven patient safety culture domains (i.e. categories of assumptions, values and norms) that included practices associated with patient safety were found: responsibility, competence, cooperation, communication, work environment, management and routines. The domains corresponded with three system levels: individual, interpersonal and organizational levels. The seven domains consisted of 16 subcategories that expressed different aspects of the registered nurses and assistants nurses' patient safety culture. Half of these subcategories were shared. Registered nurses and nurse assistants in Sweden differ considerably with regard to patient safety subcultures. The results imply that, in order to improve patient safety culture, efforts must be tailored to both registered nurses' and nurse assistants' patient safety-related assumptions, values and norms. Such efforts must also take into account different system levels. The results of the present study could be useful to facilitate discussions

  14. A Study on a Brain-Computer Interface for Motor Assist by Prefrontal Cortex

    Science.gov (United States)

    Misawa, Tadanobu; Takano, Shinya; Shimokawa, Tetsuya; Hirobayashi, Shigeki

    In recent times, considerable research has been conducted on the development of brain-computer interfaces (BCIs). Although there have been several reports on BCIs that assist motor functions by measurement of brain activity in the motor cortex, only a few studies have reported on BCI that assist motor functions by measurement of activity in areas other than the motor cortex. In this study, we experimentally develop a BCI that assists motor functions on the basis of brain activity in the prefrontal cortex. In this BCI system, subjects are shown the labyrinth problem. Concretely, brain activity is measured using fNIRS and the data are acquired in real time. The signal processing module implements low pass filtering of these signals. Further, the pattern classification module used in this system currently is a support vector machine. 22 subjects, both male and female, volunteered to participate in this experiment. 8 of these 22 subjects were able to solve the labyrinth problem. In this experiment, we could not obtain a high distinction. However, these results show that it is possible to develop BCI systems that assist motor functions using information from the prefrontal cortex.

  15. Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Min Yung; Kim, Man Deuk; Shin, Won Seon; Shin, Min Woo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Tae Hwan [Dept. of Radiology, National Health Insurance Serivce Ilsan Hospital, Goyang (Korea, Republic of)

    2016-04-15

    To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension.

  16. Solar-assisted MED treatment of Eskom power station waste water

    Science.gov (United States)

    Roos, Thomas H.; Rogers, David E. C.; Gericke, Gerhard

    2017-06-01

    The comparative benefits of multi-effect distillation (MED) used in conjunction with Nano Filtration (NF), Reverse Osmosis (RO) and Eutectic Freeze Crystallization (EFC) are determined for waste water minimization for inland coal fired power stations for Zero Liquid Effluent Discharge (ZLED). A sequence of technologies is proposed to achieve maximal water recovery and brine concentration: NF - physico-chemical treatment - MED - EFC. The possibility of extending the concentration of RO reject arising from minewater treatment at the Lethabo power station with MED alone is evaluated with mineral formation modelling using the thermochemical modelling software Phreeq-C. It is shown that pretreatment is essential to extend the amount of water that can be recovered, and this can be beneficially supported by NF.

  17. Rapid, conservative, multidisciplinary miniscrew-assisted approach for treatment of mandibular fractures following plane crash

    Directory of Open Access Journals (Sweden)

    Azita Tehranchi

    2013-01-01

    Full Text Available Mandibular fractures are among the most common facial injuries. This case report demonstrates the efficacy of simultaneous usage of miniscrews and direct bonding techniques without open reduction in an extensive traumatized patient. A 25-year-old girl with multiple injuries in the head and facial region 1 month after a plane crash accident was referred to manage the mandibular fractures. Due to the presence of multiple injuries, a conservative treatment of symphysiseal fracture was performed. In order to keep the fractured fragments of the mandible close together, the anterior teeth of the lower arch were tied by means of the orthodontic wire. Ten miniscrews were used to improve the anchorage units and also, settling the occlusion by means of light intermaxillary elastics. Following the active treatment, clinical and radiographic analysis showed satisfactory healing without any periodontal involvement of the teeth in the fracture line.

  18. Neural correlates of motor recovery after robot-assisted stroke rehabilitation: a case series study.

    Science.gov (United States)

    Fan, Yang-Teng; Lin, Keh-Chung; Liu, Ho-Ling; Wu, Ching-Yi; Wai, Yau-Yau; Lee, Tsong-Hai

    2016-10-01

    Robot-assisted bilateral arm therapy (RBAT) has shown promising results in stroke rehabilitation; however, connectivity mapping of the sensorimotor networks after RBAT remains unclear. We used fMRI before and after RBAT and a dose-matched control intervention (DMCI) to explore the connectivity changes in 6 subacute stroke patients. Sensorimotor functions improved in the RBAT and DMCI groups after treatment. Enhanced activation changes were observed in bilateral primary motor cortex (M1) and bilateral supplementary motor area (SMA) after RBAT. Dynamic causal model analysis revealed that interhemispheric connections were enhanced in RBAT patients. These preliminary findings suggest that intracortical and intercortical coupling might underlie poststroke RBAT.

  19. Hand-assisted laparoscopic nephrectomy as a minimally invasive option in the treatment of large renal specimens

    Directory of Open Access Journals (Sweden)

    M. Tobias-Machado

    2005-12-01

    Full Text Available INTRODUCTION: We describe our experience with hand-assisted laparoscopy (HAL as an option for the treatment of large renal specimens. MATERIALS AND METHODS: Between March 2000 and August 2004, 13 patients candidate to nephrectomies due to benign renal conditions with kidneys larger than 20 cm were included in a prospective protocol. Unilateral nephrectomy was performed in cases of hydronephrosis (6 patients or giant pyonephrosis (4 patients. Bilateral nephrectomy was performed in 3 patients with adult polycystic kidney disease (APKD with low back pain refractory to clinical treatment previous to kidney transplant. The technique included the introduction of 2 to 3 10 mm ports, manual incision to allow enough space for the surgeon's wrist without a commercial device to keep the pneumoperitoneum. The kidney was empty, preferably extracorporeally, enough to be removed through manual incision. We have assessed operative times, transfusions, complications, conversions, hospital stay and convalescence. RESULTS: The patients mean age (9 women and 4 men was 58 years. Mean operating time was 120 ± 10 min (hydronephrosis, 160 ± 28 min (pyonephrosis and 190 ± 13 min (bilateral surgery for APKD. There was a need for a conversion in 1 case and another patient needed a transfusion due to a lesion in the renal vein; 2 patients had minor complications. CONCLUSION: HAL surgery is a minimally invasive alternative in the treatment of large renal specimens, with or without significant inflammation.

  20. Biofeedback effect of hybrid assistive limb in stroke rehabilitation: A proof of concept study using functional near infrared spectroscopy.

    Directory of Open Access Journals (Sweden)

    Kazuya Saita

    Full Text Available Robot-assisted rehabilitation has been increasingly drawing attention in the field of neurorehabilitation. The hybrid assistive limb (HAL is an exoskeleton robot developed based on the "interactive biofeedback" theory, and several studies have shown its efficacy for patients with stroke. We aimed to investigate the mechanisms of the facilitative effect of neurorehabilitation using a single-joint HAL (HAL-SJ and functional near-infrared spectroscopy (fNIRS.Subacute stroke patients admitted to our hospital were assessed in this study for HAL eligibility. We evaluated motor-related cortical activity using an fNIRS system at baseline and immediately after HAL-SJ treatment on the same day. Cortical activity was determined through the relative changes in the hemoglobin concentrations. For statistical analysis, we compared the number of flexion/extension movements before and immediately after HAL-SJ treatment using paired t-test. fNIRS used both the methods of statistical parametric mapping and random effect analysis.We finally included 10 patients (eight men, two women; mean age: 66.8 ± 12.0 years. The mean number of flexion/extension movements within 15 s increased significantly from 4.2 ± 3.1 to 5.3 ± 4.1 immediately after training. fNIRS showed increased cortical activation in the primary motor cortex of the ipsilesional hemisphere immediately after HAL-SJ treatment compared to the baseline condition.This study is the first to support the concept of the biofeedback effect from the perspective of changes in cortical activity measured with an fNIRS system. The biofeedback effect of HAL immediately increased the task-related cortical activity, and this may address the functional recovery. Further studies are warranted to support our findings.

  1. Performance and microbial community dynamics of electricity-assisted sequencing batch reactor (SBR) for treatment of saline petrochemical wastewater.

    Science.gov (United States)

    Liu, Jiaxin; Shi, Shengnan; Ji, Xiangyu; Jiang, Bei; Xue, Lanlan; Li, Meidi; Tan, Liang

    2017-07-01

    High-salinity wastewater is often difficult to treat by common biological technologies due to salinity stress on the bacterial community. Electricity-assisted anaerobic technologies have significantly enhanced the treatment performance by alleviating the impact of salinity stress on the bacterial community, but electricity-assisted aerobic technologies have less been reported. Herein, a novel bio-electrochemistry system has been designed and operated in which a pair of stainless iron mesh-graphite plate electrodes were installed into a sequencing batch reactor (SBR, designated as S1) to strengthen the performance of saline petrochemical wastewater under aerobic conditions. The removal efficiency of phenol and chemical oxygen demand (COD) in S1 were 94.1 and 91.2%, respectively, on day 45, which was clearly higher than the removal efficiency of a single SBR (S2) and an electrochemical reactor (S3), indicating that a coupling effect existed between the electrochemical process and biodegradation. A certain amount of salinity (≤8000 mg/L) could enhance the treatment performance in S1 but weaken that in S2. Illumina sequencing revealed that microbial communities in S1 on days 45 and 91 were richer and more diverse than in S2, which suggests that electrical stimulation could enhance the diversity and richness of the microbial community, and reduce the negative effect of salinity on the microorganisms and enrich some salt-adapted microorganisms, thus improve the ability of S1 to respond to salinity stress. This novel bio-electrochemistry system was shown to be an alternative technology for the high saline petrochemical wastewater.

  2. A study of thermal properties of sodium titanate nanotubes synthesized by microwave-assisted hydrothermal method

    Energy Technology Data Exchange (ETDEWEB)

    Preda, Silviu, E-mail: predas01@yahoo.co.uk [Institute of Physical Chemistry “Ilie Murgulescu”, 202 Splaiul Independentei, 060021 Bucharest (Romania); Rutar, Melita [Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana (Slovenia); Jožef Stefan International Postgraduate School, Jamova cesta 39, SI-1000 Ljubljana (Slovenia); Umek, Polona [Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana (Slovenia); Zaharescu, Maria [Institute of Physical Chemistry “Ilie Murgulescu”, 202 Splaiul Independentei, 060021 Bucharest (Romania)

    2015-11-15

    Highlights: • The microwave-assisted hydrothermal route was used for titanate nanotubes synthesis. • Conversion to single-phase nanotube morphology completes after 8 h reaction time. • The nanotube morphology is stable up to 600 °C, as determined by in-situ XRD and SEM. • Sodium ions migrate to the surface due to thermal motion and structure condensation. - Abstract: Sodium titanate nanotubes (NaTiNTs) were synthesized by microwave-assisted hydrothermal treatment of commercial TiO{sub 2}, at constant temperature (135 °C) and different irradiation times (15 min, 1, 4, 8 and 16 h). The products were characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, differential scanning calorimetry and specific surface area measurements. The irradiation time turned out to be the key parameter for morphological control of the material. Nanotubes were observed already after 15 min of microwave irradiation. The analyses of the products irradiated for 8 and 16 h confirm the complete transformation of the starting TiO{sub 2} powder to NaTiNTs. The nanotubes are open ended with multi-wall structures, with the average outer diameter of 8 nm and specific surface area up to 210 m{sup 2}/g. The morphology, surface area and crystal structure of the sodium titanate nanotubes synthesized by microwave-assisted hydrothermal method were similar to those obtained by conventional hydrothermal method.

  3. A randomized prospective trial of the postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy for the treatment of symptomatic uterine fibroids: clinical trial design

    Directory of Open Access Journals (Sweden)

    Park Noh

    2009-01-01

    Full Text Available Abstract Background Laparoscopy-assisted vaginal hysterectomy is one of the definite methods for the treatment of symptomatic uterine fibroids with lesser intraoperative bleeding and shorter hospitalization compared with abdominal hysterectomy. However, laparoscopy-assisted vaginal hysterectomy cannot preserve uterus and can show postoperative complications by the change of pelvic structure. Thus, laparoscopic uterine artery ligation has been introduced for relieving the symptoms caused by uterine fibroids in place of hysterectomy. The current study was designed to compare postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy, and to evaluate the efficacy of laparoscopic uterine artery ligation which can treat symptomatic uterine fibroids with the preservation of uterus. Methods and design Patients enrolled the current study are randomized to laparoscopic uterine artery ligation or laparoscopy-assisted vaginal hysterectomy. The primary outcome is to compare postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Cancer patients version 3.0. Secondary outcomes are to evaluate the volume reduction of uterus, uterine fibroids and ovaries by the 2 treatments, to compare the improvement of subjective symptoms using 11-point symptom score and postoperative clinical outcomes between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy, and to investigate the improvement of postoperative vaginal bleeding by laparoscopic uterine artery ligation. Discussion Among treatment methods for symptomatic uterine fibroids with the preservation of uterus, laparoscopic uterine artery ligation is expected to have the efficacy like uterine artery embolization, which appeared to be safe for routine use with

  4. Assisted Reproductive Technology (ART)

    Science.gov (United States)

    ... Cancel Close Email Share Dialog × Print Assisted Reproductive Technology (ART) ART refers to treatments and procedures that ... American Society for Reproductive Medicine. (2015). Assisted reproductive technologies: A guide for patients . Retrieved May 31, 2016, ...

  5. Risk factors for ectopic pregnancy in assisted reproductive technology: a 6-year, single-center study.

    Science.gov (United States)

    Bu, Zhiqin; Xiong, Yujing; Wang, Keyan; Sun, Yingpu

    2016-07-01

    To explore factors affecting the incidence of ectopic pregnancy (EP) in assisted reproductive technology (ART). A retrospective cohort study on the incidence of EPs in IVF/intracytoplasmic sperm injection (ICSI) and IUI cycles from June 2009 to August 2015. Age of patients, tubal factor infertility, type of cycle (fresh or thawed), embryo being transferred (cleavage embryo or blastocyst), and number of embryos transferred were analyzed to explore their relationship with the incidence of EP. Teaching hospital. A total of 18,432 pregnancies resulting from ART treatment were retrospectively analyzed. None. Ectopic pregnancy rate. For IVF/ICSI cycles, the incidence of EP was different between cycles transferred with cleavage embryo and blastocyst (3.45% vs. 2.47%). In multivariate logistic regression analysis, tubal infertility was associated with EP (adjusted odds ratio 1.716, 95% confidence interval 1.444-2.039). For IUI cycles, EP was significantly higher in stimulated cycles compared with natural cycles (2.62% vs. 0.99%). The EP rate in cycles with sperm from donor and husband was 1.08% and 3.54%, respectively. However, when patients were stratified according to tubal infertility, the EP rate increased with level of peak estrogen. In thawed embryo transfer cycles, the EP rate was lower in blastocyst transfer cycles and in cycles transferred with fewer embryos. Irrespective of tubal infertility, for fresh IVF/ICSI cycles the rate of EP is positively associated with ovarian stimulation; for thawed IVF/ICSI cycles, blastocyst transfer or transfer with fewer embryos reduces the EP rate. In IUI cycles, EP is associated with sperm source. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. A Study of Polishing Feature of Ultrasonic-Assisted Vibration Method in Bamboo Charcoal

    Directory of Open Access Journals (Sweden)

    Hsin-Min Lee

    2017-01-01

    Full Text Available Focusing on the feature of porosity in bamboo charcoal, this study applies the ultrasonic-assisted vibration method to perform surface polishing of the silicon wafer workpiece. The self-developed bamboo charcoal polishing spindle and ultrasonic- assisted vibration mechanism are attached to a single lapping machine. In the machining process, ultrasonic vibration enables the diamond slurry to smoothly pass through the microscopic holes of bamboo charcoal; the end of the bamboo charcoalis able to continue machining on the surface of the workpiece through the grasping force which exists in the microscopic holes. Under the polishing and machining parameters of ultrasonic-assisted vibration, with a diamond slurry concentration of 0.3%, the experimental results show a polishing time of 20 min, a loading of 25 N on the workpiece surface, a spindle speed of 1200 rpm, a vibration frequency of 30 kHz and the original surface roughness value of Ra 0.252 μm equals that of a mirror-like surface at Ra 0.017 μm. These research results prove that by using bamboo charcoal and ultrasonic-assisted vibration for polishing, a very good improvement can be achieved on the workpiece surface.

  7. Heterotrophic monitoring at a drinking water treatment plant by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry after different drinking water treatments.

    Science.gov (United States)

    Sala-Comorera, Laura; Blanch, Anicet R; Vilaró, Carles; Galofré, Belén; García-Aljaro, Cristina

    2017-10-01

    The aim of this work was to assess the suitability of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) for routine heterotrophic monitoring in a drinking water treatment plant. Water samples were collected from raw surface water and after different treatments during two campaigns over a 1-year period. Heterotrophic bacteria were studied and isolates were identified by MALDI-TOF MS. Moreover, the diversity index and the coefficient of population similarity were also calculated using biochemical fingerprinting of the populations studied. MALDI-TOF MS enabled us to characterize and detect changes in the bacterial community composition throughout the water treatment plant. Raw water showed a large and diverse population which was slightly modified after initial treatment steps (sand filtration and ultrafiltration). Reverse osmosis had a significant impact on the microbial diversity, while the final chlorination step produced a shift in the composition of the bacterial community. Although MALDI-TOF MS could not identify all the isolates since the available MALDI-TOF MS database does not cover all the bacterial diversity in water, this technique could be used to monitor bacterial changes in drinking water treatment plants by creating a specific protein profile database for tracking purposes.

  8. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

  9. Ethical and human rights imperatives to ensure medication-assisted treatment for opioid dependence in prisons and pre-trial detention.

    Science.gov (United States)

    Bruce, R Douglas; Schleifer, Rebecca A

    2008-02-01

    Opioid dependence is a complex medical condition affecting neurocognitive and physical functioning. Forced or abrupt opioid withdrawal may cause profound physical and psychological suffering, including nausea, vomiting, diarrhoea, extreme agitation and/or anxiety. Opioid-dependent individuals are especially vulnerable at the time of arrest or initial detention, when they may, as a result of their chemical dependency, be coerced into providing incriminating testimony, or be driven to engage in risky behaviour (such as sharing needles in detention) in order to avoid painful withdrawal symptoms. Upon incarceration, many opioid-dependent prisoners are forced to undergo abrupt opioid withdrawal (both from legally prescribed agonist therapy such as methadone as well as illicit opioids). Physical and psychological symptoms attendant to withdrawal may impair capacity to make informed legal decisions, and cause prisoners to risk HIV and other blood-borne diseases by sharing injection equipment. Although prisons must provide at least the standard of care to prisoners that is available in the general population, medication-assisted treatment, endorsed by international health and drug agencies as an integral part of HIV prevention and care strategies for opioid-dependent drug users, is unavailable to most prisoners. Medication-assisted treatment is a well-studied and validated pharmacological therapy for the medical condition known as opioid dependence. The failure to ensure prisoner access to this medical therapy threatens fundamental human rights protections against cruel, inhuman or degrading treatment and rights to health and to life. It also poses serious ethical problems for health care providers, violating basic principles of beneficence and non-maleficence (i.e., do good/do no harm). Governments must take immediate action to ensure access to opioid substitution to prisoners to ensure fulfilment of ethical and human rights obligations.

  10. Patterned Well-Aligned ZnO Nanorods Assisted with Polystyrene Monolayer by Oxygen Plasma Treatment

    Directory of Open Access Journals (Sweden)

    Hyun Ji Choi

    2016-08-01

    Full Text Available Zinc oxide is known as a promising material for sensing devices due to its piezoelectric properties. In particular, the alignment of ZnO nanostructures into ordered nanoarrays is expected to improve the device sensitivity due to the large surface area which can be utilized to capture significant quantities of gas particles. However, ZnO nanorods are difficult to grow on the quartz substrate with well-ordered shape. So, we investigated nanostructures by adjusting the interval distance of the arranged ZnO nanorods using polystyrene (PS spheres of various sizes (800 nm, 1300 nm and 1600 nm. In addition, oxygen plasma treatment was used to specify the nucleation site of round, patterned ZnO nanorod growth. Therefore, ZnO nanorods were grown on a quartz substrate with a patterned polystyrene monolayer by the hydrothermal method after oxygen plasma treatment. The obtained ZnO nanostructures were characterized by X-ray diffraction (XRD and field-emission scanning electron microscope (FE-SEM.

  11. Precious "MeTL": Reflections on the Use of Tablet PCs and Collaborative Interactive Software in Peer- Assisted Study Sessions

    Science.gov (United States)

    Devey, Adrian; Hicks, Marianne; Gunaratnam, Shaminka; Pan, Yijun; Plecan, Alexandru

    2012-01-01

    Peer-Assisted Study Sessions (PASS) is an academic mentoring program, where high achieving senior students assist small groups of first years in study sessions throughout semester. One of the challenges PASS Leaders face at Monash in conducting their classes is the limited time they have with their students. The current paper explores, through…

  12. The Rivalry between Simulation and Problem-Based Learning: A Study of Learning Transfer in Physician Assistant Students

    Science.gov (United States)

    Meyer, Kimberly E.

    2010-01-01

    The purpose of this dissertation was to evaluate learning transfer achieved by physician assistant students comparing two instructional methods, human patient simulation and electronic clinical case studies. This prospective, randomized, mixed-methods study utilized first and second-year physician assistant student volunteers taking a pretest and…

  13. Er:YAG Laser Assisted Treatment of Central Odontogenic Fibroma of the Mandible

    Directory of Open Access Journals (Sweden)

    Luis Silva Monteiro

    2015-01-01

    Full Text Available Central odontogenic fibroma is a very rare benign odontogenic tumour characterized by a fibrous mature stroma with variable strands or islands of inactive-looking odontogenic epithelium. Our aim is to report a case of a central odontogenic fibroma and describe the clinical usefulness of Er:YAG laser for the surgical treatment of this tumour. A 74-year-old woman presented with an expansive lesion located in a mandible with multilocular and mixed radiographic appearance. A conservative excision using Er:YAG laser was performed. Complete removal was obtained. There were no postoperative complications. The histopatologic features were consistent with the diagnosis of central odontogenic fibroma of rich-epithelium type. No recurrence was observed during follow-up.

  14. Q-switched alexandrite laser-assisted treatment of melasma: 2-year follow-up monitoring.

    Science.gov (United States)

    Rusciani, Antonio; Motta, Angela; Rusciani, Luigi; Alfano, Carmine

    2005-01-01

    Melasma is a common disorder of hyperpigmentation involving sun exposed face and neck areas. Three clinical patterns of melasma are recognized: the centrofacial, the malar, and the mandibular ones. Several factors have been implicated in the pathogenesis of this disorder including pregnancy, oral contraceptive therapy, sun exposure, genetic factors, cosmetics, and race. This condition is most frequently observed in women and affects all racial groups; however, it is commonly found in darker-complexioned individuals (skin types IV through VI) and in Asian women who live and work under strong sunlight exposure for long periods. Melasma is very difficult to treat and often resistant to therapy. Treatment of melasma includes various hypopigmenting agents, chemical peeling, and laser surgery with unsatisfactory results. We report 3 cases of facial melasma successfully treated with a Q-switched Alexandrite laser.

  15. Effectiveness of robot-assisted training added to conventional rehabilitation in patients with humeral fracture early after surgical treatment: protocol of a randomised, controlled, multicentre trial.

    Science.gov (United States)

    Nerz, Corinna; Schwickert, Lars; Becker, Clemens; Studier-Fischer, Stefan; Müßig, Janina Anna; Augat, Peter

    2017-12-06

    The incidence of proximal humeral fractures increases with age. The functional recovery of the upper arm after such fractures is slow, and results are often disappointing. Treatment is associated with long immobilisation periods. Evidence-based exercise guidelines are missing. Loss of muscle mass as well as reduced range of motion and motor performance are common consequences. These losses could be partly counteracted by training interventions using robot-assisted arm support of the affected arm derived from neurorehabilitation. Thus, shorter immobilisation could be reached. Thus far, this approach has been tested in only a few small studies. The aim of the present study is to examine whether assistive robotic training augmenting conventional occupational and physical therapy can improve functional shoulder outcomes. Patients aged between 35 and 66 years with proximal humeral fracture and surgical treatment will be recruited at three different clinics in Germany and randomised into an intervention group and a control group. Participants will be assessed before randomisation and followed after completing an intervention period of 3 weeks and additionally after 3, 6 and 12 months. The baseline assessment will include cognition (Short Orientation-Memory-Concentration Test); level of pain in the affected arm; ability to work; gait speed (10-m walk); disability of the arm, shoulder and hand (Disabilities of the Arm, Shoulder and Hand Outcome Measure [DASH]); range of motion of the affected arm (goniometer measurement); visual acuity; and motor function of orthopaedic patients (Wolf Motor Function Test-Orthopaedic version [WMFT-O]). Clinical follow-up directly after the intervention will include assessment of disability of the arm, shoulder and hand (DASH) as well as range of motion and motor function (WMFT-O). The primary outcome parameter will be the DASH, and the secondary outcome parameter will be the WMFT-O. The long-term results will be assessed prospectively by

  16. Obtaining zeolite Y synthesized by hydrothermal treatment assisted by microwave; Obtencao de zeolita Y sintetizada atraves de tratamento hidrotermico assistido por microondas

    Energy Technology Data Exchange (ETDEWEB)

    Simoes, A.N.; Simoes, V.N.; Neiva, L.S.; Rodrigues, M.G.F.; Gama, L., E-mail: Alluskynha@hotmail.com [Universidade Federal de Campina Grande (UFCG), PB (Brazil); Oliveira, J. B.L. [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Departamento de Quimica

    2011-07-01

    n search of new catalysts several man-made structures have been developed. The use of zeolites in catalysis is applied due to its ability to associate activity, selectivity and stability, the main conditions to have an effective catalyst. Thus, studies have been done on the hydrothermal synthesis of zeolites by microwave assisted, since the use of microwave radiation offers several advantages over conventional heating. In this context, this work aims to synthesis and characterization of zeolite Y via hydrothermal treatment in a microwave oven. The sample obtained was characterized by XRD, BET and SEM. XRD results showed the formation of zeolite Y in just 60 minutes. The sample showed high value of surface area, the latter being of 476.2 m² / g. The particles are agglomerated, but with a narrow distribution of size. (author)

  17. H{sub 2} production by PEM electrolysis, assisted by textile effluent treatment and a solar photovoltaic cell

    Energy Technology Data Exchange (ETDEWEB)

    Navarro-Solis, Isabel; Villalba-Almendra, Lilia; Alvarez-Gallegos, Alberto [Centro de Investigacion en Ingenieria y Ciencias Aplicadas, Universidad Autonoma del Estado de Morelos (UAEM), Av Universidad 1001, Campus Chamilpa, Cuernavaca, Morelos (Mexico)

    2010-10-15

    In this paper a new approach for H{sub 2} production by PEM electrolysis, assisted by effluent treatment in the anolyte is proposed. H{sub 2} is produced, in the catholyte, by proton reduction at a Fe-cathode, in an acid medium (1 M H{sub 2}SO{sub 4}). While in the anolyte, a mixture of Fe{sup 2+}/Fe{sup 3+} is produced from the oxidation of an iron anode. The overall energy required ({<=}1.00 V) is less than that required by conventional water electrolysis, and is delivered by solar panels. In the anolyte, iron ions can be used in favor of a Fenton-type process, in the presence of H{sub 2}O{sub 2}. This approach is used in effluent treatment. The oxidation efficiency of dyes reactive black 5 (RB 5) and acid green 25 (AG 25) was investigated, in mild conditions, during H{sub 2} production. The main experimental results show that it is possible to oxidize 0.00024 M RB 5 or 0.0002 M AG 25 in the anolyte, in 20 min. (author)

  18. An integrated qualitative and quantitative modeling framework for computer‐assisted HAZOP studies

    DEFF Research Database (Denmark)

    Wu, Jing; Zhang, Laibin; Hu, Jinqiu

    2014-01-01

    safety critical operations, its causes and consequences. The outcome is a qualitative hazard analysis of selected process deviations from normal operations and their consequences as input to a traditional HAZOP table. The list of unacceptable high risk deviations identified by the qualitative HAZOP......‐assisted HAZOP studies introduced in this article allows the HAZOP team to devote more attention to high consequence hazards. © 2014 American Institute of Chemical Engineers AIChE J 60: 4150–4173, 2014...

  19. Study of the Effect of Swelling on Irradiation Assisted Stress Corrosion Cracking

    Energy Technology Data Exchange (ETDEWEB)

    Teysseyre, Sebastien Paul [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-09-01

    This report describes the methodology used to study the effect of swelling on the crack growth rate of an irradiation-assisted stress corrosion crack that is propagating in highly irradiated stainless steel 304 material irradiated to 33 dpa in the Experimental Breeder Reactor-II. The material selection, specimens design, experimental apparatus and processes are described. The results of the current test are presented.

  20. The attitudes of infertile couples towards assisted reproductive techniques in Yazd, Iran: A cross sectional study in 2014.

    Science.gov (United States)

    Afshani, Seyed Alireza; Abdoli, Ali Mohammad; Hashempour, Mehrieh; Baghbeheshti, Maryam; Zolfaghari, Mohammad

    2016-12-01

    Knowledge about assisted reproductive techniques (ART) and its procedures affect the attitude of infertile people. Making decisions about the use of ART is affected by one's perception and attitude. The aim of this cross-sectional study was to determine the attitude of infertile couples toward applying ART, and to investigate its related factors. A randomized cross-sectional study was conducted on 184 infertile couples who had referred to the Research and Clinical Center of Infertility, Yazd, Iran for diagnosis and treatment in June 2014. The data was collected using a two-part questionnaire containing demographic and attitudinal statements. For data analysis, SPSS statistical software and statistical tests of mean differences (t-test), Pearson correlation and analysis of variance were used. A significant relationship between spouse's attitude (p0.05). In conclusion, making a decision and accepting ART can be influenced by couple's attitude, their family's attitude and applied knowledge of ART.

  1. A neuromechanics-based powered ankle exoskeleton to assist walking post-stroke: a feasibility study.

    Science.gov (United States)

    Takahashi, Kota Z; Lewek, Michael D; Sawicki, Gregory S

    2015-02-25

    In persons post-stroke, diminished ankle joint function can contribute to inadequate gait propulsion. To target paretic ankle impairments, we developed a neuromechanics-based powered ankle exoskeleton. Specifically, this exoskeleton supplies plantarflexion assistance that is proportional to the user's paretic soleus electromyography (EMG) amplitude only during a phase of gait when the stance limb is subjected to an anteriorly directed ground reaction force (GRF). The purpose of this feasibility study was to examine the short-term effects of the powered ankle exoskeleton on the mechanics and energetics of gait. Five subjects with stroke walked with a powered ankle exoskeleton on the paretic limb for three 5 minute sessions. We analyzed the peak paretic ankle plantarflexion moment, paretic ankle positive work, symmetry of GRF propulsion impulse, and net metabolic power. The exoskeleton increased the paretic plantarflexion moment by 16% during the powered walking trials relative to unassisted walking condition (p exoskeleton assistance appeared to reduce the net metabolic power gradually with each 5 minute repetition, though no statistical significance was found. In three of the subjects, the paretic soleus activation during the propulsion phase of stance was reduced during the powered assistance compared to unassisted walking (35% reduction in the integrated EMG amplitude during the third powered session). This feasibility study demonstrated that the exoskeleton can enhance paretic ankle moment. Future studies with greater sample size and prolonged sessions are warranted to evaluate the effects of the powered ankle exoskeleton on overall gait outcomes in persons post-stroke.

  2. EUS-guided gastroenterostomy: a multicenter study comparing the direct and balloon-assisted techniques.

    Science.gov (United States)

    Chen, Yen-I; Kunda, Rastislav; Storm, Andrew C; Aridi, Hanaa Dakour; Thompson, Christopher C; Nieto, Jose; Siddiqui, Ali A; James, Theodore; Irani, Shayan; Bukhari, Majidah; Gutierrez, Olaya Brewer; Agarwal, Amol; Fayad, Lea; Moran, Robert; Alammar, Nuha; Sanaei, Omid; Canto, Marcia I; Singh, Vikesh K; Baron, Todd H; Khashab, Mouen A

    2017-07-24

    Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a developing modality in the management of gastric outlet obstruction (GOO) with several technical approaches including the direct and balloon-assisted techniques. The aim of this study is to compare the direct with the balloon-assisted modality while further defining the role of EUS-GE in GOO. Multicenter, retrospective study involving consecutive patients who underwent EUS gastroenterostomy with the direct or balloon-assisted technique for GOO (January 2014-October 2016). The primary outcome is technical success. Secondary outcomes include clinical success (ability to tolerate at least a full fluid diet), procedure time, and rate/severity of adverse events (AE). Seventy-seven patients (42.9% female; mean age 63.2 ± 11.5 years) underwent EUS gastroenterostomy for GOO (n=55 DGE and n=22 BAGE). GOO was of malignant and benign etiology in 67.5% and 32.5% of the patients, respectively. Technical success was achieved in 94.5% of the direct and 90.9% of the balloon-assisted approach (p=0.62). Mean procedure time was shorter with the direct technique (35.1±31.2 minutes vs 89.9±33.3 minutes, p<0.001). Clinical success rate was 92.7% for the direct and 90.9% for balloon-assisted modality (p=0.79), with a mean time to oral intake of 1.41±2.75 days. The AE rate was 6.5% with only one severe AE noted. Rate of AE, postprocedure length of stay, need for re-intervention, and survival were similar between the 2 groups. EUS gastroenterostomy is effective and safe in the management of GOO. The direct technique may be the preferred method given its shorter procedure time when compared with balloon-assisted approach. Prospective trials are needed to confirm these findings. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  3. Control of a Pediatric Pulsatile Ventricular Assist Device: A Hybrid Cardiovascular Model Study.

    Science.gov (United States)

    Ferrari, Gianfranco; Di Molfetta, Arianna; Zieliński, Krzysztof; Fresiello, Libera; Górczyńska, Krystyna; Pałko, Krzysztof Jakub; Darowski, Marek; Amodeo, Antonio; Kozarski, Maciej

    2017-12-01

    The aim of this work is to study pediatric pneumatic ventricle (PVAD) performance, versus VAD rate (VADR) and native heart rate (HR) ratio Rr (VADR/HR). The study uses a hybrid model of the cardiovascular system (HCS). HCS consists of a computational part (a lumped parameter model including left and right ventricles, systemic and pulmonary arterial and venous circulation) interfaced to a physical part. This permits the connection of a VAD (15 mL PVAD). Echocardiographic and hemodynamic data of a pediatric patient (average weight 14.3 kg, HR 100 bpm, systemic pressure 75/44 mm Hg, CO 1.5 L/min) assisted apically with asynchronous PVAD were used to set up a basal condition in the model. After model tuning, the assistance was started, setting VAD parameters (ejection and filling pressures, systole duration) to completely fill and empty the PVAD. The study was conducted with constant HR and variable VADR (50-120, step 10, bpm). Experiments were repeated for two additional patients' HRs, 90 and 110 bpm and for two values of systemic arterial resistance (Ras ) and Emax . Experimental data were collected and stored on disk. Analyzed data include average left and right ventricular volumes (LVV, RVV), left ventricular flow (LVF), VAD flow (VADF), and total cardiac output (COt). Data were analyzed versus Rr. LVV and RVV are sensitive to Rr and a left ventricular unloading corresponds in general to a right ventricular loading. In the case of asynchronous assistance, frequency beats are always present and the beat rate is equal to the difference between HR and VADR. In the case of pulsatile asynchronous LVAD assistance, VADR should be chosen to minimize frequency beat effects and right ventricular loading and to maximize left ventricular unloading. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  4. Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy.

    Science.gov (United States)

    Pillay, Brindha; Moon, Daniel; Love, Christopher; Meyer, Denny; Ferguson, Emma; Crowe, Helen; Howard, Nicholas; Mann, Sarah; Wootten, Addie

    2017-12-01

    treatment satisfaction between groups. Higher patient treatment satisfaction was more likely to be reported for couples whose depression scores were more similar. It is important to provide preoperative penile implant counseling and encourage patients to seek postoperative counseling if needed. This is one of the first Australian-based studies comprehensively assessing treatment satisfaction and psychosocial health of men after penile prosthesis surgery after RP. This was a retrospective cross-sectional study, so there is a possibility of recall bias, and causal associations could not be determined. Men in this Australian series who underwent penile prosthesis surgery after RP generally reported good sexual function and treatment satisfaction. Nevertheless, patient and partner mental health influenced their reported experience of the treatment. Pillay B, Moon D, Love C, et al. Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy. J Sex Med 2017;14:1612-1620. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  5. Interpersonal Skills in the Practice of Food Safety Inspections: A Study of Compliance Assistance.

    Science.gov (United States)

    Buckely, Jennifer

    2016-12-01

    Conducting food safety inspections requires interpersonal skills and technical expertise. This requirement is particularly important for agencies that adopt a compliance assistance approach by encouraging inspectors to assist industry in finding solutions to violations. This article describes a study of inspections that were conducted by inspectors from the Michigan Department of Agriculture and Rural Development Food and Dairy Division at small-scale processing facilities. Interactions between inspectors and small processors were explored through a qualitative, ethnographic approach using interviews and field observations. Inspectors emphasized the importance of interpersonal skills such as communication, patience, empathy, respect, and consideration in conducting inspections. This article examines how these skills were applied, how inspectors felt they improved compliance, the experiences through which inspectors attained these skills, and the training for which they expressed a need. These results provide new insights into the core competencies required in conducting inspections, and they provide the groundwork for further research.

  6. Comparative study on Pulsed Laser Deposition and Matrix Assisted Pulsed Laser Evaporation of urease thin films

    Energy Technology Data Exchange (ETDEWEB)

    Smausz, Tomi, E-mail: tomi@physx.u-szeged.h [Department of Optics and Quantum Electronics, University of Szeged, H-6701 Szeged, P.O. Box 406 (Hungary); Megyeri, Gabor; Kekesi, Renata; Vass, Csaba [Department of Optics and Quantum Electronics, University of Szeged, H-6701 Szeged, P.O. Box 406 (Hungary); Gyoergy, Eniko; Sima, Felix; Mihailescu, Ion N. [National Institute for Lasers, Plasma and Radiation Physics, Lasers Department, PO Box MG-54, RO-77125, Bucharest-Magurele (Romania); Hopp, Bela [Hungarian Academy of Sciences and University of Szeged, Research Group on Laser Physics, H-6701 Szeged, P.O. Box 406 (Hungary)

    2009-06-01

    Urease thin films were produced by Matrix Assisted Pulsed Laser Evaporation (MAPLE) and Pulsed Laser Deposition from two types of targets: frozen water solutions of urease with different concentrations (1-10% m/v) and pure urease pellets. The fluence of the ablating KrF excimer laser was varied between 300 and 2200 mJ/cm{sup 2}. Fourier transform infrared spectra of the deposited films showed no difference as compared to the original urease. Morphologic studies proved that the films consist of a smooth 'base' layer with embedded micrometer-sized droplets. Absorption-coefficient measurements contradicted the traditional 'absorptive matrix' model for MAPLE deposition. The laser energy was absorbed by urease clusters leading to a local heating-up and evaporation of the frozen matrix from the uppermost layer accompanied by the release of dissolved urease molecules. Significant enzymatic activity of urease was preserved only during matrix assisted transfer.

  7. Perceptions of a hospital-based animal assisted intervention program: An exploratory study.

    Science.gov (United States)

    Abrahamson, Kathleen; Cai, Yun; Richards, Elizabeth; Cline, Krista; O'Haire, Marguerite E

    2016-11-01

    Research has shown that there are multiple benefits of animal assisted interventions for patients. However, the impact of interaction with these animals in staff is understudied, particularly in the acute care setting, and is thus a novel contribution to the literature on human-animal interaction. The purpose of this qualitative pilot study was to contribute to the body of knowledge surrounding the experiences and perceptions of hospital staff who have participated in a hospital-based animal assisted intervention program. Nine face-to-face semi-structured interviews were conducted (4 staff nurses, 3 support staff members, and 2 hospital volunteers). Five themes emerged from the respondent interviews: (1) descriptions of the therapy dogs; (2) contacts with the dogs at work; (3) connection with the dogs outside of work; (4) benefits; (5) drawbacks. Our findings reflect abundantly positive hospital staff experiences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Evaluating newly acquired authority of nurse practitioners and physician assistants for reserved medical procedures in the Netherlands: a study protocol

    OpenAIRE

    De Bruijn-Geraets, Daisy P; Van Eijk-Hustings, Yvonne JL; Vrijhoef, Hubertus JM

    2014-01-01

    Aim The study protocol is designed to evaluate the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Background Recent (temporarily) enacted legislation in Dutch health care authorizes nurse practitioners and physician assistants to indicate and perform specified medical procedures, i.e. catheterization, cardioversion, defibrillation, endoscopy, injection, puncture, prescribing and sim...

  9. A Follow-up Study of a Successful Assistive Technology for Children with ADHD and Their Families

    DEFF Research Database (Denmark)

    Sonne, Tobias; Marshall, Paul; Müller, Jörg

    2016-01-01

    Little research on assistive technologies for families of children with attention deficit hyperactivity disorder (ADHD) has investigated the long-term impact, after the assistive technology is returned to the researchers. In this paper, we report the outcomes of a follow-up study, conducted four...

  10. Study of brine treatment. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1977-11-01

    Available information pertinent to the treatment of geothermal brines was collected by literature search and then evaluated and summarized for use by the electric utility and geothermal industries. The information was screened from the geothermal, oil and gas, wastewater disposal, and boiler water treatment industries. The current state of knowledge and methodology concerning the treatment of geothermal brines to control scaling and corrosion in geothermal electric power production was assessed. Currently, geothermal scale in pipes and wells is removed by physical or chemical methods. There is a growing effort on developing methods to control scale formation for both fresh and spent brines, including pH adjustment and application of an electrical potential for fresh fluids, and coagulation to treat spent fluids. Current methods of corrosion control center around planned replacement of piping and other plant components, with efforts focused primarily on development of materials with improved corrosion resistance. Recommendations for additional work to improve brine treatment include the following: (1) chemical and physical characterization of brine and scale compositions, (2) basic data on the mechanism of scale formation and the effects of inhibitors, (3) development of instrumentation to monitor geothermal brine constituents, (4) correlation of laboratory results with field test data, and (5) screening of currently available commercial inhibitors for application to geothermal brines. An annotated bibliography of the reference material used in this study is included.

  11. Birth environment facilitation by midwives assisting in non-hospital births: a qualitative interview study.

    Science.gov (United States)

    Igarashi, Toshiko; Wakita, Mariko; Miyazaki, Kikuko; Nakayama, Takeo

    2014-07-01

    midwifery homes (similar to birth centres) are rich in midwifery wisdom and skills that differ from those in hospital obstetrical departments, and a certain percentage of pregnant women prefer birth in these settings. This study aimed to understand the organisation of the perinatal environment considered important by independent midwives in non-hospital settings and to clarify the processes involved. semi-structured qualitative interview study and constant comparative analysis. 14 independent midwives assisting at births in midwifery homes in Japan, and six independent midwives assisting at home births. Osaka, Kyoto, Nara, and Shiga, Japan. midwives assisting at non-hospital births organised the birth environment based on the following four categories: 'an environment where the mother and family are autonomous'; 'a physical environment that facilitates birth'; 'an environment that facilitates the movement of the mother for birth'; and 'scrupulous safety preparation'. These, along with their sub-categories, are presented in this paper. independent midwives considered it important to create a candid relationship between the midwife and the woman/family from the period of pregnancy to facilitate birth in which the woman and her family were autonomous. They also organised a distinctive environment for non-hospital birth, with preparations to guarantee safety. Experiential knowledge and skills played a major part in creating an environment to facilitate birth, and the effectiveness of this needs to be investigated objectively in future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Enhanced integrated nonthermal treatment system study

    Energy Technology Data Exchange (ETDEWEB)

    Biagi, C.; Schwinkendorf, B.; Teheranian, B.

    1997-02-01

    The purpose of the Enhanced Nonthermal Treatment Systems (ENTS) study is to evaluate alternative configurations of one of the five systems evaluated in the Integrated Nonthermal Treatment Systems (INTS) study. Five alternative configurations are evaluated. Each is designed to enhance the final waste form performance by replacing grout with improved stabilization technologies, or to improve system performance by improving the destruction efficiency for organic contaminants. AU enhanced systems are alternative configurations of System NT-5, which has the following characteristics: Nonthermal System NT-5: (1) catalytic wet oxidation (CWO) to treat organic material including organic liquids, sludges, and soft (or combustible) debris, (2) thermal desorption of inorganic sludge and process residue, (3) washing of soil and inorganic debris with treatment by CWO of removed organic material, (4) metal decontamination by abrasive blasting, (5) stabilization of treated sludge, soil, debris, and untreated debris with entrained contamination in grout, and (6) stabilization of inorganic sludge, salts and secondary waste in polymer. System NT-5 was chosen because it was designed to treat combustible debris thereby minimizing the final waste form volume, and because it uses grout for primary stabilization. The enhanced nonthermal systems were studied to determine the cost and performance impact of replacing grout (a commonly used stabilization agent in the DOE complex) with improved waste stabilization methods such as vitrification and polymer.

  13. A study on the development of a robot-assisted automatic laser hair removal system.

    Science.gov (United States)

    Lim, Hyoung-Woo; Park, Sungwoo; Noh, Seungwoo; Lee, Dong-Hun; Yoon, Chiyul; Koh, Wooseok; Kim, Youdan; Chung, Jin Ho; Kim, Hee Chan; Kim, Sungwan

    2014-11-01

    Abstract Background and Objective: The robot-assisted automatic laser hair removal (LHR) system is developed to automatically detect any arbitrary shape of the desired LHR treatment area and to provide uniform laser irradiation to the designated skin area. For uniform delivery of laser energy, a unit of a commercial LHR device, a laser distance sensor, and a high-resolution webcam are attached at the six axis industrial robot's end-effector, which can be easily controlled using a graphical user interface (GUI). During the treatment, the system provides real-time treatment progress as well as the total number of "pick and place" automatically. During the test, it was demonstrated that the arbitrary shapes were detected, and that the laser was delivered uniformly. The localization error test and the area-per-spot test produced satisfactory outcome averages of 1.04 mm error and 38.22 mm(2)/spot, respectively. RESULTS showed that the system successfully demonstrated accuracy and effectiveness. The proposed system is expected to become a promising device in LHR treatment.

  14. Study on hydrogen assisted cracking susceptibility of HSLA steel by implant test

    Directory of Open Access Journals (Sweden)

    Gopa Chakraborty

    2016-12-01

    Full Text Available DMR-249A is an indigenously developed high strength low alloy steel for Indian ship building industry for making ship-hull and is extensively used in the construction of war ships and submarines. Welding electrodes conforming to SFA 5.5 AWS E8018 C1 has been indigenously developed for welding of this steel using shielded metal arc welding process. In the present study, susceptibility to hydrogen assisted cracking of DMR-249A steel welds made using this electrode has been assessed using implant test. Implant tests were conducted using this electrode at two different levels of diffusible hydrogen, measured using gas chromatography technique. It is observed that both the steel and the welding consumable are not susceptible to hydrogen assisted cracking even with a high diffusible hydrogen level of 9 mL/100g of weld metal. In implant tests, specimen did not fracture even after loading to stress levels higher than the yield strength of the base metal. The good resistance of this steel and the welding consumable, even with high levels of diffusible hydrogen, is attributed to absence of a susceptible microstructure in both the weld metal and heat affected zone. Hence, this study shows that, in the absence of a susceptible microstructure, hydrogen assisted cracking is unlikely to occur even if hydrogen level is high. It also confirms that in welding of DMR-249A with indigenously developed E8018 C1 electrode, hydrogen assisted cracking is not a concern and no preheating is required to avoid it during welding.

  15. A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty.

    Directory of Open Access Journals (Sweden)

    Sang Hoon Song

    Full Text Available To compare the outcomes of open pyeloplasty (OP, laparoscopy-assisted extracorporeal (LEXP, and robotic-assisted laparoscopic pyeloplasty (RALP for ureteropelvic junction obstruction in pediatric patients.We retrospectively reviewed the age-matched cohort of 30 children who underwent OP, 30 who underwent LEXP, and 10 who underwent RALP at a single institution, from 1996 to 2014. Pre- and post-operative variables including success rate were compared among surgical groups.The mean age of the patients was 120.2 months, the Society for Fetal Urology grade was 3.6, the anteroposterior diameter was 3.1 cm, and the renal relative function was 44.0%. The distribution of laterality, mean body mass index, and preoperative anteroposterior pelvic diameter on ultrasound did not differ among groups. The mean length of hospital stay was significantly shorter in the RALP group (3.2 days than in the OP (6.6 days and LEXP (5.8 days groups (p<0.001. The duration of analgesics use was shorter in the RALP group (1.1 days than in the other groups (p<0.001. During the mean follow-up period of 49.0, 20.1, and 16.6 months, the success rate was 96.7%, 89.7%, and 100% in the OP, LEXP, and RALP groups, respectively, although this difference was not statistically different (p = 0.499. In multivariate regression analysis, the presence of crossing vessels was the only factor that decreased the success rate (hazard ratio: 46.09, 95% confidence interval: 2.41-879.6, p = 0.011.Patients who undergo RALP have a reduced hospital stay and lower use of pain medication; however, there is no difference in the success rates for OP, LP, and RALP surgeries. The presence of crossing vessels is a negative prognostic indicator for surgical outcome regardless of the surgical method.

  16. Pathologic findings in patients who underwent robot-assisted radical prostatectomy following active surveillance: a prospective study in a single center.

    Science.gov (United States)

    Ha, Y S; Yu, J; Patel, N; Hassanzadeh Salmasi, A; Parihar, J; Kwon, T G; Kim, W J; Kim, I Y

    2015-03-01

    Active surveillance is the recommended treatment of option for men with very low-risk prostate cancer. In this study, the clinicopathological results of patients who were initially treated with active surveillance and subsequently underwent robot-assisted radical prostatectomy during follow-up are described. A prospective cohort of 106 men enrolled in active surveillance was reviewed. Pathologic specimens for patients who ultimately underwent robot-assisted radical prostatectomy for progression or personal preference were analyzed. After exclusion of 14 patients who were lost to follow-up or with incomplete data collection, 92 men were included in the present analyses. Median follow-up was 27.6 months (range 3.3 to 193.1). Twenty-nine patients underwent robot-assisted radical prostatectomy. Progression occurred in 32 patients (34.8%), of which 23 men elected to undergo surgery. Robot-assisted radical prostatectomy was performed in 6 additional patients who chose definitive intervention due to anxiety. Pathologic analyses revealed organ-confined disease in 24 patients (82.8%), and Gleason score was ≥ 7 in nine (31%). Fourteen (48.3%) specimens were identified as having an advanced disease (Gleason score ≥ 7 and/or T3). In comparison to the patients with low-risk disease post-operatively (Gleason score robot-assisted radical prostatectomy, 48.3% displayed advanced pathologic features. Therefore we recommend that patients considering active surveillance should be counseled on risk of advanced disease as a possible hazard.

  17. Application of a computer-assisted surgical navigation system in temporomandibular joint ankylosis surgery: a retrospective study.

    Science.gov (United States)

    He, Y; Huang, T; Zhang, Y; An, J; He, L

    2017-02-01

    This retrospective study evaluated the effect of surgical computer-assisted navigation in temporomandibular joint (TMJ) ankylosis gap arthroplasty. Eighteen patients (25 sides) with bony ankylosis who underwent surgical treatment under computer-assisted navigation (navigation group) from May 2011 to April 2013 were assessed, along with 19 such patients (25 sides) treated without computer-assisted navigation (non-navigation group) from March 2009 to April 2011. The navigation group patients underwent surgery with the preservation of ≥3mm bone thickness in the skull base and anterior wall of the external auditory canal. Postoperatively, computed tomography (CT) was used to measure the residual bone thickness in the skull base and anterior wall of the external auditory canal. Maximum mouth opening (MMO) changes were evaluated at >1 year of follow-up. Postoperative CT measurements showed that the lowest skull base thickness in the navigation group was significantly lower than that in the non-navigation group (3.86±1.95mm vs. 6.01±3.07mm, P=0.009). The lowest thicknesses of the anterior wall of the external auditory canal were similar in the two groups. Postoperative follow-up showed similar average MMO in the two groups. Therefore, with the navigation system, TMJ ankylosis gap arthroplasty can achieve more extensive removal of the ankylosed bone, at least towards the skull base, under the premise of ensuring a safety distance of 3mm. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Effects of a robot-assisted training of grasp and pronation/supination in chronic stroke: a pilot study

    Directory of Open Access Journals (Sweden)

    Lambercy Olivier

    2011-11-01

    Full Text Available Abstract Background Rehabilitation of hand function is challenging, and only few studies have investigated robot-assisted rehabilitation focusing on distal joints of the upper limb. This paper investigates the feasibility of using the HapticKnob, a table-top end-effector device, for robot-assisted rehabilitation of grasping and forearm pronation/supination, two important functions for activities of daily living involving the hand, and which are often impaired in chronic stroke patients. It evaluates the effectiveness of this device for improving hand function and the transfer of improvement to arm function. Methods A single group of fifteen chronic stroke patients with impaired arm and hand functions (Fugl-Meyer motor assessment scale (FM 10-45/66 participated in a 6-week 3-hours/week rehabilitation program with the HapticKnob. Outcome measures consisted primarily of the FM and Motricity Index (MI and their respective subsections related to distal and proximal arm function, and were assessed at the beginning, end of treatment and in a 6-weeks follow-up. Results Thirteen subjects successfully completed robot-assisted therapy, with significantly improved hand and arm motor functions, demonstrated by an average 3.00 points increase on the FM and 4.55 on the MI at the completion of the therapy (4.85 FM and 6.84 MI six weeks post-therapy. Improvements were observed both in distal and proximal components of the clinical scales at the completion of the study (2.00 FM wrist/hand, 2.55 FM shoulder/elbow, 2.23 MI hand and 4.23 MI shoulder/elbow. In addition, improvements in hand function were observed, as measured by the Motor Assessment Scale, grip force, and a decrease in arm muscle spasticity. These results were confirmed by motion data collected by the robot. Conclusions The results of this study show the feasibility of this robot-assisted therapy with patients presenting a large range of impairment levels. A significant homogeneous improvement in

  19. Luteal phase support in assisted reproductive technology treatment: focus on Endometrin® (progesterone vaginal insert

    Directory of Open Access Journals (Sweden)

    Jerome H Check

    2009-05-01

    Full Text Available Jerome H CheckThe University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Camden, New Jersey, USAAbstract: Supplementation of progesterone in the luteal phase and continuance of progesterone therapy during the first trimester has been found in several studies to have benefits in promoting fertility, preventing miscarriages and even preventing pre-term labor. Though it can be administered orally, intramuscularly or even sublingually, a very effective route with fewer side effects can be achieved by an intravaginal route. The first vaginal preparations were not made commercially but were compounded by pharmacies. This had the disadvantage of lack of control by the Food and Drug Administration (FDA ensuring efficacy of the preparations. Furthermore there was a lack of precise dosing leading to batch to batch variation. The first commercially approved vaginal progesterone preparation in the United States was a vaginal gel which has proven very effective. The main side effect was accumulation of a buildup of the vaginal gel sometimes leading to irritation. Natural micronized progesterone for vaginal administration with the brand name of Utrogestan A® had been approved even before the gel in certain European countries. Endometrin® vaginal tablets are the newest natural progesterone approved by the FDA. Comparisons to the vaginal gel and to intramuscular progesterone have shown similar efficacy especially in studies following controlled ovarian hyperstimulation and oocyte egg retrieval and embryo transfer. Larger studies are needed to compare side effects.Keywords: progesterone vaginal tablets, luteal phase, miscarriage, pregnancy rates

  20. Evaluation on Hope and Psychological Symptoms in Infertile Couples Undergoing Assisted Reproduction Treatment

    Directory of Open Access Journals (Sweden)

    maryam mohammadi

    2017-03-01

    Full Text Available Background: This study evaluated hope, depression, anxiety, and stress among three groups of infertile couples. Materials and Methods: This cross-sectional study consisted of three groups of infertile couples-candidates for oocyte donation (n=60, embryo donation (n=60, and normal infertile (n=60. Participants included couples seen at Royan Institute, Tehran, Iran between 2013-2014 who were at least 18 years of age and could read and write in Persian. Participants provided demographic and general characteristics and completed the Persian version of the Adult Trait Hope Scale (hope, agency and pathway and Depression, Anxiety, and Stress Scale (DASS. Data was analyzed by the paired t test, ANOVA, ANCOVA and Pearson correlation tests using SPSS statistical software. Results: Overall, 180 infertile couples participated in the three groups. There was a significant higher mean score for hope in husbands compared to wives in the normal infertile group (P=0.046. Husbands in the normal infertile group also had a significantly higher mean score for pathway (P=0.032. The frequency of anxiety significantly differed in female subjects (P=0.028. In the normal infertile group, the anxiety distribution significantly differed between wives and husbands (P=0.006. There was a significantly different stress frequency in male subjects (P=0.048. In the embryo donation group, stress significantly differed between wives and husbands (P=0.002. In the normal infertile group, stress also significantly differed between wives and husbands (P=0.05. Conclusion: The results have suggested that hope might be important in reducing psychological symptoms and psychological adjustment in those exposed to infertility problems who follow medical recommendations, which accelerates recovery. It is recommended to hold psychological counseling sessions (hope therapy during reproduction cycles.

  1. Evaluation on Hope and Psychological Symptoms in Infertile Couples Undergoing Assisted Reproduction Treatment.

    Science.gov (United States)

    Omani Samani, Reza; Vesali, Samira; Navid, Behnaz; Vakiliniya, Bahareh; Mohammadi, Maryam

    2017-01-01

    This study evaluated hope, depression, anxiety, and stress among three groups of infertile couples. This cross-sectional study consisted of three groups of infertile couples-candidates for oocyte donation (n=60), embryo donation (n=60), and normal infertile (n=60). Participants included couples seen at Royan Institute, Tehran, Iran between 2013-2014 who were at least 18 years of age and could read and write in Persian. Participants provided demographic and general characteristics and completed the Persian version of the Adult Trait Hope Scale (hope, agency and pathway) and Depression, Anxiety, and Stress Scale (DASS). Data was analyzed by the paired t test, ANOVA, ANCOVA and Pearson correlation tests using SPSS statistical software. Overall, 180 infertile couples participated in the three groups. There was a significant higher mean score for hope in husbands compared to wives in the normal infertile group (P=0.046). Husbands in the normal infertile group also had a significantly higher mean score for pathway (P=0.032). The frequency of anxiety significantly differed in female subjects (P=0.028). In the normal infertile group, the anxiety distribution significantly differed between wives and husbands (P=0.006). There was a significantly different stress frequency in male subjects (P=0.048). In the embryo donation group, stress significantly differed between wives and husbands (P=0.002). In the normal infertile group, stress also significantly differed between wives and husbands (P=0.05). The results have suggested that hope might be important in reducing psychological symptoms and psychological adjustment in those exposed to infertility problems who follow medical recommendations, which accelerates recovery. It is recommended to hold psychological counseling sessions (hope therapy) during reproduction cycles.

  2. Euthanasia and physician-assisted suicide in dementia: A qualitative study of the views of former dementia carers.

    Science.gov (United States)

    Tomlinson, Emily; Spector, Aimee; Nurock, Shirley; Stott, Joshua

    2015-09-01

    Despite media and academic interest on assisted dying in dementia, little is known of the views of those directly affected. This study explored the views of former carers on assisted dying in dementia. This was a qualitative study using thematic analysis. A total of 16 former carers of people with dementia were recruited through national dementia charities and participated in semi-structured interviews. While many supported the individual's right to die, the complexity of assisted dying in dementia was emphasized. Existential, physical, psychological and psychosocial aspects of suffering were identified as potential reasons to desire an assisted death. Most believed it would help to talk with a trained health professional if contemplating an assisted death. Health workers should be mindful of the holistic experience of dementia at the end of life. The psychological and existential aspects of suffering should be addressed, as well as relief of physical pain. Further research is required. © The Author(s) 2015.

  3. Emergent Literacy Development and Computer Assisted Instruction

    Science.gov (United States)

    Trotti, Judy; Hendricks, Randy; Bledsoe, Christie

    2017-01-01

    In this mixed-methods study, researchers examined the literacy development of prekindergarten students (N = 162) randomly placed in one of two treatment groups with each receiving 15 minutes of computer-assisted literacy instruction for four months. Literacy development of a control group of children not receiving computer-assisted instruction was…

  4. Voice-Activated Lightweight Reacher to Assist with Upper Extremity Movement Limitations: A Case Study.

    Science.gov (United States)

    Khalid, Umer; Conti, Gerry E; Erlandson, Robert F; Ellis, Richard D; Brown, Vince; Pandya, Abhilash K

    2015-01-01

    The focus of this research was to design a functional and user-friendly reacher for people with spinal cord injuries (SCIs). Engineering advancements have taken assistive robotics to new dimensions. Technologies such as wheelchair robotics and myo-electronically controlled systems have opened up a wide range of new applications to assist people with physical disabilities. Similarly, exo-skeletal limbs and body suits have provided new foundations from which technologies can aid function. Unfortunately, these devices have issues of usability, weight, and discomfort with donning. The Smart Assistive Reacher Arm (SARA) system, developed in this research, is a voice-activated, lightweight, mobile device that can be used when needed. SARA was built to help overcome daily reach challenges faced by individuals with limited arm and hand movement capability, such as people with cervical level 5-6 (C5-6) SCI. This article shows that a functional reacher arm with voice control can be beneficial for this population. Comparison study with healthy participants and an SCI participant shows that, when using SARA, a person with SCI can perform simple reach and grasp tasks independently, without someone else's help. This suggests that the interface is intuitive and can be easily used to a high level of proficiency by a SCI individual.

  5. Use and Evaluation of a Cooling Aid in Laser-Assisted Dental Surgery: An Innovative Study.

    Science.gov (United States)

    Bernardi, Sara; Mummolo, Stefano; Zeka, Keti; Pajewski, Leonardo; Continenza, Maria Adelaide; Marzo, Giuseppe

    2016-06-01

    The aim of this study was to evaluate the beneficial effect of NeoHeal during laser-assisted oral surgery. Laser-assisted surgery is a less invasive technique than conventional surgery using a blade; however, the heat produced by the laser can damage tissue proximal to the treated area. We hypothesized the hydrogel NeoHeal could be applied during oral surgery and have similar benefits as those already described for dermatological surgery. In our randomized controlled trial, we first selected 30 patients who were to undergo laser surgical intervention using a diode laser. Both at the end of intervention and at follow-up, each patient filled out a questionnaire comprising two questions. The answers to the questions were statistically analyzed with regard to frequency of each response, and validated by the Wilcoxon test with a p value <0.05 being considered significant. The use of NeoHeal significantly reduced the pain experienced by patients both during the intervention and at the 7-day follow-up. NeoHeal clearly reduces surgery-related pain experienced by patients. The results show positive feedback from the patients, demonstrating how the hydrogel pads are necessary, useful, and effective as a cooling aid in laser-assisted dental surgery.

  6. Robot-Assisted Transoral Odontoidectomy : Experiment in New Minimally Invasive Technology, a Cadaveric Study

    Science.gov (United States)

    Yang, Moon Sul; Yoon, Tae Ho; Yoon, Do Heum; Kim, Keung Nyun; Pennant, William

    2011-01-01

    Objective In the field of spinal surgery, a few laboratory results or clinical cases about robotic spinal surgery have been reported. In vivo trials and development of related surgical instruments for spinal surgery are required before its clinical application. We investigated the use of the da Vinci® Surgical System in spinal surgery at the craniovertebral junction in a human cadaver to demonstrate the efficacy and pitfalls of robotic surgery. Methods Dissection of pharyngeal wall to the exposure of C1 and odontoid process was performed with full robotic procedure. Although assistance of another surgeon was necessary for drilling and removal of odontoid process due to the lack of appropriate end-effectors, successful robotic procedures for dural sutures and exposing spinal cord proved its safety and dexterity. Results Robot-assisted odontoidectomy was successfully performed in a human cadaver using the da Vinci® Surgical System with few robotic arm collisions and minimal soft tissue damages. Da Vinci® Surgical System manifested more dexterous movement than human hands in the deep and narrow oral cavity. Furthermore, sutures with robotic procedure in the oral cavity demonstrated the advantage over conventional procedure. Conclusion Presenting cadaveric study proved the probability of robot-assisted transoral approach. However, the development of robotic instruments specific to spinal surgery must first precede its clinical application. PMID:21607188

  7. [Clinical study on endoscope-assisted repair of zygomatic arch fracture].

    Science.gov (United States)

    Luo, Qi; Xiao, Wenzhi; Chen, Yong; Zhang, Li

    2016-04-01

    A study was conducted to investigate the relevant applied technique and clinical value of endoscope-assisted repair of zygomatic arch fracture. A total of 10 cases of unilateral zygomatic arch fracture and 8 cases ofunilateral zygomatic fracture were included. Reduction and fixation of the zygomatic arch in all cases were performed via asmall face incision by an endoscope. Endoscope-assisted repair allowed exposure of zygomatic arch fracture and ended the anatomy of the reset. Zygomatic arch was stabilized with titanium plates. Symmetric malar was achieved in allcases after operation. Patients did not show difficulty in opening the mouth. No chewing problems or severe complicationswere evident. This method had the advantage of hidden incision, and it did not leave scars on the face. Postoperative CT examination showed excellent reduction of zygomatic arch fracture and good fixed position of titanium plate. Endoscope-assisted repair of zygomatic arch fracture via a small face incision can be an alternative operation for zygomaticarch fracture. Patients are less traumatized. There are fewer complications. A good reduction of fracture is achieved.

  8. ACIDIC REMOVAL OF METALS FROM FLUIDIZED CATALYTIC CRACKING CATALYST WASTE ASSISTED BY ELECTROKINETIC TREATMENT

    Directory of Open Access Journals (Sweden)

    R. B. G. Valt

    2015-06-01

    Full Text Available AbstractOne of the main uses of catalysts in the oil industry is in the fluidized catalytic cracking process, which generates large quantities of waste material after use and regeneration cycles and that can be treated by the electrokinetic remediation technique, in which the contaminant metals are transported by migration. In this study, deactivated FCC catalyst was characterized before and after the electrokinetic remediation process to evaluate the amount of metal removed, and assess structural modifications, in order to indicate a possible use as an adsorbent material. The analyses included pH measurement and the concentration profile of vanadium ions along the reactor, X-ray microtomography, X-ray fluorescence, BET analysis and DTA analysis. The results indicated that 40% of the surface area of the material was recovered in relation to the disabled material, showing an increase in the available area for the adsorption. The remediation process removed nearly 31% of the vanadium and 72% of the P2O5 adhering to the surface of the catalyst, without causing structural or thermal stability changes.

  9. [Thymomectomy by minimally invasive surgery. Comparative study videosurgery versus robot-assisted surgery].

    Science.gov (United States)

    Witte Pfister, A; Baste, J-M; Piton, N; Bubenheim, M; Melki, J; Wurtz, A; Peillon, C

    2017-05-01

    To report the results of minimally invasive surgery in patients with stage I or II thymoma in the Masaoka classification. The reference technique is partial or complete thymectomy by sternotonomy. A retrospective single-center study of a prospective database including all cases of thymoma operated from April 2009 to February 2015 by minimally invasive techniques: either videosurgery (VATS) or robot-assisted surgery (RATS). The surgical technique, type of resection, length of hospital stay, postoperative complications and recurrences were analysed. Our series consisted of 22 patients (15 women and 7 men). The average age was 53 years. Myasthenia gravis was present in 12 patients. Eight patients were operated on by VATS and 14 patiens by RATS. There were no conversions to sternotomy and no perioperative deaths. The mean operating time was 92min for VATS and 137min for RATS (P<0.001). The average hospital stay was 5 days. The mean weight of the specimen for the VATS group was 13.2 and 45.7mg for the RATS group. Twelve patients were classified Masaoka stage I and 10 were stage II. According to the WHO classification there were 7 patients type A, 5 type AB, 4 type B1, 4 type B2 4 and 2 type B3. As proposed by the Group ITMIG-IASLC in 2015 all patients corresponded to group I. The mean follow-up period was 36 months. We noted 3 major perioperative complications according to the Clavien-Dindo classification: one pneumonia, one phrenic nerve paralysis and one recurrent laryngeal nerve palsy. We observed one case of local recurrence at 22 months. Following surgery 4 patients were treated with radiotherapy and 2 patients with chemotherapy. The minimally invasive route is safe, relatively atraumatic and may be incorporated in the therapeutic arsenal for the treatment of Masaoka stage I and II thymoma as an alternative to conventional sternotomy. RATS and VATS are two minimally invasive techniques and the results in the short and medium term are

  10. Successful treatment of a guitarist with a finger joint injury using instrument-assisted soft tissue mobilization: a case report.

    Science.gov (United States)

    Terry Loghmani, M; Bayliss, Amy J; Clayton, Greg; Gundeck, Evelina

    2015-12-01

    Finger injuries are common and can greatly affect a musician's quality of life. A 55-year-old man, who had injured the proximal interphalangeal joint of the left index finger 6 months prior to any intervention, was treated with a manual therapy approach incorporating instrument-assisted soft tissue mobilization (IASTM). Initial examination findings included self-reported pain and functional limitations and physical impairments that significantly impeded his ability to play the acoustic guitar. He was treated once a week for 6 weeks with IASTM, joint mobilization, therapeutic exercise, and ice massage. Additionally, a home exercise program and self-care instructions were provided. The patient gained positive outcomes with improvements in pain (Numerical Pain Rating Scale while playing the guitar: initial 5/10, discharge 1/10) and function (Disability Arm Shoulder Hand Sports-Performing Arts Optional Module: initial 75; discharge 6·25), each reaching a minimum clinically important difference. Importantly, he was able to play the guitar with minimal to no pain as desired. Physical measures also improved, including an immediate gain in finger range of motion with IASTM alone. Manual therapy approaches integrating IASTM may provide an effective conservative treatment strategy for patients with finger/hand conditions in the performing arts and other patient populations.

  11. Circuit to construct mapping: a mathematical tool for assisting the diagnosis and treatment in major depressive disorder.

    Science.gov (United States)

    Bielczyk, Natalia Z; Buitelaar, Jan K; Glennon, Jeffrey C; Tiesinga, Paul H E

    2015-01-01

    Major depressive disorder (MDD) is a serious condition with a lifetime prevalence exceeding 16% worldwide. MDD is a heterogeneous disorder that involves multiple behavioral symptoms on the one hand and multiple neuronal circuits on the other hand. In this review, we integrate the literature on cognitive and physiological biomarkers of MDD with the insights derived from mathematical models of brain networks, especially models that can be used for fMRI datasets. We refer to the recent NIH research domain criteria initiative, in which a concept of "constructs" as functional units of mental disorders is introduced. Constructs are biomarkers present at multiple levels of brain functioning - cognition, genetics, brain anatomy, and neurophysiology. In this review, we propose a new approach which we called circuit to construct mapping (CCM), which aims to characterize causal relations between the underlying network dynamics (as the cause) and the constructs referring to the clinical symptoms of MDD (as the effect). CCM involves extracting diagnostic categories from behavioral data, linking circuits that are causal to these categories with use of clinical neuroimaging data, and modeling the dynamics of the emerging circuits with attractor dynamics in order to provide new, neuroimaging-related biomarkers for MDD. The CCM approach optimizes the clinical diagnosis and patient stratification. It also addresses the recent demand for linking circuits to behavior, and provides a new insight into clinical treatment by investigating the dynamics of neuronal circuits underneath cognitive dimensions of MDD. CCM can serve as a new regime toward personalized medicine, assisting the diagnosis and treatment of MDD.

  12. Sestamibi scan-directed, minimally invasive video-assisted parathyroidectomy: an effective treatment for solitary parathyroid adenoma.

    Science.gov (United States)

    Murphy, A D; Andrews, E J; Ishtiaq, A; Jawad, A; McCarthy, P A; O'Keeffe, D; Dunne, F; Quill, D S

    2007-12-01

    Solitary adenomas have been shown to be responsible for almost 90% of cases of primary hyperparathyroidism. The purpose of this study was to determine the utility of sestamibi scanning pre-operatively to guide minimally invasive video-assisted (MIVA) parathyroidectomy. We reviewed 40 patients who underwent parathyroidectomy between 2003 and 2004. All patients underwent a pre-operative sestamibi scan. Thirty-three (82%) patients had a localized solitary adenoma on sestamibi scan. Of these patients 29 underwent attempted MIVA parathyroidectomy. MIVA parathyroidectomy was successful in 22 patients. When pre-operative sestamibi scanning was correlated with pathological diagnosis it was shown to have a sensitivity of 82% and positive predictive value of 94%. Pre-operative sestamibi scan localization of a parathyroid adenoma offers a 94% positive predictive value for adenoma location. This facilitates MIVA parathyroidectomy to be used effectively to treat primary hyperparathyroidism in the majority of patients.

  13. Metaevaluation of National Weatherization Assistance Program Based on State Studies, 1993-2002

    Energy Technology Data Exchange (ETDEWEB)

    Berry, L

    2003-04-02

    The National Weatherization Assistance Program, sponsored by the U.S. Department of Energy (DOE) and implemented by state and local agencies throughout the United States, weatherizes homes for low-income residents in order to increase their energy efficiency and lower utility bills. Research staff members at Oak Ridge National Laboratory (ORNL) have performed two previous metaevaluations of this program (Berry, 1997; Schweitzer and Berry, 1999). Both of these earlier metaevaluations involved synthesizing the results from individual studies of state weatherization efforts completed during a several year period. This report is the third in a series of metaevaluations of state-level studies. It is built on the foundation developed by the previous two metaevaluations. The purpose of this report, like that of the two earlier ORNL metaevaluations, is to provide a current estimate of the average national energy savings per home weatherized for the Weatherization Assistance Program based on the relevant state-level studies. All three of the metaevaluations, including this one, were designed to be updates to the findings of a national evaluation of the Weatherization Assistance Program, which examined a representative national sample of several thousand structures weatherized in 1989 (Brown, Berry, Balzer, and Faby 1993). Although the first and second metaevaluations used separate sets of state-level studies, completed during different time periods, there was little difference in their findings about the typical national energy savings per weatherized home for homes that heat with natural gas. Our initial analysis efforts for this report involved repeating the same procedures that had been used in the previous two reports. In particular, we collected and examined only the state-level evaluations that had become available between September of 1998 and August of 2002. Once again, we found little difference in the average energy savings estimates per weatherized home that were

  14. Feasibility Study of a Socially Assistive Humanoid Robot for Guiding Elderly Individuals during Walking

    Directory of Open Access Journals (Sweden)

    Chiara Piezzo

    2017-07-01

    Full Text Available The impact of the world-wide ageing population has commenced with respect to society in developed countries. Several researchers focused on exploring new methods to improve the quality of life of elderly individuals by allowing them to remain independent and healthy to the maximum possible extent. For example, new walking aids are designed to allow elderly individuals to remain mobile in a safe manner because the importance of walking is well-known. The aim of the present study involves designing a humanoid robot guide as a walking trainer for elderly individuals. It is hypothesized that the same service robot provides an assistive and social contribution with respect to interaction between elderly users by motivating them to walk more and simultaneously provides assistance, such as physical assistance and gait monitoring, while walking. This study includes a detailed statement of the research problem as well as a literature review of existing studies related to walking companion robots. A user-centred design approach is adopted to report the results of the current first feasibility study by using a commercially available humanoid robot known as Pepper developed by Softbank-Aldebaran. A quantitative questionnaire was used to investigate all elements that assess intrinsic motivation in users while performing a given activity. Conversely, basic gait data were acquired through a video analysis to test the capability of the robot to modify the gait of human users. The results in terms of the feedback received from elderly subjects and the literature review improve the design of the walking trainer for elderly individuals.

  15. Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients

    National Research Council Canada - National Science Library

    Snowden, Lonnie R; McClellan, Sean R

    2013-01-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal...

  16. Effects of contralesional robot-assisted hand training in patients with unilateral spatial neglect following stroke: a case series study.

    Science.gov (United States)

    Varalta, Valentina; Picelli, Alessandro; Fonte, Cristina; Montemezzi, Giulia; La Marchina, Elisabetta; Smania, Nicola

    2014-12-05

    A reduction of hemispatial neglect due to stroke has been associated with activation of the contralesional hand in the contralesional hemispace. Robot-assisted upper limb training was found to effectively improve paretic arm function in stroke patients. To date no proof of concept of robot-assisted hemispatial neglect therapy has been reported in literature. This study aimed to determine whether robot-assisted left (contralesional) hand activation alone could lead to an improvement in hemispatial neglect following stroke. Three stroke patients with right brain injury underwent a 2-week training program of robotic left hand activation with the Gloreha® hand rehabilitation glove, which provides repetitive, passive mobilization of the fingers. Outcomes were assessed using the Line Crossing test, the Bells test, the Sentence Reading test, the Saccadic Training, the Sustained Attention to Response Task, and the Purdue Pegboard test. Changes were observed after treatment as follows. Line Crossing test: all patients showed improved performance (6.7%, 89.5% and 80% increase in lines crossed) with two patients reaching normal performance levels. Bells test: one patient improved performance (50% increase), while one patient showed no change and one patient declined (-10.3% change); no patient reached normal performance levels. Sentence Reading test: all patients showed improved performance (800%, 57.1% and 42.9% increase in number of sentences read) with no patient reaching normal performance level. Saccadic Training: all patients showed improved performance (-62.8%, -15.5% and -9.7% change of the left hemifield reaction time). Sustained Attention to Response Task: all patients showed improved performance (-20.5%, -5.8% and -10% change of the reaction time) with two patients reducing incorrect responses (-42.9% and -73.3%) and one patient increasing them (9.1%). Purdue Pegboard test: all patients showed improved performance (100%, 27.3% and 75% change in the left

  17. Identifying strategies to assist final semester nursing students to develop numeracy skills: a mixed methods study.

    Science.gov (United States)

    Ramjan, Lucie M; Stewart, Lyn; Salamonson, Yenna; Morris, Maureen M; Armstrong, Lyn; Sanchez, Paula; Flannery, Liz

    2014-03-01

    It remains a grave concern that many nursing students within tertiary institutions continue to experience difficulties with achieving medication calculation competency. In addition, universities have a moral responsibility to prepare proficient clinicians for graduate practice. This requires risk management strategies to reduce adverse medication errors post registration. To identify strategies and potential predictors that may assist nurse academics to tailor their drug calculation teaching and assessment methods. This project builds on previous experience and explores students' perceptions of newly implemented interventions designed to increase confidence and competence in medication calculation. This mixed method study surveyed students (n=405) enrolled in their final semester of study at a large, metropolitan university in Sydney, Australia. Tailored, contextualised interventions included online practice quizzes, simulated medication calculation scenarios developed for clinical practice classes, contextualised 'pen and paper' tests, visually enhanced didactic remediation and 'hands-on' contextualised workshops. Surveys were administered to students to determine their perceptions of interventions and to identify whether these interventions assisted with calculation competence. Test scores were analysed using SPSS v. 20 for correlations between students' perceptions and actual performance. Qualitative open-ended survey questions were analysed manually and thematically. The study reinforced that nursing students preferred a 'hands-on,' contextualised approach to learning that was 'authentic' and aligned with clinical practice. Our interventions assisted with supporting students' learning and improvement of calculation confidence. Qualitative data provided further insight into students' awareness of their calculation errors and preferred learning styles. Some of the strongest predictors for numeracy skill performance included (1) being an international student, (2

  18. The psychosexual profile of sexual assistants: an internet-based explorative study

    National Research Council Canada - National Science Library

    Limoncin, Erika; Galli, Debora; Ciocca, Giacomo; Gravina, Giovanni Luca; Carosa, Eleonora; Mollaioli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A

    2014-01-01

    Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees...

  19. Feasibility studies of robot-assisted stroke rehabilitation at clinic and home settings using RUPERT.

    Science.gov (United States)

    Zhang, Hang; Austin, Hiroko; Buchanan, Sharon; Herman, Richard; Koeneman, Jim; He, Jiping

    2011-01-01

    Task based repetitive therapy has been proposed to help stroke survivors to regain functional control of arm movement. We developed a wearable exoskeleton rehabilitation robot with associated control algorithm and safety protection mechanisms, and a graphic user interface that is easy to use and intuitive to patients and therapists, as the framework for automated and customizable robot-assisted rehabilitation system for clinic and home based therapy. The system was tested in two feasibility studies. The first study involved 6 patients to receive therapeutic training during three time weekly clinic visits for 4 weeks. The second study set up the robot-assisted rehabilitation system at patient's house, where the therapeutic training was practiced on a daily base. Two patients were recruited for the home application study. Patients' performances were assessed using clinical evaluation tools, including Wolf Motor Function Test and Fugl Meyer Assessment (FMA), both before and after the training. The performances of patients during the training weeks were also objectively evaluated by using the robot sensory data. © 2011 IEEE

  20. A Preliminary Study on the Possibility of Using Ultrasound in Driver Assistance Systems

    Science.gov (United States)

    Takahashi, Hiroshi; Honda, Hirohiko

    This paper presents a preliminary study on the possibility of using ultrasound in driver assistance systems. Subjects' lap time in a driving video game was measured as an index of their performance of driving operations under acoustic conditions with and without an ultrasound signal at 23kHz, 70dB. The results show that the performance characteristics of the subjects changed when the ultrasound signal was presented. Ultrasound signal tends to concentrate on handling the vehicle and decreasing an attention to check the over speed driving, as a second task. We prove the possibility to apply ultrasound signal to control operator's attention and behavior.

  1. Microwave-Assisted Extraction of Essential Oil from Eucalyptus: Study of the Effects of Operating Conditions

    Directory of Open Access Journals (Sweden)

    A.A. Saoud

    2006-12-01

    Full Text Available Classical extraction of essential oil such as Soxhlet and steam distillation is still a formidable and time-solvent consuming. Microwave assisted process (MAP is used to accelerate the extraction process of target compounds. It can be used for the extraction of compounds from various plants and animal tissues, or the extraction of undesirable components from raw materials. The investigation of microwave extraction of eucalyptus (globules essential oil using ethanol as solvent was carried out. The influence of material (eucalyptus/solvent (ethanol ratio, required doses of microwave, and time of microwave exposure on extraction efficiency, was studied.

  2. Paid personal assistance services:an exploratory study of working-age consumers' perspectives.

    Science.gov (United States)

    Grossman, Brian R; Kitchener, Martin; Mullan, Joseph T; Harrington, Charlene

    2007-01-01

    This study examined the experiences of individuals who use paid personal assistance services (PAS). Structured interview data were collected from a convenience sample of 24 working-age individuals from diverse backgrounds recruited from Centers for Independent Living in nine states. Respondents described their general satisfaction with current paid PAS, but many reported previous experiences with poor care related to the low wages, lack of training of PAS providers, and an inadequate supply of providers. Respondents reported many unmet needs because of a shortage of hours provided by state programs and the lack of help with daily living activities, transportation, childcare, and social activities. The respondents strongly preferred consumer-directed care.

  3. Consumer acceptance of an SMS-assisted smoking cessation intervention: a multicountry study.

    Science.gov (United States)

    Andrews, Lynda; Cacho-Elizondo, Silvia; Drennan, Judy; Tossan, Vessélina

    2013-01-01

    This study assesses smokers' perceptions, motivations, and intentions towards using an SMS-assisted smoking cessation intervention in Australia, France, and Mexico through an extended technology acceptance model with mediating variables. Data was collected through online surveys. Results show that perceived usefulness and vicarious innovativeness predict use intentions for all three countries. Perceived ease of use is significant only for Mexico. Subjective norms are significant only for Mexico and Australia. Perceived monetary value and perceived annoyance are significant mediating variables for all three countries, whereas perceived enjoyment is significant only for Mexico and Australia. These results contribute to theory and practice.

  4. Successful Nicotine Intake in Medical Assisted Use of E-Cigarettes: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Roberta Pacifici

    2015-07-01

    Full Text Available The electronic cigarette (e-cig has gained popularity as an aid in smoking cessation programs mainly because it maintains the gestures and rituals of tobacco smoking. However, it has been shown in inexperienced e-cig users that ineffective nicotine delivery can cause tobacco craving that could be responsible for unsuccessful smoking reduction/cessation. Moreover, the incorrect use of an e-cig could also led to potential nicotine overdosage and intoxication. Medically assisted training on the proper use of an e-cig plus behavioral support for tobacco dependence could be a pivotal step in avoiding both issues. We performed an eight-month pilot study of adult smokers who started e-cig use after receiving a multi-component medically assisted training program with monitoring of nicotine intake as a biomarker of correct e-cig use. Participants were tested during follow-up for breath carbon monoxide (CO, plasma cotinine and trans-3’-hydroxycotinine, and number of tobacco cigarettes smoked. At the end of the first, fourth, and eighth month of follow-up, 91.1, 73.5, and 76.5% of participants respectively were e-cig users (‘only e-cig’ and ‘dual users’. They showed no significant variation in plasma cotinine and trans-3’-hydroxycotinine with respect to the start of the study when they smoked only tobacco cigarettes, but a significant reduction in breath CO. The proposed medically assisted training program of e-cig use led to a successful nicotine intake, lack of typical cigarette craving and overdosage symptoms and a significant decrease in the biomarker of cigarette combustion products.

  5. Successful Nicotine Intake in Medical Assisted Use of E-Cigarettes: A Pilot Study.

    Science.gov (United States)

    Pacifici, Roberta; Pichini, Simona; Graziano, Silvia; Pellegrini, Manuela; Massaro, Giuseppina; Beatrice, Fabio

    2015-07-08

    The electronic cigarette (e-cig) has gained popularity as an aid in smoking cessation programs mainly because it maintains the gestures and rituals of tobacco smoking. However, it has been shown in inexperienced e-cig users that ineffective nicotine delivery can cause tobacco craving that could be responsible for unsuccessful smoking reduction/cessation. Moreover, the incorrect use of an e-cig could also led to potential nicotine overdosage and intoxication. Medically assisted training on the proper use of an e-cig plus behavioral support for tobacco dependence could be a pivotal step in avoiding both issues. We performed an eight-month pilot study of adult smokers who started e-cig use after receiving a multi-component medically assisted training program with monitoring of nicotine intake as a biomarker of correct e-cig use. Participants were tested during follow-up for breath carbon monoxide (CO), plasma cotinine and trans-3'-hydroxycotinine, and number of tobacco cigarettes smoked. At the end of the first, fourth, and eighth month of follow-up, 91.1, 73.5, and 76.5% of participants respectively were e-cig users ('only e-cig' and 'dual users'). They showed no significant variation in plasma cotinine and trans-3'-hydroxycotinine with respect to the start of the study when they smoked only tobacco cigarettes, but a significant reduction in breath CO. The proposed medically assisted training program of e-cig use led to a successful nicotine intake, lack of typical cigarette craving and overdosage symptoms and a significant decrease in the biomarker of cigarette combustion products.

  6. The COACH prompting system to assist older adults with dementia through handwashing: An efficacy study

    Directory of Open Access Journals (Sweden)

    Boger Jennifer N

    2008-11-01

    Full Text Available Abstract Background Many older adults with dementia require constant assistance from a caregiver when completing activities of daily living (ADL. This study examines the efficacy of a computerized device intended to assist people with dementia through ADL, while reducing caregiver burden. The device, called COACH, uses artificial intelligence to autonomously guide an older adult with dementia through the ADL using audio and/or audio-video prompts. Methods Six older adults with moderate-to-severe dementia participated in this study. Handwashing was chosen as the target ADL. A single subject research design was used with two alternating baseline (COACH not used and intervention (COACH used phases. The data were analyzed to investigate the impact of COACH on the participants' independence and caregiver burden as well as COACH's overall performance for the activity of handwashing. Results Participants with moderate-level dementia were able to complete an average of 11% more handwashing steps independently and required 60% fewer interactions with a human caregiver when COACH was in use. Four of the participants achieved complete or very close to complete independence. Interestingly, participants' MMSE scores did not appear to robustly coincide with handwashing performance and/or responsiveness to COACH; other idiosyncrasies of each individual seem to play a stronger role. While the majority (78% of COACH's actions were considered clinically correct, areas for improvement were identified. Conclusion The COACH system shows promise as a tool to help support older adults with moderate-levels of dementia and their caregivers. These findings reinforce the need for flexibility and dynamic personalization in devices designed to assist older adults with dementia. After addressing identified improvements, the authors plan to run clinical trials with a sample of community-dwelling older adults and caregivers.

  7. Spontaneous Retroperitoneal Hemorrhage (Wunderlich Syndrome due to Large Upper Pole Renal Angiomyolipoma: Does Robotic-Assisted Laparoscopic Partial Nephrectomy Have a Role in Primary Treatment?

    Directory of Open Access Journals (Sweden)

    Achilles Ploumidis

    2013-01-01

    Full Text Available Spontaneous rapture with consequent retroperitoneal hemorrhage (Wunderlich’s syndrome is the complication mostly feared from large renal angiomyolipomas (RAMLs. In hemodynamic stable patients, minimal invasive therapies have superseded open surgery as the mainstay of treatment, with contemporary cases mostly treated by selective arterial embolization. Robotic-assisted laparoscopic partial nephrectomy (RALPN is an established minimal access treatment that has been used in the past for benign and malignant lesions of the kidney in the elective setting, but rarely in urgent situations as primary treatment. We present a case of a ruptured RAML in a young female treated effectively by RALPN.

  8. Caring labour, intersectionality and worker satisfaction: an analysis of the National Nursing Assistant Study (NNAS).

    Science.gov (United States)

    Rakovski, Carter C; Price-Glynn, Kim

    2010-03-01

    Caring labour in long-term care settings is increasingly important as the US population ages. Ethnographic research on nursing assistants (NAs) portrays nursing home care as routine and fast paced in facilities that emphasise life maintenance more than care. Recent interview-based and small quantitative studies describe a mix of positive and negative aspects of NA work, including the rewards of caring, despite shortcomings in working conditions and pay. The current study continues this research but, for the first time, using national data. The 2004 Centers for Disease Control and Prevention's National Nursing Assistant Study (NNAS) provides survey data from 3,017 NAs working in long-term care facilities across the US. The NNAS results confirm the importance and centrality of caring to NAs' work. NAs motivated by caring for others were significantly more satisfied with their jobs than those motivated by other reasons, such as convenience or salary. Overall, NAs report surprisingly high job satisfaction, particularly with learning new skills, doing challenging work, and organisational support for caring labour. Areas of dissatisfaction were salary, time for reproductive labour, and turnover. Intersectional analysis revealed race and citizenship played a stronger role than gender in worker satisfaction.

  9. Wii-Fit for Improving Gait and Balance in an Assisted Living Facility: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kalpana P. Padala

    2012-01-01

    Full Text Available Objectives. To determine the effects on balance and gait of a Wii-Fit program compared to a walking program in subjects with mild Alzheimer’s dementia (AD. Methods. A prospective randomized (1 : 1 pilot study with two intervention arms was conducted in an assisted living facility with twenty-two mild AD subjects. In both groups the intervention occurred under supervision for 30 minutes daily, five times a week for eight weeks. Repeated measures ANOVA and paired t-tests were used to analyze changes. Results. Both groups showed improvement in Berg Balance Scale (BBS, Tinetti Test (TT and Timed Up and Go (TUG over 8 weeks. However, there was no statistically significant difference between the groups over time. Intragroup analysis in the Wii-Fit group showed significant improvement on BBS (P=0.003, and TT (P=0.013. The walking group showed a trend towards improvement on BBS (P=0.06 and TUG (P=0.07 and significant improvement in TT (P=0.006. Conclusion. This pilot study demonstrates the safety and efficacy of Wii-Fit in an assisted living facility in subjects with mild AD. Use of Wii-Fit resulted in significant improvements in balance and gait comparable to those in the robust monitored walking program. These results need to be confirmed in a larger, methodologically sound study.

  10. The effect of surgically assisted rapid maxillary expansion on sleep architecture: an exploratory risk study in healthy young adults.

    Science.gov (United States)

    Bach, N; Tuomilehto, H; Gauthier, C; Papadakis, A; Remise, C; Lavigne, F; Lavigne, G J; Huynh, N

    2013-11-01

    Maxillary transverse deficiencies (MTD) cause malocclusions. Rapid maxillary expansion treatment is commonly used treatment for correcting such deficiencies and has been found to be effective in improving respiration and sleep architecture in children with obstructive sleep apnoea (OSA). However, thus far, the effect of surgically assisted rapid maxillary expansion (SARME) treatment on sleep architecture and breathing of normal subjects has not been assessed. We hypothesised that sleep quality will improve after maxillary expansion treatment. The objective of this study is to access the effect of maxillary expansion treatment on sleep structure and respiratory functions in healthy young adults with severe MTD. This is a prospective and exploratory clinical study. Twenty-eight consecutive young adult patients (15 males and 13 females, mean age 20·6 ± 5·8 years) presenting with severe MTD at the orthodontic examination were recruited into the study. All the participants underwent a standardised SARME procedure (mean expansion 6·5 ± 1·8 and 8·2 ± 1·8 mm, intercanine and intermolar distance, respectively) to correct malocclusion caused by MTD. An overnight in-laboratory polysomnography, before and after the treatment, was performed. The mean follow-up time was 9 months. The main outcome parameters were the changes in sleep architecture, including sleep stages, arousals, slow-wave activity (SWA) and respiratory variables. Before surgery, young adult patients with MTD presented no evidence of sleep breathing problems. At baseline sleep recording, 7 of 28 (25%) had apnoea-hypopnoea index (AHI) ≥ 5 events per hour. No negative effect of the SARME was observed in questionnaires or sleep laboratory parameters. In the patients with a higher baseline AHI (AHI ≥ 5 h of sleep), we observed a reduction in AHI after surgical treatment (P = 0·028). SARME did not have a negative effect on any sleep or respiration parameters in healthy young individuals

  11. The Efficacy of Dog Assisted Therapy in Detained Drug Users: A Pilot Study in an Italian Attenuated Custody Institute

    OpenAIRE

    Contalbrigo, Laura; De Santis, Marta; Toson, Marica; Montanaro, Maria; Farina, Luca; Costa, Aldo; Nava, Felice Alfonso

    2017-01-01

    Drug addiction is a major care and safety challenge in prison context. Nowadays, rehabilitation and specific therapeutic programs are suggested to improve health and well-being of inmates during their detention time and to reduce substance abuse relapse after release from prison. Among these programs, several studies reported the benefits for inmates coming from animal assisted interventions. In this pilot controlled study, we investigated the efficacy of a dog assisted therapy program addres...

  12. Using a three-dimensional computer assisted stone volume estimates to evaluate extracorporeal shockwave lithotripsy treatment of kidney stones

    DEFF Research Database (Denmark)

    Bigum, Lene Hyldgaard; Ulriksen, Peter Sommer; Omar, Omar Salah

    2016-01-01

    This study describes and evaluates the use of non-contrast enhanced computerized tomography (NCCT) before and after extracorporeal shockwave lithotripsy (SWL). Computer measured stone volume was used as an exact measurement for treatment response. 81 patients received SWL of kidney stones at Herlev...

  13. Feasibility and safety of early lower limb robot-assisted training in sub-acute stroke patients: a pilot study.

    Science.gov (United States)

    Gandolfi, Marialuisa; Geroin, Christian; Tomelleri, Christopher; Maddalena, Isacco; Kirilova Dimitrova, Eleonora; Picelli, Alessandro; Smania, Nicola; Waldner, Andreas

    2017-12-01

    So far, the development of robotic devices for the early lower limb mobilization in the sub-acute phase after stroke has received limited attention. To explore the feasibility of a newly robotic-stationary gait training in sub-acute stroke patients. To report the training effects on lower limb function and muscle activation. A pilot study. Rehabilitation ward. Two sub-acute stroke inpatients and ten age-matched healthy controls were enrolled. Healthy controls served as normative data. Patients underwent 10 robot-assisted training sessions (20 minutes, 5 days/week) in alternating stepping movements (500 repetitions/session) on a hospital bed in addition to conventional rehabilitation. Feasibility outcome measures were compliance, physiotherapist time, and responses to self-report questionnaires. Efficacy outcomes were bilateral lower limb muscle activation pattern as measured by surface electromyography (sEMG), Motricity Index (MI), Medical Research Council (MRC) grade, and Ashworth Scale (AS) scores before and after training. No adverse events occurred. No significant differences in sEMG activity between patients and healthy controls were observed. Post-training improvement in MI and MRC scores, but no significant changes in AS scores, were recorded. Post-treatment sEMG analysis of muscle activation patterns showed a significant delay in rectus femoris offset (P=0.02) and prolonged duration of biceps femoris (P=0.04) compared to pretreatment. The robot-assisted training with our device was feasible and safe. It induced physiological muscle activations pattern in both stroke patients and healthy controls. Full-scale studies are needed to explore its potential role in post-stroke recovery. This robotic device may enrich early rehabilitation in subacute stroke patients by inducing physiological muscle activation patterns. Future studies are warranted to evaluate its effects on promoting restorative mechanisms involved in lower limb recovery after stroke.

  14. Hydroxyapatite thin films grown by pulsed laser deposition and matrix assisted pulsed laser evaporation: Comparative study

    Science.gov (United States)

    Popescu-Pelin, G.; Sima, F.; Sima, L. E.; Mihailescu, C. N.; Luculescu, C.; Iordache, I.; Socol, M.; Socol, G.; Mihailescu, I. N.

    2017-10-01

    Pulsed Laser Deposition (PLD) and Matrix Assisted Pulsed Laser Evaporation (MAPLE) techniques were applied for growing hydroxyapatite (HA) thin films on titanium substrates. All experiments were conducted in a reaction chamber using a KrF* excimer laser source (λ = 248 nm, τFWHM ≈ 25 ns). Half of the samples were post-deposition thermally treated at 500 °C in a flux of water vapours in order to restore crystallinity and improve adherence. Coating surface morphologies and topographies specific to the deposition method were evidenced by scanning electron, atomic force microscopy investigations and profilometry. They were shown to depend on deposition technique and also on the post-deposition treatment. Crystalline structure of the coatings evaluated by X-ray diffraction was improved after thermal treatment. Biocompatibility of coatings, cellular adhesion, proliferation and differentiation tests were conducted using human mesenchymal stem cells (MSCs). Results showed that annealed MAPLE deposited HA coatings were supporting MSCs proliferation, while annealed PLD obtained films were stimulating osteogenic differentiation.

  15. Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study.

    Science.gov (United States)

    Wang, Hongwei; Zhou, Yue; Liu, Jun; Han, Jianda; Xiang, Liangbi

    2015-01-01

    There is much more radiation exposure to the surgeons during minimally invasive pedicle screws placement. In order to ease the surgeon's hand-eye coordination and to reduce the iatrogenic radiation injury to the surgeons, a robot assisted percutaneous pedicle screw placement is useful. This study assesses the feasibility and clinical value of robot assisted navigated drilling for pedicle screw placement and the results thus achieved formed the basis for the development of a new robot for pedicle screw fixation surgery. Preoperative computed tomography (CT) of eight bovine lumbar spines (L1-L5) in axial plane were captured for each vertebra, the entry points and trajectories of the screws were preoperatively planned. On the basis of preoperative CT scans and intraoperative fluoroscopy, we aligned the robot drill to the desired entry point and trajectory, as dictated by the surgeon's preoperative plan. Eight bovine lumbar spines were inserted 80 K-wires using the spine robot system. The time for system registration and pedicle drilling, fluoroscopy times were measured and recorded. Postoperative CT scans were used to assess the position of the K-wires. Assisted by spine robot system, the average time for system registration was (343.4 ± 18.4) s, the average time for procedure of drilling one pedicle screw trajectory was (89.5 ± 6.1) s, times of fluoroscopy for drilling one pedicle screw were (2.9 ± 0.8) times. Overall, 12 (15.0%) of the 80 K-wires violated the pedicle wall. Four screws (5.0%) were medial to the pedicle and 8 (10.5%) were lateral. The number of K-wires wholly within the pedicle were 68 (85%). The preliminary study supports the view that computer assisted pedicle screw fixation using spinal robot is feasible and the robot can decrease the intraoperative fluoroscopy time during the minimally invasive pedicle screw fixation surgery. As spine robotic surgery is still in its infancy, further research in this field is worthwhile especially the accuracy

  16. Using augmented reality as a clinical support tool to assist combat medics in the treatment of tension pneumothoraces.

    Science.gov (United States)

    Wilson, Kenneth L; Doswell, Jayfus T; Fashola, Olatokunbo S; Debeatham, Wayne; Darko, Nii; Walker, Travelyan M; Danner, Omar K; Matthews, Leslie R; Weaver, William L

    2013-09-01

    This study was to extrapolate potential roles of augmented reality goggles as a clinical support tool assisting in the reduction of preventable causes of death on the battlefield. Our pilot study was designed to improve medic performance in accurately placing a large bore catheter to release tension pneumothorax (prehospital setting) while using augmented reality goggles. Thirty-four preclinical medical students recruited from Morehouse School of Medicine performed needle decompressions on human cadaver models after hearing a brief training lecture on tension pneumothorax management. Clinical vignettes identifying cadavers as having life-threatening tension pneumothoraces as a consequence of improvised explosive device attacks were used. Study group (n = 13) performed needle decompression using augmented reality goggles whereas the control group (n = 21) relied solely on memory from the lecture. The two groups were compared according to their ability to accurately complete the steps required to decompress a tension pneumothorax. The medical students using augmented reality goggle support were able to treat the tension pneumothorax on the human cadaver models more accurately than t