WorldWideScience

Sample records for current review examines

  1. Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset

    Directory of Open Access Journals (Sweden)

    Sun-ju Byeon

    2017-03-01

    Full Text Available Background Pathologic examinations play an important role in medical services. Until recently, the overall status of pathologic examinations in Korea has not been identified. I conducted a nationwide survey of pathologic examination status using the insurance reimbursements (IRs dataset from the Health Insurance Review and Assessment Service (HIRA. The aims of this study were to estimate current pathologic examination status in Korea and to provide information for future resource arrangement in the pathology area. Methods I asked HIRA to provide data on IR requests, including pathologic examinations from 2011 to 2015. Pathologic examination status was investigated according to the following categories: annual statistics, requesting department, type of medical institution, administrative district, and location at which pathologic examinations were performed. Results Histologic mapping, immunohistochemistry, and cervicovaginal examinations have increased in the last 5 years. Internal medicine, general surgery, obstetrics/gynecology, and urology were the most common medical departments requesting pathologic examinations. The majority of pathologic examinations were frequently performed in tertiary hospitals. About 60.3% of pathologic examinations were requested in medical institutions located in Seoul, Gyeonggi-do, and Busan. More than half of the biopsies and aspiration cytologic examinations were performed using outside services. The mean period between IR requests and 99 percentile IR request completion inspections was 6.2 months. Conclusions This survey was based on the HIRA dataset, which is one of the largest medical datasets in Korea. The trends of some pathologic examinations were reflected in the policies and needs for detailed diagnosis. The numbers and proportions of pathologic examinations were correlated with the population and medical institutions of the area, as well as patient preference. These data will be helpful for future

  2. Temporomandibular joint examination reviewed

    Directory of Open Access Journals (Sweden)

    L. Guarda Nardini

    2011-09-01

    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  3. Electric current sensors: a review

    International Nuclear Information System (INIS)

    Ripka, Pavel

    2010-01-01

    The review makes a brief overview of traditional methods of measurement of electric current and shows in more detail relatively new types of current sensors. These include Hall sensors with field concentrators, AMR current sensors, magneto-optical and superconducting current sensors. The influence of the magnetic core properties on the error of the current transformer shows why nanocrystalline materials are so advantageous for this application. Built-in CMOS current sensors are important tools for monitoring the health of integrated circuits. Of special industrial value are current clamps which can be installed without breaking the measured conductor. Parameters of current sensors are also discussed, including geometrical selectivity. This parameter specific for current sensors means the ability to suppress the influence of currents external to the sensor (including the position of the return conductor) and also suppress the influence on the position of the measured conductor with respect to the current. (topical review)

  4. Anterior chest wall examination reviewed

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    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  5. Internet Addiction: A Current Review

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    Hasan Bozkurt

    2016-09-01

    Full Text Available Internet addiction, which has become a global social issue, can be broadly conceptualized as an inability to control ones use of the Internet which leads to negative consequences in daily life. Only Internet Gaming Disorder has been included in the appendix of the diagnostic and statistical manual of mental disorders fifth edition (DSM-5, but it has already been argued that Internet addiction could also comprise problematic use of other Internet applications developing an addictive behavior. This paper aims to give a current review of the gradually evolving body of literature on Internet addiction. [J Contemp Med 2016; 6(3.000: 235-247

  6. Peripartum Cardiomyopathy: A Current Review

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    Katie M. Twomley

    2010-01-01

    Full Text Available Peripartum cardiomyopathy (PPCM is a rare but potentially lethal complication of pregnancy occurring in approximately 1 : 3,000 live births in the United States although some series report a much higher incidence. African-American women are particularly at risk. Diagnosis requires symptoms of heart failure in the last month of pregnancy or within five months of delivery in the absence of recognized cardiac disease prior to pregnancy as well as objective evidence of left ventricular systolic dysfunction. This paper provides an updated, comprehensive review of PPCM, including emerging insights into the etiology of this disorder as well as current treatment options.

  7. Electroconvulsive Therapy: A Current Review

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    Gokben Hizli Sayar

    2014-06-01

    Full Text Available Most of the electroconvulsive therapy guidelines state that severe major depression with psychotic features, manic delirium, or catatonia are conditions where there is a clear consensus favoring early electroconvulsive therapy. The decision to administer electroconvulsive therapy is based on an evaluation of the risks and benefits for the individual patient and involves a combination of factors, including psychiatric diagnosis, type and severity of symptoms, prior treatment history and response, identification of possible alternative treatment options, and consumer preference. In this review history, mechanisms of action, side effects that have been referenced in the literature and clinical experience are discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 107-125

  8. Review of Current Nuclear Vacuum System Technologies

    International Nuclear Information System (INIS)

    Carroll, M.; McCracken, J.; Shope, T.

    2003-01-01

    Nearly all industrial operations generate unwanted dust, particulate matter, and/or liquid wastes. Waste dust and particulates can be readily tracked to other work locations, and airborne particulates can be spread through ventilation systems to all locations within a building, and even vented outside the building - a serious concern for processes involving hazardous, radioactive, or nuclear materials. Several varieties of vacuum systems have been proposed and/or are commercially available for clean up of both solid and liquid hazardous and nuclear materials. A review of current technologies highlights both the advantages and disadvantages of the various systems, and demonstrates the need for a system designed to address issues specific to hazardous and nuclear material cleanup. A review of previous and current hazardous/nuclear material cleanup technologies is presented. From simple conventional vacuums modified for use in industrial operations, to systems specifically engineered for such purposes, the advantages and disadvantages are examined in light of the following criteria: minimal worker exposure; minimal secondary waste generation;reduced equipment maintenance and consumable parts; simplicity of design, yet fully compatible with all waste types; and ease of use. The work effort reviews past, existing and proposed technologies in light of such considerations. Accomplishments of selected systems are presented, including identified areas where technological improvements could be suggested

  9. BOOK REVIEW: The Current Comparator

    Science.gov (United States)

    Petersons, Oskars

    1989-01-01

    This 120-page book is a concise, yet comprehensive, clearly-written and well-illustrated monograph that covers the subject matter from basic principles through design, construction and calibration details to the principal applications. The book will be useful, as a primer, to the uninitiated and, as a reference book to the practitioner involved with transformer-type ratio devices. The length of the book and the style of presentation will not overburden any informed reader. The described techniques and the cited references are primarily from the work at the National Research Council, Canada (NRC). Any omissions, however, are not serious with respect to coverage of the subject matter, since most of the development work has been done at NRC. The role of transformers and transformer-like devices for establishing accurate voltage and current ratios has been recognized for over half a century. Transformer techniques were much explored and developed in the fifties and sixties for accuracy levels suitable for standards laboratories. Three-winding voltage transformers were developed for scaling of impedances in connection with the calculable Thompson Lampard capacitor; three-winding current transformers or current comparators were initially explored for the calibration of current transformers and later for specialized impedance measurements. Extensive development of the current comparator and its applications has been and is still being conducted at the NRC by a team that was started and, until his retirement, led by N L Kusters. The team is now led by W J M Moore. He and P N Miljanic, the authors of this book, have had the principal roles in the development of the current comparator. It is fortunate for the field of metrology that considerabe resources and a talented group of researchers were available to do this development along with mechanisms that were available to transfer this technology to a private sector instrument manufacturer and, thus, disseminate it world wide

  10. Review of current drive theory: selected topics

    International Nuclear Information System (INIS)

    Fisch, N.J.

    1993-01-01

    Two themes in current drive theory in tokamaks are reviewed, both relevant to the progression of tokamak experiments toward the reactor regime. First, the physics of the tail electrons is reviewed. These electrons are capable of carrying enormous rf-driven electric current, and, in the course of current-drive experiments worldwide not only has the current drive effect been demonstrated, but the underlying physical description of these tail electrons has been established. Second, anticipating the presence of the energetic alpha particles that result from D-T reactions in a reactor, certain mechanisms through which these alpha particles can be used to facilitate current-drive are reviewed. (Author)

  11. Urban Science Education: Examining Current Issues through a Historical Lens

    Science.gov (United States)

    McLaughlin, Cheryl A.

    2014-01-01

    This paper reviews and synthesizes urban science education studies published between 2000 and 2013 with a view to identifying current challenges faced by both teachers and students in urban classrooms. Additionally, this paper considers the historical events that have shaped the conditions, bureaucracies, and interactions of urban institutions.…

  12. Advanced ultrasonic and eddy current examinations of the reactor vessel

    International Nuclear Information System (INIS)

    Cvitanovic, M.; Zado, V.

    1996-01-01

    In order to improve safety and reliability of nuclear power plant components, the existing examination methods are permanently developed as well as the new methods of examination are implemented. For the same reason, beside referent requirements, complementary NDE methods are utilized. Some examination methods techniques are not required to be used by referent safety codes and standards but they are frequently practiced as additional prevention to the component failure. This article presents the state of the art methods and techniques currently applied for examination of the reactor vessel base material, clad and weld materials. (author)

  13. Reliability of eddy current examination of steam generator tubes

    International Nuclear Information System (INIS)

    Birks, A.S.; Ferris, R.H.; Doctor, P.G.; Clark, R.A.; Spanner, G.E.

    1985-04-01

    A unique study of nondestructive examination reliability is underway at the Pacific Northwest Laboratory under US Nuclear Regulatory Commission sponsorship. Project participants include the Electric Power Research Institute and consortiums from France, Italy, and Japan. This study group has conducted a series of NDE examinations of tubes from a retired-from-service steam generator, using commercially available multifrequency eddy current equipment and ASME procedures. The examination results have been analyzed to identify factors contributing to variations in NDE inspection findings. The reliability of these examinations will then be validated by destructive analyses of the steam generator tubes. The program is expected to contribute to development of a model for steam generator inservice inspection sampling plans and inspection periods, as well as to improved regulatory guidelines for tube plugging

  14. The current status of the Korean student health examination

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    Hye-Jung Shin

    2013-08-01

    Full Text Available Recent trends place an emphasis on school health care, the ultimate goal of which is to protect,maintain, and promote students’ health. School health care is a program that integrates health careservices, health education, health counseling, and local social health services. The student healthexamination (SHE system is a part of school health care and schools and communities must beavailable to provide professional health services. Pediatricians also have important roles as experts inboth school health care and the SHE system. In this article, the history of school health care, its legalbasis, and the current status of the SHE system in Korea are reviewed. Furthermore, sample surveysfrom the past few years are reviewed. Through this holistic approach, future directions are proposed forthe improvement of SHE and school health care.

  15. Urban science education: examining current issues through a historical lens

    Science.gov (United States)

    McLaughlin, Cheryl A.

    2014-12-01

    This paper reviews and synthesizes urban science education studies published between 2000 and 2013 with a view to identifying current challenges faced by both teachers and students in urban classrooms. Additionally, this paper considers the historical events that have shaped the conditions, bureaucracies, and interactions of urban institutions. When the findings from these urban science education studies were consolidated with the historical overview provided, it was revealed that the basic design and regulatory policies of urban schools have not substantively changed since their establishment in the nineteenth century. Teachers in urban science classrooms continue to face issues of inequality, poverty, and social injustice as they struggle to meet the needs of an increasingly diverse student population. Furthermore, persistent concerns of conflicting Discourses, cultural dissonance, and oppression create formidable barriers to science learning. Despite the many modifications in structure and organization, urban students are still subjugated and marginalized in systems that emphasize control and order over high-quality science education.

  16. A review of the quantum current standard

    International Nuclear Information System (INIS)

    Kaneko, Nobu-Hisa; Nakamura, Shuji; Okazaki, Yuma

    2016-01-01

    The electric current, voltage, and resistance standards are the most important standards related to electricity and magnetism. Of these three standards, only the ampere, which is the unit of electric current, is an International System of Units (SI) base unit. However, even with modern technology, relatively large uncertainty exists regarding the generation and measurement of current. As a result of various innovative techniques based on nanotechnology and novel materials, new types of junctions for quantum current generation and single-electron current sources have recently been proposed. These newly developed methods are also being used to investigate the consistency of the three quantum electrical effects, i.e. the Josephson, quantum Hall, and single-electron tunneling effects, which are also known as ‘the quantum metrology triangle’. This article describes recent research and related developments regarding current standards and quantum-metrology-triangle experiments. (topical review)

  17. Slurry steam generator program and baseline eddy current examination

    International Nuclear Information System (INIS)

    Clark, R.A.; Doctor, P.G.

    1985-01-01

    The Steam Generator Group Project was initiated in January 1982 with formation of consortium including NRC, EPRI, Japanese, French, and Italian participants. The project utilizes a retired-from-service nuclear steam generator established in a specially designed facility which houses the unit in its normal vertical operating position. The most important objectives deal with validation of nondestructive examination (NDE) techniques used to characterize steam generators during service. This research generator offers the first opportunity to characterize a statistically significant number of service-induced defects nondestructively followed by destructive metallographic confirmation. The project seeks to establish the reliability of defect detection and the accuracy of sizing defects via current state-of-the-art NDE. Other service degraded tubes will be burst tested to establish remaining service integrity. The integrity information and NDE reliability results will serve as inputs to establish a model for steam generator in-service inspections, and provide a data base for evaluation of tube plugging criteria. In addition to NDE validation goals, the project will use the service degraded generator as a specimen for demonstration/proof testing of repair and maintenance techniques, including chemical cleaning/decontamination technologies. In addition to the efforts associated with NDE, a multitude of other project tasks have continued through 1984, and results are presented

  18. Surry steam generator program and baseline eddy current examination

    International Nuclear Information System (INIS)

    Clark, R.A.; Doctor, P.G.

    1985-01-01

    The Steam Generator Group Project was initiated in January 1982 with formation of consortium including NRC, EPRI, Japanese, French, and Italian participants. The project utilizes a retired-from-service nuclear steam generator established in a specially designed facility which houses the unit in its normal vertical operating position. The most important objectives deal with validation of nondestructive examination (NDE) techniques used to characterize steam generators during service. This research generator offers the first opportunity to characterize a statistically significant number of service-induced defects nondestructively followed by destructive metallographic confirmation. The project seeks to establish the reliability of defect detection and the accuracy of sizing defects via current state-of-the-art NDE. Other service degraded tubes will be burst tested to establish remaining service integrity. The integrity information and NDE reliability results will serve as inputs to establish a model for steam generator in-service inspections, and provide a data base for evaluation of tube plugging criteria. In addition to NDE validation goals, the project will use the service degraded generator as a specimen for demonstration/proof testing of repair and maintenance techniques, including chemical cleaning/decontamination technologies. In addition to the efforts associated with NDE, a multitude of other project tasks have continued through 1984, and results are presented

  19. Current biodiesel production technologies: A comparative review

    International Nuclear Information System (INIS)

    Abbaszaadeh, Ahmad; Ghobadian, Barat; Omidkhah, Mohammad Reza; Najafi, Gholamhassan

    2012-01-01

    Highlights: ► In this paper we review the technologies related to biodiesel production. ► 4 Primary approaches reviewed are direct use and blending of oils, micro-emulsions, pyrolysis and transesterification method. ► Both advantages and disadvantages of the different biodiesel production methods are also discussed. ► The most common technology of biodiesel production is transesterification of oils. ► Selection of a transesterification method depends on the amount of FFA and water content of the feedstock. - Abstract: Despite the high energy demand in the industrialized world and the pollution problems caused by widespread use of fossil fuels, the need for developing renewable energy sources with less environmental impacts are increasing. Biodiesel production is undergoing rapid and extensive technological reforms in industries and academia. The major obstacle in production and biodiesel commercialization path is production cost. Thus, in previous years numerous studies on the use of technologies and different methods to evaluate optimal conditions of biodiesel production technically and economically have been carried out. In this paper, a comparative review of the current technological methods so far used to produce biodiesel has been investigated. Four primary approaches to make biodiesel are direct use and blending of vegetable oils, micro-emulsions, thermal cracking (pyrolysis) and transesterification. Transesterification reaction, the most common method in the production of biodiesel, is emphasized in this review. The two types of transestrification process; catalytic and non-catalytic are discussed at length in the paper. Both advantages and disadvantages of the different biodiesel production methods are also discussed.

  20. Peer Review Improves the Quality of MCQ Examinations

    Science.gov (United States)

    Malau-Aduli, Bunmi S.; Zimitat, Craig

    2012-01-01

    The aim of this study was to assess the effect of the introduction of peer review processes on the quality of multiple-choice examinations in the first three years of an Australian medical course. The impact of the peer review process and overall quality assurance (QA) processes were evaluated by comparing the examination data generated in earlier…

  1. 13 CFR 120.1055 - Review and examination results.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Review and examination results. 120.1055 Section 120.1055 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1055 Review and examination results. (a) Written Reports...

  2. Examining Marketing Journals' Publication Process and Reviewer Practices

    Science.gov (United States)

    Seiler, Vicky L.; Reisenwitz, Timothy H.; Schibrowsky, John A.

    2011-01-01

    This study examines reviewer practices at 11 marketing journals. The results for the top three journals are compared to eight comparable journals that are typically considered to be non-top-tier journals. The results suggest that the reviewers and the review processes at the top journals differ significantly from those of the non-top-tier…

  3. Review: Current Advances in Gloriosa superba L.

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    MAHENDRA K. RAI

    2009-10-01

    Full Text Available Gloriosa superba L. is an important medicinal plant of Asia and Africa. It is used in diseases, like cancer, gout, scrofula and act as antipyretic, antihelmintic, purgative and antiabortive. It is a source of colchicines and colchicocides, which are very costly, being highly demanded by pharma industries. Due to excessive use of the plant for diverse medicinal purposes the species is on the verge of extinction and included in Red Data Book. The strenuous efforts of botanists, biotechnologists, policy makers and conservationists are required. It is a matter of great concern to conserve this plant otherwise we will be loosing it by 2020.The present review is focused on current status of the genus, source of alkaloids, poisonous nature, the strategies for its conservation and future perspectives of G. superba.

  4. Avoidant Personality Disorder: a Current Review.

    Science.gov (United States)

    Weinbrecht, Anna; Schulze, Lars; Boettcher, Johanna; Renneberg, Babette

    2016-03-01

    This review focuses on recent research on diagnostic aspects, etiology, and treatment of avoidant personality disorder (AVPD). Current studies stress the close relation between AVPD and social anxiety disorder, the influence of genetic factors in the development of AVPD, and the relative stability of symptoms. Treatment approaches should target the pervasive patterns of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Empirical evidence for cognitive-behavior and schema therapy is promising. Few other therapeutic approaches have been developed, but until now, these have only been investigated in case studies. We conclude that AVPD qualifies as a neglected disorder and that more research specifically on avoidant personality disorder symptoms and its treatment is needed.

  5. First language transfer in second language writing: An examination of current research

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    Khaled Karim

    2013-01-01

    Full Text Available First language (L1 transfer has been a key issue in the field of applied linguistics, second language acquisition (SLA, and language pedagogy for almost a century. Its importance, however, has been re-evaluated several times within the last few decades. The aim of this paper is to examine current research that has investigated the role of L1 transfer in second language (L2 writing. The paper begins by discussing the different views of L1 transfer and how they have changed over time and then reviews some of the major studies that have examined the role of L1 transfer both as a learning tool and as a communicative strategy in L2 writing. The paper concludes with a number of suggestions for L2 writing instruction and future research.

  6. Narcissistic personality disorder: a current review.

    Science.gov (United States)

    Ronningstam, Elsa

    2010-02-01

    The diagnosis of narcissistic personality disorder in the DSM-IV has been criticized foremost for its limitations in capturing the range and complexity of narcissistic pathology. The attention to the narcissistic individual's external, symptomatic, or social interpersonal patterns--at the expense of his or her internal complexity and individual suffering--has also added to the diagnosis' low clinical utility and limited guidance for treatment. Recent studies and reviews have pointed to the need for change in the diagnostic approach to and formulation of narcissism. This review focuses specifically on studies of features that add to the identification, understanding, and treatment of patients with pathological narcissistic functioning and narcissistic personality disorder. They have been integrated into a regulatory model that includes the functions and fluctuations of internal control, self-esteem, perfectionism with accompanying self-criticism, shame, and empathic ability and functioning.

  7. Current surgery of retinal detachment recurrence. Review

    Directory of Open Access Journals (Sweden)

    V. D. Zakharov

    2012-01-01

    Full Text Available this review presents a detailed analysis and an experience of surgical treatment of retinal detachment recurrence associated with light silicone oil tamponade of vitreous cavity. Approaches and variants of treatment were described in the historical aspect and till now. there are considered general and particular issues in case of retinal detachment recurrence appearance, expediency and volume of intraoperative manipulations, time of operation and choice of temporary substitute of vitreous body for a purpose of postoperative tamponade of vitreous cavity.

  8. Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

    Science.gov (United States)

    Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

    2016-02-01

    Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

  9. Physical examinations and laboratory tests in antenatal care visits in Denmark. Do reported practice and current official guidelines concord with results of literature reviews? A nationwide study of the public scheme of shared antenatal care in general practice, centres of midwifery and hospital

    DEFF Research Database (Denmark)

    Kristensen, F B; Andersen, K V; Andersen, A M

    1995-01-01

    To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness.......To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness....

  10. Review of current and coming attractions

    Energy Technology Data Exchange (ETDEWEB)

    Byrne, G.D.; Hindmarsh, A.C.

    1987-05-01

    Stiff ordinary differential equation (ODEs) can now be solved more or less routinely. This review is intended for the user who is interested in learning how to solve these systems of equations. Consequently, this review explains what stiff ODEs are and where they arise. It tells what is expected of the solftware and sketches how it works. So, several tried and true, as well as experimental, numerical methods are outlined. Perhaps the most salient feature is a set of examples that has been compiled during the last 15 years. These examples include several prototypical problems. The problems are deliberately tractable in size, yet display features of much larger problems in science and engineering. In each case, the choice of the software package, the ODE solver, is given. These choices are based on the author's combined experience and take into account problem structure. This then is a brief handbook which could be used to learn or to teach the pragmatics of numerically solving stiff ODEs. This work should be useful to line scientists, scientific computing managers, and to students. copyright 1987 Academic Press, Inc.

  11. Antisocial personality disorder: a current review.

    Science.gov (United States)

    Glenn, Andrea L; Johnson, Alexandria K; Raine, Adrian

    2013-12-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) classification of antisocial personality disorder (ASPD) describes individuals who engage in repetitive irresponsible, delinquent, and criminal behavior. The diagnosis is highly controversial, with many researchers and clinicians arguing that the category is too heterogeneous, overinclusive, and demonstrates considerable overlap with other disorders. This review focuses on recent studies that have improved our understanding of the characteristics of individuals who fit the ASPD definition by exploring how subtypes differ and how comorbid conditions influence the presentation of ASPD. In addition, we discuss research on the etiology of ASPD that has identified genetic and environmental factors that may contribute to the development and persistence of antisocial behavior, and brain imaging research that has improved our understanding of the relationships between ASPD and other psychopathology. Finally, we discuss promising preliminary research on treatment for this disorder.

  12. Physical examination prior to initiating hormonal contraception: a systematic review.

    Science.gov (United States)

    Tepper, Naomi K; Curtis, Kathryn M; Steenland, Maria W; Marchbanks, Polly A

    2013-05-01

    Provision of contraception is often linked with physical examination, including clinical breast examination (CBE) and pelvic examination. This review was conducted to evaluate the evidence regarding outcomes among women with and without physical examination prior to initiating hormonal contraceptives. The PubMed database was searched from database inception through March 2012 for all peer-reviewed articles in any language concerning CBE and pelvic examination prior to initiating hormonal contraceptives. The quality of each study was assessed using the United States Preventive Services Task Force grading system. The search did not identify any evidence regarding outcomes among women screened versus not screened with CBE prior to initiation of hormonal contraceptives. The search identified two case-control studies of fair quality which compared women who did or did not undergo pelvic examination prior to initiating oral contraceptives (OCs) or depot medroxyprogesterone acetate (DMPA). No differences in risk factors for cervical neoplasia, incidence of sexually transmitted infections, incidence of abnormal Pap smears or incidence of abnormal wet mount findings were observed. Although women with breast cancer should not use hormonal contraceptives, there is little utility in screening prior to initiation, due to the low incidence of breast cancer and uncertain value of CBE among women of reproductive age. Two fair quality studies demonstrated no differences between women who did or did not undergo pelvic examination prior to initiating OCs or DMPA with respect to risk factors or clinical outcomes. In addition, pelvic examination is not likely to detect any conditions for which hormonal contraceptives would be unsafe. Published by Elsevier Inc.

  13. Extended trochanteric osteotomy: current concepts review.

    Science.gov (United States)

    Sambandam, Senthil Nathan; Duraisamy, Gopinath; Chandrasekharan, Jayadev; Mounasamy, Varatharaj

    2016-04-01

    Revision total hip arthroplasty is a technically demanding procedure which has gained importance for more than two decades. It was a nightmare for revision surgeons during its initial years of inception before the advent of extended trochanteric osteotomy (ETO). This technique gains access to the femoral medullary canal without compromising the bone stock and aids removal of primary implant and cement mantle without further damaging the parent bone. Like any other surgery, ETO does have certain limitations and complications as reported by various authors. Though it has been routinely used by revision surgeons, thorough knowledge of technical details of ETO is still lacking. So this review article is aimed at addressing the indications, surgical procedure, fixation technique, implant selection and complication of ETO which has been presented over a period of years by various authors. We searched in the most commonly used portals like MEDLINE (PubMed) and Google scholar using appropriate terminologies for the literature regarding the various preoperative, intraoperative and postoperative clinical scenarios in which revision surgeons utilized ETO. ETO is an important tool in the revision surgeon's armamentarium and can be used in variety of clinical scenarios and for various intraoperative needs and goals. Awareness about biomechanics of ETO, indications, implants selection, fixation techniques and complications is paramount for good intraoperative and postoperative outcome. ETO by posterior approach continues to be a work horse approach for most revision surgeons all over the world.

  14. Technology - a review of current status

    International Nuclear Information System (INIS)

    Wolf, R.

    1986-01-01

    The book reviews the history of the efforts taken by the political and administrative authorities to acquire the technical knowledge required to fulfill their functions as competent authorities to evaluate and decide on technical feasibility and economic justification of complex technical processes, a task which constantly puts strain on the authorities, who have to keep up with the technological know-how of the industrial and technological establishments who, as it where, stand opposite to the authorities in the process of legal regulation of technological risks. The author explains the problems involved in the attempt to use existing, or establish adequate new, legal provisions to reconcile the interests of the law with those of the economy. The leading example for this purpose is the air pollution control laws. Further aspects discussed are steps taken from a technicalization of the law towards a proceduralization, and attempts towards a control of technology in a democratic constitutional state. The chapter on the 'risk to be tolerated' in the law on licensing of nuclear installations has been separately analysed and abstracted for the database. (HSCH) [de

  15. Teaching hydrogeology: a review of current practice

    Science.gov (United States)

    Gleeson, T.; Allen, D. M.; Ferguson, G.

    2012-07-01

    Hydrogeology is now taught in a broad spectrum of departments and institutions to students with diverse backgrounds. Successful instruction in hydrogeology thus requires a variety of pedagogical approaches depending on desired learning outcomes and the background of students. We review the pedagogical literature in hydrogeology to highlight recent advances and analyze a 2005 survey among 68 hydrogeology instructors. The literature and survey results suggest there are only ~ 15 topics that are considered crucial by most hydrogeologists and > 100 other topics that are considered crucial by some hydrogeologists. The crucial topics focus on properties of aquifers and fundamentals of groundwater flow, and should likely be part of all undergraduate hydrogeology courses. Other topics can supplement and support these crucial topics, depending on desired learning outcomes. Classroom settings continue to provide a venue for emphasizing fundamental knowledge. However, recent pedagogical advances are biased towards field and laboratory instruction with a goal of bolstering experiential learning. Field methods build on the fundamentals taught in the classroom and emphasize the collection of data, data uncertainty, and the development of vocational skills. Laboratory and computer-based exercises similarly build on theory, and offer an opportunity for data analysis and integration. The literature suggests curricula at all levels should ideally balance field, laboratory, and classroom pedagogy into an iterative and integrative whole. An integrated, iterative and balanced approach leads to greater student motivation and advancement of theoretical and vocational knowledge.

  16. Effect of tube current modulation for dose estimation using a simulation tool on body CT examination

    International Nuclear Information System (INIS)

    Kawaguchi, Ai; Matsunaga, Yuta; Kobayashi, Masanao; Suzuki, Shoichi; Matsubara, Kosuke; Chida, Koichi

    2015-01-01

    The purpose of this study was to evaluate the effect of tube current modulation for dose estimation of a body computed tomography (CT) examination using a simulation tool. The authors also compared longitudinal variations in tube current values between iterative reconstruction (IR) and filtered back-projection (FBP) reconstruction algorithms. One hundred patients underwent body CT examinations. The tube current values around 10 organ regions were recorded longitudinally from tube current information. The organ and effective doses were simulated by average tube current values and longitudinal modulated tube current values. The organ doses for the bladder and breast estimated by longitudinal modulated tube current values were 20 % higher and 25 % lower than those estimated using the average tube current values, respectively. The differences in effective doses were small (mean, 0.7 mSv). The longitudinal variations in tube current values were almost the same for the IR and FBP algorithms. (authors)

  17. Veganism and osteoporosis: a review of the current literature.

    Science.gov (United States)

    Smith, Annabelle M

    2006-10-01

    The purpose of this review is to examine the current literature regarding calcium and Vitamin D deficiencies in vegan diets and the possible relationship to low bone mineral density and incidence for fracture. Prominent databases were searched for original research publications providing data capable of answering these questions: (i) Do vegans have lower-than-recommended levels of calcium/Vitamin D? (ii) Do vegans have lower bone mineral density than their non-vegan counterparts? (iii) Are vegans at a greater risk for fractures than non-vegans? The findings gathered consistently support the hypothesis that vegans do have lower bone mineral density than their non-vegan counterparts. However, the evidence regarding calcium, Vitamin D and fracture incidence is inconclusive. More research is needed to definitively answer these questions and to address the effects of such deficiencies on the medical and socioeconomic aspects of life.

  18. Current concepts review: Fractures of the patella

    Science.gov (United States)

    Gwinner, Clemens; Märdian, Sven; Schwabe, Philipp; Schaser, Klaus-D.; Krapohl, Björn Dirk; Jung, Tobias M.

    2016-01-01

    Fractures of the patella account for about 1% of all skeletal injuries and can lead to profound impairment due to its crucial function in the extensor mechanism of the knee. Diagnosis is based on the injury mechanism, physical examination and radiological findings. While the clinical diagnosis is often distinct, there are numerous treatment options available. The type of treatment as well as the optimum timing of surgical intervention depends on the underlying fracture type, the associated soft tissue damage, patient factors (i.e. age, bone quality, activity level and compliance) and the stability of the extensor mechanism. Regardless of the treatment method an early rehabilitation is recommended in order to avoid contractures of the knee joint capsule and cartilage degeneration. For non-displaced and dislocated non-comminuted transverse patellar fractures (2-part) modified anterior tension band wiring is the treatment of choice and can be combined – due to its biomechanical superiority – with cannulated screw fixation. In severe comminuted fractures, open reduction and fixation with small fragment screws or new angular stable plates for anatomic restoration of the retropatellar surface and extension mechanism results in best outcome. Additional circular cerclage wiring using either typical metal cerclage wires or resorbable PDS/non-resorbable FiberWires increases fixation stability and decreases risk for re-dislocation. Distal avulsion fractures should be fixed with small fragment screws and should be protected by a transtibial McLaughlin cerclage. Partial or complete patellectomy should be regarded only as a very rare salvage operation due to its severe functional impairment. PMID:26816667

  19. Low-Frequency Pulsed Current Versus Kilohertz-Frequency Alternating Current: A Scoping Literature Review.

    Science.gov (United States)

    Vaz, Marco Aurélio; Frasson, Viviane Bortoluzzi

    2018-04-01

    To compare the effectiveness of low-frequency pulsed current versus kilohertz-frequency alternating current in terms of evoked force, discomfort level, current intensity, and muscle fatigability; to discuss the physiological mechanisms of each neuromuscular electrical stimulation type; and to determine if kilohertz-frequency alternating current is better than low-frequency pulsed current for clinical treatment. Articles were obtained from PubMed, Scopus, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, and SPORTSDiscus databases using the terms Russian current or kilohertz current or alternating current or pulsed current or Aussie current and torque or discomfort or fatigue or current intensity, and through citation tracking up to July 2017. Two independent reviewers selected studies comparing the use of the 2 neuromuscular electrical stimulation currents. Studies describing maximal current intensity tolerated and the main effects of the 2 different current types on discomfort, muscle force, and fatigability were independently reviewed. Data were systematized according to (1) methodology; (2) electrical current characteristics; and (3) outcomes on discomfort level, evoked force, current intensity, and muscle fatigability. The search revealed 15 articles comparing the 2 current types. Kilohertz-frequency alternated current generated equal or less force, similar discomfort, similar current intensity for maximal tolerated neuromuscular electrical stimulation, and more fatigue compared with low-frequency pulsed current. Similar submaximal levels of evoked force revealed higher discomfort and current intensity for kilohertz-frequency alternated current compared with low-frequency pulsed current. Available evidence does not support the idea that kilohertz-frequency alternated current is better than low-frequency pulsed current for strength training and rehabilitation. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier

  20. Aptamer therapeutics: A review of current practice

    International Nuclear Information System (INIS)

    Perkins, A.C.; Missailidis, S.

    2007-01-01

    meet the criteria for robust, generic drug discovery technology and open new horizons for the development of future radiopharmaceuticals. We have shown that aptamers directed against the MUC1 antigen, a tumour marker previously extensively used in tumour imaging and therapy, demonstrated high specificity and uniform penetration in tumour xenografts. The future strategy will be to manipulate the molecular weight of the molecules to achieve an optimum balance between the low immunogenicity and excellent tumour penetration for diagnostic imaging and targeted therapy. In this way, a balance can be achieved between the rapid renal clearance and adequate tumour uptake required for diagnostic imaging and targeted therapy. The current work and future prospects for aptamer therapeutics will be described. (author)

  1. Use of eddy current mixes to solve a weld examination application

    International Nuclear Information System (INIS)

    Ward, R.C.; LaBoissonniere, A.

    1995-01-01

    The augmentation of typical nondestructive (i.e., ultrasound) weld inspection techniques by the use of eddy current tools may significantly enhance the quality and reliability of weld inspections. One recent example is the development of an eddy current technique for use in the examination of BWR core shroud welds, where multi-frequency mixes are used to eliminate signals coming from the weld material so that the examination of the heat affected zone is enhanced. An analysis tool most commonly associated with ultrasound examinations, the C-Scan based on gated information, may be implemented with eddy current data to enhance analysis

  2. Current management of chronic hepatitis B: review | Cariem | South ...

    African Journals Online (AJOL)

    South African Gastroenterology Review. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 2 (2004) >. Log in or Register to get access to full text downloads.

  3. Laparoscopy in small bowel obstruction - current status - review.

    Science.gov (United States)

    Szeliga, Jacek; Jackowski, Marek

    2017-12-01

    Acute small bowel obstruction (SBO) is an urgent medical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical challenge is not a decision whether to perform a surgery, but a decision when and how to perform it. To determine the place of laparoscopy in contemporary management of acute SBO based on the current literature. A review of the literature based on the Medline database and including mainly the period of 2013-2017 was performed. With regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach. However, SBO is still a condition where the use of laparoscopy is limited mainly to selected cases such as SBO caused by single adhesions or foreign bodies. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.

  4. Examination of the Current Approaches to State-Level Nuclear Security Evaluation

    International Nuclear Information System (INIS)

    Kim, Chan; Yim, Mansung; Kim, So Young

    2014-01-01

    An effective global nuclear materials security system will cover all materials, employ international standards and best practices, and reduce risks by reducing weapons-usable nuclear material stocks and the number of locations where they are found. Such a system must also encourage states to accept peer reviews by outside experts in order to demonstrate that effective security is in place. It is thus critically important to create an integrative framework of state-level evaluation of nuclear security as a basis for measuring the level and progress of international effort to secure and control all nuclear materials. There have been studies to represent state-level nuclear security with a quantitative metric. A prime example is the Nuclear Materials Security Index (NMSI) by the Nuclear Threat Initiative (NTI). Another comprehensive study is the State Level Risk Metric by Texas A and M University (TAMU). This paper examines the current methods with respect to their strengths and weaknesses and identifies the directions for future research to improve upon the existing approaches

  5. Concussions in the National Football League: A Current Concepts Review.

    Science.gov (United States)

    Yengo-Kahn, Aaron M; Johnson, Daniel J; Zuckerman, Scott L; Solomon, Gary S

    2016-03-01

    Significant attention has been directed toward the immediate and long-term effects of sport-related concussions on athletes participating in contact sports, particularly football. The highest level of football, the National Football League (NFL), has received significant attention and criticism regarding player management and safety after mild traumatic brain injury (mTBI). Several review articles have reported data related to concussion in the NFL, but a succinct review and synthesis of data regarding NFL concussions is currently lacking. To (1) review systematically the published data regarding concussion in the NFL and assess limitations of the studies, (2) elucidate areas where further research is needed, and (3) identify methods to improve future investigations of concussion in the NFL. Systematic review of literature. English-language titles and abstracts published between 1900 and September 2014 were searched systematically across electronic databases, and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Peer-reviewed journal articles were included if they contained NFL concussion data with or without additional associated long-term effects. Reviews, editorials, letters to the editor, and comments were not included. Of the 344 records screened for review, 88 articles were assessed for eligibility. There were 31 studies that met the inclusion criteria and formed the basis of the evidence synthesis. Included in the current review were 8 case-control studies (Oxford Centre for Evidence-Based Medicine evidence level 3b), 6 descriptive epidemiological studies (level 4), 6 cross-sectional studies (level 4), 6 cohort studies (level 2b), and 5 case series (level 4). The study of concussions in the NFL has been limited by lack of recent empirical data, reliance on self-reported concussion history, and ascertainment bias of brains donated for autopsy studies. The scientific community

  6. Review of the current status of radiation risk estimates

    International Nuclear Information System (INIS)

    Charles, M.W.; Little, M.P.

    1988-10-01

    This report reviews the current status of radiation risk estimation for low linear energy transfer radiation. Recent statements by various national and international organisations regarding risk estimates are critically discussed. The recently published revised population risk estimates from the study of Japanese bomb survivors are also reviewed and used with some unpublished data from Japan to calculate risk figures for a general work force. (author)

  7. Dose reduction in subsecond multislice spiral CT examination of children by online tube current modulation

    International Nuclear Information System (INIS)

    Greess, H.; Lutze, J.; Noemayr, A.; Bautz, W.; Wolf, H.; Hothorn, T.; Kalender, W.A.

    2004-01-01

    The potential of online tube current modulation in subsecond multislice spiral CT (MSCT) examinations of children to reduce the dose without a loss in image quality is investigated in a controlled patient study. The dose can be reduced for oval patient sectional view without an increase in noise if the tube current is reduced where the patient diameter and, consequently, attenuation are small. We investigated a product version of an online control for tube current in a SOMATOM Sensation 4 (Siemens, Forchheim). We evaluated image quality, noise and dose reduction for examinations with online tube current modulation in 30 MSCT of thorax/abdomen and abdomen and compared mA s for tube current modulation to the mA s in standard weight-adapted children protocols. Image quality was rated as ''very good,'' ''good,'' ''diagnostic'' and ''poor'' in a consensus by three radiologists. Noise was assessed in comparison to 24 MSCT examinations without tube current modulation measured as SD in ROIs. The dose was reduced from 26 to 43% (mean 36%), depending on the patient's geometry and weight. (orig.)

  8. Examining Current Beliefs, Practices and Barriers about Technology Integration: A Case Study

    Science.gov (United States)

    Hsu, Pi-Sui

    2016-01-01

    The purpose of this mixed-methods study was to examine the current beliefs, practices and barriers concerning technology integration of Kindergarten through Grade Six teachers in the midwestern United States. The three data collection methods were online surveys with 152 teachers as well as interviews and observations with 8 teachers. The findings…

  9. A Systematic Review of Current Understandings of Employability

    Science.gov (United States)

    Williams, Stella; Dodd, Lorna J.; Steele, Catherine; Randall, Raymond

    2016-01-01

    A theoretical framework is essential for the effective evaluation of employability. However, there are a wide range of definitions of employability coexisting in current literature. A review into existing ways in which employability has been conceptualised is needed to inform a better understanding of the nature of contributions made by various…

  10. Aortopathy associated with congenital heart disease: A current literature review

    Directory of Open Access Journals (Sweden)

    Katrien Francois

    2015-01-01

    Full Text Available In patients born with congenital heart disease, dilatation of the aorta is a frequent feature at presentation and during follow-up after surgical intervention. This review provides an overview of the pathologies associated with aortopathy, and discusses the current knowledge on pathophysiology, evolution, and treatment guidelines of the aortic disease associated with congenital heart defects.

  11. Harmful algal blooms of the Southern Benguela current: A review ...

    African Journals Online (AJOL)

    Harmful algal blooms of the Southern Benguela current: A review and appraisal of monitoring from 1989 to 1997. ... The Benguela upwelling system is subjected to blooms of harmful and toxic algae, the incidence and consequences of which are documented here. Red tides are common and usually attributed to members of ...

  12. Review of coastal currents in Southern African waters

    CSIR Research Space (South Africa)

    Harris, TFW

    1978-08-01

    Full Text Available unevenly spaced. In regions where such studies were not available, recourse had to be made to ships' drift reports. Because of the nature of the data it was necessary to restrict the review, almost entirely, to surface currents. Where possible, wave...

  13. Aortopathy associated with congenital heart disease: A current literature review

    International Nuclear Information System (INIS)

    Francois, Katrien

    2015-01-01

    In patients born with congenital heart disease, dilatation of the aorta is a frequent feature at presentation and during follow-up after surgical intervention. This review provides an overview of the pathologies associated with aortopathy, and discusses the current knowledge on pathophysiology, evolution, and treatment guidelines of the aortic disease associated with congenital heart defects

  14. A Systematic Review of Research Studies Examining Telehealth Privacy and Security Practices Used By Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Valerie J.M. Watzlaf

    2017-11-01

    Full Text Available The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P. PubMed, CINAHL and INSPEC from 2003 – 2016 were searched and returned 25,404 papers (after duplications were removed. Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth.  Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen’s kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more studies with specific information about the use of privacy and security practices when using telehealth technologies as well as studies that examine patient and provider preferences on how data is kept private and secure during and after telehealth sessions. Keywords: Computer security, Health personnel, Privacy, Systematic review, Telehealth

  15. Surveys of current status in biomedical science grant review: funding organisations' and grant reviewers' perspectives

    DEFF Research Database (Denmark)

    Schroter, Sara; Groves, Trish; Højgaard, Liselotte

    2010-01-01

    The objectives of this research were (a) to describe the current status of grant review for biomedical projects and programmes from the perspectives of international funding organisations and grant reviewers, and (b) to explore funders' interest in developing uniform requirements for grant review...

  16. A review of current investigations and treatment modalities of the ...

    African Journals Online (AJOL)

    Infertility of the couple is a major health problem in Africa, affecting between 37- 66% of women of childbearing age in some regions of the continent. Because of the high cost of evaluation, a good history and thorough physical examination will narrow the investigations necessary for treatment. This paper briefly reviews the ...

  17. Physical examination tests for the diagnosis of posterior cruciate ligament rupture: a systematic review.

    Science.gov (United States)

    Kopkow, Christian; Freiberg, Alice; Kirschner, Stephan; Seidler, Andreas; Schmitt, Jochen

    2013-11-01

    Systematic literature review. To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of posterior cruciate ligament (PCL) tear. Rupture of the PCL is a severe knee injury that can lead to delayed rehabilitation, instability, or chronic knee pathologies. To our knowledge, there is currently no systematic review of studies on the diagnostic accuracy of clinical examination tests to evaluate the integrity of the PCL. A comprehensive systematic literature search was conducted in MEDLINE from 1946, Embase from 1974, and the Allied and Complementary Medicine Database from 1985 until April 30, 2012. Studies were considered eligible if they compared the results of physical examination tests performed in the context of a PCL physical examination to those of a reference standard (arthroscopy, arthrotomy, magnetic resonance imaging). Methodological quality assessment was performed by 2 independent reviewers using the revised version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The search strategy revealed 1307 articles, of which 11 met the inclusion criteria for this review. In these studies, 11 different physical examination tests were identified. Due to differences in study types, different patient populations, and methodological quality, meta-analysis was not indicated. Presently, most physical examination tests have not been evaluated sufficiently enough to be confident in their ability to either confirm or rule out a PCL tear. The diagnostic accuracy of physical examination tests to assess the integrity of the PCL is largely unknown. There is a strong need for further research in this area. Level of Evidence Diagnosis, level 3a.

  18. Nondestructive examination of irradiated fuel rods by pulsed eddy current techniques

    International Nuclear Information System (INIS)

    Francis, W.C.; Quapp, W.J.; Martin, M.R.; Gibson, G.W.

    1976-02-01

    A number of fuel rods and unfueled zircaloy cladding tubes which had been irradiated in the Saxton reactor have undergone extensive nondestructive and corroborative destructive examinations by Aerojet Nuclear Company as part of the Water Reactor Safety Research Program, Irradiation Effects Test Series. This report discusses the pulsed eddy current (PEC) nondestructive examinations on the fuel rods and tubing and the metallography results on two fuel rods and one irradiated zircaloy tube. The PEC equipment, designed jointly by Argonne National Laboratory and Aerojet, performed very satisfactorily the functions of diameter, profile, and wall thickness measurements and OD and ID surface defect detection. The destructive examination provided reasonably good confirmation of ''defects'' detected in the nondestructive examination

  19. Head in the Clouds: A Review of Current and Future Potential for Cloud-Enabled Pedagogies

    Science.gov (United States)

    Stevenson, Michael; Hedberg, John G.

    2011-01-01

    This paper reviews the research on the disruptive and transformative potential of newly-emerging cloud-based pedagogies. It takes into consideration the extent to which Cloud Computing can be leveraged to disseminate and scale web-based applications within and across learning contexts. It examines ideas from current literature in Web 2.0- and…

  20. Current Parental Depression and Offspring Perceived Self-Competence: A Quasi-Experimental Examination

    OpenAIRE

    Class, Quetzal A.; D’Onofrio, Brian M.; Singh, Amber L.; Ganiban, Jody M.; Spotts, E. L.; Lichtenstein, Paul; Reiss, David; Neiderhiser, Jenae M.

    2012-01-01

    A genetically-informed, quasi-experimental design was used to examine the genetic and environmental processes underlying associations between current parental depressive symptoms and offspring perceived self-competence. Participants, drawn from a population-based Swedish sample, were 852 twin pairs and their male (52%) and female offspring aged 15.7 ± 2.4 years. Parental depressive symptoms were measured using the Center for Epidemiological Studies Depression scale. Offspring perceived self-c...

  1. Review of the current status of linear hybrid reactor concepts

    International Nuclear Information System (INIS)

    Schultz, K.R.

    1977-07-01

    A review was made of the current status of linear fusion-fission hybrid reactor design studies in the USA. The linear hybrid reactor concepts reviewed include the linear theta-pinch hybrid reactor being studied at Los Alamos Scientific Laboratory, the electron beam-heated solenoid hybrid reactor under development at Physics International Co., the laser-heated solenoid hybrid reactor being investigated at Mathematical Sciences Northwest, Inc., and the linear fusion waste burning reactor being studied at General Atomic Company. The discussion addresses confinement and heating mechanisms for each concept, as well as the hybrid blanket designs. The current state of the four reactor designs is summarized and the performance of the various concepts compared

  2. Value of Travel Time Reliability: A review of current evidence

    OpenAIRE

    Carlos Carrion; David Levinson

    2010-01-01

    Travel time reliability is a fundamental factor in travel behavior. It represents the temporal uncertainty experienced by users in their movement between any two nodes in a network. The importance of the time reliability depends on the penalties incurred by the users. In road networks, travelers consider the existence of a trip travel time uncertainty in different choice situations (departure time, route, mode, and others). In this paper, a systematic review of the current state of research i...

  3. Creating Value through Virtual Teams: A Current Literature Review

    Directory of Open Access Journals (Sweden)

    Akemi Takeoka Chatfield

    2014-11-01

    Full Text Available Globally, virtual teams (VT as ICT-enabled emergent network organisation forms have gained international validity by innovative organisations, with a corresponding surge of interest in understanding how organisations can leverage VT to create business value. Despite growing deliberations in VT literature on managing VT, tasks and outcomes, however, creating business value through VT remains an unresolved theoretical and pragmatic conundrum. A review of prior relevant literature is essential to advancing knowledge. The paucity of published review articles seems to have impeded the field’s accumulation of VT knowledge. This research, therefore, reviews the current literature on case studies of VT to address the question: What are organisational challenges in creating business value through VT in the organisation? The key challenges found in the literature are effective communication, knowledge sharing, trust, and interpersonal skills in the new virtual boundary-less environment. Drawing on the IT business value model, we also discuss their resource-based implications.

  4. Medical Consequences of Marijuana Use: A Review of Current Literature

    OpenAIRE

    Gordon, Adam J.; Conley, James W.; Gordon, Joanne M.

    2013-01-01

    With the advent of legalization of marijuana for medicinal and recreational purposes, and the increase use of marijuana, healthcare providers will be increasingly confronted with marijuana users as patients in clinical environments. While there is vast literature regarding the societal and mental health harms associated with marijuana use, there is a paucity of reviews of the potential consequences of marijuana use on physical health or medical conditions. We examine the recent literature on ...

  5. Spontaneous and persistent currents in superconductive and mesoscopic structures (Review)

    Science.gov (United States)

    Kulik, I. O.

    2004-07-01

    We briefly review aspects of superconductive persistent currents in Josephson junctions of the S/I/S, S/O/S and S/N/S types, focusing on the origin of jumps in the current versus phase dependences, and discuss in more detail the persistent and the "spontaneous" currents in Aharonov-Bohm mesoscopic and nanoscopic (macromolecular) structures. A fixed-number-of-electrons mesoscopic or macromolecular conducting ring is shown to be unstable against structural transformation removing spatial symmetry (in particular, azimuthal periodicity) of its electron-lattice Hamiltonian. In the case when the transformation is blocked by strong coupling to an external azimuthally symmetric environment, the system becomes bistable in its electronic configuration at a certain number of electrons. Under such a condition, the persistent current has a nonzero value even at an (almost) zero applied Aharonov-Bohm flux and results in very high magnetic susceptibility dM/dH at small nonzero fields, followed by an oscillatory dependence at larger fields. We tentatively assume that previously observed oscillatory magnetization in cyclic metallo-organic molecules by Gatteschi et al. can be attributed to persistent currents. If this proves correct, it may present an opportunity for (and, more generally, macromolecular cyclic structures may suggest the possibility of) engineering quantum computational tools based on the Aharonov-Bohm effect in ballistic nanostructures and macromolecular cyclic aggregates.

  6. Current Status of Periodic Safety Review of HANARO Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Minjin; Ahn, Guk-Hoon; Lee, Choong Sung [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    A PSR for a research reactor became a legal requirement as the Nuclear Safety Act was amended and came into effect in 2014. This paper describes the current status and methodology of the first Periodic Safety Review (PSR) of HANARO that is being performed. The legal requirements, work plan, and process of implementing a PSR are described. Because this is the first PSR for a research reactor, it is our understating that the operating organization and regulatory body should communicate well with each other to complete the PSR in a timely manner. The first PSR of HANARO is under way. In order to achieve a successful result, activities of the operation organization such as scheduling, maintaining consistency in input data for review, and reviewing the PSR reports that will require intensive resources should be well planned. This means the operating organization needs to incorporate appropriate measures to ensure the transfer of knowledge and expertise arising from the PSR via a contractor to the operation organization. It is desirable for the Regulatory Body to be involved in all stage of the PSR to prevent any waste of resources and minimize the potential for a reworking of the PSR and the need for an additional assessment and review as recommended by foreign experts.

  7. Computational chemistry reviews of current trends v.4

    CERN Document Server

    1999-01-01

    This volume presents a balanced blend of methodological and applied contributions. It supplements well the first three volumes of the series, revealing results of current research in computational chemistry. It also reviews the topographical features of several molecular scalar fields. A brief discussion of topographical concepts is followed by examples of their application to several branches of chemistry.The size of a basis set applied in a calculation determines the amount of computer resources necessary for a particular task. The details of a common strategy - the ab initio model potential

  8. Current applications of nanotechnology in dentistry: a review.

    Science.gov (United States)

    Bhavikatti, Shaeesta Khaleelahmed; Bhardwaj, Smiti; Prabhuji, M L V

    2014-01-01

    With the increasing demand for advances in diagnosis and treatment modalities, nanotechnology is being considered as a groundbreaking and viable research subject. This technology, which deals with matter in nanodimensions, has widened our views of poorly understood health issues and provided novel means of diagnosis and treatment. Researchers in the field of dentistry have explored the potential of nanoparticles in existing therapeutic modalities with moderate success. The key implementations in the field of dentistry include local drug delivery agents, restorative materials, bone graft materials, and implant surface modifications. This review provides detailed insights about current developments in the field of dentistry, and discusses potential future uses of nanotechnology.

  9. Individual Performance Management: A Review of Current Practices

    Directory of Open Access Journals (Sweden)

    Ian O’ Boyle

    2013-05-01

    Full Text Available This paper provides a review of current practice in relation to individual performance management systems and process within the traditional business environment. There is a consensus that the role of the individual is central to the overall performance of any organization and how individual performances are managed and evaluated can have significant impacts on overall organizational success. Many organizations employ the traditional performance appraisal in order to monitor and assess individual employee performances. However, new approaches, such as 360-degree feedback have also become commonplace within the business environment. An analysis of each approach including benefits and challenges associated with each process is presented within this paper.

  10. Sportsman hernia; the review of current diagnosis and treatment modalities.

    Science.gov (United States)

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature.

  11. Review: New Vaccine Against Tuberculosis: Current Developments and Future Challenges

    Science.gov (United States)

    Liu, Jun

    2009-04-01

    Tuberculosis (TB) continues to be a global health threat. BCG was developed as an attenuated live vaccine for tuberculosis control nearly a century ago. Despite being the most widely used vaccine in human history, BCG is not an ideal vaccine and has two major limitations: its poor efficacy against adult pulmonary TB and its disconcerting safety in immunocompromised individuals. A safer and more effective TB vaccine is urgently needed. This review article discusses current strategies to develop the next generation of TB vaccines to replace BCG. While some progresses have been made in the past decade, significant challenges lie ahead.

  12. Robotic bariatric surgery: A general review of the current status.

    Science.gov (United States)

    Jung, Minoa K; Hagen, Monika E; Buchs, Nicolas C; Buehler, Leo H; Morel, Philippe

    2017-12-01

    While conventional laparoscopy is the gold standard for almost all bariatric procedures, robotic assistance holds promise for facilitating complex surgeries and improving clinical outcomes. Since the report of the first robotic-assisted bariatric procedure in 1999, numerous publications, including those reporting comparative trials and meta-analyses across bariatric procedures with a focus on robotic assistance, can be found. This article reviews the current literature and portrays the perspectives of robotic bariatric surgery. While there are substantial reports on robotic bariatric surgery currently in publication, most studies suffer from low levels of evidence. As such, although robotics technology is without a doubt superior to conventional laparoscopy, the precise role of robotics in bariatric surgery is not yet clear. Copyright © 2017 John Wiley & Sons, Ltd.

  13. 76 FR 81999 - Submission for Review: Certificate of Medical Examination

    Science.gov (United States)

    2011-12-29

    ... information about individuals who are incumbents of positions which require physical fitness/agility testing and/or medical examinations, or who have been selected for such a position contingent upon meeting... Americans with Disabilities Act (ADA). As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13...

  14. Pulsed eddy current inspection system for nondestructive examination of irradiated fuel rods

    International Nuclear Information System (INIS)

    Yancey, M.E.

    1979-01-01

    An inspection system has been developed for nondestructive examination of irradiated fuel rods utilizing pulsed eddy current techniques. The system employs an encircling type pulsed eddy current transducer capable of sensing small defects located on both the inner and outer diameter fuel rod surfaces during a single scan. Pulsed eddy current point probes are used to provide fuel rod wall thikness data and an indication of radial defect location. Two linear variable differential transformers are used to provide information on fuel rod diameter variation. A microprocessor based control system is used to automatically scan fuel rods up to 4.06 meters in length at predetermined radial locations. Defects as small as 0.005 cm deep by 0.254 cm long by 0.005 cm wide have been detected on outside diameter surfaces of a 1.43 cm outside diameter fuel rod cladding with a 0.094 cm wall thickness and 0.010 cm deep by 0.254 cm long by 0.005 cm wide on the inside diameter surface

  15. Addressing unwarranted clinical variation: A rapid review of current evidence.

    Science.gov (United States)

    Harrison, Reema; Manias, Elizabeth; Mears, Stephen; Heslop, David; Hinchcliff, Reece; Hay, Liz

    2018-05-15

    Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and

  16. Examining End-of-Life Case Management: Systematic Review

    Directory of Open Access Journals (Sweden)

    Roger E. Thomas

    2014-01-01

    Full Text Available Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL case management identified 17 research articles, with content analysis revealing two themes: (a seeking to determine or establish the value of EOL case management and (b identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

  17. Diagnostic accuracy of physical examination tests of the ankle/foot complex: a systematic review.

    Science.gov (United States)

    Schwieterman, Braun; Haas, Deniele; Columber, Kirby; Knupp, Darren; Cook, Chad

    2013-08-01

    Orthopedic special tests of the ankle/foot complex are routinely used during the physical examination process in order to help diagnose ankle/lower leg pathologies. The purpose of this systematic review was to investigate the diagnostic accuracy of ankle/lower leg special tests. A search of the current literature was conducted using PubMed, CINAHL, SPORTDiscus, ProQuest Nursing and Allied Health Sources, Scopus, and Cochrane Library. Studies were eligible if they included the following: 1) a diagnostic clinical test of musculoskeletal pathology in the ankle/foot complex, 2) description of the clinical test or tests, 3) a report of the diagnostic accuracy of the clinical test (e.g. sensitivity and specificity), and 4) an acceptable reference standard for comparison. The quality of included studies was determined by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Nine diagnostic accuracy studies met the inclusion criteria for this systematic review; analyzing a total of 16 special tests of the ankle/foot complex. After assessment using the QUADAS-2, only one study had low risk of bias and low concerns regarding applicability. Most ankle/lower leg orthopedic special tests are confirmatory in nature and are best utilized at the end of the physical examination. Most of the studies included in this systematic review demonstrate notable biases, which suggest that results and recommendations in this review should be taken as a guide rather than an outright standard. There is need for future research with more stringent study design criteria so that more accurate diagnostic power of ankle/lower leg special tests can be determined. 3a.

  18. Standard practice for examination of welds using the alternating current field measurement technique

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This practice describes procedures to be followed during alternating current field measurement examination of welds for baseline and service-induced surface breaking discontinuities. 1.2 This practice is intended for use on welds in any metallic material. 1.3 This practice does not establish weld acceptance criteria. 1.4 The values stated in either inch-pound units or SI units are to be regarded separately as standard. The values stated in each system might not be exact equivalents; therefore, each system shall be used independently of the other. 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  19. Strategic Classification and Examination of the Development of Current Airline Alliance Activities

    Science.gov (United States)

    Wang, Zhi H.; Evans, Michael

    2002-01-01

    Previous research argues that despite the fact that strategic alliances have become an important feature of the world airline industry, little rigorous analysis has been done on the effects of these alliances. This is partially because there is a lack of precise definitions to specify different types of airline alliances in the literature. This research identifies several categories of airline alliances through a strategic classification of the current alliance activities involving the major airlines for the period 1989 to 1999. The classification enables this research to examine how strategic alliance activities are evolving, particularly to compare how airlines in North America, the European Union and the Asia Pacific region have committed to different alliances. Findings show that there is a significant difference between the number and scope of alliances adopted in the three aviation markets. These findings facilitate research to further analyse the impact of market liberalization on various formations of strategic airline alliances.

  20. Breast cancer treatment: historical review and current approaches

    International Nuclear Information System (INIS)

    Kulakowski, A.

    1994-01-01

    The evolution and development of opinions on the diagnosis and treatment of breast cancer since Galen to present time is presented. The concept of breast cancer as a local disease has been replaced by the understanding of its systemic character. On this background described are the methods of surgical treatment beginning from early - supraradical, to present -conservative approaches. The ''milestones'' in diagnosis and treatment of breast cancer of the last 40 years are presented. Current methods of breast cancer management include correct diagnosis (clinical examination, mammography, ultrasound, fine needle aspiration biopsy), TNM staging, adequate loco-regional therapy, systemic therapy, rehabilitation, reconstruction and careful follow-up. (author)

  1. A review of high beam current RFQ accelerators and funnels

    International Nuclear Information System (INIS)

    Schneider, J.D.

    1998-01-01

    The authors review the design features of several high-current (> 20-mA) and high-power (> 1-mA average) proton or H - injectors, RFQs, and funnels. They include a summary of observed performance and will mention a sampling of new designs, including the proposed incorporation of beam choppers. Different programs and organizations have chosen to build the RFQ in diverse configurations. Although the majority of RFQs are either low-current or very low duty-factor, several versions have included high-current and/or high-power designs for either protons or H - ions. The challenges of cooling, handling high space-charge forces, and coupling with injectors and subsequent accelerators are significant. In all instances, beam tests were a valuable learning experience, because not always did these as-built structures perform exactly as predicted by the earlier design codes. They summarize the key operational parameters, indicate what was achieved, and highlight what was learned in these tests. Based on this generally good performance and high promise, even more challenging designs are being considered for new applications that include even higher powers, beam funnels and choppers

  2. Examining the cultural context of youth mentoring: a systematic review.

    Science.gov (United States)

    Farruggia, Susan P; Bullen, Pat; Solomon, Frank; Collins, Efeso; Dunphy, Ann

    2011-12-01

    While research in youth mentoring is extensive in the U.S., little research has explored its effectiveness in New Zealand, despite its growth in the past 20 years. While arguments have been raised that overseas models may not fit all cultural contexts within New Zealand, there appears to be limited evidence supporting this contention. Further, little is known about associations between effectiveness and the cultural appropriateness of programs and research. This systematic review of youth mentoring programs in New Zealand is based on 26 studies that met inclusion criteria. Of those, 14 had a significant proportion (15% or more) of indigenous Māori youth and six had a significant proportion of Pasifika (Pacific Islander) youth. While almost all programs and associated research were culturally appropriate to the overall New Zealand context, they tended to be less culturally appropriate for programs working with Māori and Pasifika youth. Further, there was a negative association between cultural appropriateness and program effectiveness.

  3. Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature.

    Science.gov (United States)

    Lucas, Nicholas; Macaskill, Petra; Irwig, Les; Moran, Robert; Bogduk, Nikolai

    2009-01-01

    Trigger points are promoted as an important cause of musculoskeletal pain. There is no accepted reference standard for the diagnosis of trigger points, and data on the reliability of physical examination for trigger points are conflicting. To systematically review the literature on the reliability of physical examination for the diagnosis of trigger points. MEDLINE, EMBASE, and other sources were searched for articles reporting the reliability of physical examination for trigger points. Included studies were evaluated for their quality and applicability, and reliability estimates were extracted and reported. Nine studies were eligible for inclusion. None satisfied all quality and applicability criteria. No study specifically reported reliability for the identification of the location of active trigger points in the muscles of symptomatic participants. Reliability estimates varied widely for each diagnostic sign, for each muscle, and across each study. Reliability estimates were generally higher for subjective signs such as tenderness (kappa range, 0.22-1.0) and pain reproduction (kappa range, 0.57-1.00), and lower for objective signs such as the taut band (kappa range, -0.08-0.75) and local twitch response (kappa range, -0.05-0.57). No study to date has reported the reliability of trigger point diagnosis according to the currently proposed criteria. On the basis of the limited number of studies available, and significant problems with their design, reporting, statistical integrity, and clinical applicability, physical examination cannot currently be recommended as a reliable test for the diagnosis of trigger points. The reliability of trigger point diagnosis needs to be further investigated with studies of high quality that use current diagnostic criteria in clinically relevant patients.

  4. Magnetic resonance neurography. Current perspectives and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Chhabra, Avneesh [UT Southwestern Medical Center, Radiology and Orthopedic Surgery and Musculoskeletal Radiology, Dallas, TX (United States); Johns Hopkins University, Adjunct Faculty, Baltimore, MD (United States); Madhuranthakam, Ananth J. [UT Southwestern Medical Center, Department of Radiology and Advanced Imaging Research Institute, Dallas, TX (United States); Andreisek, Gustav [University of Zurich, Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zuerich (Switzerland)

    2018-02-15

    Magnetic resonance neurography (also called MRN or MR neurography) refers to MR imaging dedicated to the peripheral nerves. It is a technique that enhances selective multiplanar visualisation of the peripheral nerve and pathology by encompassing a combination of two-dimensional, three-dimensional and diffusion imaging pulse sequences. Referring physicians who seek imaging techniques that can depict and diagnose peripheral nerve pathologies superior to conventional MR imaging are driving the demand for MRN. This article reviews the pathophysiology of peripheral nerves in common practice scenarios, technical considerations of MRN, current indications of MRN, normal and abnormal neuromuscular appearances, and imaging pitfalls. Finally, the emerging utility of diffusion-weighted and diffusion tensor imaging is discussed and future directions are highlighted. (orig.)

  5. Magnetic resonance neurography. Current perspectives and literature review

    International Nuclear Information System (INIS)

    Chhabra, Avneesh; Madhuranthakam, Ananth J.; Andreisek, Gustav

    2018-01-01

    Magnetic resonance neurography (also called MRN or MR neurography) refers to MR imaging dedicated to the peripheral nerves. It is a technique that enhances selective multiplanar visualisation of the peripheral nerve and pathology by encompassing a combination of two-dimensional, three-dimensional and diffusion imaging pulse sequences. Referring physicians who seek imaging techniques that can depict and diagnose peripheral nerve pathologies superior to conventional MR imaging are driving the demand for MRN. This article reviews the pathophysiology of peripheral nerves in common practice scenarios, technical considerations of MRN, current indications of MRN, normal and abnormal neuromuscular appearances, and imaging pitfalls. Finally, the emerging utility of diffusion-weighted and diffusion tensor imaging is discussed and future directions are highlighted. (orig.)

  6. Current management of bronchiectasis: review and 3 case studies.

    Science.gov (United States)

    Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne

    2003-01-01

    Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.

  7. Current management options for latent tuberculosis: a review

    Directory of Open Access Journals (Sweden)

    Norton BL

    2012-11-01

    Full Text Available Brianna L Norton, David P HollandDepartment of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USAAbstract: Tuberculosis remains the world’s second leading infectious cause of death, with nearly one-third of the global population latently infected. Treatment of latent tuberculosis infection is a mainstay of tuberculosis-control efforts in low-to medium-incidence countries. Isoniazid monotherapy has been the standard of care for decades, but its utility is impaired by poor completion rates. However, new, shorter-course regimens using rifamycins improve completion rates and are cost-saving compared with standard isoniazid monotherapy. We review the currently available therapies for latent tuberculosis infection and their toxicities and include a brief economic comparison of the different regimens.Keywords: isoniazid, rifampin, rifapentine, tuberculin skin test, interferon-gamma release assay

  8. Contrast media for fluoroscopic examinations of the GI and GU tracts: current challenges and recommendations.

    Science.gov (United States)

    Federle, Michael P; Jaffe, Tracy A; Davis, Peter L; Al-Hawary, Mahmoud M; Levine, Marc S

    2017-01-01

    One of the significant challenges facing radiologists who perform and interpret studies of the gastrointestinal and genitourinary systems have been periodic interruptions in the availability of barium and iodinated contrast media specially formulated for gastrointestinal (GI) and genitourinary (GU) studies. These interruptions are due to the US Food and Drug Administration's recent requirement for more stringent documentation of the safety and efficacy of contrast media and the consolidation among contrast manufacturers. Therefore, radiologists may be required to recommend an alternative means of evaluation, such as computed tomography, magnetic resonance, or endoscopy, or they may need to substitute a different formulation of a contrast agent not specifically developed for GI or GU use, for example the utilization of an agent designed and marketed for vascular use. This article reviews the current status of fluoroscopic contrast media, and provides suggestions and recommendations for the optimal and alternative use of contrast media formulations.

  9. Type 2 Diabetes Mellitus: A Review of Current Trends

    Directory of Open Access Journals (Sweden)

    Abdulfatai B. Olokoba

    2012-07-01

    Full Text Available Type 2 diabetes mellitus (DM is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO and American Diabetes Association (ADA criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.

  10. THE CURRENT METHODS FOR MOLECULAR DIAGNOSTICS OF FISH DISEASES (REVIEW

    Directory of Open Access Journals (Sweden)

    O. Zaloilo

    2016-06-01

    Full Text Available Purpose. The methods of molecular diagnostic (MMD gradually become widespread in modern fish farming. MMD contain a wide variety of specific approaches, each of which has distinct limits of their possible applications and is characterized by individual peculiarities in practical performance. In addition to high sensitivity and the possibility of rapid diagnostics, the main advantage of molecular methods is to determine the uncultivated infectious agents. DNA amplification allows identifying pathogenic microorganisms at very small quantities even in the minimum sample volume. Molecular methods of diagnostic enable the determination of infection in latent or acute phases. These methods allow showing the differences between pathogens with similar antigenic structures. The current literature data on this subject usually show a methodology in the narrow context of the tasks or practical results obtained through such approaches. Thus, a synthesis of existing information on the mechanisms of action and the limits of the typical problems of basic methods of molecular diagnostics are an urgent task of fish breeding. In particular, the following description will more effectively choose one or several approaches to identify pathogens in fish. Findings. This paper reviews the basic molecular methods that are used in the world's aquaculture for diagnosis of various diseases in commercial fish species. Originality. This work is a generalization of data on the principles and mechanisms for the implementation of diagnostics based on modern molecular techniques. For each of the mentioned approaches, the most promising areas of application were shown. The information is provided in the form of a comparative analysis of each methodology, indicating positive and negative practical aspects. Practical value. The current review of modern methods of molecular diagnostic in aquaculture is focused on practical application. Generalizing and analytical information can be

  11. Concierge and Second-Opinion Radiology: Review of Current Practices.

    Science.gov (United States)

    Shaikh, Shehbaz; Bafana, Rounak; Halabi, Safwan S

    2016-01-01

    Radiology's core assets include the production, interpretation, and distribution of quality imaging studies. Second-opinion services and concierge practices in radiology aim to augment traditional services by providing patient-centered and physician-centered care, respectively. Patient centeredness enhances patients' understanding and comfort with their radiology tests and procedures and allows them to make better decisions about their health care. As the fee-for-service paradigm shifts to value-based care models, radiology practices have begun to diversify imaging service delivery and communication to coincide with the American College of Radiology Imaging 3.0 campaign. Physician-centered consultation allows for communication of evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. There are disparate practice models and payment schema for the various second-opinion and concierge practices. This review article explores the current state and payment models of second-opinion and concierge practices in radiology. This review also includes a discussion on the benefits, roadblocks, and ethical issues that surround these novel types of practices. Copyright © 2015 Mosby, Inc. All rights reserved.

  12. Helicobacter pylori eradication therapy: A review of current trends.

    Science.gov (United States)

    Olokoba, A B; Obateru, O A; Bojuwoye, M O

    2013-01-01

    Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.

  13. Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy-a systematic review.

    Science.gov (United States)

    Haldane, Chloe E; Ekhtiari, Seper; de Sa, Darren; Simunovic, Nicole; Ayeni, Olufemi R

    2017-08-01

    The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior-posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence : Level IV, Systematic Review of Level I-IV Studies.

  14. Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

    Science.gov (United States)

    Haldane, Chloe E.; Ekhtiari, Seper; de SA, Darren; Simunovic, Nicole

    2017-01-01

    Abstract The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior–posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence: Level IV, Systematic Review of Level I–IV Studies. PMID:28948032

  15. Glycolic acid peel therapy – a current review

    Directory of Open Access Journals (Sweden)

    Sharad J

    2013-11-01

    Full Text Available Jaishree Sharad Skinfiniti Aesthetic Skin and Laser Clinic, Mumbai, India Abstract: Chemical peels have been time-tested and are here to stay. Alpha-hydroxy peels are highly popular in the dermatologist's arsenal of procedures. Glycolic acid peel is the most common alpha-hydroxy acid peel, also known as fruit peel. It is simple, inexpensive, and has no downtime. This review talks about various studies of glycolic acid peels for various indications, such as acne, acne scars, melasma, postinflammatory hyperpigmentation, photoaging, and seborrhea. Combination therapies and treatment procedure are also discussed. Careful review of medical history, examination of the skin, and pre-peel priming of skin are important before every peel. Proper patient selection, peel timing, and neutralization on-time will ensure good results, with no side effects. Depth of the glycolic acid peel depends on the concentration of the acid used, the number of coats applied, and the time for which it is applied. Hence, it can be used as a very superficial peel, or even a medium depth peel. It has been found to be very safe with Fitzpatrick skin types I–IV. All in all, it is a peel that is here to stay. Keywords: acne scar, melasma, photoaging, chemical peel, alpha-hydroxy peel

  16. Leishmaniases in Ecuador: Comprehensive review and current status.

    Science.gov (United States)

    Hashiguchi, Yoshihisa; Velez, Lenin N; Villegas, Nancy V; Mimori, Tatsuyuki; Gomez, Eduardo A L; Kato, Hirotomo

    2017-02-01

    This article reviews current knowledge about leishmaniases in Ecuador, proceeding from 1920, when the first human case was described, to the present, mainly focusing on the recent research events published. Regarding basic situations, it appears that 23 of Ecuador's 24 provinces have leishmaniasis-case reports. The disease is one of the mandatory notification infectious diseases in the country since 2005. All the 21,305 cases notified to the Ministry of Public Health, during the period from 2001 through 2014, were said to involve different clinical features of cutaneous leishmaniasis (CL) but not visceral (VL). Eight Leishmania species, L. (Viannia) guyanensis, L. (V.) panamensis, L. (V.) braziliensis, L. (Leishmania) mexicana, L. (L.) amazonensis, L. (L.) major-like, L. (V.) naiffiand L. (V.) lainsoni were characterized. The last two species were most recently reported from the Ecuadorian Amazon regions. Of the 73 Ecuadorian Lutzomyia species (43 man-biting species) recorded, only four, Lu. trapidoi, Lu. gomezi, Lu. ayacuchensis, and Lu. tortura were incriminated as vectors of the Leishmania parasites. Current knowledge on the reservoir hosts of Leishmania in Ecuador is extremely poor. Recently, in Ecuador different kinds of molecular techniques were developed for diagnosis and mass screening of the disease, employing various materials derived from patients and sand fly vectors. These are PCR-RFLP, colorimetric FTA-LAMP etc. Brief comments and recommendations were also given, for future research and control of leishmaniases in Ecuador. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Air travel and radiation risks - review of current knowledge

    International Nuclear Information System (INIS)

    Zeeb, H.; Blettner, M.

    2004-01-01

    Aircrew and passengers are exposed to cosmic radiation, in particular when travelling routes close to the poles and in high altitudes. The paper reviews current radiation measurement and estimation approaches as well as the actual level of cosmic radiation that personnel and travellers receive and summarizes the available epidemiological evidence on health effects of cosmic radiation. On average, German aircrew is exposed to les than 5 mSv per annum, and even frequent travellers only rarely reach values above 1 mSv/year. Cohort studies among aircrew have found very little evidence for an increased incidence or mortality of radiation-associated cancers. Only malignant melanoma rates have consistently found to be increased among male aircrew. Socioeconomic and reproductive aspects are likely to contribute to the slightly elevated breast cancer risk of female aircrew. Cytogenetic studies have not yielded consistent results. Based on these data overall risk increases for cancer among occupationally exposed aircrew appear unlikely. This also applies to air travellers who are usually exposed to much lower radiation levels. Occasional air travel during pregnancy does not pose a significant radiation risk, but further considerations apply in this situation. The currently available studies are limited with regard to methodological issues and case numbers so that a continuation of cohort studies in several European countries is being planned. (orig.) [de

  18. UAS Integration Into the NAS: An Examination of Baseline Compliance in the Current Airspace System

    Science.gov (United States)

    Fern, Lisa; Kenny, Caitlin A.; Shively, Robert J.; Johnson, Walter

    2012-01-01

    As a result of the FAA Modernization and Reform Act of 2012, Unmanned Aerial Systems (UAS) are expected to be integrated into the National Airspace System (NAS) by 2015. Several human factors challenges need to be addressed before UAS can safely and routinely fly in the NAS with manned aircraft. Perhaps the most significant challenge is for the UAS to be non-disruptive to the air traffic management system. Another human factors challenge is how to provide UAS pilots with intuitive traffic information in order to support situation awareness (SA) of their airspace environment as well as a see-and-avoid capability comparable to manned aircraft so that a UAS pilot could safely maneuver the aircraft to maintain separation and collision avoidance if necessary. A simulation experiment was conducted to examine baseline compliance of UAS operations in the current airspace system. Researchers also examined the effects of introducing a Cockpit Situation Display (CSD) into a UAS Ground Control Station (GCS) on UAS pilot performance, workload and situation awareness while flying in a positively controlled sector. Pilots were tasked with conducting a highway patrol police mission with a Medium Altitude Long Endurance (MALE) UAS in L.A. Center airspace with two mission objectives: 1) to reroute the UAS when issued new instructions from their commander, and 2) to communicate with Air Traffic Control (ATC) to negotiate flight plan changes and respond to vectoring and altitude change instructions. Objective aircraft separation data, workload ratings, SA data, and subjective ratings regarding UAS operations in the NAS were collected. Results indicate that UAS pilots were able to comply appropriately with ATC instructions. In addition, the introduction of the CSD improved pilot SA and reduced workload associated with UAS and ATC interactions.

  19. Energy use in pig production: an examination of current Iowa systems.

    Science.gov (United States)

    Lammers, P J; Kenealy, M D; Kliebenstein, J B; Harmon, J D; Helmers, M J; Honeyman, M S

    2012-03-01

    This paper compares energy use for different pig production systems in Iowa, a leader in US swine production. Pig production systems include not only the growth and performance of the pigs, but also the supporting infrastructure of pig production. This supporting infrastructure includes swine housing, facility management, feedstuff provision, swine diets, and manure management. Six different facility type × diet formulation × cropping sequence scenarios were modeled and compared. The baseline system examined produces 15,600 pigs annually using confinement facilities and a corn-soybean cropping sequence. Diet formulations for the baseline system were corn-soybean meal diets that included the synthetic AA l-lysine and exogenous phytase. The baseline system represents the majority of current US pork production in the Upper Midwest, where most US swine are produced. This system was found to require 744.6 MJ per 136-kg market pig. An alternative system that uses bedded hoop barns for grow-finish pigs and gestating sows would require 3% less (720.8 MJ) energy per 136-kg market pig. When swine production systems were assessed, diet type and feed ingredient processing were the major influences on energy use, accounting for 61 and 79% of total energy in conventional and hoop barn-based systems, respectively. Improving feed efficiency and better matching the diet formulation with the thermal environment and genetic potential are thus key aspects of reducing energy use by pig production, particularly in a hoop barn-based system. The most energy-intensive aspect of provisioning pig feed is the production of synthetic N for crop production; thus, effectively recycling manure nutrients to cropland is another important avenue for future research. Almost 25% of energy use by a conventional farrow-to-finish pig production system is attributable to operation of the swine buildings. Developing strategies to minimize energy use for heating and ventilation of swine buildings while

  20. Current Parental Depression and Offspring Perceived Self-Competence: A Quasi-Experimental Examination

    Science.gov (United States)

    Class, Quetzal A.; D’Onofrio, Brian M.; Singh, Amber L.; Ganiban, Jody M.; Spotts, E. L.; Lichtenstein, Paul; Reiss, David; Neiderhiser, Jenae M.

    2013-01-01

    A genetically-informed, quasi-experimental design was used to examine the genetic and environmental processes underlying associations between current parental depressive symptoms and offspring perceived self-competence. Participants, drawn from a population-based Swedish sample, were 852 twin pairs and their male (52%) and female offspring aged 15.7 ± 2.4 years. Parental depressive symptoms were measured using the Center for Epidemiological Studies Depression scale. Offspring perceived self-competence was measured using a modified Harter Perceived Competence Scale. Cousin comparisons and Children of Twins (CoT) designs suggested that associations between maternal depressive symptoms and offspring perceived self-competence were due to shared genetic/environmental liability. The mechanism responsible for father-offspring associations, however, was independent of genetic factors and of extended-family environmental factors, supporting a causal inference. Thus, mothers and fathers may impact offspring perceived self-competence via different mechanisms and unmeasured genetic and environmental selection factors must be considered when studying the intergenerational transmission of cognitive vulnerabilities for depression. PMID:22692226

  1. Dose conversion coefficients for paediatric CT examinations with automatic tube current modulation

    International Nuclear Information System (INIS)

    Schlattl, H; Zankl, M; Becker, J; Hoeschen, C

    2012-01-01

    A common dose-saving technique used in modern CT devices is automatic tube current modulation (TCM), which was originally designed to also reduce the dose in paediatric CT patients. In order to be able to deduce detailed organ doses of paediatric models, dose conversion coefficients normalized to CTDI vol for an eight-week-old baby and seven- and eight-year-old children have been computed accounting for TCM. The relative difference in organ dose conversion coefficients with and without TCM is for many organs and examinations less than 10%, but can in some cases amount up to 30%, e.g., for the thyroid in the chest CT of the seven-year-old child. Overall, the impact of TCM on the conversion coefficients increases with increasing age. Besides TCM, also the effect of collimation and tube voltage on organ dose conversion coefficients has been investigated. It could be shown that the normalization to CTDI vol leads to conversion coefficients that can in most cases be considered to be independent of collimation and tube voltage. (paper)

  2. Current parental depression and offspring perceived self-competence: a quasi-experimental examination.

    Science.gov (United States)

    Class, Quetzal A; D'Onofrio, Brian M; Singh, Amber L; Ganiban, Jody M; Spotts, E L; Lichtenstein, Paul; Reiss, David; Neiderhiser, Jenae M

    2012-09-01

    A genetically-informed, quasi-experimental design was used to examine the genetic and environmental processes underlying associations between current parental depressive symptoms and offspring perceived self-competence. Participants, drawn from a population-based Swedish sample, were 852 twin pairs and their male (52 %) and female offspring aged 15.7 ± 2.4 years. Parental depressive symptoms were measured using the Center for Epidemiological Studies Depression scale. Offspring perceived self-competence was measured using a modified Harter Perceived Competence Scale. Cousin comparisons and Children of Twins designs suggested that associations between maternal depressive symptoms and offspring perceived self-competence were due to shared genetic/environmental liability. The mechanism responsible for father-offspring associations, however, was independent of genetic factors and of extended family environmental factors, supporting a causal inference. Thus, mothers and fathers may impact offspring perceived self-competence via different mechanisms and unmeasured genetic and environmental selection factors must be considered when studying the intergenerational transmission of cognitive vulnerabilities for depression.

  3. 13 CFR 120.1051 - Frequency of on-site reviews and examinations.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Frequency of on-site reviews and examinations. 120.1051 Section 120.1051 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1051 Frequency of on-site reviews and examinations...

  4. Diagnostic accuracy of radiographer reporting of computed tomography colonography examinations: A systematic review

    International Nuclear Information System (INIS)

    Meertens, R.; Brealey, S.; Nightingale, J.; McCoubrie, P.

    2013-01-01

    Computed tomography colonography (CTC) is the primary radiological test for the detection of colorectal tumours and precancerous polyps. Radiographer reporting of CTC examinations could help to improve the provision of this expanding service. We undertook a systematic review to assess the accuracy with which radiographers can provide formal written reports on intraluminal disease entities of CTC examinations compared to a reference standard. Data sources searched included online databases, peer-reviewed journals, grey literature, and reference and citation tracking. Eligible studies were assessed for bias, and data were extracted on study characteristics. Pooled estimates of sensitivities and specificities and chi-square tests of heterogeneity were calculated. Eight studies were eligible for inclusion with some risk to bias. Pooled estimates from three studies showed per patient sensitivity and specificity of reporting radiographers was 76% (95% CI: 70–80%) and 74% (95% CI: (67–80%), respectively. From seven studies, per lesion sensitivity for the detection of lesions >5 and >10 mm was 68% (95% CI: 65–71%) and 75% (95% CI: 72–79%) respectively. Pooled sensitivity for detection of lesions >5 mm in studies for which radiographers reported 50 or less training cases was 57% (95% CI: 52–61%) and more than 50 cases was 78% (95% CI: 74–81%). The current evidence does not support radiographers in a role involving the single formal written reporting of CTC examinations. Radiographers' performance, however, did appear to improve significantly with the number read. Therefore, when provided with adequate training and experience, there may be a potential role for radiographers in the reporting of CTC examinations

  5. Vitamin D and alcohol: A review of the current literature.

    Science.gov (United States)

    Tardelli, Vitor Soares; Lago, Mariana Pimentel Pádua do; Silveira, Dartiu Xavier da; Fidalgo, Thiago Marques

    2017-02-01

    Vitamin D is associated with bone mineral density, and its deficiency is a global health problem. In psychiatry, low vitamin D levels have been associated with schizophrenia, depression, psychotic symptoms, and, more recently, alcohol use disorders. Alcohol use disorders are among the most prevalent mental disorders worldwide. Therefore, our aim was to evaluate the association between alcohol use and vitamin D serum levels. The PubMed, SCIELO, and Lilacs databases were searched for this systematic review. We assessed all articles published from 1976 to December 2015, and we examined the associated reference lists to retrieve articles that appeared to fulfill our criteria. Of 932 articles, 49 met our inclusion criteria. The majority of the papers (71.4%) were cross-sectional studies. Alcohol intake was found to be positively associated with vitamin D status in 15 articles and negatively associated with vitamin D in 18 articles; no association was found in 16 articles. Heterogeneous results were found in our review, with a similar number of papers indicating a positive association, a negative association or the absence of any association between alcohol use and vitamin D levels. Nevertheless, it is important to note that the studies in which a positive association was found were more recent papers that involved considerably larger sample sizes than those in other studies. The older studies compared vitamin D levels in alcoholic and non-alcoholic patients, in contrast to more recent studies, which focused on more specific populations. In addition, most of the selected papers were from high latitude countries, where exposure to sunlight tends to be lower than in tropical countries. The data concerning vitamin D levels in patients with alcohol use disorders remain controversial. Additional research using a standardized methodology is necessary to demonstrate the real impact of alcohol consumption on vitamin D serum levels as well as on the health status of alcohol users

  6. Short Review: Mitigation of Current Environmental Concerns from Methanol Synthesis

    Directory of Open Access Journals (Sweden)

    Andrew Young

    2013-06-01

    Full Text Available Methanol has become a widely used and globally distributed product. Methanol is very important due to the current depletion of fossil fuels. Industrially, methanol produced from the catalytic reaction of synthetic gas composed of hydrogen, carbon monoxide, and carbon dioxide. Methanol production has brought great attention due to carbon dioxide as the main source of greenhouse gas emissions. Combined of reducing CO2 emissions and supplying an alternative fuel source has created the idea of a carbon neutral cycle called “the methanol economy”. The best catalyst for the methanol economy would show a high CO2 conversion and high selectivity for methanol production. This paper investigates research focused on catalyst development for efficient methanol synthesis from hydrogenation of carbon dioxide through added various supports and additives such as silica, zirconium, and palladium. Catalysts that displayed the highest activity included a zirconia and silicon-titanium oxide promoted Cu/Zn/Al2O3 catalyst. Alternative method of catalyst preparation, include the oxalate-gel, solid-state reaction, co-precipitation and combustion method also investigated.  © 2013 BCREC UNDIP. All rights reservedReceived: 10th October 2012; Revised: 7th February 2012; Accepted: 10th February 2013[How to Cite: Young, A., Lesmana, D., Dai, D.J., Wu, H.S. (2013. Short Review: Mitigation of Current En-vironmental Concerns from Methanol Synthesis. Bulletin of Chemical Reaction Engineering & Catalysis, 8 (1: 1-13. (doi:10.9767/bcrec.8.1.4055.1-13][Permalink/DOI: http://dx.doi.org/10.9767/bcrec.8.1.4055.1-13] | View in  |

  7. Physical articular examination in the activity of rheumatoid arthritis: a systematic review of the literature : Systematic review of the literature regarding physical examination in rheumatoid arthritis.

    Science.gov (United States)

    Medina, Yimy F; Ruíz-Gaviria, Rafael Eduardo; Buitrago-Lopez, Adriana; Villota, Catalina

    2018-06-01

    To summarize evidence concerning the articular examination needed to determine rheumatoid arthritis (RA) activity (follow-up or control) via a systematic review. A search of Medline, Embase, Lilacs, SciELO, the Web of Science, the National Technical Reports Library, and the reference lists of relevant studies through March 2017 was conducted using a systematic methodology to identify studies of patients with RA older than 18 years in which a detailed description of the physical examination or a description of the components of the articular examination was provided. Of 8322 references, 74 studies were included according to the selection criteria, and 6 references were ultimately included at the end of the review. Most of the included studies (n = 5) were associated with a moderate risk of bias. There was great variability among the studies and the articular examination methods used. Some studies presented the examination with a complete specification of the technique (n = 2), the consensus of rheumatologists (n = 2), or training through audiovisual materials and face-to-face courses (n = 2), but none of the studies explicitly showed the technique by which the physical examination was performed. Despite the importance of the clinical evaluation and physical examination of patients with RA for diagnosis, prognosis, clinimetrics, and follow-up, evidence concerning how to perform the articular examination is scarce.

  8. Review of the Current State of UAV Regulations

    Directory of Open Access Journals (Sweden)

    Claudia Stöcker

    2017-05-01

    Full Text Available UAVs—unmanned aerial vehicles—facilitate data acquisition at temporal and spatial scales that still remain unachievable for traditional remote sensing platforms. However, current legal frameworks that regulate UAVs present significant barriers to research and development. To highlight the importance, impact, and diversity of UAV regulations, this paper provides an exploratory investigation of UAV regulations on the global scale. For this, the methodological approach consists of a research synthesis of UAV regulations, including a thorough literature review and a comparative analysis of national regulatory frameworks. Similarities and contrasting elements in the various national UAV regulations are explored including their statuses from the perspectives of past, present, and future trends. Since the early 2000s, countries have gradually established national legal frameworks. Although all UAV regulations have one common goal—minimizing the risks to other airspace users and to both people and property on the ground—the results reveal distinct variations in all the compared variables. Furthermore, besides the clear presence of legal frameworks, market forces such as industry design standards and reliable information about UAVs as public goods are expected to shape future developments.

  9. Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Meredith Harrell

    2014-01-01

    Full Text Available Objective. To perform an evidence-based review of treatments for Toxoplasma retinochoroiditis (TRC. Methods. A systematic literature search was performed using the PubMed database and the key phrase “ocular toxoplasmosis treatment” and the filter for “controlled clinical trial” and “randomized clinical trial” as well as OVID medline (1946 to May week 2 2014 using the keyword ‘‘ocular toxoplasmosis’’. The included studies were used to evaluate the various treatment modalities of TRC. Results. The electronic search yielded a total of 974 publications of which 44 reported on the treatment of ocular toxoplasmosis. There were 9 randomized controlled studies and an additional 3 comparative studies on the treatment of acute TRC with systemic or intravitreous antibiotics or on reducing the recurrences of TRC. Endpoints of studies included visual acuity improvement, inflammatory response, lesion size changes, recurrences of lesions, and adverse effects of medications. Conclusions. There was conflicting evidence as to the effectiveness of systemic antibiotics for TRC. There is no evidence to support that one antibiotic regimen is superior to another so choice needs to be informed by the safety profile. Intravitreous clindamycin with dexamethasone seems to be as effective as systemic treatments. There is currently level I evidence that intermittent trimethoprim-sulfamethoxazole prevents recurrence of the disease.

  10. Obsessive-compulsive personality disorder: a current review.

    Science.gov (United States)

    Diedrich, Alice; Voderholzer, Ulrich

    2015-02-01

    This review provides a current overview on the diagnostics, epidemiology, co-occurrences, aetiology and treatment of obsessive-compulsive personality disorder (OCPD). The diagnostic criteria for OCPD according to the recently published Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include an official set of criteria for clinical practice and a new, alternative set of criteria for research purposes. OCPD is a personality disorder prevalent in the general population (3-8 %) that is more common in older and less educated individuals. Findings on sex distribution and course of OCPD are inconsistent. OCPD is comorbid with several other medical and psychological conditions. As for causes of OCPD, most empirical evidence provides support for disturbed attachment as well as the heritability of OCPD. So far, cognitive (behavioural) therapy is the best validated treatment of OCPD. Self-esteem variability, stronger early alliances as well as the distress level seem to predict cognitive (behavioural) therapy outcome. Future research is needed to further advance knowledge in OCPD and to resolve inconsistencies.

  11. Review of Current Immunologic Therapies for Hidradenitis Suppurativa

    Directory of Open Access Journals (Sweden)

    Victoria K. Shanmugam

    2017-01-01

    Full Text Available Hidradenitis suppurativa (HS is a chronic, recurrent, inflammatory disease of apocrine gland-bearing skin which affects approximately 1–4% of the population. The disease is more common in women and patients of African American descent and approximately one-third of patients report a family history. Obesity and smoking are known risk factors, but associations with other immune disorders, especially inflammatory bowel disease, are also recognized. The pathogenesis of HS is poorly understood and host innate or adaptive immune response, defective keratinocyte function, and the microbial environment in the hair follicle and apocrine gland have all been postulated to play a role in disease activity. While surgical interventions can be helpful to reduce disease burden, there is a high recurrence rate. Increasingly, data supports targeted immune therapy for HS, and longitudinal studies suggest benefit from these agents, both when used alone and as an adjunct to surgical treatments. The purpose of this review is to outline the current data supporting use of targeted immune therapy in HS management.

  12. Gender relations and health research: a review of current practices

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-12-01

    Full Text Available Abstract Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a as emergent findings; and b as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

  13. Review on the current trends in tongue diagnosis systems

    Directory of Open Access Journals (Sweden)

    Chang Jin Jung

    2012-12-01

    Full Text Available Tongue diagnosis is an essential process to noninvasively assess the condition of a patient's internal organs in traditional medicine. To obtain quantitative and objective diagnostic results, image acquisition and analysis devices called tongue diagnosis systems (TDSs are required. These systems consist of hardware including cameras, light sources, and a ColorChecker, and software for color correction, segmentation of tongue region, and tongue classification. To improve the performance of TDSs, various types TDSs have been developed. Hyperspectral imaging TDSs have been suggested to acquire more information than a two-dimensional (2D image with visible light waves, as it allows collection of data from multiple bands. Three-dimensional (3D imaging TDSs have been suggested to provide 3D geometry. In the near future, mobile devices like the smart phone will offer applications for assessment of health condition using tongue images. Various technologies for the TDS have respective unique advantages and specificities according to the application and diagnostic environment, but this variation may cause inconsistent diagnoses in practical clinical applications. In this manuscript, we reviewed the current trends in TDSs for the standardization of systems. In conclusion, the standardization of TDSs can supply the general public and oriental medical doctors with convenient, prompt, and accurate information with diagnostic results for assessing the health condition.

  14. Review on the current trends in tongue diagnosis systems.

    Science.gov (United States)

    Jung, Chang Jin; Jeon, Young Ju; Kim, Jong Yeol; Kim, Keun Ho

    2012-12-01

    Tongue diagnosis is an essential process to noninvasively assess the condition of a patient's internal organs in traditional medicine. To obtain quantitative and objective diagnostic results, image acquisition and analysis devices called tongue diagnosis systems (TDSs) are required. These systems consist of hardware including cameras, light sources, and a ColorChecker, and software for color correction, segmentation of tongue region, and tongue classification. To improve the performance of TDSs, various types TDSs have been developed. Hyperspectral imaging TDSs have been suggested to acquire more information than a two-dimensional (2D) image with visible light waves, as it allows collection of data from multiple bands. Three-dimensional (3D) imaging TDSs have been suggested to provide 3D geometry. In the near future, mobile devices like the smart phone will offer applications for assessment of health condition using tongue images. Various technologies for the TDS have respective unique advantages and specificities according to the application and diagnostic environment, but this variation may cause inconsistent diagnoses in practical clinical applications. In this manuscript, we reviewed the current trends in TDSs for the standardization of systems. In conclusion, the standardization of TDSs can supply the general public and oriental medical doctors with convenient, prompt, and accurate information with diagnostic results for assessing the health condition.

  15. Giant Magnetoresistance Sensors: A Review on Structures and Non-Destructive Eddy Current Testing Applications

    Directory of Open Access Journals (Sweden)

    Damhuji Rifai

    2016-02-01

    Full Text Available Non-destructive eddy current testing (ECT is widely used to examine structural defects in ferromagnetic pipe in the oil and gas industry. Implementation of giant magnetoresistance (GMR sensors as magnetic field sensors to detect the changes of magnetic field continuity have increased the sensitivity of eddy current techniques in detecting the material defect profile. However, not many researchers have described in detail the structure and issues of GMR sensors and their application in eddy current techniques for nondestructive testing. This paper will describe the implementation of GMR sensors in non-destructive testing eddy current testing. The first part of this paper will describe the structure and principles of GMR sensors. The second part outlines the principles and types of eddy current testing probe that have been studied and developed by previous researchers. The influence of various parameters on the GMR measurement and a factor affecting in eddy current testing will be described in detail in the third part of this paper. Finally, this paper will discuss the limitations of coil probe and compensation techniques that researchers have applied in eddy current testing probes. A comprehensive review of previous studies on the application of GMR sensors in non-destructive eddy current testing also be given at the end of this paper.

  16. Giant Magnetoresistance Sensors: A Review on Structures and Non-Destructive Eddy Current Testing Applications

    Science.gov (United States)

    Rifai, Damhuji; Abdalla, Ahmed N.; Ali, Kharudin; Razali, Ramdan

    2016-01-01

    Non-destructive eddy current testing (ECT) is widely used to examine structural defects in ferromagnetic pipe in the oil and gas industry. Implementation of giant magnetoresistance (GMR) sensors as magnetic field sensors to detect the changes of magnetic field continuity have increased the sensitivity of eddy current techniques in detecting the material defect profile. However, not many researchers have described in detail the structure and issues of GMR sensors and their application in eddy current techniques for nondestructive testing. This paper will describe the implementation of GMR sensors in non-destructive testing eddy current testing. The first part of this paper will describe the structure and principles of GMR sensors. The second part outlines the principles and types of eddy current testing probe that have been studied and developed by previous researchers. The influence of various parameters on the GMR measurement and a factor affecting in eddy current testing will be described in detail in the third part of this paper. Finally, this paper will discuss the limitations of coil probe and compensation techniques that researchers have applied in eddy current testing probes. A comprehensive review of previous studies on the application of GMR sensors in non-destructive eddy current testing also be given at the end of this paper. PMID:26927123

  17. Market review - Market values summary/July market review/current market data

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    This article is the July 1995 uranium market review. Data for current uranium market is presented, and a summary of recent transactions is also given. During this reporting period, there was one concentrate deal, two transactions in the long-term natural uranium market and conversion market, and three spot market transactions in the enrichment market. Active uranium supply fell, as did demand, and prices in all sectors were relatively stable

  18. The Effectiveness of Public Simulated Oral Examinations in Preparation for the American Board of Surgery Certifying Examination: A Systematic Review.

    Science.gov (United States)

    Pennell, Christopher; McCulloch, Peter

    2015-01-01

    The purpose of this study was to determine whether American Board of Surgery Certifying Examination (CE) performance is improved among residents who prepare using simulated oral examinations (SOEs). EMBASE and MEDLINE were searched using predefined search terms. No language restrictions were imposed and the latest search date was in November 2014. Included studies must have reported on residents training in a general surgery residency in the United States who used SOEs to prepare for the CE and have measured their performance against those without exposure to SOEs. Studies meeting inclusion criteria were qualitatively and quantitatively analyzed and a fixed effects meta-analysis was performed to determine the net effect of SOEs on CE performance. Overall, 4 of 25 abstracts reviewed met inclusion criteria and are included in this review. The most common simulation format included public examinations in front of resident peers during scheduled education sessions. All 4 included studies trended toward improved performance with SOEs and in 2 of these studies the improvement was statistically significant. Overall, 3 studies were of adequate quality to perform a meta-analysis and demonstrated a relative risk for first-attempt CE success of 1.22 (95% CI: 1.07-1.39, p = 0.003) for residents preparing with SOEs compared to those without SOEs. The published literature evaluating SOEs is limited and generally of fair quality. A modest improvement in CE performance was identified when public SOEs were used as an educational tool aimed to improve professionalism and communication skills, encourage reading at home, and provide a regular review of clinically relevant topics. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. An examination of methods whereby noise levels in current and new mining equipment may be reduced

    CSIR Research Space (South Africa)

    Maneylaws, A

    1997-12-01

    Full Text Available An extensive literature review of international work of mining equipment noise control has been carried out. The sources of noise on percussion rock drills, continuous miners, dust scrubbers and fans, long wall machinery and trackless vehicles...

  20. Current energy usage and sustainable energy in Kazakhstan: A review

    Science.gov (United States)

    Karatayev, Marat; Islam, Tofazzal; Salnikov, Vitaliy

    2014-05-01

    Kazakhstan has abundant natural resources. The country has enough coal to supply its energy needs for the next 150 years, and has the world's largest deposits of uranium, substantial quantities of natural gas and petroleum deposits. However, despite such energy riches, due to the size of the territory, its geography, and the country's economic structure, distribution of electricity in Kazakhstan is not uniform. As a result, Kazakhstani rural and remote areas suffer from serious electricity deficits. According to the latest estimates from the Ministry of Industry and New Technologies, about 25-30% of the Kazakhstani population lives in rural communities, where access to affordable energy (for heating, cooling, cooking, refrigeration, lighting, household as well as IT use) is limited. Furthermore, with the main electricity production infrastructure concentrated in the main urban areas, a high amount of electricity is therefore lost during transmission. Moreover, the consumption of poor quality coal as the main source of power generation creates a significant amount of environmental pollution. To illustrate this development, fuel combustion from coal has produced around 75% of carbon dioxide emissions in Kazakhstan. Thus, in order to address the country's electricity and environmental challenges, the Kazakhstani government is taking initiatives to promote renewable energy resources. However, so far, the outcome of these initiatives remains negligible. The current contribution of renewable energy to the total energy consumption is less than 1% (with 90% provided by hydropower) despite the significant potential for renewable energy in the country. As yet, no comprehensive study has been published on the energy scenario and on the potential for renewable energy resources in Kazakhstan. This comprehensive review aims to present an overview of the country's energy resources, supply and demand as the current energy scenario, while discussing the potential for renewable

  1. Current and Under Development Treatment Modalities of Psoriasis: A Review.

    Science.gov (United States)

    Albaghdadi, Abdullah

    2017-01-01

    Psoriasis is a chronic and complex autoimmune inflammatory skin disease that affects over 125 million people worldwide. It can exhibit at any age, in spite of the fact that children are less normally influenced than adults. It is characterized by distinct erythematous plaques shielded with conspicuous silvery scales that shows up in different areas of the skin. Knowledge of pathophysiology, especially the pathogenesis of psoriasis, has significantly progressed in the recent decade. Advancement in molecular knowledge leads to better understanding of the disease, thus influencing the development of efficient treatment modalities. However, even with the availability of various options of treatment most of the efficient treatment modalities are costly. Expenses of health care bring about major financial weight to the patients as well as to health care systems. Thus, it was important to review the available current treatment options and those which are under development, in terms of efficacy, safety and cost to assist in selecting the most appropriate treatment for psoriasis patients. Literatures were searched by using key words psoriasis, topical treatment, systemic treatment, biologics and phototherapies, on Embase, Medline, Jstor, Cochrane and Merck Index databases. Life-style choices such as smoking, alcohol consumption, obesity and stress are recognised as risk factors and triggers associated with psoriasis. Psoriasis poses psycho-social and economic burden on affected patients that sometimes leads to depression, reduced social interaction and suicidal tendencies in patients. Depending on the type, severity and extent of the disease, comorbidities, patient preference, efficacy and safety profile, numerous treatment modalities and therapeutic agents are available such as topical, systemic, biologic and phototherapeutic treatments. However, it was found that among all the current available treatments for psoriasis, biologic agents and phototherapeutic modalities are

  2. Titanium dioxide nanoparticles: a review of current toxicological data

    Science.gov (United States)

    2013-01-01

    Titanium dioxide (TiO2) nanoparticles (NPs) are manufactured worldwide in large quantities for use in a wide range of applications. TiO2 NPs possess different physicochemical properties compared to their fine particle (FP) analogs, which might alter their bioactivity. Most of the literature cited here has focused on the respiratory system, showing the importance of inhalation as the primary route for TiO2 NP exposure in the workplace. TiO2 NPs may translocate to systemic organs from the lung and gastrointestinal tract (GIT) although the rate of translocation appears low. There have also been studies focusing on other potential routes of human exposure. Oral exposure mainly occurs through food products containing TiO2 NP-additives. Most dermal exposure studies, whether in vivo or in vitro, report that TiO2 NPs do not penetrate the stratum corneum (SC). In the field of nanomedicine, intravenous injection can deliver TiO2 nanoparticulate carriers directly into the human body. Upon intravenous exposure, TiO2 NPs can induce pathological lesions of the liver, spleen, kidneys, and brain. We have also shown here that most of these effects may be due to the use of very high doses of TiO2 NPs. There is also an enormous lack of epidemiological data regarding TiO2 NPs in spite of its increased production and use. However, long-term inhalation studies in rats have reported lung tumors. This review summarizes the current knowledge on the toxicology of TiO2 NPs and points out areas where further information is needed. PMID:23587290

  3. Titanium dioxide nanoparticles: a review of current toxicological data.

    Science.gov (United States)

    Shi, Hongbo; Magaye, Ruth; Castranova, Vincent; Zhao, Jinshun

    2013-04-15

    Titanium dioxide (TiO2) nanoparticles (NPs) are manufactured worldwide in large quantities for use in a wide range of applications. TiO2 NPs possess different physicochemical properties compared to their fine particle (FP) analogs, which might alter their bioactivity. Most of the literature cited here has focused on the respiratory system, showing the importance of inhalation as the primary route for TiO2 NP exposure in the workplace. TiO2 NPs may translocate to systemic organs from the lung and gastrointestinal tract (GIT) although the rate of translocation appears low. There have also been studies focusing on other potential routes of human exposure. Oral exposure mainly occurs through food products containing TiO2 NP-additives. Most dermal exposure studies, whether in vivo or in vitro, report that TiO2 NPs do not penetrate the stratum corneum (SC). In the field of nanomedicine, intravenous injection can deliver TiO2 nanoparticulate carriers directly into the human body. Upon intravenous exposure, TiO2 NPs can induce pathological lesions of the liver, spleen, kidneys, and brain. We have also shown here that most of these effects may be due to the use of very high doses of TiO2 NPs. There is also an enormous lack of epidemiological data regarding TiO2 NPs in spite of its increased production and use. However, long-term inhalation studies in rats have reported lung tumors. This review summarizes the current knowledge on the toxicology of TiO2 NPs and points out areas where further information is needed.

  4. Examining current or future trade-offs for biodiversity conservation in north-eastern Australia.

    Science.gov (United States)

    Reside, April E; VanDerWal, Jeremy; Moilanen, Atte; Graham, Erin M

    2017-01-01

    With the high rate of ecosystem change already occurring and predicted to occur in the coming decades, long-term conservation has to account not only for current biodiversity but also for the biodiversity patterns anticipated for the future. The trade-offs between prioritising future biodiversity at the expense of current priorities must be understood to guide current conservation planning, but have been largely unexplored. To fill this gap, we compared the performance of four conservation planning solutions involving 662 vertebrate species in the Wet Tropics Natural Resource Management Cluster Region in north-eastern Australia. Input species data for the four planning solutions were: 1) current distributions; 2) projected distributions for 2055; 3) projected distributions for 2085; and 4) current, 2055 and 2085 projected distributions, and the connectivity between each of the three time periods for each species. The four planning solutions were remarkably similar (up to 85% overlap), suggesting that modelling for either current or future scenarios is sufficient for conversation planning for this region, with little obvious trade-off. Our analyses also revealed that overall, species with small ranges occurring across steep elevation gradients and at higher elevations were more likely to be better represented in all solutions. Given that species with these characteristics are of high conservation significance, our results provide confidence that conservation planning focused on either current, near- or distant-future biodiversity will account for these species.

  5. Preclinical QSP Modeling in the Pharmaceutical Industry: An IQ Consortium Survey Examining the Current Landscape

    Science.gov (United States)

    Wu, Fan; Bansal, Loveleena; Bradshaw‐Pierce, Erica; Chan, Jason R.; Liederer, Bianca M.; Mettetal, Jerome T.; Schroeder, Patricia; Schuck, Edgar; Tsai, Alice; Xu, Christine; Chimalakonda, Anjaneya; Le, Kha; Penney, Mark; Topp, Brian; Yamada, Akihiro

    2018-01-01

    A cross‐industry survey was conducted to assess the landscape of preclinical quantitative systems pharmacology (QSP) modeling within pharmaceutical companies. This article presents the survey results, which provide insights on the current state of preclinical QSP modeling in addition to future opportunities. Our results call attention to the need for an aligned definition and consistent terminology around QSP, yet highlight the broad applicability and benefits preclinical QSP modeling is currently delivering. PMID:29349875

  6. Review of inservice inspection and nondestructive examination practices at DOE Category A test and research reactors

    International Nuclear Information System (INIS)

    Anderson, M.T.; Aldrich, D.A.

    1990-09-01

    In-service inspection (ISI) programs are used at commercial nuclear power plants for monitoring the pressure boundary integrity of various systems and components to ensure their continued safe operation. The Department of Energy (DOE) operates several test and research reactors. This report represents an evaluation of the ISI and nondestructive examination (NDE) practices at five DOE Category A (> 20 MW thermal) reactors as compared, where applicable, to the current ISI activities of commercial nuclear power facilities. The purpose of an inservice inspection (ISI) program is to establish regular surveillance of safety-related components to ensure their safe and reliable operation. The integrity of materials comprising these components is generally monitored by means of periodic nondestructive examinations (NDE), which, if appropriately performed, provide methods for identifying degradation that could render components unable to perform their intended safety functions. The reactors evaluated during this review were the Experimental Breeder Reactor 2 and the Fast Flux Test Facility (liquid-metal cooled plants), the Advanced Test Reactor and the High Flux Isotopes Reactor (light-water cooled reactors), and the High Flux Beam Reactor (a heavy-water cooled facility). Although these facilities are extremely diverse in design and operation, they all have less stored energy, smaller inventories of radionuclides, and generally, more remote locations than commercial reactors. However, all DOE test and research facilities contain components similar to those of commercial reactors for which continued integrity is important to maintain plant safety. 10 refs., 6 tabs

  7. Examining Congruence within School-Family Partnerships: Definition, Importance, and Current Measurement Approaches

    Science.gov (United States)

    Glueck, Courtney L.; Reschly, Amy L.

    2014-01-01

    The purpose of this article is to explore the construct of congruence, particularly with regard to school-family collaboration and partnerships. An in-depth review of the empirical and theoretical literature supporting a shift in focus from encouraging family involvement to creating effective school-family partnerships is presented, followed by an…

  8. [Investigation on current situation of malaria blood examinations in township-level hospitals of Nantong City].

    Science.gov (United States)

    Gui-Sheng, Ding; Cai-Qun, Cao; Ping, Miao; Mei-Fang, Gu; Xiao-Bin, Cao

    2016-11-18

    To understand the quality of malaria blood examinations in township-level hospitals, so as to provide the evidence for continuing the malaria blood examinations in the stage of post-malaria elimination. A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators in "Malaria Elimination Technical Scheme" in 2013 and 2014. The single and multiple indicators were calculated, and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzed during the period of 2011-2014. For the single indicator, 29.5% of the thick blood films did not reach the standard, and 35.8% of thin blood films did not reach the standard. For the multiple indicators, blood slides with more than 4 indicators below the standard (poor quality) accounted for 32.5%. From malaria blood examinations and malaria situation, the number of slides was 194 635 during the period of 2011-2014, and there were no local vivax malaria casesin 4 consecutive years from 2011 to 2014, and local malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented, the township and village level accounted for 16.3%, and county and higher level accounted for 83.7%. The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of malaria cases. A new model for malaria blood examinations needs to be further explored.

  9. Clinical review: Current state and future perspectives in the diagnosis of diabetes insipidus: a clinical review.

    Science.gov (United States)

    Fenske, Wiebke; Allolio, Bruno

    2012-10-01

    The differential diagnosis of diabetes insipidus (DI) is often challenging but essential, because treatment may vary substantially. This article analyzes the database and performance of currently used differential diagnostic tests for DI and discusses future perspectives for diagnostic improvement. A review of electronic and print data comprising original and review articles retrieved from the PubMed or Cochrane Library database up to January 2012 was conducted. The search term "polyuria polydipsia syndrome" was cross-referenced with underlying forms of disease and associated clinical, diagnostic, and therapeutic MeSH terms. In addition, references from review articles and textbook chapters were screened for papers containing original data. Search results were narrowed to articles containing primary data with a description of criteria for the differential diagnosis of DI. Fifteen articles on differential diagnosis of DI were identified, mainly consisting of small series of patients, and mostly covering only part of the differential diagnostic spectrum of DI. Test protocols differed, and prospective validation of diagnostic criteria was consistently missing. Inconsistent data were reported on the diagnostic superiority of direct plasma arginine vasopressin determination over the indirect water deprivation test. Both test methods revealed limitations, especially in the differentiation of disorders with a milder phenotype. The available data demonstrate limitations of current biochemical tests for the differential diagnosis of DI, potentially leading to incorrect diagnosis and treatment. The newly available assay for copeptin, the C terminus of the vasopressin precursor, holds promise for a higher diagnostic specificity and simplification of the differential diagnostic protocol in DI.

  10. Using Peer Reviews to Examine Micropolitics and Disciplinary Development of Engineering Education: A Case Study

    Science.gov (United States)

    Beddoes, Kacey

    2014-01-01

    This article presents a case study of the peer review process for a feminist article submitted to an engineering education journal. It demonstrates how an examination of peer review can be a useful approach to further understanding the development of feminist thought in education fields. Rather than opposition to feminist thought per se, my…

  11. UK DTI wind programme area - review and current priorities

    International Nuclear Information System (INIS)

    Craig, J.W.

    1998-01-01

    The Wind Energy programme commenced in 1979 initially to determine the technical and economic feasibility of the technology. Since that time the programme has progressed from research, development and assessment to commercial deployment. It now provides a technology push to complement the market pull created by the Non-Fossil Fuel Obligation (NFFO). Over 280 MW of capacity has now been commissioned. The wind energy programme, is based upon a five year strategy in common with other DTI renewable energy technologies, which were outlined in Energy Paper 62. The programme has four key aims: 1. To encourage the uptake of wind energy. 2. To encourage internationally competitive industries to develop and utilise capabilities for the domestic and export markets. 3. To quantify environmental improvements and disbenefits associated with wind energy. 4. To manage the programme effectively. During the mid 1980s and early 1990s the programme concentrated on technology development and demonstration, which has helped to establish UK expertise in wind energy. Non-technical barriers such as planning have been addressed but are now largely for the industry to resolve. The development of wind turbine technology and related components is aimed at meeting the challenge of both the domestic and world markets. The ability of the DTI programme to meet these challenges is partly dependent on the technical ability and commercially acumen of British companies and partly on the level of support offered by Government. The programme budget has fallen from Pound8.7M/year in 1992/93 to current level of Pound1.4M/year and is yet to fall further. It should be stressed that the decline in budgets followed a review of the Renewables Programme in 1995 which affected all technologies. The wind programme budget was reduced substantially at that time which resulted in a revision of priorities. Continued support for market enablement measures was reduced partly because the industry, supported by the NFFO

  12. Overview and current management of computerized adaptive testing in licensing/certification examinations

    Directory of Open Access Journals (Sweden)

    Dong Gi Seo

    2017-07-01

    Full Text Available Computerized adaptive testing (CAT has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees’ ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations.

  13. [Current teaching, learning and examination methods in medical education and potential applications in rehabilitative issues].

    Science.gov (United States)

    Schwarzkopf, S R; Morfeld, M; Gülich, M; Lay, W; Horn, K; Mau, W

    2007-04-01

    With introduction of the new Federal Medical Licensing Regulations (Approbationsordnung) in Germany, integrated teaching in "Rehabilitation, Physical Medicine, Naturopathic Treatment" (Querschnittsbereich Q12) has become obligatory for the first time. Furthermore, the new Regulations require the medical faculties in Germany to realize an innovative didactic orientation in teaching. This paper provides an overview of recent applications of teaching techniques and examination methods in medical education with special consideration of the new integrated course Q12 and further teaching methods related to rehabilitative issues. Problem-oriented learning (POL), problem-based learning (PBL), bedside teaching, eLearning, and the examination methods Objective Structured Clinical Examination (OSCE) and Triple Jump are in the focus. This overview is intended as the basis for subsequent publications of the Commission for Undergraduate and Postgraduate Training of the German Society of Rehabilitation Science (DGRW), which will present examples of innovative teaching material.

  14. Music Education--A Personal Matter? Examining the Current Discourses of Music Education in Sweden

    Science.gov (United States)

    Georgii-Hemming, Eva; Westvall, Maria

    2010-01-01

    The embedding of informal practices in music education in school relates to significant issues concerning students' engagement, participation, inclusion and the role of the teacher. This article addresses these issues by presenting and discussing current music education in compulsory comprehensive schooling in Sweden. It does so by drawing upon…

  15. A review of nondestructive examination technology for polyethylene pipe in nuclear power plant

    Science.gov (United States)

    Zheng, Jinyang; Zhang, Yue; Hou, Dongsheng; Qin, Yinkang; Guo, Weican; Zhang, Chuck; Shi, Jianfeng

    2018-05-01

    Polyethylene (PE) pipe, particularly high-density polyethylene (HDPE) pipe, has been successfully utilized to transport cooling water for both non-safety- and safety-related applications in nuclear power plant (NPP). Though ASME Code Case N755, which is the first code case related to NPP HDPE pipe, requires a thorough nondestructive examination (NDE) of HDPE joints. However, no executable regulations presently exist because of the lack of a feasible NDE technique for HDPE pipe in NPP. This work presents a review of current developments in NDE technology for both HDPE pipe in NPP with a diameter of less than 400 mm and that of a larger size. For the former category, phased array ultrasonic technique is proven effective for inspecting typical defects in HDPE pipe, and is thus used in Chinese national standards GB/T 29460 and GB/T 29461. A defect-recognition technique is developed based on pattern recognition, and a safety assessment principle is summarized from the database of destructive testing. On the other hand, recent research and practical studies reveal that in current ultrasonic-inspection technology, the absence of effective ultrasonic inspection for large size was lack of consideration of the viscoelasticity effect of PE on acoustic wave propagation in current ultrasonic inspection technology. Furthermore, main technical problems were analyzed in the paper to achieve an effective ultrasonic test method in accordance to the safety and efficiency requirements of related regulations and standards. Finally, the development trend and challenges of NDE test technology for HDPE in NPP are discussed.

  16. Review of mercury pollution in South Africa: current status

    CSIR Research Space (South Africa)

    Walters, Chavon R

    2011-08-01

    Full Text Available The present paper is a review on the status of mercury (Hg) as a pollutant in South African aquatic ecosystems. Spatial patterns of Hg distribution and bioaccumulation in water resources were investigated by collecting and analyzing multimedia...

  17. Review of Factor Analytic Studies Examining Symptoms of Autism Spectrum Disorders

    Science.gov (United States)

    Shuster, Jill; Perry, Adrienne; Bebko, James; Toplak, Maggie E.

    2014-01-01

    Factor analytic studies have been conducted to examine the inter-relationships and degree of overlap among symptoms in Autism Spectrum Disorder (ASD). This paper reviewed 36 factor analytic studies that have examined ASD symptoms, using 13 different instruments. Studies were grouped into three categories: Studies with all DSM-IV symptoms, studies…

  18. Music Student Teaching Seminars: An Examination of Current Practices Across the United States

    Science.gov (United States)

    Baumgartner, Christopher M.; Councill, Kimberly H.

    2017-01-01

    The purpose of this study was to examine the structure and content of music student teaching seminars at 4-year, degree-granting institutions accredited by the National Association of Schools of Music across the United States. A secondary purpose was to determine how these seminars (a) addressed perceived needs of student teachers and beginning…

  19. Current and future state of FDA-CMS parallel reviews.

    Science.gov (United States)

    Messner, D A; Tunis, S R

    2012-03-01

    The US Food and Drug Administration (FDA) and the Centers for Medicare and Medicaid Services (CMS) recently proposed a partial alignment of their respective review processes for new medical products. The proposed "parallel review" not only offers an opportunity for some products to reach the market with Medicare coverage more quickly but may also create new incentives for product developers to conduct studies designed to address simultaneously the information needs of regulators, payers, patients, and clinicians.

  20. Activity-based costing for pathology examinations and comparison with the current pricing system in Turkey.

    Science.gov (United States)

    Ergün, Ferda A K; Ağirbaş, Ismail; Kuzu, Işınsu

    2013-01-01

    To demonstrate the real cost data of the pathology examinations by using the activity-based costing method and to contribute to the financial planning of the departments, health managers and also the social security institution. Forty-four examinations selected from the Healthcare Implementation Notification system list and performed at the Ankara University Faculty of Medicine Pathology Department during September 2010 were studied. The analysis and the real cost calculations were done according to the duration of the procedures. Calculated costs were compared with the Healthcare Implementation Notification system and Medicare price lists. The costs of the pathology tests listed within the same pricing levels in the Healthcare Implementation Notification system list showed great differences. The minimum and maximum costs in level 1, 2, 3, and 4 were 15,98-80,15 TL, 15,95-258,59 TL, 42,38- 236,87 TL, and 124,42-406,76 TL, respectively. Medicare price levels were more consistent with the real costs of the examinations compared to the Healthcare Implementation Notification system price list. The prices of the pathology examination listed at different levels in the Healthcare Implementation Notification system lists do not cover the real costs of the work done. The principal parameters of Activity-Based Costing system are more suitable for making the most realistic cost categorization. Although the prices could differ between countries, the Medicare system categories are more realistic than the Healthcare Implementation Notification system. The Healthcare Implementation Notification system list needs to be revised in order to reflect the real costs of the pathology examinations.

  1. Postural Control Impairments in Individuals With Autism Spectrum Disorder: A Critical Review of Current Literature

    Science.gov (United States)

    Memari, Amir Hossein; Ghanouni, Parisa; Shayestehfar, Monir; Ghaheri, Banafsheh

    2014-01-01

    Context: Motor impairments in individuals with autism spectrum disorder (ASD) have been frequently reported. In this review, we narrow our focus on postural control impairments to summarize current literature for patterns, underlying mechanisms, and determinants of posture in this population. Evidence Acquisition: A literature search was conducted through Medline, ISI web of Knowledge, Scopus and Google Scholar to include studies between 1992 and February 2013. Results: Individuals with ASD have problems in maintaining postural control in infancy that well persists into later years. However, the patterns and underlying mechanisms are still unclear. Conclusions: Examining postural control as an endophenotype or early diagnostic marker of autism is a conceptual premise which should be considered in future investigations. At the end of the review, methodological recommendations on the assessment of postural control have also been provided. PMID:25520765

  2. Assessment of panoramic radiography as a national oral examination tool: review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Woo [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2011-03-15

    The purpose of this review is to evaluate the possibility of panoramic radiography as a national oral examination tool. This report was carried out by review of the literatures. Panoramic radiography has sufficient diagnostic accuracy in dental caries, periodontal diseases, and other lesions. Also, the effective dose of panoramic radiography is lower than traditional full-mouth periapical radiography. Panoramic radiography will improve the efficacy of dental examination in national oral examination. However, more studies are required to evaluate the benefit, financial cost, and operation time and also to make selection criteria and quality management program.

  3. In-service examination of IHX tubing with eddy current NDT equipment

    International Nuclear Information System (INIS)

    Brown, R.L.

    1972-01-01

    Single and multiple frequency eddy current (ET) nondestructive testing (NDT) techniques and equipment were investigated for in-service inspection of sodium-contaminated intermediate heat exchanger (IHX) tubing. A four frequency technique, demonstrated in the laboratory, was relatively insensitive to signals caused by probe motion, tube support plates, and residual sodium on the outer surface of the tubes. No method was found to avoid the signals from residual sodium on the inside surfaces of the tube. (U.S.)

  4. A Model based Examination of Conditions for Ignition of Turbidity Currents on Slopes

    Science.gov (United States)

    Mehta, A. J.; Krishna, G.

    2009-12-01

    Turbidity currents form a major mechanism for the movement of sediment in the natural environment. Self-accelerating turbidity currents over continental slopes are of considerable scientific and engineering interest due to their role as agents for submarine sediment transportation from the shelf to the seabed. Such currents are called ignitive provided they eventually reach a catastrophic state as acceleration results in high sediment loads due to erosion of the sloping bed. A numerical model, which treats the fluid and the particles as two separate phases, is applied to investigate the effects of particle size, initial flow friction velocity and mild bed slope on the ignitive condition. Laboratory experimental data have been included as part of the analysis for qualitative comparison purposes. Ignition for the smallest of the three selected sizes (0.21mm) of medium sand typical of Florida beaches was found to depend on the initial conditions at the head of the slope as determined by the pressure gradient. Bed slope seemed to be of secondary importance. For the two sands with larger grain sizes (0.28mm and 0.35mm) the slope was found to play a more important role when compared to the initial pressure gradient. For a given pressure gradient, increasing the slope increased the likelihood of self-acceleration. It is concluded that in general ignition cannot be defined merely in terms of positive values of the velocity gradient and the sediment flux gradient along the slope. Depending on particle size the initial pressure gradient can also play a role. For the selected initial conditions (grain size, pressure gradient and bed slope), out of the 54 combinations tested, all except three satisfied the Knapp-Bagnold criterion for auto-suspension irrespective of whether the turbid current was ignitive or non-ignitive. In all 54 cases the current was found to erode the bed. Further use of the model will require accommodation of wider ranges of sediment size and bed density

  5. An examination of gender differences in the American Fisheries Society peer-review process

    Science.gov (United States)

    Handley, Grace; Frantz, Cynthia M; Kocovsky, Patrick; DeVries, Dennis R.; Cooke, Steven J.; Claussen, Julie

    2015-01-01

    This study investigated the possibility of gender differences in outcomes throughout the peer review process of American Fisheries Society (AFS) journals. For each manuscript submitted to four AFS journals between January 2003 and December 2010, we collated information regarding the gender and nationality of authors, gender of associate editor, gender of reviewers, reviewer recommendations, associate editor's decision, and publication status of the manuscript. We used hierarchical linear modeling to test for differences in manuscript decision outcomes associated with author, reviewer, and associate editor gender. Gender differences were present at some but not every stage of the review process and were not equal among the four journals. Although there was a small gender difference in decision outcomes, we found no evidence of bias in editors’ and reviewers’ recommendations. Our results support the conclusion that the current single-blind review system does not result in bias against female authors within AFS journals.

  6. Common Ice Hockey Injuries and Treatment: A Current Concepts Review.

    Science.gov (United States)

    Mosenthal, William; Kim, Michael; Holzshu, Robert; Hanypsiak, Bryan; Athiviraham, Aravind

    Injuries are common in ice hockey, a contact sport where players skate at high speeds on a sheet of ice and shoot a vulcanized rubber puck in excess of one hundred miles per hour. This article reviews the diagnoses and treatment of concussions, injuries to the cervical spine, and lower and upper extremities as they pertain to hockey players. Soft tissue injury of the shoulder, acromioclavicular joint separation, glenohumeral joint dislocation, clavicle fractures, metacarpal fractures, and olecranon bursitis are discussed in the upper-extremity section of the article. Lower-extremity injuries reviewed in this article include adductor strain, athletic pubalgia, femoroacetabular impingement, sports hernia, medial collateral and anterior cruciate ligament tears, skate bite, and ankle sprains. This review is intended to aid the sports medicine physician in providing optimal sports-specific care to allow their athlete to return to their preinjury level of performance.

  7. An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

    Science.gov (United States)

    McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

    2018-05-01

    This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and

  8. The current state of epilepsy guidelines: A systematic review.

    Science.gov (United States)

    Sauro, Khara M; Wiebe, Samuel; Dunkley, Colin; Janszky, Jozsef; Kumlien, Eva; Moshé, Solomon; Nakasato, Nobukazu; Pedley, Timothy A; Perucca, Emilio; Senties, Horacio; Thomas, Sanjeev V; Wang, Yuping; Wilmshurst, Jo; Jetté, Nathalie

    2016-01-01

    The International League Against Epilepsy (ILAE) Epilepsy Guidelines Task Force, composed of 14 international members, was established in 2011 to identify, using systematic review methodology, international epilepsy clinical care guidelines, assess their quality, and determine gaps in areas of need of development. A systematic review of the literature (1985-2014) was performed in six electronic databases (e.g. Medline, Embase) using a broad search strategy without initial limits to language or study design. Six gray literature databases (e.g., American Academy of Neurology [AAN], ILAE) were also searched to minimize publication bias. Two independent reviewers screened abstracts, reviewed full text articles, and performed data abstraction. Descriptive statistics and a meta-analysis were generated. The search identified 10,926 abstracts. Of the 410 articles selected for full text review, 63 met our eligibility criteria for a guideline. Of those included, 54 were in English and 9 were in other languages (French, Spanish, and Italian). Of all guidelines, 29% did not specify the target age groups, 27% were focused on adults, 22% included only children, and 6% specifically addressed issues related to women with epilepsy. Guidelines included in the review were most often aimed at guiding clinical practice for status epilepticus (n = 7), first seizure (n = 6), drug-resistant epilepsy (n = 5), and febrile seizures (n = 4), among others. Most of the guidelines were therapeutic (n = 35) or diagnostic (n = 16) in nature. The quality of the guidelines using a 1-7 point scale (7 = highest) varied and was moderate overall (mean = 4.99 ± 1.05 [SD]). We identified substantial gaps in topics (e.g., epilepsy in the elderly) and there was considerable heterogeneity in methodologic quality. The findings should offer a valuable resource for health professionals caring for people with epilepsy, since they will help guide the prioritization, development, and dissemination of future

  9. Mercury-induced motor and sensory neurotoxicity: systematic review of workers currently exposed to mercury vapor.

    Science.gov (United States)

    Fields, Cheryl A; Borak, Jonathan; Louis, Elan D

    2017-11-01

    The neurotoxicity of elemental mercury (Hg 0 ) is well-recognized, but it is uncertain whether and for how long neurotoxicity persists; among studies that evaluated previously exposed workers, only one examined workers during and also years after exposure ceased. The aim of this review is to document the type, frequency, and dose-relatedness of objective neurological effects in currently exposed mercury workers and thereby provide first approximations of the effects one would have expected in previously exposed workers evaluated during exposure. We systematically reviewed studies of neurotoxicity in currently exposed mercury workers identified by searching MEDLINE (1950-2015), government reports, textbook chapters, and references cited therein; dental cohorts were not included. Outcomes on physical examination (PE), neurobehavioral (NB) tests, and electrophysiological studies were extracted and evaluated for consistency and dose-relatedness. Forty-five eligible studies were identified, comprising over 3000 workers chronically exposed to a range of Hg 0 concentrations (0.002-1.7 mg/m 3 ). Effects that demonstrated consistency across studies and increased frequency across urine mercury levels (200 μg/L, while NB testing is more appropriate for those with lower U Hg levels. They also provide benchmarks to which findings in workers with historical exposure can be compared.

  10. Review of the current state of UAV regulations

    NARCIS (Netherlands)

    Stöcker, Elvira Claudia; Bennett, Rohan; Nex, Francesco; Gerke, Markus; Zevenbergen, Jaap

    2017-01-01

    UAVs-unmanned aerial vehicles-facilitate data acquisition at temporal and spatial scales that still remain unachievable for traditional remote sensing platforms. However, current legal frameworks that regulate UAVs present significant barriers to research and development. To highlight the

  11. Reflecting on the mirror neuron system in autism: a systematic review of current theories.

    Science.gov (United States)

    Hamilton, Antonia F de C

    2013-01-01

    There is much interest in the claim that dysfunction of the mirror neuron system in individuals with autism spectrum condition causes difficulties in social interaction and communication. This paper systematically reviews all published studies using neuroscience methods (EEG/MEG/TMS/eyetracking/EMG/fMRI) to examine the integrity of the mirror system in autism. 25 suitable papers are reviewed. The review shows that current data are very mixed and that studies using weakly localised measures of the integrity of the mirror system are hard to interpret. The only well localised measure of mirror system function is fMRI. In fMRI studies, those using emotional stimuli have reported group differences, but studies using non-emotional hand action stimuli do not. Overall, there is little evidence for a global dysfunction of the mirror system in autism. Current data can be better understood under an alternative model in which social top-down response modulation is abnormal in autism. The implications of this model and future research directions are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. A Review of Atmospheric Ozone and Current Thinking on the Antarctic Ozone Hole.

    Science.gov (United States)

    1987-01-01

    UNIVERSITY OF CALIFORNIA 0 A Review of Atmospheric ozone and Current Thinking on the Antartic Ozone Hole A thesis submitted in partial satisfaction of the...4. TI TLE (Pit 5,1tlfie) S. TYPE OF REPORT & PFRIOO COVERED A Review of Atmospheric Ozone and Current THESIS/DA/;J.At1AAU00 Thinking on the Antartic ...THESIS A Review of Atmospheric Ozone and Current Thinking on the Antartic Ozone Hole by Randolph Antoine Fix Master of Science in Atmospheric Science

  13. The critical current of superconductors: an historical review

    International Nuclear Information System (INIS)

    Dew-Hughes, D.

    2001-01-01

    The most important practical characteristic of a superconductor is its critical current density. This article traces the history, both of the experimental discoveries and of the development of the theoretical ideas that have lead to the understanding of those factors that control critical current densities. These include Silsbee's hypothesis, the Meissner effect, London, Ginsburg-Landau and Abrikosov theories, flux pinning and the critical state, and the control of texture in high temperature superconductors

  14. CANADA’S MOTHER-CHILD PROGRAM: EXAMINING ITS EMERGENCE, USAGE, AND CURRENT STATE

    Directory of Open Access Journals (Sweden)

    Sarah Brennan

    2014-04-01

    Full Text Available One of many issues a mother must face while incarcerated is separation from her child(ren for an extended period of time. Empirical findings have consistently highlighted various negative effects for both mothers and their children as a result of this separation. To curb some of the negative effects, Correctional Service Canada’s Mother-Child Program offers full- and part-time visitation between children and their incarcerated mothers at various women’s federal correctional facilities in Canada. The current study involves an in-depth critical analysis of Canada’s MCP by asking three related questions. First, to what extent has the MCP been used since its full implementation in 2001? Second, to what extent is the MCP used today? Third, do any barriers exist currently that are inhibiting the success of the MCP and, if so, how can these be addressed? The results of the study reveal that, since the full implementation of the program in 2001, the participation rate declined from an already low starting point and has remained relatively low since. Further, three main factors were suggested as potential barriers impeding the success of the MCP: correctional overcrowding, a more punitive institutional culture, and a series of changes to the program’s eligibility criteria. Recommendations on ways to increase the usage of the program are offered and suggestions for future research are made.

  15. Eddy current examination of the nuclear fuel elements of IPR-R1 research reactor

    International Nuclear Information System (INIS)

    Silva, Roger F.; Frade, Rangel T.; Oliveira, Paulo F.; Silva, Marlucio A.; Silva Junior, Silverio F.

    2015-01-01

    Tubes of AISI 304 stainless steel as well as tubes of Aluminum 1100-F are used as cladding of the fuel elements of TRIGA MARK 1 nuclear research reactor. Usually, these tubes are periodically inspected by means of visual test and sipping test. The visual test allows the detection of changes occurred at the external fuel elements surface, such as those promoted by corrosion processes. However, this test method cannot be used for detection of internal discontinuities at the tube walls. Sipping test allows the detection of fuel elements in which the cladding has failed, but it is not able to determine the place where the discontinuity is located. In turn, eddy current testing, an electromagnetic nondestructive test method, allows the detection of discontinuities and monitoring their growth. In this paper, a study about the use of eddy current testing for detection and characterization of discontinuities in the fuel elements cladding is proposed. The study involves the development of probes able to operate in underwater inspections, the design and manufacture of reference standards and the development of a test methodology to perform the evaluations. (author)

  16. Multifrequency eddy current examination for surface defects detection of hot steel products

    International Nuclear Information System (INIS)

    Hiroshima, Tatsuo; Sakamoto, Takahide; Takahashi, Akio; Miyata, Kenichi.

    1985-01-01

    Multifrequency eddy current testing method using probe coils has been studied for surface defects detection in hot steel products at high temperature over the magnetic Curie point. The conventional signal processing method is not available for suppression of an undesirable signal caused by lift-off variation or unevenness in inspected surfaces, because the undesirable signal pattern is similar to a defect signal pattern. In order to suppress the undesirable signal a new dual frequency signal processing method using three phase rotators has been developed, and was applied to several hot steel inspections. The results are as follows. 1. In the rotating eddy current machine for hot steel rods, the lift-off variation signal caused by a wobble of rods or the difference between rotating center and pass center of rods can be suppressed. A long seam or crack whose depth is more than 0.5mm can be detected. 2. In the hot inspection for continuously cast slabs, the signal caused by oscillation mark whose depth is under 1 mm can be suppressed. A fine transversal crack whose depth is 2 mm can be detected. 3. In the hot inspection for round billets, the lift-off variation signal caused by oval shape can be eliminated, and a crack which is deeper than 1.5 mm can be clearly detected. The detectability of defects can be improved by the analysis of dual frequency signal pattern. (author)

  17. Eddy current examination of the nuclear fuel elements of IPR-R1 research reactor

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Roger F.; Frade, Rangel T.; Oliveira, Paulo F.; Silva, Marlucio A.; Silva Junior, Silverio F., E-mail: rfs@cdtn.br, E-mail: rtf@cdtn.br, E-mail: pfo@cdtn.br, E-mail: mas@cdtn.br, E-mail: silvasf@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2015-07-01

    Tubes of AISI 304 stainless steel as well as tubes of Aluminum 1100-F are used as cladding of the fuel elements of TRIGA MARK 1 nuclear research reactor. Usually, these tubes are periodically inspected by means of visual test and sipping test. The visual test allows the detection of changes occurred at the external fuel elements surface, such as those promoted by corrosion processes. However, this test method cannot be used for detection of internal discontinuities at the tube walls. Sipping test allows the detection of fuel elements in which the cladding has failed, but it is not able to determine the place where the discontinuity is located. In turn, eddy current testing, an electromagnetic nondestructive test method, allows the detection of discontinuities and monitoring their growth. In this paper, a study about the use of eddy current testing for detection and characterization of discontinuities in the fuel elements cladding is proposed. The study involves the development of probes able to operate in underwater inspections, the design and manufacture of reference standards and the development of a test methodology to perform the evaluations. (author)

  18. Current Status of Acanthamoeba in Iran: A Narrative Review Article.

    Directory of Open Access Journals (Sweden)

    Maryam Niyyati

    2015-06-01

    Full Text Available Free-living amoebae belonging to the genus Acanthamoeba have an environmental distribution. Amoebic keratitis due to these protozoan parasites continue to rise in Iran and worldwide. In Iran, there are various researches regarding both morphological and molecular identification of Acanthamoeba spp. in environmental and clinical samples. However, there is no thorough review about Acanthamoeba genotypes and their distribution in environmental sources such as water, dust and biofilm in Iran. Besides, according to increasing cases of Amoebic keratitis in the region awareness regarding the pathogenic potential of these sight-threatening amoebae is of utmost importance.We conducted a thorough review based on the database sources such as MEDLINE, PubMed and Google scholar. No restrictions were placed on study date, study design or language of publication. We searched all valuable and relevant information considering the occurrence of the Acanthamoeba in both environmental and clinical samples.According to our thorough review Acanthamoeba belonging to T4 genotype is the most prevalent type strain in environmental and clinical samples in several regions in Iran and worldwide, however, there are reports regarding Acanthamoeba belonging to other genotypes such as T2, T3, T5, T6 and T11 and the mentioned point could leads us to more researches with the goal of presenting the real genotype dominance of Acanthamoeba and related disease in the country.Overall, the present review will focus on present status of genotypes of Acanthamoeba in Iran during recent years.

  19. Helicobacter pylori eradication therapy: A review of current trends ...

    African Journals Online (AJOL)

    Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa‑associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the ...

  20. A review of the current literature on management of halitosis.

    NARCIS (Netherlands)

    Broek, A.M. van den; Feenstra, L.; Baat, C. de

    2008-01-01

    Halitosis is an unpleasant or offensive odour, emanating from the oral cavity. In approximately 80% of all cases, halitosis is caused by microbial degradation of oral organic substrates. Major degradation products are volatile sulphur-containing compounds. In this review, the available management

  1. Coherent control of single electrons: a review of current progress

    Science.gov (United States)

    Bäuerle, Christopher; Glattli, D. Christian; Meunier, Tristan; Portier, Fabien; Roche, Patrice; Roulleau, Preden; Takada, Shintaro; Waintal, Xavier

    2018-05-01

    In this report we review the present state of the art of the control of propagating quantum states at the single-electron level and its potential application to quantum information processing. We give an overview of the different approaches that have been developed over the last few years in order to gain full control over a propagating single-electron in a solid-state system. After a brief introduction of the basic concepts, we present experiments on flying qubit circuits for ensemble of electrons measured in the low frequency (DC) limit. We then present the basic ingredients necessary to realise such experiments at the single-electron level. This includes a review of the various single-electron sources that have been developed over the last years and which are compatible with integrated single-electron circuits. This is followed by a review of recent key experiments on electron quantum optics with single electrons. Finally we will present recent developments in the new physics that has emerged using ultrashort voltage pulses. We conclude our review with an outlook and future challenges in the field.

  2. Examining the safety of PPAR agonists - current trends and future prospects.

    Science.gov (United States)

    Bortolini, Michele; Wright, Matthew B; Bopst, Martin; Balas, Bogdana

    2013-01-01

    The peroxisome proliferator-activated receptor (PPAR)-α and -γ agonists, fibrates and glitazones, are effective treatments for dyslipidemia and type 2 diabetes mellitus, respectively, but exhibit class-related, as well as compound-specific safety characteristics. This article reviews the profiles of PPAR-α, PPAR-γ, and dual PPAR-α/γ agonists with regard to class-related and compound-specific efficacy and adverse effects. We explore how learnings from first-generation drugs are being applied to develop safer PPAR-targeted therapies. The finding that rosiglitazone may increase risk for cardiovascular events has led to regulatory guidelines requiring demonstration of cardiovascular safety in appropriate outcome trials for new type 2 diabetes mellitus drugs. The emerging data on the possibly increased risk of bladder cancer with pioglitazone may prompt the need for post-approval safety studies for new drugs. Since PPAR-α and -γ affect key cardiometabolic risk factors (diabetic dyslipidemia, insulin resistance, hyperglycemia, and inflammation) in a complementary fashion, combining their benefits has emerged as a particularly attractive option. New PPAR-targeted therapies that balance the relative potency and/or activity toward PPAR-α and -γ have shown promise in retaining efficacy while reducing potential side effects.

  3. [Development and Current Status of Quality Management Systems for Specimen Examination].

    Science.gov (United States)

    Kanemura, Shigeru

    2015-07-01

    ISO 15189:2003 was published as an International Standard in 2003 by Technical Committee ISO/TC212 of the International Organization for Standardization (ISO). This international standard based on ISO 9001 specifies requirements for competence and quality that are specific to medical laboratories. With the publication of this standard, we will have to markedly change our concept. We have to adopt methods to manage the causes of errors in measurement processes rather than methods to manage only the results of measurements. The new concept of the Quality Management System (QMS) which manages the result of measurements is summarized. With the publication of ISO 15189, the definition of the quality assurance of examination results became clearer and stricter. This report describes the contents of ISO 15189 and the method of enforcing it.

  4. 77 FR 4366 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Current...

    Science.gov (United States)

    2012-01-27

    ... with disabilities for employment; the work history, barriers to employment, and workplace... for OMB Review; Comment Request; Current Population Survey Disability Supplement ACTION: Notice... information collection request (ICR) proposal titled, ``Current Population Survey Disability Supplement,'' to...

  5. Review of current therapies for secondary hypertrophic pulmonary osteoarthropathy.

    Science.gov (United States)

    Nguyen, Sheila; Hojjati, Mehrnaz

    2011-01-01

    Hypertrophic osteoarthropathy (HOA) is a disabling condition that may occur secondarily to primary lung cancer. It is characterized by digital clubbing, arthralgia/arthritis, and periostosis of the tubular bones. The pain associated with HOA can be disabling and often refractory to conventional analgesics. We performed a comprehensive review of the literature using the PubMed database on treatment modalities available for HOA. We found 52 relevant articles-40 case reports, six case series, two review papers, and four combined case series and review papers. There were no randomized controlled trials reported. We then classified treatments used for HOA into two categories: (1) treatment of primary cause (i.e., resection of tumor, chemotherapy, radiotherapy, treatment of infection, etc.) and (2) symptomatic treatments (i.e., bisphosphonates, octreotide, NSAIDs, vagotomy, etc.). Subsequently, we summarized the main findings for each treatment. Although the clinical diagnosis of HOA has existed for over 100 years, the pathogenesis mechanism has not yet been elucidated, and treatment options for this condition remain experimental. Primary treatment is the most widely reported modality to be efficacious. In cases which primary therapy is not possible, several symptomatic treatment modalities are suggested, with various degree of success. Further research is needed to clarify the pathophysiological mechanism of HOA as to appropriately direct therapy.

  6. Application of eddy currents to post-irradiation examination of fuel rods

    International Nuclear Information System (INIS)

    Domizzi, G.; Ruch, M.; Ruggirello, G.; Spinosa, C.

    1997-01-01

    Postirradiation tests are performed on the fuel bundles of nuclear power plants, in order to evaluate their performance. The Zircaloy-4 cladding, the first containment of the fission products, is a very important part of these bundles. A fundamental step of these tests is the in-pool identification of the failed bars in the 'suspect' bundles. Later, once in the hot cell facility and prior to the destructive tests, it is necessary to characterize the defects in the cladding. The eddy current method provides a means for fast and reliable detection and characterisation of defects unobservable in visual inspection, such as tiny cracks, pores and anomalously hydride regions. The project for the application of this method in postirradiation tests has been divided into three stages, namely laboratory set up, in-pool tests, hot-cell application, the first one being described here. Techniques for the construction of synthetic defects (machined, micro cracks, abnormal hydride concentration, hydride blisters, oxide layers) were developed. A mechanical device for automatic probe movement was designed and constructed. Special external probes for the particular defects were developed. The inspection procedure was prepared. (author) [es

  7. Experimental typography : reviewing the modernist and the current approaches

    OpenAIRE

    Makal, Eray

    1993-01-01

    Ankara : The Department of Graphic Design and Institute of Fine Arts, Bilkent Univ., 1993. Thesis (Master's) -- Bilkent University, 1993. Includes bibliographical references leaves 65-66. The intention of this study is to evaluate the experimental typography within the history of graphic design by taking in consideration of two epochs. The Modernist and The Current. Makal, Eray M.S.

  8. Abnormal compression wood in Pinus taeda : a review of current ...

    African Journals Online (AJOL)

    Abnormal compression wood in P. taeda stands was first discovered in the early 1980s. Since then several research projects and surveys have been carried out in order to develop a better understanding of the problem and to try to find a solution. Currently a large proportion of the sawmill intake of logs in the Mpumalanga ...

  9. Overcoming pitfalls: Results from a mandatory peer review process for written examinations.

    Science.gov (United States)

    Wilby, Kyle John; El Hajj, Maguy S; El-Bashir, Marwa; Mraiche, Fatima

    2018-04-01

    Written assessments are essential components of higher education practices. However, faculty members encounter common pitfalls when designing questions intended to evaluate student-learning outcomes. The objective of this project was to determine the impact of a mandatory examination peer review process on question accuracy, alignment with learning objectives, use of best practices in question design, and language/grammar. A mandatory peer review process was implemented for all midterm (before phase) and final (after phase) examinations. Peer review occurred by two reviewers and followed a pre-defined guidance document. Non-punitive feedback given to faculty members served as the intervention. Frequencies of flagged questions according to guidance categories were compared between phases. A total of 21 midterm and 21 final exam reviews were included in the analysis. A total of 637 questions were reviewed across all midterms and 1003 questions were reviewed across all finals. Few questions were flagged for accuracy and alignment with learning outcomes. The median total proportion of questions flagged for best practices was significantly lower for final exams versus midterm exams (15.8 vs. 6.45%, p = 0.014). The intervention did not influence language and grammar errors (9.68 vs. 10.0% of questions flagged before and after, respectively, p = 0.305). A non-punitive peer review process for written examinations can overcome pitfalls in exam creation and improve best practices in question writing. The peer-review process had a substantial effect at flagging language/grammar errors but error rate did not differ between midterm and final exams. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Osteoarthritis: A review of old myths and current concepts

    International Nuclear Information System (INIS)

    Alexander, C.J.

    1990-01-01

    Radiology is dependent on an accurate understanding of the pathological process. This review of primary osteoarthritis identifies eight areas in which widely held concepts are either demonstrably false or fall short of proof. In some, the concepts have been disproved by the gradual accumulation of evidence. In others, the error is due to readiological misinterpretation while in a third group, the evidence is not in dispute, but the logical framework used in its assessment is flawed. Awareness of these deficiencies simplifies radiological interpretation and clarifies research objectives. (orig.)

  11. Equestrian sport-related injuries: a review of current literature.

    Science.gov (United States)

    Havlik, Heather S

    2010-01-01

    Equestrian sports continue to grow in popularity in the Unites States and abroad, with an estimated 30 million people riding horses annually in the United States alone. Approximately one in five of these riders will suffer a serious injury during their riding career, requiring medical care and potentially hospitalization. Riding carries with it an implicit risk of injury associated with the unpredictability of the animals, the rider's head being positioned approximately 9 feet off the ground, and traveling unrestrained at speeds up to 40 mph. This article reviews common equestrian injuries, epidemiology, mechanism of injury, risk factors, and prevention strategies, with an emphasis on the more dangerous aspects of the sport.

  12. Review of lower hybrid wave heating and current drive

    International Nuclear Information System (INIS)

    Gormezano, C.

    1986-01-01

    Interaction of Lower Hybrid waves and plasmas is a very versatile method which has proven to be effective in a large range of applications: bulk ion heating, bulk electron heating, non inductive current drive. If the ratio between the mean velocity of HF induced fast particles and the thermal velocity of the bulk population is relatively small, effective bulk ion heating or bulk electron heating can occur via collisional transfer. If the above ratio is too large, fast ions, which have mainly a perpendicular energy, are poorly confined. Moreover they can be harmful for the discharge (impurities, etc...) since they are lost on the walls. In contrast, HF induced fast electrons gain essentially a parallel momentum from the wave. If unidirectional waves are launched, the dissymetry in electron distribution result in the obtention of an effective non inductive current

  13. Gestational Diabetes Mellitus: a review of current diagnostic strategies concepts

    Directory of Open Access Journals (Sweden)

    Juan Sebastián Frías-Ordoñez

    2016-10-01

    Full Text Available Gestational diabetes mellitus (GDM is a state of carbohydrate intolerance that is first recognized during pregnancy. The initial criteria for diagnosis were established more than 50 years ago by O’Sullivan & Mahan, and since then, some modifications have been made. Currently, diagnosis considers two methods: the onestep approach, consisting of an oral glucose tolerance test (OGTT for 2 hours with 75g of glucose, and the two-step approach, which involves an initial screening test with 50g of glucose and OGTT with 100g of glucose if screening is positive. Both diagnostic approaches have been justified by expert consensus; however, an absolute concept about the method to be applied has not been established yet. To select a method, the clinician must take into account various factors. This paper proposes a historical overview and the presentation of the current status of GDM diagnosis.

  14. Combined Wave and Current Bottom Boundary Layers: A Review

    Science.gov (United States)

    2016-03-01

    transport, (3) the process of wave transition in shallow water in the presence of strong alongshore currents, (4) the interaction between oblique...conducted in relatively deep water with bottom sediment comprised mostly of silt. One of the earlier studies for a wide shallow shelf was conducted off...wave asymmetry in combined flows and how this drives mass transport, (3) the process of wave transition in shallow water in the presence of strong

  15. ULTRAHIGH ENERGY COSMIC RAYS: REVIEW OF THE CURRENT SITUATION

    Directory of Open Access Journals (Sweden)

    Todor Stanev

    2013-12-01

    Full Text Available We describe the current situation of the data on the highest energy particles in the Universe – the ultrahigh energy cosmic rays. The new results in the field come from the Telescope Array experiment in Utah, U.S.A. For this reason we concentrate on the results from these experiments and compare them to the measurements of the other two recent experiments, the High Resolution Fly’sEye and the Southern Auger Observatory.

  16. A review of current sleep screening applications for smartphones

    International Nuclear Information System (INIS)

    Behar, Joachim; Roebuck, Aoife; Domingos, João S; Gederi, Elnaz; Clifford, Gari D

    2013-01-01

    Sleep disorders are a common problem and contribute to a wide range of healthcare issues. The societal and financial costs of sleep disorders are enormous. Sleep-related disorders are often diagnosed with an overnight sleep test called a polysomnogram, or sleep study involving the measurement of brain activity through the electroencephalogram. Other parameters monitored include oxygen saturation, respiratory effort, cardiac activity (through the electrocardiogram), as well as video recording, sound and movement activity. Monitoring can be costly and removes the patients from their normal sleeping environment, preventing repeated unbiased studies. The recent increase in adoption of smartphones, with high quality on-board sensors has led to the proliferation of many sleep screening applications running on the phone. However, with the exception of simple questionnaires, no existing sleep-related application available for smartphones is based on scientific evidence. This paper reviews the existing smartphone applications landscape used in the field of sleep disorders and proposes possible advances to improve screening approaches. (topical review)

  17. A review of current treatment strategies for gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kristi W Kelley

    2015-07-01

    Full Text Available Approximately 90% of diabetes cases in pregnant women are considered gestational diabetes mellitus (GDM. It is well known that uncontrolled glucose results in poor pregnancy outcomes in both the mother and fetus. Worldwide there are many guidelines with recommendations for appropriate management strategies for GDM once lifestyle modifications have been instituted and failed to achieve control. The efficacy and particularly the safety of other treatment modalities for GDM has been the source of much debate in recent years. Studies that have demonstrated the safety and efficacy of both glyburide and metformin in the management of patients with GDM will be reviewed. There is a lack of evidence with other oral and injectable non-insulin agents to control blood glucose in GDM. The role of insulin will be discussed, with emphasis on insulin analogs. Ideal patient characteristics for each treatment modality will be reviewed. In addition, recommendations for postpartum screening of patients will be described as well as recommendations for use of agents to manage subsequent type 2 diabetes in patients who are breastfeeding.

  18. The Clinical anatomy of the physical examination of the abdomen: A comprehensive review.

    Science.gov (United States)

    Bilal, Muhammad; Voin, Vlad; Topale, Nitsa; Iwanaga, Joe; Loukas, Marios; Tubbs, R Shane

    2017-04-01

    Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Book Review: Current Issues in International Human Resource Management and Strategy Research

    DEFF Research Database (Denmark)

    Gretzinger, Susanne

    2009-01-01

    The article reviews the book "Current Issues in International Human Resource Management and Strategy Research," edited by Marion Festing and Susanne Royer.......The article reviews the book "Current Issues in International Human Resource Management and Strategy Research," edited by Marion Festing and Susanne Royer....

  20. Current Trends on Lean Management – A review

    Directory of Open Access Journals (Sweden)

    M. Shabeena Begam

    2013-12-01

    Full Text Available All manufacturing industry has put in continuous efforts for its survival in the current impulsive and competitive economy. In order to handle the critical situation, manufacturers are trying to implement new and innovative techniques in their manufacturing process by making it more effective and efficient. A detailed literature survey has been conducted to identify the lean practices in various manufacturing industry. The results revealed that the status of Lean Manufacturing (LM implementation in still in thriving stage. This paper will further assist the organizations to improve its process, align it to the requirements of its customers and relentless contribution to manufacturing sector to enhance productivity, quality and competitiveness is immense.

  1. Review. The incentive sensitization theory of addiction: some current issues.

    Science.gov (United States)

    Robinson, Terry E; Berridge, Kent C

    2008-10-12

    We present a brief overview of the incentive sensitization theory of addiction. This posits that addiction is caused primarily by drug-induced sensitization in the brain mesocorticolimbic systems that attribute incentive salience to reward-associated stimuli. If rendered hypersensitive, these systems cause pathological incentive motivation ('wanting') for drugs. We address some current questions including: what is the role of learning in incentive sensitization and addiction? Does incentive sensitization occur in human addicts? Is the development of addiction-like behaviour in animals associated with sensitization? What is the best way to model addiction symptoms using animal models? And, finally, what are the roles of affective pleasure or withdrawal in addiction?

  2. Robotic Buccal Ureteroplasty: a Review of the Current Literature.

    Science.gov (United States)

    Waldorf, Benjamin; Lee, Ziho; Kidd, Laura; Kaplan, Joshua; Harris, Andrew; Metro, Michael; Liu, Jeffrey; Eun, Daniel

    2017-05-01

    This study aimed to provide an overview of the literature on buccal mucosal ureteroplasty for ureteral stricture disease, with a specific focus on the application of the robotic platform to buccal ureteroplasty. In our review, we highlight the results of Zhao et al. from the New York University School of Medicine Department of Urology, as well as our own results from Temple University Hospital. Zhao et al. published the first series of four patients who underwent robotic buccal ureteroplasty. Mean stricture length was 3.0 cm, and at a mean follow-up of 15 months, all repairs remained patent. We also describe our results in 10 patients who underwent robotic buccal ureteroplasty at Temple University Hospital. Median stricture length was 3.0 cm, and at a median follow-up of 5 months, all repairs remain patent. Robotic buccal ureteroplasty offers a promising option for repair of complex ureteral strictures.

  3. Current aspects of polycystic ovary syndrome: A literature review

    Directory of Open Access Journals (Sweden)

    VICTOR HUGO LOPES DE ANDRADE

    Full Text Available SUMMARY Polycystic ovary syndrome (PCOS is a heterogeneous endocrine disorder with variable prevalence, affecting about one in every 15 women worldwide. The diagnosis of polycystic ovary syndrome requires at least two of the following criteria: oligoovulation and/or anovulation, clinical and/or biochemical evidence of hyperandrogenism and morphology of polycystic ovaries. Women with PCOS appear to have a higher risk of developing metabolic disorders, hypertension and cardiovascular disorders. The aim of this article was to present a review of the literature by searching the databases Pubmed and Scielo, focusing on publications related to polycystic ovaries, including its pathogenesis, clinical manifestations, diagnosis and therapeutic aspects, as well as its association with cardiovascular and arterial hypertensive disorders.

  4. Filtered neutron beams at the FMRB - review and current status

    International Nuclear Information System (INIS)

    Alberts, W.G.; Dietz, E.

    1987-12-01

    A review is presented of our experience with filtered neutron beams installed in beam tubes of the Research and Measurement Reactor Braunschweig since 1976: Desing of the filters and measurement of the beam parameters are reported and an outline of the research work done with the beams is given. The present status of the irradiation facility, which consists of 5 beams (144 keV, 24.5 keV, 2 keV, 0.2 keV and thermal neutrons), is described in some detail to allow understanding of the physical as well as the technical prerequisites for performing calibrations of neutron measuring instruments. An appendix contains the actual beam parameters. (orig.) [de

  5. A review of current sleep screening applications for smartphones.

    Science.gov (United States)

    Behar, Joachim; Roebuck, Aoife; Domingos, João S; Gederi, Elnaz; Clifford, Gari D

    2013-07-01

    Sleep disorders are a common problem and contribute to a wide range of healthcare issues. The societal and financial costs of sleep disorders are enormous. Sleep-related disorders are often diagnosed with an overnight sleep test called a polysomnogram, or sleep study involving the measurement of brain activity through the electroencephalogram. Other parameters monitored include oxygen saturation, respiratory effort, cardiac activity (through the electrocardiogram), as well as video recording, sound and movement activity. Monitoring can be costly and removes the patients from their normal sleeping environment, preventing repeated unbiased studies. The recent increase in adoption of smartphones, with high quality on-board sensors has led to the proliferation of many sleep screening applications running on the phone. However, with the exception of simple questionnaires, no existing sleep-related application available for smartphones is based on scientific evidence. This paper reviews the existing smartphone applications landscape used in the field of sleep disorders and proposes possible advances to improve screening approaches.

  6. Review of the Current Management of Pressure Ulcers

    Science.gov (United States)

    Boyko, Tatiana V.; Longaker, Michael T.; Yang, George P.

    2018-01-01

    Significance: The incidence of pressure ulcers is increasing due to our aging population and the increase in the elderly living with disability. Learning how to manage pressure ulcers appropriately is increasingly important for all professionals in wound care. Recent Advances: Many new dressings and treatment modalities have been developed over the recent years and the goal of this review is to highlight their benefits and drawbacks to help providers choose their tools appropriately. Critical Issues: Despite an increased number of therapies available on the market, none has demonstrated any clear benefit over the others and pressure ulcer treatment remains frustrating and time-consuming. Future Directions: Additional research is needed to develop products more effective in prevention and treatment of pressure ulcers. PMID:29392094

  7. Current Status of Simulation in Otolaryngology: A Systematic Review.

    Science.gov (United States)

    Musbahi, Omar; Aydin, Abdullatif; Al Omran, Yasser; Skilbeck, Christopher James; Ahmed, Kamran

    Otolaryngology is a highly technical and demanding specialty and the requirements for surgical trainees to acquire proficiency remains challenging. Simulation has been purported to be an effective tool in assisting with this. The aim of this systematic review is to identify the available otolaryngology simulators, their status of validation, and evaluation the level of evidence behind each training model and thereby establish a level of recommendation. PubMed, ERIC, and Google Scholar databases were searched for articles that described otolaryngology simulators or training models between 1980 and April 2016. Any validation studies for simulators were also retrieved. Titles and abstracts were screened for relevance using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Level of evidence (LoE) and Level of recommendation (LoR) was awarded to each study and model, respectively. A total of 70 studies were identified describing 64 simulators. Out of these, at least 54 simulators had 1 validation study. Simulators for the ear and temporal bone surgery were the most common (n = 32), followed by laryngeal and throat (n = 20) and endoscopic sinus surgery (n = 12). Face validity was evaluated by 29 studies, 20 attempted to show construct, 20 assessed content, 20 transfer, and only 2 assessed concurrent validity. Of the validation assessments, 2 were classified as Level 1b, 10 Level 2a, and 48 Level 2b. No simulators received the highest LoR, but 8 simulators received a LoR of 2. Despite the lack of evidence in outcome studies and limited number of high-validity otolaryngology simulators, the role of simulation continues to grow across surgical specialties Hence, it is imperative that the simulators are of high validity and construct for trainees to practice and rehearse surgical skills to develop confidence. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. 13 CFR 120.1050 - On-site reviews and examinations.

    Science.gov (United States)

    2010-01-01

    ... losses); (3) Management quality (including internal controls, loan portfolio management, and asset... Risk-Based Lender Oversight Supervision § 120.1050 On-site reviews and examinations. (a) On-site... operations management; (3) Credit administration; and (4) Compliance with Loan Program Requirements. (b) On...

  9. Reviewing the Evidence on How Adult Students Learn: An Examination of Knowles' Model of Andragogy

    Science.gov (United States)

    McGrath, Valerie

    2009-01-01

    While there may be similarities between adults and children in how they learn (such as language, interaction and communication), many writers argue that adult learners are different from child learners in a number of ways. This article aims to review how adults learn through examining one particular theory of adult learning. Two conflicting…

  10. Preliminary perspectives gaines from individual plant examination of external events (IPEEE) seismic and fire submittal review

    International Nuclear Information System (INIS)

    Chen, J.T.; Connell, E.; Chokshi, N.

    1997-01-01

    As a result of the U.S. Nuclear Regulatory Commission (USNRC) initiated Individual plant Examination of External Events (IPEEE) program, every operating nuclear power reactor in the United States has performed an assessment of severe accident due to external events. This paper provides a summary of the preliminary insights gained through the review of 24 IPEEE submittals

  11. Current concepts of contrast-induced nephropathy: A brief review

    Directory of Open Access Journals (Sweden)

    Chao-Fu Chang

    2013-12-01

    Full Text Available Contrast-induced nephropathy (CIN is a common hospital-acquired acute kidney injury. Published studies on this condition have dramatically increased in recent years. This article aims to provide a brief literature review. English articles published from 1983 to 2012 were retrieved from PubMed by searching using the term “contrast-induced nephropathy.” Patients with CIN were associated with increased resource utilization, prolonged hospital stay, and increased long-term mortality. CIN is defined as a ≥0.5 mg/dL rise in serum creatinine or a 25% increase, assessed within 48–72 hours after administration of contrast medium (CM. All patients receiving CM should be evaluated for their CIN risk, especially preexisting kidney disease. The CM should be prewarmed to 37 °C and injected at the lowest possible dose. Repeat injection within 72 hours should be avoided. Either iso-osmolar CM or low-osmolar CM, except ioxaglate or iohexol, can be used in all patients. Iso-osmolar CM iodixanol may be a better choice for high-risk patients with chronic kidney disease requiring intra-arterial administration. Nephrotoxic drugs should be stopped 2 days prior to when the patient undergoes a procedure. All patients receiving CM should be at an optimal volume status. Parenteral isotonic saline without any diuretic should be started 12 hours prior to CM at a rate of 1 mL/kg/h and continued for 24 hours if there is no contraindication. In patients who require shorter volume supplement periods or are at a higher risk, bicarbonate infusion (154 mEq/L, 3 mL/kg/h for 1 hour bolus prior to CM, followed by 1 mL/kg/h for 6 hours may be used as an alternative to isotonic saline. Oral N-acetylcysteine (600 mg bid, starting on the day prior to the procedure together with parenteral hydration is suggested for patients at risk. Hemodialysis/hemofiltration is only considered in chronic kidney disease stage 4/5 patients when an access is available. The other medications

  12. Current Status of Mechanical Circulatory Support: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kyriakos Spiliopoulos

    2012-01-01

    Full Text Available Heart failure is a major public health problem and its management requires a significant amount of health care resources. Even with administration of the best available medical treatment, the mortality associated with the disease remains high. As therapeutical strategies for heart failure have been refined, the number of patients suffering from the disease has expanded dramatically. Although heart transplantation still represents the gold standard therapeutical approach, the implantation of mechanical circulatory support devices (MCSDs evolved to a well-established management for this disease. The limited applicability of heart transplantation caused by a shortage of donor organs and the concurrent expand of the patient population with end-stage heart failure led to a considerable utilization of MCSDs. This paper outlines the current status of mechanical circulatory support.

  13. Radiation and breast cancer: a review of current evidence

    International Nuclear Information System (INIS)

    Ronckers, Cécile M; Erdmann, Christine A; Land, Charles E

    2005-01-01

    This paper summarizes current knowledge on ionizing radiation-associated breast cancer in the context of established breast cancer risk factors, the radiation dose–response relationship, and modifiers of dose response, taking into account epidemiological studies and animal experiments. Available epidemiological data support a linear dose–response relationship down to doses as low as about 100 mSv. However, the magnitude of risk per unit dose depends strongly on when radiation exposure occurs: exposure before the age of 20 years carries the greatest risk. Other characteristics that may influence the magnitude of dose-specific risk include attained age (that is, age at observation for risk), age at first full-term birth, parity, and possibly a history of benign breast disease, exposure to radiation while pregnant, and genetic factors

  14. Current Status of Mycotoxin Analysis: A Critical Review.

    Science.gov (United States)

    Shephard, Gordon S

    2016-07-01

    It is over 50 years since the discovery of aflatoxins focused the attention of food safety specialists on fungal toxins in the feed and food supply. Since then, analysis of this important group of natural contaminants has advanced in parallel with general developments in analytical science, and current MS methods are capable of simultaneously analyzing hundreds of compounds, including mycotoxins, pesticides, and drugs. This profusion of data may advance our understanding of human exposure, yet constitutes an interpretive challenge to toxicologists and food safety regulators. Despite these advances in analytical science, the basic problem of the extreme heterogeneity of mycotoxin contamination, although now well understood, cannot be circumvented. The real health challenges posed by mycotoxin exposure occur in the developing world, especially among small-scale and subsistence farmers. Addressing these problems requires innovative approaches in which analytical science must also play a role in providing suitable out-of-laboratory analytical techniques.

  15. Current management of parainfluenza pneumonitis in immunocompromised patients: a review

    Directory of Open Access Journals (Sweden)

    Falsey AR

    2012-08-01

    Full Text Available Ann R FalseyUniversity of Rochester, Rochester General Hospital, Rochester, NY, USAAbstract: Parainfluenza viruses (PIV are common respiratory viruses that belong to the Paramyxoviridae family. PIV infection can lead to a wide variety of clinical syndromes ranging from mild upper respiratory illness to severe pneumonia. Severe disease can be seen in elderly or chronically ill persons and may be fatal in persons with compromised immune systems, particularly children with severe combined immunodeficiency disease syndrome and hematopathic stem cell transplant recipients. At present, there are no licensed antiviral agents for the treatment of PIV infection. Aerosolized or systemic ribavirin in combination with intravenous gamma globulin has been reported in small, uncontrolled series and case reports of immunocompromised patients. A number of agents show antiviral activity in vitro and in animals, but none are currently approved for human use.Keywords: parainfluenza virus, antiviral agents, immunocompromised host

  16. REVIEW OF CURRENT PRACTICE IN CHARACTERIZATION AND MONITORING

    Energy Technology Data Exchange (ETDEWEB)

    M.A.Ebadian, Ph.D.

    2001-01-01

    Characterization and monitoring are important parts of environmental remediation of contaminated sites by the Department of Energy--Office of Environmental Management (DOE-EM). The actual remediation process often cannot begin or even be planned until characterization is complete. Monitoring is essential to verify the progress of remediation and of the waste stream. However, some contaminated sites are difficult, costly, or have a high exposure risk to personnel to characterize or monitor using the baseline technology or current practice. Therefore, development of new characterization and monitoring technologies is time-critical to remediate these sites. The main task of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to develop and deploy innovative characterization and monitoring technologies that improve performance and reduce personnel exposure, cost, and detection limits. However, to evaluate different proposals for new technologies to decide which ones to develop or deploy, it is necessary to compare their cost and performance to the baseline technology. The goal of this project is to facilitate the direct comparison of new technologies to the baseline technology by documenting the current practices for site characterization and monitoring at DOE sites and by presenting the information in an easy-to-use, concise database. The database will assist the CMST-CP and others in evaluating or designing new technologies by identifying the baseline technologies and describing their performance and cost. The purpose of this document is to report on the completion of this project and to describe the database. Section 2.0 describes the data assessment methodology. Section 3.0 presents the database and serves as a user manual. Section 4.0 lists the references used for each baseline technology in the database. The full references can be found in the Appendix.

  17. REVIEW OF CURRENT PRACTICE IN CHARACTERIZATION AND MONITORING

    International Nuclear Information System (INIS)

    Ebadian, M.A.

    2001-01-01

    Characterization and monitoring are important parts of environmental remediation of contaminated sites by the Department of Energy--Office of Environmental Management (DOE-EM). The actual remediation process often cannot begin or even be planned until characterization is complete. Monitoring is essential to verify the progress of remediation and of the waste stream. However, some contaminated sites are difficult, costly, or have a high exposure risk to personnel to characterize or monitor using the baseline technology or current practice. Therefore, development of new characterization and monitoring technologies is time-critical to remediate these sites. The main task of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to develop and deploy innovative characterization and monitoring technologies that improve performance and reduce personnel exposure, cost, and detection limits. However, to evaluate different proposals for new technologies to decide which ones to develop or deploy, it is necessary to compare their cost and performance to the baseline technology. The goal of this project is to facilitate the direct comparison of new technologies to the baseline technology by documenting the current practices for site characterization and monitoring at DOE sites and by presenting the information in an easy-to-use, concise database. The database will assist the CMST-CP and others in evaluating or designing new technologies by identifying the baseline technologies and describing their performance and cost. The purpose of this document is to report on the completion of this project and to describe the database. Section 2.0 describes the data assessment methodology. Section 3.0 presents the database and serves as a user manual. Section 4.0 lists the references used for each baseline technology in the database. The full references can be found in the Appendix

  18. Liquid phase microextraction of pesticides: a review on current methods

    International Nuclear Information System (INIS)

    Farajzadeh, Mir Ali; Sorouraddin, Saeed Mohammad; Mogaddam, Mohammad Reza Afshar

    2014-01-01

    Liquid phase microextraction (LPME) enables analytes to be extracted with a few microliters of an organic solvent. LPME is a technique for sample preparation that is extremely simple, affordable and virtually a solvent-free. It can provide a high degree of selectivity and enrichment by eliminating carry-over between single runs. A variety of solvents are known for the extraction of the various analytes. These features have led to the development of techniques such as single drop microextraction, hollow fiber LPME, dispersive liquid-liquid microextraction, and others. LPME techniques have been applied to the analysis of pharmaceuticals, food, beverages, and pesticides. This review covers the history of LPME methods, and then gives a comprehensive collection of their application to the preconcentration and determination of pesticides in various matrices. Specific sections cover (a) sample treatment techniques in general, (b) single-drop microextraction, (c) extraction based on the use of ionic liquids, (d) solidified floating organic drop microextraction, and various other techniques. (author)

  19. Ebola Virus Shedding and Transmission: Review of Current Evidence.

    Science.gov (United States)

    Vetter, Pauline; Fischer, William A; Schibler, Manuel; Jacobs, Michael; Bausch, Daniel G; Kaiser, Laurent

    2016-10-15

     The magnitude of the 2013-2016 Ebola virus disease outbreak in West Africa was unprecedented, with >28 500 reported cases and >11 000 deaths. Understanding the key elements of Ebola virus transmission is necessary to implement adequate infection prevention and control measures to protect healthcare workers and halt transmission in the community.  We performed an extensive PubMed literature review encompassing the period from discovery of Ebola virus, in 1976, until 1 June 2016 to evaluate the evidence on modes of Ebola virus shedding and transmission.  Ebola virus has been isolated by cell culture from blood, saliva, urine, aqueous humor, semen, and breast milk from infected or convalescent patients. Ebola virus RNA has been noted in the following body fluids days or months after onset of illness: saliva (22 days), conjunctiva/tears (28 days), stool (29 days), vaginal fluid (33 days), sweat (44 days), urine (64 days), amniotic fluid (38 days), aqueous humor (101 days), cerebrospinal fluid (9 months), breast milk (16 months [preliminary data]), and semen (18 months). Nevertheless, the only documented cases of secondary transmission from recovered patients have been through sexual transmission. We did not find strong evidence supporting respiratory or fomite-associated transmission. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  20. Patellofemoral Arthroplasty: Current Concepts and Review of the Literature

    Science.gov (United States)

    Pisanu, Gabriele; Rosso, Federica; Bertolo, Corrado; Dettoni, Federico; Blonna, Davide; Bonasia, Davide Edoardo; Rossi, Roberto

    2017-01-01

    Patellofemoral osteoarthritis (PFOA) can be associated with anterior knee pain, stiffness, and functional impairment. Some authors report that PFOA affects approximately 9% of patients older than 40 years with a greater prevalence in females. Etiology of PFOA is multifactorial and is related to the presence of abnormal stresses at the PF joint due to knee- and patient-related factors. The need for a joint preserving treatment by isolated replacement of the injured compartment of the knee led to the development of PF arthroplasty (PFA). When a correct PF replacement is performed, PFA preserves physiologic tibiofemoral joint, thus allowing patients for a rapid recovery with a high satisfaction. The outcomes for PFA are quite variable with a trend toward good to excellent results, mainly owing to the improvement in surgical techniques, patient selection, and implant design. The development of the second generation of PFA improved the outcomes, which is attributed to the different trochlear designs. Recently, encouraging results have been provided by the association of PFA and unicompartmental knee arthroplasty (UKA). In many studies, the main cause of PFA failure is progression of tibiofemoral OA. The aim of this brief review of literature is to summarize the clinical features, indications and contraindications, surgical techniques, complications, and outcomes of PFA. PMID:29270562

  1. Plasmablastic Lymphoma: A Review of Current Knowledge and Future Directions

    Directory of Open Access Journals (Sweden)

    Ghaleb Elyamany

    2015-01-01

    Full Text Available Plasmablastic lymphoma (PBL is an aggressive subtype of non-Hodgkin’s lymphoma (NHL, which frequently arises in the oral cavity of human immunodeficiency virus (HIV infected patients. PBL shows diffuse proliferation of large neoplastic cells resembling B-immunoblasts/plasmablasts, or with plasmacytic features and an immunophenotype of plasma cells. PBL remains a diagnostic challenge due to its peculiar morphology and an immunohistochemical profile similar to plasma cell myeloma (PCM. PBL is also a therapeutic challenge with a clinical course characterized by a high rate of relapse and death. There is no standard chemotherapy protocol for treatment of PBL. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP or CHOP-like regimens have been the backbone while more intensive regimens such as cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, high-dose cytarabine (CODOX-M/IVAC, or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH are possible options. Recently, a few studies have reported the potential value of the proteasome inhibitor bortezomib and thalidomide in PBL patients. The introduction of genes encoding artificial receptors called chimeric antigen receptors (CARs and CAR-modified T cells targeted to the B cell-specific CD19 antigen have demonstrated promising results in multiple early clinical trials. The aim of this paper is to review the recent advances in epidemiology; pathophysiology; clinical, pathologic, and molecular characteristics; therapy; and outcome in patients with PBL.

  2. Current concept review: quality and process improvement in orthopedics

    Directory of Open Access Journals (Sweden)

    Pinney SJ

    2015-12-01

    Full Text Available Stephen J Pinney,1 Alexandra E Page,2 David S Jevsevar,3 Kevin J Bozic4 1Department of Orthopaedic Surgery, St Mary's Medical Center, San Francisco, CA, USA; 2Orthopaedic Surgery, AAOS Health Care Systems Committee, San Diego, CA, USA; 3Department of Orthopaedics, Geisel School of Medicine, Dartmouth University, Hanover, NH, USA; 4Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas, Austin, TX, USAAbstract: Multiple health care stakeholders are increasingly scrutinizing musculoskeletal care to optimize quality and cost efficiency. This has led to greater emphasis on quality and process improvement. There is a robust set of business strategies that are increasingly being applied to health care delivery. These quality and process improvement tools (QPITs have specific applications to segments of, or the entire episode of, patient care. In the rapidly changing health care world, it will behoove all orthopedic surgeons to have an understanding of the manner in which care delivery processes can be evaluated and improved. Many of the commonly used QPITs, including checklist initiatives, standardized clinical care pathways, lean methodology, six sigma strategies, and total quality management, embrace basic principles of quality improvement. These principles include focusing on outcomes, optimizing communication among health care team members, increasing process standardization, and decreasing process variation. This review summarizes the common QPITs, including how and when they might be employed to improve care delivery. Keywords: clinical care pathway, musculoskeletal care, outcomes, quality management, six sigma, lean thinking

  3. Current status of robotic bariatric surgery: a systematic review

    Science.gov (United States)

    2013-01-01

    Background Bariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review. Methods A search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science. Results Twenty-two studies were included. Anastomotic leak rate was 8.51% in biliopancreatic diversion. 30-day reoperation rate was 1.14% in Roux-en-Y gastric bypass and 1.16% in sleeve gastrectomy. Major complication rate in Roux-en-Y gastric bypass resulted higher than in sleeve gastrectomy ( 4,26% vs. 1,2%). The mean hospital stay was longer in Roux-en-Y gastric bypass (range 2.6-7.4 days). Conclusions The major limitation of our analysis is due to the small number and the low quality of the studies, the small sample size, heterogeneity of the enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported by the available present evidence. The major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy). PMID:24199869

  4. Conversion disorder: A systematic review of current terminology.

    Science.gov (United States)

    Ding, Juen Mei; Kanaan, Richard Antony Alexander

    It has been argued that the label given to unexplained neurological symptoms is an important contributor to their often poor acceptance, and there has been recent debate on proposals to change the name from conversion disorder. There have been multiple studies of layperson and clinician preference and this article aimed to review these. Multiple databases were searched using terms including "conversion disorder" and "terminology", and relative preferences for the terms extracted. Seven articles were found which looked at clinician or layperson preferences for terminology for unexplained neurological symptoms. Most neurologists favoured terms such as "functional" and "psychogenic", while laypeople were comfortable with "functional" but viewed "psychogenic" as more offensive; "non-epileptic/organic" was relatively popular with both groups. "Functional" is a term that is relatively popular with both clinicians and the public. It also meets more of the other criteria proposed for an acceptable label than other popular terms - however the views of neither psychiatrists nor actual patients with the disorder were considered. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Neurofeedback for Tinnitus Treatment - Review and Current Concepts.

    Science.gov (United States)

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

  6. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    Directory of Open Access Journals (Sweden)

    Dominik Güntensperger

    2017-12-01

    Full Text Available An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB, a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

  7. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    Science.gov (United States)

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically. PMID:29249959

  8. Review of current status of LWR safety research in Japan

    International Nuclear Information System (INIS)

    Yamada, Tasaburo; Mishima, Yoshitsugu; Ando, Yoshio; Miyazono, Shohachiro; Takashima, Yoichi.

    1977-01-01

    The Japan Atomic Energy Commission has exerted efforts on the research of the safety of nuclear plants in Japan, and ''Nuclear plant safety research committees'' was established in August 1974, which is composed of the government and the people. The philosophy of safety research, research and development plan, the forwarding procedure of the plan, international cooperation, for example LOFT program, and the effective feed back of the experimental results concerning nuclear safety are reviewed in this paper at first. As for the safety of nuclear reactors the basic philosophy that radio active fission products are contained in fuel or reactors with multiple barriers, (defence in depth) and almost no fission product is released outside reactor plants even at the time of hypothetical accident, is kept, and the research and development history and the future plan are described in this paper with the related technical problems. The structural safety is also explained, for example, on the philosophy ''leak before break'', pipe rupture, pipe restraint and stress analysis. The release of radioactive gas and liquid is decreased as the philosophy ''ALAP''. And probability safety evaluation method, LOCA, reactivity, accident and aseismatic design in nuclear plants in Japan are described. (Nakai, Y.)

  9. Current nutraceuticals in the management of osteoarthritis: a review.

    Science.gov (United States)

    Akhtar, Nahid; Haqqi, Tariq M

    2012-06-01

    Osteoarthritis (OA) is a progressive degenerative joint disease that has a major impact on joint function and quality of life. Nutraceuticals and dietary supplements derived from herbs have long been used in traditional medicine and there is considerable evidence that nutraceuticals may play an important role in inflammation and joint destruction in OA. We review the biological effects of some medicinal fruits and herbs - pomegranate, green tea, cat's claw, devil's claw, ginger, Indian olibaum, turmeric and ananas - in an attempt to understand the pivotal molecular targets involved in inflammation and the joint destruction process and to summarize their toxicities and efficacy for OA management. So far there is insufficient reliable evidence on the effectiveness of ginger, turmeric and ananas. Pomegranate and green tea only have preclinical evidence of efficacy due to the lack of clinical data. In vivo and clinical studies are required to understand their targets and efficacy in OA. Limited in vitro and in vivo evidence is available for cat's claw and Indian olibaum. More extensive studies are required before long-term controlled trials of whole cat's claw and Indian olibaum extracts, or isolated active compounds, are carried out in patients with OA to determine their long-term efficacy and safety. Devil's claw has not been rigorously tested to determine its antiarthritic potential in in vitro and in vivo models. There is strong clinical evidence of the effectiveness of devil's claw in pain reduction. However, high-quality clinical trials are needed to determine its effectiveness. No serious side effects have been reported for any fruits and herbs. Overall, these studies identify and support the use of nutraceuticals to provide symptomatic relief to patients with OA and to be used as adjunct therapy for OA management. More high-quality trials are needed to provide definitive answers to questions related to their efficacy and safety for OA prevention and

  10. Review of current neutron detection systems for emergency response

    Science.gov (United States)

    Mukhopadhyay, Sanjoy; Maurer, Richard; Guss, Paul; Kruschwitz, Craig

    2014-09-01

    Neutron detectors are used in a myriad of applications—from safeguarding special nuclear materials (SNM) to determining lattice spacing in soft materials. The transformational changes taking place in neutron detection and imaging techniques in the last few years are largely being driven by the global shortage of helium-3 (3He). This article reviews the status of neutron sensors used specifically for SNM detection in radiological emergency response. These neutron detectors must be highly efficient, be rugged, have fast electronics to measure neutron multiplicity, and be capable of measuring direction of the neutron sources and possibly image them with high spatial resolution. Neutron detection is an indirect physical process: neutrons react with nuclei in materials to initiate the release of one or more charged particles that produce electric signals that can be processed by the detection system. Therefore, neutron detection requires conversion materials as active elements of the detection system; these materials may include boron-10 (10B), lithium-6 (6Li), and gadollinium-157 (157Gd), to name a few, but the number of materials available for neutron detection is limited. However, in recent years, pulse-shape-discriminating plastic scintillators, scintillators made of helium-4 (4He) under high pressure, pillar and trench semiconductor diodes, and exotic semiconductor neutron detectors made from uranium oxide and other materials have widely expanded the parameter space in neutron detection methodology. In this article we will pay special attention to semiconductor-based neutron sensors. Modern microfabricated nanotubes covered inside with neutron converter materials and with very high aspect ratios for better charge transport will be discussed.

  11. Residential cogeneration systems: review of the current technology

    International Nuclear Information System (INIS)

    Onovwiona, H.I.; Ugursal, V.I.

    2006-01-01

    There is a growing potential for the use of micro-cogeneration systems in the residential sector because they have the ability to produce both useful thermal energy and electricity from a single source of fuel such as oil or natural gas. In cogeneration systems, the efficiency of energy conversion increases to over 80% as compared to an average of 30-35% for conventional fossil fuel fired electricity generation systems. This increase in energy efficiency can result in lower costs and reduction in greenhouse gas emissions when compared to the conventional methods of generating heat and electricity separately. Cogeneration systems and equipment suitable for residential and small-scale commercial applications like hospitals, hotels or institutional buildings are available, and many new systems are under development. These products are used or aimed for meeting the electrical and thermal demands of a building for space and domestic hot water heating, and potentially, absorption cooling. The aim of this paper is to provide an up-to-date review of the various cogeneration technologies suitable for residential applications. The paper considers the various technologies available and under development for residential, i.e. single-family ( e ) and multi-family (10-30kW t ) applications, with focus on single-family applications. Technologies suitable for residential cogeneration systems include reciprocating internal combustion engine, micro-turbine, fuel cell, and reciprocating external combustion Stirling engine based cogeneration systems. The paper discusses the state of development and the performance, environmental benefits, and costs of these technologies. (author)

  12. Gulf War Syndrome: a review of current knowledge and understanding.

    Science.gov (United States)

    Minshall, D

    2014-01-01

    The 1991 Persian Gulf War was a resounding military success for coalition forces, who liberated Kuwait following the Iraqi invasion. The medical legacy we have from the conflict is the poorly understood, yet remarkable, phenomenon of Gulf War Syndrome, which surfaced soon after. Epidemiological research has proven beyond doubt that Gulf War veterans report a wide variety of symptoms, in excess of appropriately matched control subjects, and experience worse general health. Numerous toxic environmental hazards have been suggested as causes of Gulf War Syndrome, yet exhaustive scientific study has failed to provide conclusive proof of any link. No novel or recognised disease has been found to account for the symptomatic burden of veterans, and the optimal treatment remains uncertain. This understanding can be added to from an anthropological perspective, where the narratives of those afflicted provide further insight. The nature of military life was changing at the time of the Gulf War, challenging the identity and beliefs of some veterans and causing socio-cultural distress. The symptomatic presentation of Gulf War Syndrome can be considered an articulation of this disharmony. Gulf War Syndrome can also be considered within the group of post-combat disorders such as shellshock, the like of which have occurred after major wars in the last century. With the current withdrawal from Afghanistan, the Defence Medical Services (DMS) should heed the lessons of history.

  13. Haemodialysis at home: review of current dialysis machines.

    Science.gov (United States)

    Haroon, Sabrina; Davenport, Andrew

    2018-04-26

    Only a minority of patients with chronic kidney disease treated by hemodialysis are currently treated at home. Until relatively recently, the only type of hemodialysis machine available for these patients was a slightly smaller version of the standard machines used for in-center dialysis treatments. Areas covered: There are now an alternative generation of dialysis machines specifically designed for home hemodialysis. The home dialysis patient wants a smaller machine, which is intuitive to use, easy to trouble shoot, robust and reliable, quick to setup and put away, requiring minimal waste disposal. The machines designed for home dialysis have some similarities in terms of touch-screen patient interfaces, and using pre-prepared cartridges to speed up setting up the machine. On the other hand, they differ in terms of whether they use slower or standard dialysate flows, prepare batches of dialysis fluid, require separate water purification equipment, or whether this is integrated, or use pre-prepared sterile bags of dialysis fluid. Expert commentary: Dialysis machine complexity is one of the hurdles reducing the number of patients opting for home hemodialysis and the introduction of the newer generation of dialysis machines designed for ease of use will hopefully increase the number of patients opting for home hemodialysis.

  14. A review of current challenges for the identification of gemstones

    Science.gov (United States)

    Shigley, James E.

    2008-01-01

    A variety of treated and synthetic gem materials are encountered today in the jewelry marketplace in increasing quantities. Although normally entering into the market with correct information, in some cases these materials are sold with incorrect or inaccurate information on their identity. In some cases, they exhibit appearances that correspond closely to those of valuable untreated, natural gemstones. Although they can display certain distinctive gemological characteristics, some treated and synthetic gem materials can be difficult for jewelers to recognize, especially when these individuals lack gemological training and access to standard gem-testing methods and equipment. In such instances, testing by a professional gemological laboratory may be required. Accurate gem identification and complete information disclosure are essential in the jewelry trade to maintain both the commercial value of natural gemstones and the confidence among consumers who are considering gemstone purchases. The goal of most current gemological research is to provide practical means of gem identification for jewelers and gemologists to help insure integrity in the international gemstone trade. To support this goal, research on gem materials increasingly relies upon characterization with modern analytical tools such as chemical analysis, various spectroscopy methods, and other scientific techniques.

  15. Infant Nutrition and Later Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Caroline Fall

    2012-07-01

    Full Text Available There is a growing recognition of the need for a lifecourse approach to understanding the aetiology of adult disease, and there is now significant evidence that links patterns of infant feeding to differences in health outcomes, both in the short and longer term. Breastfeeding is associated with lower rates of infection in infancy; in high-income populations, it is associated with reductions in blood pressure and total blood cholesterol, and lower risks of obesity and diabetes in adult life. Breastfeeding rates are suboptimal in many countries, and strategies to promote breastfeeding could therefore confer important benefits for health at a population level. However, there are particular challenges in defining nutritional exposures in infancy, including marked social gradients in initiation and duration of breastfeeding. In recent studies of low and middle-income populations of children and young adults, where the influences on infant feeding practice differ, beneficial effects of breastfeeding on blood pressure, BMI and risk of diabetes have not been confirmed, and further information is needed. Little is currently known about the long-term consequences of differences in the timing and nature of the weaning diet. Future progress will depend on new studies that provide detailed prospective data on duration and exclusivity of breastfeeding together with appropriate characterisation of the weaning diet.

  16. Treatment of intracerebral haemorrhage with tranexamic acid – A review of current evidence and ongoing trials

    DEFF Research Database (Denmark)

    Law, Zhe Kang; Meretoja, Atte; Engelter, Stefan T

    2017-01-01

    Purpose Haematoma expansion is a devastating complication of intracerebral haemorrhage (ICH) with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid...... in improving clinical outcome after ICH. Method We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms ‘intracerebral haemorrhage’, ‘tranexamic acid’ and ‘antifibrinolytic’. Authors of ongoing clinical trials were contacted for further...... details. Findings We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials (RCTs) comparing intravenous tranexamic acid to placebo (n = 54...

  17. Dietary transition and obesity in selected Arabicspeaking countries: a review of the current evidence.

    Science.gov (United States)

    Aboul-Enein, B H; Bernstein, J; Neary, A C

    2017-01-23

    Escalating obesity rates have become a significant public health problem in the Middle East and North Africa (MENA) region and have been associated with shifts towards a westernized diet. This integrative review aimed to examine the current dietary trends and transitions and their association with obesity in Arabic-speaking countries of the MENA region. Relevant databases were searched for studies in MENA countries between 1998 and 2014 that investigated obesity trends and changes in dietary patterns at the regional level in all age groups. A total of 39 articles fulfilled the inclusion criteria. All the articles noted that obesity was increasingly prevalent and that there was a significant dietary shift away from traditional dietary patterns; 51% reported a shift towards a westernized diet and half found that the western diet was correlated with increased obesity. Culturally relevant dietary health education and health promotion strategies are warranted to address both the dietary shifts towards the westernized diet and the increasing obesity.

  18. Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis Syndrome: Current Literature Review with a Case Report

    Directory of Open Access Journals (Sweden)

    Mahmut Demirtaş

    2018-04-01

    Full Text Available Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis syndrome (PFAPA is a frequently seen, important medical condition, which must be kept in mind in periodic fever etiology. Although its etiology is not clearly understood, autoimmune etiology is suspected due to response to steroids. There is no specific test for the diagnosis of disease. Diagnosis is based on symptoms and physical examination. Although medical treatment is the first choice for the management of the disease, tonsillectomy take over in treatment options for termination of attacks and permanent results. We have presented a patient that was performed tonsillectomy in our clinic for frequent attacks despite recurrent medical therapy with diagnosis of PFAPA with review of current literature.

  19. Augmented Reality in Neurosurgery: A Review of Current Concepts and Emerging Applications.

    Science.gov (United States)

    Guha, Daipayan; Alotaibi, Naif M; Nguyen, Nhu; Gupta, Shaurya; McFaul, Christopher; Yang, Victor X D

    2017-05-01

    Augmented reality (AR) superimposes computer-generated virtual objects onto the user's view of the real world. Among medical disciplines, neurosurgery has long been at the forefront of image-guided surgery, and it continues to push the frontiers of AR technology in the operating room. In this systematic review, we explore the history of AR in neurosurgery and examine the literature on current neurosurgical applications of AR. Significant challenges to surgical AR exist, including compounded sources of registration error, impaired depth perception, visual and tactile temporal asynchrony, and operator inattentional blindness. Nevertheless, the ability to accurately display multiple three-dimensional datasets congruently over the area where they are most useful, coupled with future advances in imaging, registration, display technology, and robotic actuation, portend a promising role for AR in the neurosurgical operating room.

  20. Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2015-01-01

    Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

  1. Understanding the impact of prior depression on stress generation: examining the roles of current depressive symptoms and interpersonal behaviours.

    Science.gov (United States)

    Shih, Josephine H; Eberhart, Nicole K

    2008-08-01

    Stress generation is a process in which individuals contribute to stressful life events. While research has supported an association between current depression and stress generation, it has been noted that individuals with prior depression tend to contribute to stressors even when they are no longer experiencing a depressive episode. The aim of the study is to elucidate the pathways through which prior major depression predicts interpersonal stress generation in women. Specifically, we examined current subsyndromal depressive symptoms and problematic interpersonal behaviours as potential mediators. Fifty-one college women were followed prospectively for 6 weeks. Participants were interviewed to assess current and past depression as well as stressful life events they experienced over the 6-week period. The findings suggest that prior major depression continues to have an impact even after the episode has ended, as the disorder continues to contribute to stress generation through residual depressive symptoms.

  2. Success in Implementation of a Resident In-Service Examination Review Series

    Science.gov (United States)

    Forcucci, Jessica A.; Hyer, J. Madison; Bruner, Evelyn T.; Lewin, David N.; Batalis, Nicholas I.

    2017-01-01

    Abstract Objectives: Primary pathology board certification has been correlated with senior resident in-service examination (RISE) performance. We describe our success with an annual, month-long review series. Methods: Aggregate program RISE performance data were gathered for 3 years prior to and 3 years following initiation of the review series. In addition, mean United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge scores for residents participating in each RISE examination were obtained to control for incoming knowledge and test-taking ability. Linear models were used to evaluate differences in average RISE performance prior to and following the initiation of the review series in addition to controlling for relevant covariates. Results: Significant improvement was noted in the grand total, anatomic pathology section average, clinical pathology section average, and transfusion medicine section. Although not statistically significant, improvement was noted on the cytopathology and clinical chemistry sections. There was no significant difference in scores in hematopathology, molecular pathology, and the special topics section average. In addition, improvement in primary pathology board certification rates was also noted. Conclusions: Institution of a month-long RISE review series demonstrated improved overall performance within our training program. The success could easily be replicated in any training program without significant disruption to an annual didactic series. PMID:28340222

  3. Success in Implementation of a Resident In-Service Examination Review Series.

    Science.gov (United States)

    Forcucci, Jessica A; Hyer, J Madison; Bruner, Evelyn T; Lewin, David N; Batalis, Nicholas I

    2017-04-01

    Primary pathology board certification has been correlated with senior resident in-service examination (RISE) performance. We describe our success with an annual, month-long review series. Aggregate program RISE performance data were gathered for 3 years prior to and 3 years following initiation of the review series. In addition, mean United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge scores for residents participating in each RISE examination were obtained to control for incoming knowledge and test-taking ability. Linear models were used to evaluate differences in average RISE performance prior to and following the initiation of the review series in addition to controlling for relevant covariates. Significant improvement was noted in the grand total, anatomic pathology section average, clinical pathology section average, and transfusion medicine section. Although not statistically significant, improvement was noted on the cytopathology and clinical chemistry sections. There was no significant difference in scores in hematopathology, molecular pathology, and the special topics section average. In addition, improvement in primary pathology board certification rates was also noted. Institution of a month-long RISE review series demonstrated improved overall performance within our training program. The success could easily be replicated in any training program without significant disruption to an annual didactic series. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination.

    Science.gov (United States)

    Loprinzi, Paul D; Lee, Hyo

    2014-03-01

    To review the extant literature on the link between physical activity and health outcomes among cancer survivors; identify evidence-based strategies to promote physical activity among this population; and conduct an epidemiologic study based on gaps from the literature review, examining the association between physical activity and various biologic markers. The authors used PubMed and Google Scholar up to July 2013, as well as data from the 2003-2006 National Health and Nutrition Examination Survey for the empirical study. Studies were examined through a systematic review process. In the epidemiologic study, 227 adult cancer survivors wore an accelerometer for four days or longer, with biologic markers (e.g., cholesterol) assessed from a blood sample. The review study demonstrated that cancer survivors are relatively inactive, but physical activity may help to reduce the risk of cancer recurrence and cancer-related mortality, increase cancer treatment rates, reduce pain and other side effects associated with cancer treatment, and improve physical and mental health. The epidemiologic study showed that physical activity was associated with several understudied biomarkers (e.g., neutrophils, white blood cells) that are linked with cancer recurrence, cancer-related mortality, and other chronic diseases. Nurses are encouraged to promote physical activity in cancer survivors.

  5. Nuclear power systems: Their safety. Current issue review

    International Nuclear Information System (INIS)

    Myers, L.C.

    1994-04-01

    Human beings utilize energy in many forms and from a variety of sources. A number of countries have chosen nuclear-electric generation as a component of their energy system. At the end of 1992, there were 419 power reactors operating in 29 countries, accounting for more than 15% of the world's production of electricity. In 1992, 13 countries derived at least 25% of their electricity from nuclear units, with Lithuania leading at just over 78%, followed closely by France at 72%. In the same year, Canada produced about 16% of its electricity from nuclear units. Some 53 power reactors are under construction in 14 countries outside the former USSR. Within the ex-USSR countries, six new reactors are currently under construction. No human endeavour carries the guarantee of perfect safety and the question of whether of not nuclear-electric generation represents an 'acceptable' risk to society has long been vigorously debated. Until the events of late April 1986 in the then Soviet Union, nuclear safety had indeed been an issue for discussion, for some concern, but not for alarm. The accident at the Chernobyl reactor irrevocably changed all that. This disaster brought the matter of nuclear safety into the public mind in a dramatic fashion. Subsequent opening of the ex-Soviet nuclear power program to outside scrutiny has done little to calm people's concerns about the safety of nuclear power in that part of the world. This paper discusses the issue of safety in complex energy systems and provides brief accounts of some of the most serious reactor accidents that have occurred to date, as well as more recent, less dramatic events touching on the safety issue. (author). 7 refs

  6. Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review.

    Science.gov (United States)

    Rubio-Ochoa, J; Benítez-Martínez, J; Lluch, E; Santacruz-Zaragozá, S; Gómez-Contreras, P; Cook, C E

    2016-02-01

    It has been suggested that differential diagnosis of headaches should consist of a robust subjective examination and a detailed physical examination of the cervical spine. Cervicogenic headache (CGH) is a form of headache that involves referred pain from the neck. To our knowledge, no studies have summarized the reliability and diagnostic accuracy of physical examination tests for CGH. The aim of this study was to summarize the reliability and diagnostic accuracy of physical examination tests used to diagnose CGH. A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in four electronic databases (MEDLINE, Web of Science, Embase and Scopus). Full text reports concerning physical tests for the diagnosis of CGH which reported the clinometric properties for assessment of CGH, were included and screened for methodological quality. Quality Appraisal for Reliability Studies (QAREL) and Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) scores were completed to assess article quality. Eight articles were retrieved for quality assessment and data extraction. Studies investigating diagnostic reliability of physical examination tests for CGH scored poorer on methodological quality (higher risk of bias) than those of diagnostic accuracy. There is sufficient evidence showing high levels of reliability and diagnostic accuracy of the selected physical examination tests for the diagnosis of CGH. The cervical flexion-rotation test (CFRT) exhibited both the highest reliability and the strongest diagnostic accuracy for the diagnosis of CGH. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. 49 CFR Appendix C to Part 180 - Eddy Current Examination With Visual Inspection for DOT 3AL Cylinders Manufactured of Aluminum...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Eddy Current Examination With Visual Inspection... PACKAGINGS Pt. 180, App. C Appendix C to Part 180—Eddy Current Examination With Visual Inspection for DOT 3AL... procedure applicable to the test equipment it uses to perform eddy current examinations. 2. Visual...

  8. Simulation training for breast and pelvic physical examination: a systematic review and meta-analysis.

    Science.gov (United States)

    Dilaveri, C A; Szostek, J H; Wang, A T; Cook, D A

    2013-09-01

    Breast and pelvic examinations are challenging intimate examinations. Technology-based simulation may help to overcome these challenges. To synthesise the evidence regarding the effectiveness of technology-based simulation training for breast and pelvic examination. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was January 2012. Original research studies evaluating technology-enhanced simulation of breast and pelvic examination to teach learners, compared with no intervention or with other educational activities. The reviewers evaluated study eligibility and abstracted data on methodological quality, learners, instructional design, and outcomes, and used random-effects models to pool weighted effect sizes. In total, 11 272 articles were identified for screening, and 22 studies were eligible, enrolling 2036 trainees. In eight studies comparing simulation for breast examination training with no intervention, simulation was associated with a significant improvement in skill, with a pooled effect size of 0.86 (95% CI 0.52-1.19; P < 0.001). Four studies comparing simulation training for pelvic examination with no intervention had a large and significant benefit, with a pooled effect size of 1.18 (95% CI 0.40-1.96; P = 0.003). Among breast examination simulation studies, dynamic models providing feedback were associated with improved outcomes. In pelvic examination simulation studies, the addition of a standardised patient to the simulation model and the use of an electronic model with enhanced feedback improved outcomes. In comparison with no intervention, breast and pelvic examination simulation training is associated with moderate to large effects for skills outcomes. Enhanced feedback appears to improve learning. © 2013 RCOG.

  9. The diagnostic value of history and physical examination for COPD in suspected or known cases: a systematic review.

    Science.gov (United States)

    Broekhuizen, Berna D L; Sachs, Alfred P E; Oostvogels, Rimke; Hoes, Arno W; Verheij, Theo J M; Moons, Karel G M

    2009-08-01

    According to current guidelines, spirometry should be performed in patients suspected of chronic obstructive pulmonary disease (COPD) by the results of history taking and physical examination. However, little is known about the diagnostic value of patient history and physical examination for COPD. To review the existing evidence on the diagnostic value of history taking and physical examination in recognizing COPD in patients suspected of COPD. A systematic literature search was performed in electronic medical databases. Studies were included after using defined inclusion and exclusion criteria and judged on their methodological quality by using the Quality Assessment of Diagnostic Accuracy Studies criteria. A formal meta-analysis was not performed because all studied items of history and physical examination were investigated in only in a maximum of three studies. Six studies were included. The history items dyspnoea, wheezing, previous consultation for wheezing or cough, self-reported COPD, age and smoking and the physical examination items wheezing, forced expiratory time, laryngeal height and prolonged expiration were found to have diagnostic value for COPD. These items were studied in maximally three studies and study population studies were heterogenic. The reference test for COPD in five of the six studies concerned obstructive lung disease in general and not COPD. There is insufficient evidence to assess the value of history taking and physical examination for diagnosing COPD.

  10. Cost estimation for decommissioning: a review of current practice

    International Nuclear Information System (INIS)

    O'Sullivan, P.; Pescatore, C.

    2009-01-01

    inventory, decontamination and waste disposal. Several countries look for cost reduction possibilities through waste minimization processes. Consideration should be given to developing upgraded decommissioning management systems to deal with latest developments, data quality, completeness and safety, while offering flexibility in data processing and cost calculations. Regular interaction between system developers and users is necessary to develop the inventory and maintain user friendliness. Current good practices include the use of a standardised list of decommissioning activities, a strong quality-assurance programme, use of a dedicated decommissioning core group during the planning phase of decommissioning, and involvement of regulators and stakeholders in the drafting of decommissioning plans

  11. Objective review of mediastinal lymph node examination in a lung cancer resection cohort.

    Science.gov (United States)

    Osarogiagbon, Raymond U; Allen, Jeffrey W; Farooq, Aamer; Wu, James T

    2012-02-01

    Accurate staging of resected lung cancer requires mediastinal lymph node (MLN) examination. MLN dissection (MLND) and systematic sampling (SS) are acceptable procedures; random sampling (RS) and no sampling (NS) are not. Forty percent of US lung cancer resections have NS. We closely examined the pattern of MLN examination in a lung resection cohort. This is a retrospective review of all lung cancer resections in Memphis, TN, from 2004 to 2007. We compared operating surgeons' claims to the pathology report and an audit of the operation narrative by an independent surgeon. Forty-five percent of resections were reported by surgeons as MLND, 8% RS, and 48% NS. None met pathology criteria for MLND, 9% were SS, 50% were RS, and 42% were NS. The concordance rate between the operating surgeon and pathology report was 39%. The surgeon audit suggested 29% of resections had MLND, 26% RS, and 45% NS. Concordance between operating and auditing surgeons was 71%. Sublobar resection, T1 stage, and age were associated with NS. Most resections had suboptimal MLN examination. Concordance was poor between surgeon claims, objective review of pathology reports, and an independent surgeon audit. The higher concordance between operating and auditing surgeons may suggest incomplete pathology examination of MLN material. The terms used by operating surgeons to describe MLN retrieval were often inaccurate.

  12. Improving the peer review process: an examination of commonalities between scholarly societies and knowledge networks

    Directory of Open Access Journals (Sweden)

    Susu Nousala

    2011-08-01

    Full Text Available Whilst peer review is the common form of scholarly refereeing, there are many differing aspects to this process. There is a view that the system is not without its faults and this has given rise to increasing discussion and examination of the process as a whole. Since the importance of peer review is based on the primary way in which quality control is asserted within the academic world, the concern is what impact this is having on an ever increasing diversity of scholarship, in particular, within and between science and engineering disciplines. The peer review process as is commonly understood, and increasingly considered as a conservative approach which is failing to adequately deal with the challenges of assessing interdisciplinary research, publications and outputs.

  13. Welding and nondestructive examination issues at Seabrook Nuclear Station: An independent review team report

    International Nuclear Information System (INIS)

    Spessard, R.L.; Coley, J.; Crowley, W.; Walton, G.

    1990-07-01

    In response to congressional concerns about the adequacy of the welding and nondestructive examination (NDE) programs at the Seabrook Nuclear Station, NRC senior management established an independent review team (IRT) to conduct an assessment. The IRT focused on the quality of the finished hardware and associated records, as well as on the adequacy of the overall quality assurance program as applied to the fabrication and NDE programs for pipe welds. This report documents the findings of that investigation

  14. Evaluating mediation and moderation effects in school psychology: A presentation of methods and review of current practice

    OpenAIRE

    Fairchild, Amanda J.; McQuillin, Samuel D.

    2010-01-01

    Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are pr...

  15. Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management

    Energy Technology Data Exchange (ETDEWEB)

    Lampl, Brooke; Berdon, Walter E. [Morgan Stanley Children' s Hospital of New York-Presbyterian, Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY (United States); Levin, Terry L. [Montefiore Medical Center, Department of Radiology, Mamaroneck, NY (United States); Cowles, Robert A. [Morgan Stanley Children' s Hospital of New York-Presbyterian, Division of Pediatric Surgery, Columbia University College of Physicians and Surgeons, New York, NY (United States)

    2009-04-15

    The complex and sometimes controversial subject of malrotation and midgut volvulus is reviewed commencing with the 19th-century Bohemian anatomist, Vaclav Treitz, who described the suspensory muscle anchoring of the duodenal-jejunal junction in the left upper quadrant, and continuing with William Ladd, the 20th-century American ''father of pediatric surgery'' who pioneered the surgical treatment of midgut volvulus. In this review, we present the interesting history of malrotation and discuss the current radiologic and surgical controversies surrounding its diagnosis and treatment. In the symptomatic patient with malrotation and possible midgut volvulus, prompt diagnosis is critical. The clinical examination and plain film are often confusing, and delayed diagnosis can lead to significant morbidity and death. Despite recent intense interest in the position of the mesenteric vessels on US and CT scans, the upper gastrointestinal series remains the fastest and most accurate method of demonstrating duodenal obstruction, the position of the ligament of Treitz, and, if the contrast agent is followed distally, cecal malposition. Controversy exists over the management of asymptomatic patients with malrotation in whom the diagnosis is made incidentally during evaluation for nonspecific complaints, prior to reflux surgery, and in those with heterotaxy syndromes. (orig.)

  16. Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management

    International Nuclear Information System (INIS)

    Lampl, Brooke; Berdon, Walter E.; Levin, Terry L.; Cowles, Robert A.

    2009-01-01

    The complex and sometimes controversial subject of malrotation and midgut volvulus is reviewed commencing with the 19th-century Bohemian anatomist, Vaclav Treitz, who described the suspensory muscle anchoring of the duodenal-jejunal junction in the left upper quadrant, and continuing with William Ladd, the 20th-century American ''father of pediatric surgery'' who pioneered the surgical treatment of midgut volvulus. In this review, we present the interesting history of malrotation and discuss the current radiologic and surgical controversies surrounding its diagnosis and treatment. In the symptomatic patient with malrotation and possible midgut volvulus, prompt diagnosis is critical. The clinical examination and plain film are often confusing, and delayed diagnosis can lead to significant morbidity and death. Despite recent intense interest in the position of the mesenteric vessels on US and CT scans, the upper gastrointestinal series remains the fastest and most accurate method of demonstrating duodenal obstruction, the position of the ligament of Treitz, and, if the contrast agent is followed distally, cecal malposition. Controversy exists over the management of asymptomatic patients with malrotation in whom the diagnosis is made incidentally during evaluation for nonspecific complaints, prior to reflux surgery, and in those with heterotaxy syndromes. (orig.)

  17. A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors

    Directory of Open Access Journals (Sweden)

    Jayne Hutchinson

    2015-05-01

    Full Text Available Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling and physical activity (92 studies or sedentary behaviors (19 studies. Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14, including organic food, locally-sourced food and plate waste and other health behaviors ((n = 20 smoking, dietary intake, alcohol. These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

  18. Novel methods to optimize the effects of transcranial direct current stimulation: a systematic review of transcranial direct current stimulation patents.

    Science.gov (United States)

    Malavera, Alejandra; Vasquez, Alejandra; Fregni, Felipe

    2015-01-01

    Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that has been extensively studied. While there have been initial positive results in some clinical trials, there is still variability in tDCS results. The aim of this article is to review and discuss patents assessing novel methods to optimize the use of tDCS. A systematic review was performed using Google patents database with tDCS as the main technique, with patents filling date between 2010 and 2015. Twenty-two patents met our inclusion criteria. These patents attempt to address current tDCS limitations. Only a few of them have been investigated in clinical trials (i.e., high-definition tDCS), and indeed most of them have not been tested before in human trials. Further clinical testing is required to assess which patents are more likely to optimize the effects of tDCS. We discuss the potential optimization of tDCS based on these patents and the current experience with standard tDCS.

  19. Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review.

    Science.gov (United States)

    Wright, Alexis A; Wassinger, Craig A; Frank, Mason; Michener, Lori A; Hegedus, Eric J

    2013-09-01

    To systematically review and critique the evidence regarding the diagnostic accuracy of physical examination tests for the scapula in patients with shoulder disorders. A systematic, computerised literature search of PubMED, EMBASE, CINAHL and the Cochrane Library databases (from database inception through January 2012) using keywords related to diagnostic accuracy of physical examination tests of the scapula. The Quality Assessment of Diagnostic Accuracy Studies tool was used to critique the quality of each paper. Eight articles met the inclusion criteria; three were considered to be of high quality. Of the three high-quality studies, two were in reference to a 'diagnosis' of shoulder pain. Only one high-quality article referenced specific shoulder pathology of acromioclavicular dislocation with reported sensitivity of 71% and 41% for the scapular dyskinesis and SICK scapula test, respectively. Overall, no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.

  20. Effects of transcranial direct current stimulation on motor learning in healthy individuals: a systematic review

    Directory of Open Access Journals (Sweden)

    Águida Foerster

    Full Text Available Introduction Transcranial direct current stimulation (tDCS has been used to modify cortical excitability and promote motor learning. Objective To systematically review published data to investigate the effects of transcranial direct current stimulation on motor learning in healthy individuals. Methods Randomized or quasi-randomized studies that evaluated the tDCS effects on motor learning were included and the risk of bias was examined by Cochrane Collaboration’s tool. The following electronic databases were used: PubMed, Scopus, Web of Science, LILACS, CINAHL with no language restriction. Results It was found 160 studies; after reading the title and abstract, 17 of those were selected, but just 4 were included. All studies involved healthy, right-handed adults. All studies assessed motor learning by the Jebsen Taylor Test or by the Serial Finger Tapping Task (SFTT. Almost all studies were randomized and all were blinding for participants. Some studies presented differences at SFTT protocol. Conclusion The result is insufficient to draw conclusions if tDCS influences the motor learning. Furthermore, there was significant heterogeneity of the stimulation parameters used. Further researches are needed to investigate the parameters that are more important for motor learning improvement and measure whether the effects are long-lasting or limited in time.

  1. Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices.

    Science.gov (United States)

    Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

    2015-01-01

    Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics.

  2. Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices

    Directory of Open Access Journals (Sweden)

    Wolyniak MJ

    2015-10-01

    Full Text Available Michael J Wolyniak,1 Lynne T Bemis,2 Amy J Prunuske2 1Department of Biology, Hampden-Sydney College, Hampden-Sydney, VA, 2Department of Biomedical Sciences, University of Minnesota Medical School, Duluth, MN, USA Abstract: Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. Keywords: genetics education, medical genetics, pedagogical practice, active learning, problem-based learning

  3. Improving medical students’ knowledge of genetic disease: a review of current and emerging pedagogical practices

    Science.gov (United States)

    Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

    2015-01-01

    Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student’s critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. PMID:26604852

  4. A review of mild traumatic brain injury diagnostics: current perspectives, limitations, and emerging technology.

    Science.gov (United States)

    Cook, Glen A; Hawley, Jason S

    2014-10-01

    Mild traumatic brain injury (mTBI) or concussion is a common battlefield and in-garrison injury caused by transmission of mechanical forces to the head. The energy transferred in such events can cause structural and/or functional changes in the brain that manifest as focal neurological, cognitive, or behavioral dysfunction. Current diagnostic criteria for mTBI are highly limited, variable, and based on subjective self-report. The subjective nature of the symptoms, both in quantity and quality, together with their large overlap in other physical and behavioral maladies, limit the clinician's ability to accurately diagnose, treat, and make prognostic decisions after such injuries. These diagnostic challenges are magnified in an operational environment as well. The Department of Defense has invested significant resources into improving the diagnostic tools and accuracy for mTBI. This focus has been to supplement the clinician's examination with technology that is better able to objectify brain dysfunction after mTBI. Through this review, we discuss the current state of three promising technologies--soluble protein biomarkers, advanced neuroimaging, and quantitative electroencephalography--that are of particular interest within military medicine. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  5. Peer review of the Three Mile Island Unit 2 Vessel Investigation Project metallurgical examinations

    Energy Technology Data Exchange (ETDEWEB)

    Bohl, R.W.; Gaydos, R.G.; Vander Voort, G.F.; Diercks, D.R. [Argonne National Lab., IL (United States)

    1994-07-01

    Fifteen samples recovered from the lower head of the Three Mile Island (TMI) Unit 2 nuclear reactor pressure vessel were subjected to detailed metallurgical examinations by the Idaho National Engineering Laboratory (INEL), with supporting work carried out by Argonne National Laboratory (ANL) and several of the European participants. These examinations determined that a portion of the lower head, a so-called elliptical ``hot spot`` measuring {approx}0.8 {times} 1 m, reached temperatures as high as 1100{degrees}C during the accident and cooled from these temperatures at {approx}10--100{degrees}C/min. The remainder of the lower head was found to have remained below the ferrite-toaustenite transformation temperature of 727{degrees}C during the accident. Because of the significance of these results and their importance to the overall analysis of the TMI accident, a panel of three outside peer reviewers, Dr. Robert W. Bohl, Mr. Richard G. Gaydos, and Mr. George F. Vander Voort, was formed to conduct an independent review of the metallurgical analyses. After a thorough review of the previous analyses and examination of photo-micrographs and actual lower head specimens, the panel determined that the conclusions resulting from the INEL study were fundamentally correct. In particular, the panel reaffirmed that four lower head samples attained temperatures as high as 1100{degrees}C, and perhaps as high as 1150--1200{degrees}C in one case, during the accident. They concluded that these samples subsequently cooled at a rate of {approx}50--125{degrees}C/min in the temperature range of 600--400{degrees}C, in good agreement with the original analysis. The reviewers also agreed that the remainder of the lower head samples had not exceeded the ferrite-to-austenite transformation temperature during the accident and suggested several refinements and alternative procedures that could have been employed in the original analysis.

  6. Peer review of the Three Mile Island Unit 2 Vessel Investigation Project metallurgical examinations

    International Nuclear Information System (INIS)

    Bohl, R.W.; Gaydos, R.G.; Vander Voort, G.F.; Diercks, D.R.

    1994-07-01

    Fifteen samples recovered from the lower head of the Three Mile Island (TMI) Unit 2 nuclear reactor pressure vessel were subjected to detailed metallurgical examinations by the Idaho National Engineering Laboratory (INEL), with supporting work carried out by Argonne National Laboratory (ANL) and several of the European participants. These examinations determined that a portion of the lower head, a so-called elliptical ''hot spot'' measuring ∼0.8 x 1 m, reached temperatures as high as 1100 degrees C during the accident and cooled from these temperatures at ∼10--100 degrees C/min. The remainder of the lower head was found to have remained below the ferrite-toaustenite transformation temperature of 727 degrees C during the accident. Because of the significance of these results and their importance to the overall analysis of the TMI accident, a panel of three outside peer reviewers, Dr. Robert W. Bohl, Mr. Richard G. Gaydos, and Mr. George F. Vander Voort, was formed to conduct an independent review of the metallurgical analyses. After a thorough review of the previous analyses and examination of photo-micrographs and actual lower head specimens, the panel determined that the conclusions resulting from the INEL study were fundamentally correct. In particular, the panel reaffirmed that four lower head samples attained temperatures as high as 1100 degrees C, and perhaps as high as 1150--1200 degrees C in one case, during the accident. They concluded that these samples subsequently cooled at a rate of ∼50--125 degrees C/min in the temperature range of 600--400 degrees C, in good agreement with the original analysis. The reviewers also agreed that the remainder of the lower head samples had not exceeded the ferrite-to-austenite transformation temperature during the accident and suggested several refinements and alternative procedures that could have been employed in the original analysis

  7. A systematic review examining the effectiveness of blending technology with team-based learning.

    Science.gov (United States)

    River, Jo; Currie, Jane; Crawford, Tonia; Betihavas, Vasiliki; Randall, Sue

    2016-10-01

    Technological advancements are rapidly changing nursing education in higher education settings. Nursing academics are enthusiastically blending technology with active learning approaches such as Team Based Learning (TBL). While the educational outcomes of TBL are well documented, the value of blending technology with TBL (blended-TBL) remains unclear. This paper presents a systematic review examining the effectiveness of blended-TBL in higher education health disciplines. This paper aimed to identify how technology has been incorporated into TBL in higher education health disciplines. It also sought to evaluate the educational outcomes of blended-TBL in terms of student learning and preference. A review of TBL research in Medline, CINAHL, ERIC and Embase databases was undertaken including the search terms, team based learning, nursing, health science, medical, pharmaceutical, allied health education and allied health education. Papers were appraised using the Critical Appraisal Skills Program (CASP). The final review included 9 papers involving 2094 student participants. A variety of technologies were blended with TBL including interactive eLearning and social media. There is limited evidence that blended-TBL improved student learning outcomes or student preference. Enthusiasm to blend technology with TBL may not be as well founded as initially thought. However, few studies explicitly examined the value of incorporating technology into TBL. There is a clear need for research that can discern the impact of technology into TBL on student preference and learning outcomes, with a particular focus on barriers to student participation with online learning components. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Emerging optical techniques in advanced cystoscopy for bladder cancer diagnosis: A review of the current literature

    NARCIS (Netherlands)

    Cauberg Evelyne, C. C.; de La Rosette, Jean J. M. C. H.; de Reijke, Theo M.

    2011-01-01

    The current standard for the diagnosis and followup of bladder cancer remains white light cystoscopy, despite its well-known limitations. The aim of this paper is to review the current literature on three optical diagnostics that have been developed to improve the performance of white light

  9. Examining stress perceptions and coping strategies among Saudi nursing students: A systematic review.

    Science.gov (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M; De Los Santos, Janet Alexis A; Edet, Olaide B

    2018-06-01

    Stress is a perennial problem in nursing education and Saudi student nurses are not immune. Despite the growing literature examining stress in Saudi student nurses, a broader perspective on this concept has not been explored. This paper is a report of a review systematically appraising and synthesizing existing scientific articles reporting stress perceptions and coping styles in Saudi student nurses. A systematic review method guided this review. Four (SCOPUS, CINAHL, PubMed, Ovid) bibliographic databases were searched to locate relevant articles. An electronic database search was performed in August 2017 to locate studies published from 2010 onwards. The search words included: "stress" OR "psychological stress", "coping" OR "psychological adaptation", "Saudi Arabia", "student", and "nurse". Eleven (11) articles met the inclusion criteria. Review of the findings showed moderate to high stress levels in Saudi student nurses that originated mainly from heavy workloads and taking care of patients. However, when the students' demographic characteristics were taken into account, inconclusive results were found, although some evidence showed higher stress levels in higher level students. Both active and passive coping styles were used by nursing students when dealing with stress. Consistent with international studies, Saudi student nurses experience a considerable levels of stress from various sources. Findings may provide a direction for nursing faculty in formulating stress interventions that are empirically tested and culturally appropriate. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Using text mining for study identification in systematic reviews: a systematic review of current approaches

    OpenAIRE

    O?Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia

    2015-01-01

    Background The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic...

  11. Upper Extremity Injured Workers Stratified by Current Work Status: An Examination of Health Characteristics, Work Limitations and Work Instability

    Directory of Open Access Journals (Sweden)

    D Pichora

    2010-06-01

    Full Text Available Background: Upper extremity injured workers are an under-studied population. A descriptive comparison of workers with shoulder, elbow and hand injuries reporting to a Canadian Workplace Safety and Insurance Board (WSIB clinic was undertaken. Objective: To determine if differences existed between injury groups stratified by current work status. Methods: All WSIB claimants reporting to our upper extremity clinic between 2003 and 2008 were approached to participate in this descriptive study. 314 working and 146 non-working WSIB claimants completed the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH; Short Form health survey (SF36; Worker’s Limitations Questionnaire and the Work Instability Scale. Various parametric and non-parametric analyses were used to assess significant differences between groups on demographic, work and health related variables. Results: Hand, followed by the shoulder and elbow were the most common site of injury. Most non-workers listed their current injury as the reason for being off work, and attempted to return to work once since their injury occurrence. Non-workers and a subset of workers at high risk for work loss showed significantly worse mental functioning. Workers identified physical demands as the most frequent injury-related on the job limitation. 60% of current workers were listed as low risk for work loss on the Work Instability Scale. Conclusions: Poorer mental functioning, being female and sustaining a shoulder injury were risk factors for work instability. Our cohort of injured non-workers were unable to return to work due to their current injury, reinforcing the need to advocate for modified duties, shorter hours and a work environment where stress and injury recurrence is reduced. Future studies examining pre-injury depression as a risk factor for prolonged work absences are warranted.

  12. Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ehsanipoor, Robert M; Seligman, Neil S; Saccone, Gabriele; Szymanski, Linda M; Wissinger, Christina; Werner, Erika F; Berghella, Vincenzo

    2015-07-01

    To estimate the effectiveness of physical examination-indicated cerclage in the setting of second-trimester cervical dilatation by systematic review and meta-analysis of published studies. We searched MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, Web of Science, and the Cochrane Library for studies published between 1966 and 2014 that evaluated cervical cerclage for the treatment of cervical insufficiency. The search yielded 6,314 citations. We included cohort studies and randomized controlled trials comparing cerclage placement with expectant management of women with cervical dilatation between 14 and 27 weeks of gestation. Two investigators independently reviewed each citation for inclusion or exclusion and discordant decisions were arbitrated by a third reviewer. Summary estimates were reported as the mean difference and 95% confidence interval (CI) for continuous variables or relative risk and with 95% CI for dichotomous outcomes. Fixed- and random-effects meta-analysis was used, depending on heterogeneity. Ten studies met inclusion criteria and were included in the final analysis. One was a randomized controlled trial, two were prospective cohort studies, and the remaining seven were retrospective cohort studies. Of the 757 women, 485 (64%) underwent physical examination-indicated cerclage placement and 272 (36%) were expectantly managed. Cerclage was associated with increased neonatal survival (71% compared with 43%; relative risk 1.65, 95% CI 1.19-2.28) and prolongation of pregnancy (mean difference 33.98 days, 95% CI 17.88-50.08). Physical examination-indicated cerclage is associated with a significant increase in neonatal survival and prolongation of pregnancy of approximately 1 month when compared with no such cerclage. The strength of this conclusion is limited by the potential for bias in the included studies.

  13. Data analysis algorithms for flaw sizing based on eddy current rotating probe examination of steam generator tubes

    International Nuclear Information System (INIS)

    Bakhtiari, S.; Elmer, T.W.

    2009-01-01

    Computer-aided data analysis tools can help improve the efficiency and reliability of flaw sizing based on nondestructive examination data. They can further help produce more consistent results, which is important for both in-service inspection applications and for engineering assessments associated with steam generator tube integrity. Results of recent investigations at Argonne on the development of various algorithms for sizing of flaws in steam generator tubes based on eddy current rotating probe data are presented. The research was carried out as part of the activities under the International Steam Generator Tube Integrity Program (ISG-TIP) sponsored by the U.S. Nuclear Regulatory Commission. A computer-aided data analysis tool has been developed for off-line processing of eddy current inspection data. The main objectives of the work have been to a) allow all data processing stages to be performed under the same user interface, b) simplify modification and testing of signal processing and data analysis scripts, and c) allow independent evaluation of viable flaw sizing algorithms. The focus of most recent studies at Argonne has been on the processing of data acquired with the +Point probe, which is one of the more widely used eddy current rotating probes for steam generator tube examinations in the U.S. The probe employs a directional surface riding differential coil, which helps reduce the influence of tubing artifacts and in turn helps improve the signal-to-noise ratio. Various algorithms developed under the MATLAB environment for the conversion, segmentation, calibration, and analysis of data have been consolidated within a single user interface. Data acquired with a number of standard eddy current test equipment are automatically recognized and converted to a standard format for further processing. Because of its modular structure, the graphical user interface allows user-developed routines to be easily incorporated, modified, and tested independent of the

  14. Using text mining for study identification in systematic reviews: a systematic review of current approaches.

    Science.gov (United States)

    O'Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia

    2015-01-14

    The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic review fills that research gap. Focusing mainly on non-technical issues, the review aims to increase awareness of the potential of these technologies and promote further collaborative research between the computer science and systematic review communities. Five research questions led our review: what is the state of the evidence base; how has workload reduction been evaluated; what are the purposes of semi-automation and how effective are they; how have key contextual problems of applying text mining to the systematic review field been addressed; and what challenges to implementation have emerged? We answered these questions using standard systematic review methods: systematic and exhaustive searching, quality-assured data extraction and a narrative synthesis to synthesise findings. The evidence base is active and diverse; there is almost no replication between studies or collaboration between research teams and, whilst it is difficult to establish any overall conclusions about best approaches, it is clear that efficiencies and reductions in workload are potentially achievable. On the whole, most suggested that a saving in workload of between 30% and 70% might be possible, though sometimes the saving in workload is accompanied by the loss of 5% of relevant studies (i.e. a 95% recall). Using text mining to prioritise the order in which items are screened should be considered safe and ready for use in 'live' reviews. The use of text mining as a 'second screener' may also be used cautiously

  15. The regulatory review: general comments, current status of review, identification of critical issues

    International Nuclear Information System (INIS)

    Vigfusson, J.; Franck, E.

    2004-01-01

    Typically, a lot of interesting and important details add up to give a coherent and convincing picture of a safe repository. A good portion of these details must be studied and the scientific basis of the system must be clearly understood by the reviewing authority in order to be able to pass a judgement on the safety case. HSK has already received a large part of the documentation relating to the project, including the three high level documents that summarize the synthesis of the geological information, the demonstration of repository design and construction feasibility and the safety case. After a first look at the contents of the documentation we would like to complement Nagra on the maturity and clarity of the presentation in these reports. At this early stage, we shall not present any review judgements. The reviewer usually is dependent upon having not only the high level documents but also all the detailed reference reports in front of him in order to do his job, and HSK is still receiving very relevant documents. Thus we are still at the very beginning of our review. Here, we offer some comments of general nature about the review process and mention a few points that seem to be uppermost in our mind at this stage. (author)

  16. Examination of pulsed eddy current for inspection of second layer aircraft wing lap-joint structures using outlier detection methods

    Energy Technology Data Exchange (ETDEWEB)

    Butt, D.M., E-mail: Dennis.Butt@forces.gc.ca [Royal Military College of Canada, Dept. of Chemistry and Chemical Engineering, Kingston, Ontario (Canada); Underhill, P.R.; Krause, T.W., E-mail: Thomas.Krause@rmc.ca [Royal Military College of Canada, Dept. of Physics, Kingston, Ontario (Canada)

    2016-09-15

    Ageing aircraft are susceptible to fatigue cracks at bolt hole locations in multi-layer aluminum wing lap-joints due to cyclic loading conditions experienced during typical aircraft operation, Current inspection techniques require removal of fasteners to permit inspection of the second layer from within the bolt hole. Inspection from the top layer without fastener removal is desirable in order to minimize aircraft downtime while reducing the risk of collateral damage. The ability to detect second layer cracks without fastener removal has been demonstrated using a pulsed eddy current (PEC) technique. The technique utilizes a breakdown of the measured signal response into its principal components, each of which is multiplied by a representative factor known as a score. The reduced data set of scores, which represent the measured signal, are examined for outliers using cluster analysis methods in order to detect the presence of defects. However, the cluster analysis methodology is limited by the fact that a number of representative signals, obtained from fasteners where defects are not present, are required in order to perform classification of the data. Alternatively, blind outlier detection can be achieved without having to obtain representative defect-free signals, by using a modified smallest half-volume (MSHV) approach. Results obtained using this approach suggest that self-calibrating blind detection of cyclic fatigue cracks in second layer wing structures in the presence of ferrous fasteners is possible without prior knowledge of the sample under test and without the use of costly calibration standards. (author)

  17. Examination of pulsed eddy current for inspection of second layer aircraft wing lap-joint structures using outlier detection methods

    International Nuclear Information System (INIS)

    Butt, D.M.; Underhill, P.R.; Krause, T.W.

    2016-01-01

    Ageing aircraft are susceptible to fatigue cracks at bolt hole locations in multi-layer aluminum wing lap-joints due to cyclic loading conditions experienced during typical aircraft operation, Current inspection techniques require removal of fasteners to permit inspection of the second layer from within the bolt hole. Inspection from the top layer without fastener removal is desirable in order to minimize aircraft downtime while reducing the risk of collateral damage. The ability to detect second layer cracks without fastener removal has been demonstrated using a pulsed eddy current (PEC) technique. The technique utilizes a breakdown of the measured signal response into its principal components, each of which is multiplied by a representative factor known as a score. The reduced data set of scores, which represent the measured signal, are examined for outliers using cluster analysis methods in order to detect the presence of defects. However, the cluster analysis methodology is limited by the fact that a number of representative signals, obtained from fasteners where defects are not present, are required in order to perform classification of the data. Alternatively, blind outlier detection can be achieved without having to obtain representative defect-free signals, by using a modified smallest half-volume (MSHV) approach. Results obtained using this approach suggest that self-calibrating blind detection of cyclic fatigue cracks in second layer wing structures in the presence of ferrous fasteners is possible without prior knowledge of the sample under test and without the use of costly calibration standards. (author)

  18. Doses to patients from medical X-ray examinations in the UK. 2000 review

    CERN Document Server

    Hart, D; Wall, B F

    2002-01-01

    In 1992 NRPB established a National Collation Centre for measurements of doses to patients made by x-ray departments throughout the UK. This report is the second in a series of five-yearly reviews of the national patient dose database and analyses the information collected during the period January 1996 to December 2000. It includes the results of 28,000 entrance surface dose (ESD) measurements and 13,000 dose-area product (DAP) measurements for single radiographs, and 140,000 DAP measurements and 128,000 records of the fluoroscopy time for complete examinations, collected from 371 hospitals throughout the UK. Information on the patient dose distributions and exposure conditions for over 30 types of examination and radiograph is presented. National reference doses based on the rounded third quartile values of these dose distributions are recommended and are seen to be about 20% lower than corresponding values in the previous (1995) review. They have approximately halved since the original UK national referenc...

  19. An examination of retention factors among registered nurses in Northeastern Ontario, Canada: Nurses intent to stay in their current position.

    Science.gov (United States)

    Nowrouzi, Behdin; Rukholm, Ellen; Lariviere, Michel; Carter, Lorraine; Koren, Irene; Mian, Oxana; Giddens, Emilia

    2016-03-10

    The purpose of the study was to examine factors related to the retention of registered nurses in northeastern Ontario, Canada. A cross-sectional survey of registered nurses working in northeastern Ontario, Canada was conducted. Logistic regression analyses were used to consider intent to stay in current employment in relation to the following: 1) demographic factors, and 2) occupation and career satisfaction factors. A total of 459 (29.8% response rate) questionnaires were completed. The adjusted odds logistic regression analysis of RNs who intended to remain in their current position for the next five years, demonstrated that respondents in the 46 to 56 age group (OR: 2.65; 95% CI: 1.50 to 4.69), the importance of staff development in the organization (OR: 3.04; 95% CI: 1.13 to 8.13) northeastern Ontario lifestyle (OR: 2.61; 95% CI: 1.55 to 4.40), working in nursing for 14 to 22.5 years (OR: 2.55; 95% CI: 1.10 to 5.93), and working between 0 to 1 hour of overtime per week (OR: 1.20; 95% CI: 1.20 to 4.64) were significant factors in staying in their current position for the next five years. This study shows that a further understanding of the work environment could assist with developing retention for rural nurses. Furthermore, employers may use such information to ameliorate the working conditions of nurses, while researchers may use such evidence to develop interventions that are applicable to improving the working conditions of nurses.

  20. Application of low frequency and medium frequency currents in the management of acute and chronic pain-A narrative review

    Directory of Open Access Journals (Sweden)

    Stephen Rajan Samuel

    2015-01-01

    Full Text Available Trancutaneous electrical nerve stimulation (TENS and interferential therapy (IFT have been a regular line of treatment for various types of acute and chronic pain. This review aims to compile the latest literature in pain management using these modalities which use low-frequency and medium-frequency currents. The Cochrane Library, Scopus, PubMed, MEDLINE, and CINAHL were searched and studies were examined from their inception till October 2013. After title and abstract screening the relevant studies were included for this review. We found through this review that even though TENS and IFT are used in management of pain, there is limited amount of high quality research available in this area. Most of the studies lack methodological quality and have a low sample size.

  1. Market review - Market values summary/August market review/current market data

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    This article is the August 1995 uranium market review. During this reporting period, there were three transactions in the long-term concentrates sector, no transactions in the UF6 market, and limited activity in the spot conversion market and the enrichment services market. Active supply rose, as did active demand. Prices were stable to slightly increasing

  2. A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review.

    Science.gov (United States)

    Krill, Michael K; Rosas, Samuel; Kwon, KiHyun; Dakkak, Andrew; Nwachukwu, Benedict U; McCormick, Frank

    2018-02-01

    The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology. Individual test characteristics were combined in series and in parallel to improve sensitivities and specificities. A secondary analysis utilized subjective pre-test probabilities to create a clinical decision tree algorithm with post-test probabilities. The optimal special test combination to screen and confirm AC joint pathology combined Paxinos sign and O'Brien's Test, with a specificity of 95.8% when performed in series; whereas, Paxinos sign and Hawkins-Kennedy Test demonstrated a sensitivity of 93.7% when performed in parallel. Paxinos sign and O'Brien's Test demonstrated the greatest positive likelihood ratio (2.71); whereas, Paxinos sign and Hawkins-Kennedy Test reported the lowest negative likelihood ratio (0.35). No combination of special tests performed in series or in parallel creates more than a small impact on post-test probabilities to screen or confirm AC joint pathology. Paxinos sign and O'Brien's Test is the only special test combination that has a small and sometimes important impact when used both in series and in parallel. Physical examination testing is not beneficial for diagnosis of AC joint pathology when pretest probability is unequivocal. In these instances, it is of benefit to proceed with procedural tests to evaluate AC joint pathology. Ultrasound-guided corticosteroid injections are diagnostic and therapeutic. An ultrasound-guided AC joint

  3. Silver and titanium dioxide nanoparticle toxicity in plants: A review of current research.

    Science.gov (United States)

    Cox, Ashley; Venkatachalam, P; Sahi, Shivendra; Sharma, Nilesh

    2016-10-01

    Nanoparticles (NPs) have become widely used in recent years for many manufacturing and medical processes. Recent literature suggests that many metallic nanomaterials including those of silver (Ag) and titanium dioxide (TiO2) cause significant toxic effects in animal cell culture and animal models, however, toxicity studies using plant species are limited. This review examines current progress in the understanding of the effect of silver and titanium dioxide nanoparticles on plant species. There are many facets to this ongoing environmental problem. This review addresses the effects of NPs on oxidative stress-related gene expression, genotoxicity, seed germination, and root elongation. It is largely accepted that NP exposure results in the cellular generation of reactive oxygen species (ROS), leading to both positive and negative effects on plant growth. However, factors such as NP size, shape, surface coating and concentration vary greatly among studies resulting in conflicting reports of the effect at times. In addition, plant species tend to differ in their reaction to NP exposure, with some showing positive effects of NP augmentation while many others showing detrimental effects. Seed germination studies have shown to be less effective in gauging phytotoxicity, while root elongation studies have shown more promise. Given the large increase in nanomaterial applications in consumer products, agriculture and energy sectors, it is critical to understand their role in the environment and their effects on plant life. A closer look at nanomaterial-driven ecotoxicity is needed. Ecosystem-level studies are required to indicate how these nanomaterials transfer at the critical trophic levels affecting human health and biota. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Complementary Medicine, Exercise, Meditation, Diet, and Lifestyle Modification for Anxiety Disorders: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    J. Sarris

    2012-01-01

    Full Text Available Use of complementary medicines and therapies (CAM and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders.

  5. Information Technology in New Zealand: Review of Emerging Social Trends, Current Issues, and Policies

    OpenAIRE

    Erturk, Emre; Fail, Derwyn

    2015-01-01

    This paper discusses the general state of information technology in New Zealand society, current issues, and policies. It is a qualitative study that reviews recent scholarly articles, periodicals, and surveys in order to create an understanding of some of the information technology issues and trends in New Zealand. After reviewing previous research, it assesses the potential existence and nature of a 'digital divide' in New Zealand society whilst also evaluating possible strategic responses ...

  6. Preconception care of women with diabetes: a review of current guideline recommendations

    Directory of Open Access Journals (Sweden)

    Mazza Danielle

    2010-01-01

    Full Text Available Abstract Background The prevalence of type 2 diabetes mellitus (T2DM continues to rise worldwide. More women from developing countries who are in the reproductive age group have diabetes resulting in more pregnancies complicated by T2DM, and placing both mother and foetus at higher risk. Management of these risks is best achieved through comprehensive preconception care and glycaemic control, both prior to, and during pregnancy. The aim of this review was to compare the quality and content of current guidelines concerned with the preconception care of women with diabetes and to develop a summary of recommendations to assist in the management of diabetic women contemplating pregnancy. Methods Relevant clinical guidelines were identified through a search of several databases (MEDLINE, SCOPUS and The Cochrane Library and relevant websites. Five guidelines were identified. Each guideline was assessed for quality using the AGREE instrument. Guideline recommendations were extracted, compared and contrasted. Results All guidelines were assessed as being of high quality and strongly recommended for use in practice. All were consistent in counselling about the risk of congenital malformation related to uncontrolled blood sugar preconceptionally, ensuring adequate contraception until glycaemic control is achieved, use of HBA1C to monitor metabolic control, when to commence insulin and switching from ACE inhibitors to other antihypertensives. Major differences were in the targets recommended for optimal metabolic control and opinion regarding the usage of metformin as an adjunct or alternative treatment before or during pregnancy. Conclusions International guidelines for the care of women with diabetes who are contemplating pregnancy are consistent in their recommendations; however some are more comprehensive than others. Having established current standards for the preconception care of diabetic women, there is now a need to focus on guideline

  7. Physical examination tests for the diagnosis of femoroacetabular impingement. A systematic review.

    Science.gov (United States)

    Pacheco-Carrillo, Aitana; Medina-Porqueres, Ivan

    2016-09-01

    Numerous clinical tests have been proposed to diagnose FAI, but little is known about their diagnostic accuracy. To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of FAI. A search of the PubMed, SPORTDiscus and CINAHL databases was performed. Studies were considered eligible if they compared the results of physical examination tests to those of a reference standard. Methodological quality and internal validity assessment was performed by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. The systematic search strategy revealed 298 potential articles, five of which articles met the inclusion criteria. After assessment using the QUADAS score, four of the five articles were of high quality. Clinical tests included were Impingement sign, IROP test (Internal Rotation Over Pressure), FABER test (Flexion-Abduction-External Rotation), Stinchfield/RSRL (Resisted Straight Leg Raise) test, Scour test, Maximal squat test, and the Anterior Impingement test. IROP test, impingement sign, and FABER test showed the most sensitive values to identify FAI. The diagnostic accuracy of physical examination tests to assess FAI is limited due to its heterogenecity. There is a strong need for sound research of high methodological quality in this area. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. An Examination of the Gender Inclusiveness of Current Theories of Sexual Violence in Adulthood: Recognizing Male Victims, Female Perpetrators, and Same-Sex Violence.

    Science.gov (United States)

    Turchik, Jessica A; Hebenstreit, Claire L; Judson, Stephanie S

    2016-04-01

    Although the majority of adulthood sexual violence involves a male perpetrator and a female victim, there is also substantial evidence that members of both genders can be victims and perpetrators of sexual violence. As an alternative to viewing sexual violence within gender-specific terms, we advocate for the use of a gender inclusive conceptualization of sexual aggression that takes into account the factors that contribute to sexual victimization of, and victimization by, both men and women. The goal of the current review is to examine the need and importance of a gender inclusive conceptualization of sexual violence and to discuss how compatible our current theories are with this conceptualization. First, we examine evidence of how a gender-specific conceptualization of sexual violence aids in obscuring assault experiences that are not male to female and how this impacts victims of such violence. We specifically discuss this impact regarding research, law, public awareness, advocacy, and available victim treatment and resources. Next, we provide an overview of a number of major sexual violence theories that are relevant for adult perpetrators and adult victims, including neurobiological and integrated biological theories, evolutionary psychology theory, routine activity theory, feminist theory, social learning and related theories, typology approaches, and integrated theories. We critically examine these theories' applicability to thinking about sexual violence through a gender inclusive lens. Finally, we discuss further directions for research, clinical interventions, and advocacy in this area. Specifically, we encourage sexual violence researchers and clinicians to identify and utilize appropriate theoretical frameworks and to apply these frameworks in ways that incorporate a full range of sexual violence. © The Author(s) 2015.

  9. A review of the current state of digital plate reading of cultures in clinical microbiology.

    Science.gov (United States)

    Rhoads, Daniel D; Novak, Susan M; Pantanowitz, Liron

    2015-01-01

    Digital plate reading (DPR) is increasingly being adopted as a means to facilitate the analysis and improve the quality and efficiency within the clinical microbiology laboratory. This review discusses the role of DPR in the context of total laboratory automation and explores some of the platforms currently available or in development for digital image capturing of microbial growth on media. The review focuses on the advantages and challenges of DPR. Peer-reviewed studies describing the utility and quality of these novel DPR systems are largely lacking, and professional guidelines for DPR implementation and quality management are needed. Further development and more widespread adoption of DPR is anticipated.

  10. On Eddy current examination (ECE) of Incoloy 800 SG tube using OD encircling and ID bobbin coil

    International Nuclear Information System (INIS)

    Kapoor, K.; Sunder Krishna, K.; Bakshu, S.A.

    2015-01-01

    The purpose of this paper is to present and compare the results of ECE carried out on steam generator tubes from OD side and ID side. During the manufacturing of the tubes Eddy current testing is being carried out using OD encircling probe as per ASTM E 571. Here the purpose of the test is to capture the manufacturing defects. The parameters of the test are optimized to achieve best sensitivity to this requirement. These tubes are then installed in the steam generator and once again ECE is carried out during installation (pre-service inspection-PSI) and during in-service inspection (ISI) by using ID bobbin coil. These tests are carried out as per ASME section V article 8 appendix 1. Here the purpose of the test is to detect wall thinning, dent, pits etc due to operation and to locate these defects (OD side or ID side). Here the operating parameters are optimized for phase separation of defects from OD and ID. These parameters are quite different from those used during the manufacturing ECE. Interpretation of the signals detected in PSI/ISI in must be done with care to correlate with defect indications detected during manufacturing. In the present study, tubes with certain manufacturing defects, detected with OD encircling test were subjected to ID bobbin coil examination. Also certain tubes with signal picked up during test from ID were examined by using the OD encircling probe. This comparison of the results provides a clear picture about the sensitivity and deficiency of the either type of test. (author)

  11. Market review: Market values summary July market review/current market data

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    A summary of financial data for the uranium spot market is provided. Recent transactions are tabulated, including uranium sales, natural uranium loans, conversion sales, and enrichment sales. A market values summary and long-term price indicators are also provided. The July 1996 market review data includes summaries of near-term uranium sales, near-term supply/demand, NUEXCO values, USEC prices, and calculated worth of enriched uranium. Active projects in uranium, conversion, and separative work supply and demand are listed. International market values are tabulated for 22 selected currencies

  12. A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation.

    Science.gov (United States)

    Deci, E L; Koestner, R; Ryan, R M

    1999-11-01

    A meta-analysis of 128 studies examined the effects of extrinsic rewards on intrinsic motivation. As predicted, engagement-contingent, completion-contingent, and performance-contingent rewards significantly undermined free-choice intrinsic motivation (d = -0.40, -0.36, and -0.28, respectively), as did all rewards, all tangible rewards, and all expected rewards. Engagement-contingent and completion-contingent rewards also significantly undermined self-reported interest (d = -0.15, and -0.17), as did all tangible rewards and all expected rewards. Positive feedback enhanced both free-choice behavior (d = 0.33) and self-reported interest (d = 0.31). Tangible rewards tended to be more detrimental for children than college students, and verbal rewards tended to be less enhancing for children than college students. The authors review 4 previous meta-analyses of this literature and detail how this study's methods, analyses, and results differed from the previous ones.

  13. The Relation Between Child Maltreatment and Adolescent Suicidal Behavior: A Systematic Review and Critical Examination of the Literature

    Science.gov (United States)

    Esposito-Smythers, Christianne; Weismoore, Julie T.; Renshaw, Keith D.

    2013-01-01

    A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we evaluated all of the research literature to date examining the relationship between CM and adolescent suicidal ideation and attempts. Results generally suggest that childhood sexual abuse, physical abuse, emotional abuse, and neglect are associated with adolescent suicidal ideation and attempts across community, clinical, and high-risk samples, using cross-sectional and longitudinal research designs. In most studies, these associations remain significant when controlling for covariates such as youth demographics, mental health, family, and peer-related variables. When different forms of CM are examined in the same multivariate analysis, most research suggests that each form of CM maintains an independent association with adolescent suicidal ideation and suicide attempts. However, a subset of studies yielded evidence to suggest that sexual abuse and emotional abuse may be relatively more important in explaining suicidal behavior than physical abuse or neglect. Research also suggests an additive effect—each form of CM contributes unique variance to adolescent suicide attempts. We discuss the current limitations of this literature and offer recommendations for future research. We conclude with an overview of the clinical implications of this research, including careful, detailed screening of CM history, past suicidal behavior, and current suicidal ideation, as well as the need for integrated treatment approaches that effectively address both CM and adolescent suicidal ideation and suicide attempts. PMID:23568617

  14. Examining the Role of Perioperative Nerve Blocks in Hip Arthroscopy: A Systematic Review.

    Science.gov (United States)

    Kay, Jeffrey; de Sa, Darren; Memon, Muzammil; Simunovic, Nicole; Paul, James; Ayeni, Olufemi R

    2016-04-01

    This systematic review examined the efficacy of perioperative nerve blocks for pain control after hip arthroscopy. The databases Embase, PubMed, and Medline were searched on June 2, 2015, for English-language studies that reported on the use of perioperative nerve blocks for hip arthroscopy. The studies were systematically screened and data abstracted in duplicate. Nine eligible studies were included in this review (2 case reports, 2 case series, 3 non-randomized comparative studies, and 2 randomized controlled trials). In total, 534 patients (534 hips), with a mean age of 37.2 years, who underwent hip arthroscopy procedures were administered nerve blocks for pain management. Specifically, femoral (2 studies), fascia iliaca (2 studies), lumbar plexus (3 studies), and L1 and L2 paravertebral (2 studies) nerve blocks were used. All studies reported acceptable pain scores after the use of nerve blocks, and 4 studies showed significantly lower postoperative pain scores acutely with the use of nerve blocks over general anesthesia alone. The use of nerve blocks also resulted in a decrease in opioid consumption in 4 studies and provided a higher level of patient satisfaction in 2 studies. No serious acute complications were reported in any study, and long-term complications from lumbar plexus blocks, such as local anesthetic system toxicity (0.9%) and long-term neuropathy (2.8%), were low in incidence. The use of perioperative nerve blocks provides effective pain management after hip arthroscopy and may be more effective in decreasing acute postoperative pain and supplemental opioid consumption than other analgesic techniques. Level IV, systematic review of Level I to Level IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  15. Dietary protein to maximize resistance training: a review and examination of protein spread and change theories.

    Science.gov (United States)

    Bosse, John D; Dixon, Brian M

    2012-09-08

    An appreciable volume of human clinical data supports increased dietary protein for greater gains from resistance training, but not all findings are in agreement. We recently proposed "protein spread theory" and "protein change theory" in an effort to explain discrepancies in the response to increased dietary protein in weight management interventions. The present review aimed to extend "protein spread theory" and "protein change theory" to studies examining the effects of protein on resistance training induced muscle and strength gains. Protein spread theory proposed that there must have been a sufficient spread or % difference in g/kg/day protein intake between groups during a protein intervention to see muscle and strength differences. Protein change theory postulated that for the higher protein group, there must be a sufficient change from baseline g/kg/day protein intake to during study g/kg/day protein intake to see muscle and strength benefits. Seventeen studies met inclusion criteria. In studies where a higher protein intervention was deemed successful there was, on average, a 66.1% g/kg/day between group intake spread versus a 10.2% g/kg/day spread in studies where a higher protein diet was no more effective than control. The average change in habitual protein intake in studies showing higher protein to be more effective than control was +59.5% compared to +6.5% when additional protein was no more effective than control. The magnitudes of difference between the mean spreads and changes of the present review are similar to our previous review on these theories in a weight management context. Providing sufficient deviation from habitual intake appears to be an important factor in determining the success of additional protein in enhancing muscle and strength gains from resistance training. An increase in dietary protein favorably effects muscle and strength during resistance training.

  16. Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

    Science.gov (United States)

    Sanders, Vicki L; Flanagan, Jennifer

    2015-01-01

    The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

  17. A Qualitative Assessment of Current CCF Guidance Based on a Review of Safety System Digital Implementation Changes with Evolving Technology

    Energy Technology Data Exchange (ETDEWEB)

    Korsah, Kofi [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wood, Richard [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-04-01

    The US Nuclear Regulatory Commission (NRC) is initiating a new rulemaking project to develop a digital system common-cause failure (CCF) rule. This rulemaking will review and modify or affirm the NRC's current digital system CCF policy as discussed in the Staff Requirements Memorandum to the Secretary of the Commission, Office of the NRC (SECY) 93-087, Policy, Technical, and Licensing Issues Pertaining to Evolutionary and Advanced Light Water Reactor (ALWR) Designs, and Branch Technical Position (BTP) 7-19, Guidance on Evaluation of Defense-in-Depth and Diversity in Digital Computer-Based Instrumentation and Control Systems, as well as Chapter 7, Instrumentation and Controls, in NRC Regulatory Guide (NUREG)-0800, Standard Review Plan for Review of Safety Analysis Reports for Nuclear Power Plants (ML033580677). The Oak Ridge National Laboratory (ORNL) is providing technical support to the NRC staff on the CCF rulemaking, and this report is one of several providing the technical basis to inform NRC staff members. For the task described in this report, ORNL examined instrumentation and controls (I&C) technology implementations in nuclear power plants in the light of current CCF guidance. The intent was to assess whether the current position on CCF is adequate given the evolutions in digital safety system implementations and, if gaps in the guidance were found, to provide recommendations as to how these gaps could be closed.

  18. Robotic surgery for rectal cancer: A systematic review of current practice

    Science.gov (United States)

    Mak, Tony Wing Chung; Lee, Janet Fung Yee; Futaba, Kaori; Hon, Sophie Sok Fei; Ngo, Dennis Kwok Yu; Ng, Simon Siu Man

    2014-01-01

    AIM: To give a comprehensive review of current literature on robotic rectal cancer surgery. METHODS: A systematic review of current literature via PubMed and Embase search engines was performed to identify relevant articles from january 2007 to november 2013. The keywords used were: “robotic surgery”, “surgical robotics”, “laparoscopic computer-assisted surgery”, “colectomy” and “rectal resection”. RESULTS: After the initial screen of 380 articles, 20 papers were selected for review. A total of 1062 patients (male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the review. Out of 1062 robotic-assisted operations, 831 (78.2%) anterior and low anterior resections, 132 (12.4%) intersphincteric resection with coloanal anastomosis, 98 (9.3%) abdominoperineal resections and 1 (0.1%) Hartmann’s operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has continued to evolve to its current state with promising results; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost. PMID:24936229

  19. Mentoring and New Teacher Induction in the United States: A Review and Analysis of Current Practices

    Science.gov (United States)

    Bullough, Robert V., Jr.

    2012-01-01

    In this article, current practices were reviewed in mentoring and induction across three large states--New York, Texas, and California--and one small state, Utah. Patterns and trends are described in the United States, program results and evolving views of mentoring are discussed, gaps in the research literature are identified, and the future of…

  20. Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

    Directory of Open Access Journals (Sweden)

    Giuliano de Oliveira Freitas

    2013-12-01

    Full Text Available Preexisting corneal astigmatism, present at the time of cataract surgery, is reviewed in detail throughout this article on its most important aspects such as occurrence rates, clinical relevance and current treatment options. Special emphasis is given to the latter aspect. Each method's rationale, advantage and limitation ishigh lightened. Comparisons between treatment options, whenever possible, are also provided.

  1. A review of the current literature on aetiology and measurement methods of halitosis.

    NARCIS (Netherlands)

    Broek, A.M. van den; Feenstra, L.; Baat, C. de

    2007-01-01

    OBJECTIVES: This work reviews the current knowledge of aetiology and measurement methods of halitosis. DATA: Halitosis is an unpleasant or offensive odour emanating from the breath. The condition is multifactorial and may involve both oral and non-oral conditions. SOURCES: A private, monthly with

  2. Evaluating mediation and moderation effects in school psychology: a presentation of methods and review of current practice.

    Science.gov (United States)

    Fairchild, Amanda J; McQuillin, Samuel D

    2010-02-01

    Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described.

  3. Evaluating mediation and moderation effects in school psychology: A presentation of methods and review of current practice

    Science.gov (United States)

    Fairchild, Amanda J.; McQuillin, Samuel D.

    2017-01-01

    Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described. PMID:20006988

  4. Anatomy and physical examination of the knee menisci: a narrative review of the orthopedic literature.

    Science.gov (United States)

    Chivers, Michael D; Howitt, Scott D

    2009-12-01

    The objective of this study was to review the physical examination tests available to a practitioner in order to arrive at a clinical diagnosis or suspicion of a meniscal lesion. The menisci transmit weight bearing forces and increase stability of the knee. The menisci also facilitate nutrition, provide lubrication and shock absorption for the articular cartilage and promote knee proprioception. The combinations of torsional and axial loading appear to be the cause of most meniscal injuries. Diagnosis of acute knee injuries has long been a topic for discussion throughout the orthopedic literature. Many clinical tests and diagnostic studies have been developed to increase the clinician's ability to accurately diagnose these types of disorders of the knee. The accuracy of all diagnostic tests is thought to be dependant upon the skill of the examiner, and the severity and location of the injury. The multitude of tests described to assess meniscal lesions suggests that none are consistently reliable. However, recent research has focused on a composite score to accurately predict meniscus lesions. The combination of a comprehensive history, multiple physical tests and diagnostic imaging for confirmation is typical for a clinical meniscal lesion diagnosis while the gold standard remains the arthroscopic procedure itself.

  5. Reliability of physical examination tests for the diagnosis of knee disorders: Evidence from a systematic review.

    Science.gov (United States)

    Décary, Simon; Ouellet, Philippe; Vendittoli, Pascal-André; Desmeules, François

    2016-12-01

    Clinicians often rely on physical examination tests to guide them in the diagnostic process of knee disorders. However, reliability of these tests is often overlooked and may influence the consistency of results and overall diagnostic validity. Therefore, the objective of this study was to systematically review evidence on the reliability of physical examination tests for the diagnosis of knee disorders. A structured literature search was conducted in databases up to January 2016. Included studies needed to report reliability measures of at least one physical test for any knee disorder. Methodological quality was evaluated using the QAREL checklist. A qualitative synthesis of the evidence was performed. Thirty-three studies were included with a mean QAREL score of 5.5 ± 0.5. Based on low to moderate quality evidence, the Thessaly test for meniscal injuries reached moderate inter-rater reliability (k = 0.54). Based on moderate to excellent quality evidence, the Lachman for anterior cruciate ligament injuries reached moderate to excellent inter-rater reliability (k = 0.42 to 0.81). Based on low to moderate quality evidence, the Tibiofemoral Crepitus, Joint Line and Patellofemoral Pain/Tenderness, Bony Enlargement and Joint Pain on Movement tests for knee osteoarthritis reached fair to excellent inter-rater reliability (k = 0.29 to 0.93). Based on low to moderate quality evidence, the Lateral Glide, Lateral Tilt, Lateral Pull and Quality of Movement tests for patellofemoral pain reached moderate to good inter-rater reliability (k = 0.49 to 0.73). Many physical tests appear to reach good inter-rater reliability, but this is based on low-quality and conflicting evidence. High-quality research is required to evaluate the reliability of knee physical examination tests. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. A systematic review of the accuracy and clinical utility of the Addenbrooke's Cognitive Examination and the Addenbrooke's Cognitive Examination-Revised in the diagnosis of dementia.

    Science.gov (United States)

    Crawford, Stephanie; Whitnall, Leigh; Robertson, Joanne; Evans, Jonathan J

    2012-07-01

    To review the evidence relating to the diagnostic accuracy and clinical utility of the Addenbrooke's Cognitive Examination (ACE) and its updated version, the Addenbrooke's Cognitive Examination-Revised (ACE-R) in relation to the diagnosis of dementia. A systematic search of relevant databases was conducted, covering the period 2000 to April 2010. Specific journals and reference lists were hand searched. Identified studies that fulfilled the inclusion criteria were reviewed using a tailored, methodological quality rating checklist. The systematic search process identified nine studies for review (seven relating to the ACE, two on the ACE-R). Strengths and weaknesses across studies are considered, and diagnostic accuracy measures are presented for six out of the nine studies. The evidence suggests that the ACE/ACE-R is capable of providing information on a range of cognitive domains and of differentiating well between those with and those without cognitive impairment. Further research examining how the tools distinguish between dementia subtypes and mild cognitive impairment will further benefit the evidence base. Copyright © 2011 John Wiley & Sons, Ltd.

  7. Physical examination education in graduate medical education--a systematic review of the literature.

    Science.gov (United States)

    Mookherjee, Somnath; Pheatt, Lara; Ranji, Sumant R; Chou, Calvin L

    2013-08-01

    There is widespread recognition that physical examination (PE) should be taught in Graduate Medical Education (GME), but little is known regarding how to best teach PE to residents. Deliberate practice fosters expertise in other fields, but its utility in teaching PE is unknown. We systematically reviewed the literature to determine the effectiveness of methods to teach PE in GME, with attention to usage of deliberate practice. We searched PubMed, ERIC, and EMBASE for English language studies regarding PE education in GME published between January 1951 and December 2012. Seven eligibility criteria were applied to studies of PE education: (1) English language; (2) subjects in GME; (3) description of study population; (4) description of intervention; (5) assessment of efficacy; (6) inclusion of control group; and (7) report of data analysis. We extracted data regarding study quality, type of PE, study population, curricular features, use of deliberate practice, outcomes and assessment methods. Tabulated summaries of studies were reviewed for narrative synthesis. Fourteen studies met inclusion criteria. The mean Medical Education Research Study Quality Instrument (MERSQI) score was 9.0 out of 18. Most studies (n = 8) included internal medicine residents. Half of the studies used resident interaction with a human examinee as the primary means of teaching PE. Three studies "definitely" and four studies "possibly" used deliberate practice; all but one of these studies demonstrated improved educational outcomes. We used a non-validated deliberate practice assessment. Given the heterogeneity of assessment modalities, we did not perform a meta-analysis. No single strategy for teaching PE in GME is clearly superior to another. Following the principles of deliberate practice and interaction with human examinees may be beneficial in teaching PE; controlled studies including these educational features should be performed to investigate these exploratory findings.

  8. Thermal management issues in a PEMFC stack - A brief review of current status

    International Nuclear Information System (INIS)

    Kandlikar, Satish G.; Lu Zijie

    2009-01-01

    Understanding the thermal effects is critical in optimizing the performance and durability of proton exchange membrane fuel cells (PEMFCs). A PEMFC produces a similar amount of waste heat to its electric power output and tolerates only a small deviation in temperature from its design point. The balance between the heat production and its removal determines the operating temperature of a PEMFC. These stringent thermal requirements present a significant heat transfer challenge. In this work, the fundamental heat transfer mechanisms at PEMFC component level (including polymer electrolyte, catalyst layers, gas diffusion media and bipolar plates) are briefly reviewed. The current status of PEMFC cooling technology is also reviewed and research needs are identified

  9. Review of experiments on current drive in tokamaks by means of RF waves

    International Nuclear Information System (INIS)

    Hooke, W.

    1984-01-01

    Experimental results on lower hybrid current drive in tokamak plasmas are reviewed. Pulse lengths of 3.5 seconds and currents above 400 kA have been generated at plasma densities such that the wave frequency is greater than about twice the lower hybrid frequency. Current drive ceases above a critical density, nsub(c). However, nsub(c) increases with wave frequency. So that for f = 4.6 GHz current drive has been seen at n-barsub(e) approx.= 10 14 cm -3 and a density limit has yet to be established. Evidence for a collisional scaling law for current-drive efficiency is summarized. Detailed measurements of bremsstrahlung x-rays show a distribution which is qualitatively similar to that predicted by quasilinear theory. Microwave emission at frequencies less than the plasma frequency may shed light on the current-drive mechanism. Applications of current drive including plasma and current start-up and transformer recharging are discussed. (author)

  10. A review of sex estimation techniques during examination of skeletal remains in forensic anthropology casework.

    Science.gov (United States)

    Krishan, Kewal; Chatterjee, Preetika M; Kanchan, Tanuj; Kaur, Sandeep; Baryah, Neha; Singh, R K

    2016-04-01

    Sex estimation is considered as one of the essential parameters in forensic anthropology casework, and requires foremost consideration in the examination of skeletal remains. Forensic anthropologists frequently employ morphologic and metric methods for sex estimation of human remains. These methods are still very imperative in identification process in spite of the advent and accomplishment of molecular techniques. A constant boost in the use of imaging techniques in forensic anthropology research has facilitated to derive as well as revise the available population data. These methods however, are less reliable owing to high variance and indistinct landmark details. The present review discusses the reliability and reproducibility of various analytical approaches; morphological, metric, molecular and radiographic methods in sex estimation of skeletal remains. Numerous studies have shown a higher reliability and reproducibility of measurements taken directly on the bones and hence, such direct methods of sex estimation are considered to be more reliable than the other methods. Geometric morphometric (GM) method and Diagnose Sexuelle Probabiliste (DSP) method are emerging as valid methods and widely used techniques in forensic anthropology in terms of accuracy and reliability. Besides, the newer 3D methods are shown to exhibit specific sexual dimorphism patterns not readily revealed by traditional methods. Development of newer and better methodologies for sex estimation as well as re-evaluation of the existing ones will continue in the endeavour of forensic researchers for more accurate results. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. How do laboratory embryo transfer techniques affect IVF outcomes? A review of current literature.

    Science.gov (United States)

    Sigalos, George; Triantafyllidou, Olga; Vlahos, Nikos

    2017-04-01

    Over the last few years, many studies have focused on embryo selection methods, whereas little attention has been given to the standardization of the procedure of embryo transfer. In this review, several parameters of the embryo transfer procedure are examined, such as the: (i) culture medium volume and loading technique; (ii) syringe and catheters used for embryo transfer; (iii) viscosity and composition of the embryo transfer medium; (iv) environment of embryo culture; (v) timing of embryo transfer; (vi) and standardization of the embryo transfer techniques. The aim of this manuscript is to review these factors and compare the existing embryo transfer techniques and highlight the need for better embryo transfer standardization.

  12. Does This Patient Have Infectious Mononucleosis?: The Rational Clinical Examination Systematic Review.

    Science.gov (United States)

    Ebell, Mark H; Call, Marlene; Shinholser, JoAnna; Gardner, Jack

    2016-04-12

    Early, accurate diagnosis of infectious mononucleosis can help clinicians target treatment, avoid antibiotics, and provide an accurate prognosis. To systematically review the literature regarding the value of the clinical examination and white blood cell count for the diagnosis of mononucleosis. The databases of PubMed (from 1966-2016) and EMBASE (from 1947-2015) were searched and a total of 670 articles and abstracts were reviewed for eligibility. Eleven studies were included that reported data sufficient to calculate sensitivity, specificity, or both for clinical examination findings and white blood cell count parameters compared with a valid reference standard. Data were abstracted from each article by at least 2 reviewers, with discrepancies reconciled by consensus. Clinical findings evaluated in only 1 study are reported with sensitivity, specificity, likelihood ratio (LR), and 95% confidence interval, which were calculated from the available data. Findings evaluated in only 2 studies were summarized with their range, findings evaluated in 3 studies were summarized with a univariate random-effects summary, and findings evaluated in 4 or more studies were summarized with a bivariate random-effects meta-analysis. Sensitivity, specificity, and LRs for the diagnosis of mononucleosis. Mononucleosis is most commonly present among patients aged 5 to 25 years (especially those aged 16-20 years, among whom approximately 1 in 13 patients presenting with sore throat has mononucleosis). The likelihood of mononucleosis is reduced with the absence of any lymphadenopathy (summary sensitivity, 0.91; positive LR range, 0.23-0.44), whereas the likelihood increases with the presence of posterior cervical adenopathy (summary specificity, 0.87; positive LR, 3.1 [95% CI, 1.6-5.9]), inguinal or axillary adenopathy (specificity range, 0.82-0.91; positive LR range, 3.0-3.1), palatine petechiae (specificity, 0.95; positive LR, 5.3 [95% CI, 2.1-13]), and splenomegaly (specificity range

  13. Does This Child Have Pneumonia?: The Rational Clinical Examination Systematic Review.

    Science.gov (United States)

    Shah, Sonal N; Bachur, Richard G; Simel, David L; Neuman, Mark I

    2017-08-01

    Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria. Two authors independently abstracted raw data and assessed methodological quality. A third author resolved disputes. Likelihood ratios (LRs), sensitivity, and specificity were calculated for individual symptoms and physical examination findings for the diagnosis of pneumonia. An infiltrate on chest radiograph was considered the reference standard for the diagnosis of pneumonia. Twenty-three prospective cohort studies of children (N = 13 833) with possible pneumonia were included (8 from North America), with a range of 78 to 2829 patients per study. The prevalence of radiographic pneumonia in North American studies was 19% (95% CI, 11%-31%) and 37% (95% CI, 26%-50%) outside of North America. No single symptom was strongly associated with pneumonia; however, the presence of chest pain in 2 studies that included adolescents was associated with pneumonia (LR, 1.5-5.5; sensitivity, 8%-14%; specificity, 94%-97%). Vital sign abnormalities such as fever (temperature >37.5°C [LR range, 1.7-1.8]; sensitivity, 80%-92%; specificity, 47%-54%) and tachypnea (respiratory rate >40 breaths/min; LR, 1.5 [95% CI, 1.3-1.7]; sensitivity, 79%; specificity, 51%) were not strongly associated with pneumonia diagnosis

  14. A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people.

    Science.gov (United States)

    Priest, Naomi; Paradies, Yin; Trenerry, Brigid; Truong, Mandy; Karlsen, Saffron; Kelly, Yvonne

    2013-10-01

    Racial discrimination is increasingly recognised as a determinant of racial and ethnic health inequalities, with growing evidence of strong associations between racial discrimination and adult health outcomes. There is a growing body of literature that considers the effects of racial discrimination on child and youth health. The aim of this paper is to provide a systematic review of studies that examine relationships between reported racial discrimination and child and youth health. We describe the characteristics of 121 studies identified by a comprehensive search strategy, including definitions and measurements of racial discrimination and the nature of reported associations. Most studies were published in the last seven years, used cross-sectional designs and were conducted in the United States with young people aged 12-18 years. African American, Latino/a, and Asian populations were most frequently included in these studies. Of the 461 associations examined in these studies, mental health outcomes (e.g. depression, anxiety) were most commonly reported, with statistically significant associations with racial discrimination found in 76% of outcomes examined. Statistically significant associations were also found for over 50% of associations between racial discrimination and positive mental health (e.g. self esteem, resilience), behaviour problems, wellbeing, and pregnancy/birth outcomes. The field is currently limited by a lack of longitudinal studies, limited psychometrically validated exposure instruments and poor conceptualisation and definition of racial discrimination. There is also a need to investigate the complex and varying pathways by which reported racial discrimination affect child and youth health. Ensuring study quality in this field will allow future research to reveal the complex role that racial discrimination plays as a determinant of child and youth health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Mixed methods research in tobacco control with youth and young adults: A methodological review of current strategies.

    Directory of Open Access Journals (Sweden)

    Craig S Fryer

    Full Text Available Tobacco use among young people is a complex and serious global dilemma that demands innovative and diverse research approaches. The purpose of this methodological review was to examine the current use of mixed methods research in tobacco control with youth and young adult populations and to develop practical recommendations for tobacco control researchers interested in this methodology.Using PubMed, we searched five peer-reviewed journals that publish tobacco control empirical literature for the use of mixed methods research to study young populations, age 12-25 years. Our team analyzed the features of each article in terms of tobacco control topic, population, youth engagement strategies, and several essential elements of mixed methods research.We identified 23 mixed methods studies published by authors from five different countries reported between 2004 and 2015. These 23 articles examined various topics that included tobacco use behavior, tobacco marketing and branding, and cessation among youth and young adults. The most common mixed methods approach was variations of the concurrent design in which the qualitative and quantitative strands were administered at the same time and given equal priority. This review documented several innovative applications of mixed methods research as well as challenges in the reporting of the complex research designs.The use of mixed methods research in tobacco control has great potential for advancing the understanding of complex behavioral and sociocultural issues for all groups, especially youth and young adults.

  16. Mixed methods research in tobacco control with youth and young adults: A methodological review of current strategies.

    Science.gov (United States)

    Fryer, Craig S; Seaman, Elizabeth L; Clark, Rachael S; Plano Clark, Vicki L

    2017-01-01

    Tobacco use among young people is a complex and serious global dilemma that demands innovative and diverse research approaches. The purpose of this methodological review was to examine the current use of mixed methods research in tobacco control with youth and young adult populations and to develop practical recommendations for tobacco control researchers interested in this methodology. Using PubMed, we searched five peer-reviewed journals that publish tobacco control empirical literature for the use of mixed methods research to study young populations, age 12-25 years. Our team analyzed the features of each article in terms of tobacco control topic, population, youth engagement strategies, and several essential elements of mixed methods research. We identified 23 mixed methods studies published by authors from five different countries reported between 2004 and 2015. These 23 articles examined various topics that included tobacco use behavior, tobacco marketing and branding, and cessation among youth and young adults. The most common mixed methods approach was variations of the concurrent design in which the qualitative and quantitative strands were administered at the same time and given equal priority. This review documented several innovative applications of mixed methods research as well as challenges in the reporting of the complex research designs. The use of mixed methods research in tobacco control has great potential for advancing the understanding of complex behavioral and sociocultural issues for all groups, especially youth and young adults.

  17. Adrenal lesions encountered in current medical practice − a review of their radiological imaging

    Directory of Open Access Journals (Sweden)

    Vanesha Naidu

    2013-11-01

    Full Text Available Modern radiological technology has transformed the way that adrenal lesions are currently investigated. The contemporary radiologist has been catapulted to the forefront in the management of adrenal disease. With the increasing use of cross-sectional imaging, adrenal lesions are being serendipitously discovered in radiological studies undertaken for non-adrenal-related conditions – the so-called adrenal ‘incidentaloma’. This review discusses the imaging modalities available for characterising these lesions, highlighting current concepts and controversies in differentiating benign from malignant pathology. The article also provides a brief overview of the spectrum of adrenal pathology commonly encountered in the adult population.

  18. Online consumers reviews: examining the moderating effects of product type and product popularity on the review impact on sales

    OpenAIRE

    Moen, Øystein; Havro, Lars Jaako; Bjering, Einar

    2017-01-01

    This paper aims to study the role product category plays as a moderating factor in online reviews, by introducing a novel method for product category classification using natural language processing (NLP). The study includes a wide variety of categories, based on a high number of products and number of reviews. The data-set presented includes 1.1 million unique reviews from 4,600 products in 30 different product categories. We find evidence for reviews having an effect on sales, and that this...

  19. Prehospital Ultrasound in Trauma: A Review of Current and Potential Future Clinical Applications

    Directory of Open Access Journals (Sweden)

    Tharwat El Zahran

    2018-01-01

    Full Text Available Ultrasound (US is an essential tool for evaluating trauma patients in the hospital setting. Many previous in-hospital studies have been extrapolated to out of hospital setting to improve diagnostic accuracy in prehospital and austere environments. This review article presents the role of prehospital US in blunt and penetrating trauma management with emphasis on its current clinical applications, challenges, and future implications of such use.

  20. Small Business and Defense Acquisitions: A Review of Policies and Current Practices

    Science.gov (United States)

    2011-01-01

    Office of Management and Budget xviii Small Business and Defense Acquisitions: A Review of Policies and Current Practices PSC Product and Service Code...themselves as minority-owned, women-owned, veteran- owned, or small disadvantaged businesses . The resulting database gives sourcing managers a tool for...REPORT DATE 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Small Business and Defense Acquisitions: A

  1. Selective mutism and anxiety: a review of the current conceptualization of the disorder.

    Science.gov (United States)

    Sharp, William G; Sherman, Colleen; Gross, Alan M

    2007-01-01

    Selective mutism (SM) is a rare and interesting condition that has been associated with a wide variety of childhood psychiatric conditions. Historically viewed as more of an oddity than a distinct diagnostic entity, early conceptualizations of the condition were based largely on case studies that tended to link SM with oppositional behavior. More recently, controlled studies have enhanced our understanding of SM. This review summarizes the current conceptualization of SM, highlighting evidence supporting the notion that SM is an anxiety-related condition.

  2. Reporting Multiple Individual Injuries in Studies of Team Ball Sports: A Systematic Review of Current Practice

    OpenAIRE

    Fortington, Lauren V; van der Worp, Henk; van den Akker-Scheek, Inge; Finch, Caroline F

    2017-01-01

    Background To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. Objective The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and repor...

  3. Our Approach to Toxic Epidermal Necrolysis and Review of Current Treatment Alternatives

    Directory of Open Access Journals (Sweden)

    Fatih Uygur

    2008-09-01

    Full Text Available Toxic epidermal necrolysis (TEN is a clinical entity which has a 30 to 40 % mortality rate, with necrolysis affecting the entire epidermis. Antibiotics, nonsteroidal anti-inflammatory drugs and anticonvulsants are offender drugs in TEN etiology. A standard treatment protocol with proven efficacy is still lacking. In this study, current treatment practice and our treatment strategy for TEN is discussed and eight patients treated in our clinic between the years 2001 and 2008 are reviewed.

  4. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests.

    Science.gov (United States)

    Hegedus, Eric J; Goode, Adam P; Cook, Chad E; Michener, Lori; Myer, Cortney A; Myer, Daniel M; Wright, Alexis A

    2012-11-01

    To update our previously published systematic review and meta-analysis by subjecting the literature on shoulder physical examination (ShPE) to careful analysis in order to determine each tests clinical utility. This review is an update of previous work, therefore the terms in the Medline and CINAHL search strategies remained the same with the exception that the search was confined to the dates November, 2006 through to February, 2012. The previous study dates were 1966 - October, 2006. Further, the original search was expanded, without date restrictions, to include two new databases: EMBASE and the Cochrane Library. The Quality Assessment of Diagnostic Accuracy Studies, version 2 (QUADAS 2) tool was used to critique the quality of each new paper. Where appropriate, data from the prior review and this review were combined to perform meta-analysis using the updated hierarchical summary receiver operating characteristic and bivariate models. Since the publication of the 2008 review, 32 additional studies were identified and critiqued. For subacromial impingement, the meta-analysis revealed that the pooled sensitivity and specificity for the Neer test was 72% and 60%, respectively, for the Hawkins-Kennedy test was 79% and 59%, respectively, and for the painful arc was 53% and 76%, respectively. Also from the meta-analysis, regarding superior labral anterior to posterior (SLAP) tears, the test with the best sensitivity (52%) was the relocation test; the test with the best specificity (95%) was Yergason's test; and the test with the best positive likelihood ratio (2.81) was the compression-rotation test. Regarding new (to this series of reviews) ShPE tests, where meta-analysis was not possible because of lack of sufficient studies or heterogeneity between studies, there are some individual tests that warrant further investigation. A highly specific test (specificity >80%, LR+ ≥ 5.0) from a low bias study is the passive distraction test for a SLAP lesion. This test may

  5. Review of the critical current densities and magnetic irreversibilities in high T_c superconductors

    Science.gov (United States)

    Senoussi, S.

    1992-07-01

    This review article is concerned with critical current density (J) and magnetic irreversibilities in high-T_c superconductors (HTSC). The apparent J derived from different experimental techniques (transport, hysteresis cycle, ac-susceptibility) are compared. The influence of time (relaxation effects) as well as the macroscopic size of the sample on the criteria defining J are discussed. The dependences of the critical current on grain boundaries (“weaks-links”), texturing and other physical and chemical defects are examined in detail. The role of self fields is clarified. The critical current is strongly influenced by the anisotropy of the layered structure practically whatever the experimental conditions. Intrinsic pinning is lowered by defects. Demagnetizing effects and surface pinnings are reviewed. The usual critical state and flux creep models are recalled emphasizing the physical aspects most specific to HTSC. A theoretical model which takes into account the equilibrium magnetization and sample granularity is developed. It reproduces most of the characteristic features of both the hysteresis cycle and ac-susceptibility. A number of new formulae are introduced. They generalize the Bean model and show how to correct for the dimensions of the grains (granular materials), the macroscopic radius of the sample, anisotropy and demagnetization effects in certain situations. Several limits beyond which the usual critical state breaks down are discussed: (1) the quasi elastic limit where the variable field is too weak to depin the vortices, (2) H≈ H_C1 so that the interaction between vortex lines is exponentially weak and (3) T and H close to the “irreversibility line” where the influence of viscous forces are strong. (4) Hgg H_C1 so that J is governed by collective pinning. Ce papier de revue est consacré aux courant critiques (J) et aux irréversibilités magnétiques dans les nouveaux matériaux supraconducteurs (HTSC). Nous y comparons les densités des

  6. Transcranial Direct Current Stimulation in Tinnitus Patients: A Systemic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jae-Jin Song

    2012-01-01

    Full Text Available Although transcranial direct current stimulation (tDCS has already been used to manage tinnitus patients, paucity of reports and variations in protocols preclude a comprehensive understanding. Hence, we conducted a meta-analysis based on systemic review to assess effectiveness of tDCS in tinnitus management and to compare stimulation parameters. PubMed was searched for tDCS studies in tinnitus. For randomized controlled trials (RCTs, a meta-analysis was performed. A total of 17 studies were identified and 6 of them were included in the systemic review and 2 RCTs were included in the meta-analysis. Overall 39.5% responded to active tDCS with a mean tinnitus intensity reduction of 13.5%. Additionally, left temporal area (LTA and bifrontal tDCS indicated comparable results. Active tDCS was found to be more effective than sham tDCS for tinnitus intensity reduction (Hedges' g=.77, 95% confidence interval 0.23–1.31. The efficacy of tDCS in tinnitus could not be fully confirmed by the current study because of the limited number of studies, but all studies included in the current systemic review and meta-analysis demonstrated significant tinnitus intensity improvement. Therefore, tDCS may be a promising tool for tinnitus management. Future RCTs in a large series regarding the efficacy as well as the comparison between LTA- and bifrontal tDCS are recommended.

  7. Periodic Safety Review in Interim Storage Facilities - Current Regulation and Experiences in Germany

    International Nuclear Information System (INIS)

    Neles, Julia Mareike; Schmidt, Gerhard

    2014-01-01

    Periodic safety reviews in nuclear power plants in Germany have been performed since the end of the 1980's as an indirect follow-up of the accident in Chernobyl and, in the meantime, are formally required by law. During this process the guidelines governing this review were developed in stages and reached their final form in 1996. Interim storage facilities and other nuclear facilities at that time were not included, so the guidelines were solely focused on the specific safety issues of nuclear power plants. Following IAEA's recommendations, the Western European Nuclear Regulator Association (WENRA) introduced PSRs in its safety reference levels for storage facilities (current version in WGWD report 2.1 as of Feb 2011: SRLs 59 - 61). Based on these formulations, Germany improved its regulation in 2010 with a recommendation of the Nuclear Waste Management Commission (Entsorgungskommission, ESK), an expert advisory commission for the federal regulatory body BMU. The ESK formulated these detailed requirements in the 'ESK recommendation for guides to the performance of periodic safety reviews for interim storage facilities for irradiated fuel elements and heat-generating radioactive waste'. Before finalization of the guideline a test phase was introduced, aimed to test the new regulation in practice and to later include the lessons learned in the final formulation of the guideline. The two-year test phase started in October 2011 in which the performance of a PSR will be tested at two selected interim storage facilities. Currently these recommendations are discussed with interested/concerned institutions. The results of the test phase shall be considered for improvements of the draft and during the final preparation of guidelines. Currently the PSR for the first ISF is in an advanced stage, the second facility just started the process. Preliminary conclusions from the test phase show that the implementation of the draft guideline requires interpretation. The aim of a

  8. A systematic review of dyadic studies examining relationship quality in couples facing colorectal cancer together.

    Science.gov (United States)

    Kayser, Karen; Acquati, Chiara; Reese, Jennifer Barsky; Mark, Kristen; Wittmann, Daniela; Karam, Eli

    2018-01-01

    Despite the adverse effects that treatment for colorectal cancer can have on patients' quality of life and, in particular, their intimate relationships, very little research has been conducted on the psychosocial adjustment for both patients and their partners/spouses. The aim of this systematic review was to examine dyadic studies of adjustment in couples in which one partner has been diagnosed with colorectal cancer. Pub Med, PsychINFO, MEDLINE, Social Sciences Abstracts (EBSCO), and the Cochrane Library were systematically searched for studies reporting quality of life outcomes for colorectal cancer patients and their partners/spouses. Only studies that included dyads in the sample were eligible for inclusion. The Quality Assessment Tool for Quantitative Studies was used to evaluate each study. A total of 277 studies were identified, of which 9 studies met the inclusion criteria (N = 388 couples). The methodological quality of the studies was high in that they used standardized instruments validated with their samples, conducted dyadic data analyses (when appropriate), and used longitudinal designs. A synthesis of the studies revealed that (1) relationship factors (eg, support, communication, dyadic coping, and relationship satisfaction) affect adjustment to cancer; (2) cancer-related distress impacts each partner's adjustment or the relationship; and (3) gender, role (patient/caregiver), and clinical characteristics (treatment, mental health) can mediate adjustment to cancer. The quality of the relationship can influence patients' and their partners' adjustment to colorectal cancer. Psychosocial interventions that address relationship issues may be beneficial to couples facing the challenges of colorectal cancer. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Flux-lock type of superconducting fault current limiters: A comprehensive review

    Science.gov (United States)

    Badakhshan, M.; Mousavi G., S. M.

    2018-04-01

    Power systems must be developed and extended to supply the continuous enhancement of demands for electrical energy. This development of systems in addition to the integration of distributed generation (DG) units to the power systems results higher capacity of system. Hence, short circuit current of network is confronted with persistent increasing. Since exploration of high temperature superconducting (HTS) materials, superconducting fault current limiters (SFCLs) have attracted a lot of attention all over the world. There are different types of SFCLs. Flux-lock type of SFCL because of its characteristics in fault current limitation is an important category of SFCLs. This paper aims to present a comprehensive review of research activities and applications of Flux-lock type of SFCLs in power systems.

  10. Design and analysis of group-randomized trials in cancer: A review of current practices.

    Science.gov (United States)

    Murray, David M; Pals, Sherri L; George, Stephanie M; Kuzmichev, Andrey; Lai, Gabriel Y; Lee, Jocelyn A; Myles, Ranell L; Nelson, Shakira M

    2018-06-01

    The purpose of this paper is to summarize current practices for the design and analysis of group-randomized trials involving cancer-related risk factors or outcomes and to offer recommendations to improve future trials. We searched for group-randomized trials involving cancer-related risk factors or outcomes that were published or online in peer-reviewed journals in 2011-15. During 2016-17, in Bethesda MD, we reviewed 123 articles from 76 journals to characterize their design and their methods for sample size estimation and data analysis. Only 66 (53.7%) of the articles reported appropriate methods for sample size estimation. Only 63 (51.2%) reported exclusively appropriate methods for analysis. These findings suggest that many investigators do not adequately attend to the methodological challenges inherent in group-randomized trials. These practices can lead to underpowered studies, to an inflated type 1 error rate, and to inferences that mislead readers. Investigators should work with biostatisticians or other methodologists familiar with these issues. Funders and editors should ensure careful methodological review of applications and manuscripts. Reviewers should ensure that studies are properly planned and analyzed. These steps are needed to improve the rigor and reproducibility of group-randomized trials. The Office of Disease Prevention (ODP) at the National Institutes of Health (NIH) has taken several steps to address these issues. ODP offers an online course on the design and analysis of group-randomized trials. ODP is working to increase the number of methodologists who serve on grant review panels. ODP has developed standard language for the Application Guide and the Review Criteria to draw investigators' attention to these issues. Finally, ODP has created a new Research Methods Resources website to help investigators, reviewers, and NIH staff better understand these issues. Published by Elsevier Inc.

  11. How current Clinical Practice Guidelines for low back pain reflect Traditional Medicine in East Asian Countries: a systematic review of Clinical Practice Guidelines and systematic reviews.

    Directory of Open Access Journals (Sweden)

    Hyun-Woo Cho

    Full Text Available OBJECTIVES: The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs and evidence from current systematic reviews and meta-analyses (SR-MAs and to analyze the impact of this gap on present CPGs. METHODS: We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. RESULTS: Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54% mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure. However, the CPGs did not recommend acupuncture (or acupressure. Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (subacute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (subacute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. CONCLUSIONS: The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.

  12. Scapulothoracic bursitis and snapping scapula syndrome: a critical review of current evidence.

    Science.gov (United States)

    Warth, Ryan J; Spiegl, Ulrich J; Millett, Peter J

    2015-01-01

    Symptomatic scapulothoracic disorders, such as painful scapular crepitus and/or bursitis, are uncommon; however, they can produce significant pain and disability in many patients. To review the current knowledge pertaining to snapping scapula syndrome and to identify areas of further research that may be helpful to improve clinical outcomes and patient satisfaction. Systematic review. We performed a preliminary search of the PubMed and Embase databases using the search terms "snapping scapula," "scapulothoracic bursitis," "partial scapulectomy," and "superomedial angle resection" in September 2013. All nonreview articles related to the topic of snapping scapula syndrome were included. The search identified a total of 167 unique articles, 81 of which were relevant to the topic of snapping scapula syndrome. There were 36 case series of fewer than 10 patients, 16 technique papers, 11 imaging studies, 9 anatomic studies, and 9 level IV outcomes studies. The level of evidence obtained from this literature search was inadequate to perform a formal systematic review or meta-analysis. Therefore, a critical review of current evidence is presented. Snapping scapula syndrome, a likely underdiagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is typically unknown, specific treatments that are effective for some patients may not be effective for others. Nevertheless, bursectomy with or without partial scapulectomy is currently the most effective primary method of treatment in patients who fail nonoperative therapy. However, many patients experience continued shoulder disability even after surgical intervention. Future studies should focus on identifying the modifiable factors associated with poor outcomes after operative and nonoperative management for snapping scapula syndrome in an effort to improve clinical outcomes and patient satisfaction. © 2014 The Author(s).

  13. Working and caring for a child with chronic illness: A review of current literature.

    Science.gov (United States)

    Kish, A M; Newcombe, P A; Haslam, D M

    2018-05-01

    Advances in medical knowledge have contributed to the increase in the number of children living with some form of long-term chronic illness or condition. As a consequence of these advancements, treatments that are more accessible and easier to administer, usually within a child's home, have been developed. However, this may mean that parents take on greater treatment responsibility and require extra time and energy to meet these tasks, additional to other responsibilities. This review paper aims to summarize and critique existing literature on working parents of children with a chronic condition, by focusing on patterns of parent work, the challenges experienced, and the flow-on consequences to well-being. Employing a narrative, meta-synthesis of the current literature, this review identified 3 key themes related to working parents of children with chronic illness. The paper first identifies that although employment is less common, these parents are not necessarily nonworking. Second, these parents experience numerous challenges including balancing work and family, time constraints, stress, and feelings of "doing it all." And third, the above challenges lead to additional impacts on parental quality of life. This review summarizes what is currently known about work patterns, challenges, and consequences in parents of children with chronic conditions. Employment is clearly impacted for these parents. Although workplace challenges have been extensively researched, other challenges (eg, personal and family) and impacts on their well-being have not. This review discusses the present standing of this research. It outlines the strengths and limitations of the current literature, makes recommendations for future research, and suggests theoretical and practical implications of the further findings. © 2018 John Wiley & Sons Ltd.

  14. How often do surgeons intervene on shoulder labral lesions detected at MR examination? A retrospective review of MR examinations correlated with arthroscopy

    Science.gov (United States)

    2014-01-01

    Objective: We report the prevalence of surgical intervention on shoulder labral lesions detected at MR examinations and how surgeons describe labral tears seen at MR examinations in their arthroscopy reports. Methods: A retrospective review of 100 consecutive patients aged 50 years or younger who had shoulder labral tears on MR and went on to have surgery performed. It was determined whether surgical intervention was performed on the MR lesions. Results: Of these 100 patients, 72 had superior labral anterior to posterior (SLAP) tears, 38 had posterior labral tears and 28 had anterior labral tears on MR examination. All 100 patients went on to arthroscopy. All lesions described on MRI were described on arthroscopy. Of the 72 SLAP tears, 64 were described as fraying on arthroscopy with 51 debrided. The remaining eight SLAP tears were tacked surgically. Of the 38 posterior labral tears, 36 were described as fraying on arthroscopy with 29 debrided and 2 had surgical tacking performed. Of the 28 anterior labral tears described on MR examination, 26 had surgical tacking performed and 2 were debrided. There were four SLAP tears, two anterior labral tears and three posterior labral tears seen on arthroscopy but not seen on MR examination. Conclusion: In this series, a high percentage of SLAP tears and posterior labral tears described on MR examination did not have surgical tacking. Most anterior labral tears had surgical tacking. Based on the above, our surgeons request we describe superior and posterior labral lesions as fraying and/or tearing, unless we can see a displaced tear. Most anterior labral lesions are treated with surgical tacking. Advances in knowledge: MRI allows for sensitive detection of labral tears. The tears often are not clinically significant. PMID:24712320

  15. Current state of the effectiveness of problem-based learning in prosthodontics: a systematic review.

    Science.gov (United States)

    Eslami, Ehsan; Bassir, Seyed Hossein; Sadr-Eshkevari, Pooyan

    2014-05-01

    The aim of this study was to systematically review the available literature on the effectiveness of problem-based learning (PBL) in prosthodontics. Both electronic and manual searches were performed by two reviewers. Of the 440 studies identified, ten met the inclusion criteria (Kappa=0.83). Various assessment tools such as standardized examinations (National Board Dental Examination and North East Regional Board of Dental Examiners exam) (22 percent), tutor evaluation (practical and examinations performance) (20 percent), curriculum time (20 percent) and number of units (10 percent), peer evaluation (10 percent), and self-evaluation (100 percent) were used in the included studies. Thirty percent of the studies adopted a control group for all measurements, 30 percent did for only some measurements, and the others lacked any control group. Although 30 percent of the studies implemented a hybrid PBL, the other studies did not mention the type of PBL. Based on the Effective Public Health Practice Project (EPHPP), all of the included studies were rated as being of weak quality. Heterogeneity across these studies in outcome variables, study designs, levels of PBL intervention, and study population limits any attempt to generalize the outcomes. The generally poor quality assessment outcomes warrant further studies on the effectiveness of PBL in prosthodontics education compared to a non-PBL curriculum.

  16. Improving menstrual hygiene management in emergency contexts: literature review of current perspectives.

    Science.gov (United States)

    VanLeeuwen, Crystal; Torondel, Belen

    2018-01-01

    Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM) among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations' menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material) and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body's biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be included in an effective menstrual hygiene intervention, there is insufficient empirical evidence to establish which interventions are most effective in

  17. Current levels of gonadal irradiation from a selection of routine diagnostic X-ray examinations in Great Britain

    International Nuclear Information System (INIS)

    Wall, B.F.; Fisher, E.S.; Shrimpton, P.C.; Rae, S.

    1980-07-01

    The gonadal doses from 13 types of diagnostic examination have been measured at 21 hospitals throughout the country in preparation for a new assessment of the genetically significant dose to the population of Great Britain from diagnostic radiology. Thermoluminescent dosemeters, consisting of lithium borate powder contained in adhesive polythene sachets, were used for the measurements. They were attached to patients to monitor the testes dose directly or the entrance skin dose at the level of the ovaries. Skin doses were converted to ovarian doses using factors obtained by measurements in an anthropomorphic phantom exposed to a range of typical diagnostic X-ray fields. The results indicate that for some types of examination there has been an increase and for others there has been a reduction in the mean gonadal dose delivered per examination since a similar survey was made 20 years ago. Individual gonadal doses for the same examination still ranged over 3 or 4 orders of magnitude throughout the country with distributions described by coefficients of variation that were no less than those found in the late 1950s. This large variability in patient exposure, together with the observation that examinations were satisfactorily conducted on children with a much higher degree of gonadal protection than that offered to young adults, indicates that many patients must be receiving doses that are unnecessarily high. (author)

  18. 76 FR 4115 - Request for the Technical Review of the Draft Current Intelligence Bulletin (CIB): Derivation of...

    Science.gov (United States)

    2011-01-24

    ... NIOSH-156] Request for the Technical Review of the Draft Current Intelligence Bulletin (CIB): Derivation... public review of the draft, Current Intelligence Bulletin (CIB): Derivation of Immediately Dangerous to... established and (3) an overview of the analysis applied by NIOSH to develop a scientifically-based approach...

  19. Examining the relationship between burnout and empathy in healthcare professionals: A systematic review

    Directory of Open Access Journals (Sweden)

    Helen Wilkinson

    2017-09-01

    Conclusions: There was consistent evidence for a negative association between burnout and empathy. This review avoided a common English-speaking country bias of some areas of the literature. Given that all of the studies reviewed were cross sectional, further research is necessary to establish causality.

  20. A Review of Research Methods Used to Examine Employee Assistance Program Delivery Options.

    Science.gov (United States)

    Csiernik, Rick

    1995-01-01

    This review of literature on Employee Assistance Programs (EAPs) focuses on EAP delivery options. More than half of the 48 studies reviewed used a case study approach. EAPs provided by on-staff professionals were the most frequently discussed delivery option, although this is not the most dominant form of EAP provision. (SLD)

  1. Hepatitis C in Pregnancy: Review of Current Knowledge and Updated Recommendations for Management.

    Science.gov (United States)

    Page, Charlotte M; Hughes, Brenna L; Rhee, Eleanor H J; Kuller, Jeffrey A

    2017-06-01

    An estimated 1% to 2.5% of pregnant women in the United States are infected with hepatitis C virus (HCV), which carries approximately a 6% risk of mother-to-infant transmission. The aims of this article are to review the current evidence on HCV in pregnancy and to provide updated recommendations for management. Original research articles, review articles, and guidelines on HCV in general and specifically in pregnancy were reviewed, as were drug safety profiles from the Food and Drug Administration. Pregnancy appears to have a beneficial effect on the course of maternal chronic HCV infection. However, it is associated with an increased risk of adverse fetal outcomes, including fetal growth restriction and low birth weight, and can be transmitted to the infant in utero or during the peripartum period. No perinatal intervention has been shown to reduce the risk of vertical transmission, but some may increase this risk. To date, no treatment regimens for HCV have been approved for use in pregnancy, but the new ribavirin-free, direct-acting antiviral regimens are being used with high efficacy outside pregnancy. Hepatitis C virus infection in pregnancy generally does not adversely affect maternal well-being but is associated with adverse effects on the fetus because of pregnancy complications and vertical transmission. There are currently no approved treatment regimens for HCV in pregnancy; this should be an active area of research in obstetrics.

  2. Robot-assisted laparoscopic partial nephrectomy: Current review of the technique and literature.

    Science.gov (United States)

    Singh, Iqbal

    2009-10-01

    To visit the operative technique and to review the current published English literature on the technique, and outcomes following robot-assisted laparoscopic partial nephrectomy (RPN). We searched the published English literature and the PubMed(()) for published series of 'robotic partial nephrectomy' (RPN) using the keywords; robot, robot-assisted laparoscopic partial nephrectomy, laparoscopic partial nephrectomy, partial nephrectomy and laparoscopic surgery. The search yielded 15 major selected series of 'robotic partial nephrectomy'; these were reviewed, tracked and analysed in order to determine the current status and role of RPN in the management of early renal neoplasm(s), as a minimally invasive surgical alternative to open partial nephrectomy. A review of the initial peri-operative outcome of the 350 cases of select series of RPN reported in published English literature revealed a mean operating time, warm ischemia time, estimated blood loss and hospital stay, of 191 minutes, 25 minutes, 162 ml and 2.95 days, respectively. The overall computed mean complication rate of RPN in the present select series was about 7.4%. RPN is a safe, feasible and effective minimally invasive surgical alternative to laparoscopic partial nephrectomy for early stage (T(1)) renal neoplasm(s). It has acceptable initial renal functional outcomes without the increased risk of major complications in experienced hands. Prospective randomised, controlled, comparative clinical trials with laparoscopic partial nephrectomy (LPN) are the need of the day. While the initial oncological outcomes of RPN appear to be favourable, long-term data is awaited.

  3. Reviews on current carbon emission reduction technologies and projects and their feasibilities on ships

    Science.gov (United States)

    Wang, Haibin; Zhou, Peilin; Wang, Zhongcheng

    2017-06-01

    Concern about global climate change is growing, and many projects and researchers are committed to reducing greenhouse gases from all possible sources. International Maritime (IMO) has set a target of 20% CO2 reduction from shipping by 2020 and also presented a series of carbon emission reduction methods, which are known as Energy Efficiency Design Index (EEDI) and Energy Efficiency Operation Indicator (EEOI). Reviews on carbon emission reduction from all industries indicate that, Carbon Capture and Storage (CCS) is an excellent solution to global warming. In this paper, a comprehensive literature review of EEDI and EEOI and CCS is conducted and involves reviewing current policies, introducing common technologies, and considering their feasibilities for marine activities, mainly shipping. Current projects are also presented in this paper, thereby illustrating that carbon emission reduction has been the subject of attention from all over the world. Two case ship studies indicate the economic feasibility of carbon emission reduction and provide a guide for CCS system application and practical installation on ships.

  4. A Systematic Review of Wearable Patient Monitoring Systems - Current Challenges and Opportunities for Clinical Adoption.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Moqeem, Aasia A; Mirza, Farhaan; Lindén, Maria

    2017-07-01

    The aim of this review is to investigate barriers and challenges of wearable patient monitoring (WPM) solutions adopted by clinicians in acute, as well as in community, care settings. Currently, healthcare providers are coping with ever-growing healthcare challenges including an ageing population, chronic diseases, the cost of hospitalization, and the risk of medical errors. WPM systems are a potential solution for addressing some of these challenges by enabling advanced sensors, wearable technology, and secure and effective communication platforms between the clinicians and patients. A total of 791 articles were screened and 20 were selected for this review. The most common publication venue was conference proceedings (13, 54%). This review only considered recent studies published between 2015 and 2017. The identified studies involved chronic conditions (6, 30%), rehabilitation (7, 35%), cardiovascular diseases (4, 20%), falls (2, 10%) and mental health (1, 5%). Most studies focussed on the system aspects of WPM solutions including advanced sensors, wireless data collection, communication platform and clinical usability based on a specific area or disease. The current studies are progressing with localized sensor-software integration to solve a specific use-case/health area using non-scalable and 'silo' solutions. There is further work required regarding interoperability and clinical acceptance challenges. The advancement of wearable technology and possibilities of using machine learning and artificial intelligence in healthcare is a concept that has been investigated by many studies. We believe future patient monitoring and medical treatments will build upon efficient and affordable solutions of wearable technology.

  5. Spontaneous and persistent currents in superconductive and mesoscopic structures (Review Article)

    International Nuclear Information System (INIS)

    Kulik, I.O.

    2004-01-01

    We briefly review aspects of superconductive persistent currents in Josephson junctions of the S/I/S, S/O/S and S/N/S types, focusing on the origin of jumps in the current versus phase dependences, and discuss in more detail the persistent as well as 'spontaneous' currents in the Aharonov-Bohm mesoscopic and nanoscopic (macromolecular) structures. A fixed-number-of-electrons mesoscopic or macromolecular conducting ring is shown to be unstable against structural transformation removing spatial symmetry (in particular, azimuthal periodicity) of its electron- lattice Hamiltonian. In case when the transformation is blocked by strong coupling to an external azimuthally symmetric environment, the system becomes bistable in its electronic configuration at certain number of electrons. At such a condition, the persistent current has a nonzero value even at the (almost) zero applied Aharonov-Bohm flux, and results in very high magnetic susceptibility dM/dH at small nonzero fields, followed by an oscillatory dependence at larger fields. We tentatively assume that previously observed oscillatory magnetization in cyclic metallo-organic molecules by Gatteschi et al. can be attributed to persistent currents. If this proves correct, it may open an opportunity (and, more generally, macromolecular cyclic structures may suggest the possibility) of engineering quantum computational tools based on the Aharonov-Bohm effect in ballistic nanostructures and macromolecular cyclic aggregates

  6. Artificial Intelligence approaches in hematopoietic cell transplant: A review of the current status and future directions.

    Science.gov (United States)

    Muhsen, Ibrahim N; ElHassan, Tusneem; Hashmi, Shahrukh K

    2018-06-08

    Currently, the evidence-based literature on healthcare is expanding exponentially. The opportunities provided by the advancement in artificial intelligence (AI) tools i.e. machine learning are appealing in tackling many of the current healthcare challenges. Thus, AI integration is expanding in most fields of healthcare, including the field of hematology. This study aims to review the current applications of AI in the field hematopoietic cell transplant (HCT). Literature search was done involving the following databases: Ovid-Medline including in-Process and Other Non-Indexed Citations and google scholar. The abstracts of the following professional societies: American Society of Haematology (ASH), American Society for Blood and Marrow Transplantation (ASBMT) and European Society for Blood and Marrow Transplantation (EBMT) were also screened. Literature review showed that the integration of AI in the field of HCT has grown remarkably in the last decade and confers promising avenues in diagnosis and prognosis within HCT populations targeting both pre and post-transplant challenges. Studies on AI integration in HCT have many limitations that include poorly tested algorithms, lack of generalizability and limited use of different AI tools. Machine learning techniques in HCT is an intense area of research that needs a lot of development and needs extensive support from hematology and HCT societies / organizations globally since we believe that this would be the future practice paradigm. Key words: Artificial intelligence, machine learning, hematopoietic cell transplant.

  7. Illuminating the Dark Side of the Internet with Actor-Network Theory: An Integrative Review of Current Cybercrime Research

    Directory of Open Access Journals (Sweden)

    Rocci Luppicini

    2014-06-01

    Full Text Available Cybercrime is a relatively new area of research within criminology and media studies. The purpose of this paper is to pull together current research scholarship at the intersection of Actor-Network Theory (ANT and cybercrime by addressing the following question: How does ANT apply to cybercrime research? A selective integrative review of cybercrime research utilizing ANT was conducted to examine recent developments and identify trends. The review draws on core research papers that span 2002 to 2013. Findings provided a strong indication of ANT’s role in key areas of current cybercrime, namely, cyber bullying, cyber theft, and cyber terrorism and cyber espionage. More specifically, ANT was applied within cyber criminology research to address complex problems involving human-technological interactions, advance alternative models and theoretical perspectives, compare ANT with existing models and theoretical perspectives, and leverage understanding of network influences on actors. Recommendations are provided to help optimize the application of ANT to cybercrime research and practice. This paper helps advance knowledge at the intersection of ANT and the study of cyber criminology.

  8. Review on conformance of JMTR reactor facility to safety design examination guides for water-cooled reactors for test and research

    International Nuclear Information System (INIS)

    Ide, Hiroshi; Naka, Michihiro; Sakuta, Yoshiyuki; Hori, Naohiko; Matsui, Yoshinori; Miyazawa, Masataka

    2009-03-01

    The safety design examination guides for water-cooled reactors for test and research are formulated as fundamental judgements on the basic design validity for licensing from a viewpoint of the safety. Taking the refurbishment opportunity of the JMTR, the conformance of the JMTR reactor facility to current safety design examination guides was reviewed with licensing documents, annexes and related documents. As a result, it was found that licensing documents fully satisfied the requirements of the current guides. Moreover, it was found that the JMTR reactor facility itself also satisfied the guides requirements as well as the safety performance, since the facility with safety function such as structure, systems, devices had been installed based on the licensing documents under the permission by the regulation authority. Important devices for safety have been produced under authorization of regulating authority. Therefore, it was confirmed that the licensing was conformed to guides, and that the JMTR has enough performance. (author)

  9. Tranexamic acid for the management of uterine fibroid tumors: A systematic review of the current evidence

    Science.gov (United States)

    Peitsidis, Panagiotis; Koukoulomati, Anna

    2014-01-01

    AIM: To conduct a detailed systematic review of the current evidence on the administration and efficacy of tranexamic acid in patients with menorrhagia due to uterine fibroids. METHODS: We conducted an electronic search on the following databases PubMed and Medline (1950-2013); (1980-2013); Cochrane library (1993-2013). RESULTS: A total of 36 articles were retrieved after the initial electronic search. Careful assessment of the retrieved studies led to the final selection of 5 articles for inclusion in the review. CONCLUSION: Tranexamic acid may reduce blood loss perioperatively in myomectomies. It may reduce the menorrhagia in patients with fibroids, however a stratification of fibroids by size and location is required to define the responses. It is safe in general, with mild adverse effects observed in some cases. More studies with a double-blind randomized design and larger numbers of participants are necessary to reach more precise and safe conclusions. PMID:25516866

  10. Comprehensive Review in Current Developments of Benzimidazole-Based Medicinal Chemistry.

    Science.gov (United States)

    Keri, Rangappa S; Hiremathad, Asha; Budagumpi, Srinivasa; Nagaraja, Bhari Mallanna

    2015-07-01

    The properties of benzimidazole and its derivatives have been studied over more than one hundred years. Benzimidazole derivatives are useful intermediates/subunits for the development of molecules of pharmaceutical or biological interest. Substituted benzimidazole derivatives have found applications in diverse therapeutic areas such as antiulcer, anticancer agents, and anthelmintic species to name just a few. This work systematically gives a comprehensive review in current developments of benzimidazole-based compounds in the whole range of medicinal chemistry as anticancer, antibacterial, antifungal, anti-inflammatory, analgesic agents, anti-HIV, antioxidant, anticonvulsant, antitubercular, antidiabetic, antileishmanial, antihistaminic, antimalarial agents, and other medicinal agents. This review will further be helpful for the researcher on the basis of substitution pattern around the nucleus with an aim to help medicinal chemists for developing an SAR on benzimidazole drugs/compounds. © 2014 John Wiley & Sons A/S.

  11. A critical review of the current knowledge regarding the biological impact of nanocellulose.

    Science.gov (United States)

    Endes, C; Camarero-Espinosa, S; Mueller, S; Foster, E J; Petri-Fink, A; Rothen-Rutishauser, B; Weder, C; Clift, M J D

    2016-12-01

    Several forms of nanocellulose, notably cellulose nanocrystals and nanofibrillated cellulose, exhibit attractive property matrices and are potentially useful for a large number of industrial applications. These include the paper and cardboard industry, use as reinforcing filler in polymer composites, basis for low-density foams, additive in adhesives and paints, as well as a wide variety of food, hygiene, cosmetic, and medical products. Although the commercial exploitation of nanocellulose has already commenced, little is known as to the potential biological impact of nanocellulose, particularly in its raw form. This review provides a comprehensive and critical review of the current state of knowledge of nanocellulose in this format. Overall, the data seems to suggest that when investigated under realistic doses and exposure scenarios, nanocellulose has a limited associated toxic potential, albeit certain forms of nanocellulose can be associated with more hazardous biological behavior due to their specific physical characteristics.

  12. Technology Review of Nondestructive Methods for Examination of Water Intrusion Areas on Hanford’s Double-Shell Waste Tanks

    Energy Technology Data Exchange (ETDEWEB)

    Watkins, Michael L.; Pardini, Allan F.

    2008-05-09

    Under a contract with CH2M Hill Hanford Group, Inc., PNNL has performed a review of the NDE technology and methods for examination of the concrete dome structure of Hanford’s double-shell tanks. The objective was to provide a matrix of methodologies that could be evaluated based on applicability, ease of deployment, and results that could provide information that could be used in the ongoing structural analysis of the tank dome. PNNL performed a technology evaluation with the objective of providing a critical literature review for all applicable technologies based on constraints provided by CH2M HILL. These constraints were not mandatory, but were desired. These constraints included performing the evaluation without removing any soil from the top of the tank, or if necessary, requesting that the hole diameter needed to gain access to evaluate the top of the tank structure to be no greater than approximately 12-in. in diameter. PNNL did not address the details of statistical sampling requirements as they depend on an unspecified risk tolerance. PNNL considered these during the technology evaluation and have reported the results in the remainder of this document. Many of the basic approaches to concrete inspection that were reviewed in previous efforts are still in use. These include electromagnetic, acoustic, radiographic, etc. The primary improvements in these tools have focused on providing quantitative image reconstruction, thus providing inspectors and analysts with three-dimensional data sets that allow for operator visualization of relevant abnormalities and analytical integration into structural performance models. Available instruments, such as radar used for bridge deck inspections, rely on post-processing algorithms and do not provide real-time visualization. Commercially available equipment only provides qualitative indications of relative concrete damage. It cannot be used as direct input for structural analysis to assess fitness for use and if

  13. Ceramic tape casting: A review of current methods and trends with emphasis on rheological behaviour and flow analysis

    International Nuclear Information System (INIS)

    Jabbari, M.; Bulatova, R.; Tok, A.I.Y.; Bahl, C.R.H.; Mitsoulis, E.; Hattel, J.H.

    2016-01-01

    Highlights: • Brief review of the tape casting process for ceramics. • Role of fluid flow analysis in tape casting of ceramics. • Rheological classification of common fluids in tape casting. • Review of commonly used rheological behaviour for ceramics in tape casting. - Abstract: Tape casting has been used to produce thin layers of ceramics that can be used as single layers or can be stacked and laminated into multilayered structures. Today, tape casting is the basic fabrication process that provides multilayered capacitors and multilayered ceramic packages. In tape casting the rheological behaviour of the slurry as well as the material flow during casting are of utmost importance since these phenomena to a large extent determine the final properties and hence the quality of the cast product. During the last decades this has led to an increasing number of works in literature within fluid flow analysis of tape casting. In the present paper a review of the development of the tape casting process with particular focus on the rheological classifications as well as modelling the material flow is hence presented and in this context the current status is examined and future potential discussed.

  14. Ceramic tape casting: A review of current methods and trends with emphasis on rheological behaviour and flow analysis

    Energy Technology Data Exchange (ETDEWEB)

    Jabbari, M., E-mail: mjab@mek.dtu.dk [Process Modelling Group, Department of Mechanical Engineering, Technical University of Denmark, Nils Koppels Allé, 2800 Kgs. Lyngby (Denmark); Bulatova, R. [Department of Energy Conversion and Storage, Technical University of Denmark, Frederiksborgvej 399, Building 779, Roskilde (Denmark); Tok, A.I.Y. [School of Materials Science & Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798 (Singapore); Bahl, C.R.H. [Department of Energy Conversion and Storage, Technical University of Denmark, Frederiksborgvej 399, Building 779, Roskilde (Denmark); Mitsoulis, E. [School of Mining Engineering and Metallurgy, National Technical University of Athens, Zografou, 15780 Athens (Greece); Hattel, J.H. [Process Modelling Group, Department of Mechanical Engineering, Technical University of Denmark, Nils Koppels Allé, 2800 Kgs. Lyngby (Denmark)

    2016-10-15

    Highlights: • Brief review of the tape casting process for ceramics. • Role of fluid flow analysis in tape casting of ceramics. • Rheological classification of common fluids in tape casting. • Review of commonly used rheological behaviour for ceramics in tape casting. - Abstract: Tape casting has been used to produce thin layers of ceramics that can be used as single layers or can be stacked and laminated into multilayered structures. Today, tape casting is the basic fabrication process that provides multilayered capacitors and multilayered ceramic packages. In tape casting the rheological behaviour of the slurry as well as the material flow during casting are of utmost importance since these phenomena to a large extent determine the final properties and hence the quality of the cast product. During the last decades this has led to an increasing number of works in literature within fluid flow analysis of tape casting. In the present paper a review of the development of the tape casting process with particular focus on the rheological classifications as well as modelling the material flow is hence presented and in this context the current status is examined and future potential discussed.

  15. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  16. Occurrence and features of uveitis in patients with rheumatic diseases: current peculiarities of clinical examination and patient management.

    Directory of Open Access Journals (Sweden)

    Dzhalavyan Y.V.

    2017-06-01

    Full Text Available The objectives of the study are to establish the occurrence of uveitis in patients with rheumatic diseases, to assess the features of the uveitis in rheumatic disease in children and adults, and to analyze the effectiveness of theirtreatment. Materials and Methods. The study included 670 people with RH (stage I and 35 patients who had uveitis and / or rheumatic fever who agreed to undergo additional ophthalmologic bleeding (stage II, including a standard ophthalmological examination including visiometry, biomicroscopy of the anterior segment, ophthalmoscopy of the posterior segment of the eye, refractometry, optical coherence tomography in angiomode(tomograph-angiograph CIRRUS HD-OCT MODEL 5000 (Carl Zeiss, Germany, dopplerography of the vessels of the eye. Results. The prevalence of uveitis in rheumatic diseases was established in 21%, which is higher than that in the general population. Uveitis in rheumatic diseases is recurrent and well-treated condition with frequent and complete improvement of visual acuity, and angiographycal features of uveitis, p <0,05 for all parameters. Conclusions. The high incidence of uveitis and relapsing their course in rheumatic diseases lead to necessity of an ophthalmologist's examination every 6 months. It is desirable to perform a comprehensive angiographic examination of uvea for the timely detection of erased and subclinical forms of uveitis.

  17. A Review of Clinical Data for Currently Approved Hysteroscopic Sterilization Procedures

    Science.gov (United States)

    Basinski, Cindy M

    2010-01-01

    Two hysteroscopic permanent sterilization procedures are approved for use in the United States: Essure® Permanent Birth Control System (Conceptus Incorporated, Mountain View, CA) and Adiana® Permanent Contraception (Hologic, Inc., Bedford, MA). This review compares the clinical trial data for these procedures. A notable difference is the resultant clinical pregnancy risk. The clinical trials for the Essure procedure have reported no pregnancies in 643 relying women in the 9 years since initiation of the studies. The clinical trial for the Adiana procedure has reported 12 pregnancies in 570 relying women in nearly 5 years of collected data. Other clinical outcome parameters concerning Essure and Adiana are examined in this review. PMID:21364861

  18. Current Strategies for the Detoxification of Jatropha curcas Seed Cake: A Review.

    Science.gov (United States)

    Gomes, Taisa G; Hadi, Sámed I I A; Costa Alves, Gabriel S; Mendonça, Simone; De Siqueira, Felix G; Miller, Robert N G

    2018-03-21

    Jatropha curcas is an important oilseed plant, with considerable potential in the development of biodiesel. Although Jatropha seed cake, the byproduct of oil extraction, is a residue rich in nitrogen, phosphorus, potassium, and carbon, with high protein content suitable for application in animal feed, the presence of toxic phorbol esters limits its application in feed supplements and fertilizers. This review summarizes the current methods available for detoxification of this residue, based upon chemical, physical, biological, or combined processes. The advantages and disadvantages of each process are discussed, and future directions involving genomic and proteomic approaches for advancing our understanding of biodegradation processes involving microorganisms are highlighted.

  19. A review of post-modern management techniques as currently applied to Turkish forestry.

    Science.gov (United States)

    Dölarslan, Emre Sahin

    2009-01-01

    This paper reviews the effects of six post-modern management concepts as applied to Turkish forestry. Up to now, Turkish forestry has been constrained, both in terms of its operations and internal organization, by a highly bureaucratic system. The application of new thinking in forestry management, however, has recently resulted in new organizational and production concepts that promise to address problems specific to this Turkish industry and bring about positive changes. This paper will elucidate these specific issues and demonstrate how post-modern management thinking is influencing the administration and operational capacity of Turkish forestry within its current structure.

  20. Neurocognitive Processes and Pediatric Obesity Interventions: Review of Current Literature and Suggested Future Directions.

    Science.gov (United States)

    Miller, Alison L

    2016-06-01

    Childhood obesity is a significant problem in the United States, but current childhood obesity prevention approaches have limited efficacy. Self-regulation processes organize behavior to achieve a goal and may shape health behaviors and health outcomes. Obesity prevention approaches that focus on the cognitive and behavioral mechanisms that underlie self-regulation early in life may therefore lead to better outcomes. This article reviews the development of executive functioning (EF), identifies influences on EF development, discusses aspects of EF relating to increased risk for childhood obesity, and considers how EF-weight associations may change across development. Implications for intervention are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The effect of physical activity on mood - a review of current literature

    Directory of Open Access Journals (Sweden)

    Mateusz Łakomski

    2017-04-01

    Full Text Available The impact of physical activity on human health has many benefits. Equally important in improving physical fitness and normalizing cardiovascular system seems to be the impact of exercise on mood of patients. Physical activity improves well-being, satisfaction and self-confidence. However, the condition of effective therapeutic intervention is due to its regularity, since only systematic exercises allow to maintain the beneficial effects of physical activity. Otherwise, the results achieved are only temporary. This article aims to review the current literature and show the most important aspects of motion therapy in improving the psychophysical condition of patients.

  2. A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery.

    Science.gov (United States)

    Cho, Woojin; Job, Alan Varkey; Chen, Jing; Baek, Jung Hwan

    2018-02-01

    Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education. Intraoperatively, 3D printers have been successfully used in surgical guidance systems and in the creation of patient specific implantable devices. Furthermore, 3D printing is revolutionizing the field of regenerative medicine and tissue engineering, allowing construction of biocompatible scaffolds suitable for cell growth and vasculature. Advances in printing technology and evidence of positive clinical outcomes are needed before there is an expansion of 3D printing applied to the clinical setting.

  3. The use of elearning in medical education: a review of the current situation

    Science.gov (United States)

    Choules, A P

    2007-01-01

    Computers are increasingly used in medical education. Electronic learning (elearning) is moving from textbooks in electronic format (that are increasingly enhanced by the use of multimedia adjuncts) to a truly interactive medium that can be delivered to meet the educational needs of students and postgraduate learners. Computer technology can present reliable, reusable content in a format that is convenient to the learner. It can be used to transcend geographical boundaries and time zones. It is a valuable tool to add to the medical teacher's toolkit, but like all tools it must be used appropriately. This article endeavours to review the current “state of the art2 in use of elearning and its role in medical education alongside non‐electronic methods—a combination that is currently referred to as “blended” learning. PMID:17403945

  4. The use of elearning in medical education: a review of the current situation.

    Science.gov (United States)

    Choules, A P

    2007-04-01

    Computers are increasingly used in medical education. Electronic learning (elearning) is moving from textbooks in electronic format (that are increasingly enhanced by the use of multimedia adjuncts) to a truly interactive medium that can be delivered to meet the educational needs of students and postgraduate learners. Computer technology can present reliable, reusable content in a format that is convenient to the learner. It can be used to transcend geographical boundaries and time zones. It is a valuable tool to add to the medical teacher's toolkit, but like all tools it must be used appropriately. This article endeavours to review the current "state of the art2 in use of elearning and its role in medical education alongside non-electronic methods-a combination that is currently referred to as "blended" learning.

  5. Partitioning and transmutation. A review of the current state of the art

    International Nuclear Information System (INIS)

    Skaalberg, M.; Liljenzin, J.O.

    1992-10-01

    The recent development in the field of partitioning and transmutation (P-T) of long-lived radioactive waste nuclides from nuclear power production is reviewed and evaluated. Current national and international R and D plans are summarized. It is concluded that P-T is technically feasible but much R and D remains to be done before it is technically mature. At present there seems to be no economic gain from P-T as compared to direct disposal of spent nuclear fuel. There seems only to be an insignificant reduction in future radiation doses by P-T when compared to current disposal plans. However, future long term research may perhaps change these conclusions. Therefore the further development in this area should be followed. Some areas where a limited research by Swedish scientists could be worthwhile are indicated. (255 refs.) (au)

  6. Chemical warfare agent detection: a review of current trends and future perspective.

    Science.gov (United States)

    Pacsial-Ong, Eden Joy; Aguilar, Zoraida P

    2013-01-01

    The World Health Organization recommends countries to create a public health system that can respond to the deliberate release of chemical warfare agents (CWAs). Procedures for preparedness, response, decontamination protocols and medical countermeasures against CWA attacks are described. Known CWAs, including their properties and pharmacological consequences upon exposure, are tabulated and discussed. Requirements imposed on detection systems by various applications and environmental needs are presented in order to assess the devices for detection and identification of specific CWAs. The review surveys current and near-term detection technologies and equipments, as well as devices that are currently available to the military and civilian first responders. Brief technical discussions of several detection technologies are presented, with emphasis placed in the principles of detection. Finally, enabling technologies that form the basis for advanced sensing systems and devices are described.

  7. Current Laser Resurfacing Technologies: A Review that Delves Beneath the Surface

    Science.gov (United States)

    Preissig, Jason; Hamilton, Kristy; Markus, Ramsey

    2012-01-01

    Numerous laser platforms exist that rejuvenate the skin by resurfacing its upper layers. In varying degrees, these lasers improve the appearance of lentigines and rhytides, eliminate photoaging, soften scarring due to acne and other causes, and treat dyspigmentation. Five major classes of dermatologic lasers are currently in common use: ablative and nonablative lasers in both fractionated and unfractionated forms as well as radiofrequency technologies. The gentler nonablative lasers allow for quicker healing, whereas harsher ablative lasers tend to be more effective. Fractionating either laser distributes the effect, increasing the number of treatments but minimizing downtime and complications. In this review article, the authors seek to inform surgeons about the current laser platforms available, clarify the differences between them, and thereby facilitate the identification of the most appropriate laser for their practice. PMID:23904818

  8. Communication skills in the training of psychiatrists: A systematic review of current approaches.

    Science.gov (United States)

    Ditton-Phare, Philippa; Loughland, Carmel; Duvivier, Robbert; Kelly, Brian

    2017-07-01

    A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. The heterogeneity of communication skills training is a barrier to evaluating the efficacy of

  9. Review of current practices and requirements for the inspection of prestressed concrete pressure vessels

    International Nuclear Information System (INIS)

    Reimann, K.J.

    1980-12-01

    Code requirements for pre- and in-service inspection of prestressed concrete pressure vessels as utilized in gas-cooled reactors are reviewed and compared with practices and experiences during construction, commissioning, and operation of such reactors. The pre-service inspection relies heavily on embedded instrumentation for measurements of stresses, temperatures, and displacements. The same instrumentation is later used for in-service surveillance, which additionally includes visual examination of exposed surfaces, monitoring of tendon conditions, and measurement of tendon loads. Improvement of present monitoring instrumentation and/or techniques, rather than development of new in-service inspection methods, is recommended

  10. Review of current status for designing severe accident management support system

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kwang Sub

    2000-05-01

    The development of operator support system (OSS) is ongoing in many other countries due to the complexity both in design and in operation for nuclear power plant. The computerized operator support system includes monitoring of some critical parameters, early detection of plant transient, monitoring of component status, plant maintenance, and safety parameter display, and the operator support system for these areas are developed and are being used in some plants. Up to now, the most operator support system covers the normal operation, abnormal operation, and emergency operation. Recently, however, the operator support system for severe accident is to be developed in some countries. The study for the phenomena of severe accident is not performed sufficiently, but, based on the result up to now, the operator support system even for severe accident will be developed in this study. To do this, at first, the current status of the operator support system for normal/abnormal/emergency operation is reviewed, and the positive aspects and negative aspects of systems are analyzed by their characteristics. And also, the major items that should be considered in designing the severe accident operator support system are derived from the review. With the survey of domestic and foreign operator support systems, they are reviewed in terms of the safety parameter display system, decision-making support system, and procedure-tracking system. For the severe accident, the severe accident management guideline (SAMG) which is developed by Westinghouse is reviewed; the characteristics, structure, and logical flow of SAMG are studied. In addition, the critical parameters for severe accident, which are the basis for operators decision-making in severe accident management and are supplied to the operators and the technical support center, are reviewed, too.

  11. Review of current status for designing severe accident management support system

    International Nuclear Information System (INIS)

    Jeong, Kwang Sub

    2000-05-01

    The development of operator support system (OSS) is ongoing in many other countries due to the complexity both in design and in operation for nuclear power plant. The computerized operator support system includes monitoring of some critical parameters, early detection of plant transient, monitoring of component status, plant maintenance, and safety parameter display, and the operator support system for these areas are developed and are being used in some plants. Up to now, the most operator support system covers the normal operation, abnormal operation, and emergency operation. Recently, however, the operator support system for severe accident is to be developed in some countries. The study for the phenomena of severe accident is not performed sufficiently, but, based on the result up to now, the operator support system even for severe accident will be developed in this study. To do this, at first, the current status of the operator support system for normal/abnormal/emergency operation is reviewed, and the positive aspects and negative aspects of systems are analyzed by their characteristics. And also, the major items that should be considered in designing the severe accident operator support system are derived from the review. With the survey of domestic and foreign operator support systems, they are reviewed in terms of the safety parameter display system, decision-making support system, and procedure-tracking system. For the severe accident, the severe accident management guideline (SAMG) which is developed by Westinghouse is reviewed; the characteristics, structure, and logical flow of SAMG are studied. In addition, the critical parameters for severe accident, which are the basis for operators decision-making in severe accident management and are supplied to the operators and the technical support center, are reviewed, too

  12. Examining impacts of current-use pesticides in Southern Ontario using in situ exposures of the amphipod Hyalella azteca.

    Science.gov (United States)

    Bartlett, Adrienne J; Struger, John; Grapentine, Lee C; Palace, Vince P

    2016-05-01

    In situ exposures with Hyalella azteca were used to assess impacts of current-use pesticides in Southern Ontario, Canada. Exposures were conducted over 2 growing seasons within areas of high pesticide use: 1 site on Prudhomme Creek and 3 sites on Twenty Mile Creek. Three sites on Spencer Creek, an area of low pesticide use, were added in the second season. Surface water samples were collected every 2 wk to 3 wk and analyzed for a suite of pesticides. Hyalella were exposed in situ for 1 wk every 4 wk to 6 wk, and survival and acetylcholinesterase (AChE) activity were measured. Pesticides in surface waters reflected seasonal use patterns: lower concentrations in spring and fall and higher concentrations during summer months. Organophosphate insecticides (chlorpyrifos, azinphos methyl, diazinon) and acid herbicides (2,4-dichlorophenoxyacetic acid [2,4-D], mecoprop) were routinely detected in Prudhomme Creek, whereas neutral herbicides (atrazine, metolachlor) dominated the pesticide signature of Twenty Mile Creek. Spencer Creek contained fewer pesticides, which were measured at lower concentrations. In situ effects also followed seasonal patterns: higher survival and AChE activity in spring and fall, and lower survival and AChE activity during summer months. The highest toxicity was observed at Prudhomme Creek and was primarily associated with organophosphates. The present study demonstrated that current-use pesticides in Southern Ontario were linked to in situ effects and identified sites of concern requiring further investigation. © 2015 Crown in the Right of Canada.

  13. The Economics of Developing Countries Component of GCE "A" Level Economics--A Review of Examination Questions.

    Science.gov (United States)

    Wood, Keith

    1984-01-01

    A review of the summer examination papers in 'A' level economics set by the eight boards of England and Wales during the period 1979-1983 show that, with two notable exceptions, the boards have not devoted much space to questions relating to the economics of developing countries. (Author/RM)

  14. 75 FR 65395 - Notice Convening an Accountability Review Board To Examine the Circumstances of the Death of...

    Science.gov (United States)

    2010-10-22

    ... DEPARTMENT OF STATE [Public Notice: 7213] Notice Convening an Accountability Review Board To Examine the Circumstances of the Death of Three DoD Personnel Assigned to the U.S. Embassy's Office of Defense Representative Pakistan (ODRP) on February 3, 2010 Pursuant to Section 301 of the Omnibus...

  15. A systematic review and meta-analysis examining the effect of eating rate on energy intake and hunger

    NARCIS (Netherlands)

    Robinson, E.; Almiron-Roig, E.; Rutters, F.; Graaf, de C.; Forde, C.G.; Smith, C.T.; Nolan, S.J.; Jebb, S.A.

    2014-01-01

    Background: Reductions in eating rate are recommended to prevent and treat obesity; yet, the relation between eating rate and energy intake has not been systematically reviewed, with studies producing mixed results. Objective: Our main objective was to examine how experimentally manipulated

  16. Inter-examiner reliability of passive assessment of intervertebral motion in the cervical and lumbar spine: A systematic review

    NARCIS (Netherlands)

    van Trijffel, E.; Anderegg, Q.; Bossuyt, P. M. M.; Lucas, C.

    2005-01-01

    A systematic review was conducted to determine inter-examiner reliability of passive assessment of segmental intervertebral motion in the cervical and lumbar spine as well as to explore sources of heterogeneity. Passive assessment of motion is used to decide on treatments for neck and low-back pain

  17. The Relation between Child Maltreatment and Adolescent Suicidal Behavior: A Systematic Review and Critical Examination of the Literature

    Science.gov (United States)

    Miller, Adam B.; Esposito-Smythers, Christianne; Weismoore, Julie T.; Renshaw, Keith D.

    2013-01-01

    A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we…

  18. 78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

    Science.gov (United States)

    2013-08-16

    ...: Medical History and Examination for Foreign Service DS-1843 and DS-1622 ACTION: Notice of request for... methods: Web: Persons with access to the Internet may use the Federal Docket Management System (FDMS) to... History and Examination for Foreign Service. OMB Control Number: 1405-0068. Type of Request: Emergency...

  19. 75 FR 34941 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-06-21

    ... Commission's Program Access Rules and Examination of Programming Tying Arrangements AGENCY: Federal... Program Access Rules and Examination of Programming Tying Arrangements, MB Docket No. 07-198, FCC 10-17... information collection is contained in Sections 4(i), 303(r), and 628 of the Communications Act of 1934, as...

  20. Cholesterol Point-of-Care Testing for Community Pharmacies: A Review of the Current Literature.

    Science.gov (United States)

    Haggerty, Lauren; Tran, Deanna

    2017-08-01

    To summarize the literature on cholesterol point-of-care tests (POCTs). This article would serve as a resource to assist community pharmacists in developing cholesterol point-of-care (POC) pharmacy services. A literature search was performed in MEDLINE Ovid, PubMed, EMBASE, and Cochrane database using the following medical subject headings (MeSH) terms: point-of-care test, cholesterol, blood chemical analysis, rapid testing, collaborative practice, community pharmacy, and ambulatory care. Additional resources including device manufacturer web sites were summarized to supplement the current literature. All human research articles, review articles, meta-analyses, and abstracts published in English through September 1, 2014, were considered. A total of 36 articles were applicable for review. Information was divided into the following categories to be summarized: devices, pharmacists' impact, and operational cost for the pharmacy. The current literature suggests that POCTs in community pharmacies assist with patient outcomes by providing screenings and referring patients with dyslipidemia for further evaluation. The majority of studies on cholesterol POC devices focused on accuracy, revealing the need for further studies to develop best practices and practice models with successful reimbursement. Accuracy, device specifications, required supplies, and patient preference should be considered when selecting a POC device for purchase.

  1. Herbal extracts in oral health care - A review of the current scenario and its future needs.

    Science.gov (United States)

    Chandra Shekar, Byalakere Rudraiah; Nagarajappa, Ramesh; Suma, Shankarappa; Thakur, Rupesh

    2015-01-01

    Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. "Herbal shotgun" or "synergistic multitarget effects" are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance.

  2. Current and emerging concepts in muscle tension dysphonia: a 30-month review.

    Science.gov (United States)

    Altman, Kenneth W; Atkinson, Cory; Lazarus, Cathy

    2005-06-01

    The modern theory of hoarseness is that there are multifactorial etiologies contributing to the voice problem. The hypothesis of this study is that muscle tension dysphonia is multifactorial with various contributing etiologies. This project is a retrospective chart review of all patients seen in the Voice Speech and Language Service and Swallowing Center at our institution with a diagnosis of muscle tension (functional hypertensive) dysphonia over a 30-month period. A literature search and review is also performed regarding current and emerging concepts of muscle tension dysphonia. One hundred fifty subjects were identified (60% female, 40% male, with a mean age of 42.3 years). Significant factors in patient history believed to contribute to abnormal voice production were gastroesophageal reflux in 49%, high stress levels in 18%, excessive amounts of voice use in 63%, and excessive loudness demands on voice use in 23%. Otolaryngologic evaluation was performed in 82% of patients, in whom lesions, significant vocal fold edema, or paralysis/paresis was identified in 52.3%. Speech pathology assessment revealed poor breath support, inappropriately low pitch, and visible cervical neck tension in the majority of patients. Inappropriate intensity was observed in 23.3% of patients. This set of multiple contributing factors is discussed in the context of current and emerging understanding of muscle tension dysphonia. Results confirm multifactorial etiologies contributing to hoarseness in the patients identified with muscle tension dysphonia. An interdisciplinary approach to treating all contributing factors portends the best prognosis.

  3. Systematic review of 3D printing in spinal surgery: the current state of play.

    Science.gov (United States)

    Wilcox, Ben; Mobbs, Ralph J; Wu, Ai-Min; Phan, Kevin

    2017-09-01

    Three-dimensional printing (3DP), also known as "Additive Manufacturing", is a rapidly growing industry, particularly in the area of spinal surgery. Given the complex anatomy of the spine and delicate nature of surrounding structures, 3DP has the potential to aid surgical planning and procedural accuracy. We perform a systematic review of current literature on the applications of 3DP in spinal surgery. Six electronic databases were searched for original published studies reporting cases or outcomes for 3DP surgical models, guides or implants for spinal surgery. The findings of these studies were synthesized and summarized. These searches returned a combined 2,411 articles. Of these, 54 were included in this review. 3DP is currently used for surgical planning, intra-operative surgical guides, customised prostheses as well as "Off-the-Shelf" implants. The technology has the potential for enhanced implant properties, as well as decreased surgical time and better patient outcomes. The majority of the data thus far is from low-quality studies with inherent biases linked with the excitement of a new field. As the body of literature continues to expand, larger scale studies to evaluate advantages and disadvantages, and longer-term follow up will enhance our knowledge of the effect 3DP has in spinal surgery. In addition, issues such as financial impact, time to design and print, materials selection and bio-printing will evolve as this rapidly expanding field matures.

  4. Beer Polyphenols and Menopause: Effects and Mechanisms—A Review of Current Knowledge

    Science.gov (United States)

    Sandoval-Ramírez, Berner Andrée; M. Lamuela-Raventós, Rosa; Estruch, Ramon; Sasot, Gemma; Doménech, Monica

    2017-01-01

    Beer is one of the most frequently consumed fermented beverages in the world, and it has been part of the human diet for thousands of years. Scientific evidence obtained from the development of new techniques of food analysis over the last two decades suggests that polyphenol intake derived from moderate beer consumption may play a positive role in different health outcomes including osteoporosis and cardiovascular risk and the relief of vasomotor symptoms, which are commonly experienced during menopause and are an important reason why women seek medical care during this period; here, we review the current knowledge regarding moderate beer consumption and its possible effects on menopausal symptoms. The effect of polyphenol intake on vasomotor symptoms in menopause may be driven by the direct interaction of the phenolic compounds present in beer, such as 8-prenylnaringenin, 6-prenylnaringenin, and isoxanthohumol, with intracellular estrogen receptors that leads to the modulation of gene expression, increase in sex hormone plasma concentrations, and thus modulation of physiological hormone imbalance in menopausal women. Since traditional hormone replacement therapies increase health risks, alternative, safer treatment options are needed to alleviate menopausal symptoms in women. The present work aims to review the current data on this subject. PMID:28904736

  5. Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review.

    Science.gov (United States)

    Schlussel, Andrew T; Cherng, Nicole B; Alavi, Karim

    2017-11-01

    Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016. Twenty-six prospective articles provided directed guidelines for recommendations and these were graded based on the level of evidence. The postoperative management of Crohn's disease faces multiple challenges. Current indicated medications in this setting include: antibiotics, aminosalicylates, immunomodulators, and biologics. Each drug has inherent risks and benefits, and the optimal regimen is still unknown. Initiating therapy in a prophylactic fashion compared to endoscopic findings, or escalating therapy versus treating with the most potent drug first is debated. Although a definitive consensus on postoperative treatment is necessary, aggressive and early endoluminal surveillance is paramount in the treatment of these complicated patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Robot-assisted pyeloplasty: review of the current literature, technique and outcome.

    Science.gov (United States)

    Singh, Iqbal; Hemal, Ashok K

    2010-04-01

    To review the global select data on the current technique, perioperative outcome and literature on the robot-assisted pyeloplasty (RAP). The published English literature (PubMed) was extensively searched using the key words; robot, robot-assisted pyeloplasty, laparoscopy, laparoscopic pyeloplasty and ureteropelvic junction obstruction. The selected studies were then reviewed, tracked and analyzed in order to determine the current role, outcome and status of robot-assisted laparoscopic pyeloplasty. The search yielded about 25 published series on RAP comprising about 740 cases with a mean operative time, estimated blood loss, crossing vessel prevalence, hospital stay,perioperative complication rate and follow up duration of 194 min, 50 mL, 47%, 2.3 days, 6% and 14.9 months respectively. The initial peri-operative results and intermediate follow up of cases of repair of the ureteropelvic junction obstruction with robot-assisted pyeloplasty appear to be favorable and comparable to that of open pyeloplasty, while long term outcome data is still awaited. The da Vinci surgical robotic system is a promising surgical armamentarium in the hands of the modern day urologist for the minimally invasive definitive surgical management of both primary and secondary ureteropelvic junction obstruction.

  7. Current trials to reduce surgical intervention in ductal carcinoma in situ of the breast: Critical review.

    Science.gov (United States)

    Toss, M; Miligy, I; Thompson, A M; Khout, H; Green, A R; Ellis, I O; Rakha, E A

    2017-10-01

    The high proportion of ductal carcinoma in situ (DCIS) presented in mammographic screening and the relatively low risk of progression to invasive disease have raised questions related to overtreatment. Following a review of current DCIS management protocols a more conservative approach has been suggested. Clinical trials have been introduced to evaluate the option of avoiding surgical intervention in a proportion of patients with DCIS defined as "low-risk" using certain clinicopathological criteria. These trials can potentially provide evidence-based models of active surveillance (with or without endocrine therapy) as a future management approach. Despite the undisputable fact of our need to address the obvious overtreatment of screen-detected DCIS, some important questions need to be considered regarding these trials including the eligibility criteria and definition of risk, the proportion of patient eligible for inclusion, and the length of time required for proper analysis of the trials' outcome in view of the long-term natural history of DCIS progression particularly the low-risk group. These factors can potentially affect the practicality and future impact of such trials. This review provides critical analysis of current DCIS management trials and highlights critical issues related to their practicality and the expected outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Examining the relationship between burnout and empathy in healthcare professionals: A systematic review.

    Science.gov (United States)

    Wilkinson, Helen; Whittington, Richard; Perry, Lorraine; Eames, Catrin

    2017-09-01

    Empathy and burnout are two related yet distinct constructs that are relevant to clinical healthcare staff. The nature of their relationship is uncertain and this review aimed to complete a rigorous, systematic exploration of the literature investigating the relationship between burnout and empathy in healthcare staff. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Search terms (Burnout OR Burn-out OR "Burn out") AND (Empathy OR Empath*) enabled identification of studies investigating burnout and empathy in healthcare staff, using five electronic data bases (MEDLINE, PsycINFO, CINAHL Plus, PubMed, and SCOPUS). Manual searching amongst reference lists of eligible articles was also completed. Databases were searched for studies published in the English language, from inception to February 2017. Key inclusion criteria were: 1) participants who were nurses or medical professionals, 2) full written manuscript in English, 3) use of the Maslach Burnout Inventory to assess burnout and a standardized outcome measure for empathy, 4) quantitative methodology exclusively. Ten eligible studies were reviewed. Of those, seven were conducted in countries where English was not the first language. Eight of the studies provided empirical support for a negative relationship between empathy and burnout. One study provided support for a positive relationship between burnout and empathy. One study reported contradictory evidence with positive and negative correlations between different subscales of the empathy and burnout measures. In general, the quality of the studies was assessed to be good. However, some of the studies failed to provide information pertaining to sample size, with the reporting of data less than adequate from one study. There was consistent evidence for a negative association between burnout and empathy. This review avoided a common English-speaking country bias of some

  9. Narcissistic personality disorder: an integrative review of recent empirical data and current definitions.

    Science.gov (United States)

    Roepke, Stefan; Vater, Aline

    2014-05-01

    Although concepts of pathological narcissism are as old as psychology and psychiatry itself, only a small number of clinical studies are based on the criteria for narcissistic personality disorder (NPD), as defined in the Diagnostic and Statistical Manuals of Mental Disorders (DSM). As a result, NPD appears to be one of the most controversially discussed nosological entities in psychiatry. Whereas the majority of empirical studies used self or other ratings of NPD criteria to address issues of reliability and validity of the diagnostic category (i.e., internal consistency, factor structure, discriminant validity), only recent research has applied experimental designs to investigate specific features of NPD (e.g., self-esteem, empathy, shame). The aim of this review is to summarize available empirical data on NPD and relate these findings to current definitions of NPD (according to the DSM-5, [1]). In order to do so, this review follows the five steps to establishing diagnostic validity proposed by Robins and Guze [2], i.e., (1) clinical description, (2) laboratory studies, (3) delimitation from other disorders, (4) family studies, and (5) follow up studies. Finally, this review suggests pathways for future research that may assist further nosological evaluation of NPD and contribute to the overall goal, the improvement of treatment for patients.

  10. Transcranial Direct Current Stimulation in Substance Use Disorders: A Systematic Review of Scientific Literature.

    Science.gov (United States)

    Lupi, Matteo; Martinotti, Giovanni; Santacroce, Rita; Cinosi, Eduardo; Carlucci, Maria; Marini, Stefano; Acciavatti, Tiziano; di Giannantonio, Massimo

    2017-09-01

    New treatment options such as noninvasive brain stimulation have been recently explored in the field of substance use disorders (SUDs), including transcranial direct current stimulation (tDCS). In light of this, we have performed a review of the scientific literature to assess efficacy and technical and methodological issues resulting from applying tDCS to the field of SUDs. Our analysis highlighted the following selection criteria: clinical studies on tDCS and SUDs (alcohol, caffeine, cannabis, cocaine, heroin, methamphetamine, and nicotine). Study selection, data analysis, and reporting were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Exclusion criteria were as follows: clinical studies about tDCS among behavioral addiction; review and didactic articles; physiopathological studies; and case reports. Eighteen scientific papers were selected out of 48 articles. Among these, 16 studied the efficacy of tDCS applied to the dorsolateral prefrontal cortex, and 8 suggested the efficacy of tDCS in reducing substance craving. In light of these data, it is premature to conclude that tDCS over the dorsolateral prefrontal cortex is a very efficient technique in reducing craving. Small sample size, different stimulation protocols, and study duration were the main limitations. However, the efficacy of tDCS in treating SUDs requires further investigation.

  11. Measurement of Drug Craving in Persian Speaking Subjects; a Review on Current Experiences and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Masoomeh Maarefvand

    2012-09-01

    Full Text Available Background: Drug craving is considered as one of the main cores of drug dependency and addiction. Multidimensionality of drug craving, its cultural-bounded features and its intra individual rapidly changing nature makes it difficult to be measured. Nowadays, regarding different psychometric approaches, there are various instruments available for measurement of different aspects of drug craving but mainly for Latin-based languages in North America and European countries. High prevalence and special conditions, and unique subcultures in substance abuse and addiction in many countries, like Iran, make the design of culturally validated instruments for drug craving assessment priority. Materials and Methods: Comprehensive review on drug craving measurement instruments for Persian speaking subjects have been performed by searching in databases (ELSEVIER, Science Direct and Scientific Information Database (SID and investigating of related documents on regional experiences. Results: In this article seven main categories of drug craving instruments have been reviewed focusing on validated versions in Persian language including: self-reports, reinforcement “proxies”, drug self administration, psycho physiological responding, neurobiological responding, cognitive processing and expressive methods. Conclusion: Reviewing on weak and strength points of each instrument group and national and regional experiences shows that designing and validating a new series of ecologically-validated instruments for multidimensional measurement of drug craving in different addiction subcultures should be prioritized to cover current methodological gaps in substance abuse studies in Iran.

  12. Role of Environmental Chemicals in Obesity: A Systematic Review on the Current Evidence

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    Roya Kelishadi

    2013-01-01

    Full Text Available The purpose of this paper is to systematically review the experimental and human studies on obesogenic chemicals and their mechanisms of action to provide a comprehensive view on the multifactorial aspects of obesity. The literatures were searched in available databases. The relevant papers were selected in three phases. After quality assessment, two reviewers extracted the data while another checked their extracted data. In this review, we summarized information regarding environmental chemicals that can be associated with obesity. Most evidence comes from experimental and laboratory studies; however a growing number of human studies also support the role of obesogenic chemicals. The current evidence proposes that the systemic responses to exposure to environmental factors could potentially increase the risk of excess weight. The effects of exposure to these chemicals are of crucial importance during developmental phases of life, when preprogramming for an adipogenic outcome may occur. By considering the adverse transgenerational effects of obesogen chemicals on human health, the global obesity epidemic should be considered as a multifactorial complex disorder necessitating the emphasis of public health interventions for environmental protection.

  13. Menstrual migraine: a review of current and developing pharmacotherapies for women.

    Science.gov (United States)

    Allais, G; Chiarle, Giulia; Sinigaglia, Silvia; Benedetto, Chiara

    2018-02-01

    Migraine is one of the most common neurological disorders in the general population. It affects 18% of women and 6% of men. In more than 50% of women migraineurs the occurrence of migraine attacks correlates strongly with the perimenstrual period. Menstrual migraine is highly debilitating, less responsive to therapy, and attacks are longer than those not correlated with menses. Menstrual migraine requires accurate evaluation and targeted therapy, that we aim to recommend in this review. Areas covered: This review of the literature provides an overview of currently available pharmacological therapies (especially with triptans, anti-inflammatory drugs, hormonal strategies) and drugs in development (in particular those acting on calcitonin gene-related peptide) for the treatment of acute migraine attacks and the prophylaxis of menstrual migraine. The studies reviewed here were retrieved from the Medline database as of June 2017. Expert opinion: The treatment of menstrual migraine is highly complex. Accurate evaluation of its characteristics is prerequisite to selecting appropriate therapy. An integrated approach involving neurologists and gynecologists is essential for patient management and for continuous updating on new therapies under development.

  14. Short fiber-reinforced composite restorations: A review of the current literature.

    Science.gov (United States)

    Garoushi, Sufyan; Gargoum, Ausama; Vallittu, Pekka K; Lassila, Lippo

    2018-02-25

    A newly-recommended method for restoring large cavities is the biomimetic approach of using short fiber-reinforced composite (SFRC) as dentine-replacing material. The aim of the current review was to present an overview of SFRC and to give the clinician a detailed understanding of this new material and treatment strategy based on available-literature review. A thorough literature search was done up to December 2017. The range of relevant publications was surveyed using PubMed and Google Scholar. From the search results, articles related to our search terms were only considered. The search terms used were "short fiber-reinforced composite", "everX posterior", and "fiber-reinforced composite restorations". Of the assessed articles selected (N = 70), most were laboratory-based research with various test specimen designs prepared according to the ISO standard or with extracted teeth; only four articles were clinical reports. A common finding was that by combining the SFRC as a bulk base with conventional composite, the load-bearing capacity and failure mode of the material combination were improved, as compared to plain conventional composite restoration. In the reviewed studies, the biomimetic restoration technique of using SFRC showed promising characteristics, and therefore, might be recommended as an alternative treatment option for large cavities. © 2018 John Wiley & Sons Australia, Ltd.

  15. The Current Landscape of Transitions of Care Practice Models: A Scoping Review.

    Science.gov (United States)

    Rochester-Eyeguokan, Charmaine D; Pincus, Kathleen J; Patel, Roshni S; Reitz, Shirley J

    2016-01-01

    Transitions of care (TOC) are a set of actions to ensure patient coordination and continuity of care as patients transfer between different locations or levels. During transitions associated with chronic or acute illness, vulnerable patients may be placed at risk with fragmented systems compromising their health and safety. In addition, poor care transitions also have an enormous impact on health care spending. The primary objective of this scoping review is to summarize the current landscape of practice models that deliver TOC services in the United States. The secondary objective is to use the information to characterize the current state of best practice models. A search of the PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, International Pharmaceutical Abstracts, National Center for Biotechnology Information at the U.S. National Library of Medicine, and Cochrane Library databases (January 1, 2000-April 13, 2015) for articles pertaining to TOC models, limited to U.S. studies published in the English language with human subjects, gleaned 1362 articles. An additional 26 articles were added from the gray literature. Articles meeting inclusion criteria underwent a second review and were categorized into four groups: background information, original TOC research articles not evaluating practice model interventions, original TOC research articles describing practice models, and systematic or Cochrane reviews. The reviewers met weekly to discuss the challenges and resolve disagreements regarding literature reviews with consensus before progressing. A total of 188 articles describing TOC practice models met the inclusion criteria. Despite the strengths of several quality TOC models, none satisfied all the components recommended by leading experts. Multimodal interventions by multidisciplinary teams appear to represent a best practice model for TOC to improve patient outcomes and reduce readmissions, but one size does not fit all

  16. Improving menstrual hygiene management in emergency contexts: literature review of current perspectives

    Directory of Open Access Journals (Sweden)

    VanLeeuwen C

    2018-04-01

    Full Text Available Crystal VanLeeuwen, Belen Torondel Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK Abstract: Management of menstruation in contexts of humanitarian emergencies can be challenging. A lack of empirical research about effective interventions which improve menstrual hygiene management (MHM among female populations in humanitarian emergencies and a lack of clarity about which sectors within a humanitarian response should deliver MHM interventions can both be attributable to the lack of clear guidance on design and delivery of culturally appropriate MHM intervention in settings of humanitarian emergencies. The objective of this review was to collate, summarize, and appraise existing peer-reviewed and gray literature that describes the current scenario of MHM in emergency contexts in order to describe the breadth and depth of current policies, guidelines, empirical research, and humanitarian aid activities addressing populations’ menstrual needs. A structured-search strategy was conducted for peer-reviewed and gray literature to identify studies, published reports, guidelines, and policy papers related to menstrual response in emergency humanitarian contexts. Of the 51 articles included in the review, 16 were peer-reviewed papers and 35 were gray literature. Most of the literature agreed that hardware interventions should focus on the supply of adequate material (not only absorbent material but also other supportive material and adequate sanitation facilities, with access to water and private space for washing, changing, drying, and disposing menstrual materials. Software interventions should focus on education in the usage of materials to manage menstruation hygienically and education about the female body’s biological processes. There was clear agreement that the needs of the target population should be assessed before designing any intervention. Although there is insight about which factors should be

  17. Diagnostic and prognostic value of history-taking and physical examination in undifferentiated peripheral inflammatory arthritis: a systematic review.

    Science.gov (United States)

    Kuriya, Bindee; Villeneuve, Edith; Bombardier, Claire

    2011-03-01

    To review the diagnostic and prognostic value of history/physical examination among patients with undifferentiated peripheral inflammatory arthritis (UPIA). We conducted a systematic review evaluating the association between history/physical examination features and a diagnostic or prognostic outcome. Nineteen publications were included. Advanced age, female sex, and morning stiffness were predictive of a diagnosis of rheumatoid arthritis (RA) from UPIA. A higher number of tender and swollen joints, small/large joint involvement in the upper/lower extremities, and symmetrical involvement were associated with progression to RA. Similar features were associated with persistent disease and erosions, while disability at baseline and extraarticular features were predictive of future disability. History/physical examination features are heterogeneously reported. Several features predict progression from UPIA to RA or a poor prognosis. Continued measurements in the UPIA population are needed to determine if these features are valid and reliable predictors of outcomes, especially as new definitions for RA and disease states emerge.

  18. The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology: Review Article.

    Science.gov (United States)

    Civinini, Roberto; Carulli, Christian; Matassi, Fabrizio; Lepri, Andrea Cozzi; Sirleo, Luigi; Innocenti, Massimo

    2017-02-01

    Polyethylene (PE) wear is a major contributor to implant loosening following total knee arthroplasty (TKA), and advanced bearings in TKA are being investigated with hopes of reducing or eliminate wear-related loosening. Currently, information on knee tribology is available from national joint registries and may be the best tools to evaluate the efficacy and safety of design innovations in joint arthroplasty. We performed a review of national joint registries trying to answer the following questions: "Which is the main factor directly related to revisions rate in TKA?" and "Are there new bearing options better than conventional ones?" A review was performed of all published annual reports of National Joint Registers, as well as of the literature. The search was carried out using and comparing the National Joint Registers. Current data from registries for total knee arthroplasty indicates that age is the major factor affecting the outcome of primary total knee replacement. The 10-year cumulative revision rate for non-cross-linked PE was 5.8% and for XLPE it was 3.5%. The effect of cross-linked polyethylene was more evident in the younger patients. The survival of the oxidized zirconium (OxZr) femoral component appears better when compared to a similar age group of patients with conventional group of prostheses. Our review suggests that the revision rates are half for the OxZr components compared to conventional CoCr femoral components. Age is the most relevant single factor related to revision rate. Cross-linked PE has a statistical lower revision rate at 10 years compared to conventional PE and, in the OxZr group, the revision rate is 2 times lower than Co-Cr in the same group of age.

  19. Systematic review of current efforts to quantify the impacts of climate change on undernutrition.

    Science.gov (United States)

    Phalkey, Revati K; Aranda-Jan, Clara; Marx, Sabrina; Höfle, Bernhard; Sauerborn, Rainer

    2015-08-18

    Malnutrition is a challenge to the health and productivity of populations and is viewed as one of the five largest adverse health impacts of climate change. Nonetheless, systematic evidence quantifying these impacts is currently limited. Our aim was to assess the scientific evidence base for the impact of climate change on childhood undernutrition (particularly stunting) in subsistence farmers in low- and middle-income countries. A systematic review was conducted to identify peer-reviewed and gray full-text documents in English with no limits for year of publication or study design. Fifteen manuscripts were reviewed. Few studies use primary data to investigate the proportion of stunting that can be attributed to climate/weather variability. Although scattered and limited, current evidence suggests a significant but variable link between weather variables, e.g., rainfall, extreme weather events (floods/droughts), seasonality, and temperature, and childhood stunting at the household level (12 of 15 studies, 80%). In addition, we note that agricultural, socioeconomic, and demographic factors at the household and individual levels also play substantial roles in mediating the nutritional impacts. Comparable interdisciplinary studies based on primary data at a household level are urgently required to guide effective adaptation, particularly for rural subsistence farmers. Systemization of data collection at the global level is indispensable and urgent. We need to assimilate data from long-term, high-quality agricultural, environmental, socioeconomic, health, and demographic surveillance systems and develop robust statistical methods to establish and validate causal links, quantify impacts, and make reliable predictions that can guide evidence-based health interventions in the future.

  20. Virtual reality training in neurosurgery: Review of current status and future applications

    Science.gov (United States)

    Alaraj, Ali; Lemole, Michael G.; Finkle, Joshua H.; Yudkowsky, Rachel; Wallace, Adam; Luciano, Cristian; Banerjee, P. Pat; Rizzi, Silvio H.; Charbel, Fady T.

    2011-01-01

    Background: Over years, surgical training is changing and years of tradition are being challenged by legal and ethical concerns for patient safety, work hour restrictions, and the cost of operating room time. Surgical simulation and skill training offer an opportunity to teach and practice advanced techniques before attempting them on patients. Simulation training can be as straightforward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced virtual reality (VR) simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. Methods: A PubMed review of the literature was performed for the MESH words “Virtual reality, “Augmented Reality”, “Simulation”, “Training”, and “Neurosurgery”. Relevant articles were retrieved and reviewed. A review of the literature was performed for the history, current status of VR simulation in neurosurgery. Results: Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and credential surgeons as technically competent. The number of published literature discussing the application of VR simulation in neurosurgery training has evolved over the last decade from data visualization, including stereoscopic evaluation to more complex augmented reality models. With the revolution of computational analysis abilities, fully immersive VR models are currently available in neurosurgery training. Ventriculostomy catheters insertion, endoscopic and endovascular simulations are used in neurosurgical residency training centers across the world. Recent studies have shown the coloration of proficiency with those simulators and levels of experience in the real world. Conclusion: Fully immersive technology is starting to be applied to the practice of

  1. Robot-assisted laparoscopic partial nephrectomy: Current review of the technique and literature

    Directory of Open Access Journals (Sweden)

    Singh Iqbal

    2009-01-01

    Full Text Available Aim: To visit the operative technique and to review the current published English literature on the technique, and outcomes following robot-assisted laparoscopic partial nephrectomy (RPN. Materials and Methods: We searched the published English literature and the PubMed (TM for published series of ′robotic partial nephrectomy′ (RPN using the keywords; robot, robot-assisted laparoscopic partial nephrectomy, laparoscopic partial nephrectomy, partial nephrectomy and laparoscopic surgery. Results: The search yielded 15 major selected series of ′robotic partial nephrectomy′; these were reviewed, tracked and analysed in order to determine the current status and role of RPN in the management of early renal neoplasm(s, as a minimally invasive surgical alternative to open partial nephrectomy. A review of the initial peri-operative outcome of the 350 cases of select series of RPN reported in published English literature revealed a mean operating time, warm ischemia time, estimated blood loss and hospital stay, of 191 minutes, 25 minutes, 162 ml and 2.95 days, respectively. The overall computed mean complication rate of RPN in the present select series was about 7.4%. Conclusions: RPN is a safe, feasible and effective minimally invasive surgical alternative to laparoscopic partial nephrectomy for early stage (T 1 renal neoplasm(s. It has acceptable initial renal functional outcomes without the increased risk of major complications in experienced hands. Prospective randomised, controlled, comparative clinical trials with laparoscopic partial nephrectomy (LPN are the need of the day. While the initial oncological outcomes of RPN appear to be favourable, long-term data is awaited.

  2. Virtual reality training in neurosurgery: Review of current status and future applications.

    Science.gov (United States)

    Alaraj, Ali; Lemole, Michael G; Finkle, Joshua H; Yudkowsky, Rachel; Wallace, Adam; Luciano, Cristian; Banerjee, P Pat; Rizzi, Silvio H; Charbel, Fady T

    2011-01-01

    Over years, surgical training is changing and years of tradition are being challenged by legal and ethical concerns for patient safety, work hour restrictions, and the cost of operating room time. Surgical simulation and skill training offer an opportunity to teach and practice advanced techniques before attempting them on patients. Simulation training can be as straightforward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced virtual reality (VR) simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. A PubMed review of the literature was performed for the MESH words "Virtual reality, "Augmented Reality", "Simulation", "Training", and "Neurosurgery". Relevant articles were retrieved and reviewed. A review of the literature was performed for the history, current status of VR simulation in neurosurgery. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and credential surgeons as technically competent. The number of published literature discussing the application of VR simulation in neurosurgery training has evolved over the last decade from data visualization, including stereoscopic evaluation to more complex augmented reality models. With the revolution of computational analysis abilities, fully immersive VR models are currently available in neurosurgery training. Ventriculostomy catheters insertion, endoscopic and endovascular simulations are used in neurosurgical residency training centers across the world. Recent studies have shown the coloration of proficiency with those simulators and levels of experience in the real world. Fully immersive technology is starting to be applied to the practice of neurosurgery. In the near future, detailed VR neurosurgical modules

  3. Examining the Inclusion of Quantitative Research in a Meta-Ethnographic Review

    Science.gov (United States)

    Booker, Rhae-Ann Richardson

    2010-01-01

    This study explored how one might extend meta-ethnography to quantitative research for the advancement of interpretive review methods. Using the same population of 139 studies on racial-ethnic matching as data, my investigation entailed an extended meta-ethnography (EME) and comparison of its results to a published meta-analysis (PMA). Adhering to…

  4. Psychoanalysis and Humanism: A Review and Critical Examination of Integrationist Efforts with Some Proposed Resolutions.

    Science.gov (United States)

    Hansen, James T.

    2000-01-01

    Critically reviews efforts at theoretical integration of psychoanalysis and humanism along the lines of F. Pine's (1990) four psychologies of psychoanalysis. Concludes that psychoanalysis and humanism have certain compatible features, but that they generally represent opposing vantage points in the study of subjectivity. Provides recommendations…

  5. Recertification in allergy and immunology: an historical review with special emphasis on the 1983 examination.

    Science.gov (United States)

    Slavin, R G; Des Prez, L; Mansmann, H C; Meskauskas, J A; Pierson, W

    1985-03-01

    Recertification offers a method of evaluating a diplomate's cognitive knowledge of allergy and immunology. In 1983 candidates for the American Board of Allergy and Immunology recertification examination were offered the entire certifying examination but were informed that they would, for recertification purposes, be held responsible only for a subset of questions judged to be particularly clinically relevant. All 40 candidates elected to take the entire certifying examination. Differences between the performance of certifying and recertifying candidates on the recertifying questions were small. Except for the five-choice questions, the differences in performance between the two groups on the remaining questions were also small in an absolute sense. Recertification performance was not related to the time of original certification. Ninety-eight percent of the candidates completed a questionnaire after the examination. Ninety percent stated that they would encourage their colleagues to participate in the recertification process.

  6. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Taraka V. Gadiraju

    2015-10-01

    Full Text Available Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week. Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying, temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.

  7. A Systematic Review of Wearable Systems for Cancer Detection: Current State and Challenges.

    Science.gov (United States)

    Ray, Partha Pratim; Dash, Dinesh; De, Debashis

    2017-10-02

    Rapid growth of sensor and computing platforms have introduced the wearable systems. In recent years, wearable systems have led to new applications across all medical fields. The aim of this review is to present current state-of-the-art approach in the field of wearable system based cancer detection and identify key challenges that resist it from clinical adoption. A total of 472 records were screened and 11 were finally included in this study. Two types of records were studied in this context that includes 45% research articles and 55% manufactured products. The review was performed per PRISMA guidelines where considerations was given to records that were published or reported between 2009 and 2017. The identified records included 4 cancer detecting wearable systems such as breast cancer (36.3%), skin cancer (36.3%), prostate cancer (18.1%), and multi-type cancer (9%). Most works involved sensor based smart systems comprising of microcontroller, Bluetooth module, and smart phone. Few demonstrated Ultra-Wide Band (i.e. UWB) antenna based wearable systems. Skin cancer detecting wearable systems were most comprehensible ones. The current works are gradually progressing with seamless integration of sensory units along with smart networking. However, they lack in cloud computing and long-range communication paradigms. Artificial intelligence and machine learning are key ports that need to be attached with current wearable systems. Further, clinical inertia, lack of awareness, and high cost are altogether pulling back the actual growth of such system. It is well comprehended that upon sincere orientation of all identified challenges, wearable systems would emerge as vital alternative to futuristic cancer detection.

  8. Are adverse effects incorporated in economic models? An initial review of current practice.

    Science.gov (United States)

    Craig, D; McDaid, C; Fonseca, T; Stock, C; Duffy, S; Woolacott, N

    2009-12-01

    To identify methodological research on the incorporation of adverse effects in economic models and to review current practice. Major electronic databases (Cochrane Methodology Register, Health Economic Evaluations Database, NHS Economic Evaluation Database, EconLit, EMBASE, Health Management Information Consortium, IDEAS, MEDLINE and Science Citation Index) were searched from inception to September 2007. Health technology assessment (HTA) reports commissioned by the National Institute for Health Research (NIHR) HTA programme and published between 2004 and 2007 were also reviewed. The reviews of methodological research on the inclusion of adverse effects in decision models and of current practice were carried out according to standard methods. Data were summarised in a narrative synthesis. Of the 719 potentially relevant references in the methodological research review, five met the inclusion criteria; however, they contained little information of direct relevance to the incorporation of adverse effects in models. Of the 194 HTA monographs published from 2004 to 2007, 80 were reviewed, covering a range of research and therapeutic areas. In total, 85% of the reports included adverse effects in the clinical effectiveness review and 54% of the decision models included adverse effects in the model; 49% included adverse effects in the clinical review and model. The link between adverse effects in the clinical review and model was generally weak; only 3/80 (manipulation. Of the models including adverse effects, 67% used a clinical adverse effects parameter, 79% used a cost of adverse effects parameter, 86% used one of these and 60% used both. Most models (83%) used utilities, but only two (2.5%) used solely utilities to incorporate adverse effects and were explicit that the utility captured relevant adverse effects; 53% of those models that included utilities derived them from patients on treatment and could therefore be interpreted as capturing adverse effects. In total

  9. Current concepts and systematic review of vascularized composite allotransplantation of the abdominal wall.

    Science.gov (United States)

    Berli, Jens U; Broyles, Justin M; Lough, Denver; Shridharani, Sachin M; Rochlin, Danielle; Cooney, Damon S; Lee, W P Andrew; Brandacher, Gerald; Sacks, Justin M

    2013-01-01

    Abdominal wall vascularized composite allotransplantation (AW-VCA) is a rarely utilized technique for large composite abdominal wall defects. The goal of this article is to systematically review the literature and current concepts of AW-VCA, outline the challenges ahead, and provide an outlook for the future. Systematic review of the literature was performed using MEDLINE, EMBASE, and PubMed to identify relevant articles discussing results of AW-VCA. Cadaver and animal studies were excluded from the systematic review, but selectively included in the discussion. The resultant five papers report their results on AW-VCA(Transplantation, 85, 2008, 1607; Am J Transplant, 7, 2007, 1304; Transplant Proc, 41, 2009, 521; Transplant Proc, 36, 2004, 1561; Lancet, 361, 2003, 2173). These papers represent the result of two study groups in which a total of 18 AW-VCA were performed in 17 patients. Two different operative approaches were used. Overall flap/graft survival was 88%. No mortality related to the transplant was reported. One cadaver study and two animal models were identified and separately presented (Transplant Proc, 43, 2011, 1701; Transplantation, 90, 2010, 1590; Journal of Surgical Research, 162, 2010, 314). Literature review reports AW-VCA is technically feasible with low morbidity and mortality. Functional outcomes are not reported and minimally considered. With advancements in vascularized composite allotransplantation research and decreasing toxicity of immunosuppression therapies and immunomodulatory regimens, AW-VCA can be applied in circumstances beyond conjunction with visceral transplantation. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Physiotherapy and cardiac rhythm devices: a review of the current scope of practice.

    Science.gov (United States)

    Digby, Geneviève C; Daubney, Marguerite E; Baggs, Jim; Campbell, Debra; Simpson, Christopher S; Redfearn, Damian P; Brennan, F James; Abdollah, Hoshiar; Baranchuk, Adrian

    2009-07-01

    Several case reports have demonstrated negative interactions between various physiotherapy modalities and cardiac rhythm devices (CRD). Fear of these potential interactions may lead to suboptimal utilization of physiotherapy treatments in CRD patients. No prior review of available guidelines, or management strategies, on the interaction between physiotherapy modalities and CRD patients has been reported. To review existing guidelines regarding the use of physiotherapy modalities in patients with pacemakers and/or implantable cardioverter-defibrillators (ICDs). To retrospectively analyse CRD patient encounters at a local physiotherapy facility during a period of 2 years. A review of the literature regarding the potential interactions between physiotherapy modalities and CRDs was performed. Next, a 2 year retrospective analysis of patient encounters at a physiotherapy facility was conducted. In addition, seven international physiotherapy societies and four CRD manufacturers were surveyed with respect to recommendations regarding physiotherapy treatments in device patients. The local physiotherapy facility treated 25 patients with CRD (22 pacemaker and 3 ICD patients) for a total of 230 visits (9.2 visits/patient). Five patients received transcutaneous electrical nerve stimulation (TENS) and all 25 were administered additional treatment in the form of ultrasound (15), acupuncture (19), Laser (7), traction/manual therapy (12), exercise (8), education (18), taping (5), and/or moist heat (5). No complications occurred. Meanwhile, international societies and device manufacturers offered few specific or consistent recommendations. There are no specific international policies regarding the administration of physiotherapy modalities in CRD patients and, thus, there are no specific guidelines to be implemented at the local level. Review of the literature and of recommendations from CRD manufacturers suggests that TENS, Diathermy, and Interferential Electrical Current Therapy

  11. A systematic review comparing open-book and closed-book examinations: Evaluating effects on development of critical thinking skills.

    Science.gov (United States)

    Johanns, Beth; Dinkens, Amber; Moore, Jill

    2017-11-01

    The advantages of using traditional closed-book examinations are closely compared to the advantages of using open-book examinations for the development of critical thinking skills in nursing students. The use of critical thinking skills is vital among nurses to assess patient needs and modify standard approaches to individualize care for better patient outcomes. The following areas are compared and contrasted for both closed-book and open-book examinations: examination preparation, rote memorization versus active learning, intellectual engagement, simulation of working environment, higher order thinking skills, anxiety reduction and student satisfaction. During investigation of closed-book examinations and open-book examinations, the use of collaborative testing was unveiled. Collaborative testing combines areas from both closed-book and open-book examinations. Based on the systematic review of literature, the recommendation is to use a mixed method of examination types throughout the course of the nursing program. Each type of examination helps develop different skill sets in the nursing student. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Review of current typhoid fever vaccines, cross-protection against paratyphoid fever, and the European guidelines.

    Science.gov (United States)

    Zuckerman, Jane N; Hatz, Christoph; Kantele, Anu

    2017-10-01

    Typhoid and paratyphoid fever remain a global health problem, which - in non-endemic countries - are mainly seen in travelers, particularly in VFRs (visiting friends and relatives), with occasional local outbreaks occurring. A rise in anti-microbial resistance emphasizes the role of preventive measures, especially vaccinations against typhoid and paratyphoid fever for travelers visiting endemic countries. Areas covered: This state-of-the-art review recapitulates the epidemiology and mechanisms of disease of typhoid and paratyphoid fever, depicts the perspective of non-endemic countries and travelers (VFRs), and collectively presents current European recommendations for typhoid fever vaccination. We provide a brief overview of available (and developmental) vaccines in Europe, present current data on cross-protection to S. Paratyphi, and aim to provide a background for typhoid vaccine decision-making in travelers. Expert commentary: European recommendations are not harmonized. Experts must assess vaccination of travelers based on current country-specific recommendations. Travel health practitioners should be aware of the issues surrounding vaccination of travelers and be motivated to increase awareness of typhoid and paratyphoid fever risks.

  13. A review of spurious currents in the lattice Boltzmann method for multiphase flows

    Energy Technology Data Exchange (ETDEWEB)

    Conning Ton, Kevin; Lee, Tae Hun [The City College of the City Univ. of New York, New York (United States)

    2012-12-15

    A spurious current is a small amplitude artificial velocity field which arises from an imbalance between discretized forces in multiphase/multi component flows. If it occurs, the velocity field may persist indefinitely, preventing the achievement of a true equilibrium state. Spurious velocities can sometimes be as large as the characteristic velocities of the problem, causing severe instability and ambiguity between physical and spurious velocities. They are typically exacerbated by large values of numerical surface tension or when the two fluids being simulated have large density ratios. The resulting instability can restrict what parameters may be simulated. To varying degrees, spurious currents are found in all multiphase flow models of the lattice Boltzmann method (LBM). There have been many studies of the occurrence of the phenomenon, and many suggestions on how to eliminate it. This paper reviews the three main models of simulating multiphase/multi component flow in the lattice Boltzmann method, as well as the subsequent modifications made in order to reduce or eliminate spurious currents.

  14. Current developments in soil organic matter modeling and the expansion of model applications: a review

    International Nuclear Information System (INIS)

    Campbell, Eleanor E; Paustian, Keith

    2015-01-01

    Soil organic matter (SOM) is an important natural resource. It is fundamental to soil and ecosystem functions across a wide range of scales, from site-specific soil fertility and water holding capacity to global biogeochemical cycling. It is also a highly complex material that is sensitive to direct and indirect human impacts. In SOM research, simulation models play an important role by providing a mathematical framework to integrate, examine, and test the understanding of SOM dynamics. Simulation models of SOM are also increasingly used in more ‘applied’ settings to evaluate human impacts on ecosystem function, and to manage SOM for greenhouse gas mitigation, improved soil health, and sustainable use as a natural resource. Within this context, there is a need to maintain a robust connection between scientific developments in SOM modeling approaches and SOM model applications. This need forms the basis of this review. In this review we first provide an overview of SOM modeling, focusing on SOM theory, data-model integration, and model development as evidenced by a quantitative review of SOM literature. Second, we present the landscape of SOM model applications, focusing on examples in climate change policy. We conclude by discussing five areas of recent developments in SOM modeling including: (1) microbial roles in SOM stabilization; (2) modeling SOM saturation kinetics; (3) temperature controls on decomposition; (4) SOM dynamics in deep soil layers; and (5) SOM representation in earth system models. Our aim is to comprehensively connect SOM model development to its applications, revealing knowledge gaps in need of focused interdisciplinary attention and exposing pitfalls that, if avoided, can lead to best use of SOM models to support policy initiatives and sustainable land management solutions. (topical review)

  15. Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review.

    Science.gov (United States)

    Hoytema van Konijnenburg, Eva Mm; Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Leenders, Arnold G E; van der Lee, Johanna H

    2013-12-06

    Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion. We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0-18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool. The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment. Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment.

  16. Examining Environmental Gradients with satellite data in permafrost regions - the current state of the ESA GlobPermafrost initative

    Science.gov (United States)

    Grosse, G.; Bartsch, A.; Kääb, A.; Westermann, S.; Strozzi, T.; Wiesmann, A.; Duguay, C. R.; Seifert, F. M.; Obu, J.; Nitze, I.; Heim, B.; Haas, A.; Widhalm, B.

    2017-12-01

    Permafrost cannot be directly detected from space, but many surface features of permafrost terrains and typical periglacial landforms are observable with a variety of EO sensors ranging from very high to medium resolution at various wavelengths. In addition, landscape dynamics associated with permafrost changes and geophysical variables relevant for characterizing the state of permafrost, such as land surface temperature or freeze-thaw state can be observed with spaceborne Earth Observation. Suitable regions to examine environmental gradients across the Arctic have been defined in a community white paper (Bartsch et al. 2014, hdl:10013/epic.45648.d001). These transects have been revised and adjusted within the DUE GlobPermafrost initiative of the European Space Agency. The ESA DUE GlobPermafrost project develops, validates and implements Earth Observation (EO) products to support research communities and international organisations in their work on better understanding permafrost characteristics and dynamics. Prototype product cases will cover different aspects of permafrost by integrating in situ measurements of subsurface and surface properties, Earth Observation, and modelling to provide a better understanding of permafrost today. The project will extend local process and permafrost monitoring to broader spatial domains, support permafrost distribution modelling, and help to implement permafrost landscape and feature mapping in a GIS framework. It will also complement active layer and thermal observing networks. Both lowland (latitudinal) and mountain (altitudinal) permafrost issues are addressed. The status of the Permafrost Information System and first results will be presented. Prototypes of GlobPermafrost datasets include: Modelled mean annual ground temperature by use of land surface temperature and snow water equivalent from satellites Land surface characterization including shrub height, land cover and parameters related to surface roughness Trends from

  17. A systematic review of the diagnostic performance of orthopedic physical examination tests of the hip.

    Science.gov (United States)

    Rahman, Labib Ataur; Adie, Sam; Naylor, Justine Maree; Mittal, Rajat; So, Sarah; Harris, Ian Andrew

    2013-08-30

    Previous reviews of the diagnostic performances of physical tests of the hip in orthopedics have drawn limited conclusions because of the low to moderate quality of primary studies published in the literature. This systematic review aims to build on these reviews by assessing a broad range of hip pathologies, and employing a more selective approach to the inclusion of studies in order to accurately gauge diagnostic performance for the purposes of making recommendations for clinical practice and future research. It specifically identifies tests which demonstrate strong and moderate diagnostic performance. A systematic search of Medline, Embase, Embase Classic and CINAHL was conducted to identify studies of hip tests. Our selection criteria included an analysis of internal and external validity. We reported diagnostic performance in terms of sensitivity, specificity, predictive values and likelihood ratios. Likelihood ratios were used to identify tests with strong and moderate diagnostic utility. Only a small proportion of tests reported in the literature have been assessed in methodologically valid primary studies. 16 studies were included in our review, producing 56 independent test-pathology combinations. Two tests demonstrated strong clinical utility, the patellar-pubic percussion test for excluding radiologically occult hip fractures (negative LR 0.05, 95% Confidence Interval [CI] 0.03-0.08) and the hip abduction sign for diagnosing sarcoglycanopathies in patients with known muscular dystrophies (positive LR 34.29, 95% CI 10.97-122.30). Fifteen tests demonstrated moderate diagnostic utility for diagnosing and/or excluding hip fractures, symptomatic osteoarthritis and loosening of components post-total hip arthroplasty. We have identified a number of tests demonstrating strong and moderate diagnostic performance. These findings must be viewed with caution as there are concerns over the methodological quality of the primary studies from which we have extracted our

  18. Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis.

    Science.gov (United States)

    Lange, Toni; Matthijs, Omer; Jain, Nitin B; Schmitt, Jochen; Lützner, Jörg; Kopkow, Christian

    2017-03-01

    Shoulder pain in the general population is common and to identify the aetiology of shoulder pain, history, motion and muscle testing, and physical examination tests are usually performed. The aim of this systematic review was to summarise and evaluate intrarater and inter-rater reliability of physical examination tests in the diagnosis of shoulder pathologies. A comprehensive systematic literature search was conducted using MEDLINE, EMBASE, Allied and Complementary Medicine Database (AMED) and Physiotherapy Evidence Database (PEDro) through 20 March 2015. Methodological quality was assessed using the Quality Appraisal of Reliability Studies (QAREL) tool by 2 independent reviewers. The search strategy revealed 3259 articles, of which 18 finally met the inclusion criteria. These studies evaluated the reliability of 62 test and test variations used for the specific physical examination tests for the diagnosis of shoulder pathologies. Methodological quality ranged from 2 to 7 positive criteria of the 11 items of the QAREL tool. This review identified a lack of high-quality studies evaluating inter-rater as well as intrarater reliability of specific physical examination tests for the diagnosis of shoulder pathologies. In addition, reliability measures differed between included studies hindering proper cross-study comparisons. PROSPERO CRD42014009018. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Review of current activities to model and measure the orbital debris environment in low-earth orbit

    Science.gov (United States)

    Reynolds, R. C.

    A very active orbital debris program is currently being pursued at the NASA/Johnson Space Center (JSC), with projects designed to better define the current environment, to project future environments, to model the processes contributing to or constraining the growth of debris in the environment, and to gather supporting data needed to improve the understanding of the orbital debris problem and the hazard it presents to spacecraft. This paper is a review of the activity being conducted at JSC, by NASA, Lockheed Engineering and Sciences Company, and other support contractors, and presents a review of current activity, results of current research, and a discussion of directions for future development.

  20. Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Ohle, Robert; Kareemi, Hashim Khaliq; Wells, George; Perry, Jeffrey J

    2018-04-01

    Acute aortic dissection is a life-threatening condition due to a tear in the aortic wall. It is difficult to diagnose and if missed carries a significant mortality. We conducted a librarian-assisted systematic review of PubMed, MEDLINE, Embase, and the Cochrane database from 1968 to July 2016. Titles and abstracts were reviewed and data were extracted by two independent reviewers (agreement measured by kappa). Studies were combined if low clinical and statistical heterogeneity (I 2  < 30%). Study quality was assessed using the QUADAS-2 tool. Bivariate random effects meta analyses using Revman 5 and SAS 9.3 were performed. We identified 792 records: 60 were selected for full text review, nine studies with 2,400 participants were included (QUADAS-2 low risk of bias, κ = 0.89 [for full-text review]). Prevalence of aortic dissection ranged from 21.9% to 76.1% (mean ± SD = 39.1% ± 17.1%). The clinical findings increasing probability of aortic dissection were 1) neurologic deficit (n = 3, specificity = 95%, positive likelihood ratio [LR+] = 4.4, 95% confidence interval [CI] = 3.3-5.7, I 2  = 0%) and 2) hypotension (n = 4, specificity = 95%, LR+ = 2.9 95% CI = 1.8-4.6, I 2  = 42%), and decreasing probability were the absence of a widened mediastinum (n = 4, sensitivity = 76%-95%, negative likelihood ratio [LR-] = 0.14-0.60, I 2  = 93%) and an American Heart Association aortic dissection detection (AHA ADD) risk score < 1 (n = 1, sensitivity = 91%, LR- = 0.22, 95% CI = 0.15-0.33). Suspicion for acute aortic dissection should be raised with hypotension, pulse, or neurologic deficit. Conversely, a low AHA ADD score decreases suspicion. Clinical gestalt informed by high- and low-risk features together with an absence of an alternative diagnosis should drive investigation for acute aortic dissection. © 2017 by the Society for Academic Emergency Medicine.

  1. Methods for Examining the Psychometric Quality of Subscores: A Review and Application

    Science.gov (United States)

    Wedman, Jonathan; Lyrén, Per-Erik

    2015-01-01

    When subscores on a test are reported to the test taker, the appropriateness of reporting them depends on whether they provide useful information above what is provided by the total score. Subscores that fail to do so lack adequate psychometric quality and should not be reported. There are several methods for examining the quality of subscores,…

  2. 75 FR 9691 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-03-03

    ... involving programming they own, that impede competition in the video distribution market. See H.R. Rep. No... availability of programming and charging discriminatory prices to non- cable technologies.'' H.R. Rep. No. 102... Access Rules and Examination of Programming Tying Arrangements; Final Rule #0;#0;Federal Register / Vol...

  3. 77 FR 4061 - Submission for Review: Certificate of Medical Examination, 3206-0250.

    Science.gov (United States)

    2012-01-26

    ... medical information about individuals who are incumbents of positions which require physical fitness/agility testing and/or medical examinations, or who have been selected for such a position contingent upon... under the Americans with Disabilities Act (ADA). As required by the Paperwork Reduction Act of 1995 (Pub...

  4. What is the Current Knowledge About the Cardiovascular Risk for Users of Cannabis-Based Products? A Systematic Review.

    Science.gov (United States)

    Jouanjus, Emilie; Raymond, Valentin; Lapeyre-Mestre, Maryse; Wolff, Valérie

    2017-06-01

    The purpose of the study was to examine the published evidence on the cardiovascular risk related to the use of cannabis-based products by performing a systematic review of recent literature. The World Health Organization (WHO) emphasizes that cannabis use represents a risky behavior as it may lead to many adverse effects, and in particular, cardiovascular effects. A systematic review of articles published between January 1, 2011 and May 31, 2016 was performed in agreement with the PRISMA statement. Articles presenting data on humans exposed to cannabis-based products and suffering from any cardiovascular condition were eligible for inclusion. The inclusion process was based on a search algorithm and performed in a blinded standardized manner. Overall, 826 articles were found in the literature search, 115 of which remained after performing the inclusion procedure. These were 81 case reports, 29 observational studies, 3 clinical trials, and 2 experimental studies. A total of 116 individuals was the subject of case reports. The mean age was 31 years (95%CI = 29-34), and patients were more frequently men (81.9%) than women (18.1%). They mainly suffered from ischemic strokes or myocardial infarctions. Data provided by the 29 included observational studies evidenced an association between exposure to cannabis-based products and cardiovascular disease. Currently, this evidence is stronger for ischemic strokes than for any other cardiovascular diseases. While the data are limited, there is some suggestion that cannabis use may have negative cardiovascular consequences, particularly at large doses.

  5. The importance of preventive dental visits from a young age: systematic review and current perspectives

    Directory of Open Access Journals (Sweden)

    Bhaskar V

    2014-03-01

    -seeking pattern were frequently articulated themes in the reviewed studies. Conclusion: The currently available evidence base supporting the effectiveness of EPDVs and the year 1 first dental visit recommendation is weak, and more research is warranted. The benefits of EPDVs before the age of 3 years are evident among children at high risk or with existing dental disease. However, EPDVs may be associated with reduced restorative dental care visits and related expenditures during the first years of life. Keywords: prevention, children, dental visits, anticipatory guidance, dental home, caries

  6. A human rights approach to advocacy for people with dementia: A review of current provision in England and Wales.

    Science.gov (United States)

    Dixon, Jeremy; Laing, Judy; Valentine, Christine

    2018-01-01

    In this article, we review current advocacy services for people with dementia in England and Wales (provided, respectively, under the Mental Capacity Act 2005 , the Mental Health Act 1983 /2007 and the Care Act 2014) through the lens of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). We examine what a human rights' approach to advocacy support would entail, and whether current frameworks in England and Wales are adequate for this approach and provide a sufficient safeguard. First, we consider how the human rights of persons with dementia have become increasingly important and the extent to which the CRPD provides an opportunity to bolster safeguards and protection. Second, we discuss cause and case advocacy, and how these advocacy models could be shaped by the CRPD to promote the rights of persons with dementia at each stage of the disease. Third, we highlight current dilemmas and challenges in the provision of advocacy support in England and Wales by focusing on case law, commissioning of services and current practice. In particular, we analyse how the different legislative schemes have given rise to some confusion about the various advocacy provisions, as well as potential for overlap and discrepancies between different regimes. We also highlight the need for further research to address important gaps in knowledge, including the scale of need, patterns of referral and attitudes to advocacy services. The article concludes by highlighting how advocacy support could be recalibrated as a universal right to promote the aims and aspirations of the CRPD, and how education is needed to address the stigma of dementia and promote the benefits of advocacy in protecting the rights of those with dementia.

  7. Update on attention-deficit/hyperactivity disorder and tic disorders: a review of the current literature.

    Science.gov (United States)

    Simpson, Heather A; Jung, Leah; Murphy, Tanya K

    2011-10-01

    Tic disorders impact quality of life, but when they are co-occurring with attention-deficit/hyperactivity disorder, the combined impact takes a toll on psychosocial functioning and adds another layer of complexity to treatment approaches. A review of the current literature supports evidence of a unique relationship between comorbid attention-deficit/hyperactivity disorder and tic disorders, emphasizing the intricate phenotype and impairment associated with these co-occurring conditions. The complexity of these symptoms requires careful diagnosis and appropriate treatment as determined by the level of impairment and can include pharmacotherapy, behavioral interventions, or a combination of therapies. To achieve the greatest benefits in improving quality of life and eliminating further comorbidity, an ideal treatment plan would include a comprehensive evaluation as well as a hierarchical treatment approach involving education of the child, family, and teachers; careful medication management; and cognitive and behavioral training.

  8. Invited review current progress and limitations of spider silk for biomedical applications.

    Science.gov (United States)

    Widhe, Mona; Johansson, Jan; Hedhammar, My; Rising, Anna

    2012-06-01

    Spider silk is a fascinating material combining remarkable mechanical properties with low density and biodegradability. Because of these properties and historical descriptions of medical applications, spider silk has been proposed to be the ideal biomaterial. However, overcoming the obstacles to produce spider silk in sufficient quantities and in a manner that meets regulatory demands has proven to be a difficult task. Also, there are relatively few studies of spider silk in biomedical applications available, and the methods and materials used vary a lot. Herein we summarize cell culture- and in vivo implantation studies of natural and synthetic spider silk, and also review the current status and future challenges in the quest for a large scale production of spider silk for medical applications. Copyright © 2011 Wiley Periodicals, Inc.

  9. A review of the current state of antimicrobial susceptibility test methods for Brachyspira.

    Science.gov (United States)

    Kulathunga, D G R S; Rubin, J E

    2017-06-01

    The re-emergence of swine dysentery (Brachyspira-associated muco-haemorrhagic colitis) since the late 2000s has illuminated diagnostic challenges associated with this genus. The methods used to detect, identify, and characterize Brachyspira from clinical samples have not been standardized, and laboratories frequently rely heavily on in-house techniques. Particularly concerning is the lack of standardized methods for determining and interpreting the antimicrobial susceptibility of Brachyspira spp. The integration of laboratory data into a treatment plan is a critical component of prudent antimicrobial usage. Therefore, the lack of standardized methods is an important limitation to the evidence-based use of antimicrobials. This review will focus on describing the methodological limitations and inconsistencies between current susceptibility testing schemes employed for Brachyspira, provide an overview of what we do know about the susceptibility of these organisms, and suggest future directions to improve and standardize diagnostic strategies.

  10. Procalcitonin as a diagnostic and prognostic marker in diabetic foot infection. A current literature review.

    Science.gov (United States)

    Velissaris, Dimitrios; Pantzaris, Nikolaos-Dimitrios; Platanaki, Christina; Antonopoulou, Nikolina; Gogos, Charalampos

    2018-03-01

    Diabetic foot ulcers (DFUs) are a very common cause of mortality and morbidity. The distinction between infected and non-infected DFU remains a very challenging task for clinicians in everyday practice. Even when infection is documented, the spectrum of diabetic foot infection is wide, ranging from cellulitis and soft tissue infection to osteomyelitis. Procalcitonin (PCT), a well-established sepsis biomarker, has been used in the diagnosis of several infections including osteomyelitis in patients with diabetes mellitus. This review gathers and presents all the relevant data, up until now, regarding the use of PCT as an assessment tool in diabetic patients with foot infection. Current evidence suggests that PCT levels could aid clinicians in distinguishing infected from non-infected DFUs as well as in the distinction between soft tissue infection and bone involvement, but further and larger studies are warranted to confirm these findings.

  11. [Materials/Biomaterials in Clinical Practice - a Short Review and Current Trends].

    Science.gov (United States)

    Bolle, T; Meyer, F; Walcher, F; Lohmann, C; Jockenhövel, S; Gries, T; Hoffmann, W

    2017-04-01

    Biomaterials play a major role in interventional medicine and surgery. However, the development of biomaterials is still in its early phases in spite of the huge progress made within the last decades. On the one hand, this is because our knowledge of the molecular and cellular processes associated with biomaterials is still increasing exponentially. On the other hand, a wide variety of advanced materials with highly interesting properties is being developed currently. This review provides a short introduction into the variety of materials in use as well as their application in interventional medicine and surgery. Also the importance of biomaterials for tissue engineering in the field of regenerative medicine and the functionalisation of biomaterials, including sterilisation methods are discussed. For the future, an even broader interdisciplinary scientific collaboration is necessary in order to develop novel biomaterials and facilitate their translation into clinical practice. Georg Thieme Verlag KG Stuttgart · New York.

  12. Review of Virtual Reality Treatment in Psychiatry: Evidence Versus Current Diffusion and Use.

    Science.gov (United States)

    Mishkind, Matthew C; Norr, Aaron M; Katz, Andrea C; Reger, Greg M

    2017-09-18

    This review provides an overview of the current evidence base for and clinical applications of the use of virtual reality (VR) in psychiatric practice, in context of recent technological developments. The use of VR in psychiatric practice shows promise with much of the research demonstrating clinical effectiveness for conditions including post-traumatic stress disorder, anxiety and phobias, chronic pain, rehabilitation, and addictions. However, more research is needed before the use of VR is considered a clinical standard of practice in some areas. The recent release of first generation consumer VR products signals a change in the viability of further developing VR systems and applications. As applications increase so will the need for good quality research to best understand what makes VR effective, and when VR is not appropriate for clinical services. As the field progresses, it is hopeful that the flexibility afforded by this technology will yield superior outcomes and a better understanding of the underlying mechanisms impacting those outcomes.

  13. State-of-the-art review of sodium fire analysis and current notions for improvements

    International Nuclear Information System (INIS)

    Tasi, S.S.

    1978-01-01

    Sodium releases from postulated pipe ruptures, as well as failures of sodium handling equipment in liquid metal fast breeder reactors, may lead to substantial pressure-temperature transients in the sodium system cells, as well as in the reactor containment building. Sodium fire analyses are currently performed with analytical tools, such as the SPRAY, SOMIX, SPOOL-FIRE and SOFIRE-II codes. A review and evaluation of the state-of-the-art in sodium fire analysis is presented, and suggestions for further improvements are made. This work is based, in part, on studies made at Brookhaven National Laboratory during the past several years in the areas of model development and improvement associated with the accident analyses of LMFBRs

  14. Current technologies for biological treatment of textile wastewater--a review.

    Science.gov (United States)

    Sarayu, K; Sandhya, S

    2012-06-01

    The release of colored wastewater represents a serious environmental problem and public health concern. Color removal from textile wastewater has become a big challenge over the last decades, and up to now, there is no single and economically attractive treatment method that can effectively decolorize the wastewater. Effluents from textile manufacturing, dyeing, and finishing processes contain high concentrations of biologically difficult-to-degrade or even inert auxiliaries, chemicals like acids, waxes, fats, salts, binders, thickeners, urea, surfactants, reducing agents, etc. The various chemicals such as biocides and stain repellents used for brightening, sequestering, anticreasing, sizing, softening, and wetting of the yarn or fabric are also present in wastewater. Therefore, the textile wastewater needs environmental friendly, effective treatment process. This paper provides a critical review on the current technology available for decolorization and degradation of textile wastewater and also suggests effective and economically attractive alternatives.

  15. [Current Status and Challenges of CAR-T Immunotherapy in Hematologic Malignancies -Review].

    Science.gov (United States)

    Cheng, Xin; Wang, Ya-Jie; Feng, Shuai; Wu, Ya-Yun; Yang, Tong-Hua; Lai, Xun

    2018-04-01

    The chimeric antigen receptor (CAR) T cell therapy has gradually became a new trend in the treatment of refractory and relapsed hematologic malignancies by developing for 30 years. With the exciting development of genetic engineering, CAR-T technology has subjected to 4 generations of innovation. Structure of CAR-T started from a single signal molecule to 2 or more than 2 co-stimulatory molecules, and then coding the CAR gene or promoter. CAR-T can specifically recognize tumor antigens, and does not be restricted by major histocompatibility complex (MHC), thus making a breakthrough in clinical treatment. In this review, the history, structure and mechanism of action of CAR-T, as well as the current status and challenges of CAR-T immunotherapy in acute lymphoblastic leukemia, acute myeloid leukemia, chronic myeloid leukemia and multiple myeloma are summarized.

  16. Cervical spondylolysis: three cases and a review of the current literature.

    Science.gov (United States)

    Ahn, Poong Gee; Yoon, Do Heum; Shin, Hyun Chul; Kim, Keung Nyun; Yi, Seong; Lee, Dong Yup; Yang, Moon Sul; Ha, Yoon

    2010-02-01

    Case report. To describe a rare case of cervical spondylolysis with an adjacent secondary dysplastic change, and to review the current literature regarding cervical spondylolysis. Three patients presented with minor trauma history and radiographical C6 level spondylolysis. Cervical spines were analyzed with plain radiography, multidetector computerized tomography, and magnetic resonance imaging. In all 3 patients, plain radiographs revealed a bilateral cleft of the C6 articular mass. The patients presented with long-term minimal discomfort of the posterior neck. In 2 patients, a trauma event increased the pain and produced neurologic deficits. In addition, an adjacent dysplastic change was present on imaging studying in 2 of the patients, 1 of whom also presented with a cord signal change above the spondylolytic level. Early diagnosis and appropriate management of cases of spondylolysis are important. In addition, surgical plans for cervical spondylolysis should be considered if the adjacent levels are unstable or fragile.

  17. Review of current capabilities for the measurement of stress, displacement, and in situ deformation modulus

    International Nuclear Information System (INIS)

    Schrauf, T.W.; Pratt, H.R.

    1979-12-01

    Current capabilities for the measurement of stress, displacement, and in situ deformation modulus in rock masses are reviewed as to their accuracy, sensitivity, advantages, and limitations. Consideration is given to both the instruments themselves and the measurement technique. Recommendations concerning adaptation of existing measurement techniques to repository monitoring are also discussed. These recommendations include: (1) development of a modified borehole deformation gage with improved long-term stability and reliability and reduced thermal sensitivity; (2) development of a downhole transducer type of extensometer; (3) development of a rigid inclusion type gage; (4) development of an improved vibrating wire stressmeter with greater accuracy and simplified calibration and installation requirements; and (5) modification of standard rod extensometers to improve their sensitivity

  18. A review of current and novel therapies for idiopathic pulmonary fibrosis

    Science.gov (United States)

    Rafii, Rokhsara; Juarez, Maya M.; Albertson, Timothy E.

    2013-01-01

    Idiopathic pulmonary fibrosis (IPF) is a progressively fibrotic interstitial lung disease that is associated with a median survival of 2-3 years from initial diagnosis. To date, there is no treatment approved for IPF in the United States, and only one pharmacological agent has been approved outside of the United States. Nevertheless, research over the past 10 years has provided us with a wealth of information on its histopathology, diagnostic work-up, and a greater understanding of its pathophysiology. Specifically, IPF is no longer thought to be a predominantly pro-inflammatory disorder. Rather, the fibrosis in IPF is increasingly understood to be the result of a fibroproliferative and aberrant wound healing cascade. The development of therapeutic targets has shifted in accord with this paradigm change. This review highlights the current understanding of IPF, and the recent as well as novel therapeutics being explored in clinical trials for the treatment of this devastating disease. PMID:23372951

  19. Pangolins (Manis crassicaudata in Sri Lanka: A Review of Current Knowledge, Threats and Research Priorities

    Directory of Open Access Journals (Sweden)

    P.K.P. Perera

    2017-07-01

    Full Text Available The Indian Pangolin (Manis crassicaudata is arguably the least studied species of all Asiatic pangolin species and, is the solitary pangolin species recorded in Sri Lanka. Growing concerns over their population decline due to poaching and trading has triggered a move to uplift Indian Pangolin to Appendix I of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES. However, lack of reliable scientific information on the behavior, ecology and threats for the survival of Indian Pangolin remains a major limitation in conservation of the species. This narrative review discusses the current knowledge on Indian Pangolin with special reference to Sri Lanka, and identifies key research priorities for better conservation planning of the species.

  20. Current Advancements and Strategies in Tissue Engineering for Wound Healing: A Comprehensive Review.

    Science.gov (United States)

    Ho, Jasmine; Walsh, Claire; Yue, Dominic; Dardik, Alan; Cheema, Umber

    2017-06-01

    Significance: With an aging population leading to an increase in diabetes and associated cutaneous wounds, there is a pressing clinical need to improve wound-healing therapies. Recent Advances: Tissue engineering approaches for wound healing and skin regeneration have been developed over the past few decades. A review of current literature has identified common themes and strategies that are proving successful within the field: The delivery of cells, mainly mesenchymal stem cells, within scaffolds of the native matrix is one such strategy. We overview these approaches and give insights into mechanisms that aid wound healing in different clinical scenarios. Critical Issues: We discuss the importance of the biomimetic niche, and how recapitulating elements of the native microenvironment of cells can help direct cell behavior and fate. Future Directions: It is crucial that during the continued development of tissue engineering in wound repair, there is close collaboration between tissue engineers and clinicians to maintain the translational efficacy of this approach.

  1. The reliability of physical examination tests for the diagnosis of anterior cruciate ligament rupture--A systematic review.

    Science.gov (United States)

    Lange, Toni; Freiberg, Alice; Dröge, Patrik; Lützner, Jörg; Schmitt, Jochen; Kopkow, Christian

    2015-06-01

    Systematic literature review. Despite their frequent application in routine care, a systematic review on the reliability of clinical examination tests to evaluate the integrity of the ACL is missing. To summarize and evaluate intra- and interrater reliability research on physical examination tests used for the diagnosis of ACL tears. A comprehensive systematic literature search was conducted in MEDLINE, EMBASE and AMED until May 30th 2013. Studies were included if they assessed the intra- and/or interrater reliability of physical examination tests for the integrity of the ACL. Methodological quality was evaluated with the Quality Appraisal of Reliability Studies (QAREL) tool by two independent reviewers. 110 hits were achieved of which seven articles finally met the inclusion criteria. These studies examined the reliability of four physical examination tests. Intrarater reliability was assessed in three studies and ranged from fair to almost perfect (Cohen's k = 0.22-1.00). Interrater reliability was assessed in all included studies and ranged from slight to almost perfect (Cohen's k = 0.02-0.81). The Lachman test is the physical tests with the highest intrarater reliability (Cohen's k = 1.00), the Lachman test performed in prone position the test with the highest interrater reliability (Cohen's k = 0.81). Included studies were partly of low methodological quality. A meta-analysis could not be performed due to the heterogeneity in study populations, reliability measures and methodological quality of included studies. Systematic investigations on the reliability of physical examination tests to assess the integrity of the ACL are scarce and of varying methodological quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. The Distress Disclosure Index: a research review and multitrait-multimethod examination.

    Science.gov (United States)

    Kahn, Jeffrey H; Hucke, Brandy E; Bradley, Allyson M; Glinski, Austin J; Malak, Brittany L

    2012-01-01

    The Distress Disclosure Index (DDI; J. H. Kahn & R. M. Hessling, 2001) is a brief self-report measure of one's tendency to disclose personally distressing information. The purpose of this article was to summarize what is known about the DDI, present new validity evidence, and make recommendations for use of the DDI. This article reviews research on the DDI from the past decade that indicates that distress disclosure is associated with well-being, professional help-seeking attitudes and intentions, and success in brief psychotherapy. On the basis of the reviewed literature, the authors report a reliability generalization study of DDI scores that strongly supports the internal consistency and test-retest reliability of DDI scores, and they review criterion-related and construct validity evidence. Next, the authors present a new multitrait-multimethod validity study of the DDI. Participants (N = 153) and peer informants (N = 153)--one per participant--completed paper-and-pencil questionnaire packets. Convergent validity of self-reported DDI scores was supported by a strong association with self-reports of emotional self-disclosure in response to a specific, unpleasant event, and self- and peer reports on the DDI were moderately correlated. DDI scores were not strongly associated with cognitive reappraisal and ambivalence over emotional expression, thus supporting discriminant validity. DDI scores were strongly associated with expressive suppression, and correlations between DDI scores and affect, depression symptoms, coping, and emotional expressivity were similar to those found with expressive suppression. The authors offer possible hypotheses explaining the overlap between distress disclosure and expressive suppression and present recommendations for future use of the DDI. (c) 2012 APA, all rights reserved.

  3. Policy responses to problematic video game use: A systematic review of current measures and future possibilities.

    Science.gov (United States)

    Király, Orsolya; Griffiths, Mark D; King, Daniel L; Lee, Hae-Kook; Lee, Seung-Yup; Bányai, Fanni; Zsila, Ágnes; Takacs, Zsofia K; Demetrovics, Zsolt

    2017-09-01

    Background and aims Empirical research into problematic video game playing suggests that overuse might cause functional and psychological impairments for a minority of gamers. Therefore, the need for regulation in the case of video games (whether governmental or self-imposed) has arisen but has only been implemented in a few countries around the world, and predominantly in Asia. This paper provides a systematic review of current and potential policies addressing problematic gaming. Methods After conducting a systematic search in the areas of prevention, treatment, and policy measures relating to problematic Internet and video game use, papers were selected that targeted problematic gaming policies (N = 12; six in English and six in Korean). These papers served as the basis of this review. Results Policies were classified into three major groups: (i) policy measures limiting availability of video games (e.g., shutdown policy, fatigue system, and parental controls), (ii) measures aiming to reduce risk and harm (e.g., warning messages), and (iii) measures taken to provide help services for gamers. Beyond the attempt to classify the current and potential policy measures, the authors also tried to evaluate their efficiency theoretically and (if data were available) empirically. Discussion and conclusions Overall, it appears that although several steps have been taken to address problematic video game playing, most of these steps were not as effective as expected, or had not been evaluated empirically for efficacy. The reason for this may lie in the fact that the policies outlined only addressed or influenced specific aspects of the problem instead of using a more integrative approach.

  4. Herbal extracts in oral health care - A review of the current scenario and its future needs

    Science.gov (United States)

    Chandra Shekar, Byalakere Rudraiah; Nagarajappa, Ramesh; Suma, Shankarappa; Thakur, Rupesh

    2015-01-01

    Background: Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. Objective: To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. Materials and Methods: A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. Summary and Conclusion: The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. “Herbal shotgun” or “synergistic multitarget effects” are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance. PMID:26392704

  5. Review: Current trends in coral transplantation – an approach to preserve biodiversity

    Directory of Open Access Journals (Sweden)

    ABDELNABY ORABI

    2013-04-01

    Full Text Available Ammar MSA,El-Gammal F, Nassar M, Belal A, Farag W, El-Mesiry G, El-Haddad K, Orabi A, Abdelreheem A, Shaaban A. 2013. Review: Current trends in coral transplantation – an approach to preserve biodiversity. Biodiversitas 14: 43-53. The increasing rates of coral mortality associated with the rise in stress factors and the lack of adequate recovery worldwide have urged recent calls for actions by the scientific, conservation, and reef management communities. This work reviews the current trends in coral transplantation. Transplantation of coral colonies or fragments, whether from aqua-, mariculture or harvesting from a healthy colony, has been the most frequently recommended action for increasing coral abundance on damaged or degraded reefs and for conserving listed or “at-risk” species. Phytoplanktons are important for providing transplanted corals with complex organic compounds through photosynthesis. Artificial surfaces like concrete blocks, wrecks or other purpose-designed structures can be introduced for larval settlement. New surfaces can also be created through electrolysis. Molecular biological tools can be used to select sites for rehabilitation by asexual recruits. Surface chemistry and possible inputs of toxic leachate from artificial substrates are considered as important factors affecting natural recruitment. Transplants should be carefully maintained , revisited and reattached at least weekly in the first month and at least fortnightly in the next three months. Studies on survivorship and the reproductive ability of transplanted coral fragments are important for coral reef restoration. A coral nursery may be considered as a pool for local species that supplies reef-managers with unlimited coral colonies for sustainable management. Transplanting corals for making artificial reefs can be useful for increasing biodiversity, providing tourist diving, fishing and surfing; creating new artisanal and commercial fishing opportunities

  6. A Review of Player Monitoring Approaches in Basketball: Current Trends and Future Directions.

    Science.gov (United States)

    Fox, Jordan L; Scanlan, Aaron T; Stanton, Robert

    2017-07-01

    Fox, JL, Scanlan, AT, and Stanton, R. A review of player monitoring approaches in basketball: current trends and future directions. J Strength Cond Res 31(7): 2021-2029, 2017-Effective monitoring of players in team sports such as basketball requires an understanding of the external demands and internal responses, as they relate to training phases and competition. Monitoring of external demands and internal responses allows coaching staff to determine the dose-response associated with the imposed training load (TL), and subsequently, if players are adequately prepared for competition. This review discusses measures reported in the literature for monitoring the external demands and internal responses of basketball players during training and competition. The external demands of training and competition were primarily monitored using time-motion analysis, with limited use of microtechnology being reported. Internal responses during training were typically measured using hematological markers, heart rate, various TL models, and perceptual responses such as rating of perceived exertion (RPE). Heart rate was the most commonly reported indicator of internal responses during competition with limited reporting of hematological markers or RPE. These findings show a large discrepancy between the reporting of external and internal measures and training and competition demands. Microsensors, however, may be a practical and convenient method of player monitoring in basketball to overcome the limitations associated with current approaches while allowing for external demands and internal responses to be recorded simultaneously. The triaxial accelerometers of microsensors seem well suited for basketball and warrant validation to definitively determine their place in the monitoring of basketball players. Coaching staff should make use of this technology by tracking individual player responses across the annual plan and using real-time monitoring to minimize factors such as fatigue

  7. Electric current activated/assisted sintering (ECAS): a review of patents 1906-2008

    International Nuclear Information System (INIS)

    Grasso, Salvatore; Sakka, Yoshio; Maizza, Giovanni

    2009-01-01

    The electric current activated/assisted sintering (ECAS) is an ever growing class of versatile techniques for sintering particulate materials. Despite the tremendous advances over the last two decades in ECASed materials and products there is a lack of comprehensive reviews on ECAS apparatuses and methods. This paper fills the gap by tracing the progress of ECAS technology from 1906 to 2008 and surveys 642 ECAS patents published over more than a century. It is found that the ECAS technology was pioneered by Bloxam (1906 GB Patent No. 9020) who developed the first resistive sintering apparatus. The patents were searched by keywords or by cross-links and were withdrawn from the Japanese Patent Office (342 patents), the United States Patent and Trademark Office (175 patents), the Chinese State Intellectual Property Office of P.R.C. (69 patents) and the World Intellectual Property Organization (12 patents). A subset of 119 (out of 642) ECAS patents on methods and apparatuses was selected and described in detail with respect to their fundamental concepts, physical principles and importance in either present ECAS apparatuses or future ECAS technologies for enhancing efficiency, reliability, repeatability, controllability and productivity. The paper is divided into two parts, the first deals with the basic concepts, features and definitions of basic ECAS and the second analyzes the auxiliary devices/peripherals. The basic ECAS is classified with reference to discharge time (fast and ultrafast ECAS). The fundamental principles and definitions of ECAS are outlined in accordance with the scientific and patent literature. (topical review)

  8. Current status of achalasia management: a review on diagnosis and treatment.

    Science.gov (United States)

    Tuason, Joshua; Inoue, Haruhiro

    2017-04-01

    Achalasia is a rare esophageal motility disorder that is characterized by loss of peristalsis and failure of relaxation of the lower esophageal sphincter (LES), particularly during swallowing. This review focuses on the diagnosis of esophageal motility disorders as defined by the Chicago Classification ver 3.0, and presents management options with regard to per-oral endoscopic myotomy (POEM) as the treatment of choice. A concise review of literature was performed for articles related to the management of achalasia, and this was contrasted with our institution's current practice. Achalasia is still incompletely understood, and management is focused on establishing a proper diagnosis, and relieving the obstructive symptoms. Achalasia should be considered when dysphagia is present, and not otherwise caused by an obstruction or inflammation, and when criteria is met as per the Chicago Classification ver 3.0. Lowering LES tone and disruption of LES can be accomplished by various methods, most notably pneumatic balloon dilatation and surgical myotomy. POEM has been gaining momentum as a first line therapy for achalasia symptoms, and can be considered an important tool for motility disorders of the esophagus.

  9. Metal-enhanced luminescence: Current trend and future perspectives- A review

    International Nuclear Information System (INIS)

    Ranjan, Rajeev; Esimbekova, Elena N.; Kirillova, Maria A.; Kratasyuk, Valentina A.

    2017-01-01

    Optically enhanced biosensing strategies are prerequisites for developing miniature and highly sensitive multiplexed analytical platforms. Such smart biosensing systems are highly promising for use in the fields of biomedicine and environmental monitoring. Optical signal enhancement during bioassays is attributed to the complex opto-electronic interactions of incoming photonic signals at the nanomaterial interface. Research on the use of metals other than gold and silver for such purposes tends to extend the spectral window to observe luminescence enhancement effects. Such manifold increase in luminescence may be explained by the principles of plasmon coupling, directional emission led high collection efficiency, Rayleigh scattering and related opto-electronic events. The present review begins with a mechanistic description of important phenomena associated with metal-induced luminescence enhancement, particularly focusing on the origin of metal-enhanced luminescence. This review further analyses the hybrid nanostructure capabilities responsible for maintaining unique opto-electronic properties during bio-functionalisation. Current research trends in this area, future scope of this field for designing useful bioassays and concluding remarks are then discussed. - Highlights: • Nanomaterials significantly differ from their bulk counterparts. • Strong and pronounced photophysical effects at the metal surface provide opportunities for designing novel biosensors. • Metal-enhanced luminescence increases the quantum yield of luminescent reactions. • Under optimal conditions, plasmon coupling enhances the optical effects at the nanometal surface.

  10. Metal-enhanced luminescence: Current trend and future perspectives- A review

    Energy Technology Data Exchange (ETDEWEB)

    Ranjan, Rajeev [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Esimbekova, Elena N., E-mail: esimbekova@yandex.ru [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Institute of Biophysics SB RAS, Federal Research Center “Krasnoyarsk Science Center SB RAS”, Akademgorodok 50/50, Krasnoyarsk 660036 (Russian Federation); Kirillova, Maria A. [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Kratasyuk, Valentina A. [Laboratory of Bioluminescent Biotechnologies, Department of Biophysics, Institute of Fundamental Biology and Biotechnology, Siberian Federal University, 79 Svobodny Prospect, Krasnoyarsk 660041 (Russian Federation); Institute of Biophysics SB RAS, Federal Research Center “Krasnoyarsk Science Center SB RAS”, Akademgorodok 50/50, Krasnoyarsk 660036 (Russian Federation)

    2017-06-08

    Optically enhanced biosensing strategies are prerequisites for developing miniature and highly sensitive multiplexed analytical platforms. Such smart biosensing systems are highly promising for use in the fields of biomedicine and environmental monitoring. Optical signal enhancement during bioassays is attributed to the complex opto-electronic interactions of incoming photonic signals at the nanomaterial interface. Research on the use of metals other than gold and silver for such purposes tends to extend the spectral window to observe luminescence enhancement effects. Such manifold increase in luminescence may be explained by the principles of plasmon coupling, directional emission led high collection efficiency, Rayleigh scattering and related opto-electronic events. The present review begins with a mechanistic description of important phenomena associated with metal-induced luminescence enhancement, particularly focusing on the origin of metal-enhanced luminescence. This review further analyses the hybrid nanostructure capabilities responsible for maintaining unique opto-electronic properties during bio-functionalisation. Current research trends in this area, future scope of this field for designing useful bioassays and concluding remarks are then discussed. - Highlights: • Nanomaterials significantly differ from their bulk counterparts. • Strong and pronounced photophysical effects at the metal surface provide opportunities for designing novel biosensors. • Metal-enhanced luminescence increases the quantum yield of luminescent reactions. • Under optimal conditions, plasmon coupling enhances the optical effects at the nanometal surface.

  11. A comprehensive review in current developments of benzothiazole-based molecules in medicinal chemistry.

    Science.gov (United States)

    Keri, Rangappa S; Patil, Mahadeo R; Patil, Siddappa A; Budagumpi, Srinivasa

    2015-01-07

    Benzothiazole (BTA) and its derivatives are the most important heterocyclic compounds, which are common and integral feature of a variety of natural products and pharmaceutical agents. BTA shows a variety of pharmacological properties, and its analogs offer a high degree of structural diversity that has proven useful for the search of new therapeutic agents. The broad spectrum of pharmacological activity in individual BTA derivative indicates that, this series of compounds is of an undoubted interest. The related research and developments in BTA-based medicinal chemistry have become a rapidly developing and increasingly active topic. Particularly, numerous BTA-based compounds as clinical drugs have been extensively used in practice to treat various types of diseases with high therapeutic potency. This work systematically gives a comprehensive review in current developments of BTA-based compounds in the whole range of medicinal chemistry as anticancer, antibacterial, antifungal, antiinflammatory, analgesic, anti-HIV, antioxidant, anticonvulsant, antitubercular, antidiabetic, antileishmanial, antihistaminic, antimalarial and other medicinal agents. It is believed that, this review article is helpful for new thoughts in the quest for rational designs of more active and less toxic BTA-based drugs, as well as more effective diagnostic agents and pathologic probes. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  12. Comprehensive review in current developments of imidazole-based medicinal chemistry.

    Science.gov (United States)

    Zhang, Ling; Peng, Xin-Mei; Damu, Guri L V; Geng, Rong-Xia; Zhou, Cheng-He

    2014-03-01

    Imidazole ring is an important five-membered aromatic heterocycle widely present in natural products and synthetic molecules. The unique structural feature of imidazole ring with desirable electron-rich characteristic is beneficial for imidazole derivatives to readily bind with a variety of enzymes and receptors in biological systems through diverse weak interactions, thereby exhibiting broad bioactivities. The related research and developments of imidazole-based medicinal chemistry have become a rapidly developing and increasingly active topic. Particularly, numerous imidazole-based compounds as clinical drugs have been extensively used in the clinic to treat various types of diseases with high therapeutic potency, which have shown the enormous development value. This work systematically gives a comprehensive review in current developments of imidazole-based compounds in the whole range of medicinal chemistry as anticancer, antifungal, antibacterial, antitubercular, anti-inflammatory, antineuropathic, antihypertensive, antihistaminic, antiparasitic, antiobesity, antiviral, and other medicinal agents, together with their potential applications in diagnostics and pathology. It is hoped that this review will be helpful for new thoughts in the quest for rational designs of more active and less toxic imidazole-based medicinal drugs, as well as more effective diagnostic agents and pathologic probes. © 2013 Wiley Periodicals, Inc.

  13. Additive Manufacturing Techniques in Prosthodontics: Where Do We Currently Stand? A Critical Review.

    Science.gov (United States)

    Alharbi, Nawal; Wismeijer, Daniel; Osman, Reham B

    The aim of this article was to critically review the current application of additive manufacturing (AM)/3D-printing techniques in prosthodontics and to highlight the influence of various technical factors involved in different AM technologies. A standard approach of searching MEDLINE, EMBASE, and Google Scholar databases was followed. The following search terms were used: (Prosth* OR Restoration) AND (Prototype OR Additive Manufacture* OR Compute* OR 3D-print* OR CAD/CAM) AND (Dentistry OR Dental). Hand searching the reference lists of the included articles and personal connections revealed additional relevant articles. Selection criteria were any article written in English and reporting on the application of AM in prosthodontics from 1990 to February 2016. From a total of 4,290 articles identified, 33 were seen as relevant. Of these, 3 were narrative reviews, 18 were in vitro studies, and 12 were clinical in vivo studies. Different AM technologies are applied in prosthodontics, directly and indirectly for the fabrication of fixed metal copings, metal frameworks for removable partial dentures, and plastic mock-ups and resin patterns for further conventional metal castings. Technical factors involved in different AM techniques influence the overall quality, the mechanical properties of the printed parts, and the total cost and manufacturing time. AM is promising and offers new possibilities in the field of prosthodontics, though its application is still limited. An understanding of these limitations and of developments in material science is crucial prior to considering AM as an acceptable method for the fabrication of dental prostheses.

  14. Micropapillary bladder cancer: current treatment patterns and review of the literature.

    Science.gov (United States)

    Willis, Daniel L; Flaig, Thomas W; Hansel, Donna E; Milowsky, Matthew I; Grubb, Robert L; Al-Ahmadie, Hikmat A; Plimack, Elizabeth R; Koppie, Theresa M; McConkey, David J; Dinney, Colin P; Hoffman, Vanessa A; Droller, Michael J; Messing, Edward; Kamat, Ashish M

    2014-08-01

    No guidelines exist for the management of micropapillary bladder cancer (MPBC) and most reports of this variant of urothelial carcinoma are case series comprising small numbers of patients. We sought to determine current practice patterns for MPBC using a survey sent to the Society of Urologic Oncology (SUO) and to present those results in the setting of a comprehensive review of the existing literature. A survey developed by the Translational Science Working Group of the Bladder Cancer Advocacy Network-sponsored Think Tank meeting was distributed to members of the SUO. The results from 118 respondents were analyzed and presented with a literature review. Most survey respondents were urologists, with 80% considering bladder cancer their primary area of interest. Although 78% of the respondents reported a dedicated genitourinary pathologist at their institution, there were discrepant opinions on how a pathologic diagnosis of MPBC is determined as well as variability on the proportion of MPBC that is clinically significant. Among them, 78% treat MPBC differently than conventional urothelial carcinoma, with 81% reporting that they would treat cT1 MPBC with upfront radical cystectomy. However, the respondents had split opinions regarding the sensitivity of MPBC to cisplatin-based chemotherapy, which affected utilization of neoadjuvant chemotherapy in muscle-invasive disease. The management of MPBC is diverse among members of the SUO. Although most favors early cystectomy for cT1 MPBC, there is no consensus on the use of neoadjuvant chemotherapy for muscle-invasive MPBC. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. One-stage vs two-stage cartilage repair: a current review

    Directory of Open Access Journals (Sweden)

    Daniel Meyerkort

    2010-10-01

    Full Text Available Daniel Meyerkort, David Wood, Ming-Hao ZhengCenter for Orthopaedic Research, School of Surgery and Pathology, University of Western Australia, Perth, AustraliaIntroduction: Articular cartilage has a poor capacity for regeneration if damaged. Various methods have been used to restore the articular surface, improve pain, function, and slow progression to osteoarthritis.Method: A PubMed review was performed on 18 March, 2010. Search terms included “autologous chondrocyte implantation (ACI” and “microfracture” or “mosaicplasty”. The aim of this review was to determine if 1-stage or 2-stage procedures for cartilage repair produced different functional outcomes.Results: The main procedures currently used are ACI and microfracture. Both first-generation ACI and microfracture result in clinical and functional improvement with no significant differences. A significant increase in functional outcome has been observed in second-generation procedures such as Hyalograft C, matrix-induced ACI, and ChondroCelect compared with microfracture. ACI results in a higher percentage of patients with clinical improvement than mosaicplasty; however, these results may take longer to achieve.Conclusion: Clinical and functional improvements have been demonstrated with ACI, microfracture, mosaicplasty, and synthetic cartilage constructs. Heterogeneous products and lack of good-quality randomized-control trials make product comparison difficult. Future developments involve scaffolds, gene therapy, growth factors, and stem cells to create a single-stage procedure that results in hyaline articular cartilage.Keywords: autologous chondrocyte implantation, microfracture, cartilage repair

  16. Fast Food Pattern and Cardiometabolic Disorders: A Review of Current Studies.

    Science.gov (United States)

    Bahadoran, Zahra; Mirmiran, Parvin; Azizi, Fereidoun

    2015-01-01

    There are growing concern globally regarding the alarming trend of fast food consumption and its related cardiometabolic outcomes including overweight and obesity. This study aimed to review the current evidences available in relation to adverse effects of fast food pattern on cardiometa-bolic risk factors. Relevant articles including epidemiological and clinical studies with appropriate design and good quality were obtained through searches of the Medline, PubMed, Scopus databases and Google scholar with related key words including "fast foods", "processed foods", "obesity", "overweight", "insulin resistance", "diabetes", "cardiovascular disease", "metabolic syndrome", "dyslipidemia" and "hypertension". Fast food consumption and out-of-home eating behavior is a main risk factor for lower diet quality, higher calorie and fat intake and lower micronutrients density of diet. Frequent consumption of fast foods was accompanied with overweight and abdominal fat gain, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress. Higher fast food consumption also increases the risk of developmental diabetes, metabolic syndrome and cardiovascular disease. This review provides further evidence warning us against the irreparable effects of fast food consumption on public health especially the increasing global burden of obesity and cardiovascu-lar diseases.

  17. Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.

    Science.gov (United States)

    Massetti, Thais; Crocetta, Tânia Brusque; Silva, Talita Dias da; Trevizan, Isabela Lopes; Arab, Claudia; Caromano, Fátima Aparecida; Monteiro, Carlos Bandeira de Mello

    2017-08-01

    To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.

  18. Buried transuranic wastes at ORNL: Review of past estimates and reconciliation with current data

    International Nuclear Information System (INIS)

    Trabalka, J.R.

    1997-09-01

    Inventories of buried (generally meaning disposed of) transuranic (TRU) wastes at Oak Ridge National Laboratory (ORNL) have been estimated for site remediation and waste management planning over a period of about two decades. Estimates were required because of inadequate waste characterization and incomplete disposal records. For a variety of reasons, including changing definitions of TRU wastes, differing objectives for the estimates, and poor historical data, the published results have sometimes been in conflict. The purpose of this review was (1) to attempt to explain both the rationale for and differences among the various estimates, and (2) to update the estimates based on more recent information obtained from waste characterization and from evaluations of ORNL waste data bases and historical records. The latter included information obtained from an expert panel's review and reconciliation of inconsistencies in data identified during preparation of the ORNL input for the third revision of the Baseline Inventory Report for the Waste Isolation Pilot Plant. The results summarize current understanding of the relationship between past estimates of buried TRU wastes and provide the most up-to-date information on recorded burials thereafter. The limitations of available information on the latter and thus the need for improved waste characterization are highlighted

  19. Current status and analysis of renewable promotional policies in Indian restructured power sector - A review

    International Nuclear Information System (INIS)

    Singh, Randhir; Sood, Yog Raj

    2011-01-01

    Restructuring has changed the traditional mission and mandates of power utilities in complex ways, and had large impacts on environmental, social, and political conditions for any particular country. At the same time, new regulatory approaches are being found for reducing environmental impacts in restructured power sectors. India has a vast supply of renewable energy resources, and it has one of the largest programs in the world for deploying renewable energy based products and systems. So this paper attempts to review the various policies and measures undertaken by Indian government for promotion of renewable energy. The aim of this paper is also to review the current policy mechanisms, especially investment- or generation-based price-driven and capacity-driven mechanisms, ranging from investment incentives for the development of renewable energy projects, feed-in tariffs, production tax incentives, tradable green certificates, and their effects upon the prospects of encouraging as well as expanding the development of renewable energy in Indian restructured power sector. This will make renewable more attractive in the Indian future electricity market. (author)

  20. Fast Food Pattern and Cardiometabolic Disorders: A Review of Current Studies

    Directory of Open Access Journals (Sweden)

    Zahra Bahadoran

    2015-12-01

    Full Text Available Background: There are growing concern globally regarding the alarming trend of fast food consump­tion and its related cardiometabolic outcomes including overweight and obesity. This study aimed to review the current evidences available in relation to adverse effects of fast food pattern on cardiometa­bolic risk factors. Methods: Relevant articles including epidemiological and clinical studies with appropriate design and good quality were obtained through searches of the Medline, PubMed, Scopus databases and Google scholar with related key words including "fast foods", "processed foods", "obesity", "overweight", "insulin resistance", "diabetes", "cardiovascular disease", "metabolic syndrome", "dyslipidemia" and "hypertension". Results: Fast food consumption and out-of-home eating behavior is a main risk factor for lower diet quality, higher calorie and fat intake and lower micronutrients density of diet. Frequent consumption of fast foods was accompanied with overweight and abdominal fat gain, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress. Higher fast food consumption also increases the risk of developmental diabetes, metabolic syndrome and cardiovascular disease. Conclusion: This review provides further evidence warning us against the irreparable effects of fast food consumption on public health especially the increasing global burden of obesity and cardiovascu­lar diseases.

  1. Review of Current Experience on Intermediate Heat Exchanger (IHX) and A Recommended Code Approach

    Energy Technology Data Exchange (ETDEWEB)

    Duane Spencer; Kevin McCoy

    2010-02-02

    The purpose of the ASME/DOE Gen IV Task 7 Part I is to review the current experience on various high temperature reactor intermediate heat exchanger (IHX) concepts. There are several different IHX concepts that could be envisioned for HTR/VHTR applications in a range of temperature from 850C to 950C. The concepts that will be primarily discussed herein are: (1) Tubular Helical Coil Heat Exchanger (THCHE); (2) Plate-Stamped Heat Exchanger (PSHE); (3) Plate-Fin Heat Exchanger (PFHE); and (4) Plate-Machined Heat Exchanger (PMHE). The primary coolant of the NGNP is potentially subject to radioactive contamination by the core as well as contamination from the secondary loop fluid. To isolate the radioactivity to minimize radiation doses to personnel, and protect the primary circuit from contamination, intermediate heat exchangers (IHXs) have been proposed as a means for separating the primary circuit of the NGNP (Next Generation Nuclear Plant) or other process heat application from the remainder of the plant. This task will first review the different concepts of IHX that could be envisioned for HTR/VHTR applications in a range of temperature from 850 to 950 C. This will cover shell-and-tube and compact designs (including the platefin concept). The review will then discuss the maturity of the concepts in terms of design, fabricability and component testing (or feedback from experience when applicable). Particular attention will be paid to the feasibility of developing the IHX concepts for the NGNP with operation expected in 2018-2021. This report will also discuss material candidates for IHX applications and will discuss specific issues that will have to be addressed in the context of the HTR design (thermal aging, corrosion, creep, creep-fatigue, etc). Particular attention will be paid to specific issues associated with operation at the upper end of the creep regime.

  2. Review of Current Experience on Intermediate Heat Exchanger (IHX) and A Recommended Code Approach

    International Nuclear Information System (INIS)

    Spencer, Duane; McCoy, Kevin

    2010-01-01

    The purpose of the ASME/DOE Gen IV Task 7 Part I is to review the current experience on various high temperature reactor intermediate heat exchanger (IHX) concepts. There are several different IHX concepts that could be envisioned for HTR/VHTR applications in a range of temperature from 850C to 950C. The concepts that will be primarily discussed herein are: (1) Tubular Helical Coil Heat Exchanger (THCHE); (2) Plate-Stamped Heat Exchanger (PSHE); (3) Plate-Fin Heat Exchanger (PFHE); and (4) Plate-Machined Heat Exchanger (PMHE). The primary coolant of the NGNP is potentially subject to radioactive contamination by the core as well as contamination from the secondary loop fluid. To isolate the radioactivity to minimize radiation doses to personnel, and protect the primary circuit from contamination, intermediate heat exchangers (IHXs) have been proposed as a means for separating the primary circuit of the NGNP (Next Generation Nuclear Plant) or other process heat application from the remainder of the plant. This task will first review the different concepts of IHX that could be envisioned for HTR/VHTR applications in a range of temperature from 850 to 950 C. This will cover shell-and-tube and compact designs (including the platefin concept). The review will then discuss the maturity of the concepts in terms of design, fabricability and component testing (or feedback from experience when applicable). Particular attention will be paid to the feasibility of developing the IHX concepts for the NGNP with operation expected in 2018-2021. This report will also discuss material candidates for IHX applications and will discuss specific issues that will have to be addressed in the context of the HTR design (thermal aging, corrosion, creep, creep-fatigue, etc). Particular attention will be paid to specific issues associated with operation at the upper end of the creep regime.

  3. Modulation of Perception or Emotion? A Scoping Review of Tinnitus Neuromodulation Using Transcranial Direct Current Stimulation.

    Science.gov (United States)

    Shekhawat, Giriraj Singh; Stinear, Cathy M; Searchfield, Grant D

    2015-10-01

    Tinnitus is the phantom perception of sound and can have negative effect on the quality of life. Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique, which can increase or decrease the cortical excitability in the brain region to which it is applied. tDCS has been used for tinnitus research since 2006. To investigate whether tDCS affects tinnitus perception, related emotion, or both, and the potential implications for tinnitus management. A scoping review was undertaken using the methods proposed by Arksey and O'Malley. After initial consideration of title relevance and reading abstracts, 15 studies were included in this review. The data from these studies were charted to investigate the impact of tDCS on tinnitus perception and emotions. tDCS results in transient suppression of tinnitus loudness and annoyance; however, it does not lead to long-term impact on tinnitus related emotion. Local stimulation of different sites of stimulation (left temporoparietal area, dorsolateral prefrontal cortex, and auditory cortex) might modulate tinnitus perception (loudness) and emotions differently; however, further research is needed to explore this hypothesis. This review has identified aspects of methodologies that require attention in upcoming tinnitus and tDCS trials to offer better insights. tDCS is an effective research tool for transient tinnitus neuromodulation. However, efforts should be invested in designing clinical trials using local and multiple sites of stimulation, optimized parameters, and objective outcome measures before it can be translated in to a clinical tool for tinnitus management. © The Author(s) 2015.

  4. Breaking the Mold: A Review of Mucormycosis and Current Pharmacological Treatment Options.

    Science.gov (United States)

    Riley, Treavor T; Muzny, Christina A; Swiatlo, Edwin; Legendre, Davey P

    2016-09-01

    To review the current literature for the pathogenesis of mucormycosis, discuss diagnostic strategies, and evaluate the efficacy of polyenes, triazoles, and echinocandins as pharmacological treatment options. An electronic literature search was conducted in PubMed using the MESH terms Rhizopus, zygomycetes, zygomycosis, Mucorales and mucormycosis, with search terms amphotericin B, micafungin, anidulafungin, caspofungin, extended infusion amphotericin B, liposomal amphotericin B, combination therapy, triazole, posaconazole, isavuconazole, diagnosis, and clinical manifestations. Studies written in the English language from January 1960 to March 2016 were considered for this review article. All search results were reviewed, and the relevance of each article was determined by the authors independently. Mucormycosis is a rare invasive fungal infection with an exceedingly high mortality and few therapeutic options. It has a distinct predilection for invasion of endothelial cells in the vascular system, which is likely important in dissemination of disease from a primary focus of infection. Six distinct clinical syndromes can occur in susceptible hosts, including rhino-orbital-cerebral, pulmonary, gastrointestinal, cutaneous, widely disseminated, and miscellaneous infection. Diagnosis of mucormycosis is typically difficult to make based on imaging studies, sputum culture, bronchoalveolar lavage culture, or needle aspirate. Surgical debridement prior to dissemination of infection improves clinical outcomes. Surgery combined with early, high-dose systemic antifungal therapy yields greater than a 1.5-fold increase in survival rates. The Mucorales are inherently resistant to most widely used antifungal agents. Amphotericin B is appropriate for empirical therapy, whereas posaconazole and isavuconazole are best reserved for de-escalation, refractory cases, or patients intolerant to amphotericin B. © The Author(s) 2016.

  5. Current state of virtual reality simulation in robotic surgery training: a review.

    Science.gov (United States)

    Bric, Justin D; Lumbard, Derek C; Frelich, Matthew J; Gould, Jon C

    2016-06-01

    Worldwide, the annual number of robotic surgical procedures continues to increase. Robotic surgical skills are unique from those used in either open or laparoscopic surgery. The acquisition of a basic robotic surgical skill set may be best accomplished in the simulation laboratory. We sought to review the current literature pertaining to the use of virtual reality (VR) simulation in the acquisition of robotic surgical skills on the da Vinci Surgical System. A PubMed search was conducted between December 2014 and January 2015 utilizing the following keywords: virtual reality, robotic surgery, da Vinci, da Vinci skills simulator, SimSurgery Educational Platform, Mimic dV-Trainer, and Robotic Surgery Simulator. Articles were included if they were published between 2007 and 2015, utilized VR simulation for the da Vinci Surgical System, and utilized a commercially available VR platform. The initial search criteria returned 227 published articles. After all inclusion and exclusion criteria were applied, a total of 47 peer-reviewed manuscripts were included in the final review. There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

  6. The neuroendocrine regulation of food intake in fish: a review of current knowledge

    Directory of Open Access Journals (Sweden)

    Helene Volkoff

    2016-11-01

    Full Text Available Fish are the most diversified group of vertebrates and, although progress has been made in the past years, only relatively few fish species have been examined to date, with regards to the endocrine regulation of feeding in fish. In fish, as in mammals, feeding behavior is ultimately regulated by central effectors within feeding centers of the brain, which receive and process information from endocrine signals from both brain and peripheral tissues. Although basic endocrine mechanisms regulating feeding appear to be conserved among vertebrates, major physiological differences between fish and mammals and the diversity of fish, in particular in regard to feeding habits, digestive tract anatomy and physiology, suggest the existence of fish- and species-specific regulating mechanisms. This review provides an overview of hormones known to regulate food intake in fish, emphasizing on major hormones and the main fish groups studied to date.

  7. Current applications of robotics in spine surgery: a systematic review of the literature.

    Science.gov (United States)

    Joseph, Jacob R; Smith, Brandon W; Liu, Xilin; Park, Paul

    2017-05-01

    OBJECTIVE Surgical robotics has demonstrated utility across the spectrum of surgery. Robotics in spine surgery, however, remains in its infancy. Here, the authors systematically review the evidence behind robotic applications in spinal instrumentation. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Relevant studies (through October 2016) that reported the use of robotics in spinal instrumentation were identified from a search of the PubMed database. Data regarding the accuracy of screw placement, surgeon learning curve, radiation exposure, and reasons for robotic failure were extracted. RESULTS Twenty-five studies describing 2 unique robots met inclusion criteria. Of these, 22 studies evaluated accuracy of spinal instrumentation. Although grading of pedicle screw accuracy was variable, the most commonly used method was the Gertzbein and Robbins system of classification. In the studies using the Gertzbein and Robbins system, accuracy (Grades A and B) ranged from 85% to 100%. Ten studies evaluated radiation exposure during the procedure. In studies that detailed fluoroscopy usage, overall fluoroscopy times ranged from 1.3 to 34 seconds per screw. Nine studies examined the learning curve for the surgeon, and 12 studies described causes of robotic failure, which included registration failure, soft-tissue hindrance, and lateral skiving of the drill guide. CONCLUSIONS Robotics in spine surgery is an emerging technology that holds promise for future applications. Surgical accuracy in instrumentation implanted using robotics appears to be high. However, the impact of robotics on radiation exposure is not clear and seems to be dependent on technique and robot type.

  8. Psychological, pharmacological, and combined smoking cessation interventions for smokers with current depression: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Roberto Secades-Villa

    Full Text Available We conducted a systematic literature review and meta-analysis (ID: CRD42016051017 of smoking cessation interventions for patients with current depression. We examined the effectiveness of smoking cessation treatments in improving abstinence rates and depressive symptoms. The following electronic databases were used for potentially eligible studies: PUBMED, PSYCINFO, DIALNET and WEB OF KNOWLEDGE. The search terms used were: smoking cessation, depressive disorder, depression, mood, depressive, depressed, smoking, smokers, nicotine, nicotine dependence, and tobacco cigarette smoking. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality assessment tool (EPHPP. Of the 6,584 studies identified, 20 were eligible and included in the review. Trial designs of studies were 16 randomized controlled trials and 4 secondary studies. Studies included three types of intervention: psychological (6/30%, pharmacological (6/30% or combined (8/40%. Four trials comprised special populations of smokers. Four studies received a strong methodological quality, 7 were scored as moderate and 9 studies received a weak methodological rating. Analyses of effectiveness showed that smoking cessation interventions appear to increase short-term and long-term smoking abstinence in individuals with current depression. Subgroup analyses revealed stronger effects among studies that provided pharmacological treatments than in studies using psychological treatments. However, the evidence is weak due to the small number of studies. Smoking abstinence appears to be associated with an improvement in depressive symptoms. Heterogeneity in protocols in similar types of treatment also prevent firm conclusions being drawn on the effectiveness of any particular treatment model to optimally manage abstinence among depressed smokers. Further research is required to strengthen the evidence base.

  9. Physical examination in undergraduate medical education in the field of general practice - a scoping review.

    Science.gov (United States)

    Moßhammer, Dirk; Graf, Joachim; Joos, Stefanie; Hertkorn, Rebekka

    2017-11-25

    Physical examination (PE) is an essential clinical skill and a central part of a physician's daily activity. Teaching of PE has been integrated into medical school by many clinical disciplines with respective specific examination procedures. For instance, PE teaching in general practice may include a full-body examination approach. Studies show that PE-skills of medical students often need enhancement. The aim of this article was to scope the literature regarding the teaching and research of PE within general practice during undergraduate medical education. We evaluated a wide breadth of literature relating to the content, study design, country of research institution and year of publication. Literature search in Medline along the PRISMA-P protocol was performed by search syntax ("physical examination" AND "medical education" AND "undergraduate" AND general practice) considering Medline MeSH (Medical Subject Heading)-Terms and Medline search term tree structure. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. Full texts were analyzed by publication year, country of origin, study design and content (by categorizing articles along their main topic according to qualitative content analysis of Mayring). One-hundred seven articles were included. The annual number of publications ranged from 4 to 14 and had a slightly rising trend since 2000. Nearly half of the publications originated from the United States (n = 54), 33 from Canada and the United Kingdom. Overall, intervention studies represented the largest group (n = 60, including uncontrolled and controlled studies, randomized and non-randomized), followed by cross-sectional studies (n = 29). The 117 studies could be assigned to five categories "teaching methods (n = 53)", "teaching quality (n = 33)", "performance evaluation and examination formats (n=19)", "students' views (n = 8)" and "patients' and standardized patients' views

  10. Text mining of cancer-related information: review of current status and future directions.

    Science.gov (United States)

    Spasić, Irena; Livsey, Jacqueline; Keane, John A; Nenadić, Goran

    2014-09-01

    This paper reviews the research literature on text mining (TM) with the aim to find out (1) which cancer domains have been the subject of TM efforts, (2) which knowledge resources can support TM of cancer-related information and (3) to what extent systems that rely on knowledge and computational methods can convert text data into useful clinical information. These questions were used to determine the current state of the art in this particular strand of TM and suggest future directions in TM development to support cancer research. A review of the research on TM of cancer-related information was carried out. A literature search was conducted on the Medline database as well as IEEE Xplore and ACM digital libraries to address the interdisciplinary nature of such research. The search results were supplemented with the literature identified through Google Scholar. A range of studies have proven the feasibility of TM for extracting structured information from clinical narratives such as those found in pathology or radiology reports. In this article, we provide a critical overview of the current state of the art for TM related to cancer. The review highlighted a strong bias towards symbolic methods, e.g. named entity recognition (NER) based on dictionary lookup and information extraction (IE) relying on pattern matching. The F-measure of NER ranges between 80% and 90%, while that of IE for simple tasks is in the high 90s. To further improve the performance, TM approaches need to deal effectively with idiosyncrasies of the clinical sublanguage such as non-standard abbreviations as well as a high degree of spelling and grammatical errors. This requires a shift from rule-based methods to machine learning following the success of similar trends in biological applications of TM. Machine learning approaches require large training datasets, but clinical narratives are not readily available for TM research due to privacy and confidentiality concerns. This issue remains the main

  11. Partitioning and transmutation (P and D) 1995. A review of the current state of the art

    International Nuclear Information System (INIS)

    Skaalberg, M.; Landgren, A.; Spjuth, L.; Liljenzin, J.O.; Gudowski, W.

    1995-12-01

    The recent development in the field of partitioning and transmutation (P/T) is reviewed and evaluated. Current national and international R and D efforts are summarized. Nuclear transmutation with energy production is feasible in nuclear reactors where fast and thermal breeders are the most efficient for transmutation purposes. The operation of subcritical nuclear reactors by high current proton accelerators that generate neutrons in a spallation target is also an interesting option for transmutation and energy production, that has to be more carefully evaluated. These accelerator-driven systems are probably the only solution for the transmutation of long-lived fission products with small neutron capture cross sections and actinide isotopes with small fission cross sections. The requirements on the separation chemistry in the partitioning process depends on the transmutation strategy chosen. Recent developments in aqueous based separation chemistry opens some interesting possibilities to meet some of the requirements, such as separation of different actinides and some fission products and reduction of secondary waste streams. In the advanced accelerator-driven transmutation systems proposed, liquid fuels such as molten salts are considered. The partitioning processes that can be used for these types of fuel will, however, require a long term research program. The possibility to use centrifuge separation is an interesting partitioning option that recently has been proposed. 51 refs, 7 figs, 3 tabs

  12. Review on the current status of molten chloride reactor and its future prospect

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Seok Bin; Shin, Yukyung; Bang, In Cheol [UNIST, Ulsan (Korea, Republic of)

    2016-10-15

    This paper has summarized and reviewed the current status of MCR as an online pyroprocessing reactor, and introduced the related works in UNIST. As the developments of the next generation nuclear energy systems require the fuel sustainability, passive operation safety, nuclear proliferation, and reduction of highly radioactive waste, only several types of nuclear reactor systems survive to the last. Among these, molten salt reactor (MSR) is one of the most promising concepts of next generation nuclear reactor system that deliver on these requirements. MSR have great advantages in the fuel cycle and reduction of nuclear waste, since MSR can serve the online reprocessing system for the reprocessing of spent fuel. Especially, MSR utilizing chloride-based fuel, called molten chloride reactor (MCR) has been recently highlighted in USA under the DOE’s Gateway for Accelerated Innovation in Nuclear (GAIN) program. Recently, the interests in the molten chloride salt have arisen. The use of chloride-based salt gives great advantages to the reactor operating in a fast spectrum. Then MCR can serve waste management functions or fuel cycle sustainability functions, which can solve the current issues in nuclear field. Thus, research plan was established in UNIST which includes the investigation of thermal-hydraulic characteristics of chloride salt and optimization of heat transport system of MCR, using both numerical method and experimental method.

  13. Transcranial alternating current stimulation: A review of the underlying mechanisms and modulation of cognitive processes

    Directory of Open Access Journals (Sweden)

    Christoph S Herrmann

    2013-06-01

    Full Text Available Brain oscillations of different frequencies have been associated with a variety of cognitive functions. Convincing evidence supporting those associations has been provided by studies using intracranial stimulation, pharmacological interventions and lesion studies. The emergence of novel non-invasive brain stimulation techniques like repetitive transcranial magnetic stimulation (rTMS and transcranial alternating current stimulation (tACS now allows to modulate brain oscillations directly. Particularly, tACS offers the unique opportunity to causally link brain oscillations of a specific frequency range to cognitive processes, because it uses sinusoidal currents that are bound to one frequency only. Using tACS allows to modulate brain oscillations and in turn to influence cognitive processes, thereby demonstrating the causal link between the two. Here, we review findings about the physiological mechanism of tACS and studies that have used tACS to modulate basic motor and sensory processes as well as higher cognitive processes like memory, ambiguous perception, and decision making.

  14. [A review of current studies on leisure activities performed by community-dwelling elders].

    Science.gov (United States)

    Li, Yueh-Ping; Chen, Ching-Huey

    2010-02-01

    This article reviewed and summarized the findings of previously published studies on the leisure activities of community elders over 55 years of age. A total of 17 related articles, published before 2008, were identified in the search of electronic databases, which included the Chinese Periodical Table of Contents Index Image System, CEPS, Medline and Ageline. Leisure activities measurements used in this study consisted of recoding activities either categorically or by frequency. The majority of research indicated that elderly engage in primarily static activities and that participation in leisure activities had positive effects on cognitive and psychological health. However, inconsistencies in results were found due to differences in measurement tools and sample populations used among studies, making it difficult to conduct a valid comparison of specific features of elderly leisure activities. Most current leisure activity studies utilize cross-sectional research methodologies with restricted topics, which result in limited applicability of research results. In conclusion, we suggest that future studies should develop instruments to assess leisure activities that correspond to local conditions identified through qualitative research. With such, researchers can study different age groups by applying relevant ageing theories to construct empirical data related to current elderly leisure activities.

  15. Synergistic effects of Chinese herbal medicine: a comprehensive review of methodology and current research

    Directory of Open Access Journals (Sweden)

    Xian Zhou

    2016-07-01

    Full Text Available Traditional Chinese medicine is an important part of primary health care in Asian countries that has utilised complex herbal formulations (consisting 2 or more medicinal herbs for treating diseases over thousands of years. There seems to be a general assumption that the synergistic therapeutic effects of Chinese herbal medicine derive from the complex interactions between the multiple bioactive components within the herbs and/or herbal formulations. However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of Chinese herbal medicine, misconceptions about synergy, methodological challenges to study design. In this review, we clarify the definition of synergy, identify common errors in synergy research and describe current methodological approaches to test for synergistic interaction. We discuss the strengthen and weakness of these models in the context of Chinese herbal medicine and summarise the current status of synergy research in CHM. Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low and the clinical relevancy of most of these findings is undetermined. There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.

  16. Intercultural Communicative Competence: A Brief Review of Current Thinking and Literature

    Directory of Open Access Journals (Sweden)

    Masoud Kermani Kojour

    2016-12-01

    Full Text Available The present study aims to review current thinking and understanding of the issue of Intercultural Communicative Competence (ICC especially in foreign language education contexts. There are serious stances on the part of scholars in foreign language contexts, which must be given some serious thinking and consideration in order to uncover the hidden agendas regarding ICC. After all, it seems still unclear in English as a Foreign Language (EFL contexts whether to try to improve the way of thinking regarding the perspective of current intercultural communicative competence, whether there should be a separation of the cultural values from the target language and only integrate language learners’ native culture with the target language. Given the development of technology and globalization, what is the right thing to do? This is a serious issue which needs much attention and contemplation by the interested scholars. By presenting the existing gaps in the literature, the paper maneuvers on the challenging notes on benefiting from culture in English Language Teaching (ELT and, on the other hand, dividing language and culture by merely elaborating on the communicative aspect of language learning and teaching. The study puts the audience into question that although recent views are focusing on taking English as an international means of communication, there exist serious beliefs regarding the separation of language and culture, which demands more thinking and probably serious revisions.

  17. Review: Semen sexing - current state of the art with emphasis on bovine species.

    Science.gov (United States)

    Vishwanath, R; Moreno, J F

    2018-06-01

    It is approaching three decades since the first public evidence of sex-sorting of semen. The technology has progressed considerably since then with a number of institutions and researchers collaborating to eventually bring this to application. The technical challenges have been quite substantial and in the early years the application was limited to only heifer inseminations. Comparable fertility of sex-sorted semen with conventional semen has been an aspirational benchmark for the industry for many years. Significant investment in research in the primary biology of sex-sorted sperm and associated sorting equipment ensured steady progress over the years and current methods particularly the new SexedULTRA-4M™ seems to have now mostly bridged this fertility gap. The dairy and beef industry have adopted this technology quite rapidly. Other animal industries are progressively testing it for application in their specific niches and environments. The current state of the art in the fundamentals of sex-sorting, the biology of the process as well as new developments in machinery are described in this review.

  18. Transfusion medicine and solid organ transplant - Update and review of some current issues.

    Science.gov (United States)

    Sarkar, R S; Philip, J; Yadav, Pramod

    2013-04-01

    Transfusion medicine holds a place of prime importance in organ transplant surgeries. There is a huge demand of organs worldwide with long waiting periods before the organ is available for transplant. Currently the dependency on ABO and HLA matching has decreased considerably with the use of modern immunosuppressant drugs and transplant techniques. The greatest advance in clinical implementation of ABO-incompatible transplants came about through desensitization and isoagglutinin elimination techniques with immunoadsorption and anti-CD20 antibodies becoming the norm, and spleenectomy fading out. The implications and practices of transfusion medicine in organ transplant are also undergoing drastic changes. The practice of infusion of one unit of donor's blood preoperatively for immunomodulation is no longer practiced. Use of leuco-reduced products has shown decreasing trends of alloimmunization and graft rejection in cases of multiple surgeries related to organ transplants. Worldwide donor and recipient registry programmes are being setup and existing ones are being upgraded. Such a registry system has been opened in India for kidney transplant cases very recently. Due to such registry programmes the dependency on siblings and directed donations have decreased considerably. This review deals with some of the current issues contributing to the successful outcome of mismatched transplants and the changing concepts of transfusion medicine related to it.

  19. Technical standardization of oil well abandonment: a review of current standards and technologies

    Energy Technology Data Exchange (ETDEWEB)

    Suzart, J. Walter P.; Pessoa, Laudemar; Paiva, Maria [Halliburton Energy Services (HES), Duncan, OK (United States)

    2008-07-01

    The objective of this study is to provide a new methodology for well abandonment. This practice is becoming more and more important because of the increasing number of production fields being abandoned. We strongly recommend a study of cement slurries properties for specific use in temporary and permanent abandonment plugs based on the estimation of the cement slurry hardened when placed in the well. By using specific additives, it is possible to achieve very stable slurries. For example, when permeability is reduced, formation fluid migration can be blocked and chemical reactions between the fluid and the slurry may be inhibited. With this objective, we present a laboratory investigation model and an example of slurry testing recommendation. During the abandonment operation, all records of the well characteristics should be maintained to include the reason for the abandonment, and location of fresh water, brine, and hydrocarbon zones that may exist. This documentation will also allow the analysis of solutions for the problems that originally caused the abandonment of the well. This data could be important for future use by environmental protection commissions to reopen or to drill an adjacent well. Given the high price of oil, it may now be economically feasible to reopen the well, if the reason for abandonment was low productivity. This way, a critical analysis of the current conditions of well and field abandonment in the country is presented. Based on this information, a review of the current standards is suggested. (author)

  20. Review on the current status of molten chloride reactor and its future prospect

    International Nuclear Information System (INIS)

    Seo, Seok Bin; Shin, Yukyung; Bang, In Cheol

    2016-01-01

    This paper has summarized and reviewed the current status of MCR as an online pyroprocessing reactor, and introduced the related works in UNIST. As the developments of the next generation nuclear energy systems require the fuel sustainability, passive operation safety, nuclear proliferation, and reduction of highly radioactive waste, only several types of nuclear reactor systems survive to the last. Among these, molten salt reactor (MSR) is one of the most promising concepts of next generation nuclear reactor system that deliver on these requirements. MSR have great advantages in the fuel cycle and reduction of nuclear waste, since MSR can serve the online reprocessing system for the reprocessing of spent fuel. Especially, MSR utilizing chloride-based fuel, called molten chloride reactor (MCR) has been recently highlighted in USA under the DOE’s Gateway for Accelerated Innovation in Nuclear (GAIN) program. Recently, the interests in the molten chloride salt have arisen. The use of chloride-based salt gives great advantages to the reactor operating in a fast spectrum. Then MCR can serve waste management functions or fuel cycle sustainability functions, which can solve the current issues in nuclear field. Thus, research plan was established in UNIST which includes the investigation of thermal-hydraulic characteristics of chloride salt and optimization of heat transport system of MCR, using both numerical method and experimental method

  1. Diagnostic validity of physical examination tests for common knee disorders: An overview of systematic reviews and meta-analysis.

    Science.gov (United States)

    Décary, Simon; Ouellet, Philippe; Vendittoli, Pascal-André; Roy, Jean-Sébastien; Desmeules, François

    2017-01-01

    More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR. Seventeen reviews were included with mean AMSTAR score of 5.5 ± 2.3. Based on six SR, only the Lachman test for ACL injuries is diagnostically valid when individually performed (Likelihood ratio (LR+):10.2, LR-:0.2). Based on two SR, the Ottawa Knee Rule is a valid screening tool for knee fractures (LR-:0.05). Based on one SR, the EULAR criteria had a post-test probability of 99% for the diagnosis of knee osteoarthritis. Based on two SR, a complete physical examination performed by a trained health provider was found to be diagnostically valid for ACL, PCL and meniscal injuries as well as for cartilage lesions. When individually performed, common physical tests are rarely able to rule in or rule out a specific knee disorder, except the Lachman for ACL injuries. There is low-quality evidence concerning the validity of combining history elements and physical tests. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Examining Factors of Engagement With Digital Interventions for Weight Management: Rapid Review.

    Science.gov (United States)

    Sharpe, Emma Elizabeth; Karasouli, Eleni; Meyer, Caroline

    2017-10-23

    Digital interventions for weight management provide a unique opportunity to target daily lifestyle choices and eating behaviors over a sustained period of time. However, recent evidence has demonstrated a lack of user engagement with digital health interventions, impacting on the levels of intervention effectiveness. Thus, it is critical to identify the factors that may facilitate user engagement with digital health interventions to encourage behavior change and weight management. The aim of this study was to identify and synthesize the available evidence to gain insights about users' perspectives on factors that affect engagement with digital interventions for weight management. A rapid review methodology was adopted. The search strategy was executed in the following databases: Web of Science, PsycINFO, and PubMed. Studies were eligible for inclusion if they investigated users' engagement with a digital weight management intervention and were published from 2000 onwards. A narrative synthesis of data was performed on all included studies. A total of 11 studies were included in the review. The studies were qualitative, mixed-methods, or randomized controlled trials. Some of the studies explored features influencing engagement when using a Web-based digital intervention, others specifically explored engagement when accessing a mobile phone app, and some looked at engagement after text message (short message service, SMS) reminders. Factors influencing engagement with digital weight management interventions were found to be both user-related (eg, perceived health benefits) and digital intervention-related (eg, ease of use and the provision of personalized information). The findings highlight the importance of incorporating user perspectives during the digital intervention development process to encourage engagement. The review contributes to our understanding of what facilitates user engagement and points toward a coproduction approach for developing digital

  3. Transcranial direct-current stimulation (tDCS) for bipolar depression: A systematic review and meta-analysis.

    Science.gov (United States)

    Dondé, Clément; Amad, Ali; Nieto, Isabel; Brunoni, André Russowsky; Neufeld, Nicholas H; Bellivier, Frank; Poulet, Emmanuel; Geoffroy, Pierre-Alexis

    2017-08-01

    Bipolar disorder (BD) is a severe and recurrent brain disorder that can manifest in manic or depressive episodes. Transcranial Direct Current Stimulation (tDCS) has been proposed as a novel therapeutic modality for patients experiencing bipolar depression, for which standard treatments are often inefficient. While several studies have been conducted in this patient group, there has been no systematic review or meta-analysis that specifically examines bipolar depression. We aimed to address this gap in the literature and evaluated the efficacy and tolerability of tDCS in patients fulfilling DSM-IV-TR criteria for BD I, II, or BD not otherwise specified (NOS). We systematically searched the literature from April 2002 to November 2016 to identify relevant publications for inclusion in our systematic review and meta-analysis. Effect sizes for depression rating-scale scores were expressed as the standardized mean difference (SMD) before and after tDCS. Thirteen of 382 identified studies met eligibility criteria for our systematic review. The meta-analysis included 46 patients from 7 studies with depression rating-scale scores pre- and post-tDCS. Parameters of tDCS procedures were heterogeneous. Depression scores decreased significantly with a medium effect size after acute-phase of treatment (SMD 0.71 [0.25-1.18], z=3.00, p=0.003) and at the furthest endpoint (SMD 1.27 [0.57-1.97], z=3.57, p=0.0004). Six cases of affective switching under tDCS treatment protocols were observed. Depressive symptoms respond to tDCS in patients with BD. Additional studies, and particularly randomized controlled trials, are needed to clarify the effectiveness of tDCS in bipolar depression, the frequency of tDCS-emergent hypomania/mania, and which tDCS modalities are most efficient. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Examining the Distribution, Modularity, and Community Structure in Article Networks for Systematic Reviews.

    Science.gov (United States)

    Ji, Xiaonan; Machiraju, Raghu; Ritter, Alan; Yen, Po-Yin

    2015-01-01

    Systematic reviews (SRs) provide high quality evidence for clinical practice, but the article screening process is time and labor intensive. As SRs aim to identify relevant articles with a specific scope, we propose that a pre-defined article relationship, using similarity metrics, could accelerate this process. In this study, we established the article relationship using MEDLINE element similarities and visualized the article network with the Force Atlas layout. We also analyzed the article networks with graph diameter, closeness centrality, and module classes. The results revealed the distribution of articles and found that included articles tended to aggregate together in some module classes, providing further evidence of the existence of strong relationships among included articles. This approach can be utilized to facilitate the articles selection process through early identification of these dominant module classes. We are optimistic that the use of article network visualization can help better SR work prioritization.

  5. Systematic review of sex work interventions in sub-Saharan Africa: examining combination prevention approaches.

    Science.gov (United States)

    Awungafac, George; Delvaux, Therese; Vuylsteke, Bea

    2017-08-01

    The incidence of HIV and sexually transmitted infections is disproportionately high among sex workers (SW). We aimed to update the evidence on the effectiveness of SW interventions in sub-Saharan Africa and to provide more insights into combination prevention. The Systematic review followed PRISMA guidelines in a search of PUBMED and POPLINE for peer-reviewed literature published between 1 January 2000 and 22 July 2016 (registration number on PROSPERO: CRD42016042529). We considered cohort interventions, randomised controlled trials and cross-sectional surveys of SW programmes. A framework was used in the description and mapping of intervention to desired outcomes. Twenty-six papers(reporting on 25 studies) were included. A strategy that empowered peer educator leaders to steer community activities showed a twofold increase in coverage of behaviour change communication and utilisation of health facility among SW. Brief alcohol harm reduction effort demonstrated a significant effect on sexual violence and engagement in sex trading. A risk reduction counselling intervention among drug-injecting SW showed an effect on alcohol, substance use and engagement in sex work. No study on a promising intervention like PrEP among SWs was found. We observed that interventions that combined some structural components, biomedical and behavioural strategies tend to accumulate more desired outcomes. The evidence base that can be considered in intervention designs to prevent HIV in SW in SSA is vast. The health sector should consider interventions to reduce binge alcohol intake and intravenous drug use among sex workers. Programmes should staunchly consider multicomponent approaches that explore community-based structural approaches. © 2017 John Wiley & Sons Ltd.

  6. Psychosocial assessments for young people: a systematic review examining acceptability, disclosure and engagement, and predictive utility

    Directory of Open Access Journals (Sweden)

    Bradford S

    2012-12-01

    Full Text Available Sally Bradford,1 Debra Rickwood1,21Faculty of Health, University of Canberra, Canberra, 2Headspace National Youth Mental Health Foundation, North Melbourne, AustraliaAbstract: Adolescence and young adulthood are often turbulent periods in a person’s life. There are high rates of accidental deaths, suicide, mental health concerns, substance use, and sexual experimentation. Health care professionals need to conduct holistic assessments of clients in these developmental life stages to identify psychosocial risks and provide targeted early intervention and implement prevention strategies. The most useful psychosocial assessments for most health care professionals are those that can provide a complete picture of the young person’s life and circumstances. This article identifies psychosocial assessment instruments that can be used as an initial assessment and engagement tool with the general population of young people presenting for health care. We review the psychometric properties of each of the instruments, determining what type of instrument is most acceptable to young people, whether any can increase disclosure and improve engagement between young people and health professionals, and whether they have predictive utility. The search strategy complied with the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement. A total of 89 published articles were identified, covering 31 different assessment instruments. Results indicated that those that were self-administered were most acceptable to young people, although it is unclear whether pen-and-paper or computer formats were preferred. Most psychosocial assessments can improve rates of disclosure and enhance engagement between young people and health professionals; however, worryingly, we found evidence that clinicians did not always respond to some of the most serious identified risks. Only for one instrument was there any mention of

  7. Upon Further Review: V. An Examination of Previous Lightcurve Analysis from the Palmer Divide Observatory

    Science.gov (United States)

    Warner, Brian D.

    2011-01-01

    Updated results are given for nine asteroids previously reported from the Palmer Divide Observatory (PDO). The original images were re-measured to obtain new data sets using the latest version of MPO Canopus photometry software, analysis tools, and revised techniques for linking multiple observing runs covering several days to several weeks. Results that were previously not reported or were moderately different were found for 1659 Punkajarju, 1719 Jens, 1987 Kaplan, 2105 Gudy, 2961 Katsurahama, 3285 Ruth Wolfe, 3447 Burckhalter, 7816 Hanoi, and (34817) 2000 SE116. This is one in a series of papers that will examine results obtained during the initial years of the asteroid lightcurve program at PDO.

  8. EXAMINE THE PAST FOR GOING FURTHER: A LITERATURE REVIEW IN THE FIELD OF FAIR VALUE

    Directory of Open Access Journals (Sweden)

    Andreicovici Ionela - Irina

    2011-12-01

    Full Text Available The current study is part of the scientific approach being assumed at the beginning of the Ph.D. as the theme 'New valence of evaluation in accounting' under the guidance of prof. univ. dr. Dumitru Matis. This article aims to realize a more comprehensive study of relevant literature in accounting with fair value as the main subject. We have built our study attempting to answer the following research questions: How much fair value activity has there been since 2008? What research topics are being addressed? Who is leading fair value research? What are the limitations of current research? To achieve our proposed objectives we analyzed two databases (Science Direct and Business Source Premier during 2008-2011, analyzing in detail a total of 22 articles divided into five specific research directions: international regulations on fair value accounting, fair Value Accounting and Financial Crisis, financial reporting at fair value, the relevance of fair value and fair value versus historical cost. With this research we try to see 'what is known' in the field of fair value so far . In addition to qualitative analysis which we performed to discover the interest of researchers in this field, we conducted a quantitative analysis concerning the reported studies , being divided into research themes, research methodology and year of the article publication. Quantitative research results are those anticipated, that the most 'fair value activity ' took place in 2008 and 2009, surveys having as main research theme international regulations on fair value accounting.

  9. A rapid review examining purchasing changes resulting from fiscal measures targeted at high sugar foods and sugar-sweetened drinks.

    Science.gov (United States)

    Roberts, Katharine E; Ells, Louisa J; McGowan, Victoria J; Machaira, Theodora; Targett, Victoria C; Allen, Rachel E; Tedstone, Alison E

    2017-12-15

    To aim of the review was to examine the most recent (2010 onwards) research evidence on the health and behavioural impacts, in adults and children, of fiscal strategies that target high sugar foods and sugar-sweetened drinks (SSDs). A pragmatic rapid review was undertaken using a systematic search strategy. The review was part of a programme of work to support policy development in relation to high sugar food and SSDs. A total of 11 primary research publications were included, describing evidence from France (n = 1), the Netherlands (n = 3), and the United States of America (n = 7), assessed through a variety of study designs, with the majority in adult populations (n = 10). The evidence reviewed focused on consumer behaviour outcomes and suggested that fiscal strategies can influence purchases of high sugar products. Although the majority of studies (n = 10), including three field studies, demonstrated that an increase in the price of high sugar foods and SSDs resulted in a decrease in purchases, eight studies were conducted in a laboratory or virtual setting which may not reflect real-life situations.Findings from this review support evidence from the broader literature that suggests that fiscal measures can be effective in influencing the purchasing of high sugar foods and SSDs.

  10. The viper fangs: clinical anatomy, principles of physical examination and therapy (a review

    Directory of Open Access Journals (Sweden)

    Matteo Oliveri

    2016-01-01

    Full Text Available The assessment of fangs is a fundamental part of clinical examination of viperid snakes. The long curved venom fang is carried by short, highly mobile maxilla. Short anaesthesia is advised for safe physical examination and radiography of the mouth cavity. The fangs are gently forced outside the fang pocket by passing the bar or forceps on the palato-maxillary arch, and rotating them rostrally shifting the mucosal fold. Functional fangs are periodically shed and several generations of replacement teeth lie behind and beneath each fang. In case of fang fracture, therapy should be limited to flushing with a solution of chlorhexidine or povidone iodine, and topical application of pro-coagulant and antibacterial cream. Therapy of chronic fang inflammation is based on removal of necrotized fang and repeated abundant irrigation of the fang pocket. Treatment of chronic stomatitis consists of flushing with chlorhexidine or povidone iodine, physical removal of the plaques, administration of analgesics and antibiotics (marbofloxacin, enrofloxacin or ceftazidime. Extra-oral surgical approach is the best method for odontogenic abscess removal. A vigorous flushing with sterile saline solution, chlorhexidine and povidone iodine and topical application of antibiotics (antibiotic embedded surgical sponge is advised. Force feeding of the anorectic patient suffering from fang inflammation is a mandatory part of the standard treatment protocol.

  11. Producing Cochrane systematic reviews-a qualitative study of current approaches and opportunities for innovation and improvement.

    Science.gov (United States)

    Turner, Tari; Green, Sally; Tovey, David; McDonald, Steve; Soares-Weiser, Karla; Pestridge, Charlotte; Elliott, Julian

    2017-08-01

    Producing high-quality, relevant systematic reviews and keeping them up to date is challenging. Cochrane is a leading provider of systematic reviews in health. For Cochrane to continue to contribute to improvements in heath, Cochrane Reviews must be rigorous, reliable and up to date. We aimed to explore existing models of Cochrane Review production and emerging opportunities to improve the efficiency and sustainability of these processes. To inform discussions about how to best achieve this, we conducted 26 interviews and an online survey with 106 respondents. Respondents highlighted the importance and challenge of creating reliable, timely systematic reviews. They described the challenges and opportunities presented by current production models, and they shared what they are doing to improve review production. They particularly highlighted significant challenges with increasing complexity of review methods; difficulty keeping authors on board and on track; and the length of time required to complete the process. Strong themes emerged about the roles of authors and Review Groups, the central actors in the review production process. The results suggest that improvements to Cochrane's systematic review production models could come from improving clarity of roles and expectations, ensuring continuity and consistency of input, enabling active management of the review process, centralising some review production steps; breaking reviews into smaller "chunks", and improving approaches to building capacity of and sharing information between authors and Review Groups. Respondents noted the important role new technologies have to play in enabling these improvements. The findings of this study will inform the development of new Cochrane Review production models and may provide valuable data for other systematic review producers as they consider how best to produce rigorous, reliable, up-to-date reviews.

  12. Feeling lonely in the lab: A literature review and partial examination of recent loneliness induction procedures for experiments

    Directory of Open Access Journals (Sweden)

    Pels Fabian

    2017-01-01

    Full Text Available Few laboratory experiments have been conducted in loneliness research in the past. Therefore, the purpose of this article is to review, partially investigate and discuss loneliness induction procedures in order to facilitate future laboratory experiments in loneliness research (e.g. to examine the link between loneliness and social cognition. Previous studies have found both unconscious (i.e. professional hypnosis and conscious (i.e. recalling and calling out lonely experiences procedures to be successful in inducing loneliness. Another conscious procedure (i.e. recalling and writing down lonely experiences that has been described in recent literature has not yet been examined. Therefore, the present study aimed to examine this procedure using a one-group before-after design. However, this procedure, in which the participants had to recall and write down two lonely situations, was not found to significantly induce loneliness. Of 16 participants, only three reported at least some higher feelings of loneliness following this procedure.

  13. Imaging examinations and diagnosis of children's ectopic uretal aperture (with a review of 68 cases)

    International Nuclear Information System (INIS)

    Zhai Jiankun; Liu Liwei

    2004-01-01

    Objective: To discuss the imaging findings and examination methods of ectopic uretal aperture in children. Methods: The clinical data, imaging methods and findings of 68 cases with ectopic uretal aperture were analyzed retrospectively. Results: In 44 cases ectopic uretal aperture were associated with duplex kidneys (DK), and in 24 cases ectopic uretal aperture were associated with dysplasia of kidneys. IVU could display direct or indirect signs of DK in all cases. While it could hardly display dysplastic kidney and ectopic uretal aperture. CT scans were performed in 8 patients, in which DK, dysplastic kidney and the draining ureters could be evaluated. Conclusion: Definitive diagnosis is made in most cases with the integrating the clinical information and IVU findings. However, CT scan is recommended in a few cases

  14. Nuclear medicine technology. Review questions for the board examinations. 4. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Ramer, Karen [Ochotnicky Partners s.r.o., Marianka (Slovakia); Mantel, Eleanor [Pennsylvania Univ., Hammonton, NJ (United States). Nuclear Medicine/Molecular Imaging; Reddin, Janet S.; Alavi, Abass [Pennsylvania Univ., Philadelphia, PA (United States). Radiology/Nuclear Medicine; Cheng, Gang [Philadelphia VA Medical Center, PA (United States). Radiology

    2013-07-01

    The only comprehensive exam preparation guide on the market. Includes a mock registry exam. Provides expanded coverage of positron emission tomography and other new procedures and practices. This book prepares students and technologists for registry examinations in nuclear medicine technology by providing practice questions and answers with detailed explanations, as well as a mock registry exam. The questions are designed to test the basic knowledge required of nuclear medicine technologists, as well as the practical application of that knowledge. The topics covered closely follow the content specifications and the components of preparedness as published by the certification boards. This 4th edition includes expanded coverage of positron emission tomography and other new procedures and practices in the field of nuclear medicine and molecular imaging.

  15. The second eddy current testing of zircaloy tube samples from the OECD Halden reactor project at Reactor Fuel Examination Facility, Tokai, JAERI

    International Nuclear Information System (INIS)

    Ohwada, Isao; Nishino, Yasuharu

    1986-07-01

    The Reactor Fuel Examination Facility in Tokai/JAERI (Japan Atomic Energy Research Institute) joined to the second round robin programme on eddy current test of the Halden/IFE. In the programme, two zircaloy tube samples with some artificial defects were provided for measurements. To clarify the locations in axial and azimuthal directions, types and dimensions of the provided artificial defects, measured signals from eddy current test were analysed in comparison with the known defects on the calibration tube. As a result, fourteen defects were determined from the measurements. Then, the location, the type and the relative dimension of them were also revealed. The results of those eddy current test are described in this paper. (author)

  16. Current status of solid waste management in small island developing states: A review

    International Nuclear Information System (INIS)

    Mohee, Romeela; Mauthoor, Sumayya; Bundhoo, Zumar M.A.; Somaroo, Geeta; Soobhany, Nuhaa; Gunasee, Sanjana

    2015-01-01

    Highlights: • Waste management is a matter of great concern for small island developing states. • On average, waste generation rate in these islands amounts to 1.29 kg/capita/day. • Illegal dumping and landfilling prevail in most small island developing states. • Sustainable waste management practices, previously absent, are now emerging. • However, many challenges still hinder the implementation of these practices. - Abstract: This article reviews the current status of waste management in Small Island Developing States (SIDS) and the challenges that are faced in solid waste management. The waste generation rates of SIDS were compared within the three geographic regions namely Caribbean SIDS, Pacific SIDS and Atlantic, Indian Ocean, Mediterranean and South China (AIMS) SIDS and with countries of the Organisation for Economic Co-Operation and Development (OECD). Only Pacific SIDS had a waste generation rate less than 1 kg/capita/day. The waste generation rates for the three SIDS regions averaged 1.29 kg/capita/day while that for OECD countries was at a mean value of 1.35 kg/capita/day. The waste compositions in the different SIDS regions were almost similar owing to comparable consumption patterns while these differed to a large extent with wastes generated in OECD countries. In SIDS, the major fraction of MSW comprised of organics (44%) followed by recyclables namely paper, plastics, glass and metals (total: 43%). In contrast, MSW in OECD countries consisted mainly of recyclables (43%) followed by organics (37%). This article also reviewed the other functional elements of the waste management systems in SIDS. Several shortcomings were noted in the process of waste collection, transfer and transport namely the fact of having outdated collection vehicles and narrow roads which are inaccessible. Among the waste management practices in SIDS, waste disposal via landfilling, illegal dumping and backyard burning were favoured most of the time at the expense of

  17. Current status of solid waste management in small island developing states: A review

    Energy Technology Data Exchange (ETDEWEB)

    Mohee, Romeela [University of Mauritius, Réduit (Mauritius); Mauthoor, Sumayya, E-mail: sumayya.mauthoor@umail.uom.ac.mu [Department of Chemical & Environmental Engineering, University of Mauritius, Réduit (Mauritius); Bundhoo, Zumar M.A.; Somaroo, Geeta; Soobhany, Nuhaa; Gunasee, Sanjana [Department of Chemical & Environmental Engineering, University of Mauritius, Réduit (Mauritius)

    2015-09-15

    Highlights: • Waste management is a matter of great concern for small island developing states. • On average, waste generation rate in these islands amounts to 1.29 kg/capita/day. • Illegal dumping and landfilling prevail in most small island developing states. • Sustainable waste management practices, previously absent, are now emerging. • However, many challenges still hinder the implementation of these practices. - Abstract: This article reviews the current status of waste management in Small Island Developing States (SIDS) and the challenges that are faced in solid waste management. The waste generation rates of SIDS were compared within the three geographic regions namely Caribbean SIDS, Pacific SIDS and Atlantic, Indian Ocean, Mediterranean and South China (AIMS) SIDS and with countries of the Organisation for Economic Co-Operation and Development (OECD). Only Pacific SIDS had a waste generation rate less than 1 kg/capita/day. The waste generation rates for the three SIDS regions averaged 1.29 kg/capita/day while that for OECD countries was at a mean value of 1.35 kg/capita/day. The waste compositions in the different SIDS regions were almost similar owing to comparable consumption patterns while these differed to a large extent with wastes generated in OECD countries. In SIDS, the major fraction of MSW comprised of organics (44%) followed by recyclables namely paper, plastics, glass and metals (total: 43%). In contrast, MSW in OECD countries consisted mainly of recyclables (43%) followed by organics (37%). This article also reviewed the other functional elements of the waste management systems in SIDS. Several shortcomings were noted in the process of waste collection, transfer and transport namely the fact of having outdated collection vehicles and narrow roads which are inaccessible. Among the waste management practices in SIDS, waste disposal via landfilling, illegal dumping and backyard burning were favoured most of the time at the expense of

  18. Current status of solid waste management in small island developing states: A review.

    Science.gov (United States)

    Mohee, Romeela; Mauthoor, Sumayya; Bundhoo, Zumar M A; Somaroo, Geeta; Soobhany, Nuhaa; Gunasee, Sanjana

    2015-09-01

    This article reviews the current status of waste management in Small Island Developing States (SIDS) and the challenges that are faced in solid waste management. The waste generation rates of SIDS were compared within the three geographic regions namely Caribbean SIDS, Pacific SIDS and Atlantic, Indian Ocean, Mediterranean and South China (AIMS) SIDS and with countries of the Organisation for Economic Co-Operation and Development (OECD). Only Pacific SIDS had a waste generation rate less than 1kg/capita/day. The waste generation rates for the three SIDS regions averaged 1.29kg/capita/day while that for OECD countries was at a mean value of 1.35kg/capita/day. The waste compositions in the different SIDS regions were almost similar owing to comparable consumption patterns while these differed to a large extent with wastes generated in OECD countries. In SIDS, the major fraction of MSW comprised of organics (44%) followed by recyclables namely paper, plastics, glass and metals (total: 43%). In contrast, MSW in OECD countries consisted mainly of recyclables (43%) followed by organics (37%). This article also reviewed the other functional elements of the waste management systems in SIDS. Several shortcomings were noted in the process of waste collection, transfer and transport namely the fact of having outdated collection vehicles and narrow roads which are inaccessible. Among the waste management practices in SIDS, waste disposal via landfilling, illegal dumping and backyard burning were favoured most of the time at the expense of sustainable waste treatment technologies such as composting, anaerobic digestion and recycling. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. The Use of Medicinal Marijuana for Posttraumatic Stress Disorder: A Review of the Current Literature

    Science.gov (United States)

    2015-01-01

    Background: Medicinal marijuana has already been legalized in over 23 states with more considering legalization. Despite the trend toward legalization, to date, there has been no systematic review of the existing literature for the efficacy of medicinal marijuana for many of the conditions for which it is proposed to treat. This study seeks to understand the current literature regarding the use of medicinal marijuana in the treatment of posttraumatic stress disorder (PTSD). Data Sources: PubMed and PsycINFO databases were searched until April 2014 for articles outlining outcomes of case files, control studies, and observational studies regarding the efficacy of medicinal marijuana in treating PTSD. Various combinations of the following search terms were used: marijuana, medicinal marijuana, cannabis, cannabinoid, PTSD, efficacy, trial, and neurobiology. Study Selection: Full text of each article was reviewed, and those directly addressing the question of efficacy of medicinal marijuana on PTSD symptomatology were included. Data were extracted from a total of 46 articles. Results: Analysis revealed that most reports are correlational and observational in basis with a notable lack of randomized, controlled studies. Many of the published studies suggest a decrease in PTSD symptoms with marijuana use. Though the directionality of cannabis use and PTSD could not be fully differentiated at this time, there appears to also be a correlation between PTSD and problematic cannabis use. Despite this finding, there is a growing amount of neurobiological evidence and animal studies suggesting potential neurologically based reasons for the reported efficacy. Conclusions: Posttraumatic stress disorder is 1 of the approved conditions for medicinal marijuana in some states. While the literature to date is suggestive of a potential decrease in PTSD symptomatology with the use of medicinal marijuana, there is a notable lack of large-scale trials, making any final conclusions difficult

  20. A holistic review of the medical school admission process: examining correlates of academic underperformance

    Directory of Open Access Journals (Sweden)

    Terry D. Stratton

    2014-04-01

    Full Text Available Background: Despite medical school admission committees’ best efforts, a handful of seemingly capable students invariably struggle during their first year of study. Yet, even as entrance criteria continue to broaden beyond cognitive qualifications, attention inevitably reverts back to such factors when seeking to understand these phenomena. Using a host of applicant, admission, and post-admission variables, the purpose of this inductive study, then, was to identify a constellation of student characteristics that, taken collectively, would be predictive of students at-risk of underperforming during the first year of medical school. In it, we hypothesize that a wider range of factors than previously recognized could conceivably play roles in understanding why students experience academic problems early in the medical educational continuum. Methods: The study sample consisted of the five most recent matriculant cohorts from a large, southeastern medical school (n=537. Independent variables reflected: 1 the personal demographics of applicants (e.g., age, gender; 2 academic criteria (e.g., undergraduate grade point averages [GPA], medical college admission test; 3 selection processes (e.g., entrance track, interview scores, committee votes; and 4 other indicators of personality and professionalism (e.g., Mayer-Salovey-Caruso Emotional Intelligence Test™ emotional intelligence scores, NEO PI-R™ personality profiles, and appearances before the Professional Code Committee [PCC]. The dependent variable, first-year underperformance, was defined as ANY action (repeat, conditionally advance, or dismiss by the college's Student Progress and Promotions Committee (SPPC in response to predefined academic criteria. This study protocol was approved by the local medical institutional review board (IRB. Results: Of the 537 students comprising the study sample, 61 (11.4% met the specified criterion for academic underperformance. Significantly increased

  1. Dose reduction in CT examination of children by an attenuation-based on-line modulation of tube current (CARE Dose)

    International Nuclear Information System (INIS)

    Greess, Holger; Noemayr, Anton; Baum, Ulrich; Lell, Michael; Boewing, Bernhard; Bautz, Werner A.; Wolf, Heiko; Kalender, Willi

    2002-01-01

    In a controlled patient study we investigated the potential of attenuation-based on-line modulation of the tube current to reduce milliampere values (mAs) in CT examinations of children without loss of image quality. mAs can be reduced for non-circular patient cross sections without an increase in noise if tube current is reduced at those angular positions where the patient diameter and, consequently, attenuation are small. We investigated a technical approach with an attenuation-based on-line control for the tube current realised as a work-in-progress implementation. The CT projection data are analysed in real time to determine optimal mAs values for each projection angle. We evaluated mAs reduction for 100 spiral CT examinations with attenuation-based on-line modulation of the tube current in a group of children. Two radiologists evaluated image quality by visual interpretation in consensus. We compared the mAs values read from the CT scanner with preset mAs of a standard protocol. Four different scan regions were examined in spiral technique (neck, thorax, abdomen, thorax and abdomen). We found the mAs product to be reduced typically by 10-60% depending on patient geometry and anatomical regions. The mean reduction was 22.3% (neck 20%, thorax 23%, abdomen 23%, thorax and abdomen 22%). In general, no deterioration of image quality was observed. There was no correlation between the age and the mean mAs reduction in the different anatomical regions. By classifying the children respectively to their weight, there is a positive trend between increasing weight and mAs reduction. We conclude that mAs in spiral CT examinations of children can be reduced substantially by attenuation-based on-line modulation of the tube current without deterioration of image quality. Attenuation-based on-line modulation of tube current is efficient and practical for reducing dose exposure to children. (orig.)

  2. The advertisement calls of Brazilian anurans: Historical review, current knowledge and future directions.

    Science.gov (United States)

    Guerra, Vinicius; Llusia, Diego; Gambale, Priscilla Guedes; Morais, Alessandro Ribeiro de; Márquez, Rafael; Bastos, Rogério Pereira

    2018-01-01

    Advertisement calls are often used as essential basic information in studies of animal behaviour, ecology, evolution, conservation, taxonomy or biodiversity inventories. Yet the description of this type of acoustic signals is far to be completed, especially in tropical regions, and is frequently non-standardized or limited in information, restricting the application of bioacoustics in science. Here we conducted a scientometric review of the described adverstisement calls of anuran species of Brazil, the world richest territory in anurans, to evaluate the amount, standard and trends of the knowledge on this key life-history trait and to identify gaps and directions for future research strategies. Based on our review, 607 studies have been published between 1960 to 2016 describing the calls of 719 Brazilian anuran species (68.8% of all species), a publication rate of 10.6 descriptions per year. From each of these studies, thirty-one variables were recorded and examined with descriptive and inferential statistics. In spite of an exponential rise over the last six decades in the number of studies, described calls, and quantity of published metadata, as revealed by regression models, clear shortfalls were identified with regard to anuran families, biomes, and categories of threat. More than 55% of these species belong to the two richest families, Hylidae or Leptodactylidae. The lowest percentage of species with described calls corresponds to the most diverse biomes, namely Atlantic Forest (65.1%) and Amazon (71.5%), and to the IUCN categories of threat (56.8%), relative to the less-than-threatened categories (74.3%). Moreover, only 52.3% of the species have some of its calls deposited in the main scientific sound collections. Our findings evidence remarkable knowledge gaps on advertisement calls of Brazilian anuran species, emphasizing the need of further efforts in standardizing and increasing the description of anuran calls for their application in studies of the

  3. The advertisement calls of Brazilian anurans: Historical review, current knowledge and future directions.

    Directory of Open Access Journals (Sweden)

    Vinicius Guerra

    Full Text Available Advertisement calls are often used as essential basic information in studies of animal behaviour, ecology, evolution, conservation, taxonomy or biodiversity inventories. Yet the description of this type of acoustic signals is far to be completed, especially in tropical regions, and is frequently non-standardized or limited in information, restricting the application of bioacoustics in science. Here we conducted a scientometric review of the described adverstisement calls of anuran species of Brazil, the world richest territory in anurans, to evaluate the amount, standard and trends of the knowledge on this key life-history trait and to identify gaps and directions for future research strategies. Based on our review, 607 studies have been published between 1960 to 2016 describing the calls of 719 Brazilian anuran species (68.8% of all species, a publication rate of 10.6 descriptions per year. From each of these studies, thirty-one variables were recorded and examined with descriptive and inferential statistics. In spite of an exponential rise over the last six decades in the number of studies, described calls, and quantity of published metadata, as revealed by regression models, clear shortfalls were identified with regard to anuran families, biomes, and categories of threat. More than 55% of these species belong to the two richest families, Hylidae or Leptodactylidae. The lowest percentage of species with described calls corresponds to the most diverse biomes, namely Atlantic Forest (65.1% and Amazon (71.5%, and to the IUCN categories of threat (56.8%, relative to the less-than-threatened categories (74.3%. Moreover, only 52.3% of the species have some of its calls deposited in the main scientific sound collections. Our findings evidence remarkable knowledge gaps on advertisement calls of Brazilian anuran species, emphasizing the need of further efforts in standardizing and increasing the description of anuran calls for their application in

  4. THE CURRENT TRENDS AND FUTUREPERSPE C TIVES OF ARABINOXYLANS PREBIOTICS RESEARCH: A REVIEW

    Directory of Open Access Journals (Sweden)

    O. D. ZHURLOVA

    2017-12-01

    Full Text Available The development of new physiologically functional ingredients allows us to expand the range of these additives and to attract additional non-traditional sources of raw materials. Prebiotics are non-digestible food ingredients that stimulate the growth of probiotic microorganisms in the gastro-intestinal tract. The chemical nature of the most prebiotics are carbohydrates nature polymers: dietary fibers and nondigestible oligosaccharides. Among non-starch polysaccharides, arabinoxylan (AX, arabinogalactan (AG, and β-glucan are of paramount importance. Arabinoxylans are mainly found in cereals grains, for example, wheat, rye, barley, oat, rice, and sorghum. The current study is a review of literature and authors' own research on biosynthesis, chemical structure, production, physicochemical and physiological properties of arabinoxylans. The structure and molecular weight of AX are vital determinants of their physicochemical, technological and physiological properties. In the article is illustrated in detail the biosynthesis of arabinoxylan in a plant tissue, which makes it possible to understand the formation mechanism of complex structure of these polysaccharides. The main part of cereal grains arabinoxylans are contained mainly in the cell walls of starchy endosperm and the aleurone layer, in the bran tissues, and in the husk of some cereals. The amount of arabinoxylans in a particular tissue depends on the genus and species. However, the degree of branching was found to be lower in arabinoxylans from aleurone than in that from original bran. The molecular structure of arabinoxylans from wheat, rye, and barley is less complex than that from rice, sorghum, finger millet, and maize bran, since their side branches contain, besides the arabinose residues, small amounts of xylopyranose, galactopyranose, and α-Dglucuronic acid or 4-O-methyl-α-D-glucuronic residues.  In the review analyzed methods of obtaining water-soluble and water-unsoluble AX

  5. Types and Severity of Medication Errors in Iran; a Review of the Current Literature

    Directory of Open Access Journals (Sweden)

    Ava Mansouri

    2013-06-01

    Full Text Available Medication error (ME is the most common single preventable cause of adverse drug events which negatively affects patient safety. ME prevalence is a valuable safety indicator in healthcare system. Inadequate studies on ME, shortage of high-quality studies and wide variations in estimations from developing countries including Iran, decreases the reliability of ME evaluations. In order to clarify the status of MEs, we aimed to review current available literature on this subject from Iran. We searched Scopus, Web of Science, PubMed, CINAHL, EBSCOHOST and also Persian databases (IranMedex, and SID up to October 2012 to find studies on adults and children about prescription, transcription, dispensing, and administration errors. Two authors independently selected and one of them reviewed and extracted data for types, definitions and severity of MEs. The results were classified based on different stages of drug delivery process. Eighteen articles (11 Persian and 7 English were included in our review. All study designs were cross-sectional and conducted in hospital settings. Nursing staff and students were the most frequent populations under observation (12 studies; 66.7%. Most of studies did not report the overall frequency of MEs aside from ME types. Most of studies (15; 83.3% reported prevalence of administration errors between 14.3%-70.0%. Prescribing error prevalence ranged from 29.8%-47.8%. The prevalence of dispensing and transcribing errors were from 11.3%-33.6% and 10.0%-51.8% respectively. We did not find any follow up or repeated studies. Only three studies reported findings on severity of MEs. The most reported types of and the highest percentages for any type of ME in Iran were administration errors. Studying ME in Iran is a new area considering the duration and number of publications. Wide ranges of estimations for MEs in different stages may be because of the poor quality of studies with diversity in definitions, methods, and populations

  6. Integrative medical therapy: examination of meditation's therapeutic and global medicinal outcomes via nitric oxide (review).

    Science.gov (United States)

    Stefano, George B; Esch, Tobias

    2005-10-01

    Relaxation techniques are part of the integrative medicine movement that is of growing importance for mainstream medicine. Complementary medical therapies have the potential to affect many physiological systems. Repeatedly studies show the benefits of the placebo response and relaxation techniques in the treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, anxiety and mild and moderate depression, premenstrual syndrome, and infertility. In itself, relaxation is characterized by a decreased metabolism, heart rate, blood pressure, and rate of breathing as well as an increase in skin temperature. Relaxation approaches, such as progressive muscle relaxation, autogenic training, meditation and biofeedback, are effective in lowering systolic and diastolic blood pressure in hypertensive patients by a significant margin. Given this association with changes in vascular tone, we have hypothesized that nitric oxide, a demonstrated vasodilator substance, contribute to physiological activity of relaxation approaches. We examined the scientific literature concerning the disorders noted earlier for their nitric oxide involvement in an attempt to provide a molecular rationale for the positive effects of relaxation approaches, which are physiological and cognitive process. We conclude that constitutive nitric oxide may crucially contribute to potentially beneficial outcomes and effects in diverse pathologies, exerting a global healing effect.

  7. Technical review on irradiation tests and post-irradiation examinations in JMTR

    International Nuclear Information System (INIS)

    2017-07-01

    The Japan Materials Testing Reactor (JMTR) has been contributing to various R and D activities in the nuclear research such as the fundamental research of nuclear materials/ fuels, safety research and development of power reactors, radio isotope (RI) production since its beginning of the operation in 1968. Irradiation technologies and post irradiation examination (PIE) technologies are the important factors for irradiation test research. Moreover, these technologies induce the breakthrough in area of nuclear research. JMTR has been providing unique capabilities for the irradiation test research for about 40 years since 1968. In future, any needs for irradiation test research used irradiation test reactors will continue, such as R and D of generation 4 power reactors, fundamental research of materials/fuels, RI production. Now, decontamination and new research reactor construction are common issue in the world according to aging. This situation is the same in Japan. This report outlines irradiation and PIE technologies developed at JMTR in 40 years to contribute to the technology transfer and human resource development. We hope that this report will be used for the new research rector design as well as the irradiation test research and also used for the human resource development of nuclear engineers in future. (author)

  8. Robotics and the spine: a review of current and ongoing applications.

    Science.gov (United States)

    Shweikeh, Faris; Amadio, Jordan P; Arnell, Monica; Barnard, Zachary R; Kim, Terrence T; Johnson, J Patrick; Drazin, Doniel

    2014-03-01

    Robotics in the operating room has shown great use and versatility in multiple surgical fields. Robot-assisted spine surgery has gained significant favor over its relatively short existence, due to its intuitive promise of higher surgical accuracy and better outcomes with fewer complications. Here, the authors analyze the existing literature on this growing technology in the era of minimally invasive spine surgery. In an attempt to provide the most recent, up-to-date review of the current literature on robotic spine surgery, a search of the existing literature was conducted to obtain all relevant studies on robotics as it relates to its application in spine surgery and other interventions. In all, 45 articles were included in the analysis. The authors discuss the current status of this technology and its potential in multiple arenas of spinal interventions, mainly spine surgery and spine biomechanics testing. There are numerous potential advantages and limitations to robotic spine surgery, as suggested in published case reports and in retrospective and prospective studies. Randomized controlled trials are few in number and show conflicting results regarding accuracy. The present limitations may be surmountable with future technological improvements, greater surgeon experience, reduced cost, improved operating room dynamics, and more training of surgical team members. Given the promise of robotics for improvements in spine surgery and spine biomechanics testing, more studies are needed to further explore the applicability of this technology in the spinal operating room. Due to the significant cost of the robotic equipment, studies are needed to substantiate that the increased equipment costs will result in significant benefits that will justify the expense.

  9. Review article: liver transplantation for hepatocellular carcinoma - a critical appraisal of the current worldwide listing criteria.

    Science.gov (United States)

    Menon, K V; Hakeem, A R; Heaton, N D

    2014-10-01

    Liver transplantation (LT) plays an important role in the management of patients with hepatocellular carcinoma (HCC). Although early results following LT for HCC were poor, since the introduction of the Milan criteria in 1996 morphological criteria have since been well established. Thereafter, various expansions of the Milan criteria were introduced worldwide. Listing criteria for LT for HCC in the United Kingdom (UK) initially conformed to the Milan criteria but were re-defined in 2009 by expansion of the Milan criteria. To look at the evidence in literature on listing criteria and management of HCC worldwide in comparison with the UK. Secondly, we aim to review worldwide vs. UK literature on prioritisation models, loco-regional therapy protocols and role of alpha-fetoprotein (AFP) in LT for HCC. An electronic literature search with Medline was carried out to identify articles related to LT for HCC. Although various expansions of the Milan criteria have been described, they remain the gold standard against which other criteria are measured. The UK criteria are an expansion of the Milan criteria that go beyond Milan and University of California, San Francisco (UCSF) criteria. The current UK listing criteria for LT for HCC when compared to the worldwide criteria have a worse survival benefit (projected 5-year survival between 35-50%) when plotted on the metroticket calculator. In keeping with most transplant centres worldwide, the UK have adopted expansions to Milan to allow more patients to benefit from LT. However, currently, as it stands the UK criteria when plotted in the modification of the Metroticket model project worse survival that would seem unjustified. © 2014 John Wiley & Sons Ltd.

  10. Nursing philosophy: A review of current pre registration curricula in the UK.

    Science.gov (United States)

    Mackintosh-Franklin, Carolyn

    2016-02-01

    Nursing in the UK has been subject to criticism for failing to provide care and compassion in practice, with a series of reports highlighting inadequacies in care. This scrutiny provides nursing with an ideal opportunity to evaluate the underpinning philosophy of nursing practice, and for nurse educators to use this philosophy as the basis for programmes which can inculcate neophyte student nurses with a fundamental understanding of the profession, whilst providing other health care professionals and service users with a clear representation of professional nursing practice. The key word philosophy was used in a systematic stepwise descriptive content analysis of the programme specifications of 33 current undergraduate programme documents, leading to an undergraduate award and professional registration as a nurse. The word philosophy featured minimally in programme specification documents, with 12 (36%) documents including it. Its use was superficial in 3 documents and focused on educational philosophy in a further 3 documents. 2 programme specifications identified their philosophy as the NMC (2010) standards for pre-registration nurse education. 2 programme specifications articulated a philosophy specific to that programme and HEI, focusing on caring, and 2 made reference to underpinning philosophies present in nursing literature; the Relationship Centred Care Approach, and The Humanising Care Philosophy. The philosophy of nursing practice is not clearly articulated in pre-registration curricula. This failure to identify the fundamental nature of nursing is detrimental to the development of the profession, and given this lack of direction it is not surprising that some commentators feel nursing has lost its way. Nurse educators must review their current curricula to ensure that there is clear articulation of nursing's professional philosophical stance, and use this as the framework for pre-registration curricula to support the development of neophyte nursing

  11. Human-carnivore conflict in China: a review of current approaches with recommendations for improved management.

    Science.gov (United States)

    Pettigrew, Melissa; Xie, Yan; Kang, Aili; Rao, Madhu; Goodrich, John; Liu, Tong; Berger, Joshua

    2012-06-01

    Human-wildlife conflict (HWC) is a conservation concern that increasingly threatens the continued existence of some of the world's most endangered species. With an increase in human population, urban sprawl and subsequent encroachment on wild land, human and wildlife interaction has become inevitable. In the majority of cases, this interaction results in a negative outcome for humans, wildlife or both. In China, these key elements, along with a decrease in wild prey species, have resulted in the expansion of HWC encounters, and the need for alleviating this conflict has become a conservation priority. Loss of human life, livestock and/or crops is most often the catalysts that fuel HWC. Techniques to alleviate conflict around the world have included preventative measures and mitigation techniques, such as financial compensation and other incentive programs. Both types of measures have had variable success. We review the current status of human-carnivore conflict management in China, and, drawing lessons from around the globe, we make recommendations for improving conservation management in China. For example, an increase in law enforcement in nature reserves is vital to reducing human disturbance in prime carnivore habitat, thereby reducing conflict encounters. Also, modifications to current wildlife compensation programs, so that they are linked with preventative measures, will ensure that moral hazards are avoided. Furthermore, investigating the potential for a community self-financed insurance scheme to fund compensation and increasing efforts to restore wild prey populations will improve the outcome for wildlife conservation. Ultimately, HWC management in China will greatly benefit from an integrative approach. © 2012 ISZS, Blackwell Publishing and IOZ/CAS.

  12. Current technology and techniques in re-mineralization of white spot lesions: A systematic review

    Science.gov (United States)

    Podray, Susan S.

    White Spot lesions are a common iatrogenic occurrence on patients who are treated with fixed orthodontic appliances. There is a dynamic chemical interaction between enamel and saliva at the tooth surface that allow a lesion to have phase changes involving demineralization of enamel and reminerlization. This is due to calcium and phosphate dissolved in saliva that is deposited onto the tooth surface or removed depending on the surrounding pH. Caseinphosphopeptide-amorphous calcium phosphate (CPP-ACP) is gaining popularity in dentistry as a way to increase the available level of calcium and phosphate in plaque and saliva to improve the chemical gradient so that if favors reminerlization. The aim of our investigation is to search the available current literature and formulate a recommendation for use of CPP-ACP in orthodontics. Publications from the following electronic databases were searched: PubMed, Web of Science, Cochrane Library and Science Direct. Searches from August 2010 to April 1st 2012 were performed under the terms "MI Paste OR Recaldent OR caseinphosphopeptide-amorphous calcium phosphate OR CPP-ACP or tooth mousse". The searches yielded 155 articles, These were reviewed for relevance based on inclusion and exclusion criteria. Articles with inappropriate study design or no outcome measures at both baseline and end point were also excluded. 13 articles were deemed of relevance with a high quality study design and were included in this study for evaluation. The current literature suggests a preventative treatment regimen in which MI Paste Plus is used. It should be delivered once daily prior to bed after oral hygiene for 3 minutes in a fluoride tray, throughout orthodontic treatment. It should be recommended for high risk patients determined by poor oral hygiene, as seen by the inability to remove plaque from teeth and appliances. This protocol may prevent or assist in the remineralization of enamel white spot lesions during and after orthodontic treatment.

  13. A review on current knowledge and future prospects of organohalogen contaminants (OHCs) in Asian birds.

    Science.gov (