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Sample records for control region acquires

  1. Method to acquire regions of fruit, branch and leaf from image of red apple in orchard

    Science.gov (United States)

    Lv, Jidong; Xu, Liming

    2017-07-01

    This work proposed a method to acquire regions of fruit, branch and leaf from red apple image in orchard. To acquire fruit image, R-G image was extracted from the RGB image for corrosive working, hole filling, subregion removal, expansive working and opening operation in order. Finally, fruit image was acquired by threshold segmentation. To acquire leaf image, fruit image was subtracted from RGB image before extracting 2G-R-B image. Then, leaf image was acquired by subregion removal and threshold segmentation. To acquire branch image, dynamic threshold segmentation was conducted in the R-G image. Then, the segmented image was added to fruit image to acquire adding fruit image which was subtracted from RGB image with leaf image. Finally, branch image was acquired by opening operation, subregion removal and threshold segmentation after extracting the R-G image from the subtracting image. Compared with previous methods, more complete image of fruit, leaf and branch can be acquired from red apple image with this method.

  2. Hospital-acquired complications in a randomized controlled clinical trial of a geriatric consultation team.

    Science.gov (United States)

    Becker, P M; McVey, L J; Saltz, C C; Feussner, J R; Cohen, H J

    1987-05-01

    As part of a controlled clinical trial of a geriatric consultation team (GCT), we investigated whether a GCT could affect the incidence of hospital-acquired complications in elderly patients. One hundred eighty-five patients, aged 75 years and older, were randomized into an intervention (N = 92) and a control (N = 93) group. Members of the intervention group received a GCT consultation and were routinely followed up throughout their hospitalization. The incidence of hospital-acquired complications for the entire study population was 38%. The type and rate of hospital-acquired complications in the intervention and control groups were not significantly different. Functional status on admission and admission to the psychiatry service were predictive for the occurrence of a hospital-acquired complication. In a broadly selected population such as this, the intensity of care available through a GCT was unable to reduce the occurrence of hospital-acquired complications. However, since this is only one aspect of a GCT function, and others may be of great importance, such aspects, and more targeted populations, must be evaluated before final conclusions can be reached about GCT efficiency.

  3. Update on the prevention and control of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA).

    Science.gov (United States)

    Skov, Robert; Christiansen, Keryn; Dancer, Stephanie J; Daum, Robert S; Dryden, Matthew; Huang, Yhu-Chering; Lowy, Franklin D

    2012-03-01

    The rapid dissemination of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) since the early 2000s and the appearance of new successful lineages is a matter of concern. The burden of these infections varies widely between different groups of individuals and in different regions of the world. Estimating the total burden of disease is therefore problematic. Skin and soft-tissue infections, often in otherwise healthy young individuals, are the most common clinical manifestation of these infections. The antibiotic susceptibilities of these strains also vary, although they are often more susceptible to 'traditional' antibiotics than related hospital-acquired strains. Preventing the dissemination of these organisms throughout the general population requires a multifaceted approach, including screening and decolonisation, general hygiene and cleaning measures, antibiotic stewardship programmes and, in the future, vaccination. The current evidence on the prevention and control of CA-MRSA is appraised and summarised in this review. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  4. Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differences, in a public healthcare system

    DEFF Research Database (Denmark)

    Hedegaard Klausen, Henrik; Petersen, J; Lindhardt, T

    2012-01-01

    OBJECTIVES: To evaluate regional differences in and risk factors for admission, length of stay, mortality, and readmission for community-acquired pneumonia in elderly Danish patients. METHODS: National registry study on elderly Danish citizens with an acute admission in 2009 owing to community....... RESULTS: A total of 11,332 elderly citizens were admitted with community-acquired pneumonia. Mortality during admission and 30-days from discharge were 11.6% and 16.2%, respectively. Readmission rates within 30 days of discharge were 12.3%. There were significantly differences between hospitals in length...

  5. Immunochip analysis identifies novel susceptibility loci in the human leukocyte antigen region for acquired thrombotic thrombocytopenic purpura.

    Science.gov (United States)

    Mancini, I; Ricaño-Ponce, I; Pappalardo, E; Cairo, A; Gorski, M M; Casoli, G; Ferrari, B; Alberti, M; Mikovic, D; Noris, M; Wijmenga, C; Peyvandi, F

    2016-12-01

    Essentials Genetic predisposition to acquired thrombotic thrombocytopenic purpura (aTTP) is mainly unknown. Genetic risk factors for aTTP were studied by Immunochip analysis and replication study. Human leukocyte antigen (HLA) variant rs6903608 conferred a 2.5-fold higher risk of developing aTTP. rs6903608 and HLA-DQB1*05:03 may explain most of the HLA association signal in aTTP. Click to hear Dr Cataland's presentation on acquired thrombotic thrombocytopenic purpura SUMMARY: Background Acquired thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy associated with the development of autoantibodies against the von Willebrand factor-cleaving protease ADAMTS-13. Similarly to what has been found for other autoimmune disorders, there is evidence of a genetic contribution, including the association of the human leukocyte antigen (HLA) class II complex with disease risk. Objective To identify novel genetic risk factors in acquired TTP. Patients/Methods We undertook a case-control genetic association study in 190 European-origin TTP patients and 1255 Italian healthy controls by using the Illumina Immunochip. Replication analysis in 88 Italian cases and 456 controls was performed with single-nucleotide polymorphism (SNP) TaqMan assays. Results and conclusion We identified one common variant (rs6903608) located within the HLA class II locus that was independently associated with acquired TTP at genome-wide significance and conferred a 2.6-fold increased risk of developing a TTP episode (95% confidence interval [CI] 2.02-3.27, P = 1.64 × 10 -14 ). We also found five non-HLA variants mapping to chromosomes 2, 6, 8 and X that were suggestively associated with the disease: rs9490550, rs115265285, rs5927472, rs7823314, and rs1334768 (nominal P-values ranging from 1.59 × 10 -5 to 7.60 × 10 -5 ). Replication analysis confirmed the association of HLA variant rs6903608 with acquired TTP (pooled P = 3.95 × 10 -19 ). Imputation of classic

  6. Acquired Encephalocele With Hydrocephalus and Pineal Region Epidermoid Cyst.

    Science.gov (United States)

    Toktaş, Zafer Orkun; Yilmaz, Baran; Ekşi, Murat Şakir; Bayoumi, Ahmed B; Akakin, Akin; Yener, Yasin; Demir, Mustafa Kemal; Kiliç, Türker

    2016-07-01

    A combination of trauma and a missed inflammatory response (nasal operation) concomitant with hydrocephalus and tumor in secondary encephalocele has not been described in the English literature yet. A 38-year-old man was admitted to the clinic with rhinorrhea that started 3 months ago. In his medical history, nothing abnormal was present except a nasal operation performed 1 year ago. Brain magnetic resonance imaging depicted left frontal encephalocele concomitant with obstructive hydrocephalus caused by an epidermoid cyst originated from the pineal region. A 2-staged surgery was planned. In the first stage, a ventriculoperitoneal shunt insertion was conveyed successfully. In the second-stage surgery, the herniated brain tissue was excised, and the frontal sinus was cleansed with serum saline combined with antibiotic. The bony defect and the dura defect were repaired. The patient's presenting complaint recovered fully, and he was discharged to home in a well condition. Acquired encephalocele is a rare entity. In case of rhinorrhea and encephalocele, even in the presence of prior history of nasal surgery, intracranial evaluation should be conveyed to exclude the presence of hydrocephalus and/or tumor. The cranial defect should be repaired to prevent future infections and brain tissue damage.

  7. Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications

    OpenAIRE

    Reed, Deoine; Kemmerly, Sandra A.

    2009-01-01

    The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program ha...

  8. Relationship between the change of language symptoms and the change of regional cerebral blood flow in the recovery process of two children with acquired aphasia.

    Science.gov (United States)

    Kozuka, Junko; Uno, Akira; Matsuda, Hiroshi; Toyoshima, Yoshiya; Hamano, Shin-Ichiro

    2017-06-01

    This study aimed to investigate the relationship between the change of language symptoms and the change of regional cerebral blood flow (rCBF) in the recovery process of two children with acquired aphasia caused by infarctions from Moyamoya disease with an onset age of 8years. We compared the results for the Standard Language Test of Aphasia (SLTA) with rCBF changes in 7 language regions in the left hemisphere and their homologous regions in the right hemisphere at 4 time points from 3weeks for up to 5years after the onset of aphasia, while controlling for the effect of age. In both cases, strong correlations were seen within a hemisphere between adjacent regions or regions that are connected by neuronal fibers, and between some language regions in the left hemisphere and their homologous regions in the right hemisphere. Conversely, there were differences between the two cases in the time course of rCBF changes during their recovery process. Consistent with previous studies, the current study suggested that both hemispheres were involved in the long-term recovery of language symptoms in children with acquired aphasia. We suggest that the differences between both cases during their recovery process might be influenced by the brain states before aphasia, by which hemisphere was affected, and by the timing of the surgical revascularization procedure. However, the changes were observed in the data obtained for rCBF with strong correlations with the changes in language performance, so it is possible that rCBF could be used as a biomarker for language symptom changes. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  9. Perceived difficulty in use of everyday technology in persons with acquired brain injury of different severity: a comparison with controls.

    Science.gov (United States)

    Fallahpour, Mandana; Kottorp, Anders; Nygård, Louise; Lund, Maria Larsson

    2014-07-01

    To compare the perceived difficulty in use of everyday technology in persons with acquired brain injury with different levels of severity of disability with that of controls. This comparison study recruited 2 samples of persons with acquired brain injury and controls, comprising a total of 161 participants, age range 18-64 years. The long and short versions of the Everyday Technology Use Questionnaire and the Extended Glasgow Outcome Scale were used to evaluate participants. Persons with acquired brain injury demonstrated lower mean levels of perceived ability in use of everyday technology than controls (F = 21.84, degrees of freedom = 1, p technology between persons with severe disability and good recovery, between persons with severe disability and controls, and between persons with moderate disability and controls. No significant mean difference was found between persons with severe disability and moderate disability, between persons with moderate disability and good recovery, and between persons with good recovery and controls. Perceived difficulty in using everyday technology is significantly increased among persons with acquired brain injury with severe to moderate disability compared with controls. Rehabilitation services should consider the use of everyday technology in order to increase participation in everyday activities after acquired brain injury.

  10. Fast attainment of computer cursor control with noninvasively acquired brain signals

    Science.gov (United States)

    Bradberry, Trent J.; Gentili, Rodolphe J.; Contreras-Vidal, José L.

    2011-06-01

    Brain-computer interface (BCI) systems are allowing humans and non-human primates to drive prosthetic devices such as computer cursors and artificial arms with just their thoughts. Invasive BCI systems acquire neural signals with intracranial or subdural electrodes, while noninvasive BCI systems typically acquire neural signals with scalp electroencephalography (EEG). Some drawbacks of invasive BCI systems are the inherent risks of surgery and gradual degradation of signal integrity. A limitation of noninvasive BCI systems for two-dimensional control of a cursor, in particular those based on sensorimotor rhythms, is the lengthy training time required by users to achieve satisfactory performance. Here we describe a novel approach to continuously decoding imagined movements from EEG signals in a BCI experiment with reduced training time. We demonstrate that, using our noninvasive BCI system and observational learning, subjects were able to accomplish two-dimensional control of a cursor with performance levels comparable to those of invasive BCI systems. Compared to other studies of noninvasive BCI systems, training time was substantially reduced, requiring only a single session of decoder calibration (~20 min) and subject practice (~20 min). In addition, we used standardized low-resolution brain electromagnetic tomography to reveal that the neural sources that encoded observed cursor movement may implicate a human mirror neuron system. These findings offer the potential to continuously control complex devices such as robotic arms with one's mind without lengthy training or surgery.

  11. Significance of acquired diverticular disease of the vermiform appendix

    DEFF Research Database (Denmark)

    Kallenbach, Klaus; Hjorth, Sofie Vetli; Engel, Ulla

    2012-01-01

    To assess the prevalence of acquired diverticulum of the appendix (DA), including incipient forms and its possible significance as a marker of local/regional neoplasms.......To assess the prevalence of acquired diverticulum of the appendix (DA), including incipient forms and its possible significance as a marker of local/regional neoplasms....

  12. Differences in microbiological profile between community-acquired, healthcare-associated and hospital-acquired infections.

    Science.gov (United States)

    Cardoso, Teresa; Ribeiro, Orquídea; Aragão, Irene; Costa-Pereira, Altamiro; Sarmento, António

    2013-01-01

    Microbiological profiles were analysed and compared for intra-abdominal, urinary, respiratory and bloodstream infections according to place of acquisition: community-acquired, with a separate analysis of healthcare-associated, and hospital-acquired. Prospective cohort study performed at a university tertiary care hospital over 1 year. Inclusion criteria were meeting the Centers for Disease Control definition of intra-abdominal, urinary, respiratory and bloodstream infections. A total of 1035 patients were included in the study. More than 25% of intra-abdominal infections were polymicrobial; multi-drug resistant gram-negatives were 38% in community-acquired, 50% in healthcare-associated and 57% in hospital-acquired. E. coli was the most prevalent among urinary infections: 69% in community-acquired, 56% in healthcare-associated and 26% in hospital-acquired; ESBL producers' pathogens were 10% in healthcare-associated and 3% in community-acquired and hospital-acquired. In respiratory infections Streptococcus pneumoniae was the most prevalent in community-acquired (54%) and MRSA in healthcare-associated (24%) and hospital-acquired (24%). A significant association was found between MRSA respiratory infection and hospitalization in the previous year (adjusted OR = 6.3), previous instrumentation (adjusted OR = 4.3) and previous antibiotic therapy (adjusted OR = 5.7); no cases were documented among patients without risk factors. Hospital mortality rate was 10% in community-acquired, 14% in healthcare-associated and 19% in hospital-acquired infection. This study shows that healthcare-associated has a different microbiologic profile than those from community or hospital acquired for the four main focus of infection. Knowledge of this fact is important because the existing guidelines for community-acquired are not entirely applicable for this group of patients.

  13. Problems and solutions on issues of medical care quality in community-acquired pneumonia in hospitals of Saratov region

    Directory of Open Access Journals (Sweden)

    Lotsmanov Yu.F.

    2011-06-01

    Full Text Available Qualitative assessment of diagnostics and treatment of patients with community-acquired pneumonia (CAP was carried out in ten therapeutic departments of urban and district hospitals of Saratov region, using quality indicators (Qls. Each case of CAP was assessed in expert health care quality (HCQ card according to the diagnostic and treatment quality federal standards and the basic Ql. The application of Ql in CAP patients allowed revealing the following: low CAP agent isolation rate; late hospitalization of CAP patients; low frequency of sputum bacteriological and bacterioscopic investigations prior to antibiotic therapy; insufficient frequency of step-by-step introduction of antibiotics. Recommendations on CAP patients dispenserization were not properly prescribed; recommendations on vaccination were absent. The basic measures of HCQ improvement are as follows: organizing for each CAP patient therapeutic and diagnostic quality control according to Ql; quick administrative decisions; using of HCQ expertise during the first 2-3 days of treatment to correct diagnosis and treatment; optimizing hospital diagnostic resources (laboratory and instrumental and rational pharmacotherapy

  14. Acquired hypertrichosis lanuginosa

    Directory of Open Access Journals (Sweden)

    Kumar Pramod

    1993-01-01

    Full Text Available Acquired hypertirichosis lanuginose developed rapidly in a patient with no detectable malignancy. Soft, fine, downy hair growth was noticed on the face, ears, limbs and trunk. Bilaterally symmetrical vitiliginous macules were present on the ear and preauricular region. This case is reported because of its rarity, absence of any detectable malignancy and development of vitiligo, which to our knowledge has not been reported earlier.

  15. Acquiring a Pet Dog Significantly Reduces Stress of Primary Carers for Children with Autism Spectrum Disorder: A Prospective Case Control Study

    Science.gov (United States)

    Wright, H. F.; Hall, S.; Hames, A.; Hardiman, J.; Mills, R.; Mills, D. S.

    2015-01-01

    This study describes the impact of pet dogs on stress of primary carers of children with Autism Spectrum Disorder (ASD). Stress levels of 38 primary carers acquiring a dog and 24 controls not acquiring a dog were sampled at: Pre-intervention (17 weeks before acquiring a dog), post-intervention (3-10 weeks after acquisition) and follow-up…

  16. Enhancing regional security agreements through cooperative monitoring

    International Nuclear Information System (INIS)

    Pregenzer, A.L.

    1995-05-01

    This paper proposes that strengthening regional capabilities for formulating and implementing arms control and confidence-building measures is a tangible method of enhancing regional security. It discusses the importance of developing a regional infrastructure for arms control and confidence building and elucidates the role of technology in facilitating regional arms control and confidence-building agreements. In addition, it identifies numerous applications for regional cooperative monitoring in the areas of arms control, resource management, international commerce and disaster response. The Cooperative Monitoring Center at Sandia National Laboratories, whose aim is to help individual countries and regions acquire the tools they need to develop their own solutions to regional problems, is discussed briefly. The paper ends with recommendations for establishing regional cooperative monitoring centers

  17. The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.

    Directory of Open Access Journals (Sweden)

    Amy L Slogrove

    2018-03-01

    Full Text Available Globally, the population of adolescents living with perinatally acquired HIV (APHs continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in "real-life" settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia.Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER, individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG, and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs. Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR] duration of

  18. The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.

    Science.gov (United States)

    Slogrove, Amy L; Schomaker, Michael; Davies, Mary-Ann; Williams, Paige; Balkan, Suna; Ben-Farhat, Jihane; Calles, Nancy; Chokephaibulkit, Kulkanya; Duff, Charlotte; Eboua, Tanoh François; Kekitiinwa-Rukyalekere, Adeodata; Maxwell, Nicola; Pinto, Jorge; Seage, George; Teasdale, Chloe A; Wanless, Sebastian; Warszawski, Josiane; Wools-Kaloustian, Kara; Yotebieng, Marcel; Timmerman, Venessa; Collins, Intira J; Goodall, Ruth; Smith, Colette; Patel, Kunjal; Paul, Mary; Gibb, Diana; Vreeman, Rachel; Abrams, Elaine J; Hazra, Rohan; Van Dyke, Russell; Bekker, Linda-Gail; Mofenson, Lynne; Vicari, Marissa; Essajee, Shaffiq; Penazzato, Martina; Anabwani, Gabriel; Q Mohapi, Edith; N Kazembe, Peter; Hlatshwayo, Makhosazana; Lumumba, Mwita; Goetghebuer, Tessa; Thorne, Claire; Galli, Luisa; van Rossum, Annemarie; Giaquinto, Carlo; Marczynska, Magdalena; Marques, Laura; Prata, Filipa; Ene, Luminita; Okhonskaia, Liubov; Rojo, Pablo; Fortuny, Claudia; Naver, Lars; Rudin, Christoph; Le Coeur, Sophie; Volokha, Alla; Rouzier, Vanessa; Succi, Regina; Sohn, Annette; Kariminia, Azar; Edmonds, Andrew; Lelo, Patricia; Ayaya, Samuel; Ongwen, Patricia; Jefferys, Laura F; Phiri, Sam; Mubiana-Mbewe, Mwangelwa; Sawry, Shobna; Renner, Lorna; Sylla, Mariam; Abzug, Mark J; Levin, Myron; Oleske, James; Chernoff, Miriam; Traite, Shirley; Purswani, Murli; Chadwick, Ellen G; Judd, Ali; Leroy, Valériane

    2018-03-01

    Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in "real-life" settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow

  19. Ancestral genes can control the ability of horizontally acquired loci to confer new traits.

    Directory of Open Access Journals (Sweden)

    H Deborah Chen

    2011-07-01

    Full Text Available Horizontally acquired genes typically function as autonomous units conferring new abilities when introduced into different species. However, we reasoned that proteins preexisting in an organism might constrain the functionality of a horizontally acquired gene product if it operates on an ancestral pathway. Here, we determine how the horizontally acquired pmrD gene product activates the ancestral PmrA/PmrB two-component system in Salmonella enterica but not in the closely related bacterium Escherichia coli. The Salmonella PmrD protein binds to the phosphorylated PmrA protein (PmrA-P, protecting it from dephosphorylation by the PmrB protein. This results in transcription of PmrA-dependent genes, including those conferring polymyxin B resistance. We now report that the E. coli PmrD protein can activate the PmrA/PmrB system in Salmonella even though it cannot do it in E. coli, suggesting that these two species differ in an additional component controlling PmrA-P levels. We establish that the E. coli PmrB displays higher phosphatase activity towards PmrA-P than the Salmonella PmrB, and we identified a PmrB subdomain responsible for this property. Replacement of the E. coli pmrB gene with the Salmonella homolog was sufficient to render E. coli resistant to polymyxin B under PmrD-inducing conditions. Our findings provide a singular example whereby quantitative differences in the biochemical activities of orthologous ancestral proteins dictate the ability of a horizontally acquired gene product to confer species-specific traits. And they suggest that horizontally acquired genes can potentiate selection at ancestral loci.

  20. A dual-task home-based rehabilitation programme for improving balance control in patients with acquired brain injury: a single-blind, randomized controlled pilot study.

    Science.gov (United States)

    Peirone, Eliana; Goria, Paolo Filiberto; Anselmino, Arianna

    2014-04-01

    To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury. Single-blind, randomized controlled pilot study. Single rehabilitation centre. Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score task home-based programme six days a week for seven weeks. The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling. At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63). This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.

  1. Impact of an antimicrobial stewardship intervention on appropriateness of prescribing for community-acquired pneumonia in an Australian regional hospital.

    Science.gov (United States)

    Bond, Stuart E; Boutlis, Craig S; Yeo, Wilfred W; Miyakis, Spiros

    2017-05-01

    Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP. © 2017 Royal Australasian College of Physicians.

  2. Hospital acquired pneumonia is linked to right hemispheric peri-insular stroke.

    Directory of Open Access Journals (Sweden)

    André Kemmling

    Full Text Available Hospital acquired pneumonia (HAP is a major complication of stroke. We sought to determine associations between infarction of specific brain regions and HAP.215 consecutive acute stroke patients with HAP (2003-2009 were carefully matched with 215 non-pneumonia controls by gender, then NIHSS, then age. Admission imaging and binary masks of infarction were registered to MNI-152 space. Regional atlas and voxel-based log-odds were calculated to assess the relationship between infarct location and the likelihood of HAP. An independently validated penalized conditional logistic regression model was used to identify HAP associated imaging regions.The HAP and control patients were well matched by gender (100%, age (95% within 5-years, NIHSS (98% within 1-point, infarct size, dysphagia, and six other clinical variables. Right hemispheric infarcts were more frequent in patients with HAP versus controls (43.3% vs. 34.0%, p = 0.054, whereas left hemispheric infarcts were more frequent in controls (56.7% vs. 44.7%, p = 0.012; there was no significant difference between groups in the rate of brainstem strokes (p = 1.0. Of the 10 most infarcted regions, only right insular cortex volume was different in HAP versus controls (20 vs. 12 ml, p = 0.02. In univariate analyses, the highest log-odds regions for pneumonia were right hemisphere, cerebellum, and brainstem. The best performing multivariate model selected 7 brain regions of infarction and 2 infarct volume-based variables independently associated with HAP.HAP is associated with right hemispheric peri-insular stroke. These associations may be related to autonomic modulation of immune mechanisms, supporting recent hypotheses of stroke mediated immune suppression.

  3. Institutional Controls

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset consists of institutional control data from multiple Superfund sites in U.S. EPA Region 8. These data were acquired from multiple sources at different...

  4. Seeing the sound after visual loss: functional MRI in acquired auditory-visual synesthesia.

    Science.gov (United States)

    Yong, Zixin; Hsieh, Po-Jang; Milea, Dan

    2017-02-01

    Acquired auditory-visual synesthesia (AVS) is a rare neurological sign, in which specific auditory stimulation triggers visual experience. In this study, we used event-related fMRI to explore the brain regions correlated with acquired monocular sound-induced phosphenes, which occurred 2 months after unilateral visual loss due to an ischemic optic neuropathy. During the fMRI session, 1-s pure tones at various pitches were presented to the patient, who was asked to report occurrence of sound-induced phosphenes by pressing one of the two buttons (yes/no). The brain activation during phosphene-experienced trials was contrasted with non-phosphene trials and compared to results obtained in one healthy control subject who underwent the same fMRI protocol. Our results suggest, for the first time, that acquired AVS occurring after visual impairment is associated with bilateral activation of primary and secondary visual cortex, possibly due to cross-wiring between auditory and visual sensory modalities.

  5. Case Report: Molecular Confirmation of Lobomycosis in an Italian Traveler Acquired in the Amazon Region of Venezuela.

    Science.gov (United States)

    Beltrame, Anna; Danesi, Patrizia; Farina, Claudio; Orza, Pierantonio; Perandin, Francesca; Zanardello, Claudia; Rodari, Paola; Staffolani, Silvia; Bisoffi, Zeno

    2017-12-01

    Lobomycosis is a chronic skin mycosis endemic in Amazon regions characterized by chronic nodular or keloidal lesions caused by Lacazia loboi , an uncultivable fungus. Imported cases in nonendemic countries are rare and diagnosed after years. We describe a case of lobomycosis in a healthy 55-year-old Italian traveler who had acquired the infection during 5-day-honeymoon in the Amazon region of Venezuela in 1999. Several weeks after return, he recalled pruritus and papular skin lesions on the left lower limb, subsequently evolving to a plaque-like lesion. Blastomycosis and cryptococcosis were hypothesized based on microscopic morphology of yeast-like bodies found in three consecutive biopsies, although fungal cultures were always negative. In 2016, exfoliative cytology and a biopsy specimen examination showed round yeast-like organisms (6-12 μm), isolated or in a chain, connected by short tubular projections fulfilling the morphologic diagnostic criteria of Lacazia spp. The microscopic diagnosis was confirmed by molecular identification.

  6. New constraints on the structure of Hess Deep from regional- and micro-bathymetry data acquired during RRS James Cook in Jan-Feb 2008 (JC021)

    Science.gov (United States)

    Shillington, D. J.; Ferrini, V. L.; MacLeod, C. J.; Teagle, D. A.; Gillis, K. M.; Cazenave, P. W.; Hurst, S. D.; Scientific Party, J.

    2008-12-01

    In January-February 2008, new geophysical and geological data were acquired in Hess Deep using the RRS James Cook and the British ROV Isis. Hess Deep provides a tectonic window into oceanic crust emplaced by fast seafloor spreading at the East Pacific Rise, thereby offering the opportunity to test competing hypotheses for oceanic crustal accretion. The goal of this cruise was to collect datasets that can constrain the structure and composition of the lower crustal section exposed in the south-facing slope of the Intrarift Ridge just north of the Deep, and thus provide insights into the emplacement of gabbroic lower crust at fast spreading rates. Additionally, the acquired datasets provide site survey data for IODP Proposal 551-Full. The following datasets were acquired during JC021: 1) regional multibeam bathymetry survey complemented with sub-bottom profiler (SBP) data (in selected areas), 2) two micro-bathymetry surveys, and 3) seafloor rock samples acquired with an ROV. Here we present grids of regional multibeam and microbathymetry data following post-cruise processing. Regional multibeam bathymetry were acquired using the hull-mounted Kongsberg Simrad EM120 system (12 kHz). These data provide new coverage of the northern flank of the rift as far east as 100°W, which show that it comprises of a series of 50- to 100-km-long en echelon segments. Both E-W and NE-SW striking features are observed in the immediate vicinity of the Deep, including in a newly covered region to the SW of the rift tip. Such features might arise due to the rotation of the Galapagos microplate(s), as proposed by other authors. The ROV Isis acquired micro-bathymetry data in two areas using a Simrad SM2000 (200 kHz) multibeam sonar. Data were acquired at a nominal altitude of ~100 m and speed of 0.3 kts to facilitate high-resolution mapping of seabed features and also permit coverage of two relatively large areas. Swath widths were ~200- 350 m depending on noise and seabed characteristics

  7. Neural basis of acquired amusia and its recovery after stroke

    OpenAIRE

    Sihvonen, A.J.; Ripollés, P.; Leo, V.; Rodríguez-Fornells, Antoni; Soinila, S.; Särkämö, T.

    2016-01-01

    Although acquired amusia is a relatively common disorder after stroke, its precise neuroanatomical basis is still unknown. To evaluate which brain regions form the neural substrate for acquired amusia and its recovery, we performed a voxel-based lesion-symptom mapping (VLSM) and morphometry (VBM) study with 77 human stroke subjects. Structural MRIs were acquired at acute and 6 month poststroke stages. Amusia and aphasia were behaviorally assessed at acute and 3 month poststroke stages using t...

  8. Utility of COX1 phylogenetics to differentiate between locally acquired and imported Plasmodium knowlesi infections in Singapore

    Science.gov (United States)

    Loh, Jin Phang; Gao, Qiu Han Christine; Lee, Vernon J; Tetteh, Kevin; Drakeley, Chris

    2016-01-01

    INTRODUCTION Although there have been several phylogenetic studies on Plasmodium knowlesi (P. knowlesi), only cytochrome c oxidase subunit 1 (COX1) gene analysis has shown some geographical differentiation between the isolates of different countries. METHODS Phylogenetic analysis of locally acquired P. knowlesi infections, based on circumsporozoite, small subunit ribosomal ribonucleic acid (SSU rRNA), merozoite surface protein 1 and COX1 gene targets, was performed. The results were compared with the published sequences of regional isolates from Malaysia and Thailand. RESULTS Phylogenetic analysis of the circumsporozoite, SSU rRNA and merozoite surface protein 1 gene sequences for regional P. knowlesi isolates showed no obvious differentiation that could be attributed to their geographical origin. However, COX1 gene analysis showed that it was possible to differentiate between Singapore-acquired P. knowlesi infections and P. knowlesi infections from Peninsular Malaysia and Sarawak, Borneo, Malaysia. CONCLUSION The ability to differentiate between locally acquired P. knowlesi infections and imported P. knowlesi infections has important utility for the monitoring of P. knowlesi malaria control programmes in Singapore. PMID:26805667

  9. Utility of COX1 phylogenetics to differentiate between locally acquired and imported Plasmodium knowlesi infections in Singapore.

    Science.gov (United States)

    Loh, Jin Phang; Gao, Qiu Han Christine; Lee, Vernon J; Tetteh, Kevin; Drakeley, Chris

    2016-12-01

    Although there have been several phylogenetic studies on Plasmodium knowlesi (P. knowlesi), only cytochrome c oxidase subunit 1 (COX1) gene analysis has shown some geographical differentiation between the isolates of different countries. Phylogenetic analysis of locally acquired P. knowlesi infections, based on circumsporozoite, small subunit ribosomal ribonucleic acid (SSU rRNA), merozoite surface protein 1 and COX1 gene targets, was performed. The results were compared with the published sequences of regional isolates from Malaysia and Thailand. Phylogenetic analysis of the circumsporozoite, SSU rRNA and merozoite surface protein 1 gene sequences for regional P. knowlesi isolates showed no obvious differentiation that could be attributed to their geographical origin. However, COX1 gene analysis showed that it was possible to differentiate between Singapore-acquired P. knowlesi infections and P. knowlesi infections from Peninsular Malaysia and Sarawak, Borneo, Malaysia. The ability to differentiate between locally acquired P. knowlesi infections and imported P. knowlesi infections has important utility for the monitoring of P. knowlesi malaria control programmes in Singapore. Copyright: © Singapore Medical Association

  10. 40 CFR 81.112 - Charleston Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.112 Charleston Intrastate Air Quality Control Region. The Charleston Intrastate Air Quality Control Region (South Carolina) consists of the territorial area encompassed by the... Quality Control Region: Region 1. 81.107Greenwood Intrastate Air Quality Control Region: Region 2. 81...

  11. Software for Acquiring Image Data for PIV

    Science.gov (United States)

    Wernet, Mark P.; Cheung, H. M.; Kressler, Brian

    2003-01-01

    PIV Acquisition (PIVACQ) is a computer program for acquisition of data for particle-image velocimetry (PIV). In the PIV system for which PIVACQ was developed, small particles entrained in a flow are illuminated with a sheet of light from a pulsed laser. The illuminated region is monitored by a charge-coupled-device camera that operates in conjunction with a data-acquisition system that includes a frame grabber and a counter-timer board, both installed in a single computer. The camera operates in "frame-straddle" mode where a pair of images can be obtained closely spaced in time (on the order of microseconds). The frame grabber acquires image data from the camera and stores the data in the computer memory. The counter/timer board triggers the camera and synchronizes the pulsing of the laser with acquisition of data from the camera. PIVPROC coordinates all of these functions and provides a graphical user interface, through which the user can control the PIV data-acquisition system. PIVACQ enables the user to acquire a sequence of single-exposure images, display the images, process the images, and then save the images to the computer hard drive. PIVACQ works in conjunction with the PIVPROC program which processes the images of particles into the velocity field in the illuminated plane.

  12. Community-Acquired Acute Kidney Injury: A Nationwide Survey in China.

    Science.gov (United States)

    Wang, Yafang; Wang, Jinwei; Su, Tao; Qu, Zhen; Zhao, Minghui; Yang, Li

    2017-05-01

    This study aimed to describe the burden of community-acquired acute kidney injury (AKI) in China based on a nationwide survey about AKI. Cross-sectional and retrospective study. A national sample of 2,223,230 hospitalized adult patients from 44 academic/local hospitals in Mainland China was used. AKI was defined according to the 2012 KDIGO AKI creatinine criteria or an increase or decrease in serum creatinine level of 50% during the hospital stay. Community-acquired AKI was identified when a patient had AKI that could be defined at hospital admission. The rate, cause, recognition, and treatment of community-acquired AKI were stratified according to hospital type, latitude, and economic development of the regions in which the patients were admitted. All-cause in-hospital mortality and recovery of kidney function at hospital discharge. 4,136 patients with community-acquired AKI were identified during the 2 single-month snapshots (January 2013 and July 2013). Of these, 2,020 (48.8%) had cases related to decreased kidney perfusion; 1,111 (26.9%), to intrinsic kidney disease; and 499 (12.1%), to urinary tract obstruction. In the north versus the south, more patients were exposed to nephrotoxins or had urinary tract obstructions. 536 (13.0%) patients with community-acquired AKI had indications for renal replacement therapy (RRT), but only 347 (64.7%) of them received RRT. Rates of timely diagnosis and appropriate use of RRT were higher in regions with higher per capita gross domestic product. All-cause in-hospital mortality was 7.3% (295 of 4,068). Delayed AKI recognition and being located in northern China were independent risk factors for in-hospital mortality, and referral to nephrology providers was an independent protective factor. Possible misclassification of AKI and community-acquired AKI due to nonstandard definitions and missing data for serum creatinine. The features of community-acquired AKI varied substantially in different regions of China and were closely

  13. Residual fMRI sensitivity for identity changes in acquired prosopagnosia.

    Science.gov (United States)

    Fox, Christopher J; Iaria, Giuseppe; Duchaine, Bradley C; Barton, Jason J S

    2013-01-01

    While a network of cortical regions contribute to face processing, the lesions in acquired prosopagnosia are highly variable, and likely result in different combinations of spared and affected regions of this network. To assess the residual functional sensitivities of spared regions in prosopagnosia, we designed a rapid event-related functional magnetic resonance imaging (fMRI) experiment that included pairs of faces with same or different identities and same or different expressions. By measuring the release from adaptation to these facial changes we determined the residual sensitivity of face-selective regions-of-interest. We tested three patients with acquired prosopagnosia, and all three of these patients demonstrated residual sensitivity for facial identity changes in surviving fusiform and occipital face areas of either the right or left hemisphere, but not in the right posterior superior temporal sulcus. The patients also showed some residual capabilities for facial discrimination with normal performance on the Benton Facial Recognition Test, but impaired performance on more complex tasks of facial discrimination. We conclude that fMRI can demonstrate residual processing of facial identity in acquired prosopagnosia, that this adaptation can occur in the same structures that show similar processing in healthy subjects, and further, that this adaptation may be related to behavioral indices of face perception.

  14. Residual fMRI sensitivity for identity changes in acquired prosopagnosia

    Directory of Open Access Journals (Sweden)

    Christopher J Fox

    2013-10-01

    Full Text Available While a network of cortical regions contribute to face processing, the lesions in acquired prosopagnosia are highly variable, and likely result in different combinations of spared and affected regions of this network. To assess the residual functional sensitivities of spared regions in prosopagnosia, we designed a rapid event-related functional magnetic resonance imaging (fMRI experiment that included pairs of faces with same or different identities and same or different expressions. By measuring the release from adaptation to these facial changes we determined the residual sensitivity of face-selective regions-of-interest. We tested three patients with acquired prosopagnosia, and all three of these patients demonstrated residual sensitivity for facial identity changes in surviving fusiform and occipital face areas of either the right or left hemisphere, but not in the right posterior superior temporal sulcus. The patients also showed some residual capabilities for facial discrimination with normal performance on the Benton Facial Recognition Test, but impaired performance on more complex tasks of facial discrimination. We conclude that fMRI can demonstrate residual processing of facial identity in acquired prosopagnosia, that this adaptation can occur in the same structures that show similar processing in healthy subjects, and further, that this adaptation may be related to behavioral indices of face perception.

  15. 40 CFR 81.88 - Billings Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.88 Billings Intrastate Air Quality Control Region. The Metropolitan Billings Intrastate Air Quality Control Region (Montana) has been renamed the Billings Intrastate Air Quality Control... to by Montana authorities as follows: Sec. 481.168Great Falls Intrastate Air Quality Control Region...

  16. 40 CFR 81.51 - Portland Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.51 Portland Interstate Air Quality Control Region. The Portland Interstate Air Quality Control Region (Oregon-Washington) has been revised to consist of the territorial area... Portland Interstate Air Quality Control Region (Oregon-Washington) will be referred to by Washington...

  17. 40 CFR 81.36 - Maricopa Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.36 Maricopa Intrastate Air Quality Control Region. The Phoenix-Tucson Intrastate Air Quality Control Region has been renamed the Maricopa Intrastate Air Quality Control Region... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Maricopa Intrastate Air Quality...

  18. 40 CFR 81.77 - Puerto Rico Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Puerto Rico Air Quality Control Region... PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.77 Puerto Rico Air Quality Control Region. The Puerto Rico Air Quality Control Region...

  19. Statistical process control: A feasibility study of the application of time-series measurement in early neurorehabilitation after acquired brain injury.

    Science.gov (United States)

    Markovic, Gabriela; Schult, Marie-Louise; Bartfai, Aniko; Elg, Mattias

    2017-01-31

    Progress in early cognitive recovery after acquired brain injury is uneven and unpredictable, and thus the evaluation of rehabilitation is complex. The use of time-series measurements is susceptible to statistical change due to process variation. To evaluate the feasibility of using a time-series method, statistical process control, in early cognitive rehabilitation. Participants were 27 patients with acquired brain injury undergoing interdisciplinary rehabilitation of attention within 4 months post-injury. The outcome measure, the Paced Auditory Serial Addition Test, was analysed using statistical process control. Statistical process control identifies if and when change occurs in the process according to 3 patterns: rapid, steady or stationary performers. The statistical process control method was adjusted, in terms of constructing the baseline and the total number of measurement points, in order to measure a process in change. Statistical process control methodology is feasible for use in early cognitive rehabilitation, since it provides information about change in a process, thus enabling adjustment of the individual treatment response. Together with the results indicating discernible subgroups that respond differently to rehabilitation, statistical process control could be a valid tool in clinical decision-making. This study is a starting-point in understanding the rehabilitation process using a real-time-measurements approach.

  20. Performance of Globally Linearized Controller and Two Region Fuzzy Logic Controller on a Nonlinear Process

    Directory of Open Access Journals (Sweden)

    N. Jaya

    2008-10-01

    Full Text Available In this work, a design and implementation of a Conventional PI controller, single region fuzzy logic controller, two region fuzzy logic controller and Globally Linearized Controller (GLC for a two capacity interacting nonlinear process is carried out. The performance of this process using single region FLC, two region FLC and GLC are compared with the performance of conventional PI controller about an operating point of 50 %. It has been observed that GLC and two region FLC provides better performance. Further, this procedure is also validated by real time experimentation using dSPACE.

  1. Movement goals and feedback and feedforward control mechanisms in speech production.

    Science.gov (United States)

    Perkell, Joseph S

    2012-09-01

    Studies of speech motor control are described that support a theoretical framework in which fundamental control variables for phonemic movements are multi-dimensional regions in auditory and somatosensory spaces. Auditory feedback is used to acquire and maintain auditory goals and in the development and function of feedback and feedforward control mechanisms. Several lines of evidence support the idea that speakers with more acute sensory discrimination acquire more distinct goal regions and therefore produce speech sounds with greater contrast. Feedback modification findings indicate that fluently produced sound sequences are encoded as feedforward commands, and feedback control serves to correct mismatches between expected and produced sensory consequences.

  2. Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up

    Science.gov (United States)

    Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R

    2017-01-01

    Abstract Objective To determine the attributable risk of community acquired pneumonia on incidence of heart failure throughout the age range of affected patients and severity of the infection. Design Cohort study. Setting Six hospitals and seven emergency departments in Edmonton, Alberta, Canada, 2000-02. Participants 4988 adults with community acquired pneumonia and no history of heart failure were prospectively recruited and matched on age, sex, and setting of treatment (inpatient or outpatient) with up to five adults without pneumonia (controls) or prevalent heart failure (n=23 060). Main outcome measures Risk of hospital admission for incident heart failure or a combined endpoint of heart failure or death up to 2012, evaluated using multivariable Cox proportional hazards analyses. Results The average age of participants was 55 years, 2649 (53.1%) were men, and 63.4% were managed as outpatients. Over a median of 9.9 years (interquartile range 5.9-10.6), 11.9% (n=592) of patients with pneumonia had incident heart failure compared with 7.4% (n=1712) of controls (adjusted hazard ratio 1.61, 95% confidence interval 1.44 to 1.81). Patients with pneumonia aged 65 or less had the lowest absolute increase (but greatest relative risk) of heart failure compared with controls (4.8% v 2.2%; adjusted hazard ratio 1.98, 95% confidence interval 1.5 to 2.53), whereas patients with pneumonia aged more than 65 years had the highest absolute increase (but lowest relative risk) of heart failure (24.8% v 18.9%; adjusted hazard ratio 1.55, 1.36 to 1.77). Results were consistent in the short term (90 days) and intermediate term (one year) and whether patients were treated in hospital or as outpatients. Conclusion Our results show that community acquired pneumonia substantially increases the risk of heart failure across the age and severity range of cases. This should be considered when formulating post-discharge care plans and preventive strategies, and assessing downstream episodes

  3. Online continuing interprofessional education on hospital-acquired infections for Latin America

    Directory of Open Access Journals (Sweden)

    Julio C. Medina-Presentado

    2017-03-01

    Discussion: Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a “New Challenges” course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions.

  4. 40 CFR 81.104 - Central Pennsylvania Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.104 Section 81.104 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.104 Central Pennsylvania Intrastate Air Quality Control Region. The Central Pennsylvania Intrastate Air Quality Control Region consists of the territorial area encompassed by...

  5. 40 CFR 81.43 - Metropolitan Toledo Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.43 Section 81.43 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.43 Metropolitan Toledo Interstate Air Quality Control Region. The Metropolitan Toledo Interstate Air Quality Control Region (Ohio-Michigan) consists of the territorial area...

  6. 40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.31 Section 81.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

  7. 40 CFR 81.90 - Androscoggin Valley Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.90 Section 81.90 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.90 Androscoggin Valley Interstate Air Quality Control Region. The Androscoggin Valley Interstate Air Quality Control Region (Maine-New Hampshire) consists of the territorial...

  8. 40 CFR 81.78 - Metropolitan Portland Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.78 Section 81.78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.78 Metropolitan Portland Intrastate Air Quality Control Region. The Metropolitan Portland Intrastate Air Quality Control Region (Maine) consists of the territorial area...

  9. 40 CFR 81.30 - Southeastern Wisconsin Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.30 Section 81.30 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.30 Southeastern Wisconsin Intrastate Air Quality Control Region. The Metropolitan Milwaukee Intrastate Air Quality Control Region (Wisconsin) has been renamed the Southeastern...

  10. 40 CFR 81.16 - Metropolitan Denver Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.16 Section 81.16 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.16 Metropolitan Denver Intrastate Air Quality Control Region. The Metropolitan Denver Intrastate Air Quality Control Region (Colorado) consists of the territorial area...

  11. 40 CFR 81.47 - Central Oklahoma Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.47 Section 81.47 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.47 Central Oklahoma Intrastate Air Quality Control Region. The Metropolitan Oklahoma Intrastate Air Quality Control Region has been renamed the Central Oklahoma Intrastate...

  12. 40 CFR 81.29 - Metropolitan Indianapolis Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Air Quality Control Region. 81.29 Section 81.29 Protection of Environment ENVIRONMENTAL PROTECTION... Designation of Air Quality Control Regions § 81.29 Metropolitan Indianapolis Intrastate Air Quality Control Region. The Metropolitan Indianapolis Intrastate Air Quality Control Region consists of the territorial...

  13. 40 CFR 81.101 - Metropolitan Dubuque Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.101 Section 81.101 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.101 Metropolitan Dubuque Interstate Air Quality Control Region. The Metropolitan Dubuque Interstate Air Quality Control Region (Illinois-Iowa-Wisconsin) consists of the...

  14. 40 CFR 81.79 - Northeastern Oklahoma Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.79 Section 81.79 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.79 Northeastern Oklahoma Intrastate Air Quality Control Region. The Metropolitan Tulsa Intrastate Air Quality Control Region has been renamed the Northeastern Oklahoma Intrastate...

  15. 40 CFR 81.24 - Niagara Frontier Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.24 Section 81.24 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.24 Niagara Frontier Intrastate Air Quality Control Region. The Niagara Frontier Intrastate Air Quality Control Region (New York) consists of the territorial area...

  16. 40 CFR 81.106 - Greenville-Spartanburg Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.106 Section 81.106 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.106 Greenville-Spartanburg Intrastate Air Quality Control Region. The Greenville-Spartanburg Intrastate Air Quality Control Region (South Carolina) consists of the territorial...

  17. 40 CFR 81.44 - Metropolitan Memphis Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.44 Section 81.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.44 Metropolitan Memphis Interstate Air Quality Control Region. The Metropolitan Memphis Interstate Air Quality Control Region (Arkansas-Mississippi-Tennessee) consists of the...

  18. 40 CFR 81.19 - Metropolitan Boston Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.19 Section 81.19 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.19 Metropolitan Boston Intrastate Air Quality Control Region. The Metropolitan Boston Intrastate Air Quality Control Region (Massachusetts) consists of the territorial area...

  19. 40 CFR 81.28 - Metropolitan Baltimore Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.28 Section 81.28 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.28 Metropolitan Baltimore Intrastate Air Quality Control Region. The Metropolitan Baltimore Intrastate Air Quality Control Region (Maryland) consists of the territorial area...

  20. 40 CFR 81.119 - Western Tennessee Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.119 Section 81.119 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.119 Western Tennessee Intrastate Air Quality Control Region. The Western Tennessee Intrastate Air Quality Control Region consists of the territorial area encompassed by...

  1. 40 CFR 81.89 - Metropolitan Cheyenne Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.89 Section 81.89 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.89 Metropolitan Cheyenne Intrastate Air Quality Control Region. The Metropolitan Cheyenne Intrastate Air Quality Control Region (Wyoming) consists of the territorial area...

  2. 40 CFR 81.87 - Metropolitan Boise Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.87 Section 81.87 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.87 Metropolitan Boise Intrastate Air Quality Control Region. The Metropolitan Boise Intrastate Air Quality Control Region (Idaho) consists of the territorial area encompassed...

  3. 40 CFR 81.23 - Southwest Pennsylvania Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.23 Section 81.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.23 Southwest Pennsylvania Intrastate Air Quality Control Region. The Southwest Pennsylvania Intrastate Air Quality Control Region is redesignated to consist of the territorial...

  4. 40 CFR 81.75 - Metropolitan Charlotte Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.75 Section 81.75 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.75 Metropolitan Charlotte Interstate Air Quality Control Region. The Metropolitan Charlotte Interstate Air Quality Control Region (North Carolina-South Carolina) has been revised...

  5. 40 CFR 81.120 - Middle Tennessee Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.120 Section 81.120 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.120 Middle Tennessee Intrastate Air Quality Control Region. The Middle Tennessee Intrastate Air Quality Control Region consists of the territorial area encompassed by...

  6. 40 CFR 81.117 - Southeast Missouri Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.117 Section 81.117 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.117 Southeast Missouri Intrastate Air Quality Control Region. The Southeast Missouri Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  7. 40 CFR 81.45 - Metropolitan Atlanta Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.45 Section 81.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.45 Metropolitan Atlanta Intrastate Air Quality Control Region. The Metropolitan Atlanta Intrastate Air Quality Control Region (Georgia) has been revised to consist of the...

  8. 40 CFR 81.123 - Southeastern Oklahoma Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.123 Section 81.123 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.123 Southeastern Oklahoma Intrastate Air Quality Control Region. The Southeastern Oklahoma Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  9. 40 CFR 81.98 - Burlington-Keokuk Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.98 Section 81.98 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.98 Burlington-Keokuk Interstate Air Quality Control Region. The Burlington-Keokuk Interstate Air Quality Control Region (Illinois-Iowa) is revised to consist of the...

  10. 40 CFR 81.49 - Southeast Florida Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.49 Section 81.49 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.49 Southeast Florida Intrastate Air Quality Control Region. The Southeast Florida Intrastate Air Quality Control Region is redesignated to consist of the territorial area...

  11. 40 CFR 81.59 - Cumberland-Keyser Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.59 Section 81.59 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.59 Cumberland-Keyser Interstate Air Quality Control Region. The Cumberland-Keyser Interstate Air Quality Control Region (Maryland-West Virginia) has been revised to consist...

  12. 40 CFR 81.20 - Metropolitan Cincinnati Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.20 Section 81.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.20 Metropolitan Cincinnati Interstate Air Quality Control Region. The Metropolitan Cincinnati Interstate Air Quality Control Region (Ohio-Kentucky-Indiana) is revised to consist of...

  13. 40 CFR 81.97 - Southwest Florida Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.97 Section 81.97 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.97 Southwest Florida Intrastate Air Quality Control Region. The Southwest Florida Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  14. 40 CFR 81.116 - Northern Missouri Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.116 Section 81.116 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.116 Northern Missouri Intrastate Air Quality Control Region. The Northern Missouri Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  15. 40 CFR 81.67 - Lake Michigan Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.67 Lake Michigan Intrastate Air Quality Control Region. The Menominee-Escanaba (Michigan)-Marinette (Wisconsin) Interstate Air Quality Control Region has been renamed the Lake Michigan Intrastate Air Quality Control Region (Wisconsin) and revised to consist of the territorial area...

  16. 40 CFR 81.34 - Metropolitan Dayton Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.34 Section 81.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.34 Metropolitan Dayton Intrastate Air Quality Control Region. The Metropolitan Dayton Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  17. 40 CFR 81.115 - Northwest Nevada Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.115 Section 81.115 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.115 Northwest Nevada Intrastate Air Quality Control Region. The Northwest Nevada Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  18. 40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.41 Section 81.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

  19. 40 CFR 81.14 - Metropolitan Chicago Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.14 Section 81.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.14 Metropolitan Chicago Interstate Air Quality Control Region. The Metropolitan Chicago Interstate Air Quality Control Region (Illinois-Indiana) is revised to consist of the...

  20. 40 CFR 81.118 - Southwest Missouri Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.118 Section 81.118 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.118 Southwest Missouri Intrastate Air Quality Control Region. The Southwest Missouri Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  1. 40 CFR 81.122 - Mississippi Delta Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.122 Section 81.122 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.122 Mississippi Delta Intrastate Air Quality Control Region. The Mississippi Delta Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  2. Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada.

    Science.gov (United States)

    Ocampo, Wrechelle; Geransar, Rose; Clayden, Nancy; Jones, Jessica; de Grood, Jill; Joffe, Mark; Taylor, Geoffrey; Missaghi, Bayan; Pearce, Craig; Ghali, William; Conly, John

    2017-10-01

    Ward closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. To understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. A Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed-methods approach of descriptive statistics and thematic analysis. A total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an "appropriate," "sometimes appropriate," or "not appropriate" strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak. Results suggest the use of ward closure for containment of hospital-acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  3. 40 CFR 81.48 - Champlain Valley Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.48 Section 81.48 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.48 Champlain Valley Interstate Air Quality Control Region. The Champlain Valley Interstate Air Quality Control Region (Vermont-New York) has been revised to consist of the...

  4. 40 CFR 81.111 - Georgetown Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.111 Georgetown Intrastate Air Quality Control Region. The Georgetown Intrastate Air Quality Control Region (South Carolina) consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Georgetown Intrastate Air Quality...

  5. 40 CFR 81.107 - Greenwood Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.107 Greenwood Intrastate Air Quality Control Region. The Greenwood Intrastate Air Quality Control Region (South Carolina) consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Greenwood Intrastate Air Quality...

  6. 40 CFR 81.108 - Columbia Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.108 Columbia Intrastate Air Quality Control Region. The Columbia Intrastate Air Quality Control Region (South Carolina) consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Columbia Intrastate Air Quality...

  7. 40 CFR 81.109 - Florence Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.109 Florence Intrastate Air Quality Control Region. The Florence Intrastate Air Quality Control Region (South Carolina) consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Florence Intrastate Air Quality...

  8. 40 CFR 81.35 - Louisville Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.35 Louisville Interstate Air Quality Control Region. The Louisville Interstate Air Quality Control Region (Kentucky-Indiana) consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Louisville Interstate Air Quality...

  9. The Prevalence of Oropharyngeal Dysphagia in Danish Patients Hospitalised with Community-Acquired Pneumonia

    DEFF Research Database (Denmark)

    Kristiansen, Dorte Melgaard; Baandrup, Ulrik; Bøgsted, Martin

    2017-01-01

    Community-acquired pneumonia (CAP) and oropharyngeal dysphagia (OD) are prevalent conditions in the elderly. The aim of this study was to explore the relationship between CAP, OD, and frailty in patients admitted to a department of respiratory medicine at a regional hospital. The outcome was mort......Community-acquired pneumonia (CAP) and oropharyngeal dysphagia (OD) are prevalent conditions in the elderly. The aim of this study was to explore the relationship between CAP, OD, and frailty in patients admitted to a department of respiratory medicine at a regional hospital. The outcome...

  10. 40 CFR 81.42 - Chattanooga Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.42 Chattanooga Interstate Air Quality Control Region. The Chattanooga Interstate Air Quality Control Region (Georgia-Tennessee) has been revised to consist of the territorial area... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Chattanooga Interstate Air Quality...

  11. WAYS OF ACQUIRING FLYING PHOBIA.

    Science.gov (United States)

    Schindler, Bettina; Vriends, Noortje; Margraf, Jürgen; Stieglitz, Rolf-Dieter

    2016-02-01

    The few studies that have explored how flying phobia is acquired have produced contradictory results. We hypothesized that classical conditioning plays a role in acquiring flying phobia and investigated if vicarious (model) learning, informational learning through media, and experiencing stressful life events at the time of onset of phobia also play a role. Thirty patients with flying phobia and thirty healthy controls matched on age, sex, and education were interviewed with the Mini-DIPS, the short German version of the Anxiety Disorders Interview Schedule (DSM-IV diagnostic criteria) and the Fear-of-Flying History Interview. Fifty Percent of patients with flying phobia and 53% of healthy controls reported frightening events in the air. There was no significant difference between the two samples. Thus there were not more classical conditioning events for patients with flying phobia. There also was no significant difference between the two samples for vicarious (model) learning: 37% of flying phobia patients and 23% of healthy controls felt influenced by model learning. The influence of informational learning through media was significantly higher for the clinical sample (70%) than for the control group (37%). Patients with flying phobia experienced significantly more stressful life events in the period of their frightening flight experience (60%) than healthy controls (19%). Frightening experiences while flying are quite common, but not everybody develops a flying phobia. Stressful life events and other factors might enhance conditionability. Informational learning through negative media reports probably reinforces the development of flying phobia. Clinical implications are discussed. © 2015 Wiley Periodicals, Inc.

  12. Unified-planning, graded-administration, and centralized-controlling: a management modality for treating acquired immune deficiency syndrome with Chinese medicine in Henan Province of China.

    Science.gov (United States)

    Xu, Li-Ran; Guo, Hui-jun; Liu, Zhi-bin; Li, Qiang; Yang, Ji-ping; He, Ying

    2015-04-01

    Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Chinese medicine (CM) has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded-administration, and centralized-controlling (UGC). The UGC modality has one primary concept (patient-centered medicine from CM theory), four basic foundations (classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV), six important relationships (the "three uniformities and three combinations," and the six relationships therein guide the treatment of AIDS with CM), and four key sections (management, operation, records, and evaluation). In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.

  13. The regional costs and benefits of acid rain control

    International Nuclear Information System (INIS)

    Berkman, M.P.

    1991-01-01

    Congress recently enacted acid rain control legislation as part of the 1990 Clean Air Act Amendments following a decade-long debate among disparate regional interests. Although Congress succeeded in drafting a law acceptable to all regions, the regional costs and benefits of the legislation remain uncertain. The research presented here attempts to estimate the regional costs and benefits and the economic impacts of acid rain controls. These estimates are made using a modeling system composed of econometric, linear programming and input-output models. The econometric and linear programming components describe markets for electricity and coal. The outputs of these components including capital investment, electricity demand, and coal production are taken as exogenous inputs by a multiregional input-output model. The input-output model produces estimates of changes in final demand, gross output, and employment. The utility linear programming model also predicts sulfur dioxide emissions (an acid-rain precursor). According to model simulations, the costs of acid rain control exceed the benefits for many regions including several regions customarily thought to be the major beneficiaries of acid rain control such as New England

  14. Using statistical process control for monitoring the prevalence of hospital-acquired pressure ulcers.

    Science.gov (United States)

    Kottner, Jan; Halfens, Ruud

    2010-05-01

    Institutionally acquired pressure ulcers are used as outcome indicators to assess the quality of pressure ulcer prevention programs. Determining whether quality improvement projects that aim to decrease the proportions of institutionally acquired pressure ulcers lead to real changes in clinical practice depends on the measurement method and statistical analysis used. To examine whether nosocomial pressure ulcer prevalence rates in hospitals in the Netherlands changed, a secondary data analysis using different statistical approaches was conducted of annual (1998-2008) nationwide nursing-sensitive health problem prevalence studies in the Netherlands. Institutions that participated regularly in all survey years were identified. Risk-adjusted nosocomial pressure ulcers prevalence rates, grade 2 to 4 (European Pressure Ulcer Advisory Panel system) were calculated per year and hospital. Descriptive statistics, chi-square trend tests, and P charts based on statistical process control (SPC) were applied and compared. Six of the 905 healthcare institutions participated in every survey year and 11,444 patients in these six hospitals were identified as being at risk for pressure ulcers. Prevalence rates per year ranged from 0.05 to 0.22. Chi-square trend tests revealed statistically significant downward trends in four hospitals but based on SPC methods, prevalence rates of five hospitals varied by chance only. Results of chi-square trend tests and SPC methods were not comparable, making it impossible to decide which approach is more appropriate. P charts provide more valuable information than single P values and are more helpful for monitoring institutional performance. Empirical evidence about the decrease of nosocomial pressure ulcer prevalence rates in the Netherlands is contradictory and limited.

  15. Presence and mechanisms of acquired antimicrobial resistance in Belgian Brachyspira hyodysenteriae isolates belonging to different clonal complexes.

    Science.gov (United States)

    Mahu, M; Pasmans, F; Vranckx, K; De Pauw, N; Vande Maele, L; Vyt, Philip; Vandersmissen, Tamara; Martel, A; Haesebrouck, F; Boyen, F

    2017-08-01

    Swine dysentery (SD) is an economically important disease for which antimicrobial treatment still occupies an important place to control outbreaks. However, acquired antimicrobial resistance is increasingly observed in Brachyspira hyodysenteriae. In this study, the Minimal Inhibitory Concentrations (MIC) of six antimicrobial compounds for 30 recent Belgian B. hyodysenteriae isolates were determined using a broth microdilution method. In addition, relevant regions of the 16S rRNA, 23S rRNA and the L3 protein encoding genes were sequenced to reveal mutations associated with acquired resistance. Finally, a phylogeny was reconstructed using minimal spanning tree analysis of multi locus sequence typing of the isolates. For lincomycin, doxycycline, tylosin and tylvalosin, at least 70% of the isolates did not belong to the wild-type population and were considered to have acquired resistance. For valnemulin and tiamulin, this was over 50%. In all isolates with acquired resistance to doxycycline, the G1058C mutation was present in their 16S rRNA gene. All isolates showing acquired resistance to lincomycin and both macrolides displayed the A2058T mutation in their 23S rRNA gene. Other mutations in this gene and the N148S mutation in the L3 protein were present in both wild-type isolates and isolates considered to have acquired resistance. Multi locus sequence analysis revealed a previously undescribed clonal complex, with 4 novel sequence types in which the majority of isolates showed acquired resistance to all tested antimicrobial products. In conclusion, acquired antimicrobial resistance is widespread among Belgian B. hyodysenteriae isolates. The emergence of multi-resistant clonal complexes can pose a threat to swine industry. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Bilingualism alters brain functional connectivity between "control" regions and "language" regions: Evidence from bimodal bilinguals.

    Science.gov (United States)

    Li, Le; Abutalebi, Jubin; Zou, Lijuan; Yan, Xin; Liu, Lanfang; Feng, Xiaoxia; Wang, Ruiming; Guo, Taomei; Ding, Guosheng

    2015-05-01

    Previous neuroimaging studies have revealed that bilingualism induces both structural and functional neuroplasticity in the dorsal anterior cingulate cortex (dACC) and the left caudate nucleus (LCN), both of which are associated with cognitive control. Since these "control" regions should work together with other language regions during language processing, we hypothesized that bilingualism may also alter the functional interaction between the dACC/LCN and language regions. Here we tested this hypothesis by exploring the functional connectivity (FC) in bimodal bilinguals and monolinguals using functional MRI when they either performed a picture naming task with spoken language or were in resting state. We found that for bimodal bilinguals who use spoken and sign languages, the FC of the dACC with regions involved in spoken language (e.g. the left superior temporal gyrus) was stronger in performing the task, but weaker in the resting state as compared to monolinguals. For the LCN, its intrinsic FC with sign language regions including the left inferior temporo-occipital part and right inferior and superior parietal lobules was increased in the bilinguals. These results demonstrate that bilingual experience may alter the brain functional interaction between "control" regions and "language" regions. For different control regions, the FC alters in different ways. The findings also deepen our understanding of the functional roles of the dACC and LCN in language processing. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. [Neural mechanism underlying autistic savant and acquired savant syndrome].

    Science.gov (United States)

    Takahata, Keisuke; Kato, Motoichiro

    2008-07-01

    It is well known that the cases with savant syndrome, demonstrate outstanding mental capability despite coexisting severe mental disabilities. In many cases, savant skills are characterized by its domain-specificity, enhanced memory capability, and excessive focus on low-level perceptual processing. In addition, impaired integrative cognitive processing such as social cognition or executive function, restricted interest, and compulsive repetition of the same act are observed in savant individuals. All these are significantly relevant to the behavioral characteristics observed in individuals with autistic spectrum disorders (ASD). A neurocognitive model of savant syndrome should explain these cognitive features and the juxtaposition of outstanding talents with cognitive disabilities. In recent neuropsychological studies, Miller (1998) reported clinical cases of "acquired savant," i.e., patients who improved or newly acquired an artistic savant-like skill in the early stage of frontotemporal dementia (FTD). Although the relationship between an autistic savant and acquired savant remains to be elucidated, the advent of neuroimaging study of ASD and the clarification of FTD patients with savant-like skills may clarify the shared neural mechanisms of both types of talent. In this review, we classified current cognitive models of savant syndrome into the following 3 categories. (1) A hypermnesic model that suggests that savant skills develop from existing or dormant cognitive functions such as memory. However, recent findings obtained through neuropsychological examinations imply that savant individuals solve problems using a strategy that is fairly different from a non-autistic one. (2) A paradoxical functional facilitation model (Kapur, 1996) that offers possible explanations about how pathological states in the brain lead to development of prodigious skills. This model emphasizes the role of reciprocal inhibitory interaction among adjacent or distant cortical regions

  18. Genetic control of acquired resistance to gastrointestinal nematode parasites in sheep

    International Nuclear Information System (INIS)

    Windon, R.G.; Wagland, B.M.; Dineen, J.K.

    1988-01-01

    A radiation attenuated larval vaccine has been used to evaluate the role of genetic components of the immune response in the control of Trichostrongylus colubriformis in sheep. Through selection based on age dependent responsiveness, lines of sheep have been established in which lambs are either high or low responders to vaccination and challenge infection. The estimated and realized heritabilities for the selected trait are 0.35-0.41. Significant interline differences were demonstrated and, within the lines, ewe lambs were consistently more responsive than rams or wethers. The effect of selection was not antigenically specific, since high responsiveness to T. colubriformis was associated with increased responsiveness to other related (T. rugatus) and unrelated parasites (Ostertagia circumcincta and Haemonchus contortus). In addition, high responders had a more vigorous reaction against naturally acquired infections than low responders. The general immunological competence was also increased in high responders; this was shown by the levels of serum complement fixing antibody to larval antigens after vaccination and challenge, in vitro blastogenic responses stimulated by larval antigens and the phagocytic function of peripheral leucocytes. No production penalty (weight gain and wool growth) was associated with heightened responsiveness. (author). 10 refs, 1 fig

  19. Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in Ethiopia

    Directory of Open Access Journals (Sweden)

    Yallew WW

    2016-08-01

    Full Text Available Walelegn Worku Yallew,1 Abera Kumie,2 Feleke Moges Yehuala3 1Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, 2School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, 3Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Purpose: Hospital-acquired infection (HAI is a major safety issue affecting the quality of care of hundreds of millions of patients every year, in both developed and developing countries, including Ethiopia. In Ethiopia, there is no comprehensive research that presents the whole picture of HAIs in hospitals. The objective of this study was to examine the nature and extent of HAIs in Ethiopia. Methods: A repeated cross-sectional study was conducted in two teaching hospitals. All eligible inpatients admitted for at least 48 hours on the day of the survey were included. The survey was conducted in dry and wet seasons of Ethiopia, that is, in March to April and July 2015. Physicians and nurses collected the data according to the Centers for Disease Control and Prevention definition of HAIs. Coded and cleaned data were transferred to SPSS 21 and STATA 13 for analysis. Univariate and multivariable logistic regression analyses were used to examine the prevalence of HAIs and relationship between explanatory and outcome variables. Results: A total of 908 patients were included in this survey, the median age of the patients was 27 years (interquartile range: 16–40 years. A total of 650 (71.6% patients received antimicrobials during the survey. There were 135 patients with HAI, with a mean prevalence of 14.9% (95% confidence interval 12.7–17.1. Culture results showed that Klebsiella spp. (22.44% and Staphylococcus aureus (20.4% were the most commonly isolated HAI-causing pathogens in these hospitals. The association of patient age and hospital type with the occurrence of HAI was

  20. Mergers and concentrations occurring on the basis of acquiring of control in Serbian and EU competition law

    Directory of Open Access Journals (Sweden)

    Fišer-Šobot Sandra S.

    2016-01-01

    Full Text Available Relevant Serbian and EU competition legislation does not define what is considered a concentration, but regulates which business transactions lead to concentrations of undertakings. Concentrations can be differentiated according to whether the concentration affects legal position of the merging undertakings. A concentration shall be deemed to arise where a change of control on a lasting basis results from the merger of two or more previously independent undertakings or parts of undertakings. Second type of concentrations occurs in the case of an acquisition of control. Finally, the concentration shall be deemed to arise in the case of creation of a joint venture performing on a lasting basis all the functions of an autonomous economic entity. This paper analyses mergers and concentrations occurring on the basis of acquiring of control in Serbian and EU competition law.

  1. 40 CFR 81.62 - Northeast Mississippi Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Mississippi Intrastate Air... Air Quality Control Regions § 81.62 Northeast Mississippi Intrastate Air Quality Control Region. The Alabama-Mississippi-Tennessee Interstate Air Quality Control Region has been renamed the Northeast...

  2. 40 CFR 81.216 - Northeast Indiana Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Indiana Intrastate Air... Air Quality Control Regions § 81.216 Northeast Indiana Intrastate Air Quality Control Region. The Northeast Indiana Intrastate Air Quality Control Region (Indiana) consists of the territorial area...

  3. 40 CFR 81.162 - Northeast Plateau Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Plateau Intrastate Air... Air Quality Control Regions § 81.162 Northeast Plateau Intrastate Air Quality Control Region. The Northeast Plateau Intrastate Air Quality Control Region (California) consists of the territorial area...

  4. 40 CFR 81.17 - Metropolitan Los Angeles Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.17 Metropolitan Los Angeles Air Quality Control Region. The Metropolitan Los Angeles Air Quality Control Region consists of the following territorial area (including the territorial... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Los Angeles Air Quality...

  5. 40 CFR 81.32 - Puget Sound Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.32 Puget Sound Intrastate Air Quality Control Region. The Puget Sound Intrastate Air Quality Control Region (Washington) consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Puget Sound Intrastate Air Quality...

  6. 40 CFR 81.256 - Northeast Iowa Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Iowa Intrastate Air Quality Control Region. 81.256 Section 81.256 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Quality Control Regions § 81.256 Northeast Iowa Intrastate Air Quality Control Region. The Northeast Iowa...

  7. 40 CFR 81.237 - Northeast Georgia Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Georgia Intrastate Air... Air Quality Control Regions § 81.237 Northeast Georgia Intrastate Air Quality Control Region. The Northeast Georgia Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  8. 40 CFR 81.139 - Northeast Arkansas Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Arkansas Intrastate Air... Air Quality Control Regions § 81.139 Northeast Arkansas Intrastate Air Quality Control Region. The Northeast Arkansas Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  9. 40 CFR 81.251 - Northeast Kansas Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Kansas Intrastate Air... Air Quality Control Regions § 81.251 Northeast Kansas Intrastate Air Quality Control Region. The Northeast Kansas Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

  10. 40 CFR 81.134 - Austin-Waco Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Austin-Waco Intrastate Air Quality Control Region. 81.134 Section 81.134 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Quality Control Regions § 81.134 Austin-Waco Intrastate Air Quality Control Region. The Austin-Waco...

  11. 40 CFR 81.121 - Four Corners Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Four Corners Interstate Air Quality Control Region. 81.121 Section 81.121 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Quality Control Regions § 81.121 Four Corners Interstate Air Quality Control Region. The Four Corners...

  12. 40 CFR 81.93 - Hampton Roads Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Hampton Roads Intrastate Air Quality Control Region. 81.93 Section 81.93 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Quality Control Regions § 81.93 Hampton Roads Intrastate Air Quality Control Region. The Metropolitan...

  13. 40 CFR 81.110 - Camden-Sumter Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.110 Camden-Sumter Intrastate Air Quality Control Region. The Camden-Sumter Intrastate Air Quality Control Region (South Carolina) consists of the territorial area encompassed by the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Camden-Sumter Intrastate Air Quality...

  14. 40 CFR 81.52 - Wasatch Front Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.52 Wasatch Front Intrastate Air Quality Control Region. The Wasatch Front Intrastate Air Quality Control Region (Utah) consists of the territorial area encompassed by the boundaries... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Wasatch Front Intrastate Air Quality...

  15. 40 CFR 81.54 - Cook Inlet Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.54 Cook Inlet Intrastate Air Quality Control Region. The Cook Inlet Intrastate Air Quality Control Region (Alaska) consists of the territorial area encompassed by the boundaries... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Cook Inlet Intrastate Air Quality...

  16. 40 CFR 81.95 - Central Florida Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.95 Central Florida Intrastate Air Quality Control Region. The Central Florida Intrastate Air Quality Control Region consists of the territorial area encompassed by the boundaries of the... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Central Florida Intrastate Air Quality...

  17. 40 CFR 81.176 - San Luis Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false San Luis Intrastate Air Quality Control Region. 81.176 Section 81.176 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Quality Control Regions § 81.176 San Luis Intrastate Air Quality Control Region. The San Luis Intrastate...

  18. Childhood acquired heart diseases in Jos, north central Nigeria ...

    African Journals Online (AJOL)

    Background: The patterns of childhood acquired heart diseases (AHD) vary in different parts of the world and may evolve over time. We aimed to compare the pattern of childhood AHD in our institution to the historical and contemporary patterns in other parts of the country, and to highlight possible regional differences and ...

  19. 40 CFR 81.80 - Las Vegas Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Regions § 81.80 Las Vegas Intrastate Air Quality Control Region. The Las Vegas Intrastate Air Quality Control Region (Nevada) has been revised to consist of the territorial area encompassed by... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Las Vegas Intrastate Air Quality...

  20. Regional dialogue and multilateral arms control efforts today

    International Nuclear Information System (INIS)

    Graham, T. Jr.

    1994-01-01

    The significance of arms control and non-proliferation tasks is stressed emphasising what has been done, and-more important-what must still be done. Although tangible developments at the regional level may seem at times to be slow in coming, it is important to remember that the United States-Soviet transition from voluntary declarations to detailed arms control agreements with intrusive verification regimes spanned the entire length of cold war. Given the instabilities afflicting these regions, establishing a regional dialogue is itself a confidence-building measure. The experience of the United States and the former Soviet Union amply demonstrates that mere existence of regular dialogue can reduce tension by providing a platform for communication among military and Government participants even when political crisis prevents diplomatic contacts at senior levels. The international community should be encouraged by the progress that has been made to date to address regional instabilities. Such steps are an integral part of the international effort, carried out both at the United Nations and elsewhere, to adopt acceptable levels of conventional military forces and to eliminate weapons of mass destruction. Given the instabilities afflicting these regions, establishing a regional dialogue is itself a confidence-building measure. World changes, while potentially dangerous and certainly challenging, offer the hope of replacing antagonism with cooperation, creating a progressively more democratic global environment, preventing proliferation, and dampening regional conflicts. Continuing to make effective use of the entire mix of arms control and confidence-building tools will help to realize these hopes

  1. A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia : a controlled before-and-after study

    NARCIS (Netherlands)

    Engel, M. F.; Bruns, A. H. W.; Hulscher, M. E. J. L.; Gaillard, C. A. J. M.; Sankatsing, S. U. C.; van Berkhout, F. Teding; Emmelot-Vonk, M. H.; Kuck, E. M.; Steeghs, M. H. M.; den Breeijen, J. H.; Stellato, R. K.; Hoepelman, A. I. M.; Oosterheert, J.J.

    2014-01-01

    We previously showed that 40 % of clinically stable patients hospitalised for community-acquired pneumonia (CAP) are not switched to oral therapy in a timely fashion because of physicians' barriers. We aimed to decrease this proportion by implementing a novel protocol. In a multi-centre controlled

  2. A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia: a controlled before-and-after study

    NARCIS (Netherlands)

    Engel, M.F.; Bruns, A.H.; Hulscher, M.E.; Gaillard, C.A.; Sankatsing, S.U.; Berkhout, F. Teding van; Emmelot-Vonk, M.H.; Kuck, E.M.; Steeghs, M.H.; Breeijen, J.H. den; Stellato, R.K.; Hoepelman, A.I.; Oosterheert, J.J.

    2014-01-01

    We previously showed that 40 % of clinically stable patients hospitalised for community-acquired pneumonia (CAP) are not switched to oral therapy in a timely fashion because of physicians' barriers. We aimed to decrease this proportion by implementing a novel protocol. In a multi-centre controlled

  3. Evaluating the CARE4Carer Blended Care Intervention for Partners of Patients With Acquired Brain Injury: Protocol for a Randomized Controlled Trial.

    Science.gov (United States)

    Cox, Vincent Cm; Schepers, Vera Pm; Ketelaar, Marjolijn; van Heugten, Caroline M; Visser-Meily, Johanna Ma

    2018-02-16

    Support programs for partners of patients with acquired brain injury are necessary since these partners experience several unfavorable consequences of caregiving, such as a high burden, emotional distress, and poor quality of life. Evidence-based support strategies that can be included in these support programs are psychoeducation, skill building, problem solving, and improving feelings of mastery. A promising approach would seem to be to combine web-based support with face-to-face consultations, creating a blended care intervention. This paper outlines the protocol of a randomized controlled trial to evaluate the CARE4Carer blended care intervention for partners of patients with acquired brain injury. A multicenter two-arm randomized controlled trial will be conducted. A total of 120 partners of patients with acquired brain injury will be recruited from five rehabilitation centers in the Netherlands. The blended care intervention consists of a nine-session web-based support program and two face-to-face consultations with a social worker. Themes that will be addressed are: giving partners insight into their own situation, including possible pitfalls and strengths, learning how to cope with the situation, getting a grip on thoughts and feelings, finding a better balance in the care for the patient with acquired brain injury, thinking about other possible care options, taking care of oneself, and communication. The intervention lasts 20 weeks and the control group will receive usual care. The outcome measures will be assessed at baseline and at 24- and 40-week follow-up. The primary outcome is caregiver mastery. Secondary outcome measures are strain, burden, family functioning, emotional functioning, coping, quality of life, participation, and social network. The effect of the intervention on the primary and secondary outcome measures will be determined. Additional a process evaluation will be conducted. The findings of this study will be used to improve the care for

  4. Characterization and evolution of the mitochondrial DNA control region in hornbills (Bucerotiformes).

    Science.gov (United States)

    Delport, Wayne; Ferguson, J Willem H; Bloomer, Paulette

    2002-06-01

    We determined the mitochondrial DNA control region sequences of six Bucerotiformes. Hornbills have the typical avian gene order and their control region is similar to other avian control regions in that it is partitioned into three domains: two variable domains that flank a central conserved domain. Two characteristics of the hornbill control region sequence differ from that of other birds. First, domain I is AT rich as opposed to AC rich, and second, the control region is approximately 500 bp longer than that of other birds. Both these deviations from typical avian control region sequence are explainable on the basis of repeat motifs in domain I of the hornbill control region. The repeat motifs probably originated from a duplication of CSB-1 as has been determined in chicken, quail, and snowgoose. Furthermore, the hornbill repeat motifs probably arose before the divergence of hornbills from each other but after the divergence of hornbills from other avian taxa. The mitochondrial control region of hornbills is suitable for both phylogenetic and population studies, with domains I and II probably more suited to population and phylogenetic analyses, respectively.

  5. Learning-by-Being-Acquired

    DEFF Research Database (Denmark)

    Colombo, Massimo Gaetano; Moreira, Solon; Rabbiosi, Larissa

    2016-01-01

    In horizontal acquisitions, the post-acquisition integration of the R&D function often damages the inventive labor force and results in lower innovative productivity of acquired inventors. In this paper we study post-acquisition integration in terms of R&D team reorganization-i.e., the creation...... of new teams with both inventors of the acquiring and acquired firms-and assess the impact of this integration action in the period that immediately follows the acquisition. Drawing on social identity and self-categorization theories, we argue that R&D team reorganization increases the acquired inventors...

  6. Region based Brain Computer Interface for a home control application.

    Science.gov (United States)

    Akman Aydin, Eda; Bay, Omer Faruk; Guler, Inan

    2015-08-01

    Environment control is one of the important challenges for disabled people who suffer from neuromuscular diseases. Brain Computer Interface (BCI) provides a communication channel between the human brain and the environment without requiring any muscular activation. The most important expectation for a home control application is high accuracy and reliable control. Region-based paradigm is a stimulus paradigm based on oddball principle and requires selection of a target at two levels. This paper presents an application of region based paradigm for a smart home control application for people with neuromuscular diseases. In this study, a region based stimulus interface containing 49 commands was designed. Five non-disabled subjects were attended to the experiments. Offline analysis results of the experiments yielded 95% accuracy for five flashes. This result showed that region based paradigm can be used to select commands of a smart home control application with high accuracy in the low number of repetitions successfully. Furthermore, a statistically significant difference was not observed between the level accuracies.

  7. Potentialities of radioisotope aniocardiography in diagnosis of acquired heart diseases

    International Nuclear Information System (INIS)

    Malov, G.A.; Mikaelyan, R.S.; Dumpe, A.N.

    1980-01-01

    On the base of the examination of 40 patients with acquired heart diseases and 5 people without heart diseases for control determined are the most charactreristic signs of the acquired heart disease of visual observation on RPP transit (albumin of human serum labelled by sup(99m)Tc) through the heart cavities and magistral vessels. It is shown that there is a close connection between central and intracardial hemodynamics which permjts to judge on the cardiac output on the base of mean circulation time (MCT). Radioisotopic angiocardiography permits to find redistribution of lung blood flow in patients with acquired heart diseases, which can serve as indirect index of long hypertension

  8. Acquired neuropathies.

    Science.gov (United States)

    Lozeron, Pierre; Trocello, Jean-Marc; Kubis, Nathalie

    2013-09-01

    Acquired neuropathies represent most of the neuropathies encountered in clinical practice. Hundreds of causes have been identified even though up to 41% of patients are still classified as idiopathic (Rajabally and Shah in J Neurol 258:1431-1436, 1). Routine evaluation relies on comprehensive medical history taking, clinical examination, nerve conduction studies and laboratory tests. Other investigations such as nerve biopsy or nerve or muscle imaging are performed in specific settings. This review focuses on recent advances in acquired neuropathies.

  9. Interventions for treating acute bleeding episodes in people with acquired hemophilia A.

    Science.gov (United States)

    Zeng, Yan; Zhou, Ruiqing; Duan, Xin; Long, Dan; Yang, Songtao

    2014-08-28

    Acquired hemophilia A is a rare bleeding disorder caused by autoantibodies to coagulation factor VIII (FVIII). In most cases, bleeding episodes are spontaneous and severe at presentation. The optimal hemostatic therapy is controversial. To determine the efficacy of hemostatic therapies for acute bleeds in people with acquired hemophilia A; and to compare different forms of therapy for these bleeds. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 4) and MEDLINE (Ovid) (1948 to 30 April 2014). We searched the conference proceedings of the: American Society of Hematology; European Hematology Association; International Society on Thrombosis and Haemostasis (ISTH); and the European Association for Haemophilia and Allied Disorders (EAHAD) (from 2000 to 30 April 2014). In addition to this we searched clinical trials registers. All randomised controlled trials and quasi-randomised trials of hemostatic therapies for people with acquired hemophilia A, with no restrictions on gender, age or ethnicity. No trials matching the selection criteria were eligible for inclusion. No trials matching the selection criteria were eligible for inclusion. No randomised clinical trials of hemostatic therapies for acquired hemophilia A were found. Thus, we are not able to draw any conclusions or make any recommendations on the optimal hemostatic therapies for acquired hemophilia A based on the highest quality of evidence. GIven that carrying out randomized controlled trials in this field is a complex task, the authors suggest that, while planning randomised controlled trials in which patients can be enrolled, clinicians treating the disease continue to base their choices on alternative, lower quality sources of evidence, which hopefully, in the future, will also be appraised and incorporated in a Cochrane Review.

  10. Neural Basis of Acquired Amusia and Its Recovery after Stroke.

    Science.gov (United States)

    Sihvonen, Aleksi J; Ripollés, Pablo; Leo, Vera; Rodríguez-Fornells, Antoni; Soinila, Seppo; Särkämö, Teppo

    2016-08-24

    Although acquired amusia is a relatively common disorder after stroke, its precise neuroanatomical basis is still unknown. To evaluate which brain regions form the neural substrate for acquired amusia and its recovery, we performed a voxel-based lesion-symptom mapping (VLSM) and morphometry (VBM) study with 77 human stroke subjects. Structural MRIs were acquired at acute and 6 month poststroke stages. Amusia and aphasia were behaviorally assessed at acute and 3 month poststroke stages using the Scale and Rhythm subtests of the Montreal Battery of Evaluation of Amusia (MBEA) and language tests. VLSM analyses indicated that amusia was associated with a lesion area comprising the superior temporal gyrus, Heschl's gyrus, insula, and striatum in the right hemisphere, clearly different from the lesion pattern associated with aphasia. Parametric analyses of MBEA Pitch and Rhythm scores showed extensive lesion overlap in the right striatum, as well as in the right Heschl's gyrus and superior temporal gyrus. Lesions associated with Rhythm scores extended more superiorly and posterolaterally. VBM analysis of volume changes from the acute to the 6 month stage showed a clear decrease in gray matter volume in the right superior and middle temporal gyri in nonrecovered amusic patients compared with nonamusic patients. This increased atrophy was more evident in anterior temporal areas in rhythm amusia and in posterior temporal and temporoparietal areas in pitch amusia. Overall, the results implicate right temporal and subcortical regions as the crucial neural substrate for acquired amusia and highlight the importance of different temporal lobe regions for the recovery of amusia after stroke. Lesion studies are essential in uncovering the brain regions causally linked to a given behavior or skill. For music perception ability, previous lesion studies of amusia have been methodologically limited in both spatial accuracy and time domain as well as by small sample sizes, providing

  11. 40 CFR 81.38 - Metropolitan Houston-Galveston Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Houston-Galveston... Designation of Air Quality Control Regions § 81.38 Metropolitan Houston-Galveston Intrastate Air Quality Control Region. The Metropolitan Houston-Galveston Intrastate Air Quality Control Region (Texas) has been...

  12. Precision grip in congenital and acquired hemiparesis: similarities in impairments and implications for neurorehabilitation - review

    Directory of Open Access Journals (Sweden)

    Yannick eBleyenheuft

    2014-06-01

    Full Text Available Background: Patients with congenital and acquired hemiparesis incur long-term functional deficits, among which the loss of prehension that may impact their functional independence. Identifying, understanding and comparing the underlying mechanisms of prehension impairments represent an opportunity to better adapt neurorehabilitationObjective: The present review aims to provide a better understanding of precision grip deficits in congenital and acquired hemiparesis and to determine whether the severity and type of fine motor control impairments depend on whether or not the lesions are congenital or acquired in adulthood. Methods: Using combinations of the following key words: fingertip force, grip force, precision grip, cerebral palsy, stroke, pubmed and Scopus databases were used to search studies from 1984 to 2013. Results: Individuals with both congenital and acquired hemiparesis were able to some extent to use anticipatory motor control in precision grip tasks, even if this control was impaired in the paretic hand. In both congenital or acquired hemiparesis, the ability to plan efficient anticipatory motor control when the less-affected hand is used provides a possibility to remediate impairments in anticipatory motor control of the paretic hand. Conclusion: Surprisingly we observed very few differences between the results of studies in children with congenital hemiplegia and stroke patients. We suggest that the underlying specific strategies of neurorehabilitation developed for each one could benefit the other.

  13. Online continuing interprofessional education on hospital-acquired infections for Latin America.

    Science.gov (United States)

    Medina-Presentado, Julio C; Margolis, Alvaro; Teixeira, Lucia; Lorier, Leticia; Gales, Ana C; Pérez-Sartori, Graciela; Oliveira, Maura S; Seija, Verónica; Paciel, Daniela; Vignoli, Rafael; Guerra, Silvia; Albornoz, Henry; Arteta, Zaida; Lopez-Arredondo, Antonio; García, Sofía

    Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology. Participation, satisfaction and knowledge gain (through pre and post tests) were used. Moreover, commitment to change statements were requested from participants at the end of the course and three months later. There were 1169 participants from 19 Latin American countries who registered: 57% were physicians and 43% were other health care professionals. Of those, 1126 participated in the course, 46% received a certificate of completion and 54% a certificate of participation. There was a significant increase in knowledge between before and after the course. Of 535 participants who took both tests, the grade increased from 59 to 81%. Commitments to change were aligned with course objectives. Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a "New Challenges" course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions. Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  14. 40 CFR 81.63 - Metropolitan Fort Smith Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Metropolitan Fort Smith Interstate Air... Air Quality Control Regions § 81.63 Metropolitan Fort Smith Interstate Air Quality Control Region. The Metropolitan Fort Smith Interstate Air Quality Control Region (Arkansas-Oklahoma) has been revised to consist...

  15. Research on frequency control strategy of interconnected region based on fuzzy PID

    Science.gov (United States)

    Zhang, Yan; Li, Chunlan

    2018-05-01

    In order to improve the frequency control performance of the interconnected power grid, overcome the problems of poor robustness and slow adjustment of traditional regulation, the paper puts forward a frequency control method based on fuzzy PID. The method takes the frequency deviation and tie-line deviation of each area as the control objective, takes the regional frequency deviation and its deviation as input, and uses fuzzy mathematics theory, adjusts PID control parameters online. By establishing the regional frequency control model of water-fire complementary power generation in MATLAB, the regional frequency control strategy is given, and three control modes (TBC-FTC, FTC-FTC, FFC-FTC) are simulated and analyzed. The simulation and experimental results show that, this method has better control performance compared with the traditional regional frequency regulation.

  16. Physical Plant Design and Engineering Controls to Reduce Hospital-Acquired Infections

    Directory of Open Access Journals (Sweden)

    JM Conly

    2006-01-01

    Full Text Available The importance of the environment as a reservoir for microorganisms implicated in disease transmission in the hospital setting has been increasingly recognized, especially with respect to dialysis units, ventilation in specialized areas, and the proper use of disinfectants (1. Inherent within the environmental setting is the importance of physical plant design. Several studies have underscored the importance of optimizing design standards to maximize patient and health care worker (HCW safety, including the prevention of hospital-acquired infections in patients (2-6. Ulrich et al (7 recently completed an evidence-based review, entitled 'The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity', for the Center for Health Design in California (USA, which was funded by the Robert Wood Johnson Foundation. Ulrich and colleagues identified over 600 studies that examined the hospital environment and its effects on staff effectiveness, patient safety, patient and family stress, quality and costs. They suggested that one of the important elements in improving patient safety is the reduction of the risk of hospital-acquired infections through improved facility design.

  17. The dynamics of naturally acquired immunity to Plasmodium falciparum infection.

    Directory of Open Access Journals (Sweden)

    Mykola Pinkevych

    Full Text Available Severe malaria occurs predominantly in young children and immunity to clinical disease is associated with cumulative exposure in holoendemic settings. The relative contribution of immunity against various stages of the parasite life cycle that results in controlling infection and limiting disease is not well understood. Here we analyse the dynamics of Plasmodium falciparum malaria infection after treatment in a cohort of 197 healthy study participants of different ages in order to model naturally acquired immunity. We find that both delayed time-to-infection and reductions in asymptomatic parasitaemias in older age groups can be explained by immunity that reduces the growth of blood stage as opposed to liver stage parasites. We found that this mechanism would require at least two components - a rapidly acting strain-specific component, as well as a slowly acquired cross-reactive or general immunity to all strains. Analysis and modelling of malaria infection dynamics and naturally acquired immunity with age provides important insights into what mechanisms of immune control may be harnessed by malaria vaccine strategists.

  18. Technical Equivalency Documentation for a Newly Acquired Alpha Spectroscopy System

    International Nuclear Information System (INIS)

    Hickman, D P; Fisher, S K; Hann, P R; Hume, R

    2007-01-01

    The response of a recently acquired Canberra(trademark) Alpha Analyst 'Blue' system (Chamber Number's 173-208) used by the Hazards Control, Radiation Safety Section, WBC/Spectroscopy Team has been studied with respect to an existing Canberra system. The existing Canberra system consists of thirty Alpha Analyst dual chambers Model XXXX comprising a total of sixty detectors (Chambers Number's 101-124 and 137-172). The existing chambers were previously compared to an older system consisting of thirty-six Model 7401 alpha spectrometry chambers (Chamber Number's 1-36) Chambers 101-124 and 137-172 are DOELAP accredited. The older system was previously DOELAP accredited for the routine Alpha Spectroscopy program used in LLNL's in vitro bioassay program. The newly acquired Alpha Analyst system operates on a network with software that controls and performs analysis of the current Alpha Analyst system (Chamber Number's 101-124 and 137-172). This exact same software is used for the current system and the newly acquired system and is DOELAP accredited. This document compares results from the existing Alpha System with the newer Alpha Analyst system

  19. 40 CFR 81.76 - State of Hawaii Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false State of Hawaii Air Quality Control... PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.76 State of Hawaii Air Quality Control Region. The State of Hawaii Air Quality...

  20. Pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions

    International Nuclear Information System (INIS)

    Yan-Li, Zou; Guan-Rong, Chen

    2009-01-01

    This paper studies pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions. To study a state-feedback pinning-controlled network with N nodes, it first converts the controlled network to an extended network of N+1 nodes without controls. It is shown that the controlled synchronizability of the given network is determined by the real part of the smallest nonzero eigenvalue of the coupling matrix of its extended network when the synchronized region is unbounded; but it is determined by the ratio of the real parts of the largest and the smallest nonzero eigenvalues of the coupling matrix when the synchronized region is bounded. Both theoretical analysis and numerical simulation show that the portion of controlled nodes has no critical values when the synchronized region is unbounded, but it has a critical value when the synchronized region is bounded. In the former case, therefore, it is possible to control the network to achieve synchronization by pinning only one node. In the latter case, the network can achieve controlled synchronization only when the portion of controlled nodes is larger than the critical value. (general)

  1. Weld analysis and control system

    Science.gov (United States)

    Kennedy, Larry Z. (Inventor); Rodgers, Michael H. (Inventor); Powell, Bradley W. (Inventor); Burroughs, Ivan A. (Inventor); Goode, K. Wayne (Inventor)

    1994-01-01

    The invention is a Weld Analysis and Control System developed for active weld system control through real time weld data acquisition. Closed-loop control is based on analysis of weld system parameters and weld geometry. The system is adapted for use with automated welding apparatus having a weld controller which is capable of active electronic control of all aspects of a welding operation. Enhanced graphics and data displays are provided for post-weld analysis. The system provides parameter acquisition, including seam location which is acquired for active torch cross-seam positioning. Torch stand-off is also monitored for control. Weld bead and parent surface geometrical parameters are acquired as an indication of weld quality. These parameters include mismatch, peaking, undercut, underfill, crown height, weld width, puddle diameter, and other measurable information about the weld puddle regions, such as puddle symmetry, etc. These parameters provide a basis for active control as well as post-weld quality analysis and verification. Weld system parameters, such as voltage, current and wire feed rate, are also monitored and archived for correlation with quality parameters.

  2. Design of two molecular methodologies for the rapid identification of Colombian community-acquired methicillin-resistant Staphylococcus aureus isolates

    OpenAIRE

    Escobar, Javier Antonio; Gómez, Ingrid Tatiana; Murillo, Martha Johanna; Castro, Betsy Esperanza; Chavarro, Bibiana; Márquez, Ricaurte Alejandro; Vanegas, Natasha

    2012-01-01

    Introduction. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are found with increasing the frequency, both in healthy individuals in the community and in hospitalized patients. In Colombia and the Andean region, CA-MRSA isolates have a genetic background that is related to the pandemic USA300 clone. Objective. Two molecular methods are designed and standardized for the rapid differentiation of Colombian community-acquired and hospital-acquired methicillin-...

  3. Hospital-acquired infections in a Nigerian tertiary health facility: An ...

    African Journals Online (AJOL)

    Hospital-acquired infections in a Nigerian tertiary health facility: An audit of surveillance reports. ... This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. Materials and Methods: A retrospective survey of records from the infection control ...

  4. Altered Recruitment of the Attention Network Is Associated with Disability and Cognitive Impairment in Pediatric Patients with Acquired Brain Injury

    Directory of Open Access Journals (Sweden)

    Sandra Strazzer

    2015-01-01

    Full Text Available We assessed abnormalities of brain functional magnetic resonance imaging (fMRI activity during a sustained attention task (Conners’ Continuous Performance Test (CCPT in 20 right-handed pediatric acquired brain injury (ABI patients versus 7 right-handed age-matched healthy controls, and we estimated the correlation of such abnormalities with clinical and cognitive deficits. Patients underwent the Wechsler Intelligence Scale for Children (WISC, Wisconsin Card Sorting Test, and Functional Independence Measure (FIM evaluations. During fMRI, patients and controls activated regions of the attention network. Compared to controls, ABI patients experienced a decreased average fMRI recruitment of the left cerebellum and a decreased deactivation of the left anterior cingulate cortex. With increasing task demand, compared to controls, ABI patients had an impaired ability to increase the recruitment of several posterior regions of the attention network. They also experienced a greater activation of frontal regions, which was correlated with worse performance on FIM, WISC, and fMRI CCPT. Such abnormal brain recruitment was significantly influenced by the type of lesion (focal versus diffuse axonal injury and time elapsed from the event. Pediatric ABI patients experienced an inability to optimize attention network recruitment, especially when task difficulty was increased, which likely contributes to their clinical and cognitive deficits.

  5. Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults

    DEFF Research Database (Denmark)

    Bodilsen, Jacob; Schønheyder, Henrik Carl; Nielsen, Henrik I

    2013-01-01

    BACKGROUND: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this ......BACKGROUND: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid...... in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region. METHODS: We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13......-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded...

  6. National Automated Surveillance of Hospital-Acquired Bacteremia in Denmark Using a Computer Algorithm

    DEFF Research Database (Denmark)

    Gubbels, Sophie; Nielsen, Jens; Voldstedlund, Marianne

    2017-01-01

    BACKGROUND In 2015, Denmark launched an automated surveillance system for hospital-acquired infections, the Hospital-Acquired Infections Database (HAIBA). OBJECTIVE To describe the algorithm used in HAIBA, to determine its concordance with point prevalence surveys (PPSs), and to present trends...... advantages of automated surveillance, HAIBA allows monitoring of HA bacteremia across the healthcare system, supports prioritizing preventive measures, and holds promise for evaluating interventions. Infect Control Hosp Epidemiol 2017;1-8....... for hospital-acquired bacteremia SETTING Private and public hospitals in Denmark METHODS A hospital-acquired bacteremia case was defined as at least 1 positive blood culture with at least 1 pathogen (bacterium or fungus) taken between 48 hours after admission and 48 hours after discharge, using the Danish...

  7. Association of genetic variations in the mitochondrial DNA control region with presbycusis.

    Science.gov (United States)

    Falah, Masoumeh; Farhadi, Mohammad; Kamrava, Seyed Kamran; Mahmoudian, Saeid; Daneshi, Ahmad; Balali, Maryam; Asghari, Alimohamad; Houshmand, Massoud

    2017-01-01

    The prominent role of mitochondria in the generation of reactive oxygen species, cell death, and energy production contributes to the importance of this organelle in the intracellular mechanism underlying the progression of the common sensory disorder of the elderly, presbycusis. Reduced mitochondrial DNA (mtDNA) gene expression and coding region variation have frequently been reported as being associated with the development of presbycusis. The mtDNA control region regulates gene expression and replication of the genome of this organelle. To comprehensively understand of the role of mitochondria in the progression of presbycusis, we compared variations in the mtDNA control region between subjects with presbycusis and controls. A total of 58 presbycusis patients and 220 control subjects were enrolled in the study after examination by the otolaryngologist and audiology tests. Variations in the mtDNA control region were investigated by polymerase chain reaction and Sanger sequencing. A total of 113 sequence variants were observed in mtDNA, and variants were detected in 100% of patients, with 84% located in hypervariable regions. The frequencies of the variants, 16,223 C>T, 16,311 T>C, 16,249 T>C, and 15,954 A>C, were significantly different between presbycusis and control subjects. The statistically significant difference in the frequencies of four nucleotide variants in the mtDNA control region of presbycusis patients and controls is in agreement with previous experimental evidence and supports the role of mitochondria in the intracellular mechanism underlying presbycusis development. Moreover, these variants have potential as diagnostic markers for individuals at a high risk of developing presbycusis. The data also suggest the possible presence of changes in the mtDNA control region in presbycusis, which could alter regulatory factor binding sites and influence mtDNA gene expression and copy number.

  8. Results of a multicentre randomised controlled trial of statistical process control charts and structured diagnostic tools to reduce ward-acquired meticillin-resistant Staphylococcus aureus: the CHART Project.

    Science.gov (United States)

    Curran, E; Harper, P; Loveday, H; Gilmour, H; Jones, S; Benneyan, J; Hood, J; Pratt, R

    2008-10-01

    Statistical process control (SPC) charts have previously been advocated for infection control quality improvement. To determine their effectiveness, a multicentre randomised controlled trial was undertaken to explore whether monthly SPC feedback from infection control nurses (ICNs) to healthcare workers of ward-acquired meticillin-resistant Staphylococcus aureus (WA-MRSA) colonisation or infection rates would produce any reductions in incidence. Seventy-five wards in 24 hospitals in the UK were randomised into three arms: (1) wards receiving SPC chart feedback; (2) wards receiving SPC chart feedback in conjunction with structured diagnostic tools; and (3) control wards receiving neither type of feedback. Twenty-five months of pre-intervention WA-MRSA data were compared with 24 months of post-intervention data. Statistically significant and sustained decreases in WA-MRSA rates were identified in all three arms (Pcontrol wards, but with no significant difference between the control and intervention arms (P=0.23). There were significantly more post-intervention 'out-of-control' episodes (P=0.021) in the control arm (averages of 0.60, 0.28, and 0.28 for Control, SPC and SPC+Tools wards, respectively). Participants identified SPC charts as an effective communication tool and valuable for disseminating WA-MRSA data.

  9. Community-acquired bacterial meningitis

    NARCIS (Netherlands)

    van de Beek, Diederik; Brouwer, Matthijs; Hasbun, Rodrigo; Koedel, Uwe; Whitney, Cynthia G.; Wijdicks, Eelco

    2016-01-01

    Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. It can be acquired spontaneously in the community - community-acquired bacterial meningitis - or in the hospital as a complication of invasive procedures or head trauma

  10. Measures for regional security and arms control in the South-East Asian area

    International Nuclear Information System (INIS)

    Uren, R.T.

    1992-01-01

    The subject of regional security and arms control in the South-East Asia raises some new and difficult issues. No approach to ensuring regional security could be complete without military dimension including the following categories: regional arms control; global arms control measure; confidence building measures that are designed to enhance the transparency of defense policies; confidence building measures that encourage cooperation among the military forces in the region

  11. Acquired Methemoglobinaemia

    Directory of Open Access Journals (Sweden)

    Adil Al-Lawati

    2012-05-01

    Full Text Available Acquired methemoglobinaemia is a relatively rare condition and, therefore infrequently encountered in acute medical practice. Suspicion of the condition may be triggered when the measured PaO2 is ‘out of keeping’ with the oxygen saturations that are discovered with pulse oximetry. We describe two separate cases of acquired methemoglobinaemia secondary to the recreational use of alkyl nitrites (’poppers’. The patients presented at separate times to two different teaching hospitals in London, UK. The similarity of these cases has led the authors to conclude that a raised awareness of this potentially fatal condition, and its association with a widely-available recreational drug, is necessary to ensure a correct and timely diagnosis.

  12. Structural characterization and lipid composition of acquired cholesteatoma

    DEFF Research Database (Denmark)

    Bloksgaard, Maria; Svane-Knudsen, Viggo; Sørensen, Jens A

    2012-01-01

    HYPOTHESIS: The goal of this work is to characterize the morphology and lipid composition of acquired cholesteatoma. We hypothesize that constitutive lipid membranes are present in the cholesteatoma and resemble those found in human skin stratum corneum. METHODS: We performed a comparative...... noninvasive structural and lipid compositional study of acquired cholesteatoma and control human skin using multiphoton excitation fluorescence microscopy-related techniques and high-performance thin-layer chromatography. RESULTS: The structural arrangement of the cholesteatoma is morphologically invariant...... along a depth of more than 200 μm and resembles the stratum corneum of hyperorthokeratotic skin. Lipid compositional analyses of the cholesteatoma show the presence of all major lipid classes found in normal skin stratum corneum (ceramides, long chain fatty acids, and cholesterol). Consistent with this...

  13. Laboratory-acquired brucellosis

    DEFF Research Database (Denmark)

    Fabiansen, C.; Knudsen, J.D.; Lebech, A.M.

    2008-01-01

    Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9......Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9...

  14. Lymphatic filariasis control in Tanga Region, Tanzania

    DEFF Research Database (Denmark)

    Simonsen, Paul Erik; Derua, Yahya A.; Magesa, Stephen M.

    2014-01-01

    BackgroundLymphatic filariasis (LF) control started in Tanga Region of Tanzania in 2004, with annual ivermectin/albendazole mass drug administration (MDA). Since then, the current project has monitored the effect in communities and schools in rural areas of Tanga District. In 2013, after 8 rounds...

  15. Pseudomona pseudomallei community acquired pneumonia

    International Nuclear Information System (INIS)

    Severiche, Diego

    1998-01-01

    This is the first published case report en Colombia about pseudomona pseudomallei community acquired pneumonia. This uncommon pathogen is from the epidemiological standpoint a very important one and medical community should be aware to look after it in those patients where no other etiological pathogen is recovered. A brief summary about epidemiology is showed, emphasizing those regions where it can be found. Likewise, comments about the differential diagnosis are important since it should be considered in those patients where tuberculosis is suspected. This is particularly representative for countries with high tuberculosis rates. Furthermore, a microbiological review is shown, emphasizing on isolation techniques, descriptions about therapeutics and other regarding treatment issues according international standards. Finally; a description about the clinical picture, laboratory findings, treatment and evolution of the case reported are shown for discussion

  16. Nonlinear H∞ Optimal Control Scheme for an Underwater Vehicle with Regional Function Formulation

    Directory of Open Access Journals (Sweden)

    Zool H. Ismail

    2013-01-01

    Full Text Available A conventional region control technique cannot meet the demands for an accurate tracking performance in view of its inability to accommodate highly nonlinear system dynamics, imprecise hydrodynamic coefficients, and external disturbances. In this paper, a robust technique is presented for an Autonomous Underwater Vehicle (AUV with region tracking function. Within this control scheme, nonlinear H∞ and region based control schemes are used. A Lyapunov-like function is presented for stability analysis of the proposed control law. Numerical simulations are presented to demonstrate the performance of the proposed tracking control of the AUV. It is shown that the proposed control law is robust against parameter uncertainties, external disturbances, and nonlinearities and it leads to uniform ultimate boundedness of the region tracking error.

  17. Effect of Chlorhexidine Bathing Every Other Day on Prevention of Hospital-Acquired Infections in the Surgical ICU: A Single-Center, Randomized Controlled Trial.

    Science.gov (United States)

    Swan, Joshua T; Ashton, Carol M; Bui, Lan N; Pham, Vy P; Shirkey, Beverly A; Blackshear, Jolene E; Bersamin, Jimmy B; Pomer, Rubie May L; Johnson, Michael L; Magtoto, Audrey D; Butler, Michelle O; Tran, Shirley K; Sanchez, Leah R; Patel, Jessica G; Ochoa, Robert A; Hai, Shaikh A; Denison, Karen I; Graviss, Edward A; Wray, Nelda P

    2016-10-01

    To test the hypothesis that compared with daily soap and water bathing, 2% chlorhexidine gluconate bathing every other day for up to 28 days decreases the risk of hospital-acquired catheter-associated urinary tract infection, ventilator-associated pneumonia, incisional surgical site infection, and primary bloodstream infection in surgical ICU patients. This was a single-center, pragmatic, randomized trial. Patients and clinicians were aware of treatment-group assignment; investigators who determined outcomes were blinded. Twenty-four-bed surgical ICU at a quaternary academic medical center. Adults admitted to the surgical ICU from July 2012 to May 2013 with an anticipated surgical ICU stay for 48 hours or more were included. Patients were randomized to bathing with 2% chlorhexidine every other day alternating with soap and water every other day (treatment arm) or to bathing with soap and water daily (control arm). The primary endpoint was a composite outcome of catheter-associated urinary tract infection, ventilator-associated pneumonia, incisional surgical site infection, and primary bloodstream infection. Of 350 patients randomized, 24 were excluded due to prior enrollment in this trial and one withdrew consent. Therefore, 325 were analyzed (164 soap and water versus 161 chlorhexidine). Patients acquired 53 infections. Compared with soap and water bathing, chlorhexidine bathing every other day decreased the risk of acquiring infections (hazard ratio = 0.555; 95% CI, 0.309-0.997; p = 0.049). For patients bathed with soap and water versus chlorhexidine, counts of incident hospital-acquired infections were 14 versus 7 for catheter-associated urinary tract infection, 13 versus 8 for ventilator-associated pneumonia, 6 versus 3 for incisional surgical site infections, and 2 versus 0 for primary bloodstream infection; the effect was consistent across all infections. The absolute risk reduction for acquiring a hospital-acquired infection was 9.0% (95% CI, 1.5-16.4%; p

  18. Study on regional stratagem for coal mine disasters control and prevention in China

    Energy Technology Data Exchange (ETDEWEB)

    Shen, B.; Lei, Y. [China Coal Research Institute, Beijing (China)

    2009-09-15

    A regional strategy study was aimed at coal mine disaster control and prevention, which deepens and enriches the macro-strategy of coal mine disaster control and prevention, and provides an important support for the rapid and healthy development of China's regional coal industry. The country was divided into 4 regions: Northeast, North, South and Xinqing. In view of the regional status of coal mine disasters, the regulation and development trend of regional coal mine disasters was analysed, the outstanding problems and key factors were identified, and general thoughts on regional coal mine disaster control and prevention are put forward. 4 refs., 4 figs., 1 tab.

  19. Value-based purchasing and hospital acquired conditions: are we seeing improvement?

    Science.gov (United States)

    Spaulding, Aaron; Zhao, Mei; Haley, D Rob

    2014-12-01

    To determine if the Value-Based Purchasing Performance Scoring system correlates with hospital acquired condition quality indicators. This study utilizes the following secondary data sources: the American Hospital Association (AHA) annual survey and the Centers for Medicare and Medicaid (CMS) Value-Based Purchasing and Hospital Acquired Conditions databases. Zero-inflated negative binomial regression was used to examine the effect of CMS total performance score on counts of hospital acquired conditions. Hospital structure variables including size, ownership, teaching status, payer mix, case mix, and location were utilized as control variables. The secondary data sources were merged into a single database using Stata 10. Total performance scores, which are used to determine if hospitals should receive incentive money, do not correlate well with quality outcome in the form of hospital acquired conditions. Value-based purchasing does not appear to correlate with improved quality and patient safety as indicated by Hospital Acquired Condition (HAC) scores. This leads us to believe that either the total performance score does not measure what it should, or the quality outcome measurements do not reflect the quality of the total performance scores measure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Forming controlled inset regions by ion implantation and laser bombardment

    International Nuclear Information System (INIS)

    Gibbons, J.F.

    1981-01-01

    A semiconductor integrated circuit structure in which the inset regions are ion implanted and laser annealed to maintain substantially the dimensions of the implantation and the method of forming inset implanted regions having controlled dimensions

  1. Foliar application of systemic acquired resistance (SAR) inducers for ...

    African Journals Online (AJOL)

    nbuensanteai

    2013-08-14

    Aug 14, 2013 ... induced by chitosan and BTH were involved in defense mechanism, reflecting the strong direct positive effect that chitosan ... to control plant diseases based on the systemic acquired resistance ... salicylic acid (SA) as a signal molecule and is associated ... treated plants for SAR relating chemical analyses.

  2. Multi-region fuzzy logic controller with local PID controllers for U-tube steam generator in nuclear power plant

    Directory of Open Access Journals (Sweden)

    Puchalski Bartosz

    2015-12-01

    Full Text Available In the paper, analysis of multi-region fuzzy logic controller with local PID controllers for steam generator of pressurized water reactor (PWR working in wide range of thermal power changes is presented. The U-tube steam generator has a nonlinear dynamics depending on thermal power transferred from coolant of the primary loop of the PWR plant. Control of water level in the steam generator conducted by a traditional PID controller which is designed for nominal power level of the nuclear reactor operates insufficiently well in wide range of operational conditions, especially at the low thermal power level. Thus the steam generator is often controlled manually by operators. Incorrect water level in the steam generator may lead to accidental shutdown of the nuclear reactor and consequently financial losses. In the paper a comparison of proposed multi region fuzzy logic controller and traditional PID controllers designed only for nominal condition is presented. The gains of the local PID controllers have been derived by solving appropriate optimization tasks with the cost function in a form of integrated squared error (ISE criterion. In both cases, a model of steam generator which is readily available in literature was used for control algorithms synthesis purposes. The proposed multi-region fuzzy logic controller and traditional PID controller were subjected to broad-based simulation tests in rapid prototyping software - Matlab/Simulink. These tests proved the advantage of multi-region fuzzy logic controller with local PID controllers over its traditional counterpart.

  3. Serotonergic Hyperactivity as a Potential Factor in Developmental, Acquired and Drug-Induced Synesthesia

    Directory of Open Access Journals (Sweden)

    Berit eBrogaard

    2013-10-01

    Full Text Available Though synesthesia research has seen a huge growth in recent decades, and tremendous progress has been made in terms of understanding the mechanism and cause of synesthesia, we are still left mostly in the dark when it comes to the mechanistic commonalities (if any among developmental, acquired and drug-induced synesthesia. We know that many forms of synesthesia involve aberrant structural or functional brain connectivity. Proposed mechanisms include direct projection and disinhibited feedback mechanisms, in which information from two otherwise structurally or functionally separate brain regions mix. We also know that synesthesia sometimes runs in families. However, it is unclear what causes its onset. Studies of psychedelic drugs, such as psilocybin, LSD and mescaline, reveal that exposure to these drugs can induce synesthesia. One neurotransmitter suspected to be central to the perceptual changes is serotonin. Excessive serotonin in the brain may cause many of the characteristics of psychedelic intoxication. Excessive serotonin levels may also play a role in synesthesia acquired after brain injury. In brain injury sudden cell death floods local brain regions with serotonin and glutamate. This neurotransmitter flooding could perhaps result in unusual feature binding. Finally, developmental synesthesia that occurs in individuals with autism may be a result of alterations in the serotonergic system, leading to a blockage of regular gating mechanisms. I conclude on these grounds that one commonality among at least some cases of acquired, developmental and drug-induced synesthesia may be the presence of excessive levels of serotonin, which increases the excitability and connectedness of sensory brain regions.

  4. Serotonergic hyperactivity as a potential factor in developmental, acquired and drug-induced synesthesia.

    Science.gov (United States)

    Brogaard, Berit

    2013-01-01

    Though synesthesia research has seen a huge growth in recent decades, and tremendous progress has been made in terms of understanding the mechanism and cause of synesthesia, we are still left mostly in the dark when it comes to the mechanistic commonalities (if any) among developmental, acquired and drug-induced synesthesia. We know that many forms of synesthesia involve aberrant structural or functional brain connectivity. Proposed mechanisms include direct projection and disinhibited feedback mechanisms, in which information from two otherwise structurally or functionally separate brain regions mix. We also know that synesthesia sometimes runs in families. However, it is unclear what causes its onset. Studies of psychedelic drugs, such as psilocybin, LSD and mescaline, reveal that exposure to these drugs can induce synesthesia. One neurotransmitter suspected to be central to the perceptual changes is serotonin. Excessive serotonin in the brain may cause many of the characteristics of psychedelic intoxication. Excessive serotonin levels may also play a role in synesthesia acquired after brain injury. In brain injury sudden cell death floods local brain regions with serotonin and glutamate. This neurotransmitter flooding could perhaps result in unusual feature binding. Finally, developmental synesthesia that occurs in individuals with autism may be a result of alterations in the serotonergic system, leading to a blockage of regular gating mechanisms. I conclude on these grounds that one commonality among at least some cases of acquired, developmental and drug-induced synesthesia may be the presence of excessive levels of serotonin, which increases the excitability and connectedness of sensory brain regions.

  5. Multiple independent origins of mitochondrial control region duplications in the order Psittaciformes

    Science.gov (United States)

    Schirtzinger, Erin E.; Tavares, Erika S.; Gonzales, Lauren A.; Eberhard, Jessica R.; Miyaki, Cristina Y.; Sanchez, Juan J.; Hernandez, Alexis; Müeller, Heinrich; Graves, Gary R.; Fleischer, Robert C.; Wright, Timothy F.

    2012-01-01

    Mitochondrial genomes are generally thought to be under selection for compactness, due to their small size, consistent gene content, and a lack of introns or intergenic spacers. As more animal mitochondrial genomes are fully sequenced, rearrangements and partial duplications are being identified with increasing frequency, particularly in birds (Class Aves). In this study, we investigate the evolutionary history of mitochondrial control region states within the avian order Psittaciformes (parrots and cockatoos). To this aim, we reconstructed a comprehensive multi-locus phylogeny of parrots, used PCR of three diagnostic fragments to classify the mitochondrial control region state as single or duplicated, and mapped these states onto the phylogeny. We further sequenced 44 selected species to validate these inferences of control region state. Ancestral state reconstruction using a range of weighting schemes identified six independent origins of mitochondrial control region duplications within Psittaciformes. Analysis of sequence data showed that varying levels of mitochondrial gene and tRNA homology and degradation were present within a given clade exhibiting duplications. Levels of divergence between control regions within an individual varied from 0–10.9% with the differences occurring mainly between 51 and 225 nucleotides 3′ of the goose hairpin in domain I. Further investigations into the fates of duplicated mitochondrial genes, the potential costs and benefits of having a second control region, and the complex relationship between evolutionary rates, selection, and time since duplication are needed to fully explain these patterns in the mitochondrial genome. PMID:22543055

  6. Association of genetic variations in the mitochondrial DNA control region with presbycusis

    Directory of Open Access Journals (Sweden)

    Falah M

    2017-03-01

    Full Text Available Masoumeh Falah,1 Mohammad Farhadi,1 Seyed Kamran Kamrava,1 Saeid Mahmoudian,1 Ahmad Daneshi,1 Maryam Balali,1 Alimohamad Asghari,2 Massoud Houshmand1,3 1ENT and Head & Neck Research Center and Department, Iran University of Medical Sciences, Tehran, Iran; 2Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran; 3Department of Medical Genetics, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran Background: The prominent role of mitochondria in the generation of reactive oxygen species, cell death, and energy production contributes to the importance of this organelle in the intracellular mechanism underlying the progression of the common sensory disorder of the elderly, presbycusis. Reduced mitochondrial DNA (mtDNA gene expression and coding region variation have frequently been reported as being associated with the development of presbycusis. The mtDNA control region regulates gene expression and replication of the genome of this organelle. To comprehensively understand of the role of mitochondria in the progression of presbycusis, we compared variations in the mtDNA control region between subjects with presbycusis and controls.Methods: A total of 58 presbycusis patients and 220 control subjects were enrolled in the study after examination by the otolaryngologist and audiology tests. Variations in the mtDNA control region were investigated by polymerase chain reaction and Sanger sequencing.Results: A total of 113 sequence variants were observed in mtDNA, and variants were detected in 100% of patients, with 84% located in hypervariable regions. The frequencies of the variants, 16,223 C>T, 16,311 T>C, 16,249 T>C, and 15,954 A>C, were significantly different between presbycusis and control subjects.Conclusion: The statistically significant difference in the frequencies of four nucleotide variants in the mtDNA control region of presbycusis patients and controls is in agreement with previous experimental

  7. Regional grey matter structure differences between transsexuals and healthy controls--a voxel based morphometry study.

    Science.gov (United States)

    Simon, Lajos; Kozák, Lajos R; Simon, Viktória; Czobor, Pál; Unoka, Zsolt; Szabó, Ádám; Csukly, Gábor

    2013-01-01

    Gender identity disorder (GID) refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individuals to better understand both the neuroanatomical features of transsexualism and the background of gender identity. So far, results are inconclusive but in general, transsexualism has been associated with a distinct neuroanatomical pattern. Studies mainly focused on male to female (MTF) transsexuals and there is scarcity of data acquired on female to male (FTM) transsexuals. Thus, our aim was to analyze structural MRI data with voxel based morphometry (VBM) obtained from both FTM and MTF transsexuals (n = 17) and compare them to the data of 18 age matched healthy control subjects (both males and females). We found differences in the regional grey matter (GM) structure of transsexual compared with control subjects, independent from their biological gender, in the cerebellum, the left angular gyrus and in the left inferior parietal lobule. Additionally, our findings showed that in several brain areas, regarding their GM volume, transsexual subjects did not differ significantly from controls sharing their gender identity but were different from those sharing their biological gender (areas in the left and right precentral gyri, the left postcentral gyrus, the left posterior cingulate, precuneus and calcarinus, the right cuneus, the right fusiform, lingual, middle and inferior occipital, and inferior temporal gyri). These results support the notion that structural brain differences exist between transsexual and healthy control subjects and that majority of these structural differences are dependent on the biological gender.

  8. Regional grey matter structure differences between transsexuals and healthy controls--a voxel based morphometry study.

    Directory of Open Access Journals (Sweden)

    Lajos Simon

    Full Text Available Gender identity disorder (GID refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individuals to better understand both the neuroanatomical features of transsexualism and the background of gender identity. So far, results are inconclusive but in general, transsexualism has been associated with a distinct neuroanatomical pattern. Studies mainly focused on male to female (MTF transsexuals and there is scarcity of data acquired on female to male (FTM transsexuals. Thus, our aim was to analyze structural MRI data with voxel based morphometry (VBM obtained from both FTM and MTF transsexuals (n = 17 and compare them to the data of 18 age matched healthy control subjects (both males and females. We found differences in the regional grey matter (GM structure of transsexual compared with control subjects, independent from their biological gender, in the cerebellum, the left angular gyrus and in the left inferior parietal lobule. Additionally, our findings showed that in several brain areas, regarding their GM volume, transsexual subjects did not differ significantly from controls sharing their gender identity but were different from those sharing their biological gender (areas in the left and right precentral gyri, the left postcentral gyrus, the left posterior cingulate, precuneus and calcarinus, the right cuneus, the right fusiform, lingual, middle and inferior occipital, and inferior temporal gyri. These results support the notion that structural brain differences exist between transsexual and healthy control subjects and that majority of these structural differences are dependent on the biological gender.

  9. Orifice design for the control of coupled region flow

    International Nuclear Information System (INIS)

    Atherton, R.; Spadaro, P.R.; Brummerhop, F.G.

    1975-01-01

    A fluid system arrangement for nuclear reactors is described comprising a triplate orifice apparatus which simultaneously controls core flow distribution, flow rate ratio between hydraulically coupled regions of the blanket and radial static pressure gradients entering and leaving the blanket fuel region. The design of the apparatus is based on the parameters of the diameter of the orifice holes, the friction factor, and expansion, contraction and turning pressure loss coefficients of the geometry of each orifice region. These above parameters are properly matched to provide the desired pressure drop, flow split and negligible cross flow at the interface of standard and power-flattened open lattice blanket regions. (U.S.)

  10. Region & Gateway Mapping

    OpenAIRE

    Schröter, Derik

    2007-01-01

    State-of-the-art robot mapping approaches are capable of acquiring impressively accurate 2D and 3D models of their environments. To the best of our knowledge, few of them represent structure or acquire models of task-relevant objects. In this work, a new approach to mapping of indoor environments is presented, in which the environment structure in terms of regions and gateways is automatically extracted, while the robot explores. Objects, both in 2D and 3D, are modeled explicitly in those map...

  11. Control Mechanism and Security Region for Intentional Islanding Transition

    DEFF Research Database (Denmark)

    Chen, Yu; Xu, Zhao; Østergaard, Jacob

    2009-01-01

    in the grid. The concept of Islanding Security Region (ISR) has been proposed as an organic composition of the developed control mechanism. The purpose of this control mechanism is to maintain the frequency stability and eventually the security of power supply to the customers, by utilizing resources from...... generation and demand sides. The control mechanism can be extended to consider the distributed generations like wind power and other innovative technologies such as the Demand as Frequency controlled Reserve (DFR) technique in the future....

  12. System Acquires Data On Reactivities Of Foams

    Science.gov (United States)

    Walls, Joe T.

    1994-01-01

    Data-acquisition and -plotting system, called DAPS(TM), developed enabling accurate and objective determination of physical properties related to reactivities of polyurethane and polyisocyanurate foams. Automated, computer-controlled test apparatus that acquires data on rates of rise, rise profiles, exothermic temperatures, and internal pressures of foams prepared from both manual and machine-mixed batches. Data used to determine minute differences between reaction kinetics and exothermic profiles of foam formulations, properties of end products which are statistically undifferentiated.

  13. A preliminary report of 99Tcm-ECD brain SPECT imaging in patients with acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    Xu Hao; Tong Yuwei; Luo Jinxiang; Chen Jian; Wu Qiulian

    2001-01-01

    Objective: To investigate the changes of regional cerebral blood flow (rCBF) in patients with acquired immunodeficiency syndrome (AIDS). Methods: 99 Tc m -ECD brain SPECT imaging was performed on 5 patients with AIDS and 16 sex- and age-matched normal controls. The rCBF percentages compared to the cerebellum were calculated using a semi-quantitative processing software. Results: Hypo-perfusions in the right and left frontal, temporal, parietal lobe, basal ganglia and left thalamus were seen in 1 patient with dementia. Hypo-perfusions in the right and left frontal and temporal lobe were seen in 4 patients without dementia. The rCBF in the right and left frontal, temporal, parietal lobe, basal ganglia and thalamus, straight gyri and pons decreased significantly in patients with AIDS than those of the control subjects (P < 0.01). Conclusion: There is reduced cortico-subcortical rCBF in patients with AIDS

  14. Acquired ectropion uveae and secondary glaucoma due to trauma: report of 3 cases.

    Science.gov (United States)

    Markovic, Vujica; Vukovic, Dragan; Radosavljevic, Aleksandra; Marjanovic, Ivan

    2017-01-19

    To investigate the possible association between acquired ectropion uveae and blunt trauma to the eye. We present 3 cases of acquired ectropion uveae that occurred after blunt trauma to the eye. There are no previously published data on possible association of these conditions. A retrospective review was conducted of patients with ectropion uveae and eye injury at University Eye Hospital over a 10-year period (2006-2016). We analyzed medical records and clinical findings. Three eyes of 3 male patients with ocular trauma and ectropion uveae, ages 71, 68, and 5 years, were reviewed. The period between the eye injury and the diagnosis of ectropion uveae ranged from 10 to 36 months. All 3 eyes developed clinical evidence of secondary glaucoma with moderately to severely elevated intraocular pressure (IOP) (ranging from 29 to 48 mm Hg). Surgical treatment (trabeculectomy) was needed in 2 cases in order to control secondary glaucoma and conservative treatment was sufficient in 1 case. Mean patient follow-up was 19.3 ± 4.6 months. Trauma can be considered as a cause of acquired ectropion uveae. Acquired ectropion uveae following eye trauma may be associated with significant increase in IOP. All patients in our series had secondary glaucoma and 2 of 3 required surgical treatment for IOP control.

  15. Risk factors associated with the community-acquired colonization of extended-spectrum beta-lactamase (ESBL positive Escherichia Coli. an exploratory case-control study.

    Directory of Open Access Journals (Sweden)

    Rasmus Leistner

    Full Text Available BACKGROUND: The number of extended-spectrum beta-lactamase (ESBL positive (+ Escherichia coli is increasing worldwide. In contrast with many other multidrug-resistant bacteria, it is suspected that they predominantly spread within the community. The objective of this study was to assess factors associated with community-acquired colonization of ESBL (+ E. coli. METHODS: We performed a matched case-control study at the Charité University Hospital Berlin between May 2011 and January 2012. Cases were defined as patients colonized with community-acquired ESBL (+ E. coli identified <72 h after hospital admission. Controls were patients that carried no ESBL-positive bacteria but an ESBL-negative E.coli identified <72 h after hospital admission. Two controls per case were chosen from potential controls according to admission date. Case and control patients completed a questionnaire assessing nutritional habits, travel habits, household situation and language most commonly spoken at home (mother tongue. An additional rectal swab was obtained together with the questionnaire to verify colonization status. Genotypes of ESBL (+ E. coli strains were determined by PCR and sequencing. Risk factors associated with ESBL (+ E. coli colonization were analyzed by a multivariable conditional logistic regression analysis. RESULTS: We analyzed 85 cases and 170 controls, respectively. In the multivariable analysis, speaking an Asian language most commonly at home (OR = 13.4, CI 95% 3.3-53.8; p<0.001 and frequently eating pork (≥ 3 meals per week showed to be independently associated with ESBL colonization (OR = 3.5, CI 95% 1.8-6.6; p<0.001. The most common ESBL genotypes were CTX-M-1 with 44% (n = 37, CTX-M-15 with 28% (n = 24 and CTX-M-14 with 13% (n = 11. CONCLUSION: An Asian mother tongue and frequently consuming certain types of meat like pork can be independently associated with the colonization of ESBL-positive bacteria. We found neither frequent consumption

  16. Development and Evaluation of a Control System for Regional Traffic Management

    Directory of Open Access Journals (Sweden)

    John L. McLin

    2011-01-01

    Full Text Available Traffic congestion is a worsening problem in metropolitan areas which will require integrated regional traffic control systems to improve traffic conditions. This paper presents a regional traffic control system which can detect incident conditions and provide integrated traffic management during nonrecurrent congestion events. The system combines advanced artificial intelligence techniques with a traffic performance model based on HCM equations. Preliminary evaluation of the control system using traffic microsimulation demonstrates that it has the potential to improve system conditions during traffic incidents. In addition, several enhancements were identified which will make the system more robust in a real traffic control setting. An assessment of the control system elements indicates that there are no substantial technical barriers in implementing this system in a large traffic network.

  17. Community-acquired pneumonia.

    Science.gov (United States)

    Falguera, M; Ramírez, M F

    2015-11-01

    This article not only reviews the essential aspects of community-acquired pneumonia for daily clinical practice, but also highlights the controversial issues and provides the newest available information. Community-acquired pneumonia is considered in a broad sense, without excluding certain variants that, in recent years, a number of authors have managed to delineate, such as healthcare-associated pneumonia. The latter form is nothing more than the same disease that affects more frail patients, with a greater number of risk factors, both sharing an overall common approach. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  18. Adaptive Control of a Utility-Scale Wind Turbine Operating in Region 3

    Science.gov (United States)

    Frost, Susan A.; Balas, Mark J.; Wright, Alan D.

    2009-01-01

    Adaptive control techniques are well suited to nonlinear applications, such as wind turbines, which are difficult to accurately model and which have effects from poorly known operating environments. The turbulent and unpredictable conditions in which wind turbines operate create many challenges for their operation. In this paper, we design an adaptive collective pitch controller for a high-fidelity simulation of a utility scale, variable-speed horizontal axis wind turbine. The objective of the adaptive pitch controller in Region 3 is to regulate generator speed and reject step disturbances. The control objective is accomplished by collectively pitching the turbine blades. We use an extension of the Direct Model Reference Adaptive Control (DMRAC) approach to track a reference point and to reject persistent disturbances. The turbine simulation models the Controls Advanced Research Turbine (CART) of the National Renewable Energy Laboratory in Golden, Colorado. The CART is a utility-scale wind turbine which has a well-developed and extensively verified simulator. The adaptive collective pitch controller for Region 3 was compared in simulations with a bas celliansesical Proportional Integrator (PI) collective pitch controller. In the simulations, the adaptive pitch controller showed improved speed regulation in Region 3 when compared with the baseline PI pitch controller and it demonstrated robustness to modeling errors.

  19. A reliable approach to the closure of large acquired midline defects of the back

    International Nuclear Information System (INIS)

    Casas, L.A.; Lewis, V.L. Jr.

    1989-01-01

    A systematic regionalized approach for the reconstruction of acquired thoracic and lumbar midline defects of the back is described. Twenty-three patients with wounds resulting from pressure necrosis, radiation injury, and postoperative wound infection and dehiscence were successfully reconstructed. The latissimus dorsi, trapezius, gluteus maximus, and paraspinous muscles are utilized individually or in combination as advancement, rotation, island, unipedicle, turnover, or bipedicle flaps. All flaps are designed so that their vascular pedicles are out of the field of injury. After thorough debridement, large, deep wounds are closed with two layers of muscle, while smaller, more superficial wounds are reconstructed with one layer. The trapezius muscle is utilized in the high thoracic area for the deep wound layer, while the paraspinous muscle is used for this layer in the thoracic and lumbar regions. Superficial layer and small wounds in the high thoracic area are reconstructed with either latissimus dorsi or trapezius muscle. Corresponding wounds in the thoracic and lumbar areas are closed with latissimus dorsi muscle alone or in combination with gluteus maximus muscle. The rationale for systematic regionalized reconstruction of acquired midline back wounds is described

  20. Regionally differentiated air pollution control regulations in the installation-related emission control law of the Federal Republic of Germany

    International Nuclear Information System (INIS)

    Buettner, T.W.

    1992-01-01

    The volume treats an issue from the boundary zone between environmental law and environmental economics, namely the regionalization of air pollution control standards in installation-related emission control law. In order to examine the question of whether this proposal, which originates in the field of environmental economics, can be adopted and is purposeful, the author initially performs a complete inventorization of applicable norms, this covering emission control law, the law of regional planning, and the provisions of international law. This status quo is then reviewed using conformity and optimization criteria developed by the political sciences. The assessment comes to the conclusion that the introduction of regionally differentiated air pollution control standards is not desirable. The author further submits proposals for the streamlining of the law of installation-related air pollution control in the Federal Republic of Germany. (orig.) [de

  1. Fault-Tolerant Region-Based Control of an Underwater Vehicle with Kinematically Redundant Thrusters

    Directory of Open Access Journals (Sweden)

    Zool H. Ismail

    2014-01-01

    Full Text Available This paper presents a new control approach for an underwater vehicle with a kinematically redundant thruster system. This control scheme is derived based on a fault-tolerant decomposition for thruster force allocation and a region control scheme for the tracking objective. Given a redundant thruster system, that is, six or more pairs of thrusters are used, the proposed redundancy resolution and region control scheme determine the number of thruster faults, as well as providing the reference thruster forces in order to keep the underwater vehicle within the desired region. The stability of the presented control law is proven in the sense of a Lyapunov function. Numerical simulations are performed with an omnidirectional underwater vehicle and the results of the proposed scheme illustrate the effectiveness in terms of optimizing the thruster forces.

  2. 40 CFR 81.55 - Northeast Pennsylvania-Upper Delaware Valley Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Pennsylvania-Upper Delaware... Designation of Air Quality Control Regions § 81.55 Northeast Pennsylvania-Upper Delaware Valley Interstate Air Quality Control Region. The Northeast Pennsylvania-Upper Delaware Valley Interstate Air Quality Control...

  3. Well-control co-ops for regional responses

    International Nuclear Information System (INIS)

    Abel, L.W.; Winchester, J.

    1996-01-01

    Oilfield exploration and production companies worldwide can benefit economically and in many other ways by participating in well-control cooperatives rather than operating alone and reacting to well control (WC) events by creating one-off equipment to respond to the event. The authors have presented details of a proposed co-op in this paper. The cost to maintain a full complement of WC equipment and retain trained personnel in a given region is prohibitive for a single company; however, cost becomes reasonable when resources are shared among an operator base of co-operating companies. Each individual operator receives the full benefit of having strong WC event response capability while paying only a portion of the cost

  4. 48 CFR 1845.502-70 - Contractor-acquired property.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Contractor-acquired... Possession of Contractors 1845.502-70 Contractor-acquired property. All contractor-acquired property must be... contractor-acquired. (2) Submission of DD Form 1419, DOD Industrial Plant Requisition, or equivalent format...

  5. 76 FR 6136 - Notice of Proposals To Engage in Permissible Nonbanking Activities or To Acquire Companies That...

    Science.gov (United States)

    2011-02-03

    ...: 1. Hana Financial Group Inc., Seoul, Korea; to acquire a controlling interest in Korea Exchange Bank, Seoul, Korea, and thereby indirectly acquire voting shares of KEB Financial Corp., New York, New York... FEDERAL RESERVE SYSTEM Notice of Proposals To Engage in Permissible Nonbanking Activities or To...

  6. Acquiring taste in home economics?

    DEFF Research Database (Denmark)

    Stenbak Larsen, Christian

    Objective: To explore how home economics was taught in Denmark before the recent Danish school reform, which also revised the objectives and content of home economics, naming it Food Knowledge (Madkundskab) Methods: Participant observation was done in home economic lessons in two case schools...... appreciated by the group of boys, and others again learned to stick with their idiosyncrasies when pressured by the teacher. Conclusions: Children were acquiring taste in the home economic lessons, but not only the kind of tastes that the teacher had planned for. This leads to reflections on the very complex...... process of taste acquiring and to a call for further research into taste acquiring in complex real life contexts as home economics lessons....

  7. Acquired bleeding disorders

    African Journals Online (AJOL)

    B one marrow aplasia ... Laboratory approach to a suspected acquired bleeding disorder. (LER = leuko- .... lymphocytic leukaemia, and lymphoma). ... cells), a bone marrow aspirate and trephine biopsy (BMAT) is not ..... transplantation.

  8. Toward immunogenetic studies of amphibian chytridiomycosis: Linking innate and acquired immunity

    Science.gov (United States)

    Richmond, J.Q.; Savage, Anna E.; Zamudio, Kelly R.; Rosenblum, E.B.

    2009-01-01

    Recent declines in amphibian diversity and abundance have contributed significantly to the global loss of biodiversity. The fungal disease chytridiomycosis is widely considered to be a primary cause of these declines, yet the critical question of why amphibian species differ in susceptibility remains unanswered. Considerable evidence links environmental conditions and interspecific variability of the innate immune system to differential infection responses, but other sources of individual, population, or species-typical variation may also be important. In this article we review the preliminary evidence supporting a role for acquired immune defenses against chytridiomycosis, and advocate for targeted investigation of genes controlling acquired responses, as well as those that functionally bridge the innate and acquired immune systems. Immunogenetic data promise to answer key questions about chytridiomycosis susceptibility and host-pathogen coevolution, and will draw much needed attention to the importance of considering evolutionary processes in amphibian conservation management and practice. ?? 2009 by American Institute of Biological Sciences.

  9. Local-regional control in breast cancer patients with a possible genetic predisposition

    International Nuclear Information System (INIS)

    Freedman, Laura M.; Buchholz, Thomas A.; Thames, Howard D.; Strom, Eric A.; McNeese, Marsha D.; Hortobagyi, Gabriel N.; Singletary, S. Eva; Heaton, Keith M.; Hunt, Kelly K.

    2000-01-01

    Purpose: Local control rates for breast cancer in genetically predisposed women are poorly defined. Because such a small percentage of breast cancer patients have proven germline mutations, surrogates, such as a family history for breast cancer, have been used to examine this issue. The purpose of this study was to evaluate local-regional control following breast conservation therapy (BCT) in patients with bilateral breast cancer and a breast cancer family history. Methods and Materials: We retrospectively reviewed records of all 58 patients with bilateral breast cancer and a breast cancer family history treated in our institution between 1959 and 1998. The primary surgical treatment was a breast-conserving procedure in 55 of the 116 breast cancer cases and a mastectomy in 61. The median follow-up was 68 months for the BCT patients and 57 months for the mastectomy-treated patients. Results: Eight local-regional recurrences occurred in the 55 cases treated with BCT, resulting in 5- and 10-year actuarial local-regional control rates of 86% and 76%, respectively. In the nine cases that did not receive radiation as a component of their BCT, four developed local-regional recurrences (5- and 10-year local-regional control rates of BCT without radiation: 49% and 49%). The 5- and 10-year actuarial local-regional control rates for the 46 cases treated with BCT and radiation were 94% and 83%, respectively. In these cases, there were two late local recurrences, developing at 8 years and 9 years, respectively. A log rank comparison of radiation versus no radiation actuarial data was significant at p = 0.009. In the cases treated with BCT, a multivariate analysis of radiation use, patient age, degree of family history, margin status, and stage revealed that only the use of radiation was associated with improved local control (Cox regression analysis p = 0.021). The 10-year actuarial rates of local-regional control following mastectomy with and without radiation were 91% and 89

  10. Advanced fiber tracking in early acquired brain injury causing cerebral palsy.

    Science.gov (United States)

    Lennartsson, F; Holmström, L; Eliasson, A-C; Flodmark, O; Forssberg, H; Tournier, J-D; Vollmer, B

    2015-01-01

    Diffusion-weighted MR imaging and fiber tractography can be used to investigate alterations in white matter tracts in patients with early acquired brain lesions and cerebral palsy. Most existing studies have used diffusion tensor tractography, which is limited in areas of complex fiber structures or pathologic processes. We explored a combined normalization and probabilistic fiber-tracking method for more realistic fiber tractography in this patient group. This cross-sectional study included 17 children with unilateral cerebral palsy and 24 typically developing controls. DWI data were collected at 1.5T (45 directions, b=1000 s/mm(2)). Regions of interest were defined on a study-specific fractional anisotropy template and mapped onto subjects for fiber tracking. Probabilistic fiber tracking of the corticospinal tract and thalamic projections to the somatosensory cortex was performed by using constrained spherical deconvolution. Tracts were qualitatively assessed, and DTI parameters were extracted close to and distant from lesions and compared between groups. The corticospinal tract and thalamic projections to the somatosensory cortex were realistically reconstructed in both groups. Structural changes to tracts were seen in the cerebral palsy group and included splits, dislocations, compaction of the tracts, or failure to delineate the tract and were associated with underlying pathology seen on conventional MR imaging. Comparisons of DTI parameters indicated primary and secondary neurodegeneration along the corticospinal tract. Corticospinal tract and thalamic projections to the somatosensory cortex showed dissimilarities in both structural changes and DTI parameters. Our proposed method offers a sensitive means to explore alterations in WM tracts to further understand pathophysiologic changes following early acquired brain injury. © 2015 by American Journal of Neuroradiology.

  11. Mitochondrial DNA control region variability in wild boars from west Balkans

    Directory of Open Access Journals (Sweden)

    Đan Mihajla

    2013-01-01

    Full Text Available The wild boar (Sus scrofa is one of most abundant game species in hunting areas of Balkan region. The large fraction of pre-glacial genetic diversity in wild boar populations from the Balkans was addressed due to high proportion of unique mtDNA haplotypes found in Greece, indicating Balkan as main refugial area for wild boars. The aim of the present study is to characterize mitochondrial DNA control region variability in wild boars from different areas in the West Balkan region, in order to evaluate level of genetic variability, to detect unique haplotypes and to infer possible structuring. The total number of 163 individuals from different sampling localities were included in the study. A fragment of the mtDNA control region was amplified and sequenced by standard procedures. Population genetic analyses were performed using several computer packages: BioEdit, ARLEQUIN 3.5.1.2., Network 4.6.0.0 and MEGA5. Eleven different haplotypes were identified and haplotype diversity was 0.676, nucleotide diversity 0.0026, and the average number of nucleotide differences (k 1.169. The mismatch distribution and neutrality tests indicated the expansion of the all populations. It is shown that high level of genetic diversity is present in the wild boars from the West Balkan region and we have managed to detect regional unique haplotypes in high frequency. Genetic diversity differences have been found in regional wild boar groups, clustering them in two main clusters, but further speculations on the reasons for the observed clustering are prevented due to restricted informativness of the single locus marker. Obtained knowledge of genetic variation in the wild boar may be relevant for improving knowledge of the phylogeny and phylogeography of the wild boars, but as well as for hunting societies and responsible authorities for the effective control of wild boar populations.

  12. Region-Urbanicity Differences in Locus of Control: Social Disadvantage, Structure, or Cultural Exceptionalism?

    Science.gov (United States)

    Shifrer, Dara; Sutton, April

    2014-11-01

    People with internal rather than external locus of control experience better outcomes in multiple domains. Previous studies on spatial differences in control within America only focused on the South, relied on aggregate level data or historical evidence, or did not account for other confounding regional distinctions (such as variation in urbanicity). Using data from the National Education Longitudinal Study, we find differences in adolescents' loci of control depending on their region and urbanicity are largely attributable to differences in their social background, and only minimally to structural differences (i.e., differences in the qualities of adolescents' schools). Differences that persist net of differences across adolescents and their schools suggest the less internal control of rural Southern adolescents, and the more internal control of rural and urban Northeastern adolescents, may be due to cultural distinctions in those areas. Results indicate region is more closely associated than urbanicity with differences in locus of control, with Western and Northeastern cultures seemingly fostering more internal control than Midwestern and Southern cultures. These findings contribute to research on spatial variation in a variety of psychological traits.

  13. REGIONAL DRAINWATER MANAGEMENT: SOURCE CONTROL, AGROFORESTRY, AND EVAPORATION PONDS

    OpenAIRE

    Posnikoff, Judith F.; Knapp, Keith C.

    1996-01-01

    Source control is one way to address salinity and drainage problems in irrigated agriculture, and reuse of drainage flows on salt-tolerant crops or trees in agroforestry production is another. A regional model of agricultural production with drainwater reuse and disposal is developed. Deep percolation flows are controlled through choice of crop areas, irrigation systems, and applied-water quantities. Crop drainwater may by reused in agroforestry production, and residual emissions are disposed...

  14. The north-east Baffin Bay region, offshore Greenland - a new frontier petroleum exploration region

    Energy Technology Data Exchange (ETDEWEB)

    Gregersen, U. (Geological Survey of Denmark and Greenland, Copenhagen (Denmark))

    2008-07-15

    In recent years the Arctic has come into focus for hydrocarbon exploration, and areas offshore both West and East Greenland have been evaluated as promising frontier hydrocarbon provinces. Seven hydrocarbon exploration and exploitation licenses were awarded in 2007-2008 offshore the Disko-Nuussuaq region, and two more have been awarded in the open-door region offshore south-western Greenland. In 2007, an extensive amount of new seismic and aero-magnetic data was acquired by the TGS-NOPEC Geophysical Company in the north-eastern Baffin Bay region. Geophysical mapping has been initiated by the Geological Survey of Denmark and Greenland (GEUS) in the Melville Bugt region offshore North-West Greenland with the purpose of evaluating the hydrocarbon prospectivity. Initial interpretation of seismic and gravity data suggests the presence of deep sedimentary basins separated by structural highs. Geological information on source rock, reservoir rock and seal intervals from surrounding regions suggest that the Melville Bugt region is likely to have a significant petroleum potential. The study is based on public domain magnetic and gravity data, and all proprietary and public 2-D seismic data acquired before 2003. Seismic horizons from the 'seismic basement' to 'base Quaternary' are being interpreted regionally. Based on the seismic interpretation, a structural element map, depth-structure maps and isopach maps will be produced in order to assess the prospectivity of the Melville Bugt region. (au)

  15. Somatically acquired structural genetic differences

    DEFF Research Database (Denmark)

    Magaard Koldby, Kristina; Nygaard, Marianne; Christensen, Kaare

    2016-01-01

    Structural genetic variants like copy number variants (CNVs) comprise a large part of human genetic variation and may be inherited as well as somatically acquired. Recent studies have reported the presence of somatically acquired structural variants in the human genome and it has been suggested t...... with age.European Journal of Human Genetics advance online publication, 20 April 2016; doi:10.1038/ejhg.2016.34....

  16. [Synchronous playing and acquiring of heart sounds and electrocardiogram based on labVIEW].

    Science.gov (United States)

    Dan, Chunmei; He, Wei; Zhou, Jing; Que, Xiaosheng

    2008-12-01

    In this paper is described a comprehensive system, which can acquire heart sounds and electrocardiogram (ECG) in parallel, synchronize the display; and play of heart sound and make auscultation and check phonocardiogram to tie in. The hardware system with C8051F340 as the core acquires the heart sound and ECG synchronously, and then sends them to indicators, respectively. Heart sounds are displayed and played simultaneously by controlling the moment of writing to indicator and sound output device. In clinical testing, heart sounds can be successfully located with ECG and real-time played.

  17. Integrated Variable Speed Limits Control and Ramp Metering for Bottleneck Regions on Freeway

    Directory of Open Access Journals (Sweden)

    Ming-hui Ma

    2015-01-01

    Full Text Available To enhance the efficiency of the existing freeway system and therefore to mitigate traffic congestion and related problems on the freeway mainline lane-drop bottleneck region, the advanced strategy for bottleneck control is essential. This paper proposes a method that integrates variable speed limits and ramp metering for freeway bottleneck region control to relieve the chaos in bottleneck region. To this end, based on the analyses of spatial-temporal patterns of traffic flow, a macroscopic traffic flow model is extended to describe the traffic flow operating characteristic by considering the impacts of variable speed limits in mainstream bottleneck region. In addition, to achieve the goal of balancing the priority of the vehicles on mainline and on-ramp, increasing capacity, and reducing travel delay on bottleneck region, an improved control model, as well as an advanced control strategy that integrates variable speed limits and ramp metering, is developed. The proposed method is tested in simulation for a real freeway infrastructure feed and calibrates real traffic variables. The results demonstrate that the proposed method can substantially improve the traffic flow efficiency of mainline and on-ramp and enhance the quality of traffic flow at the investigated freeway mainline bottleneck.

  18. Acquired ventricular septal defect due to infective endocarditis

    Directory of Open Access Journals (Sweden)

    Randi E Durden

    2018-01-01

    Full Text Available Acquired intracardiac left-to-right shunts are rare occurrences. Chest trauma and myocardial infection are well-known causes of acquired ventricular septal defect (VSD. There have been several case reports describing left ventricle to right atrium shunt after infective endocarditis (IE. We present here a patient found to have an acquired VSD secondary to IE of the aortic and tricuspid valves in the setting of a known bicuspid aortic valve. This is the first case reported of acquired VSD in a pediatric patient in the setting of IE along with literature review of acquired left-to-right shunts.

  19. Improved local and regional control with radiotherapy for Merkel cell carcinoma of the head and neck.

    Science.gov (United States)

    Strom, Tobin; Naghavi, Arash O; Messina, Jane L; Kim, Sungjune; Torres-Roca, Javier F; Russell, Jeffery; Sondak, Vernon K; Padhya, Tapan A; Trotti, Andy M; Caudell, Jimmy J; Harrison, Louis B

    2017-01-01

    We hypothesized that radiotherapy (RT) would improve both local and regional control with Merkel cell carcinoma of the head and neck. A single-institution institutional review board-approved study was performed including 113 patients with nonmetastatic Merkel cell carcinoma of the head and neck. Postoperative RT was delivered to the primary tumor bed (71.7% cases) ± draining lymphatics (33.3% RT cases). Postoperative local RT was associated with improved local control (3-year actuarial local control 89.4% vs 68.1%; p = .005; Cox hazard ratio [HR] 0.18; 95% confidence interval [CI] = 0.06-0.55; p = .002). Similarly, regional RT was associated with improved regional control (3-year actuarial regional control 95.0% vs 66.7%; p = .008; Cox HR = 0.09; 95% CI = 0.01-0.69; p = .02). Regional RT played an important role for both clinical node-negative patients (3-year regional control 100% vs 44.7%; p = .03) and clinical/pathological node-positive patients (3-year regional control 90.9% vs 55.6%; p = .047). Local RT was beneficial for all patients with Merkel cell carcinoma of the head and neck, whereas regional RT was beneficial for clinical node-negative and clinical/pathological node-positive patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 48-55, 2017. © 2016 Wiley Periodicals, Inc.

  20. COORDINATION IN MULTILEVEL NETWORK-CENTRIC CONTROL SYSTEMS OF REGIONAL SECURITY: APPROACH AND FORMAL MODEL

    Directory of Open Access Journals (Sweden)

    A. V. Masloboev

    2015-01-01

    Full Text Available The paper deals with development of methods and tools for mathematical and computer modeling of the multilevel network-centric control systems of regional security. This research is carried out under development strategy implementation of the Arctic zone of the Russian Federation and national safeguarding for the period before 2020 in the Murmansk region territory. Creation of unified interdepartmental multilevel computer-aided system is proposed intended for decision-making information support and socio-economic security monitoring of the Arctic regions of Russia. The distinctive features of the investigated system class are openness, self-organization, decentralization of management functions and decision-making, weak hierarchy in the decision-making circuit and goal generation capability inside itself. Research techniques include functional-target approach, mathematical apparatus of multilevel hierarchical system theory and principles of network-centric control of distributed systems with pro-active components and variable structure. The work considers network-centric management local decisions coordination problem-solving within the multilevel distributed systems intended for information support of regional security. The coordination problem-solving approach and problem formalization in the multilevel network-centric control systems of regional security have been proposed based on developed multilevel recurrent hierarchical model of regional socio-economic system complex security. The model provides coordination of regional security indexes, optimized by the different elements of multilevel control systems, subject to decentralized decision-making. The model specificity consists in application of functional-target technology and mathematical apparatus of multilevel hierarchical system theory for coordination procedures implementation of the network-centric management local decisions. The work-out and research results can find further

  1. Oceanic protists with different forms of acquired phototrophy display contrasting biogeographies and abundance.

    Science.gov (United States)

    Leles, S G; Mitra, A; Flynn, K J; Stoecker, D K; Hansen, P J; Calbet, A; McManus, G B; Sanders, R W; Caron, D A; Not, F; Hallegraeff, G M; Pitta, P; Raven, J A; Johnson, M D; Glibert, P M; Våge, S

    2017-08-16

    This first comprehensive analysis of the global biogeography of marine protistan plankton with acquired phototrophy shows these mixotrophic organisms to be ubiquitous and abundant; however, their biogeography differs markedly between different functional groups. These mixotrophs, lacking a constitutive capacity for photosynthesis (i.e. non-constitutive mixotrophs, NCMs), acquire their phototrophic potential through either integration of prey-plastids or through endosymbiotic associations with photosynthetic microbes. Analysis of field data reveals that 40-60% of plankton traditionally labelled as (non-phototrophic) microzooplankton are actually NCMs, employing acquired phototrophy in addition to phagotrophy. Specialist NCMs acquire chloroplasts or endosymbionts from specific prey, while generalist NCMs obtain chloroplasts from a variety of prey. These contrasting functional types of NCMs exhibit distinct seasonal and spatial global distribution patterns. Mixotrophs reliant on 'stolen' chloroplasts, controlled by prey diversity and abundance, dominate in high-biomass areas. Mixotrophs harbouring intact symbionts are present in all waters and dominate particularly in oligotrophic open ocean systems. The contrasting temporal and spatial patterns of distribution of different mixotroph functional types across the oceanic provinces, as revealed in this study, challenges traditional interpretations of marine food web structures. Mixotrophs with acquired phototrophy (NCMs) warrant greater recognition in marine research. © 2017 The Author(s).

  2. Amplitude Analysis and Modeling of Regional Phases in PNE Profiles in Northern Eurasia and Seismic Regionalization

    National Research Council Canada - National Science Library

    Morozov, Igor B; Li, Hongyan; Morozova, Elena; Duenow, Joel; Zheng, Haishan; Smithson, Scott B

    2006-01-01

    ... is necessary to use regional phases for nuclear test monitoring. Over the past decades, Russian scientists acquired a network of dense, linear, long range, three-component Deep Seismic Sounding (DSS...

  3. A controlled study of funding for human immunodeficiency virus/acquired immunodeficiency syndrome as resource capacity building in the health system in Rwanda.

    Science.gov (United States)

    Shepard, Donald S; Zeng, Wu; Amico, Peter; Rwiyereka, Angelique K; Avila-Figueroa, Carlos

    2012-05-01

    Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda.

  4. A reliable user authentication and key agreement scheme for Web-based Hospital-acquired Infection Surveillance Information System.

    Science.gov (United States)

    Wu, Zhen-Yu; Tseng, Yi-Ju; Chung, Yufang; Chen, Yee-Chun; Lai, Feipei

    2012-08-01

    With the rapid development of the Internet, both digitization and electronic orientation are required on various applications in the daily life. For hospital-acquired infection control, a Web-based Hospital-acquired Infection Surveillance System was implemented. Clinical data from different hospitals and systems were collected and analyzed. The hospital-acquired infection screening rules in this system utilized this information to detect different patterns of defined hospital-acquired infection. Moreover, these data were integrated into the user interface of a signal entry point to assist physicians and healthcare providers in making decisions. Based on Service-Oriented Architecture, web-service techniques which were suitable for integrating heterogeneous platforms, protocols, and applications, were used. In summary, this system simplifies the workflow of hospital infection control and improves the healthcare quality. However, it is probable for attackers to intercept the process of data transmission or access to the user interface. To tackle the illegal access and to prevent the information from being stolen during transmission over the insecure Internet, a password-based user authentication scheme is proposed for information integrity.

  5. Acquired Inventors’ Productivity after Horizontal Acquisition

    DEFF Research Database (Denmark)

    Colombo, Massimo G.; Moreira, Solon; Rabbiosi, Larissa

    Effective integration of the R&D functions of the acquired and acquiring firms is essential for knowledge recombination after acquisition. However, prior research suggests that the post-acquisition integration process often damages the inventive labor force. We argue that an examination of the mu...

  6. Effect of storage on radiation and antibiotic acquired stability in bacilli

    International Nuclear Information System (INIS)

    Tawfik, Z.S.

    1991-01-01

    The properties of two highly radioresistant bacterial strains namely B. laterosporous and B. firmus isolated, three years ago, from the water shielding the industrial Co-60 source of NCRRT Egypt were studied. The results showed that the studied isolates had lost their resistance to gamma irradiation as compared with their properties acquired at the time of isolation. The sensitivity test of these isolates to some antibiotics and sulpha drugs was also investigated, and was compared with tests performed on the same species isolated from tap water. The pronounced resistance of these isolates to some antibiotics acquired three years ago, had been lost by storage except for the case of the drug chemotrim. The results indicated that the acquired resistivity to both gamma irradiation and antibiotics due to the chronic exposure to gamma radiation is not stable. It is concluded that the genes controlling both phenomena, in the studied strains, fall into broad categories and the case might be a repair mechanism in the DNA during successive reproduction.2 fig., 2 tab

  7. Management of bleeding in acquired hemophilia A: results from the European Acquired Haemophilia (EACH2) Registry.

    Science.gov (United States)

    Baudo, Francesco; Collins, Peter; Huth-Kühne, Angela; Lévesque, Hervé; Marco, Pascual; Nemes, László; Pellegrini, Fabio; Tengborn, Lilian; Knoebl, Paul

    2012-07-05

    Acquired hemophilia A is a rare bleeding disorder caused by autoantibodies to coagulation FVIII. Bleeding episodes at presentation are spontaneous and severe in most cases. Optimal hemostatic therapy is controversial, and available data are from observational and retrospective studies only. The EACH2 registry, a multicenter, pan-European, Web-based database, reports current patient management. The aim was to assess the control of first bleeding episodes treated with a bypassing agent (rFVIIa or aPCC), FVIII, or DDAVP among 501 registered patients. Of 482 patients with one or more bleeding episodes, 144 (30%) received no treatment for bleeding; 31 were treated with symptomatic therapy only. Among 307 patients treated with a first-line hemostatic agent, 174 (56.7%) received rFVIIa, 63 (20.5%) aPCC, 56 (18.2%) FVIII, and 14 (4.6%) DDAVP. Bleeding was controlled in 269 of 338 (79.6%) patients treated with a first-line hemostatic agent or ancillary therapy alone. Propensity score matching was applied to allow unbiased comparison between treatment groups. Bleeding control was significantly higher in patients treated with bypassing agents versus FVIII/DDAVP (93.3% vs 68.3%; P = .003). Bleeding control was similar between rFVIIa and aPCC (93.0%; P = 1). Thrombotic events were reported in 3.6% of treated patients with a similar incidence between rFVIIa (2.9%) and aPCC (4.8%).

  8. Control of bootstrap current in the pedestal region of tokamaks

    Energy Technology Data Exchange (ETDEWEB)

    Shaing, K. C. [Institute for Space and Plasma Sciences, National Cheng Kung University, Tainan City 70101, Taiwan (China); Department of Engineering Physics, University of Wisconsin, Madison, Wisconsin 53796 (United States); Lai, A. L. [Institute for Space and Plasma Sciences, National Cheng Kung University, Tainan City 70101, Taiwan (China)

    2013-12-15

    The high confinement mode (H-mode) plasmas in the pedestal region of tokamaks are characterized by steep gradient of the radial electric field, and sonic poloidal U{sub p,m} flow that consists of poloidal components of the E×B flow and the plasma flow velocity that is parallel to the magnetic field B. Here, E is the electric field. The bootstrap current that is important for the equilibrium, and stability of the pedestal of H-mode plasmas is shown to have an expression different from that in the conventional theory. In the limit where ‖U{sub p,m}‖≫ 1, the bootstrap current is driven by the electron temperature gradient and inductive electric field fundamentally different from that in the conventional theory. The bootstrap current in the pedestal region can be controlled through manipulating U{sub p,m} and the gradient of the radial electric. This, in turn, can control plasma stability such as edge-localized modes. Quantitative evaluations of various coefficients are shown to illustrate that the bootstrap current remains finite when ‖U{sub p,m}‖ approaches infinite and to provide indications how to control the bootstrap current. Approximate analytic expressions for viscous coefficients that join results in the banana and plateau-Pfirsch-Schluter regimes are presented to facilitate bootstrap and neoclassical transport simulations in the pedestal region.

  9. Acquired intrathoracic kidney in thoracic kyphosis

    International Nuclear Information System (INIS)

    Murayama, Sadayuki; Kawashima, Akira; Ohuchida, Toshiyuki; Russell, W.J.

    1986-12-01

    Two cases of acquired intrathoracic kidney associated with thoracic kyphosis are reported, with emphasis on the radiographic manifestations. A search of the scientific literature disclosed that the acquired type of this abnormality is rare. The importance of recognizing this entity from a differential diagnostic standpoint is underscored. (author)

  10. Interleukin-2 and Interleukin-8 Gene Polymorphisms and Acquired Aplastic Anemia Risk in a Chinese Population.

    Science.gov (United States)

    Zhang, Xuejie; Lin, Shengyun; Yang, Yan; Rong, Liucheng; He, Guangsheng; He, Hailong; Xue, Yao; Fang, Yongjun; Wang, Yaping

    2017-01-01

    Cytokines IL-2 and IL-8 both participate in immune regulation. However, the relationship between polymorphisms in these two cytokines and the risk of acquired aplastic anemia (acquired AA) has not been explored. We selected five SNPs including rs11575812, rs2069772 and rs2069762 of IL-2, rs2227306 and rs2227543 of IL-8. SNaPshot genotyping was used to test the genotypes of IL-2 and IL-8 polymorphisms in a population of 101 acquired AA patients and 165 healthy controls. The rs2069762 G allele appeared to be a protective mutation, but no significant differences were found in other four SNPs. We also found that rs2069762 had an impact on the transcriptional regulation. It could be assumed that the rs2069762 polymorphism might reduce the risk of acquired aplastic anemia, while the remaining four SNPs might not contribute to susceptibility to acquired AA in a Chinese population. © 2017 The Author(s)Published by S. Karger AG, Basel.

  11. Regional economic integration in sub-Saharan Africa

    NARCIS (Netherlands)

    Konings, P.J.J.; Meilink, H.A.

    1998-01-01

    The issue of regional integration has acquired a new relevance and urgency in Africa due to wide-reaching national and global changes. African leaders' commitment to regional economic integration was clearly expressed during the June 1991 OAU summit meeting in Abuja, Nigeria. On that occasion, they

  12. And the Winner is – Acquired

    DEFF Research Database (Denmark)

    Henkel, Joachim; Rønde, Thomas; Wagner, Marcus

    value in case of success—that is, a more radical innovation. In the second stage, successful entrants bid to be acquired by the incumbent. We assume that entrants cannot survive on their own, so being acquired amounts to a ‘prize’ in a contest. We identify an equilibrium in which the incumbent chooses...

  13. Histopathology of dairy cows' hooves with signs of naturally acquired laminitis

    OpenAIRE

    Mendes, Heloisa M.F.; Casagrande, Fernando P.; Lima, Ingrid R.; Souza, Cairo H.; Gontijo, Lílian D'.; Alves, Geraldo E.S.; Vasconcelos, Anilton C.; Faleiros, Rafael R.

    2013-01-01

    The purpose of this study was to investigate histological changes in dairy cows' hooves with or without injuries from naturally acquired laminitis. Cull cows with no clinical signs of hoof abnormalities (G1, n=9) and those with macroscopic lesions associated with laminitis without (G2, n=23) or with lameness (G3, n=7) were used in the study. After slaughter, samples of dermo-epidermal junctions of sole, axial and dorsal regions of the hoof were obtained and histologically processed using HE a...

  14. Sleep spindle-related reactivation of category-specific cortical regions after learning face-scene associations

    DEFF Research Database (Denmark)

    Bergmann, Til O; Mölle, Matthias; Diedrichs, Jens

    2012-01-01

    Newly acquired declarative memory traces are believed to be reactivated during NonREM sleep to promote their hippocampo-neocortical transfer for long-term storage. Yet it remains a major challenge to unravel the underlying neuronal mechanisms. Using simultaneous electroencephalography (EEG......-coupled reactivation of brain regions representing the specific task stimuli was traced during subsequent NonREM sleep with EEG-informed fMRI. Relative to the control task, learning face-scene associations triggered a stronger combined activation of neocortical and hippocampal regions during subsequent sleep. Notably......) and functional magnetic resonance imaging (fMRI) recordings in humans, we show that sleep spindles play a key role in the reactivation of memory-related neocortical representations. On separate days, participants either learned face-scene associations or performed a visuomotor control task. Spindle...

  15. 7 CFR 1779.90 - Disposition of acquired property.

    Science.gov (United States)

    2010-01-01

    ... Disposition of acquired property. (a) General. When the lender acquires title to the collateral and the final... 7 Agriculture 12 2010-01-01 2010-01-01 false Disposition of acquired property. 1779.90 Section... develop a plan to fully protect the collateral, and the lender must dispose of the collateral without...

  16. Mortality predictors in community-acquired pneumonia | Tanimowo ...

    African Journals Online (AJOL)

    acquired pneumonia to themedicalwards of Ladoke Akintola University ofTeaching Hospital between Jan. 2003 andDec. 2005. The case notes of 65 patients admitted for community-acquired pneumoniawere studiedwith respect to their admission ...

  17. Risk factors associated with the community-acquired colonization of extended-spectrum beta-lactamase (ESBL) positive Escherichia Coli. an exploratory case-control study.

    Science.gov (United States)

    Leistner, Rasmus; Meyer, Elisabeth; Gastmeier, Petra; Pfeifer, Yvonne; Eller, Christoph; Dem, Petra; Schwab, Frank

    2013-01-01

    The number of extended-spectrum beta-lactamase (ESBL) positive (+) Escherichia coli is increasing worldwide. In contrast with many other multidrug-resistant bacteria, it is suspected that they predominantly spread within the community. The objective of this study was to assess factors associated with community-acquired colonization of ESBL (+) E. coli. We performed a matched case-control study at the Charité University Hospital Berlin between May 2011 and January 2012. Cases were defined as patients colonized with community-acquired ESBL (+) E. coli identified language most commonly spoken at home (mother tongue). An additional rectal swab was obtained together with the questionnaire to verify colonization status. Genotypes of ESBL (+) E. coli strains were determined by PCR and sequencing. Risk factors associated with ESBL (+) E. coli colonization were analyzed by a multivariable conditional logistic regression analysis. We analyzed 85 cases and 170 controls, respectively. In the multivariable analysis, speaking an Asian language most commonly at home (OR = 13.4, CI 95% 3.3-53.8; p<0.001) and frequently eating pork (≥ 3 meals per week) showed to be independently associated with ESBL colonization (OR = 3.5, CI 95% 1.8-6.6; p<0.001). The most common ESBL genotypes were CTX-M-1 with 44% (n = 37), CTX-M-15 with 28% (n = 24) and CTX-M-14 with 13% (n = 11). An Asian mother tongue and frequently consuming certain types of meat like pork can be independently associated with the colonization of ESBL-positive bacteria. We found neither frequent consumption of poultry nor previous use of antibiotics to be associated with ESBL colonization.

  18. The ketogenic diet is effective for refractory epilepsy associated with acquired structural epileptic encephalopathy.

    Science.gov (United States)

    Villaluz, Mel Michel; Lomax, Lysa Boissé; Jadhav, Trupti; Cross, J Helen; Scheffer, Ingrid E

    2018-07-01

    Ketogenic diet therapies have proven efficacy for refractory epilepsy. There are many reports of their use in the genetic developmental and epileptic encephalopathies; however, little attention has been paid as to whether the diet is also effective in individuals with an acquired structural aetiology. We observed remarkable efficacy of the diet in two patients with hypoxic-ischaemic encephalopathy. We then analysed our cases with refractory structural epilepsies of acquired origin to characterize their response to the ketogenic diet. The classical ketogenic diet was implemented with dietary ratios of 3:1 to 4.4:1. Seizure frequency at 1 month, 3 months, 6 months, 1 year, and 2 years was ascertained. A responder was defined as greater than 50% seizure reduction compared to baseline. Seven of the nine patients were responders at 3 months. Somewhat surprisingly we found that the ketogenic diet was effective in patients with a developmental and epileptic encephalopathy due to an acquired structural aetiology. This cohort may not be routinely considered for the ketogenic diet because of their structural and acquired, rather than genetic, basis. The ketogenic diet should be considered early in the management of patients with acquired structural encephalopathies as it can improve seizure control with the potential to improve developmental outcome. The ketogenic diet was effective in children with epilepsy associated with an acquired structural aetiology. © 2018 Mac Keith Press.

  19. Preschoolers Acquire General Knowledge by Sharing in Pretense

    Science.gov (United States)

    Sutherland, Shelbie L.; Friedman, Ori

    2012-01-01

    Children acquire general knowledge about many kinds of things, but there are few known means by which this knowledge is acquired. In this article, it is proposed that children acquire generic knowledge by sharing in pretend play. In Experiment 1, twenty-two 3- to 4-year-olds watched pretense in which a puppet represented a "nerp" (an unfamiliar…

  20. The F-Region Equatorial Ionospheric Electrodynamics Drifts ...

    African Journals Online (AJOL)

    The ionospheric plasma drift is one of the most essential parameters for understanding the dynamics of ionospheric F-region. F-region electromagnetic drifts are calculated for three seasonal conditions from ionosonde observations acquired during quiet period of a typical year of high and low solar activity at Ibadan (7.4oN, ...

  1. The impact of community-acquired pneumonia on the health-related quality-of-life in elderly.

    Science.gov (United States)

    Mangen, Marie-Josée J; Huijts, Susanne M; Bonten, Marc J M; de Wit, G Ardine

    2017-03-14

    The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period. In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i.e. diseased cohort) and 1145 unaffected persons (i.e. non-diseased cohort) matched to pneumonia cases on age, sex, and health status (EQ-5D-3L-index). Health-related quality-of-life was determined 1-2 weeks after hospital discharge/inclusion and 1, 6 and 12 months thereafter, using Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires. One-year quality-adjusted life years (QALY) were estimated for both diseased and non-diseased cohorts. Separate analyses were performed for pneumonia cases with and without radiologically confirmed community-acquired pneumonia. The one-year excess QALY loss attributed to community-acquired pneumonia was 0.13. Mortality in the post-discharge follow-up year was 8.4% in community-acquired pneumonia patients and 1.2% in non-diseased persons (p pneumonia patients, compared to non-diseased persons, but differences in health-related quality-of-life between radiologically confirmed and non-confirmed community-acquired pneumonia cases were not statistically significant. Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community-acquired pneumonia, compared to non-diseased persons. ClinicalTrials.gov, NCT00812084 .

  2. Undiagnosed diabetes mellitus in community-acquired pneumonia

    DEFF Research Database (Denmark)

    Jensen, Andreas Vestergaard; Faurholt-Jepsen, Daniel; Egelund, Gertrud Baunbæk

    2017-01-01

    Background: Diabetes mellitus is an important risk factor for community-acquired pneumonia, whereas the prevalence of undiagnosed diabetes mellitus and prediabetes in patients with community-acquired pneumonia is largely unknown. We aimed to determine the prevalence of prediabetes, undiagnosed......-acquired pneumonia included in the German Community-Acquired Pneumonia Competence Network (CAPNETZ) study between 2007 and 2014. The prevalence of undiagnosed diabetes mellitus and prediabetes was estimated based on hemoglobin A1c measurements. Logistic regression was used to assess risk factors for undiagnosed...... diabetes mellitus. Results: Fifteen percent of patients had known diabetes mellitus. Among patients without known diabetes mellitus, 5.0% had undiagnosed diabetes mellitus and 37.5% had prediabetes. Male sex (odds ratio [OR], 2.45 [95% confidence interval {CI}, 1.35-4.45]), body mass index ≥25 kg/m2 (OR, 2...

  3. Corpus callosum demyelination associated with acquired stuttering.

    Science.gov (United States)

    Decker, Barbara McElwee; Guitar, Barry; Solomon, Andrew

    2018-04-21

    Compared with developmental stuttering, adult onset acquired stuttering is rare. However, several case reports describe acquired stuttering and an association with callosal pathology. Interestingly, these cases share a neuroanatomical localisation also demonstrated in developmental stuttering. We present a case of adult onset acquired stuttering associated with inflammatory demyelination within the corpus callosum. This patient's disfluency improved after the initiation of immunomodulatory therapy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Aetiological considerations of acquired aplastic anaemia

    International Nuclear Information System (INIS)

    Malik, S.; Sarwar, I.; Mehmood, T.; Naz, F.

    2009-01-01

    Acquired aplastic anaemia is one of the important causes of pancytopenia. This study was conducted to observe the mode of presentation of acquired aplastic anaemia and to find out its possible etiological factors. Methods: It is a hospital based descriptive study of 100 patients of acquired aplastic anaemia. Results: Out of 100 patients 60 were male and 40 female. Majority (44%) of the patients were between 12 - 20 years of age. Patient presented with variable symptoms majority (40%) with fever. Most of the patients had haemoglobin levels between 4 - 6 gm/dl. (53%). Seventy percent of the cases had no obvious cause, while in 30% some known causative factors were found. Chloramphenicol was found to be the most common causative drug. Mortality was 35%. Thirty patients were partially treated and 15 were lost to follow up. Twenty patients showed improvement with treatment. Conclusions: Acquired aplastic anaemia is common among males and more prevalent in younger age group. It is idiopathic in 70% cases while 30% had some cause. It has very high mortality. Doctors need to keep in mind this fatal condition in patients presenting with anaemia and should properly investigate before prescribing antibiotics and haematinics. (author)

  5. Risk of newly detected infections and cervical abnormalities in women seropositive for naturally acquired human papillomavirus type 16/18 antibodies: analysis of the control arm of PATRICIA.

    Science.gov (United States)

    Castellsagué, Xavier; Naud, Paulo; Chow, Song-Nan; Wheeler, Cosette M; Germar, Maria Julieta V; Lehtinen, Matti; Paavonen, Jorma; Jaisamrarn, Unnop; Garland, Suzanne M; Salmerón, Jorge; Apter, Dan; Kitchener, Henry; Teixeira, Julio C; Skinner, S Rachel; Limson, Genara; Szarewski, Anne; Romanowski, Barbara; Aoki, Fred Y; Schwarz, Tino F; Poppe, Willy A J; Bosch, F Xavier; de Carvalho, Newton S; Peters, Klaus; Tjalma, Wiebren A A; Safaeian, Mahboobeh; Raillard, Alice; Descamps, Dominique; Struyf, Frank; Dubin, Gary; Rosillon, Dominique; Baril, Laurence

    2014-08-15

    We examined risk of newly detected human papillomavirus (HPV) infection and cervical abnormalities in relation to HPV type 16/18 antibody levels at enrollment in PATRICIA (Papilloma Trial Against Cancer in Young Adults; NCT00122681). Using Poisson regression, we compared risk of newly detected infection and cervical abnormalities associated with HPV-16/18 between seronegative vs seropositive women (15-25 years) in the control arm (DNA negative at baseline for the corresponding HPV type [HPV-16: n = 8193; HPV-18: n = 8463]). High titers of naturally acquired HPV-16 antibodies and/or linear trend for increasing antibody levels were significantly associated with lower risk of incident and persistent infection, atypical squamous cells of undetermined significance or greater (ASCUS+), and cervical intraepithelial neoplasia grades 1/2 or greater (CIN1+, CIN2+). For HPV-18, although seropositivity was associated with lower risk of ASCUS+ and CIN1+, no association between naturally acquired antibodies and infection was demonstrated. Naturally acquired HPV-16 antibody levels of 371 (95% confidence interval [CI], 242-794), 204 (95% CI, 129-480), and 480 (95% CI, 250-5756) EU/mL were associated with 90% reduction of incident infection, 6-month persistent infection, and ASCUS+, respectively. Naturally acquired antibodies to HPV-16, and to a lesser extent HPV-18, are associated with some reduced risk of subsequent infection and cervical abnormalities associated with the same HPV type. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  6. New information technologies in operative control of modes in regional electrical power systems

    OpenAIRE

    ANDREY D. TEVJASHEV; TATJANA B. TIMOFEEVA

    2003-01-01

    The problem of development of software for management of modes in electrical power systems in connection with casual character of a load in network is considered. The stochastic mathematical model of a system for operating control of modes in regional electrical power systems is offered. The methods for problem solving of operating control and operating planning of operational modes in regional electrical power systems are developed. The application of the developed models and methods will al...

  7. Regional control of Drosophila gut stem cell proliferation: EGF establishes GSSC proliferative set point & controls emergence from quiescence.

    Science.gov (United States)

    Strand, Marie; Micchelli, Craig A

    2013-01-01

    Adult stem cells vary widely in their rates of proliferation. Some stem cells are constitutively active, while others divide only in response to injury. The mechanism controlling this differential proliferative set point is not well understood. The anterior-posterior (A/P) axis of the adult Drosophila midgut has a segmental organization, displaying physiological compartmentalization and region-specific epithelia. These distinct midgut regions are maintained by defined stem cell populations with unique division schedules, providing an excellent experimental model with which to investigate this question. Here, we focus on the quiescent gastric stem cells (GSSCs) of the acidic copper cell region (CCR), which exhibit the greatest period of latency between divisions of all characterized gut stem cells, to define the molecular basis of differential stem cell activity. Our molecular genetic analysis demonstrates that the mitogenic EGF signaling pathway is a limiting factor controlling GSSC proliferation. We find that under baseline conditions, when GSSCs are largely quiescent, the lowest levels of EGF ligands in the midgut are found in the CCR. However, acute epithelial injury by enteric pathogens leads to an increase in EGF ligand expression in the CCR and rapid expansion of the GSSC lineage. Thus, the unique proliferative set points for gut stem cells residing in physiologically distinct compartments are governed by regional control of niche signals along the A/P axis.

  8. Regional control of Drosophila gut stem cell proliferation: EGF establishes GSSC proliferative set point & controls emergence from quiescence.

    Directory of Open Access Journals (Sweden)

    Marie Strand

    Full Text Available Adult stem cells vary widely in their rates of proliferation. Some stem cells are constitutively active, while others divide only in response to injury. The mechanism controlling this differential proliferative set point is not well understood. The anterior-posterior (A/P axis of the adult Drosophila midgut has a segmental organization, displaying physiological compartmentalization and region-specific epithelia. These distinct midgut regions are maintained by defined stem cell populations with unique division schedules, providing an excellent experimental model with which to investigate this question. Here, we focus on the quiescent gastric stem cells (GSSCs of the acidic copper cell region (CCR, which exhibit the greatest period of latency between divisions of all characterized gut stem cells, to define the molecular basis of differential stem cell activity. Our molecular genetic analysis demonstrates that the mitogenic EGF signaling pathway is a limiting factor controlling GSSC proliferation. We find that under baseline conditions, when GSSCs are largely quiescent, the lowest levels of EGF ligands in the midgut are found in the CCR. However, acute epithelial injury by enteric pathogens leads to an increase in EGF ligand expression in the CCR and rapid expansion of the GSSC lineage. Thus, the unique proliferative set points for gut stem cells residing in physiologically distinct compartments are governed by regional control of niche signals along the A/P axis.

  9. Specific Midgut Region Controlling the Symbiont Population in an Insect-Microbe Gut Symbiotic Association

    Science.gov (United States)

    Kim, Jiyeun Kate; Kim, Na Hyang; Jang, Ho Am; Kikuchi, Yoshitomo; Kim, Chan-Hee

    2013-01-01

    Many insects possess symbiotic bacteria that affect the biology of the host. The level of the symbiont population in the host is a pivotal factor that modulates the biological outcome of the symbiotic association. Hence, the symbiont population should be maintained at a proper level by the host's control mechanisms. Several mechanisms for controlling intracellular symbionts of insects have been reported, while mechanisms for controlling extracellular gut symbionts of insects are poorly understood. The bean bug Riptortus pedestris harbors a betaproteobacterial extracellular symbiont of the genus Burkholderia in the midgut symbiotic organ designated the M4 region. We found that the M4B region, which is directly connected to the M4 region, also harbors Burkholderia symbiont cells, but the symbionts therein are mostly dead. A series of experiments demonstrated that the M4B region exhibits antimicrobial activity, and the antimicrobial activity is specifically potent against the Burkholderia symbiont but not the cultured Burkholderia and other bacteria. The antimicrobial activity of the M4B region was detected in symbiotic host insects, reaching its highest point at the fifth instar, but not in aposymbiotic host insects, which suggests the possibility of symbiont-mediated induction of the antimicrobial activity. This antimicrobial activity was not associated with upregulation of antimicrobial peptides of the host. Based on these results, we propose that the M4B region is a specialized gut region of R. pedestris that plays a critical role in controlling the population of the Burkholderia gut symbiont. The molecular basis of the antimicrobial activity is of great interest and deserves future study. PMID:24038695

  10. Characteristics of Chongan ring structure and its controlling role on uranium mineralization

    International Nuclear Information System (INIS)

    Liu Linqing

    2001-01-01

    A large ring structure has been discovered in Chong'an region on the basis of geological interpretation of remote sensing images. The data acquired from analysis of regional geology and in-situ investigation indicate that the ring structure is initiated during caledonian and activated for several times afterwards; It displays the highest activity during Yanshanian. Under the effect of this structure, Gulou-Masha lenticular geological body was firmed, controlling the regional distribution of uranium mineralization and anomalies occur in forms of central and bilateral symmetry. The data indicate that it is prospective to prospect uranium deposit in this region; therefore, more work should be placed on the deep levels

  11. Importance of Q Fever in Community Acquired Pneumonia

    Directory of Open Access Journals (Sweden)

    Monique Goyette

    1996-01-01

    Full Text Available Coxiella burnetii appears to be endemic in animals in the Mauricie region of Quebec, and causes some human cases of Q fever annually. Unlike in other rural areas, patients in this study experienced few respiratory symptoms. To determine whether C burnetii pneumonia is underdiagnosed, adults admitted to hospital for community acquired pneumonia were included in a one-year serological study. Significant immunofluorescent antibody (IFA titres in four of 118 patients with pneumonia (fewer than 4% were studied. Clinical presentation, standard laboratory tests and epidemiological data did not allow identification of these cases; however, Q fever increased during the warm months. There were no detectable complement fixing (CF antibodies in these four cases. C burnetii causes few cases of pneumonia in Mauricie. IFA seems to be a more sensitive test than CF.

  12. Efficacy of a Micro-Prompting Technology in Reducing Support Needed by People With Severe Acquired Brain Injury in Activities of Daily Living: A Randomized Control Trial.

    Science.gov (United States)

    OʼNeill, Brian; Best, Catherine; OʼNeill, Lauren; Ramos, Sara D S; Gillespie, Alex

    2017-11-29

    To evaluate the effectiveness of an automated interactive prompting technology in supporting the morning routine of persons with acquired brain injury. The morning routine included maintaining personal hygiene and dressing. An inpatient neurorehabilitation hospital. Persons with acquired brain injury who required prompting when following their morning routine (n = 24), but were not limited by physical disability or dysphasia, took part in the study. Participants (67% with traumatic brain injury) had impairment on indices of memory and executive function. A randomized control trial evaluated the effect of an automated interactive micro-prompting device on the number of prompts by trained staff required for successful completion of the morning routine. Study-specific checklists assessed sequence performance, errors, and verbal prompts required over baseline, rehabilitation as usual, intervention, and return to baseline conditions. The intervention significantly reduced the support required to complete the task compared with usual rehabilitation. Micro-prompting technology is an effective assistive technology for cognition, which reduces support needs in people with significant cognitive impairments.

  13. Soft Skills : An Important Asset Acquired from Organizing Regional Student Group Activities

    NARCIS (Netherlands)

    De Ridder, J.; Meysman, P.; Oluwagbemi, O.; Abeel, T.

    2014-01-01

    Contributing to a student organization, such as the International Society for Computational Biology Student Council (ISCB-SC) and its Regional Student Group (RSG) program, takes time and energy. Both are scarce commodities, especially when you are trying to find your place in the world of

  14. Transcription Factor Zbtb20 Controls Regional Specification of Mammalian Archicortex

    DEFF Research Database (Denmark)

    Rosenthal, Eva Helga

    2010-01-01

    Combinatorial expression of sets of transcription factors (TFs) along the mammalian cortex controls its subdivision into functional areas. Unlike neocortex, only few recent data suggest genetic mechanisms controlling the regionalization of the archicortex. TF Emx2 plays a crucial role in patterning...... later on becoming restricted exclusively to postmitotic neurons of hippocampus (Hi) proper, dentate gyrus (DG), and two transitory zones, subiculum (S) and retrosplenial cortex (Rsp). Analysis of Zbtb20-/- mice revealed altered cortical patterning at the border between neocortex and archicortex...

  15. Myelofibrosis and acquired hemophilia A: a case report.

    Science.gov (United States)

    Wrobel, Marie; Comio, Emilie; Gay, Valerie; Baroudi, Noureddine; Meyer, Pascal; Chuniaud-Louche, Christine; Hacini, Maya; Pica, Gian Matteo

    2016-05-07

    Myelofibrosis and acquired hemophilia A is a rare association. To the best of our knowledge only one case of myelofibrosis and acquired hemophilia A has been previously described. A 66-year-old Caucasian man diagnosed with myelofibrosis evolving in acute myeloid leukemia was referred to us for postoperative bleeding. Hemostatic studies showed prolonged activated partial thromboplastin time, decreased factor VIII coagulation, and a high factor VIII inhibitor titer; these findings led to a diagnosis of acquired hemophilia A for which he was treated with methylprednisolone and recombinant activated factor VII on admission. Due to a lack of response he was subsequently treated with rituximab combined with activated prothrombin complex concentrates. Furthermore, he received azacytidine to treat the underlying hematological malignancies. Immunosuppressive rituximab therapy resolved acquired hemophilia A with marked efficacy. Rapid and accurate diagnosis, effective hemostatic therapy, and timely treatment for underlying disease are important in the management of acquired hemophilia A secondary to hematological malignancy.

  16. 14 CFR 1274.402 - Contractor acquired property.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Contractor acquired property. 1274.402 Section 1274.402 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION COOPERATIVE AGREEMENTS WITH COMMERCIAL FIRMS Property § 1274.402 Contractor acquired property. As provided in § 1274.923...

  17. Contributions of Lateral and Orbital Frontal Regions to Abstract Rule Acquisition and Reversal in Monkeys

    Science.gov (United States)

    La Camera, Giancarlo; Bouret, Sebastien; Richmond, Barry J.

    2018-01-01

    The ability to learn and follow abstract rules relies on intact prefrontal regions including the lateral prefrontal cortex (LPFC) and the orbitofrontal cortex (OFC). Here, we investigate the specific roles of these brain regions in learning rules that depend critically on the formation of abstract concepts as opposed to simpler input-output associations. To this aim, we tested monkeys with bilateral removals of either LPFC or OFC on a rapidly learned task requiring the formation of the abstract concept of same vs. different. While monkeys with OFC removals were significantly slower than controls at both acquiring and reversing the concept-based rule, monkeys with LPFC removals were not impaired in acquiring the task, but were significantly slower at rule reversal. Neither group was impaired in the acquisition or reversal of a delayed visual cue-outcome association task without a concept-based rule. These results suggest that OFC is essential for the implementation of a concept-based rule, whereas LPFC seems essential for its modification once established. PMID:29615854

  18. Second Order Sliding Mode Control Scheme for an Autonomous Underwater Vehicle with Dynamic Region Concept

    Directory of Open Access Journals (Sweden)

    Zool H. Ismail

    2015-01-01

    Full Text Available The main goal in developing closed loop control system for an Autonomous Underwater Vehicle (AUV is to make a robust vehicle from natural and exogenous perturbations such as wind, wave, and ocean currents. However a well-known robust control, for instance, Sliding Mode Controller (SMC, gives a chattering effect and it influences the stability of an AUV. Furthermore, some researchers combined other controls to get better result but it tends to present long computational time and causes large energy consumption. Thus, this paper proposed a Super Twisting Sliding Mode Controller (STSMC with dynamic region concept for an AUV. STSMC or a second order SMC is adopted as a robust controller which is free from chattering effect. Meanwhile, the implementation of dynamic region is useful to reduce the energy usage. As a result, the proposed controller obtains global asymptotic stability which is validated by using Lyapunov-like function. Moreover, some simulations present the efficiency of proposed controller. In conclusion, STSMC with region based control is effective to be applied for the robust tracking of an AUV. It contributes to give a fast response when handling the perturbations, short computational time, and low energy demand.

  19. Isolated acquired factor VII deficiency: review of the literature.

    Science.gov (United States)

    Mulliez, Sylvie M N; Devreese, Katrien M J

    2016-04-01

    Isolated acquired factor VII (FVII) deficiency is a rare haemorrhagic disorder. We report what is currently known about the pathogenesis, clinical features, diagnosis, treatment and prognosis of acquired FVII deficiency. We performed a literature search and included all articles published between 1980 and August 2015. Acquired FVII deficiency has been reported in 42 patients. There are well-established clinical diseases associated with acquired FVII deficiency, most notably infections, malignancy and haematological stem cell transplantation. The exact pathogenesis of the diseases is still unknown, but different pathophysiological hypotheses have been suggested. The clinical manifestation of acquired FVII deficiency varies greatly in severity; asymptomatic course as well as severe life-threatening bleeding diathesis and fatal bleedings have been described.

  20. How are Concepts of Infinity Acquired?

    Directory of Open Access Journals (Sweden)

    Trzęsicki Kazimierz

    2015-03-01

    Full Text Available Concepts of infinity have been subjects of dispute since antiquity. The main problems of this paper are: is the mind able to acquire a concept of infinity? and: how are concepts of infinity acquired? The aim of this paper is neither to say what the meanings of the word “infinity” are nor what infinity is and whether it exists. However, those questions will be mentioned, but only in necessary extent.

  1. Acquired hypofibrinogenemia: current perspectives

    Directory of Open Access Journals (Sweden)

    Besser MW

    2016-09-01

    Full Text Available Martin W Besser,1 Stephen G MacDonald2 1Department of Haematology, 2Department of Specialist Haemostasis, The Pathology Partnership, Addenbrooke’s Hospital, Cambridge, UK Abstract: Acquired hypofibrinogenemia is most frequently caused by hemodilution and consumption of clotting factors. The aggressive replacement of fibrinogen has become one of the core principles of modern management of massive hemorrhage. The best method for determining the patient’s fibrinogen level remains controversial, and particularly in acquired dysfibrinogenemia, could have major therapeutic implications depending on which quantification method is chosen. This review introduces the available laboratory and point-of-care methods and discusses the relative advantages and limitations. It also discusses current strategies for the correction of hypofibrinogenemia. Keywords: Clauss fibrinogen assay, fibrinogen antigen, viscoelastic testing, ­gravimetric fibrinogen assay, PT-derived fibrinogen, functional fibrinogen, direct oral anticoagulant, dysfibrinogenemia, afibrinogenemia

  2. Pneumonia - children - community acquired

    Science.gov (United States)

    Bronchopneumonia - children; Community-acquired pneumonia - children; CAP - children ... Viruses are the most common cause of pneumonia in infants and children. Ways your child can get CAP include: Bacteria and viruses living in the nose, sinuses, or mouth may spread ...

  3. The role of acquired immunity and periodontal disease progression.

    Science.gov (United States)

    Teng, Yen-Tung A

    2003-01-01

    Our understanding of the pathogenesis in human periodontal diseases is limited by the lack of specific and sensitive tools or models to study the complex microbial challenges and their interactions with the host's immune system. Recent advances in cellular and molecular biology research have demonstrated the importance of the acquired immune system not only in fighting the virulent periodontal pathogens but also in protecting the host from developing further devastating conditions in periodontal infections. The use of genetic knockout and immunodeficient mouse strains has shown that the acquired immune response-in particular, CD4+ T-cells-plays a pivotal role in controlling the ongoing infection, the immune/inflammatory responses, and the subsequent host's tissue destruction. In particular, studies of the pathogen-specific CD4+ T-cell-mediated immunity have clarified the roles of: (i) the relative diverse immune repertoire involved in periodontal pathogenesis, (ii) the contribution of pathogen-associated Th1-Th2 cytokine expressions in periodontal disease progression, and (iii) micro-organism-triggered periodontal CD4+ T-cell-mediated osteoclastogenic factor, 'RANK-L', which is linked to the induction of alveolar bone destruction in situ. The present review will focus on some recent advances in the acquired immune responses involving B-cells, CD8+ T-cells, and CD4+ T-cells in the context of periodontal disease progression. New approaches will further facilitate our understanding of their underlying molecular mechanisms that may lead to the development of new treatment modalities for periodontal diseases and their associated complications.

  4. The role of haloaerosolotherapy in immunorehabilitation of convalescents after community acquired pneumonia

    Directory of Open Access Journals (Sweden)

    Olha Lemko

    2015-02-01

    Full Text Available Aim: Investigation of the peculiarities of different haloaerosoltherapy regimes influence (treatment with different intensity of haloaerosol load upon non-specific defense and cellular immunity at convalescents after community acquired pneumonia. Objectives: patients with community acquired pneumonia in the early convalescence period (after completing antibiotic therapy, who received treatment in conditions of artificial rock salt aerosol medium (haloaerosoltherapy. Material and Methods. 42 patients with non-severe community acquired pneumonia were examined in the early convalescence period before and after the course of haloaerosoltherapy, which was prescribed after antibacterial therapy. Immunological studies included: evaluation of phagocytic activity of neutrophils (PhAN - the percentage of phagocytic neutrophils, phagocytic number (PhN - average number of latex particles absorbed by a neutrophil; metabolism of neutrophils in the test with nitroblue tetrasolium (NBT-test spontaneous and induced, which allowed to assess the functional reserve of neutrophils (FR; calculation of cytochemical coefficient (CCC for lysosomal cationic proteins (LCP and for myeloperoxidase (MPO of neutrophils; number of T- and B-lymphocytes and their subpopulations (CD3+ -, CD4+ -, CD8+ -, CD22+ - lymphocytes, calculation the number of 0- lymphocytes and the ratio of CD4+ /CD8+ lymphocytes. Laboratory examinations were also conducted in 21 practically healthy individuals (control group. Two regimes of haloaerosoltherapy were used in recovery treatment of patients with community acquired pneumonia: treating complex №1 (TC-1 with standard haloaerosol load and with increased haloaerosol load (TC-2. Results. After completion the antibiotic therapy at patients with community acquired pneumonia the moderate inhibition of phagocytic activity of neutrophils (47,6±0,58% to 55,5±1,14% in control group remained and was accompanied with a decrease in neutrophil bactericidal

  5. Connectionist neuropsychology: uncovering ultimate causes of acquired dyslexia.

    Science.gov (United States)

    Woollams, Anna M

    2014-01-01

    Acquired dyslexia offers a unique window on to the nature of the cognitive and neural architecture supporting skilled reading. This paper provides an integrative overview of recent empirical and computational work on acquired dyslexia within the context of the primary systems framework as implemented in connectionist neuropsychological models. This view proposes that damage to general visual, phonological or semantic processing abilities are the root causes of different forms of acquired dyslexia. Recent case-series behavioural evidence concerning pure alexia, phonological dyslexia and surface dyslexia that supports this perspective is presented. Lesion simulations of these findings within connectionist models of reading demonstrate the viability of this approach. The commitment of such models to learnt representations allows them to capture key aspects of performance in each type of acquired dyslexia, particularly the associated non-reading deficits, the role of relearning and the influence of individual differences in the premorbid state of the reading system. Identification of these factors not only advances our understanding of acquired dyslexia and the mechanisms of normal reading but they are also relevant to the complex interactions underpinning developmental reading disorders.

  6. Intercontrole acquiring by Framatome

    International Nuclear Information System (INIS)

    1997-01-01

    The Framatome group, as the worldwide leader in nuclear power plant construction, has reinforced his competences in nuclear services thanks to the acquiring of the Intercontrole company, specialized in non-destructive testing in nuclear and industrial environments. After a presentation of the functioning principle and of the safety aspects of a PWR reactor, this press dossier presents in a first part the role of nuclear services and in particular of non-destructive testing in nuclear power plants (in-service inspection, regulatory aspects, testing processes). This part is illustrated with some examples of inspection performed on some components of the primary coolant loop (steam generators, reactor vessel, pressurizer, pipes, primary pumps). A second part presents the technical centres and units of Framatome in charge of performing non-destructive inspections, while a third part describes the industrial policy and strategy of the group in this domain (market of nuclear park maintenance in France, in the USA and worldwide, creation of the 'inspection and control' centre of Framatome). A last part presents the activities of the Intercontrole company and of its daughter companies with some examples of actions realized in the nuclear and natural gas domains. (J.S.)

  7. Constraining the brachial plexus does not compromise regional control in oropharyngeal carcinoma

    International Nuclear Information System (INIS)

    Robert, Mutter W; Wolden, Suzanne L; Lee, Nancy Y; Lok, Benjamin H; Dutta, Pinaki R; Riaz, Nadeem; Setton, Jeremy; Berry, Sean L; Goenka, Anuj; Zhang, Zhigang; Rao, Shyam S

    2013-01-01

    Accumulating evidence suggests that brachial plexopathy following head and neck cancer radiotherapy may be underreported and that this toxicity is associated with a dose–response. Our purpose was to determine whether the dose to the brachial plexus (BP) can be constrained, without compromising regional control. The radiation plans of 324 patients with oropharyngeal carcinoma (OPC) treated with intensity-modulated radiation therapy (IMRT) were reviewed. We identified 42 patients (13%) with gross nodal disease <1 cm from the BP. Normal tissue constraints included a maximum dose of 66 Gy and a D 05 of 60 Gy for the BP. These criteria took precedence over planning target volume (PTV) coverage of nodal disease near the BP. There was only one regional failure in the vicinity of the BP, salvaged with neck dissection (ND) and regional re-irradiation. There have been no reported episodes of brachial plexopathy to date. In combined-modality therapy, including ND as salvage, regional control did not appear to be compromised by constraining the dose to the BP. This approach may improve the therapeutic ratio by reducing the long-term risk of brachial plexopathy

  8. Superior voice recognition in a patient with acquired prosopagnosia and object agnosia.

    Science.gov (United States)

    Hoover, Adria E N; Démonet, Jean-François; Steeves, Jennifer K E

    2010-11-01

    Anecdotally, it has been reported that individuals with acquired prosopagnosia compensate for their inability to recognize faces by using other person identity cues such as hair, gait or the voice. Are they therefore superior at the use of non-face cues, specifically voices, to person identity? Here, we empirically measure person and object identity recognition in a patient with acquired prosopagnosia and object agnosia. We quantify person identity (face and voice) and object identity (car and horn) recognition for visual, auditory, and bimodal (visual and auditory) stimuli. The patient is unable to recognize faces or cars, consistent with his prosopagnosia and object agnosia, respectively. He is perfectly able to recognize people's voices and car horns and bimodal stimuli. These data show a reverse shift in the typical weighting of visual over auditory information for audiovisual stimuli in a compromised visual recognition system. Moreover, the patient shows selectively superior voice recognition compared to the controls revealing that two different stimulus domains, persons and objects, may not be equally affected by sensory adaptation effects. This also implies that person and object identity recognition are processed in separate pathways. These data demonstrate that an individual with acquired prosopagnosia and object agnosia can compensate for the visual impairment and become quite skilled at using spared aspects of sensory processing. In the case of acquired prosopagnosia it is advantageous to develop a superior use of voices for person identity recognition in everyday life. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Determination of equivalent cross sections for representation of control rod regions in diffusion calculations

    International Nuclear Information System (INIS)

    Scherer, W.; Neef, H.J.

    1976-07-01

    The representation of control rod regions in reactor calculations requires a combination of transport and diffusion theory calculations. A method is described which produces equivalent cross sections for a rodded region. These cross sections used in a diffusion theory calcualtion yield the same rod efficiency and reaction rate distribution as the transport theory calculation for the explicit heterogeneous control rod. The description of the method is complemented by sample problems. (orig.) [de

  10. The Complete Genome and Phenome of a Community-Acquired Acinetobacter baumannii

    Science.gov (United States)

    Farrugia, Daniel N.; Elbourne, Liam D. H.; Hassan, Karl A.; Eijkelkamp, Bart A.; Tetu, Sasha G.; Brown, Melissa H.; Shah, Bhumika S.; Peleg, Anton Y.; Mabbutt, Bridget C.; Paulsen, Ian T.

    2013-01-01

    Many sequenced strains of Acinetobacter baumannii are established nosocomial pathogens capable of resistance to multiple antimicrobials. Community-acquired A. baumannii in contrast, comprise a minor proportion of all A. baumannii infections and are highly susceptible to antimicrobial treatment. However, these infections also present acute clinical manifestations associated with high reported rates of mortality. We report the complete 3.70 Mbp genome of A. baumannii D1279779, previously isolated from the bacteraemic infection of an Indigenous Australian; this strain represents the first community-acquired A. baumannii to be sequenced. Comparative analysis of currently published A. baumannii genomes identified twenty-four accessory gene clusters present in D1279779. These accessory elements were predicted to encode a range of functions including polysaccharide biosynthesis, type I DNA restriction-modification, and the metabolism of novel carbonaceous and nitrogenous compounds. Conversely, twenty genomic regions present in previously sequenced A. baumannii strains were absent in D1279779, including gene clusters involved in the catabolism of 4-hydroxybenzoate and glucarate, and the A. baumannii antibiotic resistance island, known to bestow resistance to multiple antimicrobials in nosocomial strains. Phenomic analysis utilising the Biolog Phenotype Microarray system indicated that A. baumannii D1279779 can utilise a broader range of carbon and nitrogen sources than international clone I and clone II nosocomial isolates. However, D1279779 was more sensitive to antimicrobial compounds, particularly beta-lactams, tetracyclines and sulphonamides. The combined genomic and phenomic analyses have provided insight into the features distinguishing A. baumannii isolated from community-acquired and nosocomial infections. PMID:23527001

  11. Prevention of Malaria Resurgence in Greece through the Association of Mass Drug Administration (MDA) to Immigrants from Malaria-Endemic Regions and Standard Control Measures

    Science.gov (United States)

    Tseroni, Maria; Baka, Agoritsa; Kapizioni, Christina; Snounou, Georges; Tsiodras, Sotirios; Charvalakou, Maria; Georgitsou, Maria; Panoutsakou, Maria; Psinaki, Ioanna; Tsoromokou, Maria; Karakitsos, George; Pervanidou, Danai; Vakali, Annita; Mouchtouri, Varvara; Georgakopoulou, Theano; Mamuris, Zissis; Papadopoulos, Nikos; Koliopoulos, George; Badieritakis, Evangelos; Diamantopoulos, Vasilis; Tsakris, Athanasios; Kremastinou, Jenny; Hadjichristodoulou, Christos

    2015-01-01

    Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011–2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases were detected. Despite a significant decrease of the number of malaria cases in 2012, a mass drug administration (MDA) program was considered as an additional measure to prevent reestablishment of the disease in the area. During 2013 and 2014, a combination of 3-day chloroquine and 14-day primaquine treatment was administered under direct observation to immigrants living in the epicenter of the 2011 outbreak in Evrotas. Adverse events were managed and recorded on a daily basis. The control measures implemented since 2011 continued during the period of 2013–2014 as a part of a national integrated malaria control program that included active case detection (ACD), vector control measures and community education. The MDA program was started prior to the transmission periods (from May to December). One thousand ninety four (1094) immigrants successfully completed the treatment, corresponding to 87.3% coverage of the target population. A total of 688 adverse events were recorded in 397 (36.2%, 95% C.I.: 33.4–39.1) persons, the vast majority minor, predominantly dizziness and headache for chloroquine (284 events) and abdominal pain (85 events) for primaquine. A single case of primaquine-induced hemolysis was recorded in a person whose initial G6PD test proved incorrect. No malaria cases were recorded in Evrotas, Laconia, in 2013 and 2014, though three locally acquired malaria cases were recorded in other regions of Greece in 2013. Preventive antimalarial MDA to a high-risk population in a low transmission setting appears to have synergized with the usual antimalarial activities to achieve malaria elimination. This study suggests that judicious use of

  12. Prevention of Malaria Resurgence in Greece through the Association of Mass Drug Administration (MDA) to Immigrants from Malaria-Endemic Regions and Standard Control Measures.

    Science.gov (United States)

    Tseroni, Maria; Baka, Agoritsa; Kapizioni, Christina; Snounou, Georges; Tsiodras, Sotirios; Charvalakou, Maria; Georgitsou, Maria; Panoutsakou, Maria; Psinaki, Ioanna; Tsoromokou, Maria; Karakitsos, George; Pervanidou, Danai; Vakali, Annita; Mouchtouri, Varvara; Georgakopoulou, Theano; Mamuris, Zissis; Papadopoulos, Nikos; Koliopoulos, George; Badieritakis, Evangelos; Diamantopoulos, Vasilis; Tsakris, Athanasios; Kremastinou, Jenny; Hadjichristodoulou, Christos

    2015-11-01

    Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011-2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases were detected. Despite a significant decrease of the number of malaria cases in 2012, a mass drug administration (MDA) program was considered as an additional measure to prevent reestablishment of the disease in the area. During 2013 and 2014, a combination of 3-day chloroquine and 14-day primaquine treatment was administered under direct observation to immigrants living in the epicenter of the 2011 outbreak in Evrotas. Adverse events were managed and recorded on a daily basis. The control measures implemented since 2011 continued during the period of 2013-2014 as a part of a national integrated malaria control program that included active case detection (ACD), vector control measures and community education. The MDA program was started prior to the transmission periods (from May to December). One thousand ninety four (1094) immigrants successfully completed the treatment, corresponding to 87.3% coverage of the target population. A total of 688 adverse events were recorded in 397 (36.2%, 95% C.I.: 33.4-39.1) persons, the vast majority minor, predominantly dizziness and headache for chloroquine (284 events) and abdominal pain (85 events) for primaquine. A single case of primaquine-induced hemolysis was recorded in a person whose initial G6PD test proved incorrect. No malaria cases were recorded in Evrotas, Laconia, in 2013 and 2014, though three locally acquired malaria cases were recorded in other regions of Greece in 2013. Preventive antimalarial MDA to a high-risk population in a low transmission setting appears to have synergized with the usual antimalarial activities to achieve malaria elimination. This study suggests that judicious use of MDA can

  13. A new epidemic modeling approach: Multi-regions discrete-time model with travel-blocking vicinity optimal control strategy.

    Science.gov (United States)

    Zakary, Omar; Rachik, Mostafa; Elmouki, Ilias

    2017-08-01

    First, we devise in this paper, a multi-regions discrete-time model which describes the spatial-temporal spread of an epidemic which starts from one region and enters to regions which are connected with their neighbors by any kind of anthropological movement. We suppose homogeneous Susceptible-Infected-Removed (SIR) populations, and we consider in our simulations, a grid of colored cells, which represents the whole domain affected by the epidemic while each cell can represent a sub-domain or region. Second, in order to minimize the number of infected individuals in one region, we propose an optimal control approach based on a travel-blocking vicinity strategy which aims to control only one cell by restricting movements of infected people coming from all neighboring cells. Thus, we show the influence of the optimal control approach on the controlled cell. We should also note that the cellular modeling approach we propose here, can also describes infection dynamics of regions which are not necessarily attached one to an other, even if no empty space can be viewed between cells. The theoretical method we follow for the characterization of the travel-locking optimal controls, is based on a discrete version of Pontryagin's maximum principle while the numerical approach applied to the multi-points boundary value problems we obtain here, is based on discrete progressive-regressive iterative schemes. We illustrate our modeling and control approaches by giving an example of 100 regions.

  14. 19 CFR 148.33 - Articles acquired abroad.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Articles acquired abroad. 148.33 Section 148.33... Articles acquired abroad. (a) Exemption. Each returning resident is entitled to bring in free of duty and..., Harmonized Tariff Schedule of the United States (19 U.S.C. 1202), articles for his personal or household use...

  15. 26 CFR 1.9002-6 - Acquiring corporation.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Acquiring corporation. 1.9002-6 Section 1.9002... (CONTINUED) INCOME TAXES General Actuarial Valuations § 1.9002-6 Acquiring corporation. Section 5(d) of the... corporation by another corporation in a distribution or transfer described in section 381(a) of the Code the...

  16. An extra X does not prevent acquired hemophilia - Pregnancy-associated acquired hemophilia A.

    Science.gov (United States)

    Barg, Assaf A; Livnat, Tami; Kenet, Gili

    2017-03-01

    Acquired hemophilia A (AHA) is a severe bleeding disorder caused by autoantibodies against clotting factor VIII (FVIII). With an estimated annual incidence of 1.3 to 1.5 per million, AHA is a rare disease. An extremely rare form of AHA has been described among women in the peripartum period, and may present with peripartum hemorrhage. Notably, although hemorrhagic symptoms commonly present 1-4 months around delivery, they may occur up to 1 year after parturition. When caring for a mother with AHA it is important to note that Factor VIII inhibitor may be transferred via the placenta from the mother to the fetus. Hence the newborn may also be affected. It is important to increase the awareness of Gynecologists for clinical symptoms and laboratory signs of AHA in order to avoid delayed diagnosis. Treatment may involve use of bypass agents to control hemorrhage, despite the risk of thrombosis, while immunomodulation (with increasing role for Rituximab) may be required to eradicate the inhibiting antibodies. Our review will evaluate the epidemiology, diagnosis, clinical course and treatment of peripartum AHA, focusing upon mother and infant care. © 2017 Elsevier Ltd. All rights reserved.

  17. Double control systems for human T-cell leukemia virus type 1 by innate and acquired immunity.

    Science.gov (United States)

    Kannagi, Mari; Hasegawa, Atsuhiko; Kinpara, Shuichi; Shimizu, Yukiko; Takamori, Ayako; Utsunomiya, Atae

    2011-04-01

    Human T-cell leukemia virus type 1 (HTLV-1) is the causative retrovirus of adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HTLV-1-specific T-cell responses elicit antitumor and antiviral effects in experimental models, and are considered to be one of the most important determinants of the disease manifestation, since they are activated in HAM/TSP but not in ATL patients. The combination of low T-cell responses and elevated HTLV-1 proviral loads are features of ATL, and are also observed in a subpopulation of HTLV-1 carriers at the asymptomatic stage, suggesting that these features may be underlying risk factors. These risks may potentially be reduced by vaccination to activate HTLV-1-specific T-cell responses. HAM/TSP and ATL patients also differ in their levels of HTLV-1 mRNA expression, which are generally low in vivo but slightly higher in HAM/TSP patients. Our recent study indicated that viral expression in HTLV-1-infected T-cells is suppressed by stromal cells in culture through type-I IFNs. The suppression was reversible after isolation from the stromal cells, mimicking a long-standing puzzling phenomenon in HTLV-1 infection where the viral expression is very low in vivo and rapidly induced in vitro. Collectively, HTLV-1 is controlled by both acquired and innate immunity in vivo: HTLV-1-specific T-cells survey infected cells, and IFNs suppress viral expression. Both effects would contribute to a reduction in viral pathogenesis, although they may potentially influence or conflict with one another. The presence of double control systems for HTLV-1 infection provides a new concept for understanding the pathogenesis of HTLV-1-mediated malignant and inflammatory diseases. © 2011 Japanese Cancer Association.

  18. 40 CFR 81.142 - Central Massachusetts Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Central Massachusetts Intrastate Air Quality Control Region. 81.142 Section 81.142 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...: Township—Ashburnham, Ashby, Athol, Auburn, Barre, Berlin, Blackstone, Boylston, Brookfield, Charlton...

  19. 40 CFR 81.143 - Central Virginia Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Central Virginia Intrastate Air Quality Control Region. 81.143 Section 81.143 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., Lynchburg, Martinsville, South Boston. Towns—Blackstone, Farmville, Rocky Mount, South Hill. ...

  20. Acquire uterine vascular malformation: Clinical outcome of transarterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Chae Hoon [Dept. of Radiology, Gangneung Asan Hospital, Gangneung (Korea, Republic of); Yang, Seung Boo; Goo, Dong Erk; Kim, Yong Jae; Lee, Jae Myung; Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of)

    2017-02-15

    To evaluate clinical outcomes of transarterial embolization of bilateral uterine arteries (UAE) in patients with acquired uterine vascular malformation (UVM). This retrospective study was performed on the medical records of all 19 patients who underwent transarterial embolization of bilateral UAE for the treatment of symptomatic UVMs from January 2003 to June 2011. Embolization was performed via the unilateral femoral artery approach with a catheter and angiographic techniques. Clinical success was defined as definitive resolution of abnormal vaginal bleeding. Post-procedural complications included all adverse events related to the embolization procedure. A total of 20 procedures were performed in 19 patients. One patient required repeat embolization because of incomplete embolization related to prominent high flow malformation. Clinically, in all patients, bleeding was controlled immediately after embolization. No complications occurred in all patients during the follow up period. In all patients who underwent successful UAE, menstrual cycles were normally restored within 1-2 months. Normal pregnancy with term delivery was observed in two of the 19 cases. Transarterial bilateral UAE is a safe and effective treatment in patients with vaginal bleeding caused by acquired UVM, and it allows the possibility of future pregnancy.

  1. Acquire uterine vascular malformation: Clinical outcome of transarterial embolization

    International Nuclear Information System (INIS)

    Kang, Chae Hoon; Yang, Seung Boo; Goo, Dong Erk; Kim, Yong Jae; Lee, Jae Myung; Lee, Woong Hee

    2017-01-01

    To evaluate clinical outcomes of transarterial embolization of bilateral uterine arteries (UAE) in patients with acquired uterine vascular malformation (UVM). This retrospective study was performed on the medical records of all 19 patients who underwent transarterial embolization of bilateral UAE for the treatment of symptomatic UVMs from January 2003 to June 2011. Embolization was performed via the unilateral femoral artery approach with a catheter and angiographic techniques. Clinical success was defined as definitive resolution of abnormal vaginal bleeding. Post-procedural complications included all adverse events related to the embolization procedure. A total of 20 procedures were performed in 19 patients. One patient required repeat embolization because of incomplete embolization related to prominent high flow malformation. Clinically, in all patients, bleeding was controlled immediately after embolization. No complications occurred in all patients during the follow up period. In all patients who underwent successful UAE, menstrual cycles were normally restored within 1-2 months. Normal pregnancy with term delivery was observed in two of the 19 cases. Transarterial bilateral UAE is a safe and effective treatment in patients with vaginal bleeding caused by acquired UVM, and it allows the possibility of future pregnancy

  2. Una alternative estratégica en el desarrollo regional

    OpenAIRE

    Molina , Rubén; Vázquez, Glafira

    2008-01-01

    Faced to the globalization process, regional development in Mexico shall address new challenges, particularly when referring to the competitiveness of the regions and social survival. Given that in this a country a high percentage of companies are small and medium sized, it is essential to promote their installation in different regions of this country. With the creation of new companies, economic, social,environmental, and territorial development is acquired in many regions. In this sense, t...

  3. Influences of Regional Development on Land Use of Nagara Basin and Flood Risk Control

    Directory of Open Access Journals (Sweden)

    Banba Michiko

    2016-01-01

    Full Text Available Land developments, and construction of factories or logistic centers should be implemented with the wellconsidered land use plans by taking account of disaster risks to improve the resilience of region to mitigate damages. In this paper, the relationship between regional development and land use from the perspective of flood risk control. Nagara basin in Gifu prefecture (Gifu, Mino, and Seki City, where transportation network has been developed to raise the potential for more development, is selected as a case study site. First, changes of industrial structures of the region and its influences on land use were analyzed. Then, possible flood control measures were summarized, and issues from the land use perspective are analysed

  4. 40 CFR 81.73 - South Bend-Elkhart (Indiana)-Benton Harbor (Michigan) Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false South Bend-Elkhart (Indiana)-Benton Harbor (Michigan) Interstate Air Quality Control Region. 81.73 Section 81.73 Protection of Environment... PLANNING PURPOSES Designation of Air Quality Control Regions § 81.73 South Bend-Elkhart (Indiana)-Benton...

  5. Preliminary study of community-acquired Staphylococcus aureus infection in Manaus Hospital, Amazonia Region, Brazil Estudo preliminar das infeccões por Staphylococcus aureus na comunidade de um Hospital em Manaus, Região do Amazonas, Brasil

    Directory of Open Access Journals (Sweden)

    Jesus M. Egido

    2003-12-01

    Full Text Available Methicillin resistant Staphylococcus aureus is considered a public health problem with a strong potential for dissemination and high rates of morbidity and mortality. In this study we describe bacteriological and epidemiological characteristics of Staphylococcus aureus in Manaus (Amazon region. During the one-year study period (2000-2001, sixteen cases of acute pyogenic multiple abscess were evaluated. Community-acquired S. aureus was identified as causative agent in 10 (62.5% patients. The strains tested with antimicrobials by discs diffusion method, exhibited a high rate of sensitivity to cephalexin (100%, erythromycin (90%. Oxacillin-susceptible Staphylococcus aureus was 90%. No isolate was resistant to Vancomycin. To our knowledge, no series of community-acquired Staphylococcus aureus in Manaus hospital has been published. Our partial results showed a high rate of antimicrobial sensitivity among community-acquired Staphylococcus aureus in the hospital of Tropical Medicine Institute of Manaus, Amazon Region.O Staphylococcus aureus resistente a meticilina é considerado como um problema na saúde publica por seu grande potencial de disseminação e altas porcentagens de morbidade e mortalidade. No estudo descrevemos as características bacteriológicas e epidemiológicas do Staphylococcus aureus na cidade de Manaus. No período de um ano (2000-2001 avaliou-se dezesseis casos de abscessos piogênicos múltiplos. Em 10 (62,5% doentes o agente causal foi identificado como Staphylococcus aureus adquirido na comunidade O estudo das bacterias isoladas frente aos diferentes antimicrobianos, seguindo o método de difusão em disco, mostrou boa sensibilidade a cefalexina (100% e eritromicina (90%. Noventa porcento dos Staphylococcus aureus isolados foram sensíveis ao oxacilina. Nenhum dos isolados mostrou ser resistente a Vancomicina. Não temos informações sobre publicações dos Staphylococcus aureus adquiridos na comunidade em hospitais de Manaus

  6. Best practices in tobacco control in the South-East Asia Region.

    Science.gov (United States)

    Zolty, B C; Sinha, P K; Sinha, D N

    2012-01-01

    The tobacco epidemic is an increasing threat to public health with the tobacco burden particularly high in WHO's South-East Asia Region (SEAR). The Region has many obstacles to tobacco control, but despite these challenges, significant progress has been made in many countries. Although much work still needs to be done, SEAR countries have nevertheless implemented strong and often innovative tobacco control measures that can be classified as "best practices," with some setting global precedents. The best practice measures implemented in SEAR include bans on gutka, reducing tobacco imagery in movies, and warning about the dangers of tobacco. In a time of scarce resources, countries in SEAR and elsewhere must ensure that the most effective and cost-efficient measures are implemented. It is hoped that countries can learn from these examples and as appropriate, adapt these measures to their own specific cultural, social and political realities.

  7. Retention of laparoscopic procedural skills acquired on a virtual-reality surgical trainer

    DEFF Research Database (Denmark)

    Nielsen, Mathilde Maagaard; Sørensen, J L; Oestergaard, Jeanett

    2011-01-01

    BACKGROUND: Virtual-reality (VR) simulator training has been shown to improve surgical performance in laparoscopic procedures in the operating room. We have, in a randomised controlled trial, demonstrated transferability to real operations. The validity of the LapSim virtual-reality simulator...... as an assessment tool has been demonstrated in several reports. However, an unanswered question regarding simulator training is the durability, or retention, of skills acquired during simulator training. The aim of the present study is to assess the retention of skills acquired using the LapSim VR simulator, 6...... and 18 months after an initial training course. METHODS AND MATERIALS: The investigation was designed as a 6- and 18-month follow-up on a cohort of participants who earlier participated in a skills training programme on the LapSim VR. The follow-up cohort consisted of trainees and senior consultants...

  8. Networked Predictive Control for Nonlinear Systems With Arbitrary Region Quantizers.

    Science.gov (United States)

    Yang, Hongjiu; Xu, Yang; Xia, Yuanqing; Zhang, Jinhui

    2017-04-06

    In this paper, networked predictive control is investigated for planar nonlinear systems with quantization by an extended state observer (ESO). The ESO is used not only to deal with nonlinear terms but also to generate predictive states for dealing with network-induced delays. Two arbitrary region quantizers are applied to take effective values of signals in forward channel and feedback channel, respectively. Based on a "zoom" strategy, sufficient conditions are given to guarantee stabilization of the closed-loop networked control system with quantization. A simulation example is proposed to exhibit advantages and availability of the results.

  9. Regional homogeneity changes in patients with primary insomnia

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Tianyue [Guangdong No. 2 Provincial People' s Hospital of Southern Medical University, The Third Clinical Medical College of Southern Medical University, Guangzhou (China); Li, Shumei; Jiang, Guihua; Lin, Chulan; Li, Meng; Ma, Xiaofen; Zhan, Wenfeng; Fang, Jin; Li, Liming; Li, Cheng; Tian, Junzhang [Guangdong No. 2 Provincial People' s Hospital of Southern Medical University, Guangzhou (China)

    2016-05-15

    The study aimed to explore the regional spontaneous activity changes in primary insomnia (PI) patients. Based on the resting-state fMRI datasets acquired from 59 PI patients and 47 healthy controls, a two-sample t-test was performed on individual normalized regional homogeneity (ReHo) maps. Relationships between abnormal ReHo values and the Pittsburgh Sleep Quality Index (PSQI), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were investigated with Pearson correlation analysis. In PI patients, we found increased ReHo in the left insula, right anterior cingulate gyrus, bilateral precentral gyrus and left cuneus, as well as decreased ReHo in the right middle cingulate cortex and left fusiform (p < 0.05, AlphaSim-corrected). We also found a significant positive correlation between increased ReHo in the left insula and SAS scores, decreased ReHo in the right middle cingulated cortex and SDS, SAS scores as well as a negative correlation between increased ReHo in the right precentral gyrus and SDS scores (p < 0.05). Our study found abnormal spontaneous activities in multiple brain regions, especially in emotion-related areas in PI patients. Alterative activities in these regions might contribute to an understanding the intrinsic functional architecture of insomnia and its clinical features. (orig.)

  10. Regional homogeneity changes in patients with primary insomnia

    International Nuclear Information System (INIS)

    Wang, Tianyue; Li, Shumei; Jiang, Guihua; Lin, Chulan; Li, Meng; Ma, Xiaofen; Zhan, Wenfeng; Fang, Jin; Li, Liming; Li, Cheng; Tian, Junzhang

    2016-01-01

    The study aimed to explore the regional spontaneous activity changes in primary insomnia (PI) patients. Based on the resting-state fMRI datasets acquired from 59 PI patients and 47 healthy controls, a two-sample t-test was performed on individual normalized regional homogeneity (ReHo) maps. Relationships between abnormal ReHo values and the Pittsburgh Sleep Quality Index (PSQI), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were investigated with Pearson correlation analysis. In PI patients, we found increased ReHo in the left insula, right anterior cingulate gyrus, bilateral precentral gyrus and left cuneus, as well as decreased ReHo in the right middle cingulate cortex and left fusiform (p < 0.05, AlphaSim-corrected). We also found a significant positive correlation between increased ReHo in the left insula and SAS scores, decreased ReHo in the right middle cingulated cortex and SDS, SAS scores as well as a negative correlation between increased ReHo in the right precentral gyrus and SDS scores (p < 0.05). Our study found abnormal spontaneous activities in multiple brain regions, especially in emotion-related areas in PI patients. Alterative activities in these regions might contribute to an understanding the intrinsic functional architecture of insomnia and its clinical features. (orig.)

  11. A review of Hyalomma scupense (Acari, Ixodidae in the Maghreb region: from biology to control

    Directory of Open Access Journals (Sweden)

    2014-01-01

    Full Text Available Hyalomma scupense (syn. Hyalomma detritum is a two-host domestic endophilic tick of cattle and secondarily other ungulates in the Maghreb region (Africa. This species transmits several pathogens, among which two are major livestock diseases: Theileria annulata and Theileria equi. Various other pathogens are also transmitted by this tick species, such as Anaplasma phagocytophilum and Ehrlichia bovis. Hyalomma scupense is common in sub-humid and semi-arid areas of several regions in the world, mainly in the Maghreb region. In this region, adults attach to animals during the summer season; larvae and nymphs attach to their hosts during autumn, but there is a regional difference in H. scupense phenology. There is an overlap between immature and adult ticks, leading in some contexts to a dramatic modification of the epidemiology of tick-borne diseases. This tick species attaches preferentially to the posterior udder quarters and thighs. Tick burdens can reach 130 ticks per animal, with a mean of 60 ticks. Calves are 70 times less infested than adult cattle. The control can be implemented through six options: (i rehabilitation of the farm buildings by roughcasting and smoothing the outer and inner surfaces of the enclosures and walls. This control option should be recommended to be combined with a thorough cleaning of the farm and its surrounding area. With regard to Theileria annulata infection, this control option is the most beneficial. (ii Acaricide application to animals during the summer season, targeting adults. (iii Acaricide application during the autumn period for the control of the immature stages. (iv Acaricide application to the walls: many field veterinarians have suggested this option but it is only partially efficient since nymphs enter deep into the cracks and crevices. It should be used if there is a very high tick burden or if there is a high risk of tick-borne diseases. (v Manual tick removal: this method is not efficient since the

  12. Antimicrobial Resistance Control Strategies: A Coordinated Research Initiative Experience in the Asia Pacific Region.

    Science.gov (United States)

    Lapierre, Lisette; Asenjo, Gabriela; Vergara, Constanza; Cornejo, Javiera

    2017-05-01

    The objective was to gather information on the status of antimicrobial surveillance in the Asia Pacific region and suggest control strategies. Twenty-one economies of the Asia Pacific region participated in this initiative. A survey was conducted on antimicrobial use and surveillance throughout the region. A workshop was carried out to create awareness about the issue and discuss the implementation of control strategies. Based on the survey results and workshop conclusions, it can be established that there is better understanding of the implications of antimicrobial resistance in the human medicine area. Only few economies take actions to control antimicrobial resistance on a veterinary/agricultural level. To confront antimicrobial resistance, it is critical to raise awareness; cooperation between all countries is needed to apply international standards, to be able to have harmonized public policies. Countries must align and improve their systems for surveillance and monitoring of antimicrobial resistance in human, animals, and the environment.

  13. Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

    Science.gov (United States)

    2014-01-01

    SUMMARY There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens. PMID:25278571

  14. GWAS of DNA Methylation Variation Within Imprinting Control Regions Suggests Parent-of-Origin Association

    NARCIS (Netherlands)

    Renteria, M.E.; Coolen, M.W.; Statham, A.L.; Choi, R.S.; Qu, W.; Campbell, M.J.; Smith, S.; Henders, A.K.; Montgomery, G.W.; Clark, S. J.; Martin, N.G.; Medland, S.E.

    2013-01-01

    Imprinting control regions (ICRs) play a fundamental role in establishing and maintaining the non-random monoallelic expression of certain genes, via common regulatory elements such as non-coding RNAs and differentially methylated regions (DMRs) of DNA. We recently surveyed DNA methylation levels

  15. CMS reimbursement reform and the incidence of hospital-acquired pulmonary embolism or deep vein thrombosis.

    Science.gov (United States)

    Gidwani, Risha; Bhattacharya, Jay

    2015-05-01

    In October 2008, the Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for the marginal cost of treating certain preventable hospital-acquired conditions. This study evaluates whether CMS's refusal to pay for hospital-acquired pulmonary embolism (PE) or deep vein thrombosis (DVT) resulted in a lower incidence of these conditions. We employ difference-in-differences modeling using 2007-2009 data from the Nationwide Inpatient Sample, an all-payer database of inpatient discharges in the U.S. Discharges between 1 January 2007 and 30 September 2008 were considered "before payment reform;" discharges between 1 October 2008 and 31 December 2009 were considered "after payment reform." Hierarchical regression models were fit to account for clustering of observations within hospitals. The "before payment reform" and "after payment reform" incidences of PE or DVT among 65-69-year-old Medicare recipients were compared with three different control groups of: a) 60-64-year-old non-Medicare patients; b) 65-69-year-old non-Medicare patients; and c) 65-69-year-old privately insured patients. Hospital reimbursements for the control groups were not affected by payment reform. CMS payment reform for hospital-based reimbursement of patients with hip and knee replacement surgeries. The outcome was the incidence proportion of hip and knee replacement surgery admissions that developed pulmonary embolism or deep vein thrombosis. At baseline, pulmonary embolism or deep vein thrombosis were present in 0.81% of all hip or knee replacement surgeries for Medicare patients aged 65-69 years old. CMS payment reform resulted in a 35% lower incidence of hospital-acquired pulmonary embolism or deep vein thrombosis in these patients (p = 0.015). Results were robust to sensitivity analyses. CMS's refusal to pay for hospital-acquired conditions resulted in a lower incidence of hospital-acquired pulmonary embolism or deep vein thrombosis after hip or knee replacement surgery

  16. Social, economic and legal dimensions of tobacco and its control in South-East Asia region.

    Science.gov (United States)

    Kyaing, Nyo Nyo; Islam, Md Ashadul; Sinha, Dhirendra N; Rinchen, Sonam

    2011-01-01

    This paper examines the social, cultural, economic and legal dimensions of tobacco control in the South-East Asia Region in a holistic view through the review of findings from various studies on prevalence, tobacco economics, poverty alleviation, women and tobacco and tobacco control laws and regulations. Methods were Literature review of peer reviewed publications, country reports, WHO publications, and reports of national and international meetings on tobacco and findings from national level surveys and studies. Tobacco use has been a social and cultural part of the people of South-East Asia Region. Survey findings show that 30% to 60% of men and 1.8% to 15.6% of women in the Region use one or the other forms of tobacco products. The complex nature of tobacco use with both smoking and smokeless forms is a major challenge for implementing tobacco control measures. Prevalence of tobacco use is high among the poor and the illiterate. It is higher among males than females but studies show a rising trend among girls and women due to intensive marketing of tobacco products by the tobacco industry. Tobacco users spend a huge percent of their income on tobacco which deprives them and their families of proper nutrition, good education and health care. Some studies of the Region show that cost of treatment of diseases attributable to tobacco use was more than double the revenue that governments received from tobacco taxation. Another challenge the Region faces is the application of uniform tax to all forms of tobacco, which will reduce not only the availability of tobacco products in the market but also control people switching over to cheaper tobacco products. Ten out of eleven countries are Parties to the WHO Framework Convention on Tobacco Control and nine countries have tobacco control legislation. Enforcement of control measures is weak, particularly in areas such as smoke-free environments, advertisement at the point of sale and sale of tobacco to minors. Socio

  17. Unmanned Water Craft Identification and Adaptive Control in Low-Speed and Reversing Regions

    DEFF Research Database (Denmark)

    Theisen, Lukas Roy Svane; Galeazzi, Roberto; Blanke, Mogens

    2013-01-01

    This paper treats L1 adaptive hovering control of an unmanned surface vehicle in a station-keeping mode where a region of zero control authority and under-actuation are main challenges. Low-speed and reversing dynamics are identied from full scale sea trials, and parameter uncertainty is estimate...

  18. Psychometric evaluation of a motor control test battery of the craniofacial region.

    Science.gov (United States)

    von Piekartz, H; Stotz, E; Both, A; Bahn, G; Armijo-Olivo, S; Ballenberger, N

    2017-12-01

    The primary objective of this study was to determine the structural and known-group validity as well as the inter-rater reliability of a test battery to evaluate the motor control of the craniofacial region. Seventy volunteers without TMD and 25 subjects with TMD (Axes I) per the DC/TMD were asked to execute a test battery consisting of eight tests. The tests were video-taped in the same sequence in a standardised manner. Two experienced physical therapists participated in this study as blinded assessors. We used exploratory factor analysis to identify the underlying component structure of the eight tests. Internal consistency (Cronbach's α), inter-rater reliability (intra-class correlation coefficient) and construct validity (ie, hypothesis testing-known-group validity) (receiver operating curves) were also explored for the test battery. The structural validity showed the presence of one factor underlying the construct of the test battery. The internal consistency was excellent (0.90) as well as the inter-rater reliability. All values of reliability were close to 0.9 or above indicating very high inter-rater reliability. The area under the curve (AUC) was 0.93 for rater 1 and 0.94 for rater two, respectively, indicating excellent discrimination between subjects with TMD and healthy controls. The results of the present study support the psychometric properties of test battery to measure motor control of the craniofacial region when evaluated through videotaping. This test battery could be used to differentiate between healthy subjects and subjects with musculoskeletal impairments in the cervical and oro-facial regions. In addition, this test battery could be used to assess the effectiveness of management strategies in the craniofacial region. © 2017 John Wiley & Sons Ltd.

  19. Cognitive control of drug craving inhibits brain reward regions in cocaine abusers

    International Nuclear Information System (INIS)

    Volkow, N.D.; Fowler, J.; Wang, G.J.; Telang, F.; Logan, J.; Jayne, M.; Ma, Y.; Pradhan, K.; Wong, C.T.; Swanson, J.M.

    2010-01-01

    Loss of control over drug taking is considered a hallmark of addiction and is critical in relapse. Dysfunction of frontal brain regions involved with inhibitory control may underlie this behavior. We evaluated whether addicted subjects when instructed to purposefully control their craving responses to drug-conditioned stimuli can inhibit limbic brain regions implicated in drug craving. We used PET and 2-deoxy-2[18F]fluoro-D-glucose to measure brain glucose metabolism (marker of brain function) in 24 cocaine abusers who watched a cocaine-cue video and compared brain activation with and without instructions to cognitively inhibit craving. A third scan was obtained at baseline (without video). Statistical parametric mapping was used for analysis and corroborated with regions of interest. The cocaine-cue video increased craving during the no-inhibition condition (pre 3 ± 3, post 6 ± 3; p < 0.001) but not when subjects were instructed to inhibit craving (pre 3 ± 2, post 3 ± 3). Comparisons with baseline showed visual activation for both cocaine-cue conditions and limbic inhibition (accumbens, orbitofrontal, insula, cingulate) when subjects purposefully inhibited craving (p < 0.001). Comparison between cocaine-cue conditions showed lower metabolism with cognitive inhibition in right orbitofrontal cortex and right accumbens (p < 0.005), which was associated with right inferior frontal activation (r = -0.62, p < 0.005). Decreases in metabolism in brain regions that process the predictive (nucleus accumbens) and motivational value (orbitofrontal cortex) of drug-conditioned stimuli were elicited by instruction to inhibit cue-induced craving. This suggests that cocaine abusers may retain some ability to inhibit craving and that strengthening fronto-accumbal regulation may be therapeutically beneficial in addiction.

  20. Cognitive control of drug craving inhibits brain reward regions in cocaine abusers

    Energy Technology Data Exchange (ETDEWEB)

    Volkow, N.D.; Fowler, J.; Wang, G.J.; Telang, F.; Logan, J.; Jayne, M.; Ma, Y.; Pradhan, K.; Wong, C.T.; Swanson, J.M.

    2010-01-01

    Loss of control over drug taking is considered a hallmark of addiction and is critical in relapse. Dysfunction of frontal brain regions involved with inhibitory control may underlie this behavior. We evaluated whether addicted subjects when instructed to purposefully control their craving responses to drug-conditioned stimuli can inhibit limbic brain regions implicated in drug craving. We used PET and 2-deoxy-2[18F]fluoro-D-glucose to measure brain glucose metabolism (marker of brain function) in 24 cocaine abusers who watched a cocaine-cue video and compared brain activation with and without instructions to cognitively inhibit craving. A third scan was obtained at baseline (without video). Statistical parametric mapping was used for analysis and corroborated with regions of interest. The cocaine-cue video increased craving during the no-inhibition condition (pre 3 {+-} 3, post 6 {+-} 3; p < 0.001) but not when subjects were instructed to inhibit craving (pre 3 {+-} 2, post 3 {+-} 3). Comparisons with baseline showed visual activation for both cocaine-cue conditions and limbic inhibition (accumbens, orbitofrontal, insula, cingulate) when subjects purposefully inhibited craving (p < 0.001). Comparison between cocaine-cue conditions showed lower metabolism with cognitive inhibition in right orbitofrontal cortex and right accumbens (p < 0.005), which was associated with right inferior frontal activation (r = -0.62, p < 0.005). Decreases in metabolism in brain regions that process the predictive (nucleus accumbens) and motivational value (orbitofrontal cortex) of drug-conditioned stimuli were elicited by instruction to inhibit cue-induced craving. This suggests that cocaine abusers may retain some ability to inhibit craving and that strengthening fronto-accumbal regulation may be therapeutically beneficial in addiction.

  1. Regional Use of Social Networking Tools

    Science.gov (United States)

    2014-12-01

    4 2.1.7 Tumblr 4 2.1.8 Instagram 4 2.2 Local Social Networking Services 5 3 Regional Preferences for Social Networking Tools 6 4 African Region...YouTube 280 million Twitter 255 million LinkedIn n/a Pinterest n/a Tumblr 300 million Instagram 200 million The active-user base numbers...so this percentage may decline in the future. 2.1.8 Instagram Instagram , acquired by Facebook in 2012, is a mobile social networking service that

  2. Acquiring energy savings in manufactured housing

    International Nuclear Information System (INIS)

    Davey, D.

    1993-01-01

    In 1991, the Northwest utilities faced a complex situation. They needed new sources of electrical power to avoid future deficits. A significant block of energy savings was available in the manufactured housing sector in the form of energy savings from increased insulation to new manufactured homes. The manufacturers were interested in saving the electricity in the homes, but would only deal with the utility sector as a whole. Half of the homes targeted were sited in investor-owned utility (IOU) service territories, and half in the public sector made up of utilities that purchased some or all of their electricity from the Bonneville Power Administration. Utilities agreed to acquire energy from manufacturers In the form of thermal efficiency measures specified by the Bonneville Power Administration. The program that resulted from over one year of negotiations was called the Manufactured Housing Acquisition Program, or MAP. Manufacturers, the utilities, State Energy Offices, the Northwest Power Planning Council and Bonneville all worked closely and with tenacity to build the program that went into effect on April 1, 1992, and should save the region between 7 and 9 megawatts, enough energy to supply 11,000 homes in the Northwest

  3. Communicable diseases in the Eastern Mediterranean Region: prevention and control 2010-2011.

    Science.gov (United States)

    Haq, Z; Mahjour, J; Khan, W

    2013-10-01

    One-third of all morbidities and mortalities in the Eastern Mediterranean Region are attributed to communicable diseases. A continued situation of war and conflict, and growing political unrest in the Region, coupled with factors such as travel and migration, and insufficient infrastructure and inadequate technical and managerial capacity ofthe programmes are the major challenges. Despite these challenges, the Region continued making progress towards the elimination of specific diseases such as lymphatic filariasis, measles, malaria, schistosomiasis and dracunculiasis during 2010-11. Coverage for vaccine-preventable diseases was enhanced. Preparedness and response to emerging (e.g. dengue fever in Pakistan and Yemen) and re-emerging (e.g. cholera in Sudan) infections was improved. The Region has continued its efforts for controlling tuberculosis and curbing HIV/AIDS. Looking ahead, the Region aims to improve surveillance and response capacities, legislation issues, coordination, bio-risk and bio-security and quality management in the coming years.

  4. Hospital-Acquired Condition Reduction Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2014, CMS began reducing Medicare payments for subsection (d) hospitals that rank in the worst performing quartile with respect to hospital-acquired...

  5. Effect of intermittent feedback control on robustness of human-like postural control system

    Science.gov (United States)

    Tanabe, Hiroko; Fujii, Keisuke; Suzuki, Yasuyuki; Kouzaki, Motoki

    2016-03-01

    Humans have to acquire postural robustness to maintain stability against internal and external perturbations. Human standing has been recently modelled using an intermittent feedback control. However, the causality inside of the closed-loop postural control system associated with the neural control strategy is still unknown. Here, we examined the effect of intermittent feedback control on postural robustness and of changes in active/passive components on joint coordinative structure. We implemented computer simulation of a quadruple inverted pendulum that is mechanically close to human tiptoe standing. We simulated three pairs of joint viscoelasticity and three choices of neural control strategies for each joint: intermittent, continuous, or passive control. We examined postural robustness for each parameter set by analysing the region of active feedback gain. We found intermittent control at the hip joint was necessary for model stabilisation and model parameters affected the robustness of the pendulum. Joint sways of the pendulum model were partially smaller than or similar to those of experimental data. In conclusion, intermittent feedback control was necessary for the stabilisation of the quadruple inverted pendulum. Also, postural robustness of human-like multi-link standing would be achieved by both passive joint viscoelasticity and neural joint control strategies.

  6. [Neural Mechanisms That Facilitate Adaptive Behavior Based on Acquired Stimulus-Outcome Information].

    Science.gov (United States)

    Ogawa, Masaaki

    2017-11-01

    In response to changing internal and external situations, we always need to adapt our behavior based on previous experiences, particularly, acquired stimulus-outcome information. The orbitofrontal cortex (OFC), a prefrontal cortical region, is critical for this type of decision-making. The current understanding of the fundamental functions of the OFC has been reviewed by introducing, as an example, how the OFC contributes to the processing of uncertain rewards. Furthermore, the importance of revealing context and temporally specific causal roles of neural circuits including the OFC in decision-making, as well as the techniques to achieve the goal, have been discussed.

  7. Social media interruption affects the acquisition of visually, not aurally, acquired information during a pathophysiology lecture.

    Science.gov (United States)

    Marone, Jane R; Thakkar, Shivam C; Suliman, Neveen; O'Neill, Shannon I; Doubleday, Alison F

    2018-06-01

    Poor academic performance from extensive social media usage appears to be due to students' inability to multitask between distractions and academic work. However, the degree to which visually distracted students can acquire lecture information presented aurally is unknown. This study examined the ability of students visually distracted by social media to acquire information presented during a voice-over PowerPoint lecture, and to compare performance on examination questions derived from information presented aurally vs. that presented visually. Students ( n = 20) listened to a 42-min cardiovascular pathophysiology lecture containing embedded cartoons while taking notes. The experimental group ( n = 10) was visually, but not aurally, distracted by social media during times when cartoon information was presented, ~40% of total lecture time. Overall performance among distracted students on a follow-up, open-note quiz was 30% poorer than that for controls ( P < 0.001). When the modality of presentation (visual vs. aural) was compared, performance decreased on examination questions from information presented visually. However, performance on questions from information presented aurally was similar to that of controls. Our findings suggest the ability to acquire information during lecture may vary, depending on the degree of competition between the modalities of the distraction and the lecture presentation. Within the context of current literature, our findings also suggest that timing of the distraction relative to delivery of material examined affects performance more than total distraction time. Therefore, when delivering lectures, instructors should incorporate organizational cues and active learning strategies that assist students in maintaining focus and acquiring relevant information.

  8. Acquired ichthyosis with hoffman's syndrome

    Directory of Open Access Journals (Sweden)

    Sathyanarayana B

    2003-01-01

    Full Text Available A middle aged man presented with features of acquired ichthyosis with Hoffman's syndrome. Laboratory tests support hypothyodism. Myoedema and hypertrophy of muscles were present. Patient was previously treated for Pellagra.

  9. Risk factors associated with hantavirosis fatality: a regional analysis from a case-control study in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Antunes Willemann

    2014-01-01

    Full Text Available Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality.

  10. Occupationally Acquired American Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Maria Edileuza Felinto de Brito

    2012-01-01

    Full Text Available We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL: one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples and characterized as Leishmania (Viannia naiffi through an indirect immunofluorescence assay (IFA with species-specific monoclonal antibodies (mAbs and by multilocus enzyme electrophoresis (MLEE. Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis.

  11. Modified Adaptive Control for Region 3 Operation in the Presence of Wind Turbine Structural Modes

    Science.gov (United States)

    Frost, Susan Alane; Balas, Mark J.; Wright, Alan D.

    2010-01-01

    Many challenges exist for the operation of wind turbines in an efficient manner that is reliable and avoids component fatigue and failure. Turbines operate in highly turbulent environments resulting in aerodynamic loads that can easily excite turbine structural modes, possibly causing component fatigue and failure. Wind turbine manufacturers are highly motivated to reduce component fatigue and failure that can lead to loss of revenue due to turbine down time and maintenance costs. The trend in wind turbine design is toward larger, more flexible turbines that are ideally suited to adaptive control methods due to the complexity and expense required to create accurate models of their dynamic characteristics. In this paper, we design an adaptive collective pitch controller for a high-fidelity simulation of a utility-scale, variable-speed horizontal axis wind turbine operating in Region 3. The objective of the adaptive pitch controller is to regulate generator speed, accommodate wind gusts, and reduce the excitation of structural modes in the wind turbine. The control objective is accomplished by collectively pitching the turbine blades. The adaptive collective pitch controller for Region 3 was compared in simulations with a baseline classical Proportional Integrator (PI) collective pitch controller. The adaptive controller will demonstrate the ability to regulate generator speed in Region 3, while accommodating gusts, and reducing the excitation of certain structural modes in the wind turbine.

  12. Visual memory and visual mental imagery recruit common control and sensory regions of the brain.

    Science.gov (United States)

    Slotnick, Scott D; Thompson, William L; Kosslyn, Stephen M

    2012-01-01

    Separate lines of research have shown that visual memory and visual mental imagery are mediated by frontal-parietal control regions and can rely on occipital-temporal sensory regions of the brain. We used fMRI to assess the degree to which visual memory and visual mental imagery rely on the same neural substrates. During the familiarization/study phase, participants studied drawings of objects. During the test phase, words corresponding to old and new objects were presented. In the memory test, participants responded "remember," "know," or "new." In the imagery test, participants responded "high vividness," "moderate vividness," or "low vividness." Visual memory (old-remember) and visual imagery (old-high vividness) were commonly associated with activity in frontal-parietal control regions and occipital-temporal sensory regions. In addition, visual memory produced greater activity than visual imagery in parietal and occipital-temporal regions. The present results suggest that visual memory and visual imagery rely on highly similar--but not identical--cognitive processes.

  13. 7 CFR 3575.90 - Disposition of acquired property.

    Science.gov (United States)

    2010-01-01

    ... property. (a) General. When the lender acquires title to the collateral and the final loss claim is not... 7 Agriculture 15 2010-01-01 2010-01-01 false Disposition of acquired property. 3575.90 Section... protect the collateral, and the lender must dispose of the collateral without delay. (b) Re-title...

  14. Blended learning is an effective strategy for acquiring competence in public health biostatistics.

    Science.gov (United States)

    Milic, Natasa; Masic, Srdjan; Bjegovic-Mikanovic, Vesna; Trajkovic, Goran; Marinkovic, Jelena; Milin-Lazovic, Jelena; Bukumiric, Zoran; Savic, Marko; Cirkovic, Andja; Gajic, Milan; Stanisavljevic, Dejana

    2018-04-01

    We sought to determine whether blended learning is an effective strategy for acquiring competence in public health biostatistics. The trial was conducted with 69 Masters' students of public health attending the School of Public Health at University of Belgrade. Students were exposed to the traditional and blended learning styles. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course. Curriculum development was guided by competencies as suggested by the Association of Schools of Public Health in the European Region (ASPHER). Teaching methods were compared according to the final competence score. Forty-four students were enrolled in the traditional method of education delivery, and 25 to the blended learning format. Mean exam scores for the blended learning group were higher than for the on-site group for both the final statistics score (89.65 ± 6.93 vs. 78.21 ± 13.26; p  0.8). A blended learning approach is an attractive and effective way of acquiring biostatistics competence for Masters of Public Health (MPH) graduate students.

  15. Hypertension Control and Cardiometabolic Risk: A Regional Perspective

    Directory of Open Access Journals (Sweden)

    Martin Thoenes

    2012-01-01

    Full Text Available Background. We investigated the association between blood pressure control and common cardiometabolic risk factors from a global and regional perspective. Methods. In the present analysis of a large cross-sectional i-SEARCH study, 17.092 outpatients receiving antihypertensive treatment were included in 26 countries. According to clinical guidelines for the management of arterial hypertension, patients were classified based on the level of seated systolic/diastolic blood pressure (SBP/DBP. Uncontrolled hypertension was defined as SBP/DBP ≥140/90 mmHg for non-diabetics, and ≥130/80 mmHg for diabetics. Results. Overall, mean age was 63.1 years, 52.8% were male, and mean BMI was 28.9 kg/m2. Mean SBP/DBP was 148.9/87.0 mmHg, and 76.3% of patients had uncontrolled hypertension. Diabetes was present in 29.1% with mean HbA1c of 6.8%. Mean LDL-cholesterol was 3.2 mmol/L, HDL-cholesterol 1.3 mmol/L, and triglycerides 1.8 mmol/L; 49.0% had hyperlipidemia. Patients with uncontrolled hypertension had a higher BMI (29.4 versus 28.6 kg/m2, LDL-cholesterol (3.4 versus 3.0 mmol/L, triglycerides (1.9 versus 1.7 mmol/L, and HbA1c (6.8 versus 6.7% than those with controlled blood pressure (P<0.0001 for all parameters. Conclusions. Among outpatients treated for arterial hypertension, three quarters had uncontrolled blood pressure. Elevated SBP/DBP and uncontrolled hypertension were associated with increasing BMI, LDL-cholesterol, triglycerides, and HbA1c, both globally and regionally.

  16. Fitness and mobility training in patients with Intensive Care Unit-acquired muscle weakness (FITonICU): study protocol for a randomised controlled trial

    OpenAIRE

    Mehrholz, Jan; Thomas, Simone; Burridge, Jane H.; Schmidt, Andr?; Scheffler, Bettina; Schellin, Ralph; R?ckriem, Stefan; Mei?ner, Daniel; Mehrholz, Katja; Sauter, Wolfgang; Bodechtel, Ulf; Elsner, Bernhard

    2016-01-01

    Background Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no random...

  17. Human neutrophil peptides and complement factor Bb in pathogenesis of acquired thrombotic thrombocytopenic purpura.

    Science.gov (United States)

    Cao, Wenjing; Pham, Huy P; Williams, Lance A; McDaniel, Jenny; Siniard, Rance C; Lorenz, Robin G; Marques, Marisa B; Zheng, X Long

    2016-11-01

    Acquired thrombotic thrombocytopenic purpura is primarily caused by the deficiency of plasma ADAMTS13 activity resulting from autoantibodies against ADAMTS13. However, ADAMTS13 deficiency alone is often not sufficient to cause acute thrombotic thrombocytopenic purpura. Infections or systemic inflammation may precede acute bursts of the disease, but the underlying mechanisms are not fully understood. Herein, 52 patients with acquired autoimmune thrombotic thrombocytopenic purpura and 30 blood donor controls were recruited for the study. The plasma levels of human neutrophil peptides 1-3 and complement activation fragments (i.e. Bb, iC3b, C4d, and sC5b-9) were determined by enzyme-linked immunosorbent assays. Univariate analyses were performed to determine the correlation between each biomarker and clinical outcomes. We found that the plasma levels of human neutrophil peptides 1-3 and Bb in patients with acute thrombotic thrombocytopenic purpura were significantly higher than those in the control (Ppurpura patients and the control. We conclude that innate immunity, i.e. neutrophil and complement activation via the alternative pathway, may play a role in the pathogenesis of acute autoimmune thrombotic thrombocytopenic purpura, and a therapy targeted at these pathways may be considered in a subset of these patients. Copyright© Ferrata Storti Foundation.

  18. Exact fan-beam image reconstruction algorithm for truncated projection data acquired from an asymmetric half-size detector

    International Nuclear Information System (INIS)

    Leng Shuai; Zhuang Tingliang; Nett, Brian E; Chen Guanghong

    2005-01-01

    In this paper, we present a new algorithm designed for a specific data truncation problem in fan-beam CT. We consider a scanning configuration in which the fan-beam projection data are acquired from an asymmetrically positioned half-sized detector. Namely, the asymmetric detector only covers one half of the scanning field of view. Thus, the acquired fan-beam projection data are truncated at every view angle. If an explicit data rebinning process is not invoked, this data acquisition configuration will reek havoc on many known fan-beam image reconstruction schemes including the standard filtered backprojection (FBP) algorithm and the super-short-scan FBP reconstruction algorithms. However, we demonstrate that a recently developed fan-beam image reconstruction algorithm which reconstructs an image via filtering a backprojection image of differentiated projection data (FBPD) survives the above fan-beam data truncation problem. Namely, we may exactly reconstruct the whole image object using the truncated data acquired in a full scan mode (2π angular range). We may also exactly reconstruct a small region of interest (ROI) using the truncated projection data acquired in a short-scan mode (less than 2π angular range). The most important characteristic of the proposed reconstruction scheme is that an explicit data rebinning process is not introduced. Numerical simulations were conducted to validate the new reconstruction algorithm

  19. Regional Competition for Confidence: Features of Formation

    Directory of Open Access Journals (Sweden)

    Irina Svyatoslavovna Vazhenina

    2016-09-01

    Full Text Available The increase in economic independence of the regions inevitably leads to an increase in the quality requirements of the regional economic policy. The key to successful regional policy, both during its development and implementation, is the understanding of the necessity of gaining confidence (at all levels, and the inevitable participation in the competition for confidence. The importance of confidence in the region is determined by its value as a competitive advantage in the struggle for partners, resources and tourists, and attracting investments. In today’s environment the focus of governments, regions and companies on long-term cooperation is clearly expressed, which is impossible without a high level of confidence between partners. Therefore, the most important competitive advantages of territories are intangible assets such as an attractive image and a good reputation, which builds up confidence of the population and partners. The higher the confidence in the region is, the broader is the range of potential partners, the larger is the planning horizon of long-term concerted action, the better are the chances of acquiring investment, the higher is the level of competitive immunity of the territories. The article defines competition for confidence as purposeful behavior of a market participant in economic environment, aimed at acquiring specific intangible competitive advantage – the confidence of the largest possible number of other market actors. The article also highlights the specifics of confidence as a competitive goal, presents factors contributing to the destruction of confidence, proposes a strategy to fight for confidence as a program of four steps, considers the factors which integrate regional confidence and offers several recommendations for the establishment of effective regional competition for confidence

  20. Does Regional Lung Strain Correlate With Regional Inflammation in Acute Respiratory Distress Syndrome During Nonprotective Ventilation? An Experimental Porcine Study.

    Science.gov (United States)

    Retamal, Jaime; Hurtado, Daniel; Villarroel, Nicolás; Bruhn, Alejandro; Bugedo, Guillermo; Amato, Marcelo Britto Passos; Costa, Eduardo Leite Vieira; Hedenstierna, Göran; Larsson, Anders; Borges, João Batista

    2018-06-01

    It is known that ventilator-induced lung injury causes increased pulmonary inflammation. It has been suggested that one of the underlying mechanisms may be strain. The aim of this study was to investigate whether lung regional strain correlates with regional inflammation in a porcine model of acute respiratory distress syndrome. Retrospective analysis of CT images and positron emission tomography images using [F]fluoro-2-deoxy-D-glucose. University animal research laboratory. Seven piglets subjected to experimental acute respiratory distress syndrome and five ventilated controls. Acute respiratory distress syndrome was induced by repeated lung lavages, followed by 210 minutes of injurious mechanical ventilation using low positive end-expiratory pressures (mean, 4 cm H2O) and high inspiratory pressures (mean plateau pressure, 45 cm H2O). All animals were subsequently studied with CT scans acquired at end-expiration and end-inspiration, to obtain maps of volumetric strain (inspiratory volume - expiratory volume)/expiratory volume, and dynamic positron emission tomography imaging. Strain maps and positron emission tomography images were divided into 10 isogravitational horizontal regions-of-interest, from which spatial correlation was calculated for each animal. The acute respiratory distress syndrome model resulted in a decrease in respiratory system compliance (20.3 ± 3.4 to 14.0 ± 4.9 mL/cm H2O; p < 0.05) and oxygenation (PaO2/FIO2, 489 ± 80 to 92 ± 59; p < 0.05), whereas the control animals did not exhibit changes. In the acute respiratory distress syndrome group, strain maps showed a heterogeneous distribution with a greater concentration in the intermediate gravitational regions, which was similar to the distribution of [F]fluoro-2-deoxy-D-glucose uptake observed in the positron emission tomography images, resulting in a positive spatial correlation between both variables (median R = 0.71 [0.02-0.84]; p < 0.05 in five of seven animals

  1. New approaches to infection prevention and control: implementing a risk-based model regionally.

    Science.gov (United States)

    Wale, Martin; Kibsey, Pamela; Young, Lisa; Dobbyn, Beverly; Archer, Jana

    2016-06-01

    Infectious disease outbreaks result in substantial inconvenience to patients and disruption of clinical activity. Between 1 April 2008 and 31 March 2009, the Vancouver Island Health Authority (Island Health) declared 16 outbreaks of Vancomycin Resistant Enterococci and Clostridium difficile in acute care facilities. As a result, infection prevention and control became one of Island Health's highest priorities. Quality improvement methodology, which promotes a culture of co-production between front-line staff, physicians and Infection Control Practitioners, was used to develop and test a bundle of changes in practices. A series of rapid Plan-Do-Study-Act cycles, specific to decreasing hospital-acquired infections, were undertaken by a community hospital, selected for its size, clinical specialty representation, and enthusiasm amongst staff and physicians for innovation and change. Positive results were incorporated into practice at the test site, and then introduced throughout the rest of the Health Authority. The changes implemented as a result of this study have enabled better control of antibiotic resistant organisms and have minimized disruption to routine activity, as well as saving an estimated $6.5 million per annum. When outbreaks do occur, they are now controlled much more promptly, even in existing older facilities. Through this process, we have changed our approach in Infection Prevention and Control (IPAC) from a rules-based approach to one that is risk-based, focusing attention on identifying and managing high-risk situations. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  2. In Reply - Statin Use and Risk of Community-Acquired Staphylococcus aureus Bacteremia

    DEFF Research Database (Denmark)

    Smit, Jesper; Schønheyder, Henrik C; Nielsen, Henrik

    2018-01-01

    OBJECTIVE: To ascertain whether persons treated with statins experience a decreased risk of community-acquired Staphylococcus aureus bacteremia (CA-SAB) as compared with nonusers. PATIENTS AND METHODS: Using population-based medical registries, we conducted a case-control study including all adults...... with first-time CA-SAB and population controls matched on age, sex, and residence in Northern Denmark from January 1, 2000, through December 31, 2011. Statin users were categorized as current users (new or long-term use), former users, and nonusers. We used conditional logistic regression to compute odds...... ratios (ORs) for CA-SAB according to statin exposure, overall and stratified by intensity (statin...

  3. Acquired factor VII deficiency associated with acute myeloid leukemia.

    Science.gov (United States)

    Anoun, Soumaya; Lamchahab, Mouna; Oukkache, Bouchra; Qachouh, Maryam; Benchekroun, Said; Quessar, Asmaa

    2015-04-01

    Isolated acquired factor VII deficiency is a rare coagulopathy. It has been reported in 31 patients with malignancy, sepsis, postoperatively, aplastic anemia, and during bone marrow transplantation. We discuss, through a new case of acquired factor VII deficiency, the characteristics of this disease when it is associated with acute myeloid leukemia. Acquired factor VII deficiency in hematological diseases can be caused by intensive chemotherapy, infections, or hepatic dysfunction. The best treatment in developing countries remains corticosteroids associated with plasma exchange, frozen plasma, and antibiotics.

  4. Immunomodulation in community-acquired pneumonia

    NARCIS (Netherlands)

    Remmelts, H.H.F.

    2013-01-01

    Community-acquired pneumonia (CAP) is a common disease with considerable morbidity and mortality, despite effective antibiotic treatment. In this thesis, we showed that the major causative microorganisms in CAP trigger distinct inflammatory response profiles in the host. While an inflammatory

  5. Postural control in blind subjects.

    Science.gov (United States)

    Soares, Antonio Vinicius; Oliveira, Cláudia Silva Remor de; Knabben, Rodrigo José; Domenech, Susana Cristina; Borges Junior, Noe Gomes

    2011-12-01

    To analyze postural control in acquired and congenitally blind adults. A total of 40 visually impaired adults participated in the research, divided into 2 groups, 20 with acquired blindness and 20 with congenital blindness - 21 males and 19 females, mean age 35.8 ± 10.8. The Brazilian version of Berg Balance Scale and the motor domain of functional independence measure were utilized. On Berg Balance Scale the mean for acquired blindness was 54.0 ± 2.4 and 54.4 ± 2.5 for congenitally blind subjects; on functional independence measure the mean for acquired blind group was 87.1 ± 4.8 and 87.3 ± 2.3 for congenitally blind group. Based upon the scale used the results suggest the ability to control posture can be developed by compensatory mechanisms and it is not affected by visual loss in congenitally and acquired blindness.

  6. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections

    DEFF Research Database (Denmark)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel

    2016-01-01

    OBJECTIVES: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. METHODS: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) ...

  7. Radiation therapy for Kaposi's sarcoma associated with acquired immunodeficiency syndrome. Tokyo Metropolitan Komagome Hospital experience

    International Nuclear Information System (INIS)

    Ebara, Takeshi; Karasawa, Katsuyuki; Maebayashi, Katsuya; Kurosaki, Hiromasa; Ishikawa, Hitoshi; Kaizu, Toshihide; Tanaka, Yoshiaki; Akagi, Kumiko; Masuda, Gota

    2000-01-01

    Kaposi's sarcoma is frequently found in association with acquired immunodeficiency syndrome (AIDS). We report on radiotherapy for patients with AIDS-related Kaposi's sarcoma at Tokyo Metropolitan Komagome Hospital. Between April 1991 and May 1997, radiotherapy was given to 11 lesions in eight men with AIDS-related Kaposi's sarcoma to relieve their symptoms. The lesions involved the head and neck region, the legs, and the gastrointestinal tract. Radiotherapy was carried out with 4-MV photon through parallel opposed field or high energy electrons. Total doses ranged from 20 to 38 Gy, with a median of 30 Gy, delivered in 2- to 3-Gy fractions. Four patients were given other treatments prior to the radiotherapy. Acute reaction was evaluated according to the modified acute radiation morbidity scoring criteria of the Radiation Therapy Oncology Group (RTOG). Radiotherapy had relieved the symptoms in all patients at completion of this therapy. Lesions that involved the hard palate and vocal cords had completely disappeared. The lesions that received radiotherapy were controlled without symptoms until the patients died. Patients who had the head and neck region treated exhibited severe acute mucosal reaction (at a dose of 30 Gy, there was grade 2 morbidity by modified RTOG criteria, in two patients, and grade 3 in three patients) although the radiation therapy was completed for these patients. Radiotherapy promises a favorable outcome for symptom relief in AIDS-related Kaposi's sarcoma. (author)

  8. Impacts of Mergers and Acquisitions on Acquirer Banks’ Performance

    Directory of Open Access Journals (Sweden)

    Burhan Ali Shah

    2017-09-01

    Full Text Available This study investigates the effects of mergers and acquisitions (M & A on the operating performance of the acquirer banks in Pakistan. For this purpose, a sample of 18 transactions, involving acquirer banks, listed on the Karachi Stock Exchange, is used. The Financial Ratio Analysis (FRA is used to determine the effects of M & A. The significance of change in the operating performances is tested through a paired sample t-test. The results indicate deterioration in the performances of the acquirer banks in the post-merger period.

  9. Multiple independent origins of mitochondrial control region duplications in the order Psittaciformes

    DEFF Research Database (Denmark)

    Schirtzinger, Erin E.; Tavares, Erika S.; Gonzales, Lauren A.

    2012-01-01

    with increasing frequency, particularly in birds (Class Aves). In this study, we investigate the evolutionary history of mitochondrial control region states within the avian order Psittaciformes (parrots and cockatoos). To this aim, we reconstructed a comprehensive multi-locus phylogeny of parrots, used PCR...

  10. Optimal supplementary frequency controller design using the wind farm frequency model and controller parameters stability region.

    Science.gov (United States)

    Toulabi, Mohammadreza; Bahrami, Shahab; Ranjbar, Ali Mohammad

    2018-03-01

    In most of the existing studies, the frequency response in the variable speed wind turbines (VSWTs) is simply realized by changing the torque set-point via appropriate inputs such as frequency deviations signal. However, effective dynamics and systematic process design have not been comprehensively discussed yet. Accordingly, this paper proposes a proportional-derivative frequency controller and investigates its performance in a wind farm consisting of several VSWTs. A band-pass filter is deployed before the proposed controller to avoid responding to either steady state frequency deviations or high rate of change of frequency. To design the controller, the frequency model of the wind farm is first characterized. The proposed controller is then designed based on the obtained open loop system. The stability region associated with the controller parameters is analytically determined by decomposing the closed-loop system's characteristic polynomial into the odd and even parts. The performance of the proposed controller is evaluated through extensive simulations in MATLAB/Simulink environment in a power system comprising a high penetration of VSWTs equipped with the proposed controller. Finally, based on the obtained feasible area and appropriate objective function, the optimal values associated with the controller parameters are determined using the genetic algorithm (GA). Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

  11. Pulmonary infiltrates during community acquired Gram-negative bacteremia

    DEFF Research Database (Denmark)

    Fjeldsøe-Nielsen, Hans; Gjeraa, Kirsten; Berthelsen, Birgitte G

    2013-01-01

    The primary aim of this study was to describe the frequency of pulmonary infiltrates on chest X-ray (CXR) during community acquired Gram-negative bacteremia at a single centre in Denmark.......The primary aim of this study was to describe the frequency of pulmonary infiltrates on chest X-ray (CXR) during community acquired Gram-negative bacteremia at a single centre in Denmark....

  12. Acquired arteriovenous fistula in a grizzly bear (Ursus arctos horribilis).

    Science.gov (United States)

    Tuttle, Allison D; MacLean, Robert A; Linder, Keith; Cullen, John M; Wolfe, Barbara A; Loomis, Michael

    2009-03-01

    A captive adult male grizzly bear (Ursus arctos horribilis) was evaluated due to multifocal wounds of the skin and subcutaneous tissues sustained as a result of trauma from another grizzly bear. On presentation, one lesion that was located in the perineal region seemed to be a deep puncture with purple tissue protruding from it. This perineal wound did not heal in the same manner or rate as did the other wounds. Twenty-five days after initial detection, substantial active hemorrhage from the lesion occurred and necessitated anesthesia for examination of the bear. The entire lesion was surgically excised, which later proved curative. An acquired arteriovenous fistula was diagnosed via histopathology. Arteriovenous fistulas can develop after traumatic injury and should be considered as a potential complication in bears with nonhealing wounds.

  13. A three-region conduction-controlled rewetting analysis by the Heat Balance Integral Method

    International Nuclear Information System (INIS)

    Sahu, S.K.; Das, P.K.; Bhattacharyya, S.

    2009-01-01

    Conduction-controlled rewetting of two-dimensional objects is analyzed by the Heat Balance Integral Method (HBIM) considering three distinct regions: a dry region ahead of wet front, the sputtering region immediately behind the wet front and a continuous film region further upstream. The HBIM yields solutions for wet front velocity, sputtering length and temperature field with respect to wet front. Employing this method, it is seen that heat transfer mechanism is dependent upon two temperature parameters. One of them characterizes the initial wall temperature while the other specifies the range of temperature for sputtering region. Additionally, the mechanism of heat transfer is found to be dependent on two Biot numbers comprising a convective heat transfer in the wet region and a boiling heat transfer in the sputtering region. The present solution exactly matches with the one-dimensional analysis of K.H. Sun, G.E. Dix, C.L. Tien [Cooling of a very hot vertical surface by falling liquid film, ASME J. Heat Transf. 96 (1974) 126-131] for low Biot numbers. Good agreement with experimental results is also observed. (authors)

  14. Fuzzy Control and Connected Region Marking Algorithm-Based SEM Nanomanipulation

    Directory of Open Access Journals (Sweden)

    Dongjie Li

    2012-01-01

    Full Text Available The interactive nanomanipulation platform is established based on fuzzy control and connected region marking (CRM algorithm in SEM. The 3D virtual nanomanipulation model is developed to make up the insufficiency of the 2D SEM image information, which provides the operator with depth and real-time visual feedback information to guide the manipulation. The haptic device Omega3 is used as the master to control the 3D motion of the nanopositioner in master-slave mode and offer the force sensing to the operator controlled with fuzzy control algorithm. Aiming at sensing of force feedback during the nanomanipulation, the collision detection method of the virtual nanomanipulation model and the force rending model are studied to realize the force feedback of nanomanipulation. The CRM algorithm is introduced to process the SEM image which provides effective position data of the objects for updating the virtual environment (VE, and relevant issues such as calibration and update rate of VE are also discussed. Finally, the performance of the platform is validated by the ZnO nanowire manipulation experiments.

  15. Epidemiological Study of Hospital-Acquired Bacterial Conjunctivitis in a Level III Neonatal Unit

    Directory of Open Access Journals (Sweden)

    Catarina Dias

    2013-01-01

    Full Text Available Background. Conjunctivitis is one of the most frequently occurring hospital-acquired infections among neonates, although it is less studied than potentially life-threatening infections, such as sepsis and pneumonia. Objectives. The aims of our work were to identify epidemiologic characteristics, pathogens, and susceptibility patterns of bacterial hospital-acquired conjunctivitis (HAC in a level III neonatal unit. Materials and Methods. Data were collected retrospectively from patient charts and laboratory databases. Hospital-acquired conjunctivitis was defined in accordance with the Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN diagnostic criteria. Results. One or more episodes of HAC were diagnosed in 4,0% ( of 1492 neonates admitted during the study period. Most of the episodes involved premature (75,4% and low birth weight (75,4% neonates. Infection rates were higher among patients undergoing noninvasive mechanical ventilation (46,7%, parenteral nutrition (13,6%, and phototherapy (6,8%. Predominant pathogens included Serratia marcescens (27,9%, Escherichia coli (23%, and Pseudomonas aeruginosa (18%. Susceptibility patterns revealed bacterial resistances to several antibiotic classes. Gentamicin remains the adequate choice for empirical treatment of HAC in our NICU. Conclusion. It is important to know the local patterns of the disease in order to adjust prevention strategies. Our work contributes to the epidemiological characterization of a sometimes overlooked disease.

  16. Evaluation of the reconstruction of image acquired from CT simulator to reduce metal artifact

    International Nuclear Information System (INIS)

    Choi, Ji Hun; Park, Jin Hong; Choi, Byung Don; Won, Hui Su; Chang, Nam Jun; Goo, Jang Hyun; Hong, Joo Wan

    2014-01-01

    This study presents the usefulness assessment of metal artifact reduction for orthopedic implants(O-MAR) to decrease metal artifacts from materials with high density when acquired CT images. By CT simulator, original CT images were acquired from Gammex and Rando phantom and those phantoms inserted with high density materials were scanned for other CT images with metal artifacts and then O-MAR was applied to those images, respectively. To evaluate CT images using Gammex phantom, 5 regions of interest(ROIs) were placed at 5 organs and 3 ROIs were set up at points affected by artifacts. The averages of standard deviation(SD) and CT numbers were compared with a plan using original image. For assessment of variations in dose of tissue around materials with high density, the volume of a cylindrical shape was designed at 3 places in images acquired from Rando phantom by Eclipse. With 6 MV, 7-fields, 15x15cm 2 and 100 cGy per fraction, treatment planning was created and the mean dose were compared with a plan using original image. In the test with the Gammex phantom, CT numbers had a few difference at established points and especially 3 points affected by artifacts had most of the same figures. In the case of O-MAR image, the more reduction in SD appeared at all of 8 points than non O-MAR image. In the test using the Rando Phantom, the variations in dose of tissue around high density materials had a few difference between original CT image and CT image with O-MAR. The CT images using O-MAR were acquired clearly at the boundary of tissue around high density materials and applying O-MAR was useful for correcting CT numbers

  17. Engineering of Data Acquiring Mobile Software and Sustainable End-User Applications

    Science.gov (United States)

    Smith, Benton T.

    2013-01-01

    The criteria for which data acquiring software and its supporting infrastructure should be designed should take the following two points into account: the reusability and organization of stored online and remote data and content, and an assessment on whether abandoning a platform optimized design in favor for a multi-platform solution significantly reduces the performance of an end-user application. Furthermore, in-house applications that control or process instrument acquired data for end-users should be designed with a communication and control interface such that the application's modules can be reused as plug-in modular components in greater software systems. The application of the above mentioned is applied using two loosely related projects: a mobile application, and a website containing live and simulated data. For the intelligent devices mobile application AIDM, the end-user interface have a platform and data type optimized design, while the database and back-end applications store this information in an organized manner and manage access to that data to only to authorized user end application(s). Finally, the content for the website was derived from a database such that the content can be included and uniform to all applications accessing the content. With these projects being ongoing, I have concluded from my research that the applicable methods presented are feasible for both projects, and that a multi-platform design for the mobile application only marginally drop the performance of the mobile application.

  18. LPV Control for the Full Region Operation of a Wind Turbine Integrated with Synchronous Generator

    Science.gov (United States)

    Grigoriadis, Karolos M.; Nyanteh, Yaw D.

    2015-01-01

    Wind turbine conversion systems require feedback control to achieve reliable wind turbine operation and stable current supply. A robust linear parameter varying (LPV) controller is proposed to reduce the structural loads and improve the power extraction of a horizontal axis wind turbine operating in both the partial load and the full load regions. The LPV model is derived from the wind turbine state space models extracted by FAST (fatigue, aerodynamics, structural, and turbulence) code linearization at different operating points. In order to assure a smooth transition between the two regions, appropriate frequency-dependent varying scaling parametric weighting functions are designed in the LPV control structure. The solution of a set of linear matrix inequalities (LMIs) leads to the LPV controller. A synchronous generator model is connected with the closed LPV control loop for examining the electrical subsystem performance obtained by an inner speed control loop. Simulation results of a 1.5 MW horizontal axis wind turbine model on the FAST platform illustrates the benefit of the LPV control and demonstrates the advantages of this proposed LPV controller, when compared with a traditional gain scheduling PI control and prior LPV control configurations. Enhanced structural load mitigation, improved power extraction, and good current performance were obtained from the proposed LPV control. PMID:25884036

  19. LPV Control for the Full Region Operation of a Wind Turbine Integrated with Synchronous Generator

    Directory of Open Access Journals (Sweden)

    Guoyan Cao

    2015-01-01

    Full Text Available Wind turbine conversion systems require feedback control to achieve reliable wind turbine operation and stable current supply. A robust linear parameter varying (LPV controller is proposed to reduce the structural loads and improve the power extraction of a horizontal axis wind turbine operating in both the partial load and the full load regions. The LPV model is derived from the wind turbine state space models extracted by FAST (fatigue, aerodynamics, structural, and turbulence code linearization at different operating points. In order to assure a smooth transition between the two regions, appropriate frequency-dependent varying scaling parametric weighting functions are designed in the LPV control structure. The solution of a set of linear matrix inequalities (LMIs leads to the LPV controller. A synchronous generator model is connected with the closed LPV control loop for examining the electrical subsystem performance obtained by an inner speed control loop. Simulation results of a 1.5 MW horizontal axis wind turbine model on the FAST platform illustrates the benefit of the LPV control and demonstrates the advantages of this proposed LPV controller, when compared with a traditional gain scheduling PI control and prior LPV control configurations. Enhanced structural load mitigation, improved power extraction, and good current performance were obtained from the proposed LPV control.

  20. Coupled core criticality calculations with control rods located in the central reflector region

    Energy Technology Data Exchange (ETDEWEB)

    Sobhy, M [Reactor depatrment, nuclear research center, Inshaas (Egypt)

    1995-10-01

    The reactivity of a coupled core is controlled by a set of control rods distributed in the central reflector region. The reactor contains two compact cores cooled and moderated by light water. Control rods are designed to have reactivity worths sufficient to start, control and shutdown the coupled system. Each core in a coupled system is in subcritical conditions without any absorber then each core needs to the other core to fulfill nuclear chain reaction and to approach the criticality. In this case, each core is considered clean which is suitable for research reactor with low flux disturbance and better neutron economy, in addition to the advantage of disappearing the cut corner fuel baskets. This facilitate the in core fuel management with identical fuel baskets. Hot spots will disappear. This leads to a good heat transfer process. the excess reactivity and the shutdown margin are calculated for some of reflector as coupling region gives sufficient area for coupled core are calculated cost. The fluctuations of reactivity for coupled core are calculated by noise analysis technique and compared with that for rode core. The results show low reactivity perturbation associated with coupled core.

  1. MRI of fetal acquired brain lesions

    International Nuclear Information System (INIS)

    Prayer, Daniela; Brugger, Peter C.; Kasprian, Gregor; Witzani, Linde; Helmer, Hanns; Dietrich, Wolfgang; Eppel, Wolfgang; Langer, Martin

    2006-01-01

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images

  2. MRI of fetal acquired brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: daniela.prayer@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Kasprian, Gregor [Department of Radiodiagnostics, Medical University of Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna (Austria); Helmer, Hanns [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Dietrich, Wolfgang [Department of Neurosurgery, Medical University of Vienna (Austria); Eppel, Wolfgang [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Langer, Martin [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria)

    2006-02-15

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

  3. Erlotinib is a viable treatment for tumors with acquired resistance to cetuximab

    Science.gov (United States)

    Brand, Toni M; Dunn, Emily F; Iida, Mari; Myers, Rebecca A; Kostopoulos, Kellie T; Li, Chunrong; Peet, Chimera R

    2011-01-01

    The epidermal growth factor receptor (EGFR) is an ubiquitously expressed receptor tyrosine kinase (RTK) and is recognized as a key mediator of tumorigenesis in many human tumors. Currently there are five EGFR inhibitors used in oncology, two monoclonal antibodies (panitumumab and cetuximab) and three tyrosine kinase inhibitors (erlotinib, gefitinib and lapatinib). Both strategies of EGFR inhibition have demonstrated clinical success; however, many tumors remain non-responsive or acquire resistance during therapy. To explore potential molecular mechanisms of acquired resistance to cetuximab we previously established a series of cetuximab-resistant clones by chronically exposing the NCI-H226 NSCLC cell line to escalating doses of cetuximab. Cetuximab-resistant clones exhibited a dramatic increase in the activation of EGFR, HER2 and HER3 receptors as well as increased signaling through the MAP K and AKT pathways. RNAi studies demonstrated dependence of cetuximab-resistant clones on the EGFR signaling network. These findings prompted investigation on whether or not cells with acquired resistance to cetuximab would be sensitive to the EGFR targeted TKI erlotinib. In vitro, erlotinib was able to decrease signaling through the EGFR axis, decrease cellular proliferation and induce apoptosis. To determine if erlotinib could have therapeutic benefit in vivo, we established cetuximab-resistant NCI-H226 mouse xenografts, and subsequently treated them with erlotinib. Mice harboring cetuximab-resistant tumors treated with erlotinib exhibited either a tumor regression or growth delay as compared with vehicle controls. Analysis of the erlotinib treated tumors demonstrated a decrease in cell proliferation and increased rates of apoptosis. The work presented herein suggests that (1) cells with acquired resistance to cetuximab maintain their dependence on EGFR and (2) tumors developing resistance to cetuximab can benefit from subsequent treatment with erlotinib, providing rationale

  4. Measuring Progress on the Control of Porcine Reproductive and Respiratory Syndrome (PRRS at a Regional Level: The Minnesota N212 Regional Control Project (Rcp as a Working Example.

    Directory of Open Access Journals (Sweden)

    Pablo Valdes-Donoso

    Full Text Available Due to the highly transmissible nature of porcine reproductive and respiratory syndrome (PRRS, implementation of regional programs to control the disease may be critical. Because PRRS is not reported in the US, numerous voluntary regional control projects (RCPs have been established. However, the effect of RCPs on PRRS control has not been assessed yet. This study aims to quantify the extent to which RCPs contribute to PRRS control by proposing a methodological framework to evaluate the progress of RCPs. Information collected between July 2012 and June 2015 from the Minnesota Voluntary Regional PRRS Elimination Project (RCP-N212 was used. Demography of premises (e.g. composition of farms with sows = SS and without sows = NSS was assessed by a repeated analysis of variance. By using general linear mixed-effects models, active participation of farms enrolled in the RCP-N212, defined as the decision to share (or not to share PRRS status, was evaluated and used as a predictor, along with other variables, to assess the PRRS trend over time. Additionally, spatial and temporal patterns of farmers' participation and the disease dynamics were investigated. The number of farms enrolled in RCP-N212 and its geographical coverage increased, but the proportion of SS and NSS did not vary significantly over time. A significant increasing (p<0.001 trend in farmers' decision to share PRRS status was observed, but with NSS producers less willing to report and a large variability between counties. The incidence of PRRS significantly (p<0.001 decreased, showing a negative correlation between degree of participation and occurrence of PRRS (p<0.001 and a positive correlation with farm density at the county level (p = 0.02. Despite a noted decrease in PRRS, significant spatio-temporal patterns of incidence of the disease over 3-weeks and 3-kms during the entire study period were identified. This study established a systematic approach to quantify the effect of RCPs on

  5. 76 FR 50326 - Regional Rail, LLC-Continuance in Control Exemption-Tyburn Railroad, LLC

    Science.gov (United States)

    2011-08-12

    .... Regional is a Delaware limited liability company that currently controls 2 Class III railroads, East Penn... Company and operate approximately 0.9 miles of rail lines in Morrisville, Pa. The parties intend to...

  6. Postural control in blind subjects

    Directory of Open Access Journals (Sweden)

    Antonio Vinicius Soares

    2011-12-01

    Full Text Available Objective: To analyze postural control in acquired and congenitally blind adults. Methods: A total of 40 visually impaired adults participated in the research, divided into 2 groups, 20 with acquired blindness and 20 with congenital blindness - 21 males and 19 females, mean age 35.8 ± 10.8. The Brazilian version of Berg Balance Scale and the motor domain of functional independence measure were utilized. Results: On Berg Balance Scale the mean for acquired blindness was 54.0 ± 2.4 and 54.4 ± 2.5 for congenitally blind subjects; on functional independence measure the mean for acquired blind group was 87.1 ± 4.8 and 87.3 ± 2.3 for congenitally blind group. Conclusion: Based upon the scale used the results suggest the ability to control posture can be developed by compensatory mechanisms and it is not affected by visual loss in congenitally and acquired blindness.

  7. Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units.

    Directory of Open Access Journals (Sweden)

    Vu Dinh Phu

    Full Text Available Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs. We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs across Vietnam.Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included.Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing. Pneumonia accounted for 79.4% (804/1012 of HAIs Most HAIs (84.5% [855/1012] were acquired in the survey hospital with 42.5% (363/855 acquired prior to ICU admission and 57.5% (492/855 developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76, urinary catheter (OR 2.12, no involvement of a family member in patient care (OR 1.94, and surgery after admission (OR 1.66. 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%], Pseudomonas aeruginosa (100/726 [13.8%], and Klebsiella pneumoniae (84/726 [11.6%], with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287 patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively.A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts.

  8. Multinational Exploration of Acquired R&D Activities

    DEFF Research Database (Denmark)

    Gammelgaard, Jens

    2004-01-01

    R&D. This paper establishes the connection between amultinational corporation that follows a capability-motivated acquisition strategy and theR&D role new subsidiaries should play in order for the acquired resources to be utilizedcorporation-wide. Statistical findings reveal the need to follow......This paper presents the results of a survey of 54 Danish multinational corporations that haveacquired activities abroad. The role of the acquired R&D units was the focus of the survey,particularly with respect to the schism between basic and applied R&D, and the schismbetween autonomous and network...

  9. Acquiring the optimal time for hyperbaric therapy in the rat model of CFA induced arthritis.

    Science.gov (United States)

    Koo, Sung Tae; Lee, Chang-Hyung; Shin, Yong Il; Ko, Hyun Yoon; Lee, Da Gyo; Jeong, Han-Sol

    2014-01-01

    We previously published an article about the pressure effect using a rheumatoid animal model. Hyperbaric therapy appears to be beneficial in treating rheumatoid arthritis (RA) by reducing the inflammatory process in an animal model. In this sense, acquiring the optimal pressure-treatment time parameter for RA is important and no optimal hyperbaric therapy time has been suggested up to now. The purpose of our study was to acquire the optimal time for hyperbaric therapy in the RA rat model. Controlled animal study. Following injection of complete Freund's adjuvant (CFA) into one side of the knee joint, 32 rats were randomly assigned to 3 different time groups (1, 3, 5 hours a day) under 1.5 atmospheres absolute (ATA) hyperbaric chamber for 12 days. The pain levels were assessed daily for 2 weeks by weight bearing force (WBF) of the affected limb. In addition, the levels of gelatinase, MMP-2, and MMP-9 expression in the synovial fluids of the knees were analyzed. The reduction of WBF was high at 2 days after injection and then it was spontaneously increased up to 14 days in all 3 groups. There were significant differences of WBF between 5 hours and control during the third through twelfth days, between 3 hours and control during the third through fifth and tenth through twelfth days, and between 3 hours and 5 hours during the third through seventh days (P CFA injection in all groups compared to the initial findings, however, the 3 hour group showed a smaller MMP-9/MMP-2 ratio than the control group. Although enough samples were used for the study to support our hypothesis, more samples will be needed to raise the validity and reliability. The effect of hyperbaric treatment appears to be dependent upon the elevated therapy time under 1.5 ATA pressure for a short period of time; however, the long-term effects were similar in all pressure groups. Further study will be needed to acquire the optimal pressure-treatment parameter relationship in various conditions for

  10. A case of acquired port wine stain: an association with repeated sunburn?

    Science.gov (United States)

    Seremet, Sila; Benar, Elif B; Afsar, Fatma Sule; Calli, Aylin; Ulusarac, Ozlem

    2016-10-01

    Unlike congenital port wine stain (PWS), an acquired PWS is a rare vascular lesion that develops later in life. Although solar damage is associated with acquired PWS, there is no reported case of acquired PWS after sunburn in the literature. We report a case of a 54-year-old man diagnosed with acquired PWS possibly caused by repeated sunburn. We recommended laser treatment to our patient; however, the patient did not chose to receive any treatment. Our case demonstrates a possible rare occurrence of an acquired PWS after sunburn with larger lesions and more diffuse distribution. For this reason, our case differs from other acquired PWS cases. © 2016 The International Society of Dermatology.

  11. Effects of animal-assisted therapy on concentration and attention span in patients with acquired brain injury: A randomized controlled trial.

    Science.gov (United States)

    Gocheva, Vanya; Hund-Georgiadis, Margret; Hediger, Karin

    2018-01-01

    Previous studies have reported that brain-injured patients frequently suffer from cognitive impairments such as attention and concentration deficits. Numerous rehabilitation clinics offer animal-assisted therapy (AAT) to address these difficulties. The authors' aim was to investigate the immediate effects of AAT on the concentration and attention span of brain-injured patients. Nineteen patients with acquired brain injury were included in a randomized, controlled, within-subject trial. The patients alternately received 12 standard therapy sessions (speech therapy, physiotherapy, occupational therapy) and 12 paralleled AAT sessions with comparable content. A total of 429 therapy sessions was analyzed consisting of 214 AAT and 215 control sessions. Attention span and instances of distraction were assessed via video coding in Noldus Observer. The Mehrdimensionaler Befindlichkeitsbogen ([Multidimensional Affect Rating Scale] MDBF questionnaire; Steyer, Schwenkmezger, Notz, & Eid, 1997) was used to measure the patient's self-rated alertness. Concentration was assessed through Visual Analogue Scale (VAS) via self-assessment and therapist's ratings. The patients' attention span did not differ whether an animal was present or not. However, patients displayed more instances of distraction during AAT. Moreover, patients rated themselves more concentrated and alert during AAT sessions. Further, therapists' evaluation of patients' concentration indicated that patients were more concentrated in AAT compared with the control condition. Although the patients displayed more instances of distraction while in the presence of an animal, it did not have a negative impact on their attention span. In addition, patients reported to be more alert and concentrated when an animal was present. Future studies should examine other attentional processes such as divided attention and include neurobiological correlates of attention. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  12. Tandemly repeated sequence in 5'end of mtDNA control region of ...

    African Journals Online (AJOL)

    Extensive length variability was observed in 5' end sequence of the mitochondrial DNA control region of the Japanese Spanish mackerel (Scomberomorus niphonius). This length variability was due to the presence of varying numbers of a 56-bp tandemly repeated sequence and a 46-bp insertion/deletion (indel).

  13. Prevention of ventilator-associated pneumonia, mortality and all intensive care unit acquired infections by topically applied antimicrobial or antiseptic agents: a meta-analysis of randomized controlled trials in intensive care units.

    Science.gov (United States)

    Pileggi, Claudia; Bianco, Aida; Flotta, Domenico; Nobile, Carmelo G A; Pavia, Maria

    2011-06-24

    Given the high morbidity and mortality attributable to ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients, prevention plays a key role in the management of patients undergoing mechanical ventilation. One of the candidate preventive interventions is the selective decontamination of the digestive or respiratory tract (SDRD) by topical antiseptic or antimicrobial agents. We performed a meta-analysis to investigate the effect of topical digestive or respiratory tract decontamination with antiseptics or antibiotics in the prevention of VAP, of mortality and of all ICU-acquired infections in mechanically ventilated ICU patients. A meta-analysis of randomised controlled trials was performed. The U.S. National Library of Medicine's MEDLINE database, Embase, and Cochrane Library computerized bibliographic databases, and reference lists of selected studies were used. Selection criteria for inclusion were: randomised controlled trials (RCTs); primary studies; examining the reduction of VAP and/or mortality and/or all ICU-acquired infections in ICU patients by prophylactic use of one or more of following topical treatments: 1) oropharyngeal decontamination using antiseptics or antibiotics, 2) gastrointestinal tract decontamination using antibiotics, 3) oropharyngeal plus gastrointestinal tract decontamination using antibiotics and 4) respiratory tract decontamination using antibiotics; reported enough data to estimate the odds ratio (OR) or risk ratio (RR) and their variance; English language; published through June 2010. A total of 28 articles met all inclusion criteria and were included in the meta-analysis. The overall estimate of efficacy of topical SDRD in the prevention of VAP was 27% (95% CI of efficacy = 16% to 37%) for antiseptics and 36% (95% CI of efficacy = 18% to 50%) for antibiotics, whereas in none of the meta-analyses conducted on mortality was a significant effect found. The effect of topical SDRD in the prevention of all ICU-acquired

  14. Experimental Space Shuttle Orbiter Studies to Acquire Data for Code and Flight Heating Model Validation

    Science.gov (United States)

    Wadhams, T. P.; Holden, M. S.; MacLean, M. G.; Campbell, Charles

    2010-01-01

    thin-film resolution in both the span and chord direction in the area of peak heating. Additional objectives of this first study included: obtaining natural or tripped turbulent wing leading edge heating levels, assessing the effectiveness of protuberances and cavities placed at specified locations on the orbiter over a range of Mach numbers and Reynolds numbers to evaluate and compare to existing engineering and computational tools, obtaining cavity floor heating to aid in the verification of cavity heating correlations, acquiring control surface deflection heating data on both the main body flap and elevons, and obtain high speed schlieren videos of the interaction of the orbiter nose bow shock with the wing leading edge. To support these objectives, the stainless steel 1.8% scale orbiter model in addition to the sensors on the wing leading edge was instrumented down the windward centerline, over the wing acreage on the port side, and painted with temperature sensitive paint on the starboard side wing acreage. In all, the stainless steel 1.8% scale Orbiter model was instrumented with over three-hundred highly sensitive thin-film heating sensors, two-hundred of which were located in the wing leading edge shock interaction region. Further experimental studies will also be performed following the successful acquisition of flight data during the Orbiter Entry Boundary Layer Flight Experiment and HYTHIRM on STS-119 at specific data points simulating flight conditions and geometries. Additional instrumentation and a protuberance matching the layout present during the STS-119 boundary layer transition flight experiment were added with testing performed at Mach number and Reynolds number conditions simulating conditions experienced in flight. In addition to the experimental studies, CUBRC also performed a large amount of CFD analysis to confirm and validate not only the tunnel freestream conditions, but also 3D flows over the orbiter acreage, wing leading edge, and

  15. Acquired versus Non-Acquired Subsidiaries - Which Entry Mode do Parent Firms Prefer

    OpenAIRE

    Esther Kalkbrenner

    2010-01-01

    Despite the economic importance of international foreign direct investment (FDI) flows, investment decisions of multinational firms are not well understood. A multinational firm can establish a subsidiary in a foreign country through greenfield investment or through acquiring an existing firm in the target country. The goal of this paper is to shed some light on the determinants of foreign market entry modes. In particular to analyze the systematic variation in the mode choice of FDI, namely ...

  16. The challenge of retaining customers acquired with free trials

    NARCIS (Netherlands)

    Datta, H.; Foubert, B.; van Heerde, H.J.

    Many service firms acquire customers by offering free-trial promotions. A crucial challenge is to retain customers acquired with these free trials. To address this challenge, firms need to understand how free-trial customers differ from regular customers in terms of their decision making to retain

  17. Dynamic MR cardiac perfusion studies in patients with acquired heart diseases

    International Nuclear Information System (INIS)

    Finelli, D.A.; Adler, L.P.; Paschal, C.B.; Haacke, E.M.

    1990-01-01

    The combination of ultrafast scanning techniques with contrast administration has opened new venues for MR imaging relating to the physiology of organ perfusion. Regional cardiac perfusion determinations lend important additional information to the morphologic and functional data provided by conventional cardiac MR imaging. The authors of this paper studied 10 patients with acquired heart diseases, including ischemic heart disease, cardiomyopathy, ventricular hypertrophy, and cardiac tumor, using conventional spin-echo imaging, cine gradient-echo imaging, and dynamic Gd-DTPA--enhanced perfusion imaging with an ultrafast, inversion-recovery, Turbo-fast low-angle shot sequence. This technique enables analysis of the first pass and early biodistribution phases following contrast administration, information that has been correlated with cardiac catheterization, single photo emission CT (SPECT), and administration emission tomographic (PET) data

  18. Recurrent and acquired tracheoesophageal fistulae (TEF)-Minimally invasive management.

    Science.gov (United States)

    Nazir, Zafar; Khan, Muhammad Arif Mateen; Qamar, Javaria

    2017-10-01

    Recurrent and acquired fistulae are a serious complication of congenital esophageal atresia and tracheoesophageal fistula (TEF) repair and foreign body ingestion (FBI) (e.g., button battery). We report our experience with a minimally invasive approach to recurrent and acquired TEF. Medical records of patients referred for management of recurrent and acquired TEF between 2003 and 2015 were reviewed retrospectively. Patients underwent endoscopic procedures (de-epithelization of fistulous tract and fibrin tissue adhesive-Tisseel R ) under general anesthesia. Nine children (7 male, 2 female) with age range 3months to 3years (mean 1.5year) were managed. TEF closed spontaneously in four patients, whereas in 5 patients the TEF closed after combined endoscopic procedure. Three patients required repeat endoscopic procedures. Follow-up ranged between 7months to 10years (mean 4.2years). Active observation and repeat combined endoscopic procedures are safe alternatives to open surgical repair of acquired and recurrent TEF. Level IV study. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Common acquired kidney diseases in children

    African Journals Online (AJOL)

    5. Common acquired kidney diseases in children. Examination of the urine is probably the most important investigation ... result from the same streptococcal infection. .... musculoskeletal system. ... Prediction of histopathology from clinical.

  20. IOC-UNEP regional workshop to review priorities for marine pollution monitoring, research, control and abatement in the wider Caribbean

    International Nuclear Information System (INIS)

    1989-01-01

    The IOC-UNEP Regional Workshop to Review Priorities for Marine Pollution Monitoring, Research, Control and Abatement in the Wider Caribbean Region (San Jose, 24-30 August 1989) examined a possible general framework for a regionally co-ordinated comprehensive joint IOC/UNEP programme for marine pollution assessment and control in the Wider Caribbean region (CEPPOL). The overall objective of CEPPOL is to establish a regionally co-ordinated comprehensive joint IOC/UNEP Marine Pollution Assessment and Control Programme catering to the immediate and long-term requirements of the Cartagena Convention as well as the requirements of the member States of IOCARIBE. The specific objectives of the programmes are: (i) To organize and carry out a regionally co-ordinated marine pollution monitoring and research programme concentrating on contaminants and pollutants affecting the quality of the marine and coastal environment, as well as the human health in the Wider Caribbean and to interpret/assess the results of the programme as part of the scientific basis for the region; (ii) To generate information on the sources, levels, amounts, trends and effects of marine pollution within the Wider Caribbean region as an additional component of the scientific basis upon which the formulation of proposals for preventive and remedial actions can be based; (iii) To formulate proposals for technical, administrative and legal pollution control, abatement, and preventive measures and to assist the Governments in the region in implementing and evaluating their effectiveness; and (iv) To strengthen and , when necessary, to develop/establish the capabilities of national institutions to carry out marine pollution monitoring and research, as well as to formulate and apply pollution control and abatement measures

  1. Parenting program versus telephone support for Mexican parents of children with acquired brain injury: A blind randomized controlled trial.

    Science.gov (United States)

    Chávez, Clara; Catroppa, Cathy; Hearps, Stephen J C; Yáñez-Téllez, Guillermina; Prieto-Corona, Belén; de León, Miguel A; García, Antonio; Sandoval-Lira, Lucero; Anderson, Vicki

    2017-09-01

    Acquired brain injury (ABI) during childhood typically causes behavior problems in the child and high levels of stress in the family. The aims of this study are: (1) to investigate the effectiveness and feasibility of a parenting intervention in improving behavior and self-regulation in Mexican children with ABI compared to telephone support; (2) to investigate the effectiveness and feasibility of a parenting intervention in improving parenting skills, parent self-efficacy and decreasing parental stress in parents of children with ABI compared to telephone support. Our secondary aims are (1) to explore the impact that parent characteristics have on the intervention outcomes; (2) to investigate if changes are maintained 3 months after the intervention. The research design is a blind randomized controlled trial (RCT). Eligible participants include children with a diagnosis of ABI, between 6 and 12 years of age, and their parents. Sixty-six children and their parents will be randomly allocated to either a parenting program group or telephone support group. The parenting program involves six face-to-face weekly group sessions of 2.5 h each. Participants in the control group receive an information sheet with behavioral strategies, and six weekly phone calls, in which strategies to improve academic skills are provided. Children and their parents are evaluated by blind assessors before the intervention, immediately after the intervention and 3-months post-intervention. This study will be the first to evaluate the efficacy and feasibility of a parenting program for Mexican parents of children with ABI. ACTRN12617000360314.

  2. Regional White Matter Decreases in Alzheimer's Disease Using Optimized Voxel-Based Morphometry

    International Nuclear Information System (INIS)

    Shuyu Li; Fang Pu; Feng Shi; Sheng Xie; Yinhua Wang; Tianzi Jiang

    2008-01-01

    Background: Most studies that attempt to clarify structural abnormalities related to functional disconnection in patients with Alzheimer's disease (AD) have focused on exploring pathological changes in cortical gray matter. However, white matter fibers connecting these cerebral areas may also be abnormal. Purpose: To investigate the regional changes of white matter volume in patients with AD compared to healthy subjects. Material and Methods: White matter volume changes in whole-brain magnetic resonance images acquired from 19 patients with AD and 20 healthy subjects (control group) were observed using the optimized voxel-based morphometry (VBM) method. In addition, the corpus callosum (CC) of AD patients and the control group was investigated further by outlining manually the boundary of the CC on a midsagittal slice. Each area of the CC was then corrected by dividing each subject's intracranial area in the midsagittal plane. Results: Compared with the control group, AD patients showed significantly reduced white matter volumes in the posterior part of the CC and the temporal lobe in the left and right hemispheres. Moreover, the voxel showing peak statistical difference in the posterior of the CC was left sided. The five subdivisions of the CC were also significantly smaller among the AD patients relative to the control group. Conclusion: Our findings suggest that these abnormalities in white matter regions may contribute to the functional disconnections in AD

  3. Interconnection between flowering time control and activation of systemic acquired resistance

    Directory of Open Access Journals (Sweden)

    Zeeshan Zahoor Banday

    2015-03-01

    Full Text Available The ability to avoid or neutralize pathogens is inherent to all higher organisms including plants. Plants recognize pathogens through receptors, and mount resistance against the intruders, with the help of well-elaborated defense arsenal. In response to some local infections, plants develop systemic acquired resistance (SAR, which provides heightened resistance during subsequent infections. Infected tissues generate mobile signalling molecules that travel to the systemic tissues, where they epigenetically modify expression of a set of genes to initiate the manifestation of SAR in distant tissues. Immune responses are largely regulated at transcriptional level. Flowering is a developmental transition that occurs as a result of the coordinated action of large numbers of transcription factors that respond to intrinsic signals and environmental conditions. The plant hormone salicylic acid (SA which is required for SAR activation positively regulates flowering. Certain components of chromatin remodelling complexes that are recruited for suppression of precocious flowering are also involved in suppression of SAR in healthy plants. FLOWERING LOCUS D (FLD, a putative histone demethylase positively regulates SAR manifestation and flowering transition in Arabidopsis. Similarly, incorporation of histone variant H2A.Z in nucleosomes mediated by PHOTOPERIOD-INDEPENDENT EARLY FLOWERING 1 (PIE1, an orthologue of yeast chromatin remodelling complex SWR1, concomitantly influences SAR and flowering time. SUMO conjugation and deconjugation mechanisms also similarly affect SAR and flowering in an SA-dependent manner. The evidences suggest a common underlying regulatory mechanism for activation of SAR and flowering in plants.

  4. Complete mitochondrial genome of endangered Yellow-shouldered Amazon (Amazona barbadensis): two control region copies in parrot species of the Amazona genus.

    Science.gov (United States)

    Urantowka, Adam Dawid; Hajduk, Kacper; Kosowska, Barbara

    2013-08-01

    Amazona barbadensis is an endangered species of parrot living in northern coastal Venezuela and in several Caribbean islands. In this study, we sequenced full mitochondrial genome of the considered species. The total length of the mitogenome was 18,983 bp and contained 13 protein-coding genes, 22 transfer RNA genes, two ribosomal RNA genes, duplicated control region, and degenerate copies of ND6 and tRNA (Glu) genes. High degree of identity between two copies of control region suggests their coincident evolution and functionality. Comparative analysis of both the control region sequences from four Amazona species revealed their 89.1% identity over a region of 1300 bp and indicates the presence of distinctive parts of two control region copies.

  5. 33 CFR 211.2 - Authority to acquire real estate.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Authority to acquire real estate..., DEPARTMENT OF DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Real Estate; General § 211.2 Authority to acquire real estate. (a) Congressional authority...

  6. Enhancing Medicares Hospital Acquired Conditions Policy

    Data.gov (United States)

    U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...

  7. Municipal tobacco control in the Capital Region of Denmark can be improved

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Robinson, Kirstine Magtengaard; Jørgensen, Torben

    2013-01-01

    Smoking remains the single preventable factor with the highest impact on morbidity and mortality in Denmark. The aims of this study were to assess the quality of municipal tobacco control (TC) in the 29 municipalities of the Capital Region of Denmark, and to compare the quality of the TC...

  8. Control of the low-load region in partially premixed combustion

    Science.gov (United States)

    Ingesson, Gabriel; Yin, Lianhao; Johansson, Rolf; Tunestal, Per

    2016-09-01

    Partially premixed combustion (PPC) is a low temperature, direct-injection combustion concept that has shown to give promising emission levels and efficiencies over a wide operating range. In this concept, high EGR ratios, high octane-number fuels and early injection timings are used to slow down the auto-ignition reactions and to enhance the fuel and are mixing before the start of combustion. A drawback with this concept is the combustion stability in the low-load region where a high octane-number fuel might cause misfire and low combustion efficiency. This paper investigates the problem of low-load PPC controller design for increased engine efficiency. First, low-load PPC data, obtained from a multi-cylinder heavy- duty engine is presented. The data shows that combustion efficiency could be increased by using a pilot injection and that there is a non-linearity in the relation between injection and combustion timing. Furthermore, intake conditions should be set in order to avoid operating points with unfavourable global equivalence ratio and in-cylinder temperature combinations. Model predictive control simulations were used together with a calibrated engine model to find a gas-system controller that fulfilled this task. The findings are then summarized in a suggested engine controller design. Finally, an experimental performance evaluation of the suggested controller is presented.

  9. [Acquired angioedema – clinical characteristic of the patients diagnosed in 2012-2016 with acquired C1 inhibitor deficiency].

    Science.gov (United States)

    Stobiecki, Marcin; Czarnobilska, Ewa; Obtułowicz, Krystyna

    Acquired angioedema is a rare disease caused by a deficiency of C1 esterase inhibitor with recurrent swelling symptoms. It may occur in the course of lymphoproliferative disorders or autoimmune diseases. Symptoms resemble hereditary angioedema, and the only differentiating features is negative family history, late onset of symptoms and accompanying lymphoproliferative disorder. The aim of the study was to analyze the cases of acquired angioedema. The retrospective analysis of 341 patients from the registry of patients with C1 inhibitor deficiency. Results: We identified 4 patients among 119 with HAE (3.57%) diagnosed in this same period of time 2012-2016 who fulfilled the criteria of acquired edema. In two cases the primary reason of angioedema was lymphoproliferive disease, in two monoclonal gammapathy of unknown reason. We analyzed also the results of laboratory tests C4, C1 inhibitor, C1q. In all cases the face was dominated localization. After the treatment of primary lymphoproliferive disease, in two cases, we observed total remission of angioedema. Only one patient with gammapathy require treatment with C1 inhibitor during the attacks. In these case we observed both plasma deriver, and recombinant C1 inhibitor were effective.

  10. Soft skills: an important asset acquired from organizing regional student group activities.

    Science.gov (United States)

    de Ridder, Jeroen; Meysman, Pieter; Oluwagbemi, Olugbenga; Abeel, Thomas

    2014-07-01

    Contributing to a student organization, such as the International Society for Computational Biology Student Council (ISCB-SC) and its Regional Student Group (RSG) program, takes time and energy. Both are scarce commodities, especially when you are trying to find your place in the world of computational biology as a graduate student. It comes as no surprise that organizing ISCB-SC-related activities sometimes interferes with day-to-day research and shakes up your priority list. However, we unanimously agree that the rewards, both in the short as well as the long term, make the time spent on these extracurricular activities more than worth it. In this article, we will explain what makes this so worthwhile: soft skills.

  11. Borrowing and Loan Words: The Lemmatizing of Newly Acquired ...

    African Journals Online (AJOL)

    rbr

    or foreign acquisition. English, for instance, is spoken in many countries on all five continents and is, therefore, able to acquire vocabulary from many lan- guages worldwide. This is coupled with the readiness and the ability of the language to acquire new terminology through borrowing, instead of following the puristic ...

  12. Significance of anaerobes and oral bacteria in community-acquired pneumonia.

    Directory of Open Access Journals (Sweden)

    Kei Yamasaki

    Full Text Available BACKGROUND: Molecular biological modalities with better detection rates have been applied to identify the bacteria causing infectious diseases. Approximately 10-48% of bacterial pathogens causing community-acquired pneumonia are not identified using conventional cultivation methods. This study evaluated the bacteriological causes of community-acquired pneumonia using a cultivation-independent clone library analysis of the 16S ribosomal RNA gene of bronchoalveolar lavage specimens, and compared the results with those of conventional cultivation methods. METHODS: Patients with community-acquired pneumonia were enrolled based on their clinical and radiological findings. Bronchoalveolar lavage specimens were collected from pulmonary pathological lesions using bronchoscopy and evaluated by both a culture-independent molecular method and conventional cultivation methods. For the culture-independent molecular method, approximately 600 base pairs of 16S ribosomal RNA genes were amplified using polymerase chain reaction with universal primers, followed by the construction of clone libraries. The nucleotide sequences of 96 clones randomly chosen for each specimen were determined, and bacterial homology was searched. Conventional cultivation methods, including anaerobic cultures, were also performed using the same specimens. RESULTS: In addition to known common pathogens of community-acquired pneumonia [Streptococcus pneumoniae (18.8%, Haemophilus influenzae (18.8%, Mycoplasma pneumoniae (17.2%], molecular analysis of specimens from 64 patients with community-acquired pneumonia showed relatively higher rates of anaerobes (15.6% and oral bacteria (15.6% than previous reports. CONCLUSION: Our findings suggest that anaerobes and oral bacteria are more frequently detected in patients with community-acquired pneumonia than previously believed. It is possible that these bacteria may play more important roles in community-acquired pneumonia.

  13. Association between Mycobacterium tuberculosis complex phylogenetic lineage and acquired drug resistance.

    Directory of Open Access Journals (Sweden)

    Courtney M Yuen

    Full Text Available BACKGROUND: Development of resistance to antituberculosis drugs during treatment (i.e., acquired resistance can lead to emergence of resistant strains and consequent poor clinical outcomes. However, it is unknown whether Mycobacterium tuberculosis complex species and lineage affects the likelihood of acquired resistance. METHODS: We analyzed data from the U.S. National Tuberculosis Surveillance System and National Tuberculosis Genotyping Service for tuberculosis cases during 2004-2011 with assigned species and lineage and both initial and final drug susceptibility test results. We determined univariate associations between species and lineage of Mycobacterium tuberculosis complex bacteria and acquired resistance to isoniazid, rifamycins, fluoroquinolones, and second-line injectables. We used Poisson regression with backward elimination to generate multivariable models for acquired resistance to isoniazid and rifamycins. RESULTS: M. bovis was independently associated with acquired resistance to isoniazid (adjusted prevalence ratio = 8.46, 95% CI 2.96-24.14 adjusting for HIV status, and with acquired resistance to rifamycins (adjusted prevalence ratio = 4.53, 95% CI 1.29-15.90 adjusting for homelessness, HIV status, initial resistance to isoniazid, site of disease, and administration of therapy. East Asian lineage was associated with acquired resistance to fluoroquinolones (prevalence ratio = 6.10, 95% CI 1.56-23.83. CONCLUSIONS: We found an association between mycobacterial species and lineage and acquired drug resistance using U.S. surveillance data. Prospective clinical studies are needed to determine the clinical significance of these findings, including whether rapid genotyping of isolates at the outset of treatment may benefit patient management.

  14. Reducing the risk of ventilator-acquired pneumonia through head of bed elevation.

    Science.gov (United States)

    Keeley, Libby

    2007-01-01

    It has been suggested that placing critically ill ventilated patients in a semirecumbent position minimizes the likelihood of nosocomial pneumonia. This pilot study explores whether the incidence of ventilator-acquired pneumonia (VAP) can be reduced by elevating the head of the bed to 45 degrees. The design is quantitative in nature, using a randomized controlled trial. The method involves adult ventilated patients being randomly assigned to one of two positions, i.e. 45 degrees raised head of bed (treatment group) or 25 degrees raised head of bed (control group). Data collection relied upon the diagnosis of clinically suspected and microbiologically confirmed pneumonia defined by the Consensus Conference on VAP. Thirty patients were included in the study--17 in the treatment group and 13 in the control group. Results showed that 29% (five) in the treatment group and 54% (seven) in the control group contracted VAP (P VAP in the patients nursed at 45 degrees. However, because of the sample size this difference did not reach statistical significance.

  15. Shipping emission forecasts and cost-benefit analysis of China ports and key regions' control.

    Science.gov (United States)

    Liu, Huan; Meng, Zhi-Hang; Shang, Yi; Lv, Zhao-Feng; Jin, Xin-Xin; Fu, Ming-Liang; He, Ke-Bin

    2018-05-01

    China established Domestic Emission Control Area (DECA) for sulphur since 2015 to constrain the increasing shipping emissions. However, future DECA policy-makings are not supported due to a lack of quantitive evaluations. To investigate the effects of current and possible Chinese DECAs policies, a model is presented for the forecast of shipping emissions and evaluation of potential costs and benefits of an DECA policy package set in 2020. It includes a port-level and regional-level projection accounting for shipping trade volume growth, share of ship types, and fuel consumption. The results show that without control measures, both SO 2 and particulate matter (PM) emissions are expected to increase by 15.3-61.2% in Jing-Jin-Ji, the Yangtze River Delta, and the Pearl River Delta from 2013 to 2020. However, most emissions can be reduced annually by the establishment of a DECA that depends on the size of the control area and the fuel sulphur content limit. Costs range from 0.667 to 1.561 billion dollars (control regional shipping emissions) based on current fuel price. A social cost method shows the regional control scenarios benefit-cost ratios vary from 4.3 to 5.1 with large uncertainty. Chemical transportation model combined with health model method is used to get the monetary health benefits and then compared with the results from social cost method. This study suggests that Chinese DECAs will reduce the projected emissions at a favorable benefit-cost ratio, and furthermore proposes policy combinations that provide high cost-effective benefits as a reference for future policy-making. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  16. 45 CFR 7.4 - Option to acquire foreign rights.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Option to acquire foreign rights. 7.4 Section 7.4... Option to acquire foreign rights. In any case where it is determined that all domestic rights should be...-wide regulations issued thereunder, that the Government shall reserve an option to require the...

  17. 34 CFR 7.4 - Option to acquire foreign rights.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Option to acquire foreign rights. 7.4 Section 7.4 Education Office of the Secretary, Department of Education EMPLOYEE INVENTIONS § 7.4 Option to acquire... issued thereunder, that the Government shall reserve an option to require the assignment of such rights...

  18. Using the SIMGRO regional hydrological model to evaluate salinity control measures in an irrigation area

    NARCIS (Netherlands)

    Kupper, E.; Querner, E.P.; Morábito, J.A.; Menenti, M.

    2002-01-01

    In irrigated areas with drainage and an important interaction with the groundwater system, it is often difficult to predict effects of measures to control salinity. Therefore, in order to evaluate measures to control salinity the SIMGRO integrated regional hydrological model was extended with a

  19. Distinct regions of prefrontal cortex are associated with the controlled retrieval and selection of social information.

    Science.gov (United States)

    Satpute, Ajay B; Badre, David; Ochsner, Kevin N

    2014-05-01

    Research in social neuroscience has uncovered a social knowledge network that is particularly attuned to making social judgments. However, the processes that are being performed by both regions within this network and those outside of this network that are nevertheless engaged in the service of making a social judgment remain unclear. To help address this, we drew upon research in semantic memory, which suggests that making a semantic judgment engages 2 distinct control processes: A controlled retrieval process, which aids in bringing goal-relevant information to mind from long-term stores, and a selection process, which aids in selecting the information that is goal-relevant from the information retrieved. In a neuroimaging study, we investigated whether controlled retrieval and selection for social information engage distinct portions of both the social knowledge network and regions outside this network. Controlled retrieval for social information engaged an anterior ventrolateral portion of the prefrontal cortex, whereas selection engaged both the dorsomedial prefrontal cortex and temporoparietal junction within the social knowledge network. These results suggest that the social knowledge network may be more involved with the selection of social information than the controlled retrieval of it and incorporates lateral prefrontal regions in accessing memory for making social judgments.

  20. Comparative dermatology: acquired digital fibrokeratoma

    OpenAIRE

    Cunha Filho, Roberto Rheingantz da

    2008-01-01

    Demonstra-se quadro característico de fibroqueratoma digital adquirido em trabalhadora rural de 42 anos de idade, que se compara a corno de rinoceronte.It is presented a case of a 42 year-old white female farmer with the classical feature of acquired digital fibrokeratoma, which is compared to rhinoceros horn.

  1. Innervation of periesophageal region of cat's diaphragm - Implication for studies of control of vomiting

    Science.gov (United States)

    Tan, L. K.; Miller, A. D.

    1986-01-01

    The extent of the region of the diaphragm around the esophagus that displays greatly reduced activity during the expulsive phase of vomiting was determined from electromyographic studies in cats to be about 0.75-1.0 cm from the esophagus. Horseradish peroxidase injected into this region retrogradely labeled motoneurons throughout most of the rostral-caudal extent of the phrenic nucleus, with the exception of caudal C6 and rostral C7. This widespread intermingling of motoneurons that innervate the region of reduced activity with other phrenic motoneurons creates a difficulty for needed follow-up studies of diaphragmatic control during vomiting.

  2. Diagnostic and prognostic value of factor VIII binding antibodies in acquired hemophilia A: data from the GTH-AH 01/2010 study.

    Science.gov (United States)

    Werwitzke, S; Geisen, U; Nowak-Göttl, U; Eichler, H; Stephan, B; Scholz, U; Holstein, K; Klamroth, R; Knöbl, P; Huth-Kühne, A; Bomke, B; Tiede, A

    2016-05-01

    Essentials Factor VIII (FVIII) binding IgG detected by ELISA could be an alternative to the Bethesda assay. We studied the performance of anti-FVIII IgG ELISA in patients with acquired hemophilia and controls. Anti-FVIII IgG > 99th percentile of controls was highly sensitive and specific. Patients with high anti-FVIII IgG have a lower chance of achieving remission. Background Acquired hemophilia A is a severe bleeding disorder that requires fast and accurate diagnosis as it occurs often unexpectedly in previously healthy men and women of every age. The Nijmegen-modified Bethesda assay is the diagnostic reference standard for detecting neutralizing autoantibodies against factor VIII (FVIII), but is not widely available, not ideal for quantifying the complex type 2 inhibitors seen in acquired hemophilia, and suffers from high inter-laboratory variability. Objectives To assess the diagnostic and prognostic value of FVIII-binding antibodies as detected by ELISA compared with the Nijmegen Bethesda assay. Methods Samples from the time of first diagnosis and clinical data were available from 102 patients with acquired hemophilia enrolled in the prospective GTH-AH 01/2010 study. Controls (n = 102) were matched for gender and age. Diagnostic cut-offs were determined by receiver-operator curve analysis. The prognostic value was assessed in 92 of the 102 patients by Cox regression analysis of time to partial remission. Results Anti-FVIII IgG above the 99th percentile (> 15 arbitrary units per mL) revealed high sensitivity and specificity (both 0.99; 95% confidence interval, 0.95-1.0) for diagnosing acquired hemophilia. The likelihood of achieving partial remission was related to anti-FVIII IgG concentration ( 1050, 0.39). The Bethesda titer was only associated with the likelihood of partial remission when analyzed in the central laboratory, but not when data from local GTH study sites were used. Conclusion Although the Nijmegen-modified Bethesda assay is the reference

  3. Naturally acquired immunity to Plasmodium falciparum malaria in Africa

    DEFF Research Database (Denmark)

    Hviid, Lars

    2005-01-01

    Infection by Plasmodium falciparum parasites can lead to substantial protective immunity to malaria, and available evidence suggest that acquisition of protection against some severe malaria syndromes can be fairly rapid. Although these facts have raised hopes that the development of effective...... protective immunity to P. falciparum malaria is acquired following natural exposure to the parasites is beginning to emerge, not least thanks to studies that have combined clinical and epidemiological data with basic immunological research. This framework involves IgG with specificity for clonally variant...... antigens on the surface of the infected erythrocytes, can explain some of the difficulties in relating particular immune responses with specificity for well-defined antigenic targets to clinical protection, and suggests a radically new approach to controlling malaria-related morbidity and mortality...

  4. Development the Controller Input Power of Peripheral Interfacing Controller Using Other Micro controller

    International Nuclear Information System (INIS)

    Syirrazie Che Soh; Harzawardi Hashim; Nor Arymaswati Abdullah; Nur Aira Abdul Rahman; Mohd Ashhar Khalid

    2011-01-01

    This Controller Input Power of a Peripheral Interfacing Controller was developed using the other micro controller. This paper discuss the switching technique are practiced using proper electronic device to develop the controller, thus enable to control the input power of a PIC in order to expand their interfacing capacity and control. This may allow the PIC could be used to acquire input and control output signal from electronic and electromechanical device and instrument as well as software in wide scale and application. (author)

  5. REVIEW OF A CASE OF CHILD WITH ACQUIRED APHASIA

    Directory of Open Access Journals (Sweden)

    Silvana FILIPOVA

    2004-12-01

    Full Text Available Achieved children speech disabilities are manifested at certain level of development of speech from the age of 3 to 12 years. The speech disabilities with children from the age of one to three years have developmental and acquired characteristics. It is well-known when and why the disabilities occurr at acquired aphasia or disphasia.The child with acquired aphasia or disphasia has early brain impairements and a relative improvement happens with adequate treatment and prompt rehabilitation treatment. It is more obvious with children than with adults.This fast and complete rehabilitation happens due to the plastic character of child’s brain and the possibilities for intro-hemisphere and inter-hemisphere reorganization of speech functions in childhood.

  6. Prognostic value of severity indicators of nursing-home-acquired pneumonia versus community-acquired pneumonia in elderly patients

    Directory of Open Access Journals (Sweden)

    Ugajin M

    2014-02-01

    Full Text Available Motoi Ugajin, Kenichi Yamaki, Natsuko Hirasawa, Takanori Kobayashi, Takeo Yagi Department of Respiratory Medicine, Ichinomiya-Nishi Hospital, Ichinomiya City, Japan Background: The credibility of prognostic indicators in nursing-home-acquired pneumonia (NHAP is not clear. We previously reported a simple prognostic indicator in community-acquired pneumonia (CAP: blood urea nitrogen to serum albumin (B/A ratio. This retrospective study investigated the prognostic value of severity indicators in NHAP versus CAP in elderly patients. Methods: Patients aged ≥65 years and hospitalized because of NHAP or CAP within the previous 3 years were enrolled. Demographics, coexisting illnesses, laboratory and microbiological findings, and severity scores (confusion, urea, respiratory rate, blood pressure, and age ≥65 [CURB-65] scale; age, dehydration, respiratory failure, orientation disturbance, and pressure [A-DROP] scale; and pneumonia severity index [PSI] were retrieved from medical records. The primary outcome was mortality within 28 days of admission. Results: In total, 138 NHAP and 307 CAP patients were enrolled. Mortality was higher in NHAP (18.1% than in CAP (4.6% (P<0.001. Patients with NHAP were older and had lower functional status and a higher rate of do-not-resuscitate orders, heart failure, and cerebrovascular diseases. The NHAP patients more frequently had typical bacterial pathogens. Using the receiver-operating characteristics curve for predicting mortality, the area under the curve in NHAP was 0.70 for the A-DROP scale, 0.69 for the CURB-65 scale, 0.67 for the PSI class, and 0.65 for the B/A ratio. The area under the curve in CAP was 0.73 for the A-DROP scale, 0.76 for the CURB-65 scale, 0.81 for the PSI class, and 0.83 for the B/A ratio. Conclusion: Patient mortality was greater in NHAP than in CAP. Patient characteristics, coexisting illnesses, and detected pathogens differed greatly between NHAP and CAP. The existing severity indicators

  7. Patient referral patterns and the spread of hospital-acquired infections through national health care networks.

    Directory of Open Access Journals (Sweden)

    Tjibbe Donker

    2010-03-01

    Full Text Available Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA, are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2004 to measure the connectedness between hospitals. This allowed us to reconstruct the network of hospitals in the Netherlands. We used mathematical models to assess the effect of different patient referral patterns on the potential spread of hospital-acquired infections between hospitals, and between categories of hospitals (University medical centers, top clinical hospitals and general hospitals. University hospitals have a higher number of shared patients than teaching or general hospitals, and are therefore more likely to be among the first to receive colonized patients. Moreover, as the network is directional towards university hospitals, they have a higher prevalence, even when infection control measures are equally effective in all hospitals. Patient referral patterns have a profound effect on the spread of health care-associated infections like hospital-acquired MRSA. The MRSA prevalence therefore differs between hospitals with the position of each hospital within the health care network. Any comparison of MRSA rates between hospitals, as a benchmark for hospital hygiene, should therefore take the position of a hospital within the network into account.

  8. Randomized, controlled trial of antibiotics in the management of community-acquired skin abscesses in the pediatric patient.

    Science.gov (United States)

    Duong, Myto; Markwell, Stephen; Peter, John; Barenkamp, Stephen

    2010-05-01

    Emergency department visits for skin and soft tissue infections are increasing with the discovery of community-acquired methicillin-resistant Staphylococcus aureus. Whether abscesses treated surgically also require antibiotics is controversial. There are no published pediatric randomized controlled trials evaluating the need for antibiotics in skin abscess management. We determine the benefits of antibiotics in surgically managed pediatric skin abscesses. This was a double-blind, randomized, controlled trial. Pediatric patients were randomized to receive 10 days of placebo or trimethoprim-sulfamethoxazole after incision and draining. Follow-up consisted of a visit/call at 10 to 14 days and a call at 90 days. Primary outcome was treatment failure at the 10-day follow-up. Secondary outcome was new lesion development at the 10- and 90-day follow-ups. Noninferiority of placebo relative to trimethoprim-sulfamethoxazole for primary and secondary outcomes was assessed. One hundred sixty-one patients were enrolled, with 12 lost to follow-up. The failure rates were 5.3% (n=4/76) and 4.1% (n=3/73) in the placebo and antibiotic groups, respectively, yielding a difference of 1.2%, with a 1-sided 95% confidence interval (CI) (-infinity to 6.8%). Noninferiority was established with an equivalence threshold of 7%. New lesions occurred at the 10-day follow-up: 19 on placebo (26.4%) and 9 on antibiotics (12.9%), yielding a difference of 13.5%, with 95% 1-sided CI (-infinity to 24.3%). At the 3-month follow-up, 15 of 52 (28.8%) in the placebo group and 13 of 46 (28.3%) in the antibiotic group developed new lesions. The difference was 0.5%, with 95% 1-sided CI (-infinity to 15.6%). Antibiotics are not required for pediatric skin abscess resolution. Antibiotics may help prevent new lesions in the short term, but further studies are required. Copyright 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  9. Histopathology of dairy cows' hooves with signs of naturally acquired laminitis

    Directory of Open Access Journals (Sweden)

    Heloisa M.F. Mendes

    2013-05-01

    Full Text Available The purpose of this study was to investigate histological changes in dairy cows' hooves with or without injuries from naturally acquired laminitis. Cull cows with no clinical signs of hoof abnormalities (G1, n=9 and those with macroscopic lesions associated with laminitis without (G2, n=23 or with lameness (G3, n=7 were used in the study. After slaughter, samples of dermo-epidermal junctions of sole, axial and dorsal regions of the hoof were obtained and histologically processed using HE and PAS staining. Congestion, hemorrhage and inflammatory infiltrate in the dermis of sole, axial and dorsal regions were blindly and semiquantitatively evaluated by the same researcher. Inflammatory infiltrate was evaluated in the dermal laminae of axial and dorsal regions. The morphology of epidermal cells and the presence of irregularities in three regions of the basement membrane (BM length were examined using PAS staining. Scores of lesions in different regions of the hoof in the same group and in different groups for each region of the hoof were compared using non-parametric analyses. Inflammatory infiltrate in the dermis of all regions of the hoof was detected in all groups with no significant statistical difference. Cows with no clinical signs of hoof abnormalities secondary to laminitis (G1 have inflammation scores and epidermal cell changes similar to those of groups with laminitis injuries, suggesting the existence of a prodromal phase for this disease in bovines. BM had irregularities with a variable intensity along its length, however, with no difference among groups. The pattern of BM irregularities found has not been reported so far and does not resemble the BM collapse described in horses and cattle with induced acute laminitis. Is it concluded that even in the absence of macroscopic hoof signs associated to laminitis, dairy cows have histological injuries compatible with inflammation of the dermo-epidermal junction as in affected animals

  10. Taking Action on Air Pollution Control in the Beijing-Tianjin-Hebei (BTH) Region: Progress, Challenges and Opportunities

    Science.gov (United States)

    Wang, Li; Zhang, Fengying; Pilot, Eva; Yu, Jie; Holdaway, Jennifer; Yang, Linsheng; Li, Yonghua; Wang, Wuyi; Vardoulakis, Sotiris; Krafft, Thomas

    2018-01-01

    Due to rapid urbanization, industrialization and motorization, a large number of Chinese cities are affected by heavy air pollution. In order to explore progress, remaining challenges, and sustainability of air pollution control in the Beijing-Tianjin-Hebei (BTH) region after 2013, a mixed method analysis was undertaken. The quantitative analysis comprised an overview of air quality management in the BTH region. Semi-structured expert interviews were conducted with 12 stakeholders from various levels of government and research institutions who played substantial roles either in decision-making or in research and advising on air pollution control in the BTH region. The results indicated that with the stringent air pollution control policies, the air quality in BTH meets the targets of the Air Pollution Prevention and Control Action Plan. However, improvements vary across the region and for different pollutants. Although implementation has been decisive and was at least in parts effectively enforced, significant challenges remained with regard to industrial and traffic emission control, and national air quality limits continued to be significantly exceeded and competing development interests remained mainly unsolved. There were also concerns about the sustainability of the current air pollution control measures especially for industries due to the top-down enforcement, and the associated large burden of social cost including unemployment and social inequity resulting industrial restructuring. Better mechanisms for ensuring cross-sectoral coordination and for improved central-local government communication were suggested. Further suggestions were provided to improve the conceptual design and effective implementation of respective air pollution control strategies in BTH. Our study highlights some of the major hurdles that need to be addressed to succeed with a comprehensive air pollution control management for the Chinese mega-urban agglomerations. PMID:29425189

  11. Taking Action on Air Pollution Control in the Beijing-Tianjin-Hebei (BTH) Region: Progress, Challenges and Opportunities.

    Science.gov (United States)

    Wang, Li; Zhang, Fengying; Pilot, Eva; Yu, Jie; Nie, Chengjing; Holdaway, Jennifer; Yang, Linsheng; Li, Yonghua; Wang, Wuyi; Vardoulakis, Sotiris; Krafft, Thomas

    2018-02-09

    Due to rapid urbanization, industrialization and motorization, a large number of Chinese cities are affected by heavy air pollution. In order to explore progress, remaining challenges, and sustainability of air pollution control in the Beijing-Tianjin-Hebei (BTH) region after 2013, a mixed method analysis was undertaken. The quantitative analysis comprised an overview of air quality management in the BTH region. Semi-structured expert interviews were conducted with 12 stakeholders from various levels of government and research institutions who played substantial roles either in decision-making or in research and advising on air pollution control in the BTH region. The results indicated that with the stringent air pollution control policies, the air quality in BTH meets the targets of the Air Pollution Prevention and Control Action Plan. However, improvements vary across the region and for different pollutants. Although implementation has been decisive and was at least in parts effectively enforced, significant challenges remained with regard to industrial and traffic emission control, and national air quality limits continued to be significantly exceeded and competing development interests remained mainly unsolved. There were also concerns about the sustainability of the current air pollution control measures especially for industries due to the top-down enforcement, and the associated large burden of social cost including unemployment and social inequity resulting industrial restructuring. Better mechanisms for ensuring cross-sectoral coordination and for improved central-local government communication were suggested. Further suggestions were provided to improve the conceptual design and effective implementation of respective air pollution control strategies in BTH. Our study highlights some of the major hurdles that need to be addressed to succeed with a comprehensive air pollution control management for the Chinese mega-urban agglomerations.

  12. Taking Action on Air Pollution Control in the Beijing-Tianjin-Hebei (BTH Region: Progress, Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Li Wang

    2018-02-01

    Full Text Available Due to rapid urbanization, industrialization and motorization, a large number of Chinese cities are affected by heavy air pollution. In order to explore progress, remaining challenges, and sustainability of air pollution control in the Beijing-Tianjin-Hebei (BTH region after 2013, a mixed method analysis was undertaken. The quantitative analysis comprised an overview of air quality management in the BTH region. Semi-structured expert interviews were conducted with 12 stakeholders from various levels of government and research institutions who played substantial roles either in decision-making or in research and advising on air pollution control in the BTH region. The results indicated that with the stringent air pollution control policies, the air quality in BTH meets the targets of the Air Pollution Prevention and Control Action Plan. However, improvements vary across the region and for different pollutants. Although implementation has been decisive and was at least in parts effectively enforced, significant challenges remained with regard to industrial and traffic emission control, and national air quality limits continued to be significantly exceeded and competing development interests remained mainly unsolved. There were also concerns about the sustainability of the current air pollution control measures especially for industries due to the top-down enforcement, and the associated large burden of social cost including unemployment and social inequity resulting industrial restructuring. Better mechanisms for ensuring cross-sectoral coordination and for improved central-local government communication were suggested. Further suggestions were provided to improve the conceptual design and effective implementation of respective air pollution control strategies in BTH. Our study highlights some of the major hurdles that need to be addressed to succeed with a comprehensive air pollution control management for the Chinese mega-urban agglomerations.

  13. Acquired epidermolysis bullosa

    Directory of Open Access Journals (Sweden)

    Maricel Sucar Batista

    2015-12-01

    Full Text Available Epidermolysis bullosa is a group of diseases or skin disorders genetically transmitted and it is characterized by the appearance of bullae, ulcers and skin wounds. It usually appears at birth or in the first months of life. This is a case of a 72-year-old female patient who comes to the dermatology department with skin lesions of 6 months of evolution. A skin biopsy was performed, taking a sample for direct and indirect immunofluorescence. Acquired epidermolysis bullosa of unknown etiology was diagnosed. Treatment was started with low-dose colchicine to increase it later, according to the patient’s tolerance and disease progression.

  14. Immunosuppression for acquired hemophilia A: results from the European Acquired Haemophilia Registry (EACH2).

    Science.gov (United States)

    Collins, Peter; Baudo, Francesco; Knoebl, Paul; Lévesque, Hervé; Nemes, László; Pellegrini, Fabio; Marco, Pascual; Tengborn, Lilian; Huth-Kühne, Angela

    2012-07-05

    Acquired hemophilia A (AHA) is an autoimmune disease caused by an autoantibody to factor VIII. Patients are at risk of severe and fatal hemorrhage until the inhibitor is eradicated, and guidelines recommend immunosuppression as soon as the diagnosis has been made. The optimal immunosuppressive regimen is unclear; therefore, data from 331 patients entered into the prospective EACH2 registry were analyzed. Steroids combined with cyclophosphamide resulted in more stable complete remission (70%), defined as inhibitor undetectable, factor VIII more than 70 IU/dL and immunosuppression stopped, than steroids alone (48%) or rituximab-based regimens (59%). Propensity score-matched analysis controlling for age, sex, factor VIII level, inhibitor titer, and underlying etiology confirmed that stable remission was more likely with steroids and cyclophosphamide than steroids alone (odds ratio = 3.25; 95% CI, 1.51-6.96; P < .003). The median time to complete remission was approximately 5 weeks for steroids with or without cyclophosphamide; rituximab-based regimens required approximately twice as long. Immunoglobulin administration did not improve outcome. Second-line therapy was successful in approximately 60% of cases that failed first-line therapy. Outcome was not affected by the choice of first-line therapy. The likelihood of achieving stable remission was not affected by underlying etiology but was influenced by the presenting inhibitor titer and FVIII level.

  15. Innate-Type and Acquired-Type Allergy Regulated by IL-33

    Directory of Open Access Journals (Sweden)

    Tomohiro Yoshimoto

    2014-01-01

    Full Text Available We propose two types of allergic response: IgE-dependent and IgE-independent, and designate these as 'acquired-type allergy' and 'innate-type allergy', respectively. IL-33 stimulates both innate (basophils, mast cells, or group 2 innate lymphoid cells and acquired (Th2 cells allergy-related cells to induce and/or augment Th2 cytokine production, which leads to eosinophilic inflammation in vivo. Thus, IL-33 is an essential regulator for both 'innate-type allergy' and 'acquired-type allergy', and might be an attractive therapeutic target for allergic diseases.

  16. Pennzoil to acquire part of Chevron's production

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that Pennzoil Co., Houston, will exchange 48% of its $2.2 billion investment in Chevron Corp. for a chunk of chevron's U.S. producing leases. The trade is to involve a tax free exchange of 15.75 million chevron Corp. shares held by Pennzoil for all the stock of Chevron PBC Inc., a Chevron unit owning Gulf of Mexico, Gulf Coast, Permian basin, and other U.S. oil and gas producing leases. Sixty percent of the acquired reserves are in the Gulf of Mexico and Gulf Coast where Pennzoil's operations are concentrated, and 60% of the acquired reserves consist of natural gas, mirroring Pennzoil's reserve ratios

  17. Optimal control and optimal trajectories of regional macroeconomic dynamics based on the Pontryagin maximum principle

    Science.gov (United States)

    Bulgakov, V. K.; Strigunov, V. V.

    2009-05-01

    The Pontryagin maximum principle is used to prove a theorem concerning optimal control in regional macroeconomics. A boundary value problem for optimal trajectories of the state and adjoint variables is formulated, and optimal curves are analyzed. An algorithm is proposed for solving the boundary value problem of optimal control. The performance of the algorithm is demonstrated by computing an optimal control and the corresponding optimal trajectories.

  18. Acquired Credit Unions: Drivers of Takeover

    Directory of Open Access Journals (Sweden)

    R. Raymond Sant

    2015-08-01

    Full Text Available In this paper we study acquired credit unions and analyze their financial performance up to six years prior to merger, on a quarterly basis. The primary focus is on balance sheet (asset liability management and profitability variables (return on assets. We find that acquired credit unions during the period 2008 (third quarter to 2014 (first quarter experienced negative return on assets for several quarters prior to their takeover. This was the result of a declining loan portfolio and increasing charge offs. In spite of decreasing lending activity, such credit unions continued to increase their deposits, i.e., adding to their cost base. Due to declining loans, their net interest margin as a proportion of deposits was also in decline. We argue that this is an indicator of poor management ability. Furthermore, our analysis finds that operating expenses were increasing over time, something that has been documented in previous literature also for smaller credit unions and is attributable to lack of economies of scale. The average asset size of the acquired credit unions in our sample is about $22 million just before acquisition. We attribute our findings to poor business strategy followed by such credit unions. We also conclude that signs of trouble are evident up to two years before merger on average and regulatory policy may have to become more proactive to manage the consolidation challenge faced by the credit union industry in general.

  19. Acquiring Customers via Word-of-Mouth Referrals : A Virtuous Strategy?

    NARCIS (Netherlands)

    Pieters, Constant; Lemmens, Aurélie

    2015-01-01

    Managers are increasingly using word-of-mouth (WOM) acquisition strategies, such as seeded WOM or referral programs, to acquire new customers. These strategies have proven successful in recruiting customers with higher margin and lower churn probability compared to customers acquired otherwise.

  20. [Community-acquired Acinetobacter pneumonia].

    Science.gov (United States)

    Bernasconi, E; Wüst, J; Speich, R; Flury, G; Krause, M

    1993-08-21

    We report the history of a 38-year-old male native of Sri Lanka admitted to the emergency ward because of chest pain and shortness of breath. On physical and radiographic examination a bilateral predominantly right-sided pneumonia was found. The patient was admitted to the medical ICU and an antibiotic regimen with amoxicillin/clavulanic acid and erythromycin was initiated. Shortly afterwards septic shock developed. The patient was intubated and received high doses of catecholamines. He died 30 hours after admission to the hospital. Cultures from sputum, tracheal aspirate and blood grew Acinetobacter baumanni. Acinetobacter is an ubiquitous gram-negative rod with coccobacillary appearance in clinical specimens, that may appear gram-positive due to poor discoloration on Gram-stain. It is a well known causative agent of nosocomial infections, particularly in intensive care units. Community-acquired pneumonias, however, are quite rare. Sporadic cases have been reported from the US, Papua-New Guinea and Australia. Interestingly, these pneumonias are fulminant and have a high mortality. Chronic obstructive lung disease, diabetes, and tobacco and alcohol consumption appear to be predisposing factors. Due to the rapid course and poor prognosis, prompt diagnosis and adequate antibiotic treatment are indicated. Antibiotics use for community-acquired pneumonias, such as amoxicillin/clavulanic acid or macrolides, are not sufficient. Appropriate antibiotics for the initial treatment of suspected Acinetobacter infections include imipenem and carboxy- and ureidopenicillins combined with an aminoglycoside.

  1. Implications of the cattle trade network in Cameroon for regional disease prevention and control

    Science.gov (United States)

    Motta, Paolo; Porphyre, Thibaud; Handel, Ian; Hamman, Saidou M.; Ngu Ngwa, Victor; Tanya, Vincent; Morgan, Kenton; Christley, Rob; Bronsvoort, Barend M. Dec.

    2017-03-01

    Movement of live animals is a major risk factor for the spread of livestock diseases and zoonotic infections. Understanding contact patterns is key to informing cost-effective surveillance and control strategies. In West and Central Africa some of the most rapid urbanization globally is expected to increase the demand for animal-source foods and the need for safer and more efficient animal production. Livestock trading points represent a strategic contact node in the dissemination of multiple pathogens. From October 2014 to May 2015 official transaction records were collected and a questionnaire-based survey was carried out in cattle markets throughout Western and Central-Northern Cameroon. The data were used to analyse the cattle trade network including a total of 127 livestock markets within Cameroon and five neighboring countries. This study explores for the first time the influence of animal trade on infectious disease spread in the region. The investigations showed that national borders do not present a barrier against pathogen dissemination and that non-neighbouring countries are epidemiologically connected, highlighting the importance of a regional approach to disease surveillance, prevention and control. Furthermore, these findings provide evidence for the benefit of strategic risk-based approaches for disease monitoring, surveillance and control, as well as for communication and training purposes through targeting key regions, highly connected livestock markets and central trading links.

  2. Diagnosis and Treatment of Community-Acquired Pneumonia in Children

    Directory of Open Access Journals (Sweden)

    I.A. Karymdzhanov

    2016-02-01

    The initial antibiotic therapy of community-acquired pneumonia is carried out empirically. In the treatment of severe community-acquired pneumonia in children from 2 months to 5 years, the drug of choice is amoxicillin orally. Macrolides are the drugs of choice for children aged 5 to 16 years. In severe pneumonia, drugs of choice are amoxicillin clavulanate, 2nd–4th generation cephalosporins. In general, the duration of antibiotic therapy in the community-acquired pneumonia caused by typical bacteria is 7–10 days, by atypical bacteria — 10–14 days. In the real clinical practice, the errors associated with the choice of drug, route of administration, dosage, regimen of application, length of treatment are frequent during antibacterial therapy.

  3. Recent experiments testing an opponent-process theory of acquired motivation.

    Science.gov (United States)

    Solomon, R L

    1980-01-01

    There are acquired motives of the addiction type which seem to be non-associative in nature. They all seem to involve affective phenomena caused by reinforcers, unconditioned stimuli or innate releasers. When such stimuli are repeatedly presented, at least three affective phenomena occur: (1) affective contrast effects, (2) affective habituation (tolerance), and (3) affective withdrawal syndromes. These phenomena can be precipitated either by pleasant or unpleasant events (positive or negative reinforcers). Whenever we see these three phenomena, we also see the development of an addictive cycle, a new motivational system. These phenomena are explained by an opponent-process theory of motivation which holds that there are affect control systems which oppose large departures from affective equilibrium. The control systems are strengthened by use and weakened by disuse. Current observations and experiments testing the theory are described for: (1) the growth of social attachment (imprinting) in ducklings; and (2) the growth of adjunctive behaviors. The findings so far support the theory.

  4. The Short Wave Aerostat-Mounted Imager (SWAMI): A novel platform for acquiring remotely sensed data from a tethered balloon

    Science.gov (United States)

    Vierling, L.A.; Fersdahl, M.; Chen, X.; Li, Z.; Zimmerman, P.

    2006-01-01

    We describe a new remote sensing system called the Short Wave Aerostat-Mounted Imager (SWAMI). The SWAMI is designed to acquire co-located video imagery and hyperspectral data to study basic remote sensing questions and to link landscape level trace gas fluxes with spatially and temporally appropriate spectral observations. The SWAMI can fly at altitudes up to 2 km above ground level to bridge the spatial gap between radiometric measurements collected near the surface and those acquired by other aircraft or satellites. The SWAMI platform consists of a dual channel hyperspectral spectroradiometer, video camera, GPS, thermal infrared sensor, and several meteorological and control sensors. All SWAMI functions (e.g. data acquisition and sensor pointing) can be controlled from the ground via wireless transmission. Sample data from the sampling platform are presented, along with several potential scientific applications of SWAMI data.

  5. Evaluation of a PCR Assay for Detection of Streptococcus pneumoniae in Respiratory and Nonrespiratory Samples from Adults with Community-Acquired Pneumonia

    OpenAIRE

    Murdoch, David R.; Anderson, Trevor P.; Beynon, Kirsten A.; Chua, Alvin; Fleming, Angela M.; Laing, Richard T. R.; Town, G. Ian; Mills, Graham D.; Chambers, Stephen T.; Jennings, Lance C.

    2003-01-01

    Streptococcus pneumoniae is the most common cause of community-acquired pneumonia, but it is undoubtedly underdiagnosed. We used a nested PCR assay (targeting the pneumolysin gene) to detect S. pneumoniae DNA in multiple sample types from 474 adults with community-acquired pneumonia and 183 control patients who did not have pneumonia. Plasma or buffy coat samples were PCR positive in only 6 of the 21 patients with positive blood cultures for S. pneumoniae and in 12 other patients (4 of whom h...

  6. The IAEA Regional Training Course on Regulatory Control of Radiation Sources

    International Nuclear Information System (INIS)

    2000-01-01

    Materials of the IAEA Regional Training Course contains 8 presented lectures. Authors deals with regulatory control of radiation sources. The next materials of the IAEA were presented: Organization and implementation of a national regulatory infrastructure governing protection against ionizing radiation and the safety of radiation sources. (IAEA-TECDOC-1067); Safety assessment plants for authorization and inspection of radiation sources (IAEA-TECDOC-1113); Regulatory authority information system RAIS, Version 2.0, Instruction manual

  7. Idiopathic Acquired Hemophilia A with Undetectable Factor VIII Inhibitor

    Directory of Open Access Journals (Sweden)

    Nicholas B. Abt

    2014-01-01

    Full Text Available Objective. We present the case of a 73-year-old female, with no family or personal history of a bleeding disorder, who had a classic presentation for acquired hemophilia A. Factor VIII activity was low but detectable and a factor VIII inhibitor was undetectable. Methods. The patient’s plasma was comprehensively studied to determine the cause of the acquired coagulopathy. Using the Nijmegen modification of the Bethesda assay, no factor VIII autoantibody was measureable despite varying the incubation time from 1 to 3 hours. Results. The aPTT was prolonged at 46.8 seconds, which did not correct in the 4 : 1 mix but did with 1 : 1 mix. Using a one stage factor VIII activity assay, the FVIII activity was 16% and chromogenic FVIII activity was also 16%. The patient was treated with recombinant FVII and transfusion, significantly reducing bleeding. Long-term therapy was initiated with cyclophosphamide and prednisone with normalization of FVIII activity. Conclusions. Physicians can be presented with the challenging clinical picture of an acquired factor VIII inhibitor without a detectable inhibitor by the Bethesda assay. Standard therapy for an acquired hemophilia A should be considered.

  8. Generalized stability regions of current control for LCL-filtered grid-connected converters without passive or active damping

    DEFF Research Database (Denmark)

    Tang, Yi; Yoon, Changwoo; Zhu, Rongwu

    2015-01-01

    This paper investigates the stability regions of current control for LCL-filtered grid-connected converters, where no active or passive damping is required to stabilize the closed-loop control system. It is already identified in the literature that if the LCL resonance frequency is placed within 1....../6 to 1/2 of the system sampling frequency, the grid current control can be directly used without damping. If the resonance frequency is smaller than 1/6 of the sampling frequency, the converter current control should then be adopted. This paper further extends the analysis to the cases where...... the resonance frequency could be larger than 1/2 of the sampling frequency, and derives the complete stability regions for both grid and converter current control. Interestingly, it is found that for any given LCL-filter design, there will always be one stable current control design without any damping, which...

  9. Forecasting Precipitation over the MENA Region: A Data Mining and Remote Sensing Based Approach

    Science.gov (United States)

    Elkadiri, R.; Sultan, M.; Elbayoumi, T.; Chouinard, K.

    2015-12-01

    We developed and applied an integrated approach to construct predictive tools with lead times of 1 to 12 months to forecast precipitation amounts over the Middle East and North Africa (MENA) region. The following steps were conducted: (1) acquire and analyze temporal remote sensing-based precipitation datasets (i.e. Tropical Rainfall Measuring Mission [TRMM]) over five main water source regions in the MENA area (i.e. Atlas Mountains in Morocco, Southern Sudan, Red Sea Hills of Yemen, and Blue Nile and White Nile source areas) throughout the investigation period (1998 to 2015), (2) acquire and extract monthly values for all of the climatic indices that are likely to influence the climatic patterns over the MENA region (e.g., Northern Atlantic Oscillation [NOI], Southern Oscillation Index [SOI], and Tropical North Atlantic Index [TNA]); and (3) apply data mining methods to extract relationships between the observed precipitation and the controlling factors (climatic indices) and use predictive tools to forecast monthly precipitation over each of the identified pilot study areas. Preliminary results indicate that by using the period from January 1998 until August 2012 for model training and the period from September 2012 to January 2015 for testing, precipitation can be successfully predicted with a three-months lead over South West Yemen, Atlas Mountains in Morocco, Southern Sudan, Blue Nile sources and White Nile sources with confidence (Pearson correlation coefficient: 0.911, 0.823, 0.807, 0.801 and 0.895 respectively). Future work will focus on applying this technique for prediction of precipitation over each of the climatically contiguous areas of the MENA region. If our efforts are successful, our findings will lead the way to the development and implementation of sound water management scenarios for the MENA countries.

  10. Death rates for acquired hypothyroidism and thyrotoxicosis in English populations (1979-2010): comparison of underlying cause and all certified causes.

    Science.gov (United States)

    Goldacre, M J; Duncan, M E

    2013-03-01

    Overt hypothyroidism and thyrotoxicosis have widespread systemic effects and are associated with increased mortality. Most death certificates that include them do not have the thyroid disease coded as the underlying cause of death. To describe regional (1979-2010) and national (1995-2010) trends in mortality rates for acquired hypothyroidism and thyrotoxicosis, analysing all certified causes of death (termed 'mentions') and not just the underlying cause. Analysis of death registration data. Analysis of data for the Oxford region (mentions available from 1979) and English national data (mentions available from 1995). The data were grouped in periods defined by different national rules for selecting the underlying cause of death (1979-83, 1984-92, 1993-2000 and 2001-10) and were also analysed as single calendar years. Mentions mortality for acquired hypothyroidism in the Oxford region declined significantly from 1979 to 2010: the average annual percentage change (AAPC) was -2.6% (95% confidence intervals -3.5, -1.8). Most of the decrease occurred during the 1980s. The AAPC in rates for later years in England (1995-2010) was non-significant at 0.2% (-0.7, 1.0). Mortality rates for thyrotoxicosis decreased significantly: the AAPC was -2.8% (-4.1, -1.5) in the Oxford region and -3.8% (-4.7, -3.0) in England. In England, between 2001 and 2010, hypothyroidism or thyrotoxicosis was coded as the underlying cause of death on, respectively, 17 and 24% of death certificates that included them. Mortality rates for hypothyroidism and thyrotoxicosis have fallen substantially. The fall is probably wholly or mainly a result of improved care.

  11. Audit Domain Acquire And Implement dengan Cobit 4.1 pada PT Erajaya Swasembada Tbk

    Directory of Open Access Journals (Sweden)

    Viany Utami Tjhin

    2014-12-01

    Full Text Available The main priority aspect of information and communication technologies is given to control mechanisms, both internal and external in enterprises. It ensures that the reports and the decisions received and generated by the management will support their decision-making. The decisions have honesty and high integrity based on the results of the audit conducted on systems of information and communication technology. The objective of this research is to deliver audit reports of information systems for management and make recommendations on the audit findings in PT Erajaya Swasembada Tbk. Business processes studied included sales, purchasing, finance, and the warehouse. The system used was "Erajaya Live Application Server" and ERP (Enterprise Resource Planning-based. This research used thedomain of COBIT 4.1: Acquire and Implement. The domain included several sub-domains, which were:identify automated solutions (AI1, acquire and maintain application software (AI2, acquire and maintain technology infrastructure (AI3, enable operation and use (AI4, procure IT resources (AI5, manage changes (AI6, and install and accredit solutions and changes (AI7. Data were collected from interviewing IT Department, distributing questionnaires to respondents, and observing the business processes of this enterprise. Research obtained 57 audit findings on IT implementation. The results of process reference model formulation are 3 findings on AI1subdomain, 5 findings on AI2subdomain, 9 findings on AI3subdomain, 6 findings on AI4 subdomain, 11 findings on AI5subdomain, 13 findings pada AI6subdomain, and 10 findings on AI7subdomain. The level of maturity model of this domain, Acquire and Implement (AI, was found on level 3.

  12. Regional and international approaches on prevention and control of animal transboundary and emerging diseases.

    Science.gov (United States)

    Domenech, J; Lubroth, J; Eddi, C; Martin, V; Roger, F

    2006-10-01

    Transboundary animal diseases pose a serious risk to the world animal agriculture and food security and jeopardize international trade. The world has been facing devastating economic losses from major outbreaks of transboundary animal diseases (TADs) such as foot-and-mouth disease, classical swine fever, rinderpest, peste des petits ruminants (PPR), and Rift Valley fever. Lately the highly pathogenic avian influenza (HPAI) due to H5N1 virus, has become an international crisis as all regions around the world can be considered at risk. In the past decades, public health authorities within industrialized countries have been faced with an increasing number of food safety issues. The situation is equally serious in developing countries. The globalization of food (and feed) trade, facilitated by the liberalization of world trade, while offering many benefits and opportunities, also represents new risks. The GF-TADs Global Secretariat has carried out several regional consultations for the identification of priority diseases and best ways for their administration, prevention and control. In the questionnaires carried out and through the consultative process, it was noted that globally, FMD was ranked as the first and foremost priority. Rift Valley fever, and today highly pathogenic avian influenza, are defined as major animal diseases which also affect human health. PPR and CBPP, a disease which is particularly serious in Africa and finally, African swine fever (ASF) and classical swine fever (CSF) are also regionally recognised as top priorities on which the Framework is determined to work. The FAO philosophy--shared by the OIE--embraces the need to prevent and control TADs and emerging diseases at their source, which is most of the time in developing countries. Regional and international approaches have to be followed, and the FAO and OIE GF-TADs initiative provides the appropriate concepts and objectives as well as an organizational framework to link international and

  13. Radiation therapy for Kaposi's sarcoma associated with acquired immunodeficiency syndrome. Tokyo Metropolitan Komagome Hospital experience

    Energy Technology Data Exchange (ETDEWEB)

    Ebara, Takeshi [Municipal Kanbara General Hospital, Fujikawa, Shizuoka (Japan); Karasawa, Katsuyuki; Maebayashi, Katsuya; Kurosaki, Hiromasa; Ishikawa, Hitoshi; Kaizu, Toshihide; Tanaka, Yoshiaki; Akagi, Kumiko; Masuda, Gota

    2000-12-01

    Kaposi's sarcoma is frequently found in association with acquired immunodeficiency syndrome (AIDS). We report on radiotherapy for patients with AIDS-related Kaposi's sarcoma at Tokyo Metropolitan Komagome Hospital. Between April 1991 and May 1997, radiotherapy was given to 11 lesions in eight men with AIDS-related Kaposi's sarcoma to relieve their symptoms. The lesions involved the head and neck region, the legs, and the gastrointestinal tract. Radiotherapy was carried out with 4-MV photon through parallel opposed field or high energy electrons. Total doses ranged from 20 to 38 Gy, with a median of 30 Gy, delivered in 2- to 3-Gy fractions. Four patients were given other treatments prior to the radiotherapy. Acute reaction was evaluated according to the modified acute radiation morbidity scoring criteria of the Radiation Therapy Oncology Group (RTOG). Radiotherapy had relieved the symptoms in all patients at completion of this therapy. Lesions that involved the hard palate and vocal cords had completely disappeared. The lesions that received radiotherapy were controlled without symptoms until the patients died. Patients who had the head and neck region treated exhibited severe acute mucosal reaction (at a dose of 30 Gy, there was grade 2 morbidity by modified RTOG criteria, in two patients, and grade 3 in three patients) although the radiation therapy was completed for these patients. Radiotherapy promises a favorable outcome for symptom relief in AIDS-related Kaposi's sarcoma. (author)

  14. Cholecystitis in a child with acquired immunodeficiency syndrome: ultrasonographic findings in a case of uncommon presentation during childhood

    International Nuclear Information System (INIS)

    Rubi-Palomares, I.; Martinez-Leon, M. I.; Alonso-Usabiaga, I.; Ceres-Ruiz, L.

    2001-01-01

    We present the case of a boy with acquired immunodeficiency syndrome (AIDS) in whom ultrasound revealed the presence of a calculous cholecystitis. Abdominal ultrasound was essential in the initial diagnosis and the assessment of the response to treatment. This entity has rarely been reported in the pediatric radiology literature. In our patient, the cholecystitis may have been caused by infection, and the involvement of regional lymphatic obstruction in the pathogenesis is considered. (Author) 14 refs

  15. The Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC) as safeguard regional agency

    International Nuclear Information System (INIS)

    Alvim, C.F.

    1994-01-01

    The Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials - ABACC applies regional safeguards on nuclear materials in Brazil and Argentina. The framework of international agreements concerning ABACC is presented, and the characteristics and requirements that a regional nuclear safeguards organization must fulfill are discussed. (author). 2 refs, 1 tab

  16. Patients' Hand Washing and Reducing Hospital-Acquired Infection.

    Science.gov (United States)

    Haverstick, Stacy; Goodrich, Cara; Freeman, Regi; James, Shandra; Kullar, Rajkiran; Ahrens, Melissa

    2017-06-01

    Hand hygiene is important to prevent hospital-acquired infections. Patients' hand hygiene is just as important as hospital workers' hand hygiene. Hospital-acquired infection rates remain a concern across health centers. To improve patients' hand hygiene through the promotion and use of hand washing with soap and water, hand sanitizer, or both and improve patients' education to reduce hospital-acquired infections. In August 2013, patients in a cardiothoracic postsurgical step-down unit were provided with individual bottles of hand sanitizer. Nurses and nursing technicians provided hand hygiene education to each patient. Patients completed a 6-question survey before the intervention, at hospital discharge and 1, 2, and 3 months after the intervention. Hospital-acquired infection data were tracked monthly by infection prevention staff. Significant correlations were found between hand hygiene and rates of infection with vancomycin-resistant enterococci ( P = .003) and methicillin-resistant Staphylococcus aureus ( P = .01) after the intervention. After the implementation of hand hygiene interventions, rates of both infections declined significantly and patients reported more staff offering opportunities for and encouraging hand hygiene. This quality improvement project demonstrates that increased hand hygiene compliance by patients can influence infection rates in an adult cardiothoracic step-down unit. The decreased infection rates and increased compliance with hand hygiene among the patients may be attributed to the implementation of patient education and the increased accessibility and use of hand sanitizer. ©2017 American Association of Critical-Care Nurses.

  17. Clinical role of Cefixime in community-acquired infections.

    Science.gov (United States)

    Dreshaj, Sh; Doda-Ejupi, T; Tolaj, I Q; Mustafa, A; Kabashi, S; Shala, N; Geca, Nj; Aliu, A; Daka, A; Basha, N

    2011-01-01

    Cefixime is an oral third generation cephalosporin, frequently used in respiratory tract infections (RTI) in the pediatric population. However, in some publications cefixime has demonstrated poor efficacy against staphylococci and streptococci. of this study was to evaluate the efficacy of cefixime in the treatment of community-acquired infections in a country where parenteral third generation cephalosporins have been used for a long time. The present study was designed to assess the clinical efficacy, bacteriological eradication rates and tolerability of cefixime in children with community-acquired upper RTI (URTI), lower RTI (LRTI) and uncomplicated urinary tract infections (UTI). The study was prospective, open, and included 89 patients, from 6 months to 28 years, of both sexes, with the diagnosis of community-acquired URTI, LRTI and UTI. The treatment with cefixime was successful in 30/30 (100%) patients suffering from acute otitis media (AOM), in 10/12 (83.3%) with acute sinusitis, in 12/12 patients (100%) with pneumonia, in 31/35 (88.57) with uncomplicated UTI. The antibiotic was well tolerated. In 10 days treatment we recorded one case (1.3%) with acute gastroenteritis and two cases (2.6%) of maculopapular rash. Side-effects were transient and disappeared after finishing therapy in all three of the cases. Community-acquired infections, such as AOM, LRTI and UTI, caused by susceptible pathogens, can be treated with cefixime, as a good choice for a successful clinical response.

  18. Acquiring, encoding, and re-using clinical knowledge in PRODIGY

    Directory of Open Access Journals (Sweden)

    Richard Hall

    2002-11-01

    Full Text Available The development, implementation and maintenance of computer-executable clinical guidelines encompass a series of complex processes. As they are often performed by more than one organisation, this introduces further complexity. Within the PRODIGY project we attempt to control as many aspects of the process as possible, in order to increase the likelihood of achieving success. To illustrate the complexity of the process and many of the inherent problems and solutions, this paper describes the evolution of the PRODIGY knowledge base, describing the steps from acquiring knowledge, through encoding, to the execution of guidelines, and 'closing the loop' by discussing an approach to knowledge re-use. We will also consider some of the wider implications of our work and propose directions for future research and development activities.

  19. On the factors controlling occurrence of F-region coherent echoes

    Directory of Open Access Journals (Sweden)

    D. W. Danskin

    2002-09-01

    Full Text Available Several factors are known to control the HF echo occurrence rate, including electron density distribution in the ionosphere (affecting the propagation path of the radar wave, D-region radio wave absorption, and ionospheric irregularity intensity. In this study, we consider 4 days of CUTLASS Finland radar observations over an area where the EISCAT incoherent scatter radar has continuously monitored ionospheric parameters. We illustrate that for the event under consideration, the D-region absorption was not the major factor affecting the echo appearance. We show that the electron density distribution and the radar frequency selection were much more significant factors. The electron density magnitude affects the echo occurrence in two different ways. For small F-region densities, a minimum value of 1 × 1011 m-3 is required to have sufficient radio wave refraction so that the orthogonality (with the magnetic field lines condition is met. For too large densities, radio wave strong "over-refraction" leads to the ionospheric echo disappearance. We estimate that the over-refraction is important for densities greater than 4 × 1011 m-3. We also investigated the backscatter power and the electric field magnitude relationship and found no obvious relationship contrary to the expectation that the gradient-drift plasma instability would lead to stronger irregularity intensity/echo power for larger electric fields.Key words. Ionosphere (ionospheric irregularities; plasma waves and instabilities; auroral ionosphere

  20. Heterochronicity of white matter development and aging explains regional patient control differences in schizophrenia.

    Science.gov (United States)

    Kochunov, Peter; Ganjgahi, Habib; Winkler, Anderson; Kelly, Sinead; Shukla, Dinesh K; Du, Xiaoming; Jahanshad, Neda; Rowland, Laura; Sampath, Hemalatha; Patel, Binish; O'Donnell, Patricio; Xie, Zhiyong; Paciga, Sara A; Schubert, Christian R; Chen, Jian; Zhang, Guohao; Thompson, Paul M; Nichols, Thomas E; Hong, L Elliot

    2016-12-01

    Altered brain connectivity is implicated in the development and clinical burden of schizophrenia. Relative to matched controls, schizophrenia patients show (1) a global and regional reduction in the integrity of the brain's white matter (WM), assessed using diffusion tensor imaging (DTI) fractional anisotropy (FA), and (2) accelerated age-related decline in FA values. In the largest mega-analysis to date, we tested if differences in the trajectories of WM tract development influenced patient-control differences in FA. We also assessed if specific tracts showed exacerbated decline with aging. Three cohorts of schizophrenia patients (total n = 177) and controls (total n = 249; age = 18-61 years) were ascertained with three 3T Siemens MRI scanners. Whole-brain and regional FA values were extracted using ENIGMA-DTI protocols. Statistics were evaluated using mega- and meta-analyses to detect effects of diagnosis and age-by-diagnosis interactions. In mega-analysis of whole-brain averaged FA, schizophrenia patients had lower FA (P = 10 -11 ) and faster age-related decline in FA (P = 0.02) compared with controls. Tract-specific heterochronicity measures, that is, abnormal rates of adolescent maturation and aging explained approximately 50% of the regional variance effects of diagnosis and age-by-diagnosis interaction in patients. Interactive, three-dimensional visualization of the results is available at www.enigma-viewer.org. WM tracts that mature later in life appeared more sensitive to the pathophysiology of schizophrenia and were more susceptible to faster age-related decline in FA values. Hum Brain Mapp 37:4673-4688, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. Sequence organization and control of transcription in the bacteriophage T4 tRNA region.

    Science.gov (United States)

    Broida, J; Abelson, J

    1985-10-05

    Bacteriophage T4 contains genes for eight transfer RNAs and two stable RNAs of unknown function. These are found in two clusters at 70 X 10(3) base-pairs on the T4 genetic map. To understand the control of transcription in this region we have completed the sequencing of 5000 base-pairs in this region. The sequence contains a part of gene 3, gene 1, gene 57, internal protein I, the tRNA genes and five open reading frames which most likely code for heretofore unidentified proteins. We have used subclones of the region to investigate the kinetics of transcription in vivo. The results show that transcription in this region consists of overlapping early, middle and late transcripts. Transcription is directed from two early promoters, one or two middle promoters and perhaps two late promoters. This region contains all of the features that are seen in T4 transcription and as such is a good place to study the phenomenon in more detail.

  2. Foodborne listeriosis acquired in hospitals.

    Science.gov (United States)

    Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M

    2014-08-15

    Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  3. Risk factors for hospital-acquired bacteremia due to carbapenem-resistant Pseudomonas aeruginosa in a Colombian hospital.

    Science.gov (United States)

    Valderrama, Sandra Liliana; González, Pedro Felipe; Caro, María Alejandra; Ardila, Natalia; Ariza, Beatriz; Gil, Fabián; Álvarez, Carlos

    2016-02-23

    Bacteremia due to Pseudomonas aeruginosa resistant to carbapenems is a public health problem due to the limitations it places on therapeutic options, as well as the increased time patients must spend in hospital, costs and the risk of mortality.  To evaluate the risk factors for presentation of bacteremia due to carbapenem-resistant P. aeruginosa acquired in the Hospital Universitario San Ignacio between January 2008 and June 2014.  This was a case control study in which the case patients presented bacteremia due to P. aeruginosa resistant to carbapenems and the control group included patients with P. aeruginosa susceptible to this group of antibiotics. Variables such as the previous use of meropenem and ertapenem, immunosuppression and neoplasia were measured. Mortality and duration of hospital were also described.  In all, 168 patients were evaluated, of which 42 were cases and 126 controls. Using a multivariate model, the risk factors related to bacteremia due to carbapenem-resistant P. aeruginosa acquired in hospital were the following: use of parenteral nutrition (OR=8.28; 95% CI: 2.56-26.79; p=0); use of meropenem (OR=1.15; 95% CI: 1.03-1.28; p=0.01); and use of ciprofloxacin (OR=81.99; 95% CI: 1.14-5884; p=0.043).  In order to prevent the emergence of carbapenem-resistant P. aeruginosa, antimicrobial control programs should be strengthened by promoting the prudent administration of carbapenems and quinolones. The correct use of parenteral nutrition should also be monitored.

  4. Automated surveillance system for hospital-acquired urinary tract infections in Denmark

    DEFF Research Database (Denmark)

    Condell, Orla; Gubbels, Sophie; Nielsen, J

    2016-01-01

    BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI) and to de......BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI......) and to describe surveillance data from 2010 to 2014. METHODS: The HA-UTI algorithm defined a laboratory-diagnosed UTI as a urine culture positive for no more than two micro-organisms with at least one at ≥10(4)cfu/mL, and a probable UTI as a negative urine culture and a relevant diagnosis code or antibiotic...... treatment. UTI was considered hospital-acquired if a urine sample was collected ≥48h after admission and UTI was calculated per 10,000 risk-days. For validation, prevalence was calculated for each day and compared to point prevalence survey (PPS) data. FINDINGS: HAIBA...

  5. How Did Light Acquire a Velocity?

    Science.gov (United States)

    Lauginie, Pierre

    2013-01-01

    We discuss how light acquired a velocity through history, from the ancient Greeks to the early modern era. Combining abstract debates, models of light, practical needs, planned research and chance, this history illustrates several key points that should be brought out in science education.

  6. Regional White Matter Decreases in Alzheimer's Disease Using Optimized Voxel-Based Morphometry

    Energy Technology Data Exchange (ETDEWEB)

    Shuyu Li; Fang Pu; Feng Shi; Sheng Xie; Yinhua Wang; Tianzi Jiang [Dept. of Bioengineering, Beijing Univ. of Aeronautics and Astronautics, Beijing (China)

    2008-02-15

    Background: Most studies that attempt to clarify structural abnormalities related to functional disconnection in patients with Alzheimer's disease (AD) have focused on exploring pathological changes in cortical gray matter. However, white matter fibers connecting these cerebral areas may also be abnormal. Purpose: To investigate the regional changes of white matter volume in patients with AD compared to healthy subjects. Material and Methods: White matter volume changes in whole-brain magnetic resonance images acquired from 19 patients with AD and 20 healthy subjects (control group) were observed using the optimized voxel-based morphometry (VBM) method. In addition, the corpus callosum (CC) of AD patients and the control group was investigated further by outlining manually the boundary of the CC on a midsagittal slice. Each area of the CC was then corrected by dividing each subject's intracranial area in the midsagittal plane. Results: Compared with the control group, AD patients showed significantly reduced white matter volumes in the posterior part of the CC and the temporal lobe in the left and right hemispheres. Moreover, the voxel showing peak statistical difference in the posterior of the CC was left sided. The five subdivisions of the CC were also significantly smaller among the AD patients relative to the control group. Conclusion: Our findings suggest that these abnormalities in white matter regions may contribute to the functional disconnections in AD.

  7. Regional White Matter Decreases in Alzheimer's Disease Using Optimized Voxel-Based Morphometry

    Energy Technology Data Exchange (ETDEWEB)

    Shuyu Li; Fang Pu; Feng Shi; Sheng Xie; Yinhua Wang; Tianzi Jiang (Dept. of Bioengineering, Beijing Univ. of Aeronautics and Astronautics, Beijing (China))

    2008-02-15

    Background: Most studies that attempt to clarify structural abnormalities related to functional disconnection in patients with Alzheimer's disease (AD) have focused on exploring pathological changes in cortical gray matter. However, white matter fibers connecting these cerebral areas may also be abnormal. Purpose: To investigate the regional changes of white matter volume in patients with AD compared to healthy subjects. Material and Methods: White matter volume changes in whole-brain magnetic resonance images acquired from 19 patients with AD and 20 healthy subjects (control group) were observed using the optimized voxel-based morphometry (VBM) method. In addition, the corpus callosum (CC) of AD patients and the control group was investigated further by outlining manually the boundary of the CC on a midsagittal slice. Each area of the CC was then corrected by dividing each subject's intracranial area in the midsagittal plane. Results: Compared with the control group, AD patients showed significantly reduced white matter volumes in the posterior part of the CC and the temporal lobe in the left and right hemispheres. Moreover, the voxel showing peak statistical difference in the posterior of the CC was left sided. The five subdivisions of the CC were also significantly smaller among the AD patients relative to the control group. Conclusion: Our findings suggest that these abnormalities in white matter regions may contribute to the functional disconnections in AD

  8. Factors controlling the regional distribution of vanadium in ground water

    Science.gov (United States)

    Wright, Michael T.; Belitz, Kenneth

    2010-01-01

    Although the ingestion of vanadium (V) in drinking water may have possible adverse health effects, there have been relatively few studies of V in groundwater. Given the importance of groundwater as a source of drinking water in many areas of the world, this study examines the potential sources and geochemical processes that control the distribution of V in groundwater on a regional scale. Potential sources of V to groundwater include dissolution of V rich rocks, and waste streams from industrial processes. Geochemical processes such as adsorption/desorption, precipitation/dissolution, and chemical transformations control V concentrations in groundwater. Based on thermodynamic data and laboratory studies, V concentrations are expected to be highest in samples collected from oxic and alkaline groundwater. However, the extent to which thermodynamic data and laboratory results apply to the actual distribution of V in groundwater is not well understood. More than 8400 groundwater samples collected in California were used in this study. Of these samples, high (> or = 50 μg/L) and moderate (25 to 49 μg/L) V concentrations were most frequently detected in regions where both source rock and favorable geochemical conditions occurred. The distribution of V concentrations in groundwater samples suggests that significant sources of V are mafic and andesitic rock. Anthropogenic activities do not appear to be a significant contributor of V to groundwater in this study. High V concentrations in groundwater samples analyzed in this study were almost always associated with oxic and alkaline groundwater conditions, which is consistent with predictions based on thermodynamic data.

  9. Seizure Control and Memory Impairment Are Related to Disrupted Brain Functional Integration in Temporal Lobe Epilepsy.

    Science.gov (United States)

    Park, Chang-Hyun; Choi, Yun Seo; Jung, A-Reum; Chung, Hwa-Kyoung; Kim, Hyeon Jin; Yoo, Jeong Hyun; Lee, Hyang Woon

    2017-01-01

    Brain functional integration can be disrupted in patients with temporal lobe epilepsy (TLE), but the clinical relevance of this disruption is not completely understood. The authors hypothesized that disrupted functional integration over brain regions remote from, as well as adjacent to, the seizure focus could be related to clinical severity in terms of seizure control and memory impairment. Using resting-state functional MRI data acquired from 48 TLE patients and 45 healthy controls, the authors mapped functional brain networks and assessed changes in a network parameter of brain functional integration, efficiency, to examine the distribution of disrupted functional integration within and between brain regions. The authors assessed whether the extent of altered efficiency was influenced by seizure control status and whether the degree of altered efficiency was associated with the severity of memory impairment. Alterations in the efficiency were observed primarily near the subcortical region ipsilateral to the seizure focus in TLE patients. The extent of regional involvement was greater in patients with poor seizure control: it reached the frontal, temporal, occipital, and insular cortices in TLE patients with poor seizure control, whereas it was limited to the limbic and parietal cortices in TLE patients with good seizure control. Furthermore, TLE patients with poor seizure control experienced more severe memory impairment, and this was associated with lower efficiency in the brain regions with altered efficiency. These findings indicate that the distribution of disrupted brain functional integration is clinically relevant, as it is associated with seizure control status and comorbid memory impairment.

  10. Growth and gene expression are predominantly controlled by distinct regions of the human IL-4 receptor.

    Science.gov (United States)

    Ryan, J J; McReynolds, L J; Keegan, A; Wang, L H; Garfein, E; Rothman, P; Nelms, K; Paul, W E

    1996-02-01

    IL-4 causes hematopoietic cells to proliferate and express a series of genes, including CD23. We examined whether IL-4-mediated growth, as measured by 4PS phosphorylation, and gene induction were similarly controlled. Studies of M12.4.1 cells expressing human IL-4R truncation mutants indicated that the region between amino acids 557-657 is necessary for full gene expression, which correlated with Stat6 DNA binding activity. This region was not required for 4PS phosphorylation. Tyrosine-to-phenylalanine mutations in the interval between amino acids 557-657 revealed that as long as one tyrosine remained unmutated, CD23 was fully induced. When all three tyrosines were mutated, the receptor was unable to induce CD23. The results indicate that growth regulation and gene expression are principally controlled by distinct regions of IL-4R.

  11. 26 CFR 1.1014-2 - Property acquired from a decedent.

    Science.gov (United States)

    2010-04-01

    ... TAX (CONTINUED) INCOME TAXES Basis Rules of General Application § 1.1014-2 Property acquired from a..., devise, or inheritance, or by the decedent's estate from the decedent, whether the property was acquired... inheritance from a decedent dying after August 26, 1937, and if such property consists of stock or securities...

  12. Acquired Aplastic Anemia in Children

    Science.gov (United States)

    Hartung, Helge D.; Olson, Timothy S.; Bessler, Monica

    2013-01-01

    SYNOPSIS This article provides a practice-based and concise review of the etiology, diagnosis, and management of acquired aplastic anemia in children. Bone marrow transplantation, immunosuppressive therapy, and supportive care are discussed in detail. The aim is to provide the clinician with a better understanding of the disease and to offer guidelines for the management of children with this uncommon yet serious disorder. PMID:24237973

  13. Immunological studies in acquired immunodeficiency syndrome. Functional studies of lymphocyte subpopulations

    DEFF Research Database (Denmark)

    Hofmann, B; Ødum, Niels; Platz, P

    1985-01-01

    The lymphocyte transformation response in vitro to mitogens (phytohaemagglutinin, concanavalin A, and pokeweed mitogen) and antigens (purified protein derivative and tetanus) was studied in three patients with acquired immunodeficiency syndrome (AIDS), three patients with pre-AIDS, and six healthy...... controls before and after depletion of T4- or T8-positive cells. In controls, T8-depleted lymphocytes responded as well as peripheral blood mononuclear cells (PBMC) when monocytes were added, whereas T4-depleted cells gave about 50% of this response to mitogens and no response at all to antigens....... No evidence of suppression was seen when various mixtures of T4- and T8-depleted cells were made. In particular, there was a virtually linear relationship between the percentage of T8-depleted cells and the response to antigens. The PBMC of all AIDS and pre-AIDS patients had very low or absent responses...

  14. Rehabilitation of discourse impairments after acquired brain injury

    Directory of Open Access Journals (Sweden)

    Gigiane Gindri

    Full Text Available ABSTRACT Language impairments in patients with acquired brain injury can have a negative impact on social life as well as on other cognitive domains. Discourse impairments are among the most commonly reported communication deficits among patients with acquired brain damage. Despite advances in the development of diagnostic tools for detecting such impairments, few studies have investigated interventions to rehabilitate patients presenting with these conditions. Objective: The aim of this study was to present a systematic review of the methods used in the rehabilitation of discourse following acquired brain injury. Methods: The PubMed database was searched for articles using the following keywords: "rehabilitation", "neurological injury", "communication" and "discursive abilities". Results: A total of 162 abstracts were found, but only seven of these met criteria for inclusion in the review. Four studies involved samples of individuals with aphasia whereas three studies recruited samples of individuals with traumatic brain injury. Conclusion: All but one article found that patient performance improved following participation in a discourse rehabilitation program.

  15. The acquired hyperostosis syndrome

    International Nuclear Information System (INIS)

    Dihlmann, W.; Hering, L.; Bargon, G.W.

    1988-01-01

    Sterno-costo-clavicular hyperostosis (SCCH) is the most common manifestation of a syndrome, consisting of increased bone metabolism, mostly new bone formation and heterotopic ossification of fibrous tissue, which we have characterised as the acquired hyperostosis syndrome. In part I we discuss the terminology, radiological appearances, scintigraphy, clinical and laboratory findings, bacteriology, histology, nosology, complications, treatment and differential diagnosis of SCCH. Chronic recurrent multifocal osteomyelitis (CRMO) is regarded as a phaenotype of SCCH, depending on the age. CRMO occurs in children, adolescents and young adults, SCCH predominantly in middleaged and elderly adults. (orig.) [de

  16. Magnetic Oculomotor Prosthetics for Acquired Nystagmus.

    Science.gov (United States)

    Nachev, Parashkev; Rose, Geoff E; Verity, David H; Manohar, Sanjay G; MacKenzie, Kelly; Adams, Gill; Theodorou, Maria; Pankhurst, Quentin A; Kennard, Christopher

    2017-10-01

    Acquired nystagmus, a highly symptomatic consequence of damage to the substrates of oculomotor control, often is resistant to pharmacotherapy. Although heterogeneous in its neural cause, its expression is unified at the effector-the eye muscles themselves-where physical damping of the oscillation offers an alternative approach. Because direct surgical fixation would immobilize the globe, action at a distance is required to damp the oscillation at the point of fixation, allowing unhindered gaze shifts at other times. Implementing this idea magnetically, herein we describe the successful implantation of a novel magnetic oculomotor prosthesis in a patient. Case report of a pilot, experimental intervention. A 49-year-old man with longstanding, medication-resistant, upbeat nystagmus resulting from a paraneoplastic syndrome caused by stage 2A, grade I, nodular sclerosing Hodgkin's lymphoma. We designed a 2-part, titanium-encased, rare-earth magnet oculomotor prosthesis, powered to damp nystagmus without interfering with the larger forces involved in saccades. Its damping effects were confirmed when applied externally. We proceeded to implant the device in the patient, comparing visual functions and high-resolution oculography before and after implantation and monitoring the patient for more than 4 years after surgery. We recorded Snellen visual acuity before and after intervention, as well as the amplitude, drift velocity, frequency, and intensity of the nystagmus in each eye. The patient reported a clinically significant improvement of 1 line of Snellen acuity (from 6/9 bilaterally to 6/6 on the left and 6/5-2 on the right), reflecting an objectively measured reduction in the amplitude, drift velocity, frequency, and intensity of the nystagmus. These improvements were maintained throughout a follow-up of 4 years and enabled him to return to paid employment. This work opens a new field of implantable therapeutic devices-oculomotor prosthetics-designed to modify eye

  17. Randomized trial of two swallowing assessment approaches in patients with acquired brain injury

    DEFF Research Database (Denmark)

    Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H.

    2014-01-01

    trial. SETTING: Specialized, national neurorehabilitation centre. SUBJECTS: Adult patients with acquired brain injury. Six hundred and seventy-nine patients were assessed for eligibility and 138 were randomly allocated between June 2009 and April 2011. INTERVENTIONS: Assessment by Facial-Oral Tract....... Seven patients were left for analysis, 4 of whom developed aspiration pneumonia within 10 days after initiating oral intake (1 control/3 interventions). CONCLUSION: In the presence of a structured clinical assessment with the Facial-Oral Tract Therapy approach, it is unnecessary to undertake...

  18. Hospital-acquired infections associated with poor air quality in air-conditioned environments

    Directory of Open Access Journals (Sweden)

    Daniela Pinheiro da Silva

    2013-10-01

    Full Text Available Backgound and Objectives: Individuals living in cities increasingly spend more time indoors in air-conditioned environments. Air conditioner contamination can be caused by the presence of aerosols from the external or internal environment, which may be associated with disease manifestations in patients present in this type of environment. Therefore, the aim of this review was to assess the air quality in air-conditioned hospital environments as a risk factor for hospital-acquired infections – HAI – as the air can be a potential source of infection, as well as assess the exposure of professionals and patients to different pollutants. Material and Methods: A literature review was performed in the LILACS, MEDLINE, SCIELO, SCIENCE DIRECT databases, CAPES thesis database and Ministry of Health – Brazil, including studies published between 1982 and 2008. The literature search was grouped according to the thematic focus, as follows: ventilation, maintenance and cleaning of systems that comprehend the environmental quality standard. Discussion and Conclusion: Outbreaks of hospital-acquired infections associated with Aspergillus, Acinetobacter, Legionella, and other genera such as Clostridium and Nocardia, which were found in air conditioners, were observed, thus indicating the need for air-conditioning quality control in these environments.

  19. Acquired dysfibrinogenemia secondary to multiple myeloma

    Czech Academy of Sciences Publication Activity Database

    Kotlín, R.; Sobotková, A.; Riedel, Tomáš; Salaj, P.; Suttnar, J.; Reicheltová, Z.; Májek, P.; Khaznadar, T.; Dyr, J. E.

    2008-01-01

    Roč. 120, č. 2 (2008), s. 75-81 ISSN 0001-5792 R&D Projects: GA AV ČR KAN200670701 Institutional research plan: CEZ:AV0Z40500505 Keywords : acquired dysfibrinogenemia * amorphous clot * fibrinogen Subject RIV: CD - Macromolecular Chemistry Impact factor: 1.191, year: 2008

  20. Accounting and Control in Ensuring Economic Security of the Organizations of Perm Region

    Directory of Open Access Journals (Sweden)

    Vyacheslav Valetyevich Epishin

    2016-09-01

    Full Text Available The article deals with the urgent problem concerning the regional development as well as the specific organization, or to the development of an integrated system of economic security of the organization. The article discusses the importance of such an element of economic security (including the financial security as the accounting and control as well as their possible violations. The authors substantiate their position on the relationship of the violations of accounting and control and also the internal theft, other economic crimes and their negative consequences. The analysis of the existing national and foreign sources related to the subject of the study is carried out. The conclusion is made about the lack of modern research devoted to the study of the protective properties of accounting, control and their violations, which condition economic crimes. The methodological tools of the research include dialectic method, systemic analysis, complex sociological methods: the analysis of the legal sources, of statistical information and judicial practice. On the basis of the analysis of criminal cases, financial statements, publications media, the authors made the conclusion about the conditionality of the theft in the organizations as there are the violations of accounting and control, low efficiency of control and auditing, of preventive measures for neutralization of the violations of accounting and control from the services of economic security, accounting offices, auditing and law enforcement services. The recommendations for the optimization of this work are introduced. They can be used by accounting departments, auditing bodies, fiscal authorities at the municipal and regional level and by law enforcement officials. The economic security is necessary for any organizations regardless of their forms of ownership, ranging from government organizations to small kiosks. The difference will only consist in the means and methods.

  1. Acquired portosystemic collaterals: anatomy and imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Andrea Farias de Melo; Mota Junior, Americo, E-mail: andreafariasm@gmail.com [Instituto de Medicina Integral Professor Fernando Figueira de Pernambuco (IMIP), Recife, PE (Brazil); Chagas-Neto, Francisco Abaete [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Teixeira, Sara Reis; Elias Junior, Jorge; Muglia, Valdair Francisco [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    2016-07-15

    Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common - increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings. Imaging of portosystemic shunts provides subclinical markers of increased portal venous pressure. Therefore, radiologists play a crucial role in the identification of portosystemic shunts. Early detection of portosystemic shunts can allow ample time to perform endovascular shunt operations, which can relieve portal hypertension and prevent acute or chronic complications in at-risk patient populations. (author)

  2. Acquired portosystemic collaterals: anatomy and imaging

    International Nuclear Information System (INIS)

    Leite, Andrea Farias de Melo; Mota Junior, Americo; Chagas-Neto, Francisco Abaete; Teixeira, Sara Reis; Elias Junior, Jorge; Muglia, Valdair Francisco

    2016-01-01

    Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common - increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings. Imaging of portosystemic shunts provides subclinical markers of increased portal venous pressure. Therefore, radiologists play a crucial role in the identification of portosystemic shunts. Early detection of portosystemic shunts can allow ample time to perform endovascular shunt operations, which can relieve portal hypertension and prevent acute or chronic complications in at-risk patient populations. (author)

  3. Natural selection among Eurasians at genomic regions associated with HIV-1 control

    Directory of Open Access Journals (Sweden)

    Allison David B

    2011-06-01

    Full Text Available Abstract Background HIV susceptibility and pathogenicity exhibit both interindividual and intergroup variability. The etiology of intergroup variability is still poorly understood, and could be partly linked to genetic differences among racial/ethnic groups. These genetic differences may be traceable to different regimes of natural selection in the 60,000 years since the human radiation out of Africa. Here, we examine population differentiation and haplotype patterns at several loci identified through genome-wide association studies on HIV-1 control, as determined by viral-load setpoint, in European and African-American populations. We use genome-wide data from the Human Genome Diversity Project, consisting of 53 world-wide populations, to compare measures of FST and relative extended haplotype homozygosity (REHH at these candidate loci to the rest of the respective chromosome. Results We find that the Europe-Middle East and Europe-South Asia pairwise FST in the most strongly associated region are elevated compared to most pairwise comparisons with the sub-Saharan African group, which exhibit very low FST. We also find genetic signatures of recent positive selection (higher REHH at these associated regions among all groups except for sub-Saharan Africans and Native Americans. This pattern is consistent with one in which genetic differentiation, possibly due to diversifying/positive selection, occurred at these loci among Eurasians. Conclusions These findings are concordant with those from earlier studies suggesting recent evolutionary change at immunity-related genomic regions among Europeans, and shed light on the potential genetic and evolutionary origin of population differences in HIV-1 control.

  4. City-specific vehicle emission control strategies to achieve stringent emission reduction targets in China's Yangtze River Delta region.

    Science.gov (United States)

    Zhang, Shaojun; Wu, Ye; Zhao, Bin; Wu, Xiaomeng; Shu, Jiawei; Hao, Jiming

    2017-01-01

    The Yangtze River Delta (YRD) region is one of the most prosperous and densely populated regions in China and is facing tremendous pressure to mitigate vehicle emissions and improve air quality. Our assessment has revealed that mitigating vehicle emissions of NOx would be more difficult than reducing the emissions of other major vehicular pollutants (e.g., CO, HC and PM 2.5 ) in the YRD region. Even in Shanghai, where the emission control implemented are more stringent than in Jiangsu and Zhejiang, we observed little to no reduction in NOx emissions from 2000 to 2010. Emission-reduction targets for HC, NOx and PM 2.5 are determined using a response surface modeling tool for better air quality. We design city-specific emission control strategies for three vehicle-populated cities in the YRD region: Shanghai and Nanjing and Wuxi in Jiangsu. Our results indicate that even if stringent emission control consisting of the Euro 6/VI standards, the limitation of vehicle population and usage, and the scrappage of older vehicles is applied, Nanjing and Wuxi will not be able to meet the NOx emissions target by 2020. Therefore, additional control measures are proposed for Nanjing and Wuxi to further mitigate NOx emissions from heavy-duty diesel vehicles. Copyright © 2016. Published by Elsevier B.V.

  5. Global and Regional Patterns of Tobacco Smoking and Tobacco Control Policies.

    Science.gov (United States)

    Islami, Farhad; Stoklosa, Michal; Drope, Jeffrey; Jemal, Ahmedin

    2015-08-01

    Tobacco smoking is a major worldwide cause of morbidity and mortality from various diseases, including urologic diseases. We reviewed, at global and regional levels, the prevalence and trends of tobacco smoking and legislative and regulatory efforts around tobacco control. We also provided information about electronic cigarette (e-cigarette) use. We used several sources to present the most up-to-date information from national surveys, including the Global Adult Tobacco Survey, the Global Tobacco Control Report, and the Global Youth Tobacco Survey. Smoking prevalence has been decreasing globally, although trends in smoking vary substantially across countries and by gender. Among men, smoking prevalence in most high-income countries started to decrease in the mid-1990s, followed after a few decades by generally smaller decreases in some low- and middle-income countries (LMICs). However, there has been no change, or there has even been an increase, in smoking prevalence in many other LMICs. Countries with the highest male smoking prevalence are located in East Asia, Southeast Asia, and Eastern Europe. Similar to men, smoking prevalence for women has been decreasing in most high-income countries and some LMICs, although the decrease began later and was slower than that for men. Except in a few countries, smoking is much less common for women than for men. Most countries with the highest smoking prevalence in women are in Europe. Countries that have implemented the best practices for tobacco control, including monitoring, smoke-free policies, cessation programs, health warnings, advertising bans, and taxation, have been able to reduce smoking rates and related harms. E-cigarette use has rapidly increased since its introduction to the market. Health care providers should advise smoking patients about quitting smoking. Countries must improve the implementation and enforcement of tobacco control policies. Particular attention should be paid to preventing an increase in

  6. A compensation controller based on a regional pole-assignment method for AMD control systems with a time-varying delay

    Science.gov (United States)

    Li, Zuohua; Chen, Chaojun; Teng, Jun; Wang, Ying

    2018-04-01

    Active mass damper/driver (AMD) control system has been proposed as an effective tool for high-rise buildings to resist strong dynamic loads. However, such disadvantage as time-varying delay in AMD control systems impedes their application in practices. Time-varying delay, which has an effect on the performance and stability of single-degree-of-freedom (SDOF) and multi-degree-of-freedom (MDOF) systems, is considered in the paper. In addition, a new time-delay compensation controller based on regional pole-assignment method is presented. To verify its effectiveness, the proposed method is applied to a numerical example of a ten-storey frame and an experiment of a single span four-storey steel frame. Both numerical and experimental results demonstrate that the proposed method can enhance the performances of an AMD control system with time-varying delays.

  7. Surveillance for hospital-acquired infections on surgical wards in a Dutch university hospital

    NARCIS (Netherlands)

    Kamp-Hopmans, Titia E. M.; Blok, Hetty E. M.; Troelstra, Annet; Gigengack-Baars, Ada C. M.; Weersink, Annemarie J. L.; Vandenbroucke-Grauls, Christina M. J. E.; Verhoef, Jan; Mascini, Ellen M.

    2003-01-01

    OBJECTIVES: To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections. METHODS: Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and

  8. Tuberculosis and the acquired immune deficiency syndrome in South Brazil

    International Nuclear Information System (INIS)

    Vieira, M.V.; Genro, C.H.; Santos Silveira, R. de C. dos

    1989-01-01

    Tuberculosis and the acquired immune deficiency syndrome in South Brazil. The authors studied the incidence of tuberculosis in South Brazilian patients with acquired immune deficiency syndrome from January 1985 to June 1988. During this period, tuberculosis occurred in 10.3% of acquired immune deficiency syndrome patients. The socioeconomic conditions and the incidence of disease in the population were not confirmed as a potential risk for tuberculosis infection. Chest radiographs revealed pulmonary infiltrates in six patients, hilar and/or mediastinal adenopathy in three, and pleural effusion in two. The two remaining patients had pulmonary consolidation associated with other features. None of these patients presented pulmonary cavitation or radiographic findings of typical reactivation of pulmonary tuberculosis. (author) [pt

  9. Processes Adopted to Integrate Intangible Resources in Global Acquisitions among Container Lines: Perceptions of Acquirer and Acquired

    Directory of Open Access Journals (Sweden)

    Indika Sigera

    2018-03-01

    Full Text Available The spectrum of strategic co-operations among container lines varies from loose-knitted slot charters, liner conferences, shipping alliances, joint services and consortia, through to mergers and acquisitions (M&As. However, these forms of strategic co-operations have not always been able to achieve the intended synergetic growth resulting from the integration of resources. The Resource Based View (RBV suggests that integrating intangible resources, which are valuable, rare, inimitable and non-substitutable (VRIN, can make a significant contribution to the performance of post strategic co-operations. This research paper investigates the contribution of intangible resources to the post acquisition success six global acquisitions among container lines. The nine senior managers attached to global container lines were the main participants of this study. Five of them represented acquired container lines, four represented acquirer container lines. The paper explains their personnel experience on the processes adopts to integrate intangible resources in acquisitions. Keywords: Merger and Acquisitions, Intangible Resources, Container Lines, Task Integration, Human Integration

  10. Musicality: instinct or acquired skill?

    Science.gov (United States)

    Marcus, Gary F

    2012-10-01

    Is the human tendency toward musicality better thought of as the product of a specific, evolved instinct or an acquired skill? Developmental and evolutionary arguments are considered, along with issues of domain-specificity. The article also considers the question of why humans might be consistently and intensely drawn to music if musicality is not in fact the product of a specifically evolved instinct. Copyright © 2012 Cognitive Science Society, Inc.

  11. Regional Community and International Relations: the Volgograd Region Experience

    Directory of Open Access Journals (Sweden)

    Danakari Richard A.

    2016-06-01

    Full Text Available The article deals with the complex and controversial problems of the new regional communities’ formation and the impact of the interethnic relations sphere on them. The author notes that the processes of interaction between representatives of different cultures and civilizations, ethnic groups and religions have become increasingly controversial and tense in the context of continuous social dynamics. Similarly to the Russian society as a whole, regional communities are in a state of transitivity. They get transformed, they acquire new qualities such as multicasting and heterogeneity, multi-ethnicity and multi-confessionalism, fragmentarity and multiculturality. This fact increases the risks and uncertainties, problematizes future prospects. National non-governmental organizations are increasingly positioning themselves as civil society institutions at the present stage of social development at the regional level. They perform a difficult dual task: on the one hand, they ensure the preservation and development of history, native language, culture, ethnic traditions, and on the other hand, they work on the integration, on the common identity and the Russian nation formation. On the territory of the Volgograd region, largely due to the active cooperation of regional authorities and local authorities with national public associations, international and inter-confessional relations are stable. The basis of such activity is respect for history, native language, culture, tradition, religion, national dignity of all people in the region, regardless of their belonging to a certain ethnic group or religion. Over two decades of accumulated considerable experience of joint inter-ethnic dialogue and cooperation, provided tolerance and peace, harmony and mutual understanding between people of different ethnicities and religions in the country.

  12. Tumor Hypoxia is Independent of Hemoglobin and Prognostic for Loco-regional Tumor Control after Primary Radiotherapy in Advanced Head and Neck Cancer

    International Nuclear Information System (INIS)

    Nordsmark, Marianne; Overgaard, Jens

    2004-01-01

    There is evidence that tumor hypoxia adversely affects loco-regional tumor control and survival in head and neck cancer. The aim of the current study was to compare pretreatment tumor oxygenation measured by Eppendorf pO2 electrodes with known prognostic factors in advanced head and neck tumors after definitive radiotherapy, and to evaluate the prognostic significance of these parameters on loco-regional tumor control. Sixty-seven patients, median age 56 years (22-82), all with primary stage III-IV squamous cell carcinoma were available for survival analysis. Tumor oxygenation was described as the fraction of pO2 values=2.5 mmHg (HP2.5) and the median tumor pO2. By regression analysis HP2.5 was independent of known prognostic factors including stage, pretreatment hemoglobin (Hb) and the largest tumor diameter at the site of pO2 measurement. By Kaplan-Meier analysis loco-regional tumor control at 5 years was in favor of less hypoxic tumors using either HP2.5 or median tumor pO2 as descriptors and stratifying by the median values. Also, Hb was prognostic of loco-regional tumor control at 5 years using the median value as cut off. HP2.5 as continuous parameter was highly significant for loco-regional tumor control in a multivariate analysis. In conclusion both HP2.5 and total Hb were prognostic for loco-regional tumor control, but HP2.5 as continuous variable was independently the strongest prognostic indicator for loco-regional tumor control after definitive primary radiotherapy in advanced head and neck tumors

  13. A rare case of acquired lymphangioma circumscriptum of the penis.

    Science.gov (United States)

    Adikari, S; Philippidou, M; Samuel, M

    2017-02-01

    Acquired lymphangioma circumscriptum is a rare occurrence on the penis. We report a case of a 47-year-old man who presented with a single lesion of acquired lymphangioma circumscriptum on the penis resembling genital warts. We report the case to increase awareness of this rare condition which may mimic sexually transmitted infections such as genital warts.

  14. Rocky Mountain spotted fever acquired in Florida, 1973-83.

    Science.gov (United States)

    Sacks, J J; Janowski, H T

    1985-01-01

    From 1973 to 1983, 49 Florida residents were reported with confirmed Rocky Mountain spotted fever (RMSF), 25 of whom were considered to have had Florida-acquired disease. Although there was no history of tick exposure for six of these 25 persons, all had contact with dogs or outdoor activities during the incubation period. The tick vectors of RMSF are widely distributed throughout Florida. We conclude that RMSF, although rare in Florida, can be acquired in the state. PMID:4061716

  15. Newborn hearing screening protocol in tuscany region.

    Science.gov (United States)

    Berrettini, Stefano; Ghirri, Paolo; Lazzerini, Francesco; Lenzi, Giovanni; Forli, Francesca

    2017-09-20

    Newborn hearing screening has to be considered the first step of a program for the identification, diagnosis, treatment and habilitation/rehabilitation of children with hearing impairment. In Tuscany Region of Italy, the universal newborn hearing screening is mandatory since november 2007. The first guidelines for the execution of the screening have been released in June 2008; then many other Italian regions partially or totally adopted these guidelines. On the basis of the experience from 2008 and according to the recent evidences in the scientific literature, a new screening protocol was released in Tuscany region. The new protocol is an evolution of the previous one. Some issues reported in the previous protocol and in the Joint Committee on Infant Hearing statement published in 2007 were revised, such as the risk factors for auditory neuropathy and for late onset, progressive or acquired hearing loss. The new updated guidelines were submitted to the Sanitary Regional Council and then they have been approved in August 2016. The updated screening protocol is mainly aimed to identify newborns with a congenital moderate-to-profound hearing loss, but it also provides indications for the audiological follow-up of children with risk's factor for progressive or late onset hearing loss; further it provides indications for the audiological surveillance of children at risk for acquired hearing impairment. Then, in the new guidelines the role of the family paediatrician in the newborn hearing screening and audiological follow-up and surveillance is underscored. Finally the new guidelines provide indications for the treatment with hearing aids and cochlear implant, in accordance with the recent Italian Health Technology Assessment (HTA) guidelines. In the paper we report the modality of execution of the universal newborn hearing screening in the Tuscany Region, according to the recently updated protocol. The main features of the protocol and the critical issues are

  16. Quantitative computed tomography determined regional lung mechanics in normal nonsmokers, normal smokers and metastatic sarcoma subjects.

    Directory of Open Access Journals (Sweden)

    Jiwoong Choi

    Full Text Available Extra-thoracic tumors send out pilot cells that attach to the pulmonary endothelium. We hypothesized that this could alter regional lung mechanics (tissue stiffening or accumulation of fluid and inflammatory cells through interactions with host cells. We explored this with serial inspiratory computed tomography (CT and image matching to assess regional changes in lung expansion.We retrospectively assessed 44 pairs of two serial CT scans on 21 sarcoma patients: 12 without lung metastases and 9 with lung metastases. For each subject, two or more serial inspiratory clinically-derived CT scans were retrospectively collected. Two research-derived control groups were included: 7 normal nonsmokers and 12 asymptomatic smokers with two inspiratory scans taken the same day or one year apart respectively. We performed image registration for local-to-local matching scans to baseline, and derived local expansion and density changes at an acinar scale. Welch two sample t test was used for comparison between groups. Statistical significance was determined with a p value < 0.05.Lung regions of metastatic sarcoma patients (but not the normal control group demonstrated an increased proportion of normalized lung expansion between the first and second CT. These hyper-expanded regions were associated with, but not limited to, visible metastatic lung lesions. Compared with the normal control group, the percent of increased normalized hyper-expanded lung in sarcoma subjects was significantly increased (p < 0.05. There was also evidence of increased lung "tissue" volume (non-air components in the hyper-expanded regions of the cancer subjects relative to non-hyper-expanded regions. "Tissue" volume increase was present in the hyper-expanded regions of metastatic and non-metastatic sarcoma subjects. This putatively could represent regional inflammation related to the presence of tumor pilot cell-host related interactions.This new quantitative CT (QCT method for linking

  17. Regional differences in infection control conditions in a sample of primary health care services in Brazil

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    Mauro Henrique Nogueira Guimarães de Abreu

    2017-11-01

    Full Text Available International guidelines have pointed out the importance of the physical environment of health care facilities in preventing and controlling infection. We aimed to describe the physical environment of dental care facilities in Brazil in 2014, focusing on characteristics designed to control infections. Exactly 16,202 dental offices in the Brazilian Unified National Health System (SUS participated in this survey. Trained researchers extracted information about the infection control characteristics of health facilities by using a structured instrument. We used data from 12 dichotomous questions that evaluated the wall, floor, sink and tap conditions, and the presence and condition of sterilization equipment. We calculated a score by summing the number of characteristics handled appropriately for infection control, which could range from 0 to 12. Hierarchical cluster analyses were developed. None of the 12 criteria were met by all the oral health teams. Only 208 (1.3% dental offices correctly performed all 12-infection control practices. Two clusters, with different frequencies of structure for infection control in dental offices, were identified. South and Southeast regions had the highest frequencies for Cluster 1, with better structure of infection control in dental offices. Dental care facilities of oral health teams were not typically meeting the infection control guidelines regarding clinic design and equipment. Adherence to the guidelines varied among the Brazilian geographic regions.

  18. Evidence for widespread degradation of gene control regions in hominid genomes.

    Directory of Open Access Journals (Sweden)

    Peter D Keightley

    2005-02-01

    Full Text Available Although sequences containing regulatory elements located close to protein-coding genes are often only weakly conserved during evolution, comparisons of rodent genomes have implied that these sequences are subject to some selective constraints. Evolutionary conservation is particularly apparent upstream of coding sequences and in first introns, regions that are enriched for regulatory elements. By comparing the human and chimpanzee genomes, we show here that there is almost no evidence for conservation in these regions in hominids. Furthermore, we show that gene expression is diverging more rapidly in hominids than in murids per unit of neutral sequence divergence. By combining data on polymorphism levels in human noncoding DNA and the corresponding human-chimpanzee divergence, we show that the proportion of adaptive substitutions in these regions in hominids is very low. It therefore seems likely that the lack of conservation and increased rate of gene expression divergence are caused by a reduction in the effectiveness of natural selection against deleterious mutations because of the low effective population sizes of hominids. This has resulted in the accumulation of a large number of deleterious mutations in sequences containing gene control elements and hence a widespread degradation of the genome during the evolution of humans and chimpanzees.

  19. Management of Acquired Atresia of the External Auditory Canal.

    Science.gov (United States)

    Bajin, Münir Demir; Yılmaz, Taner; Günaydın, Rıza Önder; Kuşçu, Oğuz; Sözen, Tevfik; Jafarov, Shamkal

    2015-08-01

    The aim was to evaluate surgical techniques and their relationship to postoperative success rate and hearing outcomes in acquired atresia of the external auditory canal. In this article, 24 patients with acquired atresia of the external auditory canal were retrospectively evaluated regarding their canal status, hearing, and postoperative success. Acquired stenosis occurs more commonly in males with a male: female ratio of 2-3:1; it seems to be a disorder affecting young adults. Previous ear surgery (13 patients, 54.2%) and external ear trauma (11 patients, 45.8%) were the main etiological factors of acquired ear canal stenosis. Mastoidectomy (12/13) and traffic accidents (8/11) comprise the majority of these etiological factors. Endaural incision is performed in 79.2% and postauricular incision for 20.8% of cases during the operation. As types of surgical approach, transcanal (70.8%), transmastoid (20.8%), and combined (8.4%) approaches are chosen. The atretic plate is generally located at the bony-cartilaginous junction (37.5%) and in the cartilaginous canal (33.3%); the bony canal is involved in a few cases only. Preserved healthy canal skin, split- or full-thickness skin grafts, or pre- or postauricular skin flaps are used to line the ear canal, but preserved healthy canal skin is preferred. The results of surgery are generally satisfactory, and complications are few if surgical principles are followed.

  20. Case report: unicameral bone cysts in a young patient with acquired generalized lipodystrophy.

    Science.gov (United States)

    Gregory, James M; Arkader, Alexandre; Bokhari, Aqiba; Bothari, Aqiba; Dormans, John P

    2010-05-01

    We report the case of a 13-year-old boy with bilateral distal femoral unicameral bone cysts (UBCs) associated with acquired generalized lipodystrophy. As opposed to congenital generalized lipodystrophy, cystic bone lesions in acquired generalized lipodystrophy are rare. After radiographic and histologic confirmation of the UBCs, we performed percutaneous intramedullary decompression, curettage, and grafting. UBCs can be an important manifestation of acquired generalized lipodystrophy. Cystic bone lesions appear to be less common in acquired generalized lipodystrophy than in congenital generalized lipodystrophy, and intramedullary adipose tissue loss may be a predisposing factor for the development of bone lesions in patients with acquired generalized lipodystrophy. When evaluating a patient with lipodystrophy, doctors should recognize the clinical course may include the development of UBCs.

  1. Europos Sąjungos regioninė politika: regionų konkurencingumo analizė

    OpenAIRE

    Stasiulionis, Tadas

    2018-01-01

    European Union regions’ competitiveness analysis is based on European Commission data about European regions’ competitiveness. Regions, that want to implement their economic, political and social goals, have to properly compete and be involved into an economic activities. For this reason it is important to analyse European Union regions’ competitiveness and search for appropriate methods, that could be applied to acquire the appropriate competitiveness in European regions. By analysing differ...

  2. Temporal stability of naturally acquired immunity to Merozoite Surface Protein-1 in Kenyan Adults

    Directory of Open Access Journals (Sweden)

    Crabb Brendan S

    2009-07-01

    Full Text Available Abstract Background Naturally acquired immunity to blood-stage Plasmodium falciparum infection develops with age and after repeated infections. In order to identify immune surrogates that can inform vaccine trials conducted in malaria endemic populations and to better understand the basis of naturally acquired immunity it is important to appreciate the temporal stability of cellular and humoral immune responses to malaria antigens. Methods Blood samples from 16 adults living in a malaria holoendemic region of western Kenya were obtained at six time points over the course of 9 months. T cell immunity to the 42 kDa C-terminal fragment of Merozoite Surface Protein-1 (MSP-142 was determined by IFN-γ ELISPOT. Antibodies to the 42 kDa and 19 kDa C-terminal fragments of MSP-1 were determined by serology and by functional assays that measure MSP-119 invasion inhibition antibodies (IIA to the E-TSR (3D7 allele and growth inhibitory activity (GIA. The haplotype of MSP-119 alleles circulating in the population was determined by PCR. The kappa test of agreement was used to determine stability of immunity over the specified time intervals of 3 weeks, 6 weeks, 6 months, and 9 months. Results MSP-1 IgG antibodies determined by serology were most consistent over time, followed by MSP-1 specific T cell IFN-γ responses and GIA. MSP-119 IIA showed the least stability over time. However, the level of MSP-119 specific IIA correlated with relatively higher rainfall and higher prevalence of P. falciparum infection with the MSP-119 E-TSR haplotype. Conclusion Variation in the stability of cellular and humoral immune responses to P. falciparum blood stage antigens needs to be considered when interpreting the significance of these measurements as immune endpoints in residents of malaria endemic regions.

  3. [Acquired disorders of color vision].

    Science.gov (United States)

    Lascu, Lidia; Balaş, Mihaela

    2002-01-01

    This article is a general view of acquired disorders of color vision. The revision of the best known methods and of the etiopathogenic classification is not very important in ophthalmology but on the other hand, the detection of the blue defect advertise and associated ocular pathology. There is a major interest in serious diseases as multiple sclerosis, AIDS, diabetes melitus, when the first ocular sign can be a defect in the color vision.

  4. Universal acquired melanosis (Carbon baby

    Directory of Open Access Journals (Sweden)

    Kaviarasan P

    2008-01-01

    Full Text Available We report a 3-year-old girl born with fair complexion which became darker. The color change was insidious in onset at the age of 5 months, asymptomatic and progressive involving the entire body surface. Histopathology revealed increased pigmentation of the epidermal basal layer. Universal acquired melanosis is a rare form of hypermelanosis which was synonymously referred to as "Carbon baby". This is a rare presentation with only one earlier case report.

  5. Regions Matter

    DEFF Research Database (Denmark)

    Laursen, Keld; Masciarelli, Francesca; Prencipe, Andrea

    2012-01-01

    capital at the regional level, with a large-scale data set of the innovative activities of a representative sample of 2,413 Italian manufacturing firms from 21 regions, and controlling for a large set of firm and regional characteristics, we find that being located in a region characterized by a high...

  6. Community-acquired pneumonia in older patients: does age influence systemic cytokine levels in community-acquired pneumonia?

    LENUS (Irish Health Repository)

    Kelly, Emer

    2009-03-01

    Community-acquired pneumonia (CAP) is a major cause of death in the elderly. The age-related increase in comorbid illnesses plays a part but the effect of aging on the immune response may be equally important. We aimed to evaluate patients with CAP for evidence of a muted response to infection in elderly patients admitted to hospital compared with a younger patient group.

  7. Severe recurrent achalasia cardia responding to treatment of severe autoimmune acquired haemophilia

    OpenAIRE

    Al-Jafar, H; Laffan, M; Al-Sabah, S; Elmorsi, M; Habeeb, M; Alnajar, F

    2012-01-01

    Acquired haemophilia A and severe acquired achalasia are both very rare conditions with unknown aetiology. Haemophilia A is a haemorrhagic disease induced by deficiency or malfunction of coagulation factor VIII. Congenital haemophilia is an inherited disease transmitted by the mother through X-linked inheritance and primarily affects males. However, acquired haemophilia A is a serious, sudden-onset, autoimmune disease that affects either sex. In addition, achalasia is a disease of the oesopha...

  8. Origins and consequences of technology acquirement by independent-living seniors: towards an integrative model.

    Science.gov (United States)

    Peek, S T M; Luijkx, K G; Vrijhoef, H J M; Nieboer, M E; Aarts, S; van der Voort, C S; Rijnaard, M D; Wouters, E J M

    2017-08-22

    Living independently can be challenging for seniors. Technologies are expected to help older adults age in place, yet little empirical research is available on how seniors develop a need for technologies, how they acquire these technologies, and how these subsequently affect their lives. Aging is complex, dynamic and personal. But how does this translate to seniors' adoption and acceptance of technology? To better understand origins and consequences of technology acquirement by independent-living seniors, an explorative longitudinal qualitative field study was set up. Home visits were made to 33 community-dwelling seniors living in the Netherlands, on three occasions (2012-2014). Semi-structured interviews were conducted on the timeline of acquirements, and people and factors involved in acquirements. Additionally, participants were interviewed on experiences in using technologies since acquirement. Thematic analysis was employed to analyze interview transcripts, using a realist approach to better understand the contexts, mechanisms and outcomes of technology acquirements. Findings were accumulated in a new conceptual model: The Cycle of Technology Acquirement by Independent-Living Seniors (C-TAILS), which provides an integrative perspective on why and how technologies are acquired, and why these may or may not prove to be appropriate and effective, considering an independent-living senior's needs and circumstances at a given point in time. We found that externally driven and purely desire-driven acquirements led to a higher risk of suboptimal use and low levels of need satisfaction. Technology acquirement by independent-living seniors may be best characterized as a heterogeneous process with many different origins, pathways and consequences. Furthermore, technologies that are acquired in ways that are not congruent with seniors' personal needs and circumstances run a higher risk of proving to be ineffective or inappropriate. Yet, these needs and circumstances are

  9. Management and control of parasites on dairy farms in northwestern region of São Paulo state

    Directory of Open Access Journals (Sweden)

    Cecília José Veríssimo

    Full Text Available Abstract Dairy cattle farming is of great economic and social importance in all Brazilian’s regions. Parasites can reduce milk productivity, especially the tick Rhipicephalus (Boophilus microplus. This study consisted of a questionnaire answered by 40 milk producers in the northwestern region of the State of São Paulo. The aim was to ascertain how these producers controlled ticks and other parasites. Very many of them knew nothing about the biological cycle of the cattle tick or about strategic control or acaricide efficacy tests. The majority (87.5% controlled ticks at a high frequency, without technical criteria and care to apply the acaricide. Spraying was the most used mode of acaricide application (95% and endectocides were used by 45%. Cattle tick fever was the harm most associated with ticks (87.5% followed closely by screwworm (77.5%. However, 65% were satisfied with their tick control. About the control of others parasites, all dewormed at least twice a year their animals; 65% were controlling horn fly; 40% had problems with screwworm. The interviewers had in general good level of education and the farms generally exhibited a high degree of technology for milk production on pasture because half of them received technical assistance frequently.

  10. Delineation and analysis of chromosomal regions specifying Yersinia pestis.

    Science.gov (United States)

    Derbise, Anne; Chenal-Francisque, Viviane; Huon, Christèle; Fayolle, Corinne; Demeure, Christian E; Chane-Woon-Ming, Béatrice; Médigue, Claudine; Hinnebusch, B Joseph; Carniel, Elisabeth

    2010-09-01

    Yersinia pestis, the causative agent of plague, has recently diverged from the less virulent enteropathogen Yersinia pseudotuberculosis. Its emergence has been characterized by massive genetic loss and inactivation and limited gene acquisition. The acquired genes include two plasmids, a filamentous phage, and a few chromosomal loci. The aim of this study was to characterize the chromosomal regions acquired by Y. pestis. Following in silico comparative analysis and PCR screening of 98 strains of Y. pseudotuberculosis and Y. pestis, we found that eight chromosomal loci (six regions [R1pe to R6pe] and two coding sequences [CDS1pe and CDS2pe]) specified Y. pestis. Signatures of integration by site specific or homologous recombination were identified for most of them. These acquisitions and the loss of ancestral DNA sequences were concentrated in a chromosomal region opposite to the origin of replication. The specific regions were acquired very early during Y. pestis evolution and were retained during its microevolution, suggesting that they might bring some selective advantages. Only one region (R3pe), predicted to carry a lambdoid prophage, is most likely no longer functional because of mutations. With the exception of R1pe and R2pe, which have the potential to encode a restriction/modification and a sugar transport system, respectively, no functions could be predicted for the other Y. pestis-specific loci. To determine the role of the eight chromosomal loci in the physiology and pathogenicity of the plague bacillus, each of them was individually deleted from the bacterial chromosome. None of the deletants exhibited defects during growth in vitro. Using the Xenopsylla cheopis flea model, all deletants retained the capacity to produce a stable and persistent infection and to block fleas. Similarly, none of the deletants caused any acute flea toxicity. In the mouse model of infection, all deletants were fully virulent upon subcutaneous or aerosol infections. Therefore

  11. Functionality predictors in acquired brain damage.

    Science.gov (United States)

    Huertas Hoyas, E; Pedrero Pérez, E J; Águila Maturana, A M; García López-Alberca, S; González Alted, C

    2015-01-01

    Most individuals who have survived an acquired brain injury present consequences affecting the sensorimotor, cognitive, affective or behavioural components. These deficits affect the proper performance of daily living activities. The aim of this study is to identify functional differences between individuals with unilateral acquired brain injury using functional independence, capacity, and performance of daily activities. Descriptive cross-sectional design with a sample of 58 people, with right-sided injury (n=14 TBI; n=15 stroke) or left-sided injury (n = 14 TBI, n = 15 stroke), right handed, and with a mean age of 47 years and time since onset of 4 ± 3.65 years. The functional assessment/functional independence measure (FIM/FAM) and the International Classification of Functioning (ICF) were used for the study. The data showed significant differences (P<.000), and a large size effect (dr=0.78) in the cross-sectional estimates, and point to fewer restrictions for patients with a lesion on their right side. The major differences were in the variables 'speaking' and 'receiving spoken messages' (ICF variables), and 'Expression', 'Writing' and 'intelligible speech' (FIM/FAM variables). In the linear regression analysis, the results showed that only 4 FIM/FAM variables, taken together, predict 44% of the ICF variance, which measures the ability of the individual, and up to 52% of the ICF, which measures the individual's performance. Gait alone predicts a 28% of the variance. It seems that individuals with acquired brain injury in the left hemisphere display important differences regarding functional and communication variables. The motor aspects are an important prognostic factor in functional rehabilitation. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  12. A Neural Basis for the Acquired Capability for Suicide

    Directory of Open Access Journals (Sweden)

    Gopikrishna Deshpande

    2016-08-01

    Full Text Available The high rate of fatal suicidal behavior in men is an urgent issue as highlighted in the public eye via news sources and media outlets. In this study, we have attempted to address this issue and understand the neural substrates underlying the gender differences in the rate of fatal suicidal behavior. The Interpersonal-Psychological Theory of Suicide (IPTS has proposed an explanation for the seemingly paradoxical relationship between gender and suicidal behavior, i.e. greater non-fatal suicide attempts by women but higher number of deaths by suicide in men. This theory states that possessing suicidal desire (due to conditions such as depression alone is not sufficient for a lethal suicide attempt. It is imperative for an individual to have acquired the capability for suicide (ACS along with suicidal desire in order to die by suicide. Therefore, higher levels of ACS in men may explain why men are more likely to die by suicide than women, despite being less likely to experience suicidal ideation or depression. In this study, we used activation likelihood estimation meta-analysis to investigate a potential ACS network that involves neural substrates underlying emotional stoicism, sensation seeking, pain tolerance, and fearlessness of death along with a potential depression network that involves neural substrates that underlie clinical depression. Brain regions commonly found in ACS and depression networks for males and females were further used as seeds to obtain regions functionally and structurally connected to them. We found that the male-specific networks were more widespread and diverse than the female-specific ones. Also, while the former involved motor regions such as the premotor cortex and cerebellum, the latter was dominated by limbic regions. This may support the fact that suicidal desire generally leads to fatal/decisive action in males while in females, it manifests as depression, ideation and generally non-fatal actions. The proposed

  13. Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Picel, Andrew C., E-mail: apicel@ucsd.edu [University of California, San Diego, Department of Radiology (United States); Koo, Sonya J. [University of Texas Southwestern Medical Center, Department of Radiology (United States); Roberts, Anne C. [University of California, San Diego, Department of Radiology (United States)

    2016-08-15

    PurposeThe purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs).Materials and methodsA retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %).ResultsEmbolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization.ConclusionsTAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion.

  14. Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations

    International Nuclear Information System (INIS)

    Picel, Andrew C.; Koo, Sonya J.; Roberts, Anne C.

    2016-01-01

    PurposeThe purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs).Materials and methodsA retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %).ResultsEmbolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization.ConclusionsTAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion.

  15. Alteration of Hepatic Gene Expression along with the Inherited Phenotype of Acquired Fatty Liver in Chicken

    Science.gov (United States)

    Zhang, Yonghong; Liu, Zhen; Liu, Ranran; Wang, Jie; Zheng, Maiqing; Li, Qinghe; Cui, Huanxian; Zhao, Guiping; Wen, Jie

    2018-01-01

    Fatty liver is a widespread disease in chickens that causes a decrease in egg production and even death. The characteristics of the inherited phenotype of acquired fatty liver and the molecular mechanisms underlying it, however, are largely unknown. In the current study, fatty liver was induced in 3 breeds by a high-fat (HF) diet and a methionine choline-deficient (MCD) diet. The results showed that the dwarf Jingxing-Huang (JXH) chicken was more susceptible to fatty liver compared with the layer White Leghorns (WL) and local Beijing-You (BJY) breeds. In addition, it was found that the paternal fatty livers induced by HF diet in JXH chickens were inherited. Compared to birds without fatty liver in the control group, both offsprings and their sires with fatty livers in the paternal group exhibited altered hepatic gene expression profiles, including upregulation of several key genes involved in fatty acid metabolism, lipid metabolism and glucose metabolism (ACACA, FASN, SCD, ACSL5, FADS2, FABP1, APOA4 and ME1). This study uniquely revealed that acquired fatty liver in cocks can be inherited. The hepatic gene expression profiles were altered in chickens with the inherited phenotype of acquired paternal fatty liver and several genes could be candidate biomarkers. PMID:29642504

  16. Alteration of Hepatic Gene Expression along with the Inherited Phenotype of Acquired Fatty Liver in Chicken.

    Science.gov (United States)

    Zhang, Yonghong; Liu, Zhen; Liu, Ranran; Wang, Jie; Zheng, Maiqing; Li, Qinghe; Cui, Huanxian; Zhao, Guiping; Wen, Jie

    2018-04-08

    Fatty liver is a widespread disease in chickens that causes a decrease in egg production and even death. The characteristics of the inherited phenotype of acquired fatty liver and the molecular mechanisms underlying it, however, are largely unknown. In the current study, fatty liver was induced in 3 breeds by a high-fat (HF) diet and a methionine choline-deficient (MCD) diet. The results showed that the dwarf Jingxing-Huang (JXH) chicken was more susceptible to fatty liver compared with the layer White Leghorns (WL) and local Beijing-You (BJY) breeds. In addition, it was found that the paternal fatty livers induced by HF diet in JXH chickens were inherited. Compared to birds without fatty liver in the control group, both offsprings and their sires with fatty livers in the paternal group exhibited altered hepatic gene expression profiles, including upregulation of several key genes involved in fatty acid metabolism, lipid metabolism and glucose metabolism ( ACACA , FASN , SCD , ACSL5 , FADS2 , FABP1 , APOA4 and ME1 ). This study uniquely revealed that acquired fatty liver in cocks can be inherited. The hepatic gene expression profiles were altered in chickens with the inherited phenotype of acquired paternal fatty liver and several genes could be candidate biomarkers.

  17. Alteration of Hepatic Gene Expression along with the Inherited Phenotype of Acquired Fatty Liver in Chicken

    Directory of Open Access Journals (Sweden)

    Yonghong Zhang

    2018-04-01

    Full Text Available Fatty liver is a widespread disease in chickens that causes a decrease in egg production and even death. The characteristics of the inherited phenotype of acquired fatty liver and the molecular mechanisms underlying it, however, are largely unknown. In the current study, fatty liver was induced in 3 breeds by a high-fat (HF diet and a methionine choline-deficient (MCD diet. The results showed that the dwarf Jingxing-Huang (JXH chicken was more susceptible to fatty liver compared with the layer White Leghorns (WL and local Beijing-You (BJY breeds. In addition, it was found that the paternal fatty livers induced by HF diet in JXH chickens were inherited. Compared to birds without fatty liver in the control group, both offsprings and their sires with fatty livers in the paternal group exhibited altered hepatic gene expression profiles, including upregulation of several key genes involved in fatty acid metabolism, lipid metabolism and glucose metabolism (ACACA, FASN, SCD, ACSL5, FADS2, FABP1, APOA4 and ME1. This study uniquely revealed that acquired fatty liver in cocks can be inherited. The hepatic gene expression profiles were altered in chickens with the inherited phenotype of acquired paternal fatty liver and several genes could be candidate biomarkers.

  18. Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Chung-Hsu Lai

    Full Text Available The clinical characteristics of Q fever are poorly identified in the tropics. Fever with pneumonia or hepatitis are the dominant presentations of acute Q fever, which exhibits geographic variability. In southern Taiwan, which is located in a tropical region, the role of Q fever in community-acquired pneumonia (CAP has never been investigated.During the study period, May 2012 to April 2013, 166 cases of adult CAP and 15 cases of acute Q fever were prospectively investigated. Cultures of clinical specimens, urine antigen tests for Streptococcus pneumoniae and Legionella pneumophila, and paired serologic assessments for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Q fever (Coxiella burnetii were used for identifying pathogens associated with CAP. From April 2004 to April 2013 (the pre-study period, 122 cases of acute Q fever were also included retrospectively for analysis. The geographic distribution of Q fever and CAP cases was similar. Q fever cases were identified in warmer seasons and younger ages than CAP. Based on multivariate analysis, male gender, chills, thrombocytopenia, and elevated liver enzymes were independent characteristics associated with Q fever. In patients with Q fever, 95% and 13.5% of cases presented with hepatitis and pneumonia, respectively. Twelve (7.2% cases of CAP were seropositive for C. burnetii antibodies, but none of them had acute Q fever. Among CAP cases, 22.9% had a CURB-65 score ≧2, and 45.8% had identifiable pathogens. Haemophilus parainfluenzae (14.5%, S. pneumoniae (6.6%, Pseudomonas aeruginosa (4.8%, and Klebsiella pneumoniae (3.0% were the most common pathogens identified by cultures or urine antigen tests. Moreover, M. pneumoniae, C. pneumoniae, and co-infection with 2 pathogens accounted for 9.0%, 7.8%, and 1.8%, respectively.In southern Taiwan, Q fever is an endemic disease with hepatitis as the major presentation and is not a common etiology of CAP.

  19. Impact of an Educational Program to Reduce Healthcare Resources in Community-Acquired Pneumonia: The EDUCAP Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Jordi Adamuz

    Full Text Available Additional healthcare visits and rehospitalizations after discharge are frequent among patients with community-acquired pneumonia (CAP and have a major impact on healthcare costs. We aimed to determine whether the implementation of an individualized educational program for hospitalized patients with CAP would decrease subsequent healthcare visits and readmissions within 30 days of hospital discharge.A multicenter, randomized trial was conducted from January 1, 2011 to October 31, 2014 at three hospitals in Spain. We randomly allocated immunocompetent adults patients hospitalized for CAP to receive either an individualized educational program or conventional information before discharge. The educational program included recommendations regarding fluid intake, adherence to drug therapy and preventive vaccines, knowledge and management of the disease, progressive adaptive physical activity, and counseling for alcohol and smoking cessation. The primary trial endpoint was a composite of the frequency of additional healthcare visits and rehospitalizations within 30 days of hospital discharge. Intention-to-treat analysis was performed.We assigned 102 patients to receive the individualized educational program and 105 to receive conventional information. The frequency of the composite primary end point was 23.5% following the individualized program and 42.9% following the conventional information (difference, -19.4%; 95% confidence interval, -6.5% to -31.2%; P = 0.003.The implementation of an individualized educational program for hospitalized patients with CAP was effective in reducing subsequent healthcare visits and rehospitalizations within 30 days of discharge. Such a strategy may help optimize available healthcare resources and identify post-acute care needs in patients with CAP.Controlled-Trials.com ISRCTN39531840.

  20. The human microbiota: novel targets for hospital-acquired infections and antibiotic resistance.

    Science.gov (United States)

    Pettigrew, Melinda M; Johnson, J Kristie; Harris, Anthony D

    2016-05-01

    Hospital-acquired infections are increasing in frequency due to multidrug resistant organisms (MDROs), and the spread of MDROs has eroded our ability to treat infections. Health care professionals cannot rely solely on traditional infection control measures and antimicrobial stewardship to prevent MDRO transmission. We review research on the microbiota as a target for infection control interventions. We performed a literature review of key research findings related to the microbiota as a target for infection control interventions. These data are summarized and used to outline challenges, opportunities, and unanswered questions in the field. The healthy microbiota provides protective functions including colonization resistance, which refers to the microbiota's ability to prevent colonization and/or expansion of pathogens. Antibiotic use and other exposures in hospitalized patients are associated with disruptions of the microbiota that may reduce colonization resistance and select for antibiotic resistance. Novel methods to exploit protective mechanisms provided by an intact microbiota may provide the key to preventing the spread of MDROs in the health care setting. Research on the microbiota as a target for infection control has been limited. Epidemiologic studies will facilitate progress toward the goal of manipulating the microbiota for control of MDROs in the health care setting. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The estimated lifetime probability of acquiring human papillomavirus in the United States.

    Science.gov (United States)

    Chesson, Harrell W; Dunne, Eileen F; Hariri, Susan; Markowitz, Lauri E

    2014-11-01

    Estimates of the lifetime probability of acquiring human papillomavirus (HPV) can help to quantify HPV incidence, illustrate how common HPV infection is, and highlight the importance of HPV vaccination. We developed a simple model, based primarily on the distribution of lifetime numbers of sex partners across the population and the per-partnership probability of acquiring HPV, to estimate the lifetime probability of acquiring HPV in the United States in the time frame before HPV vaccine availability. We estimated the average lifetime probability of acquiring HPV among those with at least 1 opposite sex partner to be 84.6% (range, 53.6%-95.0%) for women and 91.3% (range, 69.5%-97.7%) for men. Under base case assumptions, more than 80% of women and men acquire HPV by age 45 years. Our results are consistent with estimates in the existing literature suggesting a high lifetime probability of HPV acquisition and are supported by cohort studies showing high cumulative HPV incidence over a relatively short period, such as 3 to 5 years.

  2. Inherited weaknesses control deformation in the flat slab region of Central Argentina

    Science.gov (United States)

    Stevens, A.; Carrapa, B.; Larrovere, M.; Aciar, R. H.

    2015-12-01

    The Sierras Pampeanas region of west-central Argentina has long been considered a geologic type-area for flat-slab induced thick-skinned deformation. Frictional coupling between the horizontal subducting plate and South American lithosphere from ~12 Ma to the present provides an obvious causal mechanism for the basement block uplifts that characterize this region. New low temperature thermochronometry data show basement rocks from the central Sierras Pampeanas (~ longitude 66 ̊ W) including Sierras Cadena de Paiman, Velasco and Mazan retain a cooling history of Paleozoic - Mesozoic tectonics events. Results from this study indicate that less than 2 km of basement has been exhumed since at least the Mesozoic. These trends recorded by both apatite fission track (AFT) and apatite helium (AHe) thermochronometry suggest that recent Mio-Pliocene thick-skinned deformation associated with flat-slab subduction follow inherited zones of weakness from Paleozoic terrane sutures and shear zones and Mesozoic rifting. If a Cenozoic foreland basin exisited in this region, its thickness was minimal and was controlled by paleotopography. Pre-Cenozoic cooling ages in these ranges that now reach as high as 4 km imply significant exhumation of basement rocks before the advent of flat slab subduction in the mid-late Miocene. It also suggests that thick-skinned deformation associated with flat slab subduction may at least be facilitated by inherited crustal-scale weaknesses. At the most, pre-existing zones of weakness may be required in regions of thick-skinned deformation. Although flat-slab subduction plays an important role in the exhumation of the Sierras Pampeanas, it is likely not the sole mechanism responsible for thick-skinned deformation in this region. This insight sheds light on the interpretation of modern and ancient regions of thick-skinned deformation in Cordilleran systems.

  3. Exploring the physical controls of regional patterns of flow duration curves – Part 2: Role of seasonality, the regime curve, and associated process controls

    Directory of Open Access Journals (Sweden)

    M. Sivapalan

    2012-11-01

    Full Text Available The goal of this paper is to explore the process controls underpinning regional patterns of variations of streamflow regime behavior, i.e., the mean seasonal variation of streamflow within the year, across the continental United States. The ultimate motivation is to use the resulting process understanding to generate insights into the physical controls of another signature of streamflow variability, namely the flow duration curve (FDC. The construction of the FDC removes the time dependence of flows. Thus in order to better understand the physical controls in regions that exhibit strong seasonal dependence, the regime curve (RC, which is closely connected to the FDC, is studied in this paper and later linked back to the FDC. To achieve these aims a top-down modeling approach is adopted; we start with a simple two-stage bucket model, which is systematically enhanced through addition of new processes on the basis of model performance assessment in relation to observations, using rainfall-runoff data from 197 United States catchments belonging to the MOPEX dataset. Exploration of dominant processes and the determination of required model complexity are carried out through model-based sensitivity analyses, guided by a performance metric. Results indicated systematic regional trends in dominant processes: snowmelt was a key process control in cold mountainous catchments in the north and north-west, whereas snowmelt and vegetation cover dynamics were key controls in the north-east; seasonal vegetation cover dynamics (phenology and interception were important along the Appalachian mountain range in the east. A simple two-bucket model (with no other additions was found to be adequate in warm humid catchments along the west coast and in the south-east, with both regions exhibiting strong seasonality, whereas much more complex models are needed in the dry south and south-west. Agricultural catchments in the mid-west were found to be difficult to predict

  4. Differential Protein Expression in Congenital and Acquired Cholesteatomas.

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    Seung-Ho Shin

    Full Text Available Congenital cholesteatomas are epithelial lesions that present as an epithelial pearl behind an intact eardrum. Congenital and acquired cholesteatomas progress quite differently from each other and progress patterns can provide clues about the unique origin and pathogenesis of the abnormality. However, the exact pathogenic mechanisms by which cholesteatomas develop remain unknown. In this study, key proteins that directly affect cholesteatoma pathogenesis are investigated with proteomics and immunohistochemistry. Congenital cholesteatoma matrices and retroauricular skin were harvested during surgery in 4 patients diagnosed with a congenital cholesteatoma. Tissue was also harvested from the retraction pocket in an additional 2 patients during middle ear surgery. We performed 2-dimensional (2D electrophoresis to detect and analyze spots that are expressed only in congenital cholesteatoma and matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF/MS to separate proteins by molecular weight. Protein expression was confirmed by immunohistochemical staining. The image analysis of 2D electrophoresis showed that 4 congenital cholesteatoma samples had very similar protein expression patterns and that 127 spots were exclusively expressed in congenital cholesteatomas. Of these 127 spots, 10 major spots revealed the presence of titin, forkhead transcription activator homolog (FKH 5-3, plectin 1, keratin 10, and leucine zipper protein 5 by MALDI-TOF/MS analysis. Immunohistochemical staining showed that FKH 5-3 and titin were expressed in congenital cholesteatoma matrices, but not in acquired cholesteatomas. Our study shows that protein expression patterns are completely different in congenital cholesteatomas, acquired cholesteatomas, and skin. Moreover, non-epithelial proteins, including FKH 5-3 and titin, were unexpectedly expressed in congenital cholesteatoma tissue. Our data indicates that congenital cholesteatoma origins

  5. Three-dimensional magnetic resonance spectroscopic imaging in the substantia nigra of healthy controls and patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Groeger, Adriane; Godau, Jana; Berg, Daniela; Chadzynski, Grzegorz; Klose, Uwe

    2011-01-01

    To investigate the substantia nigra in patients with Parkinson's disease three-dimensional magnetic resonance spectroscopic imaging with high spatial resolution at 3 Tesla was performed. Regional variations of spectroscopic data between the rostral and caudal regions of the substantia nigra as well as the midbrain tegmentum areas were evaluated in healthy controls and patients with Parkinson's disease. Nine patients with Parkinson's disease and eight age- and gender-matched healthy controls were included in this study. Data were acquired by using three-dimensional magnetic resonance spectroscopic imaging measurements. The ratios between rostral and caudal voxels of the substantia nigra as well as the midbrain tegmentum areas were calculated for the main-metabolites N-acetyl aspartate, creatine, choline, and myo-inositol. Additionally, the metabolite/creatine ratios were calculated. In all subjects spectra of acceptable quality could be obtained with a nominal voxel size of 0.252 ml. The calculated rostral-to-caudal ratios of the metabolites as well as of the metabolite/creatine ratios showed with exception of choline/creatine ratio significant differences between healthy controls and patients with Parkinson's disease. The findings from this study indicate that regional variations in N-acetyl aspartate/creatine ratios in the regions of the substantia nigra may differentiate patients with Parkinson's disease and healthy controls. (orig.)

  6. Toward relating the subthalamic nucleus spiking activity to the local field potentials acquired intranuclearly

    International Nuclear Information System (INIS)

    Michmizos, K P; Nikita, K S; Sakas, D

    2011-01-01

    Studies on neurophysiological correlates of the functional magnetic resonance imaging (fMRI) signals reveal a strong relationship between the local field potential (LFP) acquired invasively and metabolic signal changes in fMRI experiments. Most of these studies failed to reveal an analogous relationship between metabolic signals and the spiking activity. That would allow for the prediction of the neural activity exclusively from the fMRI signals. However, the relationship between fMRI signals and spiking activity can be inferred indirectly provided that the LFPs can be used to predict the spiking activity of the area. Until now, only the LFP–spike relationship in cortical areas has been examined. Herein, we show that the spiking activity can be predicted by the LFPs acquired in a deep nucleus, namely the subthalamic nucleus (STN), using a nonlinear cascade model. The model can reproduce the spike patterns inside the motor area of the STN that represent information about the motor plans. Our findings expand the possibility of further recruiting non-invasive neuroimaging techniques to understand the activity of the STN and predict or even control movement

  7. The mitochondrial DNA makeup of Romanians: A forensic mtDNA control region database and phylogenetic characterization.

    Science.gov (United States)

    Turchi, Chiara; Stanciu, Florin; Paselli, Giorgia; Buscemi, Loredana; Parson, Walther; Tagliabracci, Adriano

    2016-09-01

    To evaluate the pattern of Romanian population from a mitochondrial perspective and to establish an appropriate mtDNA forensic database, we generated a high-quality mtDNA control region dataset from 407 Romanian subjects belonging to four major historical regions: Moldavia, Transylvania, Wallachia and Dobruja. The entire control region (CR) was analyzed by Sanger-type sequencing assays and the resulting 306 different haplotypes were classified into haplogroups according to the most updated mtDNA phylogeny. The Romanian gene pool is mainly composed of West Eurasian lineages H (31.7%), U (12.8%), J (10.8%), R (10.1%), T (9.1%), N (8.1%), HV (5.4%),K (3.7%), HV0 (4.2%), with exceptions of East Asian haplogroup M (3.4%) and African haplogroup L (0.7%). The pattern of mtDNA variation observed in this study indicates that the mitochondrial DNA pool is geographically homogeneous across Romania and that the haplogroup composition reveals signals of admixture of populations of different origin. The PCA scatterplot supported this scenario, with Romania located in southeastern Europe area, close to Bulgaria and Hungary, and as a borderland with respect to east Mediterranean and other eastern European countries. High haplotype diversity (0.993) and nucleotide diversity indices (0.00838±0.00426), together with low random match probability (0.0087) suggest the usefulness of this control region dataset as a forensic database in routine forensic mtDNA analysis and in the investigation of maternal genetic lineages in the Romanian population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Acquired hemophilia A: a review of recent data and new therapeutic options.

    Science.gov (United States)

    Franchini, Massimo; Vaglio, Stefania; Marano, Giuseppe; Mengoli, Carlo; Gentili, Sara; Pupella, Simonetta; Liumbruno, Giancarlo Maria

    2017-10-01

    Acquired hemophilia A (AHA) is a rare, but potentially life-threatening, bleeding disorder caused by an autoantibody against factor VIII that interferes with its coagulant function. We performed a narrative review focusing on the diagnostic aspects of AHA and on the current treatment strategies with particular regard to new data and therapeutic developments. The management of this severe hemorrhagic disorder is based on the control of bleeding with the use of bypassing agents and on the utilization of a variety of immunosuppressant agents with the goal of eliminating the autoantibody permanently. The optimal management of AHA should be multidisciplinary and requires a close collaboration between physicians from various specialties.

  9. Naturally acquired antibody responses to recombinant Pfs230 and Pfs48/45 transmission blocking vaccine candidates.

    Science.gov (United States)

    Jones, Sophie; Grignard, Lynn; Nebie, Issa; Chilongola, Jaffu; Dodoo, Daniel; Sauerwein, Robert; Theisen, Michael; Roeffen, Will; Singh, Shrawan Kumar; Singh, Rajesh Kumar; Singh, Sanjay; Kyei-Baafour, Eric; Tetteh, Kevin; Drakeley, Chris; Bousema, Teun

    2015-07-01

    Pfs48/45 and Pfs230 are Plasmodium falciparum sexual stage proteins and promising malaria transmission-blocking vaccine candidates. Antibody responses against these proteins may be naturally acquired and target antigens may be under selective pressure. This has consequences for the future evaluation of vaccine immunogenicity and efficacy in populations naturally exposed to malaria. We determined naturally acquired antibody responses to the recombinant proteins Pfs48/45-10C and Pfs230-230CMB in children from three malaria endemic settings in Ghana, Tanzania and Burkina Faso. We also examined genetic polymorphisms in the P. falciparum gene pfs48/45. Antibody prevalence was 1.1-18.2% for 10C and 6.7-18.9% for 230CMB. In Burkina Faso we observed evidence of an age-dependent acquisition pattern for both 10C (p < 0.001) and 230CMB (p = 0.031). Membrane feeding assays on a separate dataset demonstrated an association between functional transmission reducing activity and antibody prevalence for both 10C (p = 0.017) and 230CMB (p = 0.049). 17 single nucleotide polymorphisms were found in pfs48/45 (from 126 samples), with 5 non-synonymous SNPs in the Pfs48/45 10C region. We conclude there are naturally acquired antibody responses to both vaccine candidates which have functional relevance by reducing the transmissibility of infected individuals. We identified genetic polymorphisms, in pfs48/45 which exhibited geographical specificity. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  10. Risk factors for community-acquired urinary tract infections caused by ESBL-producing enterobacteriaceae--a case-control study in a low prevalence country.

    Directory of Open Access Journals (Sweden)

    Arne Søraas

    Full Text Available Community-acquired urinary tract infection (CA-UTI is the most common infection caused by extended-spectrum β-lactamase (ESBL-producing Enterobacteriaceae, but the clinical epidemiology of these infections in low prevalence countries is largely unknown. A population based case-control study was conducted to assess risk factors for CA-UTI caused by ESBL-producing E. coli or K. pneumoniae. The study was carried out in a source population in Eastern Norway, a country with a low prevalence of infections caused by ESBL-producing Enterobacteriaceae. The study population comprised 100 cases and 190 controls with CA-UTI caused by ESBL-producing and non-ESBL-producing E. coli or K. pneumoniae, respectively. The following independent risk factors of ESBL-positive UTIs were identified: Travel to Asia, The Middle East or Africa either during the past six weeks (Odds ratio (OR = 21; 95% confidence interval (CI: 4.5-97 or during the past 6 weeks to 24 months (OR = 2.3; 95% CI: 1.1-4.4, recent use of fluoroquinolones (OR = 16; 95% CI: 3.2-80 and β-lactams (except mecillinam (OR = 5.0; 95% CI: 2.1-12, diabetes mellitus (OR = 3.2; 95% CI: 1.0-11 and recreational freshwater swimming the past year (OR = 2.1; 95% CI: 1.0-4.0. Factors associated with decreased risk were increasing number of fish meals per week (OR = 0.68 per fish meal; 95% CI: 0.51-0.90 and age (OR = 0.89 per 5 year increase; 95% CI: 0.82-0.97. In conclusion, we have identified risk factors that elucidate mechanisms and routes for dissemination of ESBL-producing Enterobacteriaceae in a low prevalence country, which can be used to guide appropriate treatment of CA-UTI and targeted infection control measures.

  11. Microsoft Acquired Nokia in Unipolar Operating System Market

    Directory of Open Access Journals (Sweden)

    Netra Pal Singh

    2014-09-01

    Full Text Available The recent big tickets include Microsoft acquiring part of Nokia for US$ 7.2 billion, Verizon buy 45% stake in Vodafone for US$130 billion, Google acquiring Motorola for 12.5 billion. These buyouts are analyzed and commented by experts of the industry. This research paper attempted to collate their view in the context of Microsoft and Nokia deal on six parameters. These parameters are (i reasons for the downfall of the Nokia market share, (ii general comments of the experts, (iii similarities / dissimilarities of past and business models of the smartphone business, (iv reasons for Microsoft to buy out Nokia, (vi impact of buyout on Microsoft, Nokia, consumers and markets.

  12. Acquired pathology of the pediatric spine and spinal cord

    International Nuclear Information System (INIS)

    Palasis, Susan; Hayes, Laura L.

    2015-01-01

    Pediatric spine pathology poses a diagnostic challenge for radiologists. Acquired spine pathology often yields nonspecific signs and symptoms in children, especially in the younger age groups, and diagnostic delay can carry significant morbidity. This review is focused on some of the more common diagnostic dilemmas we face when attempting to evaluate and diagnose acquired pediatric spine anomalies in daily practice. An understanding of some of the key differentiating features of these disease processes in conjunction with pertinent history, physical exam, and advanced imaging techniques can indicate the correct diagnosis. (orig.)

  13. Acquired pathology of the pediatric spine and spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Palasis, Susan; Hayes, Laura L. [Children' s Healthcare of Atlanta, Department of Radiology at Scottish Rite, Atlanta, GA (United States)

    2015-09-15

    Pediatric spine pathology poses a diagnostic challenge for radiologists. Acquired spine pathology often yields nonspecific signs and symptoms in children, especially in the younger age groups, and diagnostic delay can carry significant morbidity. This review is focused on some of the more common diagnostic dilemmas we face when attempting to evaluate and diagnose acquired pediatric spine anomalies in daily practice. An understanding of some of the key differentiating features of these disease processes in conjunction with pertinent history, physical exam, and advanced imaging techniques can indicate the correct diagnosis. (orig.)

  14. RELATION BETWEEN THE LATENT MOTOR DIMENSIONS RESPONSIBLE FOR MOVEMENTS OF STUDENTS IN ACQUIRING THE MOTOR TESTS

    Directory of Open Access Journals (Sweden)

    Viktor Mitrevski

    2012-09-01

    Full Text Available The research has been carried out on a sample defined by the population of students who attended regularly their training classes in primary school in the Republic of Macedonia (from the region of Prespa and Pelagonia and the Republic of Serbia (from the region of Banat, municipality Kikinda. The total number of entities is 179, of which 124 are from Macedonia, and 55 – from Serbia who are eight-grade students, aged 14-15 (± 3 months. The aim of the study is to establish the relation between the results and obtained marks in motor tests with the latent motor dimensions responsible for the movements of students. By using factor analysis – varimax rotation, there is determined the effect and relation between the marks obtained in acquiring the motor tests for estimating the explosive power, start speed, and precisity of students.

  15. Building information for systematic improvement of the prevention of hospital-acquired pressure ulcers with statistical process control charts and regression.

    Science.gov (United States)

    Padula, William V; Mishra, Manish K; Weaver, Christopher D; Yilmaz, Taygan; Splaine, Mark E

    2012-06-01

    To demonstrate complementary results of regression and statistical process control (SPC) chart analyses for hospital-acquired pressure ulcers (HAPUs), and identify possible links between changes and opportunities for improvement between hospital microsystems and macrosystems. Ordinary least squares and panel data regression of retrospective hospital billing data, and SPC charts of prospective patient records for a US tertiary-care facility (2004-2007). A prospective cohort of hospital inpatients at risk for HAPUs was the study population. There were 337 HAPU incidences hospital wide among 43 844 inpatients. A probit regression model predicted the correlation of age, gender and length of stay on HAPU incidence (pseudo R(2)=0.096). Panel data analysis determined that for each additional day in the hospital, there was a 0.28% increase in the likelihood of HAPU incidence. A p-chart of HAPU incidence showed a mean incidence rate of 1.17% remaining in statistical control. A t-chart showed the average time between events for the last 25 HAPUs was 13.25 days. There was one 57-day period between two incidences during the observation period. A p-chart addressing Braden scale assessments showed that 40.5% of all patients were risk stratified for HAPUs upon admission. SPC charts complement standard regression analysis. SPC amplifies patient outcomes at the microsystem level and is useful for guiding quality improvement. Macrosystems should monitor effective quality improvement initiatives in microsystems and aid the spread of successful initiatives to other microsystems, followed by system-wide analysis with regression. Although HAPU incidence in this study is below the national mean, there is still room to improve HAPU incidence in this hospital setting since 0% incidence is theoretically achievable. Further assessment of pressure ulcer incidence could illustrate improvement in the quality of care and prevent HAPUs.

  16. Acquired Duodenal Obstruction in Children

    Directory of Open Access Journals (Sweden)

    Jen-Hung Chien

    2008-10-01

    Full Text Available Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity.

  17. Problem of two-level hierarchical minimax program control the final state of regional social and economic system in the presence of risks

    International Nuclear Information System (INIS)

    Shorikov, A. F.

    2015-01-01

    This article discusses a discrete-time dynamical system consisting of a set a controllable objects (region and forming it municipalities). The dynamics each of these is described by the corresponding vector nonlinear discrete-time recurrent vector equations and its control system consist from two levels: basic (control level I) that is dominating and subordinate level (control level II). Both levels have different criterions of functioning and united a priori by determined informational and control connections defined in advance. In this paper we study the problem of optimization of guaranteed result for program control by the final state of regional social and economic system in the presence of risks. For this problem we proposed in this work an economical and mathematical model of two-level hierarchical minimax program control the final state of regional social and economic system in the presence of risks and the general scheme for its solving

  18. Problem of two-level hierarchical minimax program control the final state of regional social and economic system in the presence of risks

    Energy Technology Data Exchange (ETDEWEB)

    Shorikov, A. F., E-mail: afshorikov@mail.ru [Ural Federal University, 19 S. Mira, Ekaterinburg, 620002, Russia Institute of Mathematics and Mechanics, Ural Branch of Russian Academy of Sciences, 16 S. Kovalevskaya, Ekaterinburg, 620990 (Russian Federation)

    2015-11-30

    This article discusses a discrete-time dynamical system consisting of a set a controllable objects (region and forming it municipalities). The dynamics each of these is described by the corresponding vector nonlinear discrete-time recurrent vector equations and its control system consist from two levels: basic (control level I) that is dominating and subordinate level (control level II). Both levels have different criterions of functioning and united a priori by determined informational and control connections defined in advance. In this paper we study the problem of optimization of guaranteed result for program control by the final state of regional social and economic system in the presence of risks. For this problem we proposed in this work an economical and mathematical model of two-level hierarchical minimax program control the final state of regional social and economic system in the presence of risks and the general scheme for its solving.

  19. Ultrasound-Guided Regional Anesthesia Simulation Training: A Systematic Review.

    Science.gov (United States)

    Chen, Xiao Xu; Trivedi, Vatsal; AlSaflan, AbdulHadi A; Todd, Suzanne Clare; Tricco, Andrea C; McCartney, Colin J L; Boet, Sylvain

    Ultrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA. Studies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes). Two authors independently reviewed all identified references for eligibility, abstracted data, and appraised quality. After screening 176 citations and 45 full-text articles, 12 studies were included. Simulation-enhanced training improved knowledge acquisition (Kirkpatrick level 2) when compared with nonsimulation training. Seven studies measuring skill acquisition (Kirkpatrick level 2) found that simulation-enhanced UGRA training was significantly more effective than alternative teaching methods or no intervention. One study measuring transfer of learning into the clinical setting (Kirkpatrick level 3) found no difference between simulation-enhanced UGRA training and non-simulation-based training. However, this study was discontinued early because of technical challenges. Two studies examined patient outcomes (Kirkpatrick level 4), and one of these found that simulation-based UGRA training improved patient outcomes compared with didactic teaching. Ultrasound-guided regional anesthesia knowledge and skills significantly improved with simulation training. The acquired UGRA skills may be transferred to the clinical setting; however, further studies are required to confirm these changes translate to improved patient outcomes.

  20. 12 CFR 574.4 - Control.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Control. 574.4 Section 574.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY ACQUISITION OF CONTROL OF SAVINGS ASSOCIATIONS § 574.4 Control. (a) Conclusive control. (1) An acquiror shall be deemed to have acquired control of a...

  1. Reversible chronic acquired complete atrioventricular block.

    Science.gov (United States)

    Rakovec, P; Milcinski, G; Voga, G; Korsic, L

    1982-01-01

    The return of atrioventricular conduction is reported in a case after nearly four years of complete acquired heart block. After recovery from atrioventricular block, right bundle branch block persisted, but P-R interval and H-V interval were normal. Three months later a relapse of second degree infranodal atrioventricular block was noted. A short review of similar cases from the literature is given.

  2. Professions and Working Conditions Associated With Community-Acquired Pneumonia.

    Science.gov (United States)

    Almirall, Jordi; Serra-Prat, Mateu; Bolíbar, Ignasi; Palomera, Elisabet; Roig, Jordi; Boixeda, Ramon; Bartolomé, Maria; de la Torre, Mari; Parra, Olga; Torres, Antoni

    2015-12-01

    Community-acquired pneumonia (CAP) is not considered a professional disease, and the effect of different occupations and working conditions on susceptibility to CAP is unknown. The aim of this study is to determine whether different jobs and certain working conditions are risk factors for CAP. Over a 1-year period, all radiologically confirmed cases of CAP (n=1,336) and age- and sex-matched controls (n=1,326) were enrolled in a population-based case-control study. A questionnaire on CAP risk factors, including work-related questions, was administered to all participants during an in-person interview. The bivariate analysis showed that office work is a protective factor against CAP, while building work, contact with dust and sudden changes of temperature in the workplace were risk factors for CAP. The occupational factor disappeared when the multivariate analysis was adjusted for working conditions. Contact with dust (previous month) and sudden changes of temperature (previous 3 months) were risk factors for CAP, irrespective of the number of years spent working in these conditions, suggesting reversibility. Some recent working conditions such as exposure to dust and sudden changes of temperature in the workplace are risk factors for CAP. Both factors are reversible and preventable. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  3. Mechanisms controlling rock coast evolution in paraglacial landscapes - examples from Arctic, Antarctic and Scandinavian regions

    Science.gov (United States)

    Strzelecki, M. C.; Lim, M.; Kasprzek, M.; Swirad, Z. M.; Rachlewicz, G.; Migoń, P.; Pawlowski, L.; Jaskolski, M.

    2017-12-01

    This paper presents the results of an investigation into the processes controlling development of paraglacial rock coast systems in Hornsund, Svalbard, Admiralty Bay, South Shetland Islands and Gotland Island, Scandinavia. A suite of nested geomorphological and geophysical methods have been applied to characterize the functioning of rock cliffs, shore platforms and stacks influenced by lithological control and geomorphic processes driven by paraglacial coast environments - both in glaciated and deglaciated study sites. Rock hardness, quantified by Schmidt hammer rebound tests, demonstrate strong spatial control on the degree of rock weathering (rock strength) along studied rock coasts. Elevation controlled geomorphic zones are identified and linked to distinct processes and mechanisms, transitioning from peak hardness values at the icefoot/sea-ice through the wave and storm dominated scour zones to the lowest values on the cliff tops, where the effects of periglacial weathering dominate. Observations of rock surface change using a traversing micro-erosion meter (TMEM) indicate that significant changes in erosion rates occur at the junction between shore platform and the cliff toe, where rock erosion is facilitated by frequent wetting and drying and operation of nivation and sea ice processes (formation and melting of snow patches and icefoot complexes). Electrical resistivity tomography (ERT) surveys have been used to investigate frozen ground control on rock coast dynamics and reveal the strong interaction with marine processes in polar coastal settings. In Gotland, Scandinavia the morphology of rocky coastal landforms (rauks) bear traces of numerous environmental changes that occurred in Baltic region over the Holocene including salinity, temperature, ice-cover/storminess and relative sea-level. The results are synthesised to propose a new conceptual model of paraglacial rock coast systems, with the aim of contributing towards a unifying concept of cold region

  4. Measuring hospital-acquired pressure injuries: A surveillance programme for monitoring performance improvement and estimating annual prevalence.

    Science.gov (United States)

    Jull, Andrew; McCall, Elaine; Chappell, Matt; Tobin, Sam

    2016-06-01

    To describe a surveillance approach for monitoring the effect of improvement initiatives on hospital-acquired pressure injuries and findings arising from that surveillance. Random sampling of patients on the same day of each successive month from a campus of child and adult hospitals using a standard audit tool to identify presence of hospital-acquired pressure injury. Where multiple pressure injuries were present, the most severe grade injury contributed to prevalence. Statistical process control charts were used to monitor monthly performance and Maximum Likelihood Estimation to determine timing of step change. 8274 patients were assessed over 3 years from an eligible population of 32,259 hospitalised patients. 517 patients had hospital-acquired pressure injuries giving an overall prevalence of 6.2% (95% CI 5.7-6.8%). Annual prevalence was 8.4% (95% CI 7.4-9.5%) in the first year, falling to 5.6% (95% CI 4.7-6.4%) in the second year and 4.8% (95% CI 4.0-5.6%) in the third year. A step change was signalled with mean prevalence up to July 2013 being 7.9% (95% CI 7.1-8.8%) and mean prevalence thereafter 4.8% (95% CI 4.2-5.4%). Hospital-acquired pressure injuries were found in all age ranges, but were more frequent in children up to 14 years (17.4%) and those aged 75 years or older (38.7%). Monthly random sampling of patients within clinical units can be used to monitor performance improvement. This approach represents a rational alternative to cross-sectional prevalence surveys especially if the focus is on performance improvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Wind and Photovoltaic Large-Scale Regional Models for hourly production evaluation

    DEFF Research Database (Denmark)

    Marinelli, Mattia; Maule, Petr; Hahmann, Andrea N.

    2015-01-01

    This work presents two large-scale regional models used for the evaluation of normalized power output from wind turbines and photovoltaic power plants on a European regional scale. The models give an estimate of renewable production on a regional scale with 1 h resolution, starting from a mesosca...... of the transmission system, especially regarding the cross-border power flows. The tuning of these regional models is done using historical meteorological data acquired on a per-country basis and using publicly available data of installed capacity.......This work presents two large-scale regional models used for the evaluation of normalized power output from wind turbines and photovoltaic power plants on a European regional scale. The models give an estimate of renewable production on a regional scale with 1 h resolution, starting from a mesoscale...

  6. Anticipatory parental care: acquiring resources for offspring prior to conception.

    OpenAIRE

    Boutin, S; Larsen, K W; Berteaux, D

    2000-01-01

    Many organisms acquire and defend resources outside the breeding season and this is thought to be for immediate survival and reproductive benefits. Female red squirrels (Tamiasciurus hudsonicus) acquire traditional food cache sites up to four months prior to the presence of any physiological or behavioural cues associated with mating or offspring dependency. They subsequently relinquish these resources to one of their offspring at independence (ten months later). We experimentally show that a...

  7. 3D MODEL GENERATION USING OBLIQUE IMAGES ACQUIRED BY UAV

    Directory of Open Access Journals (Sweden)

    A. Lingua

    2017-07-01

    Full Text Available In recent years, many studies revealed the advantages of using airborne oblique images for obtaining improved 3D city models (including façades and building footprints. Here the acquisition and use of oblique images from a low cost and open source Unmanned Aerial Vehicle (UAV for the 3D high-level-of-detail reconstruction of historical architectures is evaluated. The critical issues of such acquisitions (flight planning strategies, ground control points distribution, etc. are described. Several problems should be considered in the flight planning: best approach to cover the whole object with the minimum time of flight; visibility of vertical structures; occlusions due to the context; acquisition of all the parts of the objects (the closest and the farthest with similar resolution; suitable camera inclination, and so on. In this paper a solution is proposed in order to acquire oblique images with one only flight. The data processing was realized using Structure-from-Motion-based approach for point cloud generation using dense image-matching algorithms implemented in an open source software. The achieved results are analysed considering some check points and some reference LiDAR data. The system was tested for surveying a historical architectonical complex: the “Sacro Mo nte di Varallo Sesia” in north-west of Italy. This study demonstrates that the use of oblique images acquired from a low cost UAV system and processed through an open source software is an effective methodology to survey cultural heritage, characterized by limited accessibility, need for detail and rapidity of the acquisition phase, and often reduced budgets.

  8. Situational analysis of tuberculosis control programs in the Eastern Mediterranean Region: Gaps and solutions

    Directory of Open Access Journals (Sweden)

    Samiha Baghdadi

    2016-01-01

    Conclusion: The year 2015 marks a transition from the MDGs to the Sustainable Development Goals and from the Stop TB Strategy to the End TB Strategy. The region will move into three main directions: complete pending tasks, mitigate the impact of the complex emergencies on TB control, and move toward TB elimination.

  9. Regional training course on state systems of accounting for and control of nuclear material

    International Nuclear Information System (INIS)

    2001-01-01

    The publication is an outline of the subjects that are included in a regional training course organized in Buenos Aires (Argentina) by the IAEA with the cooperation of the Argentine Government and the Brazilian-Argentine Agency for the Accounting and Control of Nuclear Materials (ABACC) from September 24 to October 5, 2001

  10. Frequency of hospital acquired hyponatremia in a pediatric tertiary care setting

    International Nuclear Information System (INIS)

    Bibi, S.; Haq, A.U.; Billo, A.G.; Bibi, S.; Gilani, S.Y.H.; Shah, S.R.A.

    2015-01-01

    Background: Hyponatremia is the most commonly encountered electrolyte disorder in children. In our country the epidemiology of hospital acquired hyponatremia has hardly ever been explored whereas the administration of hypotonic IV fluids is widely practiced here. Therefore we pioneered to conduct this study to determine the frequency of hospital acquired hyponatremia. Method: This was a cross sectional study carried out at Aga Khan University Hospital, Karachi in paediatric ward and ICU over a period of 12 months. All children (>1 month and <15 years of age) admitted in paediatric units and on maintenance IV fluids who had serum sodium level measured on admission were included in the study and followed to identify patients who had a drop in serum sodium during hospitalization. Informed consent was taken from parents and collected data was recorded on a proforma. Results: A total of 865 patients were enrolled in the study. Hyponatremia was recorded in 405 patients on admission (46.8 percentage) while hospital acquired hyponatremia was documented in 240. children (27.7 percentage). Out of these 142 (59.2 percentage) were male and 98 (40.8 percentage) were female. Mean age of children in hospital acquired hyponatremia group was 60.67 months. Severity of hospital acquired hyponatremia was recorded as mild in 191 (79.6 percentage), moderate in 35 (14.6 percentage) and severe in 14 (5.8) children. Major disease categories included gastrointestinal disorder (30.4 percentage), respiratory illness (12.5 percentage), oncological disease (16.3 percentage), cardiovascular disease (11.7 percentage), infectious disease (9.2 percentage) and neurological illness (8.3 percentage). Conclusion: Hospital acquired hyponatremia is frequently encountered in our hospitalized children with majority of them receiving hypotonic IV solutions. (author)

  11. Use of CD25 as an immunohistochemical marker for acquired ocular toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Cristina Miyamoto

    2010-10-01

    Full Text Available PURPOSE: Toxoplasmosis is the most common cause of posterior infectious uveitis worldwide. It is often impossible to determine its congenital or acquired nature. Interleukin-2 (IL-2 in peripheral blood has been described as a possible marker for acquired toxoplasmosis. The purpose of this study is to evaluate the histopathological characteristics of ocular toxoplasmosis cases using CD25 as a marker for the expression of interleukin-2. METHODS: Ten formalin-fixed, paraffin-embedded enucleated globes from ten immunocompetent patients with clinical diagnosis of toxoplasmosis were evaluated. Four patients had the acquired form of ocular toxoplasmosis (positive IgM while six were IgM negative and IgG positive for toxoplasmosis. Histopathological slides were reviewed for the extension of the retinal necrosis, number of toxo cysts, the granulomatous inflammatory reaction, the presence of T and B cells within the choroid and the IL-2 expression. Immunohistochemistry using monoclonal antibodies was performed to observe the expression of CD4, CD8, CD20, CD25, and CD68. RESULTS: The histopathological evaluation disclosed no differences between acquired and the other ocular toxoplasmosis cases regarding the characteristics studied. However, CD25 showed a higher expression of IL-2 on the 4 acquired cases of ocular toxoplasmosis compared to the remainders. CONCLUSIONS: To the best of our knowledge, this is the first report showing that the use of CD25 as a marker for interleukin-2 could differentiate acquired ocular toxoplasmosis.

  12. Infection Control Link Nurse Program: An interdisciplinary approach n targeting health care-acquired infection

    Science.gov (United States)

    Sopirala, Madhuri M.; Yahle-Dunbar, Lisa; Smyer, Justin; Wellington, Linda; Dickman, Jeanne; Zikri, Nancy; Martin, Jennifer; Kulich, Pat; Taylor, David; Mekhjian, Hagop; Nash, Mary; Mansfield, Jerry; Pancholi, Preeti; Howard, Mary; Chase, Linda; Brown, Susan; Kipp, Kristopher; Lefeld, Kristen; Myers, Amber; Pan, Xueliang; Mangino, Julie E.

    2014-01-01

    Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed. Results A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62–0.83, P Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP. Conclusion Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing reeducation for the nurses by IP personnel helped drive these results. PMID:24548456

  13. AKT-mediated enhanced aerobic glycolysis causes acquired radioresistance by human tumor cells

    International Nuclear Information System (INIS)

    Shimura, Tsutomu; Noma, Naoto; Sano, Yui; Ochiai, Yasushi; Oikawa, Toshiyuki; Fukumoto, Manabu; Kunugita, Naoki

    2014-01-01

    Background and purpose: Cellular radioresistance is a major impediment to effective radiotherapy. Here, we demonstrated that long-term exposure to fractionated radiation conferred acquired radioresistance to tumor cells due to AKT-mediated enhanced aerobic glycolysis. Material and methods: Two human tumor cell lines with acquired radioresistance were established by long-term exposure to fractionated radiation with 0.5 Gy of X-rays. Glucose uptake was inhibited using 2-deoxy-D-glucose, a non-metabolizable glucose analog. Aerobic glycolysis was assessed by measuring lactate concentrations. Cells were then used for assays of ROS generation, survival, and cell death as assessed by annexin V staining. Results: Enhanced aerobic glycolysis was shown by increased glucose transporter Glut1 expression and a high lactate production rate in acquired radioresistant cells compared with parental cells. Inhibiting the AKT pathway using the AKT inhibitor API-2 abrogated these phenomena. Moreover, we found that inhibiting glycolysis with 2-deoxy-D-glucose suppressed acquired tumor cell radioresistance. Conclusions: Long-term fractionated radiation confers acquired radioresistance to tumor cells by AKT-mediated alterations in their glucose metabolic pathway. Thus, tumor cell metabolic pathway is an attractive target to eliminate radioresistant cells and improve radiotherapy efficacy

  14. Mental health and satisfaction with life among upper limb amputees: a Norwegian population-based survey comparing adult acquired major upper limb amputees with a control group.

    Science.gov (United States)

    Østlie, Kristin; Magnus, Per; Skjeldal, Ola H; Garfelt, Beate; Tambs, Kristian

    2011-01-01

    To assess how upper limb amputation affects mental health and life satisfaction. Cross-sectional study comparing the mental health and perceived satisfaction with life among adult acquired major upper limb amputees in Norway with a control group drawn from the Norwegian general population. The scales used were the Satisfaction With Life Scale (SWLS) and the Hopkins Symptom Check List 25-item (SCL-25). The groups were compared using multiple linear regression analyses. The amputees scored significantly lower on life satisfaction than the control group. A tendency to poorer mental health in the amputee group was observed, but there was no clear evidence of such a difference. The amputation effect on life satisfaction seemed to be mediated mainly by changes in occupational status and by the occurrence of short- or long-term complications related to the amputation. Our findings imply that rehabilitation of upper limb amputees should emphasise facilitating return to work as well as the prevention of short- and long-term complications, and that this will be of importance not only for the amputees' physical function, but for the maintenance of acceptable life satisfaction. Further studies on the effect of upper limb amputation on mental health are recommended.

  15. Metastatic Spreading of Community Acquired Staphylococcus aureus Bacteraemia

    Directory of Open Access Journals (Sweden)

    Giovanna Fabio

    2011-01-01

    Full Text Available A 29-year-old woman presented to the Fondazione IRCCS “Cà Granda” Ospedale Maggiore, a tertiary care university hospital in Milan (Italy, with skin lesions, fever, myalgia, joint pain and swelling, and a one-week history of low back pain. The diagnosis was Staphylococcus aureus (S. aureus bacteraemia spreading to skin, bones, and joints and a lumbosacral epidural abscess L5-S2. Neither initial focus nor predisposing conditions were apparent. The antibiotic therapy was prolonged for six-weeks with the resolution of fever, skin lesions, articular inflammation, and the epidural abscess. Community-acquired S. aureus infections can affect patients without traditional healthcare-associated risk factors, and community acquisition is a risk-factor for the development of complications. Raised awareness of S. aureus bacteraemia, also in patients without healthcare-associated risk factors, is important in the diagnosis, management, and control of this infection, because failure to recognise patients with serious infection and lack of understanding of empirical antimicrobial selection are associated with a high mortality rate in otherwise healthy people.

  16. Naturally-acquired humoral immune responses against the N- and C-termini of the Plasmodium vivax MSP1 protein in endemic regions of Brazil and Papua New Guinea using a multiplex assay

    Directory of Open Access Journals (Sweden)

    Alonso Pedro L

    2010-01-01

    Full Text Available Abstract Background Progress towards the development of a malaria vaccine against Plasmodium vivax, the most widely distributed human malaria parasite, will require a better understanding of the immune responses that confer clinical protection to patients in regions where malaria is endemic. Methods Glutathione S-transferase (GST and GST-fusion proteins representing the N- terminus of the merozoite surface protein 1 of P. vivax, PvMSP1-N, and the C-terminus, PvMSP1-C, were covalently coupled to BioPlex carboxylated beads. Recombinant proteins and coupled beads were used, respectively, in ELISA and Bioplex assays using immune sera of P. vivax patients from Brazil and PNG to determine IgG and subclass responses. Concordances between the two methods in the seropositivity responses were evaluated using the Kappa statistic and the Spearman's rank correlation. Results The results using this methodology were compared with the classical microtitre enzyme-linked immnosorbent assay (ELISA, showing that the assay was sensitive, reproducible and had good concordance with ELISA; yet, further research into different statistical analyses seems desirable before claiming conclusive results exclusively based on multiplex assays. As expected, results demonstrated that PvMSP1 was immunogenic in natural infections of patients from different endemic regions of Brazil and Papua New Guinea (PNG, and that age correlated only with antibodies against the C-terminus part of the molecule. Furthermore, the IgG subclass profiles were different in these endemic regions having IgG3 predominantly recognizing PvMSP1 in Brazil and IgG1 predominantly recognizing PvMSP1 in PNG. Conclusions This study validates the use of the multiplex assay to measure naturally-acquired IgG antibodies against the merozoite surface protein 1 of P. vivax.

  17. Gastrostomy Tube Feeding in Children With Developmental or Acquired Disorders: A Longitudinal Comparison on Healthcare Provision and Eating Outcomes 4 Years After Gastrostomy.

    Science.gov (United States)

    Backman, Ellen; Karlsson, Ann-Kristin; Sjögreen, Lotta

    2018-03-30

    Studies on long-term feeding and eating outcomes in children requiring gastrostomy tube feeding (GT) are scarce. The aim of this study was to describe children with developmental or acquired disorders receiving GT and to compare longitudinal eating and feeding outcomes. A secondary aim was to explore healthcare provision related to eating and feeding. This retrospective cohort study reviewed medical records of children in 1 administrative region of Sweden with GT placement between 2005 and 2012. Patient demographics, primary diagnoses, age at GT placement, and professional healthcare contacts prior to and after GT placement were recorded and compared. Feeding and eating outcomes were assessed 4 years after GT placement. The medical records of 51 children, 28 boys and 23 girls, were analyzed and grouped according to "acquired" (n = 13) or "developmental" (n = 38) primary diagnoses. At 4 years after GT placement, 67% were still using GT. Only 6 of 37 (16%) children with developmental disorders transferred to eating all orally, as opposed to 10 of 11 (91%) children with acquired disorders. Children with developmental disorders were younger at the time of GT placement and displayed a longer duration of GT activity when compared with children with acquired disorders. This study demonstrates a clear difference between children with developmental or acquired disorders in duration of GT activity and age at GT placement. The study further shows that healthcare provided to children with GT is in some cases multidisciplinary, but primarily focuses on feeding rather than eating. © 2018 American Society for Parenteral and Enteral Nutrition.

  18. Community-acquired Pneumonia in Hospitalized Urban Young ...

    African Journals Online (AJOL)

    As part of a comprehensive hospital-based study of acute lower respiratory infections (ALRI) in under-five urban Nigerian children, we sought to identify the possible clinical and investigative correlates of lobar versus bronchopneumonia, and the possible determinants of mortality in community-acquired pneumonia. Over a ...

  19. Evaluating the CARE4Carer Blended Care Intervention for Partners of Patients With Acquired Brain Injury : Protocol for a Randomized Controlled Trial

    NARCIS (Netherlands)

    Cox, Vincent Cm; Schepers, Vera Pm; Ketelaar, Marjolijn; van Heugten, Caroline M; Visser-Meily, Johanna Ma

    2018-01-01

    BACKGROUND: Support programs for partners of patients with acquired brain injury are necessary since these partners experience several unfavorable consequences of caregiving, such as a high burden, emotional distress, and poor quality of life. Evidence-based support strategies that can be included

  20. Organising health care services for people with an acquired brain injury: an overview of systematic reviews and randomised controlled trials.

    Science.gov (United States)

    Laver, Kate; Lannin, Natasha A; Bragge, Peter; Hunter, Peter; Holland, Anne E; Tavender, Emma; O'Connor, Denise; Khan, Fary; Teasell, Robert; Gruen, Russell

    2014-09-17

    Acquired brain injury (ABI) is the leading cause of disability worldwide yet there is little information regarding the most effective way to organise ABI health care services. The aim of this review was to identify the most up-to-date high quality evidence to answer specific questions regarding the organisation of health care services for people with an ABI. We conducted a systematic review of English papers using MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library. We included the most recently published high quality systematic reviews and any randomised controlled trials, non-randomised controlled trials, controlled before after studies or interrupted time series studies published subsequent to the systematic review. We searched for papers that evaluated pre-defined organisational interventions for adults with an ABI. Organisational interventions of interest included fee-for-service care, integrated care, integrated care pathways, continuity of care, consumer engagement in governance and quality monitoring interventions. Data extraction and appraisal of included reviews and studies was completed independently by two reviewers. A total of five systematic reviews and 21 studies were included in the review; eight of the papers (31%) included people with a traumatic brain injury (TBI) or ABI and the remaining papers (69%) included only participants with a diagnosis of stroke. We found evidence supporting the use of integrated care to improve functional outcome and reduce length of stay and evidence supporting early supported discharge teams for reducing morbidity and mortality and reducing length of stay for stroke survivors. There was little evidence to support case management or the use of integrated care pathways for people with ABI. We found evidence that a quality monitoring intervention can lead to improvements in process outcomes in acute and rehabilitation settings. We were unable to find any studies meeting our inclusion criteria regarding fee