WorldWideScience

Sample records for current state clinical

  1. Current state of clinical lithotripsy

    Science.gov (United States)

    Lingeman, James E.

    2003-10-01

    Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the treatment of urolithiasis. Because of the clinical success of the original lithotriptor, the Dornier HM3, numerous manufacturers introduced different approaches to lithotripsy based on empiricism rather than an understanding of the fundamental mechanisms of this new technology. Our understanding of shock wave physics and the physiologic effects of shock waves has progressed greatly over the last decade resulting in insights that hopefully will be reflected favorably in future lithotriptor designs and lithotripsy techniques.

  2. Clinical pharmacology in Russia-historical development and current state.

    Science.gov (United States)

    Zagorodnikova Goryachkina, Ksenia; Burbello, Aleksandra; Sychev, Dmitry; Frolov, Maxim; Kukes, Vladimir; Petrov, Vladimir

    2015-02-01

    Clinical pharmacology in Russia has long history and is currently active, but rather unrecognized internationally. It is governmentally approved as a teaching/scientific specialty since 1983 and as a medical specialty since 1997. Courses of clinical pharmacology are included in the undergraduate curricula in the 5th and/or 6th year of education at all medical schools in the Russian Federation. Postgraduate education includes initial specialization in internal medicine with further residency in clinical pharmacology. Governmental legislation recommends that every healthcare institution has either a department or a single position of clinical pharmacologist. Major routine duties include information about and monitoring of medication use, consultations in difficult clinical situations, pharmacogenetic counseling, therapeutic drug monitoring, pharmacovigilance, and participation in drug and therapeutics (formulary) committees. There are official experts in clinical pharmacology in Russia responsible for coordinating relevant legislative issues. The chief expert clinical pharmacologist represents the discipline directly at the Ministry of Health. Research in clinical pharmacology in Russia is extensive and variable, but only some of it is published internationally. Russia is a participant of international societies of clinical pharmacology and therapeutics and collaboration is actively ongoing. There are still certain problems related to the development of the discipline in Russia-some healthcare institutions do not see the need for clinical pharmacology. However, the number of clinical pharmacologists in Russia is increasing as well as their role in physicians' education, national healthcare, and research.

  3. 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.

  4. Informatics in clinical research in oncology: current state, challenges, and a future perspective.

    Science.gov (United States)

    Chahal, Amar P S

    2011-01-01

    The informatics landscape of clinical trials in oncology has changed significantly in the last 10 years. The current state of the infrastructure for clinical trial management, execution, and data management is reviewed. The systems, their functionality, the users, and the standards available to researchers are discussed from the perspective of the oncologist-researcher. Challenges in complexity and in the processing of information are outlined. These challenges include the lack of communication and information-interchange between systems, the lack of simplified standards, and the lack of implementation and adherence to the standards that are available. The clinical toxicology criteria from the National Cancer Institute (CTCAE) are cited as a successful standard in oncology, and HTTP on the Internet is referenced for its simplicity. Differences in the management of information standards between industries are discussed. Possible future advances in oncology clinical research informatics are addressed. These advances include strategic policy review of standards and the implementation of actions to make standards free, ubiquitous, simple, and easily interpretable; the need to change from a local data-capture- or transaction-driven model to a large-scale data-interpretation model that provides higher value to the oncologist and the patient; and the need for information technology investment in a readily available digital educational model for clinical research in oncology that is customizable for individual studies. These new approaches, with changes in information delivery to mobile platforms, will set the stage for the next decade in clinical research informatics.

  5. Pediatric obesity pharmacotherapy: current state of the field, review of the literature and clinical trial considerations.

    Science.gov (United States)

    Kelly, A S; Fox, C K; Rudser, K D; Gross, A C; Ryder, J R

    2016-07-01

    Despite the increasing number of medications recently approved to treat obesity among adults, few agents have been formally evaluated in children or adolescents for this indication. Moreover, there is a paucity of guidance in the literature addressing best practices with regard to pediatric obesity pharmacotherapy clinical trial design, and only general recommendations have been offered by regulatory agencies on this topic. The purposes of this article are to (1) offer a background of the current state of the field of pediatric obesity medicine, (2) provide a brief review of the literature summarizing pediatric obesity pharmacotherapy clinical trials, and (3) highlight and discuss some of the unique aspects that should be considered when designing and conducting high-quality clinical trials evaluating the safety and efficacy of obesity medications in children and adolescents. Suggestions are offered in the areas of target population and eligibility criteria, clinical trial end-point selection, trial duration, implementation of lifestyle modification therapy and recruitment and retention of participants. Efforts should be made to design and conduct trials appropriately to ensure that high-quality evidence is generated on the safety and efficacy of various medications used to treat pediatric obesity.

  6. A survey of current clinical practice of permanent prostate brachytherapy in the United States

    International Nuclear Information System (INIS)

    Prestidge, Bradley R.; Prete, James J.; Buchholz, Thomas A.; Friedland, Jay L.; Stock, Richard G.; Grimm, Peter D.; Bice, William S.

    1998-01-01

    Purpose: To help establish standards of care for transperineal interstitial permanent prostate brachytherapy (TIPPB) by obtaining data regarding current clinical practice among the most experienced TIPPB brachytherapists in the United States. Methods and Materials: The 70 brachytherapists who performed the greatest number of TIPPB cases in 1995 in the U.S. were surveyed. Each received a comprehensive four page questionnaire that included sections on training and experience, patient and isotope selection criteria, manpower, technique, and follow-up. Thirty-five (50%) surveys were ultimately returned after three mailings and follow-up phone calls. The cumulative experience of the 35 respondents represented approximately 45% of the total TIPPB volume in the U.S. for 1995. Respondents included 29 from the private sector and six from academic programs. Results: The median physician experience with TIPPB was reported as 4.9 years. Each performed an average of 73 TIPPB procedures in 1995 (range 40-300). This represented an increase in volume for most (74%) of the respondents. Sixty-three percent of the respondents attended a formal training course, 54% had TIPPB-specific residency training, and 31% had been proctored (16 had received two or more types of training experience). The most commonly reported selection criteria for implant alone was on Gleason score ≤7, PSA 125 I prescribed to 120 Gy (75%) or 103 Pd to 90 Gy (50%). Sixty percent reported using a Mick applicator, 46% prefer using preloaded needles, and (11%) use both techniques. Real-time imaging was usually performed with ultrasound (94%); most included fluoroscopy (60%). Definitions of PSA control varied widely. Conclusions: TIPPB clinical practice in the U.S. demonstrates similarities in technique, but differences in patient selection and definitions of biochemical control. It is, therefore, incumbent on those beginning TIPPB programs to carefully review the specific practice details of those institutions

  7. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play.

    Science.gov (United States)

    Savitz, J B; Rauch, S L; Drevets, W C

    2013-05-01

    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders.

  8. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play

    Science.gov (United States)

    Savitz, J B; Rauch, S L; Drevets, W C

    2013-01-01

    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders. PMID:23546169

  9. Preemptive Clinical Pharmacogenetics Implementation: Current programs in five United States medical centers

    Science.gov (United States)

    Dunnenberger, Henry M.; Crews, Kristine R.; Hoffman, James M.; Caudle, Kelly E.; Broeckel, Ulrich; Howard, Scott C.; Hunkler, Robert J.; Klein, Teri E.; Evans, William E.; Relling, Mary V.

    2015-01-01

    Although the field of pharmacogenetics has existed for decades, the implementation of, pharmacogenetic testing in clinical care has been slow. There are numerous publications, describing the barriers to clinical implementation of pharmacogenetics. Recently, several freely, available resources have been developed to help address these barriers. In this review we, discuss current programs that use preemptive genotyping to optimize the pharmacotherapy of, patients. Array-based preemptive testing includes a large number of relevant pharmacogenes, that impact multiple high-risk drugs. Using a preemptive approach allows genotyping results to, be available prior to any prescribing decision so that genomic variation may be considered as, an inherent patient characteristic in the planning of therapy. This review describes the common, elements among programs that have implemented preemptive genotyping and highlights key, processes for implementation, including clinical decision support. PMID:25292429

  10. 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.

  11. Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States.

    Science.gov (United States)

    Moore, Andrew; Nelson, Christina; Molins, Claudia; Mead, Paul; Schriefer, Martin

    2016-07-01

    In the United States, Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks. Patients with an erythema migrans lesion and epidemiologic risk can receive a diagnosis without laboratory testing. For all other patients, laboratory testing is necessary to confirm the diagnosis, but proper interpretation depends on symptoms and timing of illness. The recommended laboratory test in the United States is 2-tiered serologic analysis consisting of an enzyme-linked immunoassay or immunofluorescence assay, followed by reflexive immunoblotting. Sensitivity of 2-tiered testing is low (30%-40%) during early infection while the antibody response is developing (window period). For disseminated Lyme disease, sensitivity is 70%-100%. Specificity is high (>95%) during all stages of disease. Use of other diagnostic tests for Lyme disease is limited. We review the rationale behind current US testing guidelines, appropriate use and interpretation of tests, and recent developments in Lyme disease diagnostics.

  12. The Database of the Catalogue of Clinical Practice Guidelines Published via Internet in the Czech Language -The Current State

    Czech Academy of Sciences Publication Activity Database

    Zvolský, Miroslav

    2010-01-01

    Roč. 6, č. 1 (2010), s. 83-89 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : internet * World Wide Web * database * clinical practice guideline * clinical practice * evidence-based medicine * formalisation * GLIF (Guideline Inerchange Format) * doctor of medicine, * decision support systems Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/en/ejbi/article/63-en-the-database-of-the-catalogue-of-clinical- practice -guidelines-published-via-internet-in-the-czech-language-the-current-state.html

  13. Clinical features and pathophysiology of Complex Regional Pain Syndrome – current state of the art

    Science.gov (United States)

    Marinus, Johan; Moseley, G. Lorimer; Birklein, Frank; Baron, Ralf; Maihöfner, Christian; Kingery, Wade S.; van Hilten, Jacobus J.

    2017-01-01

    That a minor injury can trigger a complex regional pain syndrome (CRPS) - multiple system dysfunction, severe and often chronic pain and disability - has fascinated scientists and perplexed clinicians for decades. However, substantial advances across several medical disciplines have recently increased our understanding of CRPS. Compelling evidence implicates biological pathways that underlie aberrant inflammation, vasomotor dysfunction, and maladaptive neuroplasticity in the clinical features of CRPS. Collectively, the evidence points to CRPS being a multifactorial disorder that is associated with an aberrant host response to tissue injury. Varying susceptibility to perturbed regulation of any of the underlying biological pathways probably accounts for the clinical heterogeneity of CRPS. PMID:21683929

  14. [Atypical epithelial hyperplasia of the breast: current state of knowledge and clinical practice].

    Science.gov (United States)

    Lavoué, V; Bertel, C; Tas, P; Bendavid, C; Rouquette, S; Foucher, F; Audrain, O; Bouriel, C; Levêque, J

    2010-02-01

    The diagnosis of atypical epithelial hyperplasia (AEH) increases with breast cancer screening. AEH is divided in three groups: atypical ductal hyperplasia, columnar cell lesions with atypia, lobular neoplasia. The management of women with AEH is not consensual because of uncertainty about their diagnosis related to the type of the biopsy sampling (core needle biopsy or surgical excision) and their controversial clinical signification between risk marker and true precursor of breast cancer. A systematic review of published studies was performed. Medline baseline interrogation was performed with the following keywords: atypical ductal hyperplasia, columnar cell lesions with atypia, lobular neoplasia, core needle biopsy, breast cancer, precursor lesion, hormonal replacement therapy. For each breast lesion, identified publications (English or French) were assessed for clinical practise in epidemiology, diagnosis and patient management. With immunohistochemistry and molecular studies, AEH seems to be precursor of breast cancer. But, epidemiological studies show low rate of breast cancer in women with AEH. AEH were still classified as risk factor of breast cancer. Because of high rate of breast cancer underestimation, surgical excision is necessary after the diagnosis of AEH at core needle biopsy. Surgical oncology rules and collaboration with radiologist are required for this surgery. A second operation was not required due to involved margins by AEH (except with pleiomorphic lobular neoplasia) because local control of breast cancer seems to be unchanged. Besides, hormonal replacement therapy for patient with AEH is not recommended because of lack of studies about this subject. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  15. Policies for patient access to clinical data via PHRs: current state and recommendations.

    Science.gov (United States)

    Collins, Sarah A; Vawdrey, David K; Kukafka, Rita; Kuperman, Gilad J

    2011-12-01

    Healthcare delivery organizations are increasingly using online personal health records (PHRs) to provide patients with direct access to their clinical information; however, there may be a lack of consistency in the data made available. We aimed to understand the general use and functionality of PHRs and the organizational policies and decision-making structures for making data available to patients. A cross-sectional survey was administered by telephone structured interview to 21 organizations to determine the types of data made available to patients through PHRs and the presence of explicit governance for PHR data release. Organizations were identified based on a review of the literature, PHR experts, and snowball sampling. Organizations that did not provide patients with electronic access to their data via a PHR were excluded. Interviews were conducted with 17 organizations for a response rate of 81%. Half of the organizations had explicit governance in the form of a written policy that outlined the data types made available to patients. Overall, 88% of the organizations used a committee structure for the decision-making process and included senior management and information services. All organizations sought input from clinicians. Discussion There was considerable variability in the types of clinical data and the time frame for releasing these data to patients. Variability in data release policies may have implications for PHR use and adoption. Future policy activities, such as requirement specification for the latter stages of Meaningful Use, should be leveraged as an opportunity to encourage standardization of functionality and broad deployment of PHRs.

  16. The current state of dyslipidemia in Korean children and adolescents and its management in clinical practice

    Directory of Open Access Journals (Sweden)

    Jung Sub Lim

    2013-03-01

    Full Text Available Cardiovascular disease (CVD is a leading cause of death worldwide including Korea. The risk factors of CVD are known as positive family history of early CVD, obesity, hypertension, diabetes, and dyslipidemia. Among those, dyslipidemia is one of modifiable risk factors. Dyslipidemia starts in childhood and progress to adulthood. Furthermore, dyslipidemia cause atherosclerosis and is closely related to other CVD risks. On the rationale that early identification and control of pediatric dyslipidemia will reduce the risk and severity of CVD in adulthood, the National Heart, Lung, and Blood Institute guidelines expanded to universal screening for lipid levels. However, there was no guideline for lipid screening and management in Korean children and adolescents yet. This review deals with the rationale of early identification and control of pediatric dyslipidemia along with the current Korean status of pediatric dyslipidemia. This review also deals with how to screen, diagnosis, and treatment of pediatric dyslipidemia.

  17. Translating ocular biomechanics into clinical practice: current state and future prospects.

    Science.gov (United States)

    Girard, Michaël J A; Dupps, William J; Baskaran, Mani; Scarcelli, Giuliano; Yun, Seok H; Quigley, Harry A; Sigal, Ian A; Strouthidis, Nicholas G

    2015-01-01

    Biomechanics is the study of the relationship between forces and function in living organisms and is thought to play a critical role in a significant number of ophthalmic disorders. This is not surprising, as the eye is a pressure vessel that requires a delicate balance of forces to maintain its homeostasis. Over the past few decades, basic science research in ophthalmology mostly confirmed that ocular biomechanics could explain in part the mechanisms involved in almost all major ophthalmic disorders such as optic nerve head neuropathies, angle closure, ametropia, presbyopia, cataract, corneal pathologies, retinal detachment and macular degeneration. Translational biomechanics in ophthalmology, however, is still in its infancy. It is believed that its use could make significant advances in diagnosis and treatment. Several translational biomechanics strategies are already emerging, such as corneal stiffening for the treatment of keratoconus, and more are likely to follow. This review aims to cultivate the idea that biomechanics plays a major role in ophthalmology and that the clinical translation, lead by collaborative teams of clinicians and biomedical engineers, will benefit our patients. Specifically, recent advances and future prospects in corneal, iris, trabecular meshwork, crystalline lens, scleral and lamina cribrosa biomechanics are discussed.

  18. Ten years since the discovery of iPS cells: The current state of their clinical application.

    Science.gov (United States)

    Aznar, J; Tudela, J

    On the 10-year anniversary of the discovery of induced pluripotent stem cells, we review the main results from their various fields of application, the obstacles encountered during experimentation and the potential applications in clinical practice. The efficacy of induced pluripotent cells in clinical experimentation can be equated to that of human embryonic stem cells; however, unlike stem cells, induced pluripotent cells do not involve the severe ethical difficulties entailed by the need to destroy human embryos to obtain them. The finding of these cells, which was in its day a true scientific milestone worthy of a Nobel Prize in Medicine, is currently enveloped by light and shadow: high hopes for regenerative medicine versus the, as of yet, poorly controlled risks of unpredictable reactions, both in the processes of dedifferentiation and subsequent differentiation to the cell strains employed for therapeutic or experimentation goals. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  19. Current State of Dental Education: Executive Summary.

    Science.gov (United States)

    Formicola, Allan J

    2017-08-01

    This executive summary for Section 1 of the "Advancing Dental Education in the 21 st Century" project provides a composite picture of information from 12 background articles on the current state of dental education in the United States. The summary includes the following topics: the current status of the dental curriculum, the implications of student debt and dental school finances, the expansion of enrollment, student diversity, pre- and postdoctoral education, safety net status of dental school clinics, and trends in faculty.

  20. Radiopharmaceuticals - current state and trends

    International Nuclear Information System (INIS)

    Muenze, R.

    1981-07-01

    The current state as well as the tendencies of modern radiopharmaceutical development and application is reviewed. After an evaluation of the fundamental preconditions of decay characteristics and pharmaceutical properties the problems concerning sup(99m)Tc-radiopharmaceuticals, metabolizable compounds and the use of specific biological interactions are discussed. (author)

  1. Cranial MRI: Current clinical applications

    International Nuclear Information System (INIS)

    Bradley, W.G. Jr.; Kortman, K.E.

    1987-01-01

    Human MR images were first published by the Nottingham group in 1980. Since that time, there have been steady improvements in image quality and significant reductions in imaging time. After initial studies by the Hammersmith group in London, investigators at UCSF published studies comparing CT with MR, clearly demonstrating the higher sensitivity of MR to pathologic intracranial processes. Since that time, several investigators have demonstrated the efficacy of MR in the evaluation of a wide range of intracranial pathologic processes, including neoplasms, demyelinating disease, trauma, and congenital abnormalities. In the authors' studies comparing MR with CT in 400 consecutive cases of suspected CNS pathology, MR detected abnormalities which were not seen on CT in 30 percent of these cases. MR has become established as the imaging modality of choice in the evaluation of a broad range of CNS abnormalities and is rapidly being implemented not only at university medical centers but also in community hospitals and free-standing clinics. This chapter deals with fundamental principles of MR image interpretation and provides insight into current clinical indications for MR in intracranial disorders

  2. [Male contraception - the current state of knowledge].

    Science.gov (United States)

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-08-01

    Contraception is important from a health, psychological and socioeconomic point of view. Due to the fact that male-based contraceptive methods are mostly represented by condoms and vasectomy, researchers are working on the new solutions, which could let the men be more involved in a conscious family planning. In this review we will present the current state of knowledge on this subject. There is a lot going on in the field of hormonal contraception. Studies including testosterone, progestins, synthetic androgens and other derivatives are on a different stages of clinical trials and mostly demonstrate high efficacy rates. Recent discovers of Izumo and Juno proteins, essential for the fertilization process, give hope for an easily reversible, non-hormonal method. Researchers are also trying to interfere with the process of spermatogenesis using BRDT inhibitor - JQ1, or neutralize the sperm by injecting styrene maleic anhydride (SMA) into the lumen of the vas deferens. The other studies explore processes involved in proper sperm motility. A vaccine which induces an immune response to the reproductive system is also an interesting method. The latest research use ultrasound waves and mechanical device which blocks the patency of vas deferens. The aim of the study current state of knowledge male contraception. © 2016 MEDPRESS.

  3. Compliance of clinical microbiology laboratories in the United States with current recommendations for processing respiratory tract specimens from patients with cystic fibrosis.

    Science.gov (United States)

    Zhou, Juyan; Garber, Elizabeth; Desai, Manisha; Saiman, Lisa

    2006-04-01

    Respiratory tract specimens from patients with cystic fibrosis (CF) require unique processing by clinical microbiology laboratories to ensure detection of all potential pathogens. The present study sought to determine the compliance of microbiology laboratories in the United States with recently published recommendations for CF respiratory specimens. Microbiology laboratory protocols from 150 of 190 (79%) CF care sites were reviewed. Most described the use of selective media for Burkholderia cepacia complex (99%), Staphylococcus aureus (82%), and Haemophilus influenzae (89%) and identified the species of all gram-negative bacilli (87%). Only 52% delineated the use of agar diffusion assays for susceptibility testing of Pseudomonas aeruginosa. Standardizing laboratory practices will improve treatment, infection control, and our understanding of the changing epidemiology of CF microbiology.

  4. Current state of craniofacial prosthetic rehabilitation.

    Science.gov (United States)

    Ariani, Nina; Visser, Anita; van Oort, Robert P; Kusdhany, Lindawati; Rahardjo, Tri Budi W; Krom, Bastiaan P; van der Mei, Henry C; Vissink, Arjan

    2013-01-01

    This study aimed to review the current state of the techniques and materials used to rehabilitate maxillofacial defects. The MEDLINE and EMBASE databases were searched for articles pertinent to maxillofacial prostheses published from January 1990 to July 2011. The main clinical stages were the subject of analysis. A multidisciplinary approach is preferred when rehabilitating maxillofacial defects. Surgical reconstruction can be used for smaller defects, but larger defects require a prosthesis to achieve an esthetic rehabilitation. Implant retained prostheses are preferred over adhesive prostheses. Silicone elastomer is currently the best material available for maxillofacial prostheses; however, longevity and discoloration, which are greatly influenced by ultraviolet radiation, microorganisms, and environmental factors, remain significant problems. In the near future, the widespread availability and cost effectiveness of digital systems may improve the workflow and outcomes of facial prostheses. Patients report high satisfaction with their prostheses despite some areas that still need improvement. Maxillofacial prostheses are a reliable treatment option to restore maxillofacial defects and improve quality of life. Significant progress has been made in the application of implants for retention and digital technology for designing surgical guides, suprastructures, and craniofacial prostheses. Further improvements are necessary to enhance longevity of prostheses.

  5. Current management of obsessive and phobic states

    Directory of Open Access Journals (Sweden)

    Goljevscek S

    2011-09-01

    Full Text Available Serena Goljevscek1, Livia A Carvalho21Psychiatric Clinic, University of Udine, Udine, Italy; 2Health Science Research Centre, Department of Life Sciences, Roehampton University, London, UKAbstract: Obsessional states show an average point prevalence of 1%–3% and a lifetime prevalence of 2%–2.5%. Most treatment-seeking patients with obsessions continue to experience significant symptoms after 2 years of prospective follow-up. A significant burden of impairment, distress, and comorbidity characterize the course of the illness, leading to an increased need for a better understanding of the nature and management of this condition. This review aims to give a representation of the current pharmacological and psychotherapeutic strategies used in the treatment of obsessive-compulsive disorder. Antidepressants (clomipramine and selective serotonin reuptake inhibitors are generally the first-line choice used to handle obsessional states, showing good response rates and long-term positive outcomes. About 40% of patients fail to respond to selective serotonin reuptake inhibitors. So far, additional pharmacological treatment strategies have been shown to be effective, ie, administration of high doses of selective serotonin reuptake inhibitors, as well as combinations of different drugs, such as dopamine antagonists, are considered efficacious and well tolerated strategies in terms of symptom remission and side effects. Psychotherapy also plays an important role in the management of obsessive-compulsive disorder, being effective for a wide range of symptoms, and many studies have assessed its long-term efficacy, especially when added to appropriate pharmacotherapy. In this paper, we also give a description of the clinical and psychological features likely to characterize patients refractory to treatment for this illness, with the aim of highlighting the need for greater attention to more patient-oriented management of the disease.Keywords: obsessive

  6. State Emergency Department Opioid Guidelines: Current Status.

    Science.gov (United States)

    Broida, Robert I; Gronowski, Tanner; Kalnow, Andrew F; Little, Andrew G; Lloyd, Christopher M

    2017-04-01

    The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM). We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP. We found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions for opioids with 67 total recommendations; preventing/diverting abuse with 56 total recommendations; addiction-related guidelines with 29 total recommendations; and a community resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion. This study highlights the 17 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this study will provide the basis for similar efforts in other states.

  7. Current educational issues in the clinical neurosciences.

    Science.gov (United States)

    Desbiens, R; Elleker, M G; Goldsand, G; Hugenholtz, H; Puddester, D; Toyota, B; Findlay, J M

    2001-11-01

    Canadian training in the clinical neurosciences, neurology and neurosurgery, faces significant challenges. New balances are being set by residents, their associations and the Royal College of Physicians and Surgeons of Canada between clinical service, education and personal time. The nature of hospital-provided medical service has changed significantly over the past decade, impacting importantly on resident training. Finally, future manpower needs are of concern, especially in the field of neurosurgery, where it appears that soon more specialists will be trained than can be absorbed into the Canadian health care system. A special symposium on current challenges in clinical neuroscience training was held at the Canadian Congress of Neurological Sciences in June 2000. Representatives from the Canadian Association of Interns and Residents, the Royal College of Physicians and Surgeons of Canada and English and French neurology and neurosurgery training programs made presentations, which are summarized in this report. Residency training has become less service-oriented, and this trend will continue. In order to manage the increasingly sophisticated hospital services of neurology and neurosurgery, resident-alternatives in the form of physician "moonlighters" or more permanent hospital-based clinicians or "hospitalists" will be necessary in order to operate major neuroclinical units. Health authorities and hospitals will need to recognize and assume this responsibility. As clinical experience diminishes during residency training, inevitably so will the concept of the fully competent "generalist" at the end of specialty training. Additional subspecialty training is being increasingly sought by graduates, particularly in neurosurgery. Training in neurology and neurosurgery, as in all medical specialties, has changed significantly in recent years and continues to change. Programs and hospitals need to adapt to these changes in order to ensure the production of fully

  8. Current State of Craniofacial Prosthetic Rehabilitation

    NARCIS (Netherlands)

    Ariani, Nina; Visser, Anita; van Oort, Robert P.; Kusdhany, Lindawati; Rahardjo, Tri Budi W.; Krom, Bastiaan P.; van der Mei, Henny C.; Vissink, Arjan

    2013-01-01

    Purpose: This study aimed to review the current state of the techniques and materials used to rehabilitate maxillofacial defects. Materials and Methods: The MEDLINE and EMBASE databases were searched for articles pertinent to maxillofacial prostheses published from January 1990 to July 2011. The

  9. [Current clinical significance of anaerobic bacteremia].

    Science.gov (United States)

    Jirsa, Roman; Marešová, Veronika; Brož, Zdeněk

    2010-10-01

    to estimate tje current clinical significance of anaerobic bacteremia in a group of Czech hospitals. this retrospective analysis comprised 8 444 anaerobic blood cultures in patients admitted to four Czech hospitals between 2004 and 2007. in 16 patients, blood cultures yielded significant anaerobic bacteria. Thus, anaerobic bacteremia accounted for less than 2 % of clinically significant bacteremia. Four patients (18 %) died but none of the deaths could be clearly attributable to anaerobic bacteria in the bloodstream. The most common comorbidities predisposing to anaerobic bacteremia and the most frequent sources of infection were similar to those reported by other authors. The majority of anaerobic bacteremia cases were due to gram-negative bacteria, followed by Clostridium perfringens and, surprisingly, Eubacterium spp. (particularly Eubacterium lentum). anaerobic bacteremia remains rare. The comparison of our data with those by other authors suggests that (despite the reported high mortality) the actual clinical significance of anaerobic bacteremia is rather controversial and that the anaerobic bacteremia might not correspond to more serious pathogenic role of the anaerobic bacteria as the source of infection.

  10. Current clinical evidence on pioglitazone pharmacogenomics

    Directory of Open Access Journals (Sweden)

    Marina eKawaguchi-Suzuki

    2013-11-01

    Full Text Available Pioglitazone is the most widely used thiazolidinedione and acts as an insulin-sensitizer through activation of the Peroxisome Proliferator-Activated Receptor-γ (PPARγ. Pioglitazone is approved for use in the management of type 2 diabetes mellitus, but its use in other therapeutic areas is increasing due to pleiotropic effects. In this hypothesis article, the current clinical evidence on pioglitazone pharmacogenomics is summarized and related to variability in pioglitazone response. How genetic variation in the human genome affects the pharmacokinetics and pharmacodynamics of pioglitazone was examined. For pharmacodynamic effects, hypoglycemic and anti-atherosclerotic effects, risks of fracture or edema, and the increase in body mass index in response to pioglitazone based on genotype were examined. The genes CYP2C8 and PPARG are the most extensively studied to date and selected polymorphisms contribute to respective variability in pioglitazone pharmacokinetics and pharmacodynamics. We hypothesized that genetic variation in pioglitazone pathway genes contributes meaningfully to the clinically observed variability in drug response. To test the hypothesis that genetic variation in PPARG associates with variability in pioglitazone response, we conducted a meta-analysis to synthesize the currently available data on the PPARG p.Pro12Ala polymorphism. The results showed that PPARG 12Ala carriers had a more favorable change in fasting blood glucose from baseline as compared to patients with the wild-type Pro12Pro genotype (p=0.018. Unfortunately, findings for many other genes lack replication in independent cohorts to confirm association; further studies are needed. Also, the biological functionality of these polymorphisms is unknown. Based on current evidence, we propose that pharmacogenomics may provide an important tool to individualize pioglitazone therapy and better optimize therapy in patients with T2DM or other conditions for which pioglitazone

  11. Topical steroids in the current clinical practice

    Directory of Open Access Journals (Sweden)

    T. A. Belousova

    2014-01-01

    Full Text Available The article discusses issues related to current criteria for selection of glucocorticosteroids for external use as the basic therapy for a great number of allergic and inflammatory skin diseases. The authors emphasize that non-fluorinated GCSs having the best efficacy-to-safety ratio must be the drugs of first choice. The article provides data on a positive clinical experience of using a non-halogenated glucocorticosteroid for external use - hydrocortisone 17-butyrate (Laticort - for treatment of steroid-sensitive dermatoses in children and adults. The drug has a high anti-inflammatory action and minimum risk of the development of side effects, which is sufficient for using it in sensitive areas of skin (face, neck, folds, genitals both in children and in adults. The availability of three forms of the drug (solution, cream and ointment ensures the expedience and convenience of its application at any stage of the inflammatory process and for any localization.

  12. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  13. [Current state of competence assessment in nursing].

    Science.gov (United States)

    Darmann-Finck, Ingrid; Reuschenbach, Bernd

    2013-01-01

    Competency measurement is central to the optimisation of outcome oriented educational processes in nursing, similar to the concept of evidence based practice. The classification of measurement tools provides the basis for describing the current state of research and development in relation to competence measurement in nursing science, and any gaps are identified. The article concludes with questioning the importance of outcome oriented quality orientation in order to achieve an increase in quality during training. Further methodological developments and qualitative studies are needed to examine the context specific processes of interaction and learning, beyond competence diagnostics. Copyright © 2012. Published by Elsevier GmbH.

  14. RETAIL BANKING BUSINESS: CURRENT STATE ANDSPECIFIC FEATURES

    Directory of Open Access Journals (Sweden)

    Гузель Рефкадовна Фаизова

    2013-04-01

    Full Text Available The role and importance of the retail banking business in the banking sector continueto grow. The current state of the retail banking business is considered and specific features of this area in the face of growing demand for banking products and services by the public and interest from lending institutions are identified by the article.Purpose: Research of current state of retail banking business and detection specific features of this area.Methodology: In the process of analysis and researchof the question the methods of economical and statistical analysis, methods of comparison and generalizationwereused.Results: The conclusion is that interest in the retail banking business continues to grow.There were revealed the role and the importance of standardized service processes and standardized products and services delivering as one of the main line of development in the segment of retail business.DOI: http://dx.doi.org/10.12731/2218-7405-2013-3-2

  15. Hyperthermia: Clinical promise and current challenges

    International Nuclear Information System (INIS)

    Kapp, D.S.

    1987-01-01

    Local-regional hyperthermia (HT) when used in conjunction with radiation therapy (XRT), has been shown in numerous clinical trials to result in considerable improvement in response rates and local tumor control rates when compared with treatment by XRT alone. Although considerable progress has been made in understanding the biological basis for hyperthermia induced cytotoxicity and radiosensitization, additional research remains in establishing the optimal treatment schedules for the clinical utilization of HT-XRT. The number of HT treatments; the sequencing of HT and XRT; the frequency of administration of HT; and the ideal temperature-time parameters all remain to be better defined for the clinical setting. The role of tumor blood flow on the thermal distributions also warrants further investigation. In addition, considerable effort is needed to improve hyperthermia equipment in order to provide more uniform therapeutic temperature distributions (temperatures ≥42.5%C). Better heating equipment is particularly needed for the treatment of deep seeted tumors. Pertinent clinical literature will be presented summarizing the clinical promise of hyperthermia and the above mentioned clinical challenges

  16. On the Current Thermal State of Mars.

    Science.gov (United States)

    Grott, M.; Breuer, D.

    2008-09-01

    Introduction: The current thermal state of Mars is a fundamental unknown in Mars science. Although is has a huge influence on the planet's current geodynamic activity and controls the possibility for basal melting at the polar caps [1], constraints on this quantities are very scarce. This situation has lately been improved by the study of lithospheric deformation at the north polar cap [2] which constrained the current Martian elastic lithosphere thickness Te, an indirect measure of the temperatures in the planetary interior. Using radar sounding data obtained bySHARAD, the shallow radar onboard the Mars Reconnaissance Orbiter, [2] found that the current Martian lithosphere is extremely stiff and Te is larger than 300 km today. This is surprising as this value is almost twice as large as previously estimated from theoretical considerations and flexure studies [3][1]. In order to be consistent with the planets thermal evolution, [2] argue that the amount of radioactive elements in the Martian interior needs to be subchondritic. This appears to be problematic as geochemical analysis of the SNC meteorites implies higher concentrations of radioactive elements [4]. Furthermore, if the concentration of heat producing elements is indeed reduced, the resulting low interior temperatures will inhibit partial mantle melting and magmatism. However, geological evidence suggests that Mars has been volcanically active in the recent past [5]. In order to address these inconsistencies, we reinvestigate the thermal evolution of Mars and examine its current thermal state for a wide range of initial condition using the current elastic thickness Te and the potential for partial mantle melting to constrain our models. Modeling: We investigate the thermal evolution of Mars by solving the energy balance equations for the core and mantle, treating the mantle energy transport by parametrized convection models. This is done using scaling laws for stagnant lid convection and our model is

  17. Poliomyelitis in the United States: A Historical Perspective and Current Vaccination Policy.

    Science.gov (United States)

    Farizo, Karen M.; And Others

    1990-01-01

    Examines poliomyelitis in the United States by reviewing clinical manifestations and outcomes, history, recent epidemiologic characteristics, characteristics of currently available vaccines, controversies surrounding vaccination policy, current poliovirus vaccination recommendations, and prospects for worldwide eradication. Poliomyelitis remains…

  18. Evaluation of leak current of clinical electrometers

    International Nuclear Information System (INIS)

    Lopez G, W.; Campos, X.

    2002-01-01

    The present work shows the evaluation of two electrometers model Victoreen used in radiotherapy. The performance of the electrometers was proven using a source of current, built inside the work frame arcal 34, and using like reference the norm iec 60371. The results of the tests of leakage, displacement of the zero and linealty of the electrometers are presented

  19. Current clinical research in orthodontics: a perspective.

    Science.gov (United States)

    Baumrind, Sheldon

    2006-10-01

    This essay explores briefly the approach of the Craniofacial Research Instrumentation Laboratory to the systematic and rigorous investigation of the usual outcome of orthodontic treatment in the practices of experienced clinicians. CRIL's goal is to produce a shareable electronic database of reliable, valid, and representative data on clinical practice as an aid in the production of an improved environment for truly evidence-based orthodontic treatment.

  20. Current and future perspectives in clinical management

    International Nuclear Information System (INIS)

    Willett, Christopher

    1996-01-01

    In the past several years, there has been significant progress and controversy in the clinical management of patients with rectal cancer as well as important advances in the understanding the biology of these tumors. The panel will highlight relevant biologic and clinical developments. One of major advances has been in the understanding of the molecular basis for the development of colon and rectal cancer with many of the events leading to cancer development having been determined. Although there is much to be learned, there is now a much improved understanding of colon and rectal carcinogenesis with the prospect of being able to define high risk patient populations and the possibility of early detection (before cancer formation) now a real possibility. In addition, the identification of favorable or unfavorable subsets of patients wit rectal cancer based on molecular markers is under active investigation. These exciting developments will be summarized. In the clinical arena, there are a number of controversial issues in the management of patients with rectal cancer. For patients with distal rectal cancer, the goals of therapy have evolved from cure to cure with sphincter preservation. The role of resection with coloanal anastomosis as an alternative to an abdominoperineal resection is also being defined. A wide array of treatment programs of radiation therapy and chemotherapy and sphincter sparing surgery are under active investigation. The relative merits of preoperative chemo-irradiation versus postoperative chemo-irradiation continues to be debated. The utility of total mesorectal excision is being evaluated and the need for adjuvant therapy is being questioned. These clinical issues will be highlighted

  1. Current developments in clinical multiphoton tomography

    Science.gov (United States)

    König, Karsten; Weinigel, Martin; Breunig, Hans Georg; Gregory, Axel; Fischer, Peter; Kellner-Höfer, Marcel; Bückle, Rainer

    2010-02-01

    Two-photon microscopy has been introduced in 1990 [1]. 13 years later, CE-marked clinical multiphoton systems for 3D imaging of human skin with subcellular resolution have been launched by the JenLab company with the tomograph DermaInspectTM. In 2010, the second generation of clinical multiphoton tomographs was introduced. The novel mobile multiphoton tomograph MPTflexTM, equipped with a flexible articulated optical arm, provides an increased flexibility and accessibility especially for clinical and cosmetical examinations. The multiphoton excitation of fluorescent biomolecules like NAD(P)H, flavins, porphyrins, elastin, and melanin as well as the second harmonic generation of collagen is induced by picojoule femtosecond laser pulses from an tunable turn-key near infrared laser system. The ability for rapid highquality image acquisition, the user-friendly operation of the system, and the compact and flexible design qualifies this system to be used for melanoma detection, diagnostics of dermatological disorders, cosmetic research, and skin aging measurements as well as in situ drug monitoring and animal research. So far, more than 1,000 patients and volunteers have been investigated with the multiphoton tomographs in Europe, Asia, and Australia.

  2. Small Bowel Transplantation: Current Clinical Status

    Directory of Open Access Journals (Sweden)

    David Sigalet

    1991-01-01

    Full Text Available With recent refinements in immunosuppression techniques, the first successful reports of small bowel transplantation in humans have now been made, increasing interest in bowel transplantation among clinicians and patients alike. This article reviews recent developments in understanding of the functional capabilities and requirements for effective immune suppression in bowel transplantation. Both experimental and clinical experience with transplantation are discussed, as are the areas which appear to offer the most promise for future developments. Finally guidelines for consideration of patient selection for this procedure are reviewed.

  3. The Current State of Music Therapy Theory?

    DEFF Research Database (Denmark)

    Bonde, Lars Ole

    2015-01-01

    An essay on themes from Ken Aigen (2014): "The Study of Music Therapy. Current Issues and Concepts"......An essay on themes from Ken Aigen (2014): "The Study of Music Therapy. Current Issues and Concepts"...

  4. Ketamine use in current clinical practice

    Science.gov (United States)

    Gao, Mei; Rejaei, Damoon; Liu, Hong

    2016-01-01

    After nearly half a century on the market, ketamine still occupies a unique corner in the medical armamentarium of anesthesiologists or clinicians treating pain. Over the last two decades, much research has been conducted highlighting the drug's mechanisms of action, specifically those of its enantiomers. Nowadays, ketamine is also being utilized for pediatric pain control in emergency department, with its anti-hyperalgesic and anti-inflammatory effects being revealed in acute and chronic pain management. Recently, new insights have been gained on ketamine's potential anti-depressive and antisuicidal effects. This article provides an overview of the drug's pharmacokinetics and pharmacodynamics while also discussing the potential benefits and risks of ketamine administration in various clinical settings. PMID:27018176

  5. Syncope: causes, clinical evaluation, and current therapy.

    Science.gov (United States)

    Benditt, D G; Remole, S; Milstein, S; Bailin, S

    1992-01-01

    Syncope is a common clinical problem comprising the sudden loss of both consciousness and postural tone, with a subsequent spontaneous and relatively prompt recovery. Often it is difficult to differentiate a true syncopal spell from other conditions, such as seizure disorders, or from some simple accidents. Even more difficult is the identification of the cause of syncopal episodes. Nonetheless, establishing a definitive diagnosis ia an important task given the high risk of recurrent symptoms. Careful use of noninvasive and invasive cardiovascular studies (including electrophysiologic testing and tilt-table testing) along with selected hematologic, biochemical, and neurologic studies provides, in the majority of cases, the most effective strategy for obtaining a specific diagnosis and for directing therapy.

  6. The United States and Europe: Current Issues

    National Research Council Canada - National Science Library

    Archick, Kristin; Morelli, Vince L

    2006-01-01

    The United States and Europe share a long and intertwined history. Both sides of the Atlantic face a common set of international concerns, have few other comparable partners, and share a deep economic relationship...

  7. Clinical applications of resting state functional connectivity

    Directory of Open Access Journals (Sweden)

    Michael D Fox

    2010-06-01

    Full Text Available During resting conditions the brain remains functionally and metabolically active. One manifestation of this activity that has become an important research tool is spontaneous fluctuations in the blood oxygen level dependent (BOLD signal of fMRI. The identification of correlation patterns in these spontaneous fluctuations has been termed resting state functional connectivity (fcMRI and has the potential to greatly increase the translation of fMRI into clinical care. In this article we review the advantages of the resting state signal for clinical applications including detailed discussion of signal to noise considerations. We include guidelines for performing resting state research on clinical populations, outline the different areas for clinical application, and identify important barriers to be addressed to facilitate the translation of resting state fcMRI into the clinical realm.

  8. [Osteoporosis: Current state of the art].

    Science.gov (United States)

    Verbovoy, A F; Pashentseva, A V; Sharonova, L A

    As of now, osteoporosis (OP) is one of the most important sociomedical problems because of its high prevalence and resultant disability, as well as significant mortality attributable to complications. The current strategy for providing care for patients of OP is its early diagnosis, by determining the high risk of fractures, and early pathogenetic treatment. The article gives an update on the epidemiology, risk factors, diagnosis, and treatment of OP.

  9. Digital mammography: current state and future aspects

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Baum, F. [Womens Health Care Center Goettingen, Diagnostisches Brustzentrum Goettingen, Goettingen (Germany); Hermann, K.P. [Georg-August-Universitaet Goettingen, Abteilung Diagnostische Radiologie, Goettingen (Germany)

    2006-01-01

    The introduction of digital technique in mammography has been the last step in completing the process of digitalization in diagnostic imaging. Meanwhile, some different digital techniques as well as a couple of different digital mammography systems were developed and have already been available for some years. In this review article, the relevant data of key studies are reported, the current status is defined, and perspectives of digital mammography are described. (orig.)

  10. Current State of Military Hybrid Vehicle Development

    Science.gov (United States)

    2011-01-01

    programme were: • EP-50 parallel hybrid light armoured vehicle (LAV-III) and a refuse hauler • advanced hybrid electric drive (AHED) 8 × 8, 20 ton...herein do not necessarily state or reflect those of the US Government or the DoA, and shall not be used for advertising or product endorsement purposes. 2 Unclassified. Distribution Statement A. Approved for public release.

  11. Cognition in epilepsy: current clinical issues of interest.

    Science.gov (United States)

    Witt, Juri-Alexander; Helmstaedter, Christoph

    2017-04-01

    This review provides an update and summary of recent neuropsychological findings in epilepsy focusing on three major clinical topics among the many developments in the field. We will critically outline the current state with regard to cognition in new-onset epilepsies, social cognition in epilepsy, and the long-term outcome of epilepsy surgery and the cognitive outcomes of superselective surgical procedures. Current studies indicate that neuropsychological impairments are prevalent already at the onset of epilepsy and even before, social cognition (i.e., emotion recognition and theory of mind) is impaired in different epilepsy populations, the long-term outcome of epilepsy surgery is mostly characterized by a stable or even improved cognitive status, and superselective epilepsy surgeries are associated with a promising neuropsychological outcome. The high prevalence of cognitive deficits around epilepsy onset challenges the assumption that epilepsy is the major cause of cognitive problems and calls for early neuropsychological diagnostics. Social cognition seems to be a relevant domain that is not yet routinely considered in epilepsy. The cognitive long-term outcome of epilepsy surgery is mostly positive. Stereotactic thermocoagulation and gamma knife surgery appear to be cognitively safe procedures.

  12. [The current state of obesity in Mexico].

    Science.gov (United States)

    Barrera-Cruz, Antonio; Rodríguez-González, Arturo; Molina-Ayala, Mario Antonio

    2013-01-01

    Excess weight (overweight and obesity) is currently recognized as one of the most important challenges of public health in the world, given its size, speed of growth, and the negative effect on the population who suffers it. Overweight and obesity increases significantly the risk of chronic non-communicable diseases, and premature mortality, as well as the social cost of health. Today, Mexico has the second global prevalence of obesity in the adult population (30 %), which is ten times higher than Korea's or Japan's (4 %). Until 2012, 26 million Mexican adults were overweight, and 22 million, obese. This implies a major challenge for the health sector. Mexico needs to plan and implement strategies and cost-effective actions for the prevention and control of obesity in children, adolescents, and adults. Global experience shows that proper care of obesity and overweight demands to formulate and coordinate efficient multi-sectoral strategies for enhancing protective factors to health, particularly to modify individual behavior, family and community.

  13. Current state of molecular imaging research

    International Nuclear Information System (INIS)

    Grimm, J.; Wunder, A.

    2005-01-01

    The recent years have seen significant advances in both molecular biology, allowing the identification of genes and pathways related to disease, and imaging technologies that allow for improved spatial and temporal resolution, enhanced sensitivity, better depth penetration, improved image processing, and beneficial combinations of different imaging modalities. These advances have led to a paradigm shift in the scope of diagnostic imaging. The traditional role of radiological diagnostic imaging is to define gross anatomy and structure in order to detect pathological abnormalities. Available contrast agents are mostly non-specific and can be used to image physiological processes such as changes in blood volume, flow, and perfusion but not to demonstrate pathological alterations at molecular levels. However, alterations at the anatomical-morphological level are relatively late manifestations of underlying molecular changes. Using molecular probes or markers that bind specifically to molecular targets allows for the non-invasive visualization and quantitation of biological processes such as gene expression, apoptosis, or angiogenesis at the molecular level within intact living organisms. This rapidly evolving, multidisciplinary approach, referred to as molecular imaging, promises to enable early diagnosis, can provide improved classification of stage and severity of disease, an objective assessment of treatment efficacy, and a reliable prognosis. Furthermore, molecular imaging is an important tool for the evaluation of physiological and pathophysiological processes, and for the development of new therapies. This article comprises a review of current technologies of molecular imaging, describes the development of contrast agents and various imaging modalities, new applications in specific disease models, and potential future developments. (orig.)

  14. The current state of serum biomarkers of hepatotoxicity.

    Science.gov (United States)

    Ozer, Josef; Ratner, Marcia; Shaw, Martin; Bailey, Wendy; Schomaker, Shelli

    2008-03-20

    The level of serum alanine aminotransferase (ALT) activity reflects damage to hepatocytes and is considered to be a highly sensitive and fairly specific preclinical and clinical biomarker of hepatotoxicity. However, an increase in serum ALT activity level has also been associated with other organ toxicities, thus, indicating that the enzyme has specificity beyond liver in the absence of correlative histomorphologic alteration in liver. Thus, unidentified non-hepatic sources of serum ALT activity may inadvertently influence the decision of whether to continue development of a novel pharmaceutical compound. To assess the risk of false positives due to extraneous sources of serum ALT activity, additional biomarkers are sought with improved specificity for liver function compared to serum ALT activity alone. Current published biomarker candidates are reviewed herein and compared with ALT performance in preclinical and on occasion, clinical studies. An examination of the current state of hepatotoxic biomarkers indicates that serum F protein, arginase I, and glutathione-S-transferase alpha (GSTalpha) levels, all measured by ELISA, may show utility, however, antibody availability and high cost per run may present limitations to widespread applicability in preclinical safety studies. In contrast, the enzymatic markers sorbitol dehydrogenase, glutamate dehydrogenase, paraxonase, malate dehydrogenase, and purine nucleoside phosphorylase are all readily measured by photometric methods and use reagents that work across preclinical species and humans and are commercially available. The published literature suggests that these markers, once examined collectively in a large qualification study, could provide additional information relative to serum ALT and aspartate aminotransferase (AST) values. Since these biomarkers are found in the serum/plasma of treated humans and rats, they have potential to be utilized as bridging markers to monitor acute drug-induced liver injury in

  15. The current state of serum biomarkers of hepatotoxicity

    International Nuclear Information System (INIS)

    Ozer, Josef; Ratner, Marcia; Shaw, Martin; Bailey, Wendy; Schomaker, Shelli

    2008-01-01

    The level of serum alanine aminotransferase (ALT) activity reflects damage to hepatocytes and is considered to be a highly sensitive and fairly specific preclinical and clinical biomarker of hepatotoxicity. However, an increase in serum ALT activity level has also been associated with other organ toxicities, thus, indicating that the enzyme has specificity beyond liver in the absence of correlative histomorphologic alteration in liver. Thus, unidentified non-hepatic sources of serum ALT activity may inadvertently influence the decision of whether to continue development of a novel pharmaceutical compound. To assess the risk of false positives due to extraneous sources of serum ALT activity, additional biomarkers are sought with improved specificity for liver function compared to serum ALT activity alone. Current published biomarker candidates are reviewed herein and compared with ALT performance in preclinical and on occasion, clinical studies. An examination of the current state of hepatotoxic biomarkers indicates that serum F protein, arginase I, and glutathione-S-transferase alpha (GSTα) levels, all measured by ELISA, may show utility, however, antibody availability and high cost per run may present limitations to widespread applicability in preclinical safety studies. In contrast, the enzymatic markers sorbitol dehydrogenase, glutamate dehydrogenase, paraxonase, malate dehydrogenase, and purine nucleoside phosphorylase are all readily measured by photometric methods and use reagents that work across preclinical species and humans and are commercially available. The published literature suggests that these markers, once examined collectively in a large qualification study, could provide additional information relative to serum ALT and aspartate aminotransferase (AST) values. Since these biomarkers are found in the serum/plasma of treated humans and rats, they have potential to be utilized as bridging markers to monitor acute drug-induced liver injury in early

  16. Current Status of Operation and Management of Dental School Clinics.

    Science.gov (United States)

    Reinhardt, John W

    2017-08-01

    This article summarizes the current status of the operation and management of dental school clinics as schools strive to provide excellent patient-centered care in an environment that is educationally sound, efficient, and financially strong. Clinical education is a large component of dental education and an area in which many dental schools have an opportunity to enhance revenue. Clinical efficiencies and alternative models of clinical education are evolving in U.S. dental schools, and this article describes some of those evolutionary changes. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  17. Current clinical approach to patients with disorders of consciousness

    Directory of Open Access Journals (Sweden)

    Robson Luis Oliveira de Amorim

    Full Text Available Summary In clinical practice, hospital admission of patients with altered level of consciousness, sleepy or in a non-responsive state is extremely common. This clinical condition requires an effective investigation and early treatment. Performing a focused and objective evaluation is critical, with quality history taking and physical examination capable to locate the lesion and define conducts. Imaging and laboratory exams have played an increasingly important role in supporting clinical research. In this review, the main types of changes in consciousness are discussed as well as the essential points that should be evaluated in the clinical management of these patients.

  18. Clinical exome sequencing reports: current informatics practice and future opportunities.

    Science.gov (United States)

    Swaminathan, Rajeswari; Huang, Yungui; Astbury, Caroline; Fitzgerald-Butt, Sara; Miller, Katherine; Cole, Justin; Bartlett, Christopher; Lin, Simon

    2017-11-01

    The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging. This paper reviews a sample of clinical exome reports generated by Clinical Laboratory Improvement Amendments-certified genetic testing laboratories at tertiary-care facilities to assess and identify common data elements. Like structured radiology reports, which enable faster information retrieval and reuse, structuring genetic information within clinical WES reports would help facilitate integration of genetic information into electronic health records and enable retrospective research on the clinical utility of WES. We identify elements listed as mandatory according to practice guidelines but are currently missing from some of the clinical reports, which might help to organize the data when stored within structured databases. We also highlight elements, such as patient consent, that, although they do not appear within any of the current reports, may help in interpreting some of the information within the reports. Integrating genetic and clinical information would assist the adoption of personalized medicine for improved patient care and outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Historical Trust Levels Predict Current Welfare State Design

    DEFF Research Database (Denmark)

    Bergh, Andreas; Bjørnskov, Christian

    Using cross-sectional data for 76 countries, we apply instrumental variable techniques based on pronoun drop, temperature and monarchies to demonstrate that historical trust levels predict several indicators of current welfare state design, including universalism and high levels of regulatory...... freedom. We argue that high levels of trust and trustworthiness are necessary, but not sufficient, conditions for societies to develop successful universal welfare states that would otherwise be highly vulnerable to free riding and fraudulent behavior. Our results do not exclude positive feedback from...... welfare state universalism to individual trust, although we claim that the important causal link runs from historically trust levels to current welfare state design....

  20. Current state about the cuaternary knowledge of Uruguay

    International Nuclear Information System (INIS)

    Anton, D; Goso, H.

    1974-01-01

    This work is about current state of cuaternary knowledge Uruguayan. It is considered that the cuaternary presented a change from the hot and dry weather of the Pliocene to more humid and colder weather in Uruguay.

  1. A Survey of the Current Situation of Clinical Biobanks in China.

    Science.gov (United States)

    Li, Haiyan; Ni, Mingyu; Wang, Peng; Wang, Xiaomin

    2017-06-01

    The development of biomedical research urgently needs the support of a large number of high-quality clinical biospecimens. Therefore, human biobanks at different levels have been established successively in China and other countries at a significantly increasing pace in recent years. To better understand the general current state of clinical biobanks in China, we surveyed 42 clinical biobanks based in hospitals and collected information involving their management systems, sharing mechanisms, quality control systems, and informational management systems using closed questionnaire methods. Based on our current information, there has not been such a large-scale survey in China. An understanding of the status and challenges current clinical biobanks face will provide valuable insights for the construction and sustainable development of higher quality clinical biobanks.

  2. Mineralized Collagen: Rationale, Current Status, and Clinical Applications

    Directory of Open Access Journals (Sweden)

    Zhi-Ye Qiu

    2015-07-01

    Full Text Available This paper presents a review of the rationale for the in vitro mineralization process, preparation methods, and clinical applications of mineralized collagen. The rationale for natural mineralized collagen and the related mineralization process has been investigated for decades. Based on the understanding of natural mineralized collagen and its formation process, many attempts have been made to prepare biomimetic materials that resemble natural mineralized collagen in both composition and structure. To date, a number of bone substitute materials have been developed based on the principles of mineralized collagen, and some of them have been commercialized and approved by regulatory agencies. The clinical outcomes of mineralized collagen are of significance to advance the evaluation and improvement of related medical device products. Some representative clinical cases have been reported, and there are more clinical applications and long-term follow-ups that currently being performed by many research groups.

  3. Challenges of implementing fibromyalgia treatment guidelines in current clinical practice.

    Science.gov (United States)

    Arnold, Lesley M; Clauw, Daniel J

    2017-09-01

    The current diagnostic and treatment pathway for patients with fibromyalgia (FM) is lengthy, complex, and characterized by multiple physician visits with an average 2-year wait until diagnosis. It is clear that effective identification and appropriate treatment of FM remain a challenge in current clinical practice. Ideally, FM management involves a multidisciplinary approach with the preferable patient pathway originating in primary care but supported by a range of health care providers, including referral to specialist care when necessary. After the publication of individual clinical studies, high-quality reviews, and meta-analyses, recently published FM treatment guidelines have transitioned from an expert consensus to an evidence-based approach. Evidence-based guidelines provide a framework for ensuring early diagnosis and timely adoption of appropriate treatment. However, for successful outcomes, FM treatments must adopt a more holistic approach, which addresses more than just pain. Impact on the associated symptoms of fatigue and cognitive problems, sleep and mood disturbances, and lowered functional status are also important in judging the success of FM therapy. Recently published guidelines recommend the adoption of a symptom-based approach to guide pharmacologic treatment. Emerging treatment options for FM may be best differentiated on the basis of their effect on comorbid symptoms that are often associated with pain (e.g. sleep disturbance, mood, fatigue). The current review discusses the most recently published Canadian guidelines and the implications of the recent European League Against Rheumatism (EULAR) recommendations, with a focus on the challenges of implementing these guidelines in current clinical practice.

  4. THE CURRENT STATE OF CLOTHING TRADE IN THE BALKAN COUNTRIES

    OpenAIRE

    TRIPA Simona; CUC Sunhilde; YALDIZ Suleyman

    2017-01-01

    The study presented here is aimed at analysing the current state of clothing trade in the Balkan states. The dynamics of change over a 15‐year period following economic reforms are revealed. The clothing industries play a significant role and continue to contribute to the economic prosperity of countries with an inexpensive labour force. For most Balkan States clothing’s export plays an important role in promoting economic growth and development – for example, exports of garments Albania was ...

  5. [Current state of blood transfusion in Yugoslavia and its perspectives].

    Science.gov (United States)

    Bosković, S

    1975-01-01

    The current situation of the transfusion service in this country has been characterised by small-scale operational level, the lack of regional system and basic components of a single service. There is a great variety in the medical and expert point of view starting from the lack of elementary hygienic and technical conditions, down to developed institutions of the European level. This activity has been characterised for the last ten years or so by an effort to win blood-givers at all cost, to enhance production of intravenous solutions which in some factories have obtained factory production volume, to determine basic blood groups and a very modest diagnostics for haemolitic diseases of newly born children. A large number of doctors--transfusiologists have obtained specialists' titles, but without any prospects to change the present status of their work: blood conservation, efforts to win blood-givers and determine blood groups. The differentiation between transfusiologists and clinic-engaged personnel has been increasing, thus making the transfusiologists to be far from the problems of modern haematology and clinical therapy. Observing the situation and status of transfusiology in the developed countries of Western Europe, it is possible to state that the transfusiology is developing in the direction of cooperation and team-work with doctors engaged in clinics. Therefore, cooperation with doctors engaged in clinics should be cultivated and organise team work. The intermediary role of doctors-transfusiologist in the cycle of health improvement should be avoided by all means. 90% of packed blood in this country is consumed in the form of full blood or dry plasma and only 10% in the form of desired derivatives, instead of the contrary case, since the precisely set therapy using new haemostatic medicaments is an economical imperative. The electronic data processing of blood-givers enables doctors-transfusiologists to deal with these problems since this is much cheaper

  6. Ebola hemorrhagic Fever and the current state of vaccine development.

    Science.gov (United States)

    Hong, Joo Eun; Hong, Kee-Jong; Choi, Woo Young; Lee, Won-Ja; Choi, Yeon Hwa; Jeong, Chung-Hyeon; Cho, Kwang-Il

    2014-12-01

    Current Ebola virus outbreak in West Africa already reached the total number of 1,323 including 729 deaths by July 31st. the fatality is around 55% in the southeastern area of Guinea, Sierra Leone, Liberia, and Nigeria. The number of patients with Ebola Hemorrhagic Fever (EHF) was continuously increasing even though the any effective therapeutics or vaccines has not been developed yet. The Ebola virus in Guinea showed 98% homology with Zaire Ebola Virus. Study of the pathogenesis of Ebola virus infection and assess of the various candidates of vaccine have been tried for a long time, especially in United States and some European countries. Even though the attenuated live vaccine and DNA vaccine containing Ebola viral genes were tested and showed efficacy in chimpanzees, those candidates still need clinical tests requiring much longer time than the preclinical development to be approved for the practical treatment. It can be expected to eradicate Ebola virus by a safe and efficient vaccine development similar to the case of smallpox virus which was extinguished from the world by the variola vaccine.

  7. Fertility Preservation for Pediatric Patients: Current State and Future Possibilities.

    Science.gov (United States)

    Johnson, Emilie K; Finlayson, Courtney; Rowell, Erin E; Gosiengfiao, Yasmin; Pavone, Mary Ellen; Lockart, Barbara; Orwig, Kyle E; Brannigan, Robert E; Woodruff, Teresa K

    2017-07-01

    This review provides an overview of pediatric fertility preservation. Topics covered include the patient populations who could benefit, the current state of fertility preservation options and research, and considerations related to ethics and program development. A broad Embase® and PubMed® search was performed to identify publications discussing investigational, clinical, ethical and health care delivery issues related to pediatric fertility preservation. Relevant publications were reviewed and summarized. Populations who could benefit from fertility preservation in childhood/adolescence include oncology patients, patients with nononcologic conditions requiring gonadotoxic chemotherapy, patients with differences/disorders of sex development and transgender individuals. Peripubertal and postpubertal fertility preservation options are well established and include cryopreservation of oocytes, embryos or sperm. Prepubertal fertility preservation is experimental. Multiple lines of active research aim to develop technologies that will enable immature eggs and sperm to be matured and used to produce a biological child in the future. Ethical challenges include the need for parental proxy decision making and the fact that fertility preservation procedures can be considered not medically necessary. Successful multidisciplinary fertility preservation care teams emphasize partnerships with adult colleagues, prioritize timely consultations and use standardized referral processes. Some aspects of fertility preservation are not covered by insurance and out-of-pocket costs can be prohibitive. Pediatric fertility preservation is an emerging, evolving field. Fertility preservation options for prepubertal patients with fertility altering conditions such as cancer and differences/disorders of sex development are currently limited. However, multiple lines of active research hold promise for the future. Key considerations include establishing a multidisciplinary team to provide

  8. Transient and steady-state currents in epoxy resin

    International Nuclear Information System (INIS)

    Guillermin, Christophe; Rain, Pascal; Rowe, Stephen W

    2006-01-01

    Charging and discharging currents have been measured in a diglycidyl ether of bisphenol-A epoxy resin with and without silica fillers, below and above its glass transition temperature T g = 65 deg. C. Both transient and steady-state current densities have been analysed. The average applied fields ranged from 3 to 35 kV mm -1 with a sample thickness of 0.5 mm. Above T g , transient currents suggested a phenomenon of charge injection forming trapped space charges even at low fields. Steady-state currents confirmed that the behaviour was not Ohmic and suggested Schottky-type injection. Below T g , the current is not controlled by the metal-dielectric interface but by the conduction in the volume: the current is Ohmic at low fields and both transient and steady-state currents suggest a phenomenon of space-charge limited currents at high fields. The field threshold is similar in the filler-free and the filled resin. Values in the range 12-17 kV mm -1 have been measured

  9. Transient and steady-state currents in epoxy resin

    Energy Technology Data Exchange (ETDEWEB)

    Guillermin, Christophe [Schneider Electric Industries S.A.S., 37 quai Paul-Louis Merlin, 38050 Grenoble Cedex 9 (France); Rain, Pascal [Laboratoire d' Electrostatique et de Materiaux Dielectriques (LEMD), CNRS, 25 avenue des Martyrs, 38042 Grenoble Cedex 9 (France); Rowe, Stephen W [Schneider Electric Industries S.A.S., 37 quai Paul-Louis Merlin, 38050 Grenoble Cedex 9 (France)

    2006-02-07

    Charging and discharging currents have been measured in a diglycidyl ether of bisphenol-A epoxy resin with and without silica fillers, below and above its glass transition temperature T{sub g} = 65 deg. C. Both transient and steady-state current densities have been analysed. The average applied fields ranged from 3 to 35 kV mm{sup -1} with a sample thickness of 0.5 mm. Above T{sub g}, transient currents suggested a phenomenon of charge injection forming trapped space charges even at low fields. Steady-state currents confirmed that the behaviour was not Ohmic and suggested Schottky-type injection. Below T{sub g}, the current is not controlled by the metal-dielectric interface but by the conduction in the volume: the current is Ohmic at low fields and both transient and steady-state currents suggest a phenomenon of space-charge limited currents at high fields. The field threshold is similar in the filler-free and the filled resin. Values in the range 12-17 kV mm{sup -1} have been measured.

  10. Is current clinical practice modified about intraoperative breast irradiation?

    Science.gov (United States)

    Massa, Michela; Franchelli, Simonetta; Panizza, Renzo; Massa, Tiberio

    2016-04-01

    After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

  11. Tri-State Current Source Inverter With Improved Dynamic Performance

    DEFF Research Database (Denmark)

    Blaabjerg, Frede; Loh, Poh Chiang; Wong, Chow Pang

    2008-01-01

    Traditional dc-ac current source inverter (CSI) has a right-half-plane (RHP) zero in its control-to-output transfer function. This RHP zero causes the inverter output to fall before rising when a step increase in command reference is required (commonly known as non-minimum-phase effect). To achieve...... a better dynamic response, this paper proposes the design of a tri-state CSI using only an additional semiconductor switch for introducing unique freewheeling states to the traditional six active and three null states of a CSI. With the freewheeling states inserted appropriately within the inverter state...... sequence, the inductive boosting and discharging intervals can be decoupled, allowing the RHP zero to be eliminated with only minor circuit modifications (high level control schemes like predictive and multiloop voltage/current control remain unchanged). The designed inverter can be controlled using...

  12. Rectocele repair using biomaterial augmentation: current documentation and clinical experience.

    Science.gov (United States)

    Altman, Daniel; Mellgren, Anders; Zetterström, Jan

    2005-11-01

    Although the etiology of rectocele remains debated, surgical innovations are currently promoted to improve anatomic outcome while avoiding dyspareunia and alleviating rectal emptying difficulties following rectocele surgery. Use of biomaterials in rectocele repair has become widespread in a short time, but the clinical documentation of their effectiveness and complications is limited. Medline and the Cochrane database were searched electronically from 1964 to May 2005 using the Pubmed and Ovid search engines. All English language publications including any of the search terms "rectocele," "implant," "mesh," "biomaterial," "prolapse," "synthetical," "pelvic floor," "biological," and "compatibility" were reviewed. This review outlines the basic principles for use of biomaterials in pelvic reconstructive surgery and provides a condensation of peer-reviewed articles describing clinical use of biomaterials in rectocele surgery. Historical and new concepts in rectocele surgery are discussed. Factors of importance for human in vivo biomaterial compatibility are presented together with current knowledge from clinical studies. Potential risks and problems associated with the use of biomaterials in rectocele and pelvic reconstructive surgery in general are described. Although use of biomaterials in rectocele and other pelvic organ prolapse surgery offers exciting possibilities, it raises treatment costs and may be associated with unknown and potentially severe complications at short and long term. Clinical benefits are currently unknown and need to be proven in clinical studies. Obstetricians & Gynecologists, Family Physicians After completion of this article, the reader should be able to explain that the objective of surgical treatment is to improve anatomic outcome and alleviate rectal emptying difficulties, describe the efficacy of biomaterials in rectocele repair, and summarize the potential risks and problems associated with use of biomaterials in rectocele and pelvic

  13. Treatment of sepsis: current status of clinical immunotherapy.

    LENUS (Irish Health Repository)

    O'Callaghan, A

    2012-02-03

    While antibiotics address the root cause of sepsis--that of pathogen infection--they fail to provide an adequate cure for the condition. Currently, 30% to 50% of septic patients die, and this figure is likely to increase in line with the proliferation of multi-drug resistant bacteria. With an increased understanding of the immune response, it has been proposed that modulation of this defence mechanism offers the best hope of cure. Many entry-points in the immune system have been identified and targeted therapies have been developed,but why are these not in routine clinical practice? This review examines the latest evidence for the use of immuno-modulating drugs, obtained from human clinical trials. We discuss cytokine-based therapies, steroids and anti-coagulants. Finally, consideration is given as to why successful therapies in the laboratory, and in vivo models, do not automatically translate into clinical benefit

  14. Effectiveness of the current method of calculating member states' contributions

    CERN Document Server

    2002-01-01

    At its Two-hundred and eighty-sixth Meeting of 19 September 2001, the Finance Committee requested the Management to re-assess the effectiveness of the current method of forecasting Net National Income (NNI) for the purposes of calculating the Member States' contributions by comparing the results of the current weighted average method with a method based on a simple arithmetic average. The Finance Committee is invited to take note of this information.

  15. OSTEOARTHRITIS: CURRENT CLINICAL CONCEPT AND SOME PROMISING THERAPEUTIC APPROACHES

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2018-01-01

    Full Text Available In recent years, there has been a trend toward changing the clinical concept of osteoarthritis (OA. This disease has been considered as an age-related disease and the long-term result of a current pathological process for a very long time. However, many experts are now inclined to consider it necessary to identify the early, pre-X-ray stage of OA, when adequate treatment may not only halt the progression, but also achieve the regression of joint structural changes. This review deals with a number of pathogenetic and clinical aspects of the early stages of OA, which are important for timely diagnosis and pathogenetic therapy choice. It also considers some therapeutic approaches, both a "classic" and recently actively discussed methods for using platelet-rich plasma and autologous chondrocyte transplantation.

  16. Islet cell transplant: Update on current clinical trials

    Science.gov (United States)

    Schuetz, Christian; Markmann, James F.

    2016-01-01

    In the last 15 years clinical islet transplantation has made the leap from experimental procedure to standard of care for a highly selective group of patients. Due to a risk-benefit calculation involving the required systemic immunosuppression the procedure is only considered in patients with type 1 diabetes, complicated by severe hypoglycemia or end stage renal disease. In this review we summarize current outcomes of the procedure and take a look at ongoing and future improvements and refinements of beta cell therapy. PMID:28451515

  17. The Current State of Predicting Furrow Irrigation Erosion

    Science.gov (United States)

    There continues to be a need to predict furrow irrigation erosion to estimate on- and off-site impacts of irrigation management. The objective of this paper is to review the current state of furrow erosion prediction technology considering four models: SISL, WEPP, WinSRFR and APEX. SISL is an empiri...

  18. Biomarkers in prostate cancer - Current clinical utility and future perspectives.

    Science.gov (United States)

    Kretschmer, Alexander; Tilki, Derya

    2017-12-01

    Current tendencies in the treatment course of prostate cancer patients increase the need for reliable biomarkers that help in decision-making in a challenging clinical setting. Within the last decade, several novel biomarkers have been introduced. In the following comprehensive review article, we focus on diagnostic (PHI ® , 4K score, SelectMDx ® , ConfirmMDx ® , PCA3, MiPS, ExoDX ® , mpMRI) and prognostic (OncotypeDX GPS ® , Prolaris ® , ProMark ® , DNA-ploidy, Decipher ® ) biomarkers that are in widespread clinical use and are supported by evidence. Hereby, we focus on multiple clinical situations in which innovative biomarkers may guide decision-making in prostate cancer therapy. In addition, we describe novel liquid biopsy approaches (circulating tumor cells, cell-free DNA) that have been described as predictive biomarkers in metastatic castration-resistant prostate cancer and might support an individual patient-centred oncological approach in the nearer future. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. 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

  20. The current state of science in radiation protection

    International Nuclear Information System (INIS)

    Kaul, A.

    1985-01-01

    The qualification 'according to the current state of science and technology' is regularly found in radiation protection laws. It is assumed that the state of science and technology is codified in the publications of ICRP and ICRU, the International Comissions on Radiological Protection and - Units respectively, and in the UN publication USCEAR. An investigation is made on the extent the regulations of FRD comply with this requirement. Stochastic and non-stochastic damages are differentiated and the problem of assigning equivalent whole-body doses to exposures of specific body organs is considered. (G.Q.)

  1. [The current state and prospectives of military endocrinology].

    Science.gov (United States)

    Nagibovich, O A; Golota, A S; Krassiĭ, A B

    2014-10-01

    The article is dedicated to the current state and prospectives of military endocrinology demonstrated on the examples of the endocrinology services of armed forces of Serbia, Poland, France, and USA. It is shown that this branch of military healthcare receives much attention abroad. The prospectives of military endocrinology are demonstrated in the context of two nosological forms which dominate in this section of military medicine, namely, primary hypothyroidism an diabetes mellitus.

  2. Endoscopic Ultrasound Elastography: Current Clinical Use in Pancreas.

    Science.gov (United States)

    Mondal, Utpal; Henkes, Nichole; Patel, Sandeep; Rosenkranz, Laura

    2016-08-01

    Elastography is a newer technique for the assessment of tissue elasticity using ultrasound. Cancerous tissue is known to be stiffer (hence, less elastic) than corresponding healthy tissue, and as a result, could be identified in an elasticity-based imaging. Ultrasound elastography has been used in the breast, thyroid, and cervix to differentiate malignant from benign neoplasms and to guide or avoid unnecessary biopsies. In the liver, elastography has enabled a noninvasive and reliable estimate of fibrosis. Endoscopic ultrasound has become a robust diagnostic and therapeutic tool for the management of pancreatic diseases. The addition of elastography to endoscopic ultrasound enabled further characterization of pancreas lesions, and several European and Asian studies have reported encouraging results. The current clinical role of endoscopic ultrasound elastography in the management of pancreas disorders and related literature are reviewed.

  3. Introducing nuclear power into currently non-nuclear states

    International Nuclear Information System (INIS)

    Gert, Claassen

    2007-01-01

    As the nuclear renaissance gains momentum, many countries that currently have no nuclear power plants will begin to consider introducing them. It is anticipated that smaller reactors such as the Pebble Bed Modular Reactor (PBMR) will not only be sold to current nuclear states to also to states where there is currently no nuclear experience. A range of issues would have to be considered for nuclear plants to be sold to non-nuclear states, such as the appropriate regulatory environment, standardization and codes, non-proliferation, security of supply, obtaining experienced merchant operators, appropriate financial structures and education and training. The paper considers nine major issues that need to be addressed by governments and vendors alike: 1) political enabling framework, 2) regulatory framework, 3) responsible owner, 4) responsible operator, 5) finance, 6) contact management, 7) fuel supply and waste management framework, 8) training and education, and 9) industrial infrastructure. International cooperation by organisations such as the IAEA, financial institutions and international suppliers will be required to ensure that developing countries as well as developed ones share the benefits of the nuclear renaissance. The opportunities that the nuclear industry affords to develop local skills, create job opportunities and to develop local manufacturing industries are among the important reasons that the South African Government has decided to support and fund the development of the Pebble Bed Modular Reactor project. (author)

  4. Introducing nuclear power into currently non-nuclear states

    International Nuclear Information System (INIS)

    Claassen, Gert

    2007-01-01

    As the nuclear renaissance gains momentum, many countries that currently have no nuclear power plants will begin to consider introducing them. It is anticipated that smaller reactors such as the Pebble Bed Modulator Reactor (PBMR) will not only be sold to current nuclear states to also to states where there is currently no nuclear experience. A range of issues would have to be considered for nuclear plants to be solid to non-nuclear states, such as the appropriate regulatory environment, standardization and codes, non-proliferation, security of supply, obtaining experienced merchant operators, appropriate financial structures and education and training. The paper considers nine major issues that need to be addressed by governments and vendors alike. International cooperation by organisations such as the IAEA, financial institutions and international suppliers will be required to ensure that developing countries as well as developed ones share the benefits of the nuclear renaissance. The opportunities that the nuclear industry affords to develop local skills, create job opportunities and to develop local manufacturing industries are among the important reasons that the South African Government has decided to support and fund the development of the Pebble Bed Modular Reactor project. These considerations are included in the paper. (author)

  5. Figures in clinical trial reports: current practice & scope for improvement.

    Science.gov (United States)

    Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

    2007-11-19

    Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  6. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  7. Fundamentals of functional imaging I: current clinical techniques.

    Science.gov (United States)

    Luna, A; Martín Noguerol, T; Mata, L Alcalá

    2018-05-01

    Imaging techniques can establish a structural, physiological, and molecular phenotype for cancer, which helps enable accurate diagnosis and personalized treatment. In recent years, various imaging techniques that make it possible to study the functional characteristics of tumors quantitatively and reproducibly have been introduced and have become established in routine clinical practice. Perfusion studies enable us to estimate the microcirculation as well as tumor angiogenesis and permeability using ultrafast dynamic acquisitions with ultrasound, computed tomography, or magnetic resonance (MR) imaging. Diffusion-weighted sequences now form part of state-of-the-art MR imaging protocols to evaluate oncologic lesions in any anatomic location. Diffusion-weighted imaging provides information about the occupation of the extracellular and extravascular space and indirectly estimates the cellularity and apoptosis of tumors, having demonstrated its relation with biologic aggressiveness in various tumor lines and its usefulness in the evaluation of the early response to systemic and local targeted therapies. Another tool is hydrogen proton MR spectroscopy, which is used mainly in the study of the metabolic characteristics of brain tumors. However, the complexity of the technique and its lack of reproducibility have limited its clinical use in other anatomic areas, although much experience with the use of this technique in the assessment of prostate and breast cancers as well as liver lesions has also accumulated. This review analyzes the imaging techniques that make it possible to evaluate the physiological and molecular characteristics of cancer that have already been introduced into clinical practice, such as techniques that evaluate angiogenesis through dynamic acquisitions after the administration of contrast material, diffusion-weighted imaging, or hydrogen proton MR spectroscopy, as well as their principal applications in oncology. Copyright © 2018 SERAM. Publicado

  8. Neoplastic stem cells: current concepts and clinical perspectives.

    Science.gov (United States)

    Schulenburg, Axel; Brämswig, Kira; Herrmann, Harald; Karlic, Heidrun; Mirkina, Irina; Hubmann, Rainer; Laffer, Sylvia; Marian, Brigitte; Shehata, Medhat; Krepler, Clemens; Pehamberger, Hubert; Grunt, Thomas; Jäger, Ulrich; Zielinski, Christoph C; Valent, Peter

    2010-11-01

    Neoplastic stem cells have initially been characterized in myeloid leukemias where NOD/SCID mouse-repopulating progenitors supposedly reside within a CD34+/Lin- subset of the malignant clone. These progenitors are considered to be self-renewing cells responsible for the in vivo long-term growth of neoplastic cells in leukemic patients. Therefore, these cells represent an attractive target of therapy. In some lymphoid leukemias, NOD/SCID mouse-repopulating cells were also reported to reside within the CD34+/Lin- subfraction of the clone. More recently, several attempts have been made to transfer the cancer stem cell concept to solid tumors and other non-hematopoietic neoplasms. In several of these tumors, the cell surface antigens AC133 (CD133) and CD44 are considered to indicate the potential of a cell to initiate permanent tumor formation in vivo. However, several questions concerning the phenotype, self-renewal capacity, stroma-dependence, and other properties of cancer- or leukemia-initiating cells remain to be solved. The current article provides a summary of our current knowledge on neoplastic (cancer) stem cells, with special emphasis on clinical implications and therapeutic options as well as a discussion about conceptual and technical limitations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Coherent current states in mesoscopic four-terminal Josephson junction

    International Nuclear Information System (INIS)

    Zareyan, M.; Omelyanchouk, A.N.

    1999-01-01

    A theory is offered for the ballistic 4-terminal Josephson junction. The studied system consist of a mesoscopic two-dimensional normal rectangular layer which is attached on each side to the bulk superconducting banks (terminals). A relation is obtained between the currents through the different terminals, that is valid for arbitrary temperatures and junction sizes. The nonlocal coupling of the supercurrent leads to a new effect, specific for the mesoscopic weak link between two superconducting rings; an applied magnetic flux through one of the rings produces a magnetic flux in the other ring even in the absence of an external flux through the other one. The phase dependent distributions of the local density of Andreev states, of the supercurrents and of the induced order parameter are obtained. The 'interference pattern' for the anomalous average inside the two-dimensional region cam be regulated by the applied magnetic fluxes or the transport currents. For some values of the phase differences between the terminals, the current vortex state and two-dimensional phase slip center appear

  10. Single-electron states near a current-carrying core

    International Nuclear Information System (INIS)

    Masale, M.

    2004-01-01

    The energy spectrum of an electron confined near a current-carrying core is obtained as a function of the azimuthal applied magnetic field within the effective-mass approximation. The double degeneracy of the non-zero electron's axial wave number (k z ) states is lifted by the current-induced magnetic field while that of the non-zero azimuthal quantum number (m) states is preserved. A further analysis is the evaluations of the oscillator strengths for optical transitions involving the lowest-order pair of the electron's energy subbands within the dipole approximation. The radiation field is taken as that of elliptically polarized light incident along the core axis. In this polarization and within the dipole approximation, the allowed transitions are only those governed by the following specific selection rules. The azimuthal quantum numbers of the initial and final states must differ by unity while the electron's axial wave number is conserved. The azimuthal magnetic field is also found to lift the multiple degeneracies of the k z ≠0 interaction integrals as well as those of the oscillator strengths for optical transitions

  11. The US Opioid Crisis: Current Federal and State Legal Issues.

    Science.gov (United States)

    Soelberg, Cobin D; Brown, Raeford E; Du Vivier, Derick; Meyer, John E; Ramachandran, Banu K

    2017-11-01

    The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing. Other federal agencies involved with the federal regulatory effort include the Food and Drug Administration (FDA), the Drug Enforcement Agency (DEA), and the Department of Justice. Each federal agency has a unique role in helping to stem the burgeoning opioid misuse epidemic. The DEA, working with the Department of Justice, has enforcement power to prosecute pill mills and physicians for illegal prescribing. The DEA could also implement use of prescription drug monitoring programs (PDMPs), currently administered at the state level, and use of electronic prescribing for schedule II and III medications. The FDA has authority to approve new and safer formulations of immediate- and long-acting opioid medications. More importantly, the FDA can also ask pharmaceutical companies to cease manufacturing a drug. Additionally, state agencies play a critical role in reducing overdose deaths, protecting the public safety, and promoting the medically appropriate treatment of pain. One of the states' primary roles is the regulation of practice of medicine and the insurance industry within their borders. Utilizing this authority, states can both educate physicians about the dangers of opioids and make physician licensure dependent on registering and using PDMPs when prescribing controlled substances. Almost every state has implemented a PDMP to some degree; however, in addition to mandating their use, increased interstate

  12. Fueling Requirements for Steady State high butane current fraction discharges

    International Nuclear Information System (INIS)

    R.Raman

    2003-01-01

    The CT injector originally used for injecting CTs into 1T toroidal field discharges in the TdeV tokamak was shipped PPPL from the Affiliated Customs Brokers storage facility in Montreal during November 2002. All components were transported safely, without damage, and are currently in storage at PPPL, waiting for further funding in order to begin advanced fueling experiments on NSTX. The components are currently insured through the University of Washington. Several technical presentations were made to investigate the feasibility of the CT injector installation on NSTX. These technical presentations, attached to this document, were: (1) Motivation for Compact Toroida Injection in NSTX; (2) Assessment of the Engineering Feasibility of Installing CTF-II on NSTX; (3) Assessment of the Cost for CT Installation on NSTX--A Peer Review; and (4) CT Fueling for NSTX FY 04-08 steady-state operation needs

  13. Microbial production of hyaluronic acid: current state, challenges, and perspectives

    Directory of Open Access Journals (Sweden)

    Liu Long

    2011-11-01

    Full Text Available Abstract Hyaluronic acid (HA is a natural and linear polymer composed of repeating disaccharide units of β-1, 3-N-acetyl glucosamine and β-1, 4-glucuronic acid with a molecular weight up to 6 million Daltons. With excellent viscoelasticity, high moisture retention capacity, and high biocompatibility, HA finds a wide-range of applications in medicine, cosmetics, and nutraceuticals. Traditionally HA was extracted from rooster combs, and now it is mainly produced via streptococcal fermentation. Recently the production of HA via recombinant systems has received increasing interest due to the avoidance of potential toxins. This work summarizes the research history and current commercial market of HA, and then deeply analyzes the current state of microbial production of HA by Streptococcus zooepidemicus and recombinant systems, and finally discusses the challenges facing microbial HA production and proposes several research outlines to meet the challenges.

  14. New Way of Characterizing the State of the Ring Current

    Science.gov (United States)

    Wolf, R.; Bao, S.; Gkioulidou, M.; Yang, J.; Toffoletto, F.

    2017-12-01

    The flux tube entropy S is invariant in ideal MHD and is a good way to characterize the degree to which a closed flux tube is loaded with particle energy. Flux tube entropy generally increases with increasing geocentric distance. A flux tube that is injected from the plasma sheet into the ring current tends to be a bubble that has a lower S value than typical plasma sheet flux tubes, and it tends to penetrate to a position where the surroundings matches its S. From this point of view, a good way to characterize the state of the ring current is through the function dF/dS, which specifies how much magnetic flux is occupied by tubes with different degrees of loading. By displaying dF/dS curves before and during storm main phases simulated with the RCM-E code, we determine that, in the model, the injection of the stormtime ring current consists of replacing pre-storm low-S flux tubes with tubes from the plasma sheet that have a certain limited range of S, which is well below typical plasma-sheet values. We also display dF/dS curves for passes by the Van Allen Probes before and during storm main phases, and compare with the RCM-E-derived curves, to gain insight into the nature of the flux tubes that are injected to form the real storm-time ring current.

  15. The Current State of Silicone-Based Dielectric Elastomer Transducers

    DEFF Research Database (Denmark)

    Madsen, Frederikke Bahrt; Daugaard, Anders Egede; Hvilsted, Søren

    2016-01-01

    class of transducer due to their inherent lightweight and potentially large strains. For the field to progress towards industrial implementation, a leap in material devel- opment is required, specifically targeting longer lifetime and higher energy densities to provide more efficient transduction at lower...... driving voltages. In this review, the current state of sili- cone elastomers for DETs is summarised and critically discussed, including commercial elastomers, composites, polymer blends, grafted elastomers and complex network structures. For future developments in the field it is essential that all aspects...

  16. Tetracritical point and current circulations in superconducting state

    International Nuclear Information System (INIS)

    Belyavskij, V.I.; Kopaev, Yu.V.; Smirnov, M.Yu.

    2005-01-01

    Phase diagram reflecting the key peculiar features of the standard diagram of the cuprate superconductors was studied in terms of the Ginzburg-Landau phenomenology near the tetracritical point resulting from the competition of superconducting and dielectric channels of pairing. Two-component parameter of order the relative phase of which is associated with antiferromagnetic dielectric ordering corresponds to the superconducting pairing at repulsion. In case of slight doping the dielectric order coexists with superconductivity below the temperature of superconducting phase transition and manifests itself as a slight pseudoslit above the mentioned temperature. A segment of pseudoslit region adjacent to the superconducting state corresponds to the matured fluctuations of the order parameter in the form of quasi-stationary states of noncoherent superconducting pairs and may be interpreted as a region of a strong pseudoslit. At increase of doping one observes a phase transition from the coexistence region and the orbital antiferromagnetism to the conventional superconducting state covering the region of matured fluctuations of the order parameter in the form of quasi-stationary states of the noncorrelated orbital circulation currents adjacent to the line of phase transition [ru

  17. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    Directory of Open Access Journals (Sweden)

    Scott Okuno

    2011-08-01

    Full Text Available Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

  18. Clinical proteomics: Current status, challenges, and future perspectives

    Directory of Open Access Journals (Sweden)

    Shyh-Horng Chiou

    2011-01-01

    Full Text Available This account will give an overview and evaluation of the current advances in mass spectrometry (MS-based proteomics platforms and technology. A general review of some background information concerning the application of these methods in the characterization of molecular sizes and related protein expression profiles associated with different types of cells under varied experimental conditions will be presented. It is intended to provide a concise and succinct overview to those clinical researchers first exposed to this foremost powerful methodology in modern life sciences of postgenomic era. Proteomic characterization using highly sophisticated and expensive instrumentation of MS has been used to characterize biological samples of complex protein mixtures with vastly different protein structure and composition. These systems are then used to highlight the versatility and potential of the MS-based proteomic strategies for facilitating protein expression analysis of various disease-related organisms or tissues of interest. Major MS-based strategies reviewed herein include (1 matrix-assisted laser desorption ionization-MS and electron-spray ionization proteomics; (2 one-dimensional or two-dimensional gel-based proteomics; (3 gel-free shotgun proteomics in conjunction with liquid chromatography/tandem MS; (4 Multiple reaction monitoring coupled tandem MS quantitative proteomics and; (5 Phosphoproteomics based on immobilized metal affinity chromatography and liquid chromatography-MS/MS.

  19. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    International Nuclear Information System (INIS)

    Joglekar, Siddharth B.; Rose, Peter S.; Sim, Franklin; Okuno, Scott; Petersen, Ivy

    2011-01-01

    Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation

  20. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues.

    Directory of Open Access Journals (Sweden)

    Ethan Budd Russo

    2016-09-01

    Full Text Available This overview covers a wide range of cannabis topics, initially examining issue in dispensaries and self-administration, plus regulatory requirement for production of cannabis-based medicines, particularly the Food and Drug Administration Botanical Guidance. The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety and public health issues remain.

  1. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

    Science.gov (United States)

    Russo, Ethan B.

    2016-01-01

    This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions, and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability (DAL) of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety, and public health issues remain. PMID:27683558

  2. The Development and Current State of Translation Process Research

    DEFF Research Database (Denmark)

    Lykke Jakobsen, Arnt

    2014-01-01

    The development and current state of translation process research ch Arnt Lykke Jakobsen Copenhagen Business School lInterest in process-oriented translation studies has been intense for the past almost half a century. Translation process research (TPR) is the label we have used to refer to a spe...... itself, into regions like cognitive psychology, psycho- and neurolinguistics, and neuroscience, where the interest in what goes on in our heads is also very strong.......The development and current state of translation process research ch Arnt Lykke Jakobsen Copenhagen Business School lInterest in process-oriented translation studies has been intense for the past almost half a century. Translation process research (TPR) is the label we have used to refer...... which simultaneously tracks the translator’s eye movements across a screen displaying both a source text and the translator’s emerging translation. This research method was developed as a means of qualifying and strengthening translation process hypotheses based on verbal reports by providing additional...

  3. Current referral practices and adolescent transition to Adult clinic ...

    African Journals Online (AJOL)

    2016-02-02

    Feb 2, 2016 ... of adolescent transition from child to adult care ... from paediatric to adult clinics. Adolescent ... The fate of older adolescent patients in paediatric clinics is either one of ..... fer depends on physical and psychological factors and.

  4. Study of the leakage current of clinical dosimeters for teletherapy

    International Nuclear Information System (INIS)

    Damatto, Willian B.; Santos, Gelson P.; Potiens, Maria da Penha A.; Caldas, Linda V.E.; Vivolo, Vitor

    2009-01-01

    This work demonstrates the importance of quality control of clinical dosemeters and therefore the equipment for radiotherapy treatment, exhibiting the necessary care related to answers and sensibilities and the possible defects of the clinical assembly

  5. Quantum decay of metastable current states in rf squids

    International Nuclear Information System (INIS)

    Dmitrenko, I.M.; Khlus, V.A.; Tsoj, C.M.; Shnyrkov, V.I.

    1985-01-01

    Quantum decay of metastable current states in a rf SQUID superconducting ring of a hysteresis mode are considered. Point contacts are used as a Josephson weak link. The first derivative of rf IVC, dVsub(T)/dIsub(RF), is measured which gives the dependence of the density of decay probability on the amplitude of magnetic flux oscillations in the ring. The temperature dependence of probability distribution width between 4.2 and 0.5 K suggests that for most of high-ohmic contacts Nb-Nb, Nb-Ag-Nb the quantum mechanisms of decay become dominant beginning with the temperature of about 2 K. The experimental parameters of distribution of decay probability in the quantum limit are compared to those calculated by the theory of macroscopic quantum tunneling in the limit of high and low dissipation. The experimental values of probability density distribution width and characteristic quantum temperature are higher than the theoretical ones, the fact can be attributed to the deviation of current-phase relation of contact from a sinusoidal one. Besides, some contacts seem to correspond to the case of an intermediate value of dissipation. As the frequency of rf oscillations varies from 30 to 6 MHz, the distribution width remains unchanged in accordance with the theory of quantum tunneling decay of metastable current state in the ring in the limit of high damping. At low temperatures (T approximately 0.5 K), and rather small damping coefficient, the density of probability displays anomalous peaks when the amplitude of rf oscillations is lower considerably than the critical vaiue of magnetic flux in the ring

  6. Current status on performance of CT colonography and clinical indications

    International Nuclear Information System (INIS)

    Laghi, Andrea; Rengo, Marco; Graser, Anno; Iafrate, Franco

    2013-01-01

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

  7. Current status on performance of CT colonography and clinical indications

    Energy Technology Data Exchange (ETDEWEB)

    Laghi, Andrea, E-mail: andrea.laghi@uniroma1.it [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Rengo, Marco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Graser, Anno [InstitutfürKlinische Radiologie, Klinikumder Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377 München (Germany); Iafrate, Franco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome (Italy)

    2013-08-15

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

  8. Current trends in the cardiovascular clinical trial arena (I

    Directory of Open Access Journals (Sweden)

    Pater Cornel

    2004-06-01

    Full Text Available Abstract The existence of effective therapies for most cardiovascular disease states, coupled with increased requirements that potential benefits of new drugs be evaluated on clinical rather than surrogate endpoints, makes it increasingly difficult to substantiate any incremental improvements in efficacy that these new drugs might offer. Compounding the problem is the highly controversial issue of comparing new agents with placebos rather than active pharmaceuticals in drug efficacy trials. Despite the recent consensus that placebos may be used ethically in well-defined, justifiable circumstances, the problem persists, in part because of increased scrutiny by ethics committees but also because of considerable lingering disagreement regarding the propriety and scientific value of placebo-controlled trials (and trials of antihypertensive drugs in particular. The disagreement also substantially affects the most viable alternative to placebo-controlled trials: actively controlled equivalence/noninferiority trials. To a great extent, this situation was prompted by numerous previous trials of this type that were marked by fundamental methodological flaws and consequent false claims, inconsistencies, and potential harm to patients. As the development and use of generic drugs continue to escalate, along with concurrent pressure to control medical costs by substituting less-expensive therapies for established ones, any claim that a new drug, intervention, or therapy is "equivalent" to another should not be accepted without close scrutiny. Adherence to proper methods in conducting studies of equivalence will help investigators to avoid false claims and inconsistencies. These matters will be addressed in the third article of this three-part series.

  9. The current and ideal state of anatomic pathology patient safety.

    Science.gov (United States)

    Raab, Stephen Spencer

    2014-01-01

    An anatomic pathology diagnostic error may be secondary to a number of active and latent technical and/or cognitive components, which may occur anywhere along the total testing process in clinical and/or laboratory domains. For the pathologist interpretive steps of diagnosis, we examine Kahneman's framework of slow and fast thinking to explain different causes of error in precision (agreement) and in accuracy (truth). The pathologist cognitive diagnostic process involves image pattern recognition and a slow thinking error may be caused by the application of different rationally-constructed mental maps of image criteria/patterns by different pathologists. This type of error is partly related to a system failure in standardizing the application of these maps. A fast thinking error involves the flawed leap from image pattern to incorrect diagnosis. In the ideal state, anatomic pathology systems would target these cognitive error causes as well as the technical latent factors that lead to error.

  10. The current state of the California biomass energy industry

    International Nuclear Information System (INIS)

    Morris, G.P.

    1994-01-01

    During the decade of the 1980s the California biomass energy industry grew from a few isolated facilities located mostly at pulp mills into the largest biomass energy industry in the world. Currently, more than fifty biomass powered electricity generating facilities provide the state with some 850 Megawatts (MW) of generating capacity, most of it interconnected to the state's electric utility systems. Each year, more than ten million tons of wood and agricultural wastes in the state are converted into fuel, rather than being disposed of using conventional, environmentally costly methods like open burning and landfill burial. As the 1980s began, the California biomass energy industry was in a nascent state. Optimism was blooming within the wood-products and agricultural sectors of California, who foresaw an opportunity to turn costly wastes into profits. At the same time, the independent energy industry itself was being launched. Interest in biomass energy development was spreading to the engineering and construction industries and the financial community as well. A great variety of firms and individuals were engaged in the development of biomass power plants and biomass fuel sources. The second half of the 1980s saw the fruits of the developmental activity that began in the first half of the decade. Biomass energy facilities were entering construction and coming on-line in increasing numbers, and the demand for biomass fuels was increasing in step. As the decade was coming to an end, biomass fuel supplies were hard put to meet the demand, yet a huge number of new facilities entered operation in 1990. This extreme growth spurt of new generating capacity caused a fuel crisis and a shake-out in the industry just as it was entering full-scale operation. The Crisis of Success had been reached. More recently an equilibrium has been achieved in which fuel prices are at levels that produce adequate supplies, while allowing profitable operations at the power plants

  11. THE CURRENT STATE OF CLOTHING TRADE IN THE BALKAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    TRIPA Simona

    2017-05-01

    Full Text Available The study presented here is aimed at analysing the current state of clothing trade in the Balkan states. The dynamics of change over a 15‐year period following economic reforms are revealed. The clothing industries play a significant role and continue to contribute to the economic prosperity of countries with an inexpensive labour force. For most Balkan States clothing’s export plays an important role in promoting economic growth and development – for example, exports of garments Albania was in 2015, 16.81% of its exports, Republic of Macedonia 11.75% of its exports, in Turkey10.51% etc. The main factors which influence the level of competitiveness of clothing products from the Balkans are the gross value added per employee and wages. When the producers of the Balkan countries will create products with higher added value in garment industry the competitiveness of these countries will decrease. Also rising wages in this industry, as a result of trade union pressure or government policy, will lead to decreasing competitiveness of these products on the EU market and implicitly to the decrease of exports of garments from these countries. The main challenges that must face the Balkan States are related to restructuring of economic system, changing trade markets and patterns, declining of domestic demand of most merchandise, reduction of competitive ability, narrow export base, and lower economies of scale. The main opportunities that most of these countries can exploit are related to their geographical position, membership of the EU market, infrastructure in garment sector, and highly skilled workforce.

  12. Imaging of lumbar degenerative disk disease: history and current state

    International Nuclear Information System (INIS)

    Emch, Todd M.; Modic, Michael T.

    2011-01-01

    One of the most common indications for performing magnetic resonance (MR) imaging of the lumbar spine is the symptom complex thought to originate as a result of degenerative disk disease. MR imaging, which has emerged as perhaps the modality of choice for imaging degenerative disk disease, can readily demonstrate disk pathology, degenerative endplate changes, facet and ligamentous hypertrophic changes, and the sequelae of instability. Its role in terms of predicting natural history of low back pain, identifying causality, or offering prognostic information is unclear. As available modalities for imaging the spine have progressed from radiography, myelography, and computed tomography to MR imaging, there have also been advances in spine surgery for degenerative disk disease. These advances are described in a temporal context for historical purposes with a focus on MR imaging's history and current state. (orig.)

  13. Development and current state of dosimetry in Cuba

    International Nuclear Information System (INIS)

    Prieto Miranda, E.F.; Cuesta Fuente, G.; Chavez Ardanza, A.

    1999-01-01

    In Cuba, the application of the radiation technologies has been growing in the last years, and at present there are several dosimetry systems with different ranges of absorbed dose. Diverse researches were carried out on high dose dosimetry with the following dosimetry systems: Fricke, ceric-cerous sulfate, ethanol-chlorobenzene, cupric sulfate and Perspex (Red 4034 AE and Clear HX). In this paper the development achieved during the last 15 years in the high dose dosimetry for radiation processing in Cuba is presented, as well as, the current state of different dosimetry systems employed for standardization and for process control. The paper also reports the results of dosimetry intercomparison studies that were performed with the Ezeiza Atomic Center of Argentine and the International Dose Assurance Service (IDAS) of IAEA. (author)

  14. The current state of industry development in Ukraine: advance perspective

    Directory of Open Access Journals (Sweden)

    Skyba Maryna Valeriyivna

    2015-02-01

    Full Text Available The current state of the industry of Ukraine are considered at the article. The author determined that the stabilization of the situation and further development of the industry need first of all cessation of hostilities. It is necessary to implement effective measures to combat corruption, the development of consistent, constructive and concerted action on the formation of institutions guaranteeing stability, predictability and transparency of the market rules and procedures that minimize the impact of shadow factors, and implementation of professional privatization and limitation of monopoly at the markets, forming a transparent, competitive business environment, the introduction of new energy saving technologies. These measures will help attract investment, increase production and improve enterprise profitability.

  15. Licensed pertussis vaccines in the United States: History and current state

    OpenAIRE

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that w...

  16. Mixed states in bipolar disorder - changes in DSM-5 and current treatment recommendations.

    Science.gov (United States)

    Betzler, Felix; Stöver, Laura Apollonia; Sterzer, Philipp; Köhler, Stephan

    2017-11-01

    Mixed states in affective disorders represent a particular challenge in clinical routine, characterized by a complicated course of treatment and a worse treatment response. Clinical features of mixed states and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria are presented and critical discussed. We then performed a systematic review using the terms 'bipolar', 'mixed' and 'randomized' to evaluate current treatment options. For pharmacological treatment of mixed states in total, there is still insufficient data from RCTs. However, there is some evidence for efficacy in mixed states from RCTs for atypical antipsychotics, especially olanzapine, aripiprazole and asenapine as well as mood stabilizers as valproate and carbamazepine. Mixed states are of a high clinical relevance and the DSM-5 criteria substantially reduced the diagnostic threshold. Besides advantages of a better characterization of patients with former DSM-IV-defined mixed episodes, disadvantages arise for example differential diagnoses with a substantial overlap in symptoms such as borderline personality disorders. Atypical antipsychotics, valproate and carbamazepine demonstrated efficacy in a limited sample of RCTs. The number of RCTs in the treatment of mixed states is highly limited. Furthermore, nearly all studies were funded by pharmaceutical companies which may lead to an underestimation of classical mood stabilizers such as lithium.

  17. Enceladus: three-act play and current state

    Science.gov (United States)

    Luan, J.; Goldreich, P.

    2017-12-01

    Eccentricity (e) growth as Enceladus migrates deeper into mean motion resonance with Dione results in increased tidal heating. As the bottom of the ice shell melts, the rate of tidal heating jumps and runaway melting ensues. At the end of run-away melting, the shell's thickness has fallen below the value at which the frequency of free libration equals the orbital mean motion and e has damped to well below its current value. Subsequently, both the shell thickness and e partake in a limit cycle. As e damps toward its minimum value, the shell's thickness asymptotically approaches its resonant value from below. After minimum e, the shell thickens quickly and e grows even faster. This cycle is likely to have been repeated multiple times in the past. Currently, e is much smaller than its equilibrium value corresponding to the shell thickness. Physical libration resonance resolves this mystery, it ensures that the low-e and medium-thickness state is present for most of the time between consecutive limit cycles. It is a robust scenario that avoids fine tuning or extreme parameter choice, and naturally produces episodic stages of high heating, consistent with softening of topographical features on Enceladus.

  18. ["Good dying"--definition and current state of research].

    Science.gov (United States)

    Hutter, Nico; Stößel, Ulrich; Meffert, Cornelia; Körner, Mirjam; Bozzaro, Claudia; Becker, Gerhild; Baumeister, Harald

    2015-08-01

    The advances of modern medicine did not only result in prolongation of life expectancy, but also led to a shift from dying at home to dying in public institutions. In western countries most people die at advanced age in medical facilities. Hence, the question regarding the conditions, which should be provided by society and especially medicine, to allow terminally ill people to experience "good dying" is substantial. For this purpose, an examination of patients', family members' and health care providers' understanding of the term " good dying" is required. The present paper aims at shedding light on the term "good dying" and to summarize the current state of research. Therefore, the attributes of "good dying" will be described from the perspectives of patients, family members and health care providers, which are discussed and examined in current medical-sociological research. These attributes can be illustrated on three dimensions: Quality of life at the end of life (e. g. pain relief, mental well-being), quality of dying (e. g. avoiding prolonged dying, autonomy, presence of relatives) and quality of health care at the end of life (e. g. patient-oriented health care, positive communication between health care providers and patients, availability of guidelines). Although the attributes of "good dying" are described in detail in the existing literature, further studies have to clarify the relevance and impact of these attributes as predictors of "good dying". © Georg Thieme Verlag KG Stuttgart · New York.

  19. Consumer Mobile Health Apps: Current State, Barriers, and Future Directions.

    Science.gov (United States)

    Kao, Cheng-Kai; Liebovitz, David M

    2017-05-01

    This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed. These apps have the potential to provide low-cost, around-the-clock access to high-quality, evidence-based health information to end users on a global scale. However, they have not yet lived up to their potential due to multiple barriers, including lack of regulatory oversight, limited evidence-based literature, and concerns of privacy and security. The future directions may consist of improving data integration into the health care system, an interoperable app platform allowing access to electronic health record data, cloud-based personal health record across health care networks, and increasing app prescription by health care providers. For consumer mobile health apps to fully contribute value to health care delivery and chronic disease management, all stakeholders within the ecosystem must collaborate to overcome the significant barriers. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  20. [Mixed affective states in the juvenile age (historical aspects, current state of the problem, psychopathology)].

    Science.gov (United States)

    Kopeĭko, G I

    2011-01-01

    The author analyzed the problem in historical, diagnostic and psychopathological aspects and presented the results of his own study. The aim was to study the structure and dynamics of endogenous juvenile mixed states in order to work out the psychopathological typology and to clarify the criteria of diagnosis, differential treatment and clinical-social prognosis. The study included 174 patients, 118 men and 56 women, aged from 17 to 25 years (mean age 20, 4 years). Depressive states were found in 65%, mania in 16% and mixed in 19% of patients. The clinical differentiation of mixed states was carried out basing on the dominating pole of affective disorders and the following types were singled out and described: mania type (dysphoria-like mania)--34%, depressive type (association-driven depression)--38%; alternating type of mixed states--28%. The preference of the formation of alternating and atypical variants of mixed states in the juvenile age demonstrated in the study may reflect the pathogenetic and pathoplastic effect of biological features characteristic of this age--lability and polymorphism of clinical presentations as well as immaturity of emotional and cognitive spheres.

  1. Helical system. History and current state of helical research

    International Nuclear Information System (INIS)

    Yokoyama, Masayuki

    2017-01-01

    This paper described the following: (1) history of nuclear fusion research of Japan's original heliotron method, (2) worldwide development of nuclear fusion research based on helical system such as stellarator, and (3) worldwide meaning of large helical device (LHD) aiming to demonstrate the steady-state performance of heliotron type in the parameter area extrapolable to the core plasma, and research results of LHD. LHD demonstrated that the helical system is excellent in steady operation performance at the world's most advanced level. In an experiment using deuterium gas in 2017, LHD achieved to reach 120 million degrees of ion temperature, which is one index of nuclear fusion condition, demonstrated the realization of high-performance plasma capable of extrapolating to future nuclear fusion reactors, and established the foundation for full-scale research toward the realization of nuclear fusion reactor. Besides experimental research, this paper also described the helical-type stationary nuclear fusion prototype reactor, FFHR-d1, which was based on progress of large-scale simulation at the world's most advanced level. A large-scale superconducting stellarator experimental device, W7-X, with the same scale as LHD, started experiment in December 2015, whose current state is also touched on here. (A.O.)

  2. Proton Therapy Expansion Under Current United States Reimbursement Models

    Energy Technology Data Exchange (ETDEWEB)

    Kerstiens, John [Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Johnstone, Peter A.S., E-mail: pajohnst@iupui.edu [Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States)

    2014-06-01

    Purpose: To determine whether all the existing and planned proton beam therapy (PBT) centers in the United States can survive on a local patient mix that is dictated by insurers, not by number of patients. Methods and Materials: We determined current and projected cancer rates for 10 major US metropolitan areas. Using published utilization rates, we calculated patient percentages who are candidates for PBT. Then, on the basis of current published insurer coverage policies, we applied our experience of what would be covered to determine the net number of patients for whom reimbursement is expected. Having determined the net number of covered patients, we applied our average beam delivery times to determine the total number of minutes needed to treat that patient over the course of their treatment. We then calculated our expected annual patient capacity per treatment room to determine the appropriate number of treatment rooms for the area. Results: The population of patients who will be both PBT candidates and will have treatments reimbursed by insurance is significantly smaller than the population who should receive PBT. Coverage decisions made by insurers reduce the number of PBT rooms that are economically viable. Conclusions: The expansion of PBT centers in the US is not sustainable under the current reimbursement model. Viability of new centers will be limited to those operating in larger regional metropolitan areas, and few metropolitan areas in the US can support multiple centers. In general, 1-room centers require captive (non–PBT-served) populations of approximately 1,000,000 lives to be economically viable, and a large center will require a population of >4,000,000 lives. In areas with smaller populations or where or a PBT center already exists, new centers require subsidy.

  3. PUBLIC ADMINISTRATION: MODERNIZING THE CURRENT MODEL OF STATE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Evgenii V. Ohotskii

    2014-01-01

    Full Text Available Applying the method of retrospective analysis the article deals with the process of forming the scientific fundamentals and the search by the international community of effective and adequate to the current stage of social development public administration system. The author attempts to analyze, in a number of cases in terms of models, features of public administration systems at different stages of historical development, drawing attention to reasons why the Soviet model of public administration did not manage to meet competition, did not provide the required social effect and as a natural result suffered a defeat in the global confrontation between the two social systems. Current models and theoretical concepts of public administration, especially the "new public administration", which became scientific basis for administrative reforms implemented in many countries, are the particular subject of scientific analysis. The author draws attention to major comprehensive characteristics of modern state public administration: making it impossible to absolutize principles of traditional hierarchy system of forced administration; globalization - gradual destruction of boundaries between national and international levels of administration, the growing role of supranational subjects of administration relations; informatization - increasing importance of information and communication technologies and of political networks: development of civil society, especially political parties and non-governmental organizations, growing public involvement in discussion and adoption of the most important administrative decisions; making the state policy more pluralistic and which will result in the formation of nonlinear - humanistic social consciousness as the intellectual basis of modern social governance. The author's position is that Russia is yet to solve the issue of choosing a public administration model that would be effective for further administrative

  4. Positron Computed Tomography: Current State, Clinical Results and Future Trends

    Science.gov (United States)

    Schelbert, H. R.; Phelps, M. E.; Kuhl, D. E.

    1980-09-01

    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends. (ACR)

  5. Combination injuries - current state of pathology and clinical practice

    International Nuclear Information System (INIS)

    Messerschmidt, O.

    1987-01-01

    Study of the literature reveals that most animal-experimental investigations are concerned with the combination of radiation plus burn. As it seems, this form of injury is also the most dangerous type of combination injury. Investigations have shown fatality from irradiation injury plus burns to be not merely additive. Rather, the lethal effects of the combined factors of harm are raised to a power of each other's potential. On other combinations of injuries, the literature presents far less findings. Nor do the prospects for their healing seem to be as unfavourable as in the case of burns. There seems to be a time factor according to which healing prospects depend on whether a trauma was sustained before or after whole-body irradiation and on the lapse of time between the two traumas. Transfer of the results obtained from experimental animals, mostly rodents, to man carries problems. Knowledge of how to treat combination injuries in a nuclear catastrophe is inadequate, too. Some treatment proposals are put up for discussion. (orig./MG) [de

  6. Clinical management of achalasia: current state of the art

    Directory of Open Access Journals (Sweden)

    Krill JT

    2016-04-01

    Full Text Available Joseph T Krill, Rishi D Naik, Michael F Vaezi Division of Gastroenterology, Hepatology, and Nutrition, Center for Swallowing and Esophageal Disorders, Vanderbilt University Medical Center, Nashville, TN, USA Abstract: Achalasia is a primary disorder of esophageal motility. It classically presents with dysphagia to both solids and liquids but may be accompanied by regurgitation and chest pain. The gold standard for the diagnosis of achalasia is esophageal motility testing with manometry, which often reveals aperistalsis of the esophageal body and incomplete lower esophageal sphincter relaxation. The diagnosis is aided by complimentary tests, such as esophagogastroduodenoscopy and contrast radiography. Esophagogastroduodenoscopy is indicated to rule out mimickers of the disease known as “pseudoachalasia” (eg, malignancy. Endoscopic appearance of a dilated esophagus with retained food or saliva and a puckered lower esophageal sphincter should raise suspicion for achalasia. Additionally, barium esophagography may reveal a dilated esophagus with a distal tapering giving it a “bird’s beak” appearance. Multiple therapeutic modalities aid in the management of achalasia, the decision of which depends on operative risk factors. Conventional treatments include medical therapy, botulinum toxin injection, pneumatic dilation, and Heller myotomy. The last two are defined as the most definitive treatment options. New emerging therapies include peroral endoscopic myotomy, placement of self-expanding metallic stents, and endoscopic sclerotherapy. Keywords: achalasia, pseudoachalasia, pneumatic dilation, Heller myotomy, botulinum toxin injection, peroral endoscopic myotomy

  7. Clinical management of achalasia: current state of the art

    Science.gov (United States)

    Krill, Joseph T; Naik, Rishi D; Vaezi, Michael F

    2016-01-01

    Achalasia is a primary disorder of esophageal motility. It classically presents with dysphagia to both solids and liquids but may be accompanied by regurgitation and chest pain. The gold standard for the diagnosis of achalasia is esophageal motility testing with manometry, which often reveals aperistalsis of the esophageal body and incomplete lower esophageal sphincter relaxation. The diagnosis is aided by complimentary tests, such as esophagogastroduodenoscopy and contrast radiography. Esophagogastroduodenoscopy is indicated to rule out mimickers of the disease known as “pseudoachalasia” (eg, malignancy). Endoscopic appearance of a dilated esophagus with retained food or saliva and a puckered lower esophageal sphincter should raise suspicion for achalasia. Additionally, barium esophagography may reveal a dilated esophagus with a distal tapering giving it a “bird’s beak” appearance. Multiple therapeutic modalities aid in the management of achalasia, the decision of which depends on operative risk factors. Conventional treatments include medical therapy, botulinum toxin injection, pneumatic dilation, and Heller myotomy. The last two are defined as the most definitive treatment options. New emerging therapies include peroral endoscopic myotomy, placement of self-expanding metallic stents, and endoscopic sclerotherapy. PMID:27110134

  8. Positron computed tomography: current state, clinical results and future trends

    Energy Technology Data Exchange (ETDEWEB)

    Schelbert, H.R.; Phelps, M.E.; Kuhl, D.E.

    1980-09-01

    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends. (ACR)

  9. Positron computed tomography: current state, clinical results and future trends

    International Nuclear Information System (INIS)

    Schelbert, H.R.; Phelps, M.E.; Kuhl, D.E.

    1980-01-01

    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends

  10. Rufinamide from clinical trials to clinical practice in the United States and Europe.

    Science.gov (United States)

    Resnick, Trevor; Arzimanoglou, Alexis; Brown, Lawrence W; Flamini, Robert; Kerr, Michael; Kluger, Gerhard; Kothare, Sanjeev; Philip, Sunny; Harrison, Miranda; Narurkar, Milind

    2011-05-01

    Rufinamide is a triazole derivative structurally unrelated to other antiepileptic drugs that is indicated for the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients aged ≥4 years. Originally granted orphan drug status, marketing authorisation was obtained on the basis of a randomised, double-blind, placebo-controlled trial conducted in 138 LGS patients. An open-label extension study subsequently demonstrated that rufinamide's efficacy and tolerability were maintained over the longer term (median duration of treatment, 432 days). Recently published reports from Europe and the United States have described the use of adjunctive rufinamide to treat LGS in clinical practice. These data complement the clinical trial results, by providing information on the efficacy and tolerability of rufinamide when used on an individualised basis in real-world practice, under less tightly restricted conditions in terms of patient population and dosing strategies. A comparison of the data reveals that a "lower and slower" dosing strategy tends to be adopted in clinical practice, in comparison with the clinical trial, which does not appear to compromise efficacy, but may provide improvements in tolerability. Individual case reports provide additional valuable information on how rufinamide is being used to treat different seizure types associated with LGS. Since clinical experience with rufinamide is currently at an early stage, there are still unanswered questions relating to its use, and it is likely that its place in the adjunctive treatment of LGS will evolve as further data emerge.

  11. Laboratory diagnosis of Lyme borreliosis: Current state of the art and future perspectives.

    Science.gov (United States)

    Lohr, Benedikt; Fingerle, Volker; Norris, Douglas E; Hunfeld, Klaus-Peter

    2018-06-01

    This review is directed at physicians and laboratory personnel in private practice and clinics who treat and diagnose Lyme borreliosis (LB) in patients as part of their daily work. A major objective of this paper is to bring together background information on Borrelia (B.) burgdorferi sensu lato (s.l.) and basic clinical knowledge of LB, which is one of the most frequently reported vector-borne diseases in the Northern Hemisphere. The goal is to provide practical guidance for clinicians and for laboratory physicians, and scientists for a better understanding of current achievements and ongoing obstacles in the laboratory diagnosis of LB, an infectious disease that still remains one of the diagnostic chameleons of modern clinical medicine. Moreover, in bringing together current scientific information from guidelines, reviews, and original papers, this review provides recommendations for selecting the appropriate tests in relation to the patient's stage of disease to achieve effective, stage-related application of current direct and indirect laboratory methods for the detection of B. burgdorferi s.l. Additionally, the review aims to discuss the current state of the art concerning the diagnostic potential and limitations of the assays and test methods currently in use to optimize LB patient management and provide insight into the possible future prospects of this rapidly changing area of laboratory medicine.

  12. PHYLLOID TUMORS OF MAMMARY GLANDS. CURRENT STATE OF THE PROBLEM

    Directory of Open Access Journals (Sweden)

    A. D. Zikiryakhodzhaev

    2017-01-01

    Full Text Available Phylloid (leaf-shaped breast tumors are a rare disease and constitute 0.3–0.5% of all breast tumors. Due to the rare frequency of occurrence, as well as the small number of randomized studies that have been conducted on this pathology, there is currently no standardized approach to the diagnosis and treatment of phylloid tumors. The reports about these rare cases appearing in the literature are, as a rule, descriptive, which only emphasizes the difficulty of differential diagnosis, the development of the correct tactics for treating such patients. In connection with the rarity, it is very difficult to diagnose correctly this pathology, which requires a highly qualified doctor as a diagnostician in the initial contact with such a patient, and a pathologist doctor who establishes the final morphological diagnosis. Often, leaf-shaped tumors are mistaken for mammary fibroadenomas. Such difficulties in correct diagnosis in the preoperative period can lead to errors in the planning of treatment. Also, the recommendations for the treatment of patients with this diagnosis are not fully understood, since up to now there are no accepted treatment standards in both Russian and foreign recommendations. Due to the fact that this pathology of mammary glands is rare, the principles of treatment are based on small retrospective studies and clinical observations. In this review, we will discuss the results of major retrospective studies, including data on epidemiology, etiology, diagnostic approach, strategies and results of treatment of this complex group of breast pathologies.

  13. Transcatheter Pulmonary Valve Replacement: Current State of Art.

    Science.gov (United States)

    Alkashkari, Wail; Alsubei, Amani; Hijazi, Ziyad M

    2018-03-15

    The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. This review aims to summarize (1) the current state of the art for tPVR, (2) the expanding indications, and (3) the technological obstacles to optimizing tPVR. Since its introduction in 2000, more than ten thousands tPVR procedures have been performed worldwide. Although the indications for tPVR have been adapted earlier from those accepted for surgical intervention, they remain incompletely defined. The new imaging modalities give better assessment of cardiac anatomy and function and determine candidacy for the procedure. The procedure has been shown to be feasible and safe when performed in patients who received pulmonary conduit and or bioprosthetic valves between the right ventricle and the pulmonary artery. Fewer selected patients post trans-annular patch repair for tetralogy of Fallot may also be candidates for this technology. Size restrictions of the currently available valves limit deployment in the majority of patients post trans-annular patch repair. Newer valves and techniques are being developed that may help such patients. Refinements and further developments of this procedure hold promise for the extension of this technology to other patient populations.

  14. CRIMEAN TATAR FACTOR IN CRIMEA: THE CURRENT STATE AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    D. A. Merenkov

    2017-01-01

    Full Text Available The article deals with the current situation of the Crimean Tatars in Crimea after joining Russia. It is considered a number of decisions taken by Russia, which changed the life of this national minority. For example, according an official status to the Crimean-Tatar language or improving living conditions in Crimean Tatars-populated areas. The article highlights the creation of the Spiritual Administration of Muslims of Crimea. The author describes the renewal of the mass media in Crimea and the creation of the TV and Radio company Millet instead of the Ukrainian TV channel ATR. The author stresses the difference in the approaches of the Ukrainian and Russian authorities to the question of the deportation of the Crimean Tatars in 1944. The article touches upon the UN General Assembly resolution A / RES / 71/205, 19 December 2016. It is devoted to “Situation of human rights in the Autonomous Republic of Crimea and the city of Sevastopol (Ukraine”. The author offers to get acquainted with the opinion of the Crimean Tatars, who live in Crimea at present, about their current situation after the reunification of Crimea and Sevastopol with Russia. It is analyzed the Ukrainian authorities’ policy on the Crimean Tatars. The author notes the negative effect of the Ukrainian authorities on radical feelings in Crimea. The process of forming these sentiments is considered in the article. The author notes the increased military activities by the illegal armed groups of the Crimean Tatars in the Ukrainian part of the Russian-Ukrainian state boundary. The article emphasizes the evaluation of the Crimean Tatars’ influence on security and stability on the peninsula, as well as the prospects of it. The author gives recommendations on the establishment of inter-ethnic relations, and notes that there is a potential for further development of inter-ethnic dialogue. The author concludes that the Crimean Tatars can act as a stabilizing and destabilizing

  15. Neutron star matter equation of state: current status and challenges

    Science.gov (United States)

    Ohnishi, Akira

    2014-09-01

    Neutron star matter has a variety of constituents and structures depending on the density; neutron-rich nuclei surounded by electrons and drip neutrons in the crust, pasta nuclei at the bottom of inner crust, and uniform isospin-asymmetric nuclear matter in a superfluid state in the outer core. In the inner core, the neutron Fermi energy becomes so large that exotic constituents such as hyperons, mesons and quarks may emerge. Radioactive beam and hypernuclear experiments provide information on the symmetry energy and superfluidity in the crust and outer core and on the hyperon potentials in the inner core, respectively. Cold atom experiments are also helpful to understand pure neutron matter, which may be simulated by the unitary gas. An equation of state (EOS) constructed based on these laboratory experiments has to be verified by the astronomical observations such as the mass, radius, and oscillations of neutron stars. One of the key but missing ingredients is the three-baryon interactions such as the hyperon-hyperon-nucleon (YYN) interaction. YYN interaction is important in order to explain the recently discovered massive neutron stars consistently with laboratory experiments. We have recently found that the ΛΛ interaction extracted from the ΛΛ correlation at RHIC is somewhat stronger than that from double Λ hypernuclei. Since these two interactions corresponds to the vacuum and in-medium ΛΛ interactions, respectively, the difference may tell us a possible way to access the YYN interaction based on experimental data. In the presentation, after a review on the current status of neutron star matter EOS studies, we discuss the necessary tasks to pin down the EOS. We also present our recent study of ΛΛ interaction from correlation data at RHIC.

  16. The current state of water resources of Transcarpathia

    Directory of Open Access Journals (Sweden)

    V. І. Nikolaichuk

    2015-07-01

    sanitary rules and regulations by the most of indicators of general health and specific indices. 19.0% of total water supply systems fail to meet the sanitary norms and regulations, in particular: 14.2% for the lack of sanitary protection zones; 1.9% because of unavailability of the necessary integrated treatment facilities, and 7.6% by the reason of absence of disinfecting plants. Possible ways of avoiding the depletion of water bodies are preventive water protection measures aimed at preventing or limiting pollution, water contamination and depletion; besides, it is necessary to educate people explaning them the current state and possible consequences of thoughtless water consumption.

  17. ANTIFUNGAL SUSCEPTIBILITY TESTING: CURRENT ROLE FROM THE CLINICAL LABORATORY PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Brunella Posteraro

    2014-04-01

    Full Text Available Despite availability of many antifungal agents, antifungal clinical resistance occurs, perhaps as a result of an infecting organism found to be resistant in vitro to one or more antifungals tested. Thus, antifungal susceptibility testing (AFST results, if timely generated by the clinical microbiology and communicated to clinicians, can aid them in the therapeutic decision making, especially for difficult-to-treat invasive candidiasis and aspergillosis. Although recently refined AFST methods are commercially available to allow a close antifungal resistance surveillance in many clinical setting, novel assays, relying on short-time antifungal drug exposure of fungal isolates, are upcoming tools for AFST. Based on emerging technologies such as flow cytometry, MALDI-TOF mass spectrometry, and isothermal microcalorimetry, these assays could provide a reliable means for quicker and sensitive assessment of AFST.

  18. Computed tomography: acquisition process, technology and current state

    Directory of Open Access Journals (Sweden)

    Óscar Javier Espitia Mendoza

    2016-02-01

    Full Text Available Computed tomography is a noninvasive scan technique widely applied in areas such as medicine, industry, and geology. This technique allows the three-dimensional reconstruction of the internal structure of an object which is lighted with an X-rays source. The reconstruction is formed with two-dimensional cross-sectional images of the object. Each cross-sectional is obtained from measurements of physical phenomena, such as attenuation, dispersion, and diffraction of X-rays, as result of their interaction with the object. In general, measurements acquisition is performed with methods based on any of these phenomena and according to various architectures classified in generations. Furthermore, in response to the need to simulate acquisition systems for CT, software dedicated to this task has been developed. The objective of this research is to determine the current state of CT techniques, for this, a review of methods, different architectures used for the acquisition and some of its applications is presented. Additionally, results of simulations are presented. The main contributions of this work are the detailed description of acquisition methods and the presentation of the possible trends of the technique.

  19. Current State of Agile User-Centered Design: A Survey

    Science.gov (United States)

    Hussain, Zahid; Slany, Wolfgang; Holzinger, Andreas

    Agile software development methods are quite popular nowadays and are being adopted at an increasing rate in the industry every year. However, these methods are still lacking usability awareness in their development lifecycle, and the integration of usability/User-Centered Design (UCD) into agile methods is not adequately addressed. This paper presents the preliminary results of a recently conducted online survey regarding the current state of the integration of agile methods and usability/UCD. A world wide response of 92 practitioners was received. The results show that the majority of practitioners perceive that the integration of agile methods with usability/UCD has added value to their adopted processes and to their teams; has resulted in the improvement of usability and quality of the product developed; and has increased the satisfaction of the end-users of the product developed. The top most used HCI techniques are low-fidelity prototyping, conceptual designs, observational studies of users, usability expert evaluations, field studies, personas, rapid iterative testing, and laboratory usability testing.

  20. Herbal Supplements for Prostate Enlargement: Current State of the Evidence.

    Science.gov (United States)

    Nabavizadeh, Reza; Zangi, Mahdi; Kim, Michelle M; Yavari Bejestani, Maryam; Tabatabaei, Shahin

    2018-02-01

    To provide a comprehensive review of the current state of herbal supplement market for lower urinary tract symptoms (LUTS) and correlate the ingredients of each product with available scientific evidence. Twenty-seven products from Amazon.com that were advertised as herbal supplements for LUTS and had listed their active ingredients were selected. Active ingredients were reviewed on Google Scholar. Product price, warranty, and consumer review information were also collected. A total of 58 unique active ingredients were identified. The mean number of ingredients was 8.26 (standard deviation 5.25). Whereas 17 (63%) products had an ingredient with a systematic review to support their use, 20 (74%) had an ingredient with conflicting evidence based on systematic reviews. Out of the supplements that contained ingredients supported by literature, all (100%) products simultaneously had other ingredients with no, conflicting, or refuting evidence. There was no (0%) product that contained only scientifically proven ingredients. There is no scientific study to evaluate these supplements as a whole. Despite the widespread use of herbal supplements for LUTS, there is scant scientific evidence to support their safety and efficacy. Lack of adequate regulation and government support for research and development are some of the factors that disincentivize researchers to study safety and efficacy of these products. We encourage physicians to warn their patients on the lack of adequate evidence to support the safety and efficacy of many of these supplements. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Electronic money in russia: current state and problems of development

    Directory of Open Access Journals (Sweden)

    T. G. Bondarenko

    2016-01-01

    Full Text Available Article is devoted to urgent problems of non-cash methods of calculation development by using electronic money – as one of the modern economically developed state strategic tasks. On modern economic science strong influence appears informatization process. The control expansion tendency, influence and distribution of commerce due to informatization of society led to emergence of the new phenomenon – information economy. Information economy brought new economic events which owing to their novelty are insufficiently studied to life. It is possible to carry electronic money to such phenomena of modern network economy Relevance and, in our opinion, timeliness of this scientific work, consisting in novelty of this non-cash payment method, its prospects and innovation within non-cash methods of calculations. Authors set as the purpose – studying of problems and the prospects of development of electronic money in the Russian Federation. In article theoretical bases of electronic money functioning are described. Determinations and classifications dismissed non-cash a method, and also the principles of electronic money functioning are considered, the questions of their historical development are raised.Authors analyzed statistical data on development of electronic services and channels of their using. Features, benefits and shortcomings of the current state of the market of electronic money are studied. The emphasis on that fact that in modern conditions considerable number of economic actors perform the activities, both in the real environment of economy, and within the virtual environment that promotes expansion of methods of their customer interaction by means of technical devices of personal computers, mobile phones is placed. In article common problems and tendencies of payments with using an electronic money are designated, the research on assessment of the current state and the prospects of electronic money

  2. Clinical knowledge management: an overview of current understanding.

    Science.gov (United States)

    Bali, Rajeev K; Dwivedi, Ashish

    2005-01-01

    This chapter outlines contributions to a workshop for ICMCC 2005. We details some of the central issues surrounding the incorporation of the Knowledge Management (KM) paradigm for the healthcare and clinical sectors. The complex nature of KM is discussed, together with some essential theories and some contemporary applications of the tools and techniques are presented.

  3. The current status of oral contraceptive clinical development in Japan.

    Science.gov (United States)

    Kuwabara, Y

    1989-01-01

    Since the oral contraceptive guideline was issued in April 1987, Japanese pharmaceutical firms have been asking physicians to perform clinical studies of the low-dose OCs. At present, eight products from six companies are under clinical development. Ethinyl estradiol (30-35 micrograms per tablet) as an estrogen component is common to all the test drugs. The progestin component in each OC is norethindrone, levonorgestrel, or desogestrel. Phase I clinical studies on small numbers of healthy volunteers showed that they could tolerate the test drugs without any serious complaints. The effects on endocrine systems, including the inhibition of ovulation, were also examined. Pharmacokinetic parameters of active ingredients were comparable to those of Western women, and no substantial difference seemed to exist between Japanese and Western women. As an example, the results of phase I studies of OJK-777 (Ortho-Novum 7/7/7) are mentioned. Phase III clinical studies, which are "open studies," are now under progress with more than 3,000 women. The major objectives are to examine (1) how well the drugs are tolerated, and the dropout rates; (2) the effects on cycle control, especially bleeding patterns; (3) effects on the cardiovascular system, including coagulation and lipid metabolism; (4) effects on hormone secretions. Although some women have been taking the test drugs for more than 12 cycles, overall statistics are not yet available, because the guideline requires long-term administration (for more than 24 cycles). However, some characteristic features observed thus far are discussed.

  4. Abnormal Uterine Bleeding: Current Classification and Clinical Management.

    Science.gov (United States)

    Bacon, Janice L

    2017-06-01

    Abnormal uterine bleeding is now classified and categorized according to the International Federation of Gynecology and Obstetrics classification system: PALM-COEIN. This applies to nongravid women during their reproductive years and allows more clear designation of causes, thus aiding clinical care and future research. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Current clinical trials testing combinations of immunotherapy and radiation.

    Science.gov (United States)

    Crittenden, Marka; Kohrt, Holbrook; Levy, Ronald; Jones, Jennifer; Camphausen, Kevin; Dicker, Adam; Demaria, Sandra; Formenti, Silvia

    2015-01-01

    Preclinical evidence of successful combinations of ionizing radiation with immunotherapy has inspired testing the translation of these results to the clinic. Interestingly, the preclinical work has consistently predicted the responses encountered in clinical trials. The first example came from a proof-of-principle trial started in 2001 that tested the concept that growth factors acting on antigen-presenting cells improve presentation of tumor antigens released by radiation and induce an abscopal effect. Granulocyte-macrophage colony-stimulating factor was administered during radiotherapy to a metastatic site in patients with metastatic solid tumors to translate evidence obtained in a murine model of syngeneic mammary carcinoma treated with cytokine FLT-3L and radiation. Subsequent clinical availability of vaccines and immune checkpoint inhibitors has triggered a wave of enthusiasm for testing them in combination with radiotherapy. Examples of ongoing clinical trials are described in this report. Importantly, most of these trials include careful immune monitoring of the patients enrolled and will generate important data about the proimmunogenic effects of radiation in combination with a variety of immune modulators, in different disease settings. Results of these studies are building a platform of evidence for radiotherapy as an adjuvant to immunotherapy and encourage the growth of this novel field of radiation oncology. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Current approach to masked hypertension: From diagnosis to clinical management.

    LENUS (Irish Health Repository)

    Dolan, Eamon

    2013-11-28

    The term masked hypertension phenomenon was first described by the late Professor Thomas Pickering and is commonly defined as having a normal clinic blood pressure (BP) but an elevated "out of office" reading. In the main these elevated readings have been provided through ambulatory blood pressure monitoring (ABPM) but sometimes home BP monitoring is used. It is now largely accepted that ABPM gives a better classification of risk than clinic BP. Thus the elevated ABPM levels should relate to higher cardiovascular risk and it follows that these people might be regarded as being genuinely hypertensive and at higher cardiovascular risk. The problem for clinical practice is how to identify and manage these subjects. The phenomenon should be suspected in subjects who have had an elevated clinic BP at some time, in young subjects with normal or normal-high clinic BP who have early left ventricular hypertrophy, in subjects with a family history of hypertension in both parents, patients with multiple risks for cardiovascular disease and perhaps diabetic patients. It appears to be more prevalent in subjects of male gender, with younger age, higher heart rate, obesity or high cholesterol levels and in smokers. Those with masked hypertension are at higher risk of events such as stroke and have a higher prevalence of target organ damage, for example, nephropathy. In conclusion most of the debate around this topic relates to its reliable identification. Given the higher ambulatory readings there is an increases cardiovascular risk making this diagnosis important. This article is protected by copyright. All rights reserved.

  7. Licensed pertussis vaccines in the United States. History and current state.

    Science.gov (United States)

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that waning protection following licensed acellular pertussis vaccines have been significant factors in the widespread reappearance of pertussis.

  8. Clinical Supervision of Substance Abuse Counselors: Current and Preferred Practices.

    Science.gov (United States)

    Culbreth, John R.

    1999-01-01

    Reports on a national survey of substance abuse counselors (N=134) to learn their current and preferred supervision practices. Results suggests that substance abuse counselor are receiving supervision similar to other counselors. No preference was indicated for the sex of the supervisor, nor for the 12-step recovery experience. Counselors did…

  9. ANALYSIS OF THE CURRENT STATE OF INSURANCE MARKET IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Melnyk Olga

    2018-03-01

    Full Text Available Introduction. Modern insurance companies provide the formation of effective market mechanisms for attracting investment resources to the national economy through the effective functioning of the insurance market with the use of modern market infrastructure and financial instruments. In Ukraine, the insurance market has a significant development potential, which requires, first of all, a detailed assessment of all available opportunities for balanced development in the context of European integration processes. Therefore, the identification and analysis of modern trends in the development of the insurance market are relevant today from theoretical and practical points of view. The purpose of the study is to analyze the current state of the insurance market in Ukraine and determine the factors affecting the effectiveness of its activities. Results. It was defined that the insurance market is the second largest in terms of capitalization among other non-bank financial markets in Ukraine. The tendencies of changes in the main indicators of the insurance market activity, in particular regarding the number of concluded insurance contracts, insurance premiums and insurance payments, reinsurance, insurance reserves, insurers’ assets and authorized capital, were investigated. It was found that the increase in gross insurance premiums was made for almost all types of insurance, and the increase of gross insurance premiums was mainly due to auto insurance, medical insurance and financial risk insurance. Nowadays, the level of insurance penetration in Ukraine is still low. However, according to the Comprehensive Program for the Development of the Financial Sector of Ukraine, a gradual increase of this indicator is planned. Conclusions. The conducted studies indicate that the insurance market of Ukraine is at the stage of formation, gradually adapting to the requirements of European and world markets. In order to improve the situation, domestic insurers

  10. CSF-1R Inhibitor Development: Current Clinical Status.

    Science.gov (United States)

    Peyraud, Florent; Cousin, Sophie; Italiano, Antoine

    2017-09-05

    Colony-stimulating factor 1 receptor (CSF-1R) and its ligands, CSF-1 and interleukin 34 (IL-34), regulate the function and survival of tumor-associated macrophages, which are involved in tumorigenesis and in the suppression of antitumor immunity. Moreover, the CSF-1R/CSF-1 axis has been implicated in the pathogenesis of pigmented villonodular synovitis (PVNS), a benign tumor of the synovium. As advanced or metastatic malignant solid tumors and relapsed/refractory PVNS remain unresolved therapeutic problems, new approaches are needed to improve the outcome of patients with these conditions. In solid tumors, targeting CSF-1R via either small molecules or antibodies has shown interesting results in vitro but limited antitumor activity in vivo. Concerning PVNS, clinical trials assessing CSF-1R inhibitors have revealed promising initial outcomes. Blocking CSF-1/CSF-1R signaling represents a promising immunotherapy approach and several new potential combination therapies for future clinical testing.

  11. Current clinical research of immunoglobulin G4-related orbital disease

    Directory of Open Access Journals (Sweden)

    Yang Wang

    2016-05-01

    Full Text Available Immunoglobulin G4-related disease(IgG4-related diseasehas received lots of attention in medical community as a recently recognized fibro-inflammatory condition. It is characterized by infiltration of IgG4-immunopositive plasmacytes and concentration of elevated serum IgG4. IgG4-related disease shows organ enlargement or nodular/hyperplastic lesions in various organs including the pancreas, hepatobiliary tract and orbit, which is called IgG4-related orbital disease. The diagnostic criteria for IgG4-related disease and IgG4-related orbital disease has recently been established, which is based on clinical, imaging and histopathologic features of the orbital lesions. Besides, attention should be drawn to the differentiation from other diseases. The treatment is empirical including corticosteroids, immunosuppressive drugs, radiotherapy, and rituximab. This article reviews clinical progression of IgG4-related orbital disease.

  12. NOAA Historical Tidal Current Data for the Coastal United States

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Knowledge of the timing and strength of tidal currents is extremely important for safe navigation in coastal waters. Tidal currents are almost always the strongest...

  13. Clinical observation of cerebrovascular diseases current in Chernobyl accident liquidators

    International Nuclear Information System (INIS)

    Golovchenko, Yu.Yi.; Usatenko, O.G.; Romanenko, N.Yi.

    1999-01-01

    The results of the clinical follow up study (1993-1997) of cerebrovascular diseases development in the Chernobyl accident liquidators are presented. The syndrome of autonomous nervous system dysfunction following to an exposure to the Chernobyl accident consequences factors promotes to fast development of atherosclerosis and arterial hypertension. On the base of an analysis of the data obtained it was established that the primary diencephalic structures damage resulted in severe changes of different metabolic system, particularly in the cerebrovascular disorders development

  14. Current challenges for clinical trials of cardiovascular medical devices.

    Science.gov (United States)

    Zannad, Faiez; Stough, Wendy Gattis; Piña, Ileana L; Mehran, Roxana; Abraham, William T; Anker, Stefan D; De Ferrari, Gaetano M; Farb, Andrew; Geller, Nancy L; Kieval, Robert S; Linde, Cecilia; Redberg, Rita F; Stein, Kenneth; Vincent, Alphons; Woehrle, Holger; Pocock, Stuart J

    2014-07-15

    Several features of cardiovascular devices raise considerations for clinical trial conduct. Prospective, randomized, controlled trials remain the highest quality evidence for safety and effectiveness assessments, but, for instance, blinding may be challenging. In order to avoid bias and not confound data interpretation, the use of objective endpoints and blinding patients, study staff, core labs, and clinical endpoint committees to treatment assignment are helpful approaches. Anticipation of potential bias should be considered and planned for prospectively in a cardiovascular device trial. Prospective, single-arm studies (often referred to as registry studies) can provide additional data in some cases. They are subject to selection bias even when carefully designed; thus, they are generally not acceptable as the sole basis for pre-market approval of high risk cardiovascular devices. However, they complement the evidence base and fill the gaps unanswered by randomized trials. Registry studies present device safety and effectiveness in day-to-day clinical practice settings and detect rare adverse events in the post-market period. No single research design will be appropriate for every cardiovascular device or target patient population. The type of trial, appropriate control group, and optimal length of follow-up will depend on the specific device, its potential clinical benefits, the target patient population and the existence (or lack) of effective therapies, and its anticipated risks. Continued efforts on the part of investigators, the device industry, and government regulators are needed to reach the optimal approach for evaluating the safety and performance of innovative devices for the treatment of cardiovascular disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Current status, opportunities and problems in clinical combined chemoradiotherapy

    International Nuclear Information System (INIS)

    Phillips, T.L.

    1979-01-01

    The clinical experience with combined radiation and chemotherapy has been positive in a number of situations. The enhanced local tumor control and patient cure due to the sterilization of distant metastases have been observed. More widespread clinical applications have been limited by the enhanced effects in normal tissues, necessitating radiation dose reduction which in some situations may be counterproductive. The limitations have been caused by the lack of a wide range of active anti-tumor compounds, particularly for most common solid tumors. The very active combinations of cyclophosphamide and adriamycin or cyclophosphamide and cis-Pt, as well as of the 3 agents, caused the response of a number of the solid tumors previously found to be drug resistant. The introduction of these compounds and a number of others active in slowly proliferating solid tumors will allow new look for improved survival in the tumors not yet amenable to combined radiation and chemotherapy. The experiments designed to elucidate the nature of the interaction of radiation and chemotherapy and in particular the nature of normal tissue response should allow for the safer employment of 2 modalities and should help in the design of prospective clinical trials on a more rational basis. (Yamashita, S.)

  16. Current status of verification practices in clinical biochemistry in Spain.

    Science.gov (United States)

    Gómez-Rioja, Rubén; Alvarez, Virtudes; Ventura, Montserrat; Alsina, M Jesús; Barba, Núria; Cortés, Mariano; Llopis, María Antonia; Martínez, Cecilia; Ibarz, Mercè

    2013-09-01

    Verification uses logical algorithms to detect potential errors before laboratory results are released to the clinician. Even though verification is one of the main processes in all laboratories, there is a lack of standardization mainly in the algorithms used and the criteria and verification limits applied. A survey in clinical laboratories in Spain was conducted in order to assess the verification process, particularly the use of autoverification. Questionnaires were sent to the laboratories involved in the External Quality Assurance Program organized by the Spanish Society of Clinical Biochemistry and Molecular Pathology. Seven common biochemical parameters were included (glucose, cholesterol, triglycerides, creatinine, potassium, calcium, and alanine aminotransferase). Completed questionnaires were received from 85 laboratories. Nearly all the laboratories reported using the following seven verification criteria: internal quality control, instrument warnings, sample deterioration, reference limits, clinical data, concordance between parameters, and verification of results. The use of all verification criteria varied according to the type of verification (automatic, technical, or medical). Verification limits for these parameters are similar to biological reference ranges. Delta Check was used in 24% of laboratories. Most laboratories (64%) reported using autoverification systems. Autoverification use was related to laboratory size, ownership, and type of laboratory information system, but amount of use (percentage of test autoverified) was not related to laboratory size. A total of 36% of Spanish laboratories do not use autoverification, despite the general implementation of laboratory information systems, most of them, with autoverification ability. Criteria and rules for seven routine biochemical tests were obtained.

  17. Pleiotropic effects of niacin: Current possibilities for its clinical use

    Directory of Open Access Journals (Sweden)

    Zeman Miroslav

    2016-12-01

    Full Text Available Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoprotein[a],and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic, which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin’s role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.

  18. Current Cigarette Smoking Among Adults - United States, 2016.

    Science.gov (United States)

    Jamal, Ahmed; Phillips, Elyse; Gentzke, Andrea S; Homa, David M; Babb, Stephen D; King, Brian A; Neff, Linda J

    2018-01-19

    The U.S. Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products (1). Cigarettes are the most commonly used tobacco product among U.S. adults, and about 480,000 U.S. deaths per year are caused by cigarette smoking and secondhand smoke exposure (1). To assess progress toward the Healthy People 2020 target of reducing the proportion of U.S. adults aged ≥18 years who smoke cigarettes to ≤12.0% (objective TU-1.1),* CDC analyzed data from the 2016 National Health Interview Survey (NHIS). In 2016, the prevalence of current cigarette smoking among adults was 15.5%, which was a significant decline from 2005 (20.9%); however, no significant change has occurred since 2015 (15.1%). In 2016, the prevalence of cigarette smoking was higher among adults who were male, aged 25-64 years, American Indian/Alaska Native or multiracial, had a General Education Development (GED) certificate, lived below the federal poverty level, lived in the Midwest or South, were uninsured or insured through Medicaid, had a disability/limitation, were lesbian, gay, or bisexual (LGB), or had serious psychological distress. During 2005-2016, the percentage of ever smokers who quit smoking increased from 50.8% to 59.0%. Proven population-based interventions are critical to reducing the health and economic burden of smoking-related diseases among U.S. adults, particularly among subpopulations with the highest smoking prevalences (1,2).

  19. Pediatric digital radiography education for radiologic technologists: current state

    International Nuclear Information System (INIS)

    Morrison, Gregory; Culbertson, John; Carbonneau, Kira; John, Susan D.; Goske, Marilyn J.; Smith, Susan N.; Charkot, Ellen; Herrmann, Tracy

    2011-01-01

    Digital radiography (DR) is one of several new products that have changed our work processes from hard copy to digital formats. The transition from analog screen-film radiography to DR requires thorough user education because of differences in image production, processing, storage and evaluation between the forms of radiography. Without adequate education, radiologic technologists could unknowingly expose children to higher radiation doses than necessary for adequate radiograph quality. To evaluate knowledge about image quality and dose management in pediatric DR among radiologic technologists in the U.S. This communication describes a survey of 493 radiologic technologists who are members of the American Society of Radiologic Technologists (ASRT) and who evaluated the current state of radiological technologist education in image quality and dose management in pediatric DR. The survey included 23 survey questions regarding image acquisition issues, quality assurance, radiation exposure and education in DR of infants and children. Radiologic technologists express many needs in areas of training and education in pediatric DR. Suggested improvements include better tools for immediate feedback about image quality and exposure, more information about appropriate technique settings for pediatric patients, more user-friendly vendor manuals and educational materials, more reliable measures of radiation exposure to patients, and more regular and frequent follow-up by equipment vendors. There is a clear and widespread need for comprehensive and practical education in digital image technology for radiologic technologists, especially those engaged in pediatric radiography. The creation of better educational materials and training programs, and the continuation of educational opportunities will require a broad commitment from equipment manufacturers and vendors, educational institutions, pediatric radiology specialty organizations, and individual imaging specialists. (orig.)

  20. The European Drought Observatory (EDO): Current State and Future Directions

    Science.gov (United States)

    Vogt, Jürgen; Sepulcre, Guadalupe; Magni, Diego; Valentini, Luana; Singleton, Andrew; Micale, Fabio; Barbosa, Paulo

    2013-04-01

    Europe has repeatedly been affected by droughts, resulting in considerable ecological and economic damage and climate change studies indicate a trend towards increasing climate variability most likely resulting in more frequent drought occurrences also in Europe. Against this background, the European Commission's Joint Research Centre (JRC) is developing methods and tools for assessing, monitoring and forecasting droughts in Europe and develops a European Drought Observatory (EDO) to complement and integrate national activities with a European view. At the core of the European Drought Observatory (EDO) is a portal, including a map server, a metadata catalogue, a media-monitor and analysis tools. The map server presents Europe-wide up-to-date information on the occurrence and severity of droughts, which is complemented by more detailed information provided by regional, national and local observatories through OGC compliant web mapping and web coverage services. In addition, time series of historical maps as well as graphs of the temporal evolution of drought indices for individual grid cells and administrative regions in Europe can be retrieved and analysed. Current work is focusing on validating the available products, developing combined indicators, improving the functionalities, extending the linkage to additional national and regional drought information systems and testing options for medium-range probabilistic drought forecasting across Europe. Longer-term goals include the development of long-range drought forecasting products, the analysis of drought hazard and risk, the monitoring of drought impact and the integration of EDO in a global drought information system. The talk will provide an overview on the development and state of EDO, the different products, and the ways to include a wide range of stakeholders (i.e. European, national river basin, and local authorities) in the development of the system as well as an outlook on the future developments.

  1. Pancreatic Cancer Diagnostics and Treatment – Current State

    Directory of Open Access Journals (Sweden)

    Zdeněk Krška

    2015-01-01

    Full Text Available Pancreatic ductal adenocarcinoma (PDAC represents permanent and ever rising issue worldwide. Five-year survival does not exceed 3 to 6%, i.e. the worst result among solid tumours. The article evaluates the current state of PDAC diagnostics and treatment specifying also development and trends. Percentage of non-resectable tumours due to locally advanced or metastatic condition varies 60–80%, mostly over 80%. Survival with non-resectable PDAC is 4 to 8 months (median 3.5. In contrast R0 resection shows the survival 18–27 months. Laboratory and imaging screening methods are not indicated on large scale. Risk factors are smoking, alcohol abuse, chronic pancreatitis, diabetes mellitus. Genetic background in most PDAC has not been detected yet. Some genes connected with high risk of PDAC (e.g. BRCA2, PALB2 have been identified as significant and highly penetrative, but link between PDAC and these genes can be seen only in 10–20%. This article surveys perspective oncogenes, tumour suppressor genes, microRNA. Albeit CT is still favoured over other imaging methods, involvement of NMR rises. Surgery prefers the “vessel first” approach, which proves to be justified especially in R0 resection. According to EBM immunotherapy same as radiotherapy are not significant in PDAC treatment. Chemotherapy shows limited importance in conversion treatment of locally advanced or borderline tumours or in case of metastatic spread. Unified procedures cannot be defined due to inhomogenous arrays. Surgical resection is the only chance for curative treatment of PDAC and depends mainly on timely indication for surgery and quality of multidisciplinary team in a high-volume centre.

  2. Current state of orthodontic patients under Bisphosphonate therapy

    Science.gov (United States)

    2013-01-01

    Background Bisphosphonates are a common medication for the prevention and therapy of osteoporosis, but are also applied for tumor diseases. They affect bone metabolism, and therefore also orthodontic treatments, but how it does has yet not been definitively clarified. Therefore, the aim of this research was to evaluate and demonstrate the reported effects and the current state of scientific research regarding orthodontic treatment and bisphosphonate medication exclusively in humans. Material and methods A systematic research of the literature for selected keywords in the Medline database (Pubmed) as well as a manual search was conducted. The following search terms were used: ‘Bisphosphonate’ in combination with: orthodontic, orthodontic treatment, tooth movement. Findings To date, only nine reported patients (case reports/series) and one original article (retrospective cohort study) regarding orthodontic treatment under bisphosphonate medication in humans have been published. Decelerated tooth movement with increased side effects (especially in high-risk patients) and longer treatment duration was reported in some articles. Patients with initial spacing or extraction cases had a higher risk of incomplete space closure and poor root parallelism. Conclusions Orthodontic tooth movement under bisphosphonate medication is possible, especially in low-risk patients (low dose and short period of intake). But the treatment is still not predictable, especially in high-risk patients. Therefore, the altered bone metabolism and higher extent of side effects should be considered in treatment planning, especially in extraction cases or high-risk patients. Regardless, longer treatment duration, decelerated tooth movement, and more side effects, e.g., incomplete space closure and poor root parallelism, should be expected, especially in extraction cases or space closure. PMID:23556517

  3. Welfare state: Milestones of development and the current status

    Directory of Open Access Journals (Sweden)

    D A Zakharyan

    2016-12-01

    Full Text Available The article describes the evolution of ideas about the social state as a fair state based on the concept of the social contract. L. von Stein argues that the purpose of the welfare state was not changing the class structure of society and the elimination of the contradictions between the classes, but rather balancing and minimizing conflicts with the help of property transformations allowing a person to change one’s class affiliation. The main condition for the existence of the welfare state is its policies compliance with the interests of citizens, which provides political stability and social security. The central idea of the welfare constitutional state is that the rights of citizens are guaranteed by the state. The functions of the state and its social responsibilities were transforming over time mainly due to the erosion of state, private and corporate responsibility for providing social services. In most cases, the social programs are developed by the state, but they can also be provided by commercial organizations in the “consumer society”, in which all things and services have a material value and benefit. The welfare state is based on the principle of social justice in the distribution of wealth among the population, thus, every democratic state seeks to become a welfare state, which implies a high level of confidence in the government.

  4. Extracorporeal membrane oxygenation: current clinical practice, coding, and reimbursement.

    Science.gov (United States)

    Schuerer, Douglas J E; Kolovos, Nikoleta S; Boyd, Kayla V; Coopersmith, Craig M

    2008-07-01

    Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support for patients experiencing both pulmonary and cardiac failure by maintaining oxygenation and perfusion until native organ function is restored. ECMO is used routinely at many specialized hospitals for infants and less commonly for children with respiratory or cardiac failure from a variety of causes. Its usage is more controversial in adults, but select medical centers have reported favorable findings in patients with ARDS and other causes of severe pulmonary failure. ECMO is also rarely used as a rescue therapy in a small subset of adult patients with cardiac failure. This article will review the current uses and techniques of ECMO in the critical care setting as well as the evidence supporting its usage. In addition, current practice management related to coding and reimbursement for this intensive therapy will be discussed.

  5. [Current situation of clinical research on impacted premolars].

    Science.gov (United States)

    Liu, Ran-Ran; Tian, Jun

    2018-04-01

    Teeth impaction is a common developmental malformation in oral diseases. Impacted teeth are usually the canines, third molar, central incisors, premolars, and second molars. The prevalence of impaction of maxillary canines and mandibular wisdom teeth is higher than that of other teeth. Most recent studies have focused on the canines and third molars, but research on impacted premolars is limited. In clinical practice, the majority of orthodontic patients require premolar extraction. Thus, impacted premolars play important roles in orthodontic design and prognosis. This article provides an overview of recent research on impacted premolars and summarizes epidemiological features, localizations, and treatments, with the aim of guiding practitioners on orthodontic design and therapy.

  6. Estado actual de la informatización de los procesos de evaluación de medios de diagnóstico y análisis de decisión clínica Current state of the informatization of the evaluation processes of diagnostic means and analysis of clinical decision

    Directory of Open Access Journals (Sweden)

    Nelsa María Sagaró del Campo

    2009-08-01

    Full Text Available La creación de un programa informático para la evaluación de medios de diagnóstico y el análisis de decisión clínica demandó indagar detenidamente acerca de la situación actual con respecto a la automatización de ambos procesos, todo lo cual se expone sintetizadamente en este artículo, donde se plantea que el tratamiento computacional de estos métodos y procedimientos puede calificarse hoy como disperso e incompleto. Por la importancia y necesidad de disponer de un sistema automatizado y dadas las condiciones objetivas que propicia el actual desarrollo cientificotécnico, se aspira a lograr que el sistema desarrollado sea una herramienta novedosa, específica y potente.The creation of a computer program for the evaluation of diagnostic means and the analysis of clinical decision demanded to investigate cautiously on the current situation in regard to the automation of both processes, all of which is briefly exposed in this article, where it is stated that the computer treatment of these methods and procedures can be qualified today as disperse and incomplete. Due to the importance and necessity of having an automated system and given the objective conditions that propitiates the current scientific and technical development, it is hoped that the developed system is a novel, specific and potent tool.

  7. Estado actual de la informatización de los procesos de evaluación de medios de diagnóstico y análisis de decisión clínica Current state of the informatization of the evaluation processes of diagnostic means and analysis of clinical decision

    Directory of Open Access Journals (Sweden)

    Nelsa María Sagaró del Campo

    2009-02-01

    Full Text Available La creación de un programa informático para la evaluación de medios de diagnóstico y el análisis de decisión clínica demandó indagar detenidamente acerca de la situación actual con respecto a la automatización de ambos procesos, todo lo cual se expone sintetizadamente en este artículo, donde se plantea que el tratamiento computacional de estos métodos y procedimientos puede calificarse hoy como disperso e incompleto. Por la importancia y necesidad de disponer de un sistema automatizado y dadas las condiciones objetivas que propicia el actual desarrollo cientificotécnico, se aspira a lograr que el sistema desarrollado sea una herramienta novedosa, específica y potente.The creation of a computer program for the evaluation of diagnostic means and the analysis of clinical decision demanded to investigate cautiously on the current situation in regard to the automation of both processes, all of which is briefly exposed in this article, where it is stated that the computer treatment of these methods and procedures can be qualified today as disperse and incomplete. Due to the importance and necessity of having an automated system and given the objective conditions that propitiates the current scientific and technical development, it is hoped that the developed system is a novel, specific and potent tool.

  8. Development of a CT simulator and its current clinical status

    International Nuclear Information System (INIS)

    Nagata, Yasushi; Hiraoka, Masahiro; Nishidai, Takehiro

    2000-01-01

    A computed tomography (CT) simulator is defined as a radiotherapy treatment planning (RTP) system which consists of an X-ray CT scanner, a treatment planning computer, and a marking projector. The developmental process from the introduction of an X-ray CT to a CT simulator is described in this article. After the development of the first CT simulator, several new developments in CT scanners, marking projector, and data transfer networks were introduced. CT simulator systems have recently become more widely available and are produced by more than 8 commercial companies. The advantages of a CT simulator are a shortening of overall RTP time, increased accuracy of RTP, and the possibility of 3-D conformal therapy. Clinical experience with CT simulators has accumulated over the past 10 years. Site-specific trials have been undertaken, and the clinical usefulness of CT simulators for breast cancer, maxillary cancer, nasopharyngeal cancer, orbital tumor, lung cancer and other tumors has been demonstrated. The use of CT simulators has resulted in a decrease in the complications of radiotherapy. It also appears to be an essential tool for dose escalation studies, which may permit increased local control of certain tumors. In Japan, CT simulators were in use at more than 134 (20%) of 682 radiotherapy institutions as of the end of 1998. In the USA, CT simulators were present in more than 12% of 1,542 radiotherapy centers in 1994. The CT simulator is now an essential RTP system for advanced radiotherapy. (author)

  9. Perceptions of dry eye disease management in current clinical practice.

    Science.gov (United States)

    Williamson, Jennifer F; Huynh, Kyle; Weaver, Mark A; Davis, Richard M

    2014-03-01

    To assess the perceptions of eye care providers regarding the clinical management of dry eye. Invitations to complete a 17-question online survey were mailed to 400 members of the North Carolina Ophthalmology and Optometry Associations including community optometrists, comprehensive ophthalmologists, and cornea specialists. The survey was completed by 100 eye care providers (25% response rate). Providers reported burning (46.5%) as the most frequent symptom described by patients, followed by foreign body sensation (30.3%) and tearing (17.2%). Most respondents (80.8%) listed artificial tears as the recommended first-line treatment, even though providers reported high failure rates for both artificial tears and cyclosporine A (Restasis). Rheumatoid arthritis, Sjögren syndrome, affective disorders such as anxiety and depression, history of photorefractive surgery, smoking, and thyroid disease were acknowledged as common comorbid conditions. The survey provided an informative snapshot into the preferences of eye care providers concerning the diagnosis and management of dry eye disease. Overall, burning was the most common symptom reported by patients. Providers relied more on patient history in guiding their clinical decisions than objective signs. The survey underscores the incongruence when comparing subjective symptoms with objective signs, thereby highlighting the urgent need for the development of reliable metrics to better quantify dry eye symptoms and also the development of a more sensitive and specific test that can be used as the gold standard to diagnose dry eye.

  10. [Clinical neuropsychology in perspective: future challenges based on current developments].

    Science.gov (United States)

    Verdejo-García, Antonio; Tirapu-Ustárroz, Javier

    2012-02-01

    New lines of translational, interdisciplinary research are emerging among different fields of the neurosciences, which often point at clinical neuropsychology as the hinge discipline capable of linking the basic findings with their clinical implications and thereby endow them with some meaning for phenomenological experience. To establish the great lines of progress made in the fields of neuroscience and neuropsychology in recent years, so as to be able to foresee the strategic lines and priorities of neuroscience in the near future. To achieve this aim, the first step will be to identify the changes of paradigm that have taken place in the areas of neuroscience and psychology in the last two decades. The next step will be to propose new topics and fields of application that these changes in paradigm offer and demand from neuroscience. The false dichotomies of genes versus environment, mind versus brain, and reason versus emotion are considered, as are the new applications of neuropsychology to the understanding of psychopathological disorders, from the neurodegenerative to neurodevelopment, from 'dirty' drugs to cognitive and affective enhancers.

  11. Possession States: Approaches to Clinical Evaluation and Classification

    Directory of Open Access Journals (Sweden)

    S. McCormick

    1992-01-01

    Full Text Available The fields of anthropology and sociology have produced a large quantity of literature on possession states, physicians however rarely report on such phenomena. As a result clinical description of possession states has suffered, even though these states may be more common and less deviant than supposed. Both ICD-10 and DSM-IV may include specific criteria for possession disorders. The authors briefly review Western notions about possession and kindred states and present guidelines for evaluation and classification.

  12. [Current status and clinical application prospect of Akabane's test].

    Science.gov (United States)

    Wang, Wenjie; Du, Yanjun

    2016-06-12

    The Akabane's test is one of the meridian diagnostic methods. Compared with the current meridian diagnostic methods, it has the advantages of convenience and efficiency, but it also has several disadvantages such as the accuracy is difficult to control, the outcome interpretation is limited, etc. In this paper, the influence factors of Akabane's test were analyzed one by one, especially proposed personal opinion on outcome interpretation, which could ascertain the location and nature of disease, leading to disease syndrome. With accurate syndrome, the treatment plan could be established. The application prospect of Akabane's test was initially explored, and it was proposed that wearable automation equipment could be one of the development directions.

  13. New radiopharmaceuticals currently used in clinical nuclear medicine

    International Nuclear Information System (INIS)

    Hladik, W.B. III

    1997-01-01

    During 1996 and 1997, six new radiopharmaceuticals have been approved by the U.S. Food and Drug Administration for use in the diagnosis and/or management of patients with various disease states. Four of these new agents are antibody-based diagnostic radiotracers, and one is a therapeutic agent. One radio-pharmaceutical that has been available for several years has been approved for a new, unique indication. Our discussion focuses on the physicochemical and pharmacokinetic properties of these recently released agents as well as their specific role in the management of patients

  14. Operating tokamaks with steady-state toroidal current

    International Nuclear Information System (INIS)

    Fisch, N.J.

    1981-04-01

    Continuous operation of a tokamak requires, among other things, a means of continuously providing the toroidal current. Various methods have been proposed to provide this current including methods which utilize radio-frequency waves in any of several frequency regimes. Here we elaborate on the prospects of incorporating these current-drive techniques in tokamak reactors, concentrating on the theoretical minimization of the power requirements

  15. Electronic States and Persistent Currents in Nanowire Quantum Ring

    Science.gov (United States)

    Kokurin, I. A.

    2018-04-01

    The new model of a quantum ring (QR) defined inside a nanowire (NW) is proposed. The one-particle Hamiltonian for electron in [111]-oriented NW QR is constructed taking into account both Rashba and Dresselhaus spin-orbit coupling (SOC). The energy levels as a function of magnetic field are found using the exact numerical diagonalization. The persistent currents (both charge and spin) are calculated. The specificity of SOC and arising anticrossings in energy spectrum lead to unusual features in persistent current behavior. The variation of magnetic field or carrier concentration by means of gate can lead to pure spin persistent current with the charge current being zero.

  16. Nuclear power reactor core melt accidents. Current State of Knowledge

    International Nuclear Information System (INIS)

    Jacquemain, Didier; Cenerino, Gerard; Corenwinder, Francois; Raimond, Emmanuel IRSN; Bentaib, Ahmed; Bonneville, Herve; Clement, Bernard; Cranga, Michel; Fichot, Florian; Koundy, Vincent; Meignen, Renaud; Corenwinder, Francois; Leteinturier, Denis; Monroig, Frederique; Nahas, Georges; Pichereau, Frederique; Van-Dorsselaere, Jean-Pierre; Couturier, Jean; Debaudringhien, Cecile; Duprat, Anna; Dupuy, Patricia; Evrard, Jean-Michel; Nicaise, Gregory; Berthoud, Georges; Studer, Etienne; Boulaud, Denis; Chaumont, Bernard; Clement, Bernard; Gonzalez, Richard; Queniart, Daniel; Peltier, Jean; Goue, Georges; Lefevre, Odile; Marano, Sandrine; Gobin, Jean-Dominique; Schwarz, Michel; Repussard, Jacques; Haste, Tim; Ducros, Gerard; Journeau, Christophe; Magallon, Daniel; Seiler, Jean-Marie; Tourniaire, Bruno; Durin, Michel; Andreo, Francois; Atkhen, Kresna; Daguse, Thierry; Dubreuil-Chambardel, Alain; Kappler, Francois; Labadie, Gerard; Schumm, Andreas; Gauntt, Randall O.; Birchley, Jonathan

    2015-11-01

    accidents and, secondly, the physical phenomena, studies and analyses described in Chapters 5 to 8. Chapter 5 is devoted to describing the physical phenomena liable to occur during a core melt accident, in the reactor vessel and the reactor containment. It also presents the sequence of events and the methods for mitigating their impact. For each of the subjects covered, a summary of the physical phenomena involved is followed by a description of the past, present and planned experiments designed to study these phenomena, along with their modelling, the validation of which is based on the test results. The chapter then describes the computer codes that couple all of the models and provide the best current state of knowledge of the phenomena. Lastly, this knowledge is reviewed while taking into account the gaps and uncertainties, and the outlook for the future is presented, notably regarding experimental programmes and the development of modelling and numerical simulation tools. Chapter 6 focuses on the behaviour of the containment enclosures during a core melt accident. After summarising the potential leakage paths of radioactive substances through the different containments in the case of the accidents chosen in the design phase, it presents the studies of the mechanical behaviour of the different containments under the loadings that can result from the hazards linked with the phenomena described in Chapter 5. Chapter 6 also discusses the risks of containment building bypass in a core melt accident situation. Chapter 7 presents the lessons learned regarding the phenomenology of core melt accidents and the improvement of nuclear reactor safety. Lastly, Chapter 8 presents a review of development and validation efforts regarding the main computer codes dealing with 'severe accidents', which draw on and build upon the knowledge mainly acquired through the research programmes: ASTEC (IRSN and GRS), MAAP-4 (FAI (US)) and used by EDF and by utilities in many other

  17. Technological advances in perioperative monitoring: Current concepts and clinical perspectives.

    Science.gov (United States)

    Chilkoti, Geetanjali; Wadhwa, Rachna; Saxena, Ashok Kumar

    2015-01-01

    Minimal mandatory monitoring in the perioperative period recommended by Association of Anesthetists of Great Britain and Ireland and American Society of Anesthesiologists are universally acknowledged and has become an integral part of the anesthesia practice. The technologies in perioperative monitoring have advanced, and the availability and clinical applications have multiplied exponentially. Newer monitoring techniques include depth of anesthesia monitoring, goal-directed fluid therapy, transesophageal echocardiography, advanced neurological monitoring, improved alarm system and technological advancement in objective pain assessment. Various factors that need to be considered with the use of improved monitoring techniques are their validation data, patient outcome, safety profile, cost-effectiveness, awareness of the possible adverse events, knowledge of technical principle and ability of the convenient routine handling. In this review, we will discuss the new monitoring techniques in anesthesia, their advantages, deficiencies, limitations, their comparison to the conventional methods and their effect on patient outcome, if any.

  18. Evaluation of the Current State of Integrated Water Quality Modelling

    Science.gov (United States)

    Arhonditsis, G. B.; Wellen, C. C.; Ecological Modelling Laboratory

    2010-12-01

    Environmental policy and management implementation require robust methods for assessing the contribution of various point and non-point pollution sources to water quality problems as well as methods for estimating the expected and achieved compliance with the water quality goals. Water quality models have been widely used for creating the scientific basis for management decisions by providing a predictive link between restoration actions and ecosystem response. Modelling water quality and nutrient transport is challenging due a number of constraints associated with the input data and existing knowledge gaps related to the mathematical description of landscape and in-stream biogeochemical processes. While enormous effort has been invested to make watershed models process-based and spatially-distributed, there has not been a comprehensive meta-analysis of model credibility in watershed modelling literature. In this study, we evaluate the current state of integrated water quality modeling across the range of temporal and spatial scales typically utilized. We address several common modeling questions by providing a quantitative assessment of model performance and by assessing how model performance depends on model development. The data compiled represent a heterogeneous group of modeling studies, especially with respect to complexity, spatial and temporal scales and model development objectives. Beginning from 1992, the year when Beven and Binley published their seminal paper on uncertainty analysis in hydrological modelling, and ending in 2009, we selected over 150 papers fitting a number of criteria. These criteria involved publications that: (i) employed distributed or semi-distributed modelling approaches; (ii) provided predictions on flow and nutrient concentration state variables; and (iii) reported fit to measured data. Model performance was quantified with the Nash-Sutcliffe Efficiency, the relative error, and the coefficient of determination. Further, our

  19. Current state of continuous ambulatory peritoneal dialysis in Egypt

    Directory of Open Access Journals (Sweden)

    Khaled Mohamed Amin Elzorkany

    2017-01-01

    Full Text Available Patients with end-stage renal disease (ESRD continue to increase in number worldwide, especially in developing countries. Although continuous ambulatory peritoneal dialysis (CAPD has comparable survival advantages as hemodialysis (HD, it is greatly underutilized in many regions worldwide. The prevalence of use of CAPD in Egypt is 0.29/million population in 2017. The aim of this study is to describe the current state and practice of CAPD in Egypt and included 22 adult patients who were treated by CAPD. All the study patients were switched to CAPD after treatment with HD failed due to vascular access problems. Patients were mainly female (68.2 % with the mean age of 49.77 ± 11.41 years. The average duration on CAPD was 1.76 ± 1.30 years. Hypertension was the main cause of end-stage renal disease (ESRD constituting 36.4%, followed by diabetes (27.3 %, and toxic nephropathy (4.5%. Of importance is that about 31.8% of patients had ESRD of unknown etiology. The mean weekly Kt/V urea of patients on PD was 1.92 ± 0.18. The mean hemoglobin, serum calcium, phosphorus, parathormone, and albumin levels were 10.27 ± 1.98 g/dL, 8.36 ± 1.19 mg/dL, 5.70 ± 1.35 mg/dL, 541.18 ± 230.12 pg/mL, and 2.98 ± 0.73 g/dL, respectively. There was no significant difference between diabetic and nondiabetic CAPD patients regarding demographic and laboratory data. Our data indicate that there is continuing underutilization of CAPD in Egypt which may be related to nonavailability of CAPD fluid, patient factors (education and motivation, gradual decline of the efficiency of health-care professionals, and lack of a national program to start PD as the first modality for renal replacement therapy. It is advised to start an organized program to make CAPD widespread and encourage local production of PD fluids to reduce the cost of CAPD.

  20. Risk factors, pre-presentation management and clinical state of ...

    African Journals Online (AJOL)

    2017-08-23

    Aug 23, 2017 ... based on provision of clean water sources, basic hygiene. CC –BY ... clinical state at presentation, management, and outcome were documented. Data was entered ... WHBPF = Washes hands before preparing food. WHBF =.

  1. Current and past strategies for bacterial culture in clinical microbiology.

    Science.gov (United States)

    Lagier, Jean-Christophe; Edouard, Sophie; Pagnier, Isabelle; Mediannikov, Oleg; Drancourt, Michel; Raoult, Didier

    2015-01-01

    A pure bacterial culture remains essential for the study of its virulence, its antibiotic susceptibility, and its genome sequence in order to facilitate the understanding and treatment of caused diseases. The first culture conditions empirically varied incubation time, nutrients, atmosphere, and temperature; culture was then gradually abandoned in favor of molecular methods. The rebirth of culture in clinical microbiology was prompted by microbiologists specializing in intracellular bacteria. The shell vial procedure allowed the culture of new species of Rickettsia. The design of axenic media for growing fastidious bacteria such as Tropheryma whipplei and Coxiella burnetii and the ability of amoebal coculture to discover new bacteria constituted major advances. Strong efforts associating optimized culture media, detection methods, and a microaerophilic atmosphere allowed a dramatic decrease of the time of Mycobacterium tuberculosis culture. The use of a new versatile medium allowed an extension of the repertoire of archaea. Finally, to optimize the culture of anaerobes in routine bacteriology laboratories, the addition of antioxidants in culture media under an aerobic atmosphere allowed the growth of strictly anaerobic species. Nevertheless, among usual bacterial pathogens, the development of axenic media for the culture of Treponema pallidum or Mycobacterium leprae remains an important challenge that the patience and innovations of cultivators will enable them to overcome. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  2. Clinical Characteristics and Current Therapies for Inherited Retinal Degenerations

    Science.gov (United States)

    Sahel, José-Alain; Marazova, Katia; Audo, Isabelle

    2015-01-01

    Inherited retinal degenerations (IRDs) encompass a large group of clinically and genetically heterogeneous diseases that affect approximately 1 in 3000 people (>2 million people worldwide) (Bessant DA, Ali RR, Bhattacharya SS. 2001. Molecular genetics and prospects for therapy of the inherited retinal dystrophies. Curr Opin Genet Dev 11: 307–316.). IRDs may be inherited as Mendelian traits or through mitochondrial DNA, and may affect the entire retina (e.g., rod–cone dystrophy, also known as retinitis pigmentosa, cone dystrophy, cone–rod dystrophy, choroideremia, Usher syndrome, and Bardet-Bidel syndrome) or be restricted to the macula (e.g., Stargardt disease, Best disease, and Sorsby fundus dystrophy), ultimately leading to blindness. IRDs are a major cause of severe vision loss, with profound impact on patients and society. Although IRDs remain untreatable today, significant progress toward therapeutic strategies for IRDs has marked the past two decades. This progress has been based on better understanding of the pathophysiological pathways of these diseases and on technological advances. PMID:25324231

  3. Current state and development trends of inspections of steam generator tubes by eddy currents method

    International Nuclear Information System (INIS)

    Kubis, S.; Herman, M.

    1988-01-01

    The requirements are presented for steam generator tube testing and the factors are discussed affecting the accuracy of measurement by the eddy currents method. The individual types of the eddy currents method are described, such as the single-frequency method, the multi-frequency method and the pulse eddy currents method. The demands are summed up on manipulator systems whose design is adapted to the steam generator configuration conditions. (E.S.). 5 figs., 16 possu

  4. HYPOPARATHYROIDISM: ETIOLOGY, CLINICAL MANIFESTATION, CURRENT DIAGNOSTICS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    N. G. Mokrysheva

    2016-01-01

    treatment with recombinant PTH is not widely used. Replacement therapy with recombinant human PTH is a  promising area, especially in severe clinical cases, refractory to conventional treatment.

  5. Autoimmune liver serology: current diagnostic and clinical challenges.

    Science.gov (United States)

    Bogdanos, Dimitrios-P; Invernizzi, Pietro; Mackay, Ian-R; Vergani, Diego

    2008-06-07

    Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseases (AiLD), namely autoimmune hepatitis types 1 and 2 (AIH-1 and 2), primary biliary cirrhosis (PBC), and the sclerosing cholangitis variants in adults and children. AIH-1 is specified by anti-nuclear antibody (ANA) and smooth muscle antibody (SMA). AIH-2 is specified by antibody to liver kidney microsomal antigen type-1 (anti-LKM1) and anti-liver cytosol type 1 (anti-LC1). SMA, ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation. PBC is specified by antimitochondrial antibodies (AMA) reacting with enzymes of the 2-oxo-acid dehydrogenase complexes (chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly reacting with nuclear pore gp210 and nuclear body sp100. Sclerosing cholangitis presents as at least two variants, first the classical primary sclerosing cholangitis (PSC) mostly affecting adult men wherein the only (and non-specific) reactivity is an atypical perinuclear antineutrophil cytoplasmic antibody (p-ANCA), also termed perinuclear anti-neutrophil nuclear antibodies (p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis (ASC) with serological features resembling those of type 1 AIH. Liver diagnostic serology is a fast-expanding area of investigation as new purified and recombinant autoantigens, and automated technologies such as ELISAs and bead assays, become available to complement (or even compete with) traditional immunofluorescence procedures. We survey for the first time global trends in quality assurance impacting as it does on (1) manufacturers/purveyors of kits and reagents, (2) diagnostic service laboratories that fulfill clinicians' requirements, and (3) the end-user, the physician providing patient care, who must properly interpret test results in the overall clinical context.

  6. Customized oligonucleotide microarray gene expression-based classification of neuroblastoma patients outperforms current clinical risk stratification.

    Science.gov (United States)

    Oberthuer, André; Berthold, Frank; Warnat, Patrick; Hero, Barbara; Kahlert, Yvonne; Spitz, Rüdiger; Ernestus, Karen; König, Rainer; Haas, Stefan; Eils, Roland; Schwab, Manfred; Brors, Benedikt; Westermann, Frank; Fischer, Matthias

    2006-11-01

    To develop a gene expression-based classifier for neuroblastoma patients that reliably predicts courses of the disease. Two hundred fifty-one neuroblastoma specimens were analyzed using a customized oligonucleotide microarray comprising 10,163 probes for transcripts with differential expression in clinical subgroups of the disease. Subsequently, the prediction analysis for microarrays (PAM) was applied to a first set of patients with maximally divergent clinical courses (n = 77). The classification accuracy was estimated by a complete 10-times-repeated 10-fold cross validation, and a 144-gene predictor was constructed from this set. This classifier's predictive power was evaluated in an independent second set (n = 174) by comparing results of the gene expression-based classification with those of risk stratification systems of current trials from Germany, Japan, and the United States. The first set of patients was accurately predicted by PAM (cross-validated accuracy, 99%). Within the second set, the PAM classifier significantly separated cohorts with distinct courses (3-year event-free survival [EFS] 0.86 +/- 0.03 [favorable; n = 115] v 0.52 +/- 0.07 [unfavorable; n = 59] and 3-year overall survival 0.99 +/- 0.01 v 0.84 +/- 0.05; both P model, the PAM predictor classified patients of the second set more accurately than risk stratification of current trials from Germany, Japan, and the United States (P < .001; hazard ratio, 4.756 [95% CI, 2.544 to 8.893]). Integration of gene expression-based class prediction of neuroblastoma patients may improve risk estimation of current neuroblastoma trials.

  7. 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

  8. Biotechnological uses of Azotobacter vinelandii : Current state, limits ...

    African Journals Online (AJOL)

    African Journal of Biotechnology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 33 (2010) >. Log in or Register to get access to full text downloads.

  9. Indian Adolescent Living with HIV-AIDS: Current Clinical Scenario.

    Science.gov (United States)

    Joshi, Kavita S; Bhaware, Bhushan D; Pazare, Amar R

    2017-07-01

    Statistics suggest that, HIV has now largely become the disease of young patients. Hence, the adolescent HIV/AIDS needs to be handled and managed separately from adult HIV. Relatively fewer Indian data exist to characterize the associations in adolescents and young adults infected with HIV disease. The present study explores the current challenges in the management of HIV infected adolescents. The study was aimed at evaluating, relationship between CD4 count and duration of antiretroviral therapy (ART), effects of ART on body mass index and the adverse effects of antiretroviral drugs in adolescent HIV positive patients. This was a cross-sectional study involving 60 HIV positive adolescent patients attending tertiary care Institute KEM Hospital, Parel over duration of one year conducted at Mumbai. Patients on ART between age group 12 to 19 years. ART naïve patients were excluded from the study. 60 adolescent HIV positive patients attended our OPD including 37 males (61.67%) and 23 females (38.33%).The most common mode of transmission was vertical (80%). Education level was: school dropouts - 15%, primary education - 30%, Completed SSC - 31.7%, higher secondary - 23%. Among ADRs were 12 (63.15%) cases of anaemia due to Zidovudine, 4 (21.05%) hepatitis due to Nevirapine, 2 (10.52%) Tenofovir induced AKI and 1 (5.26%) Nevirapine rash. Wilcoxon matched pairs test showed a highly significant increase in the BMI (p ART under government programme has increased the duration of survival of the adolescent population with HIV. Treatment with HAART showed a favourable response with a statistical significant increase in CD4 count. Longer the duration of HAART, higher was the gain in CD4 count. Indian adolescent receiving long term ART, Lipodystrophy is not a troubling issue. Indian adolescent seems to be more tolerance of ART than the other parts of world.

  10. Current State of the U.S. Ethanol Industry

    Energy Technology Data Exchange (ETDEWEB)

    Urbanchuk, John [Cardno ENTRIX, New Castle, DE (United States)

    2010-11-30

    The objective of this study is to provide a comprehensive overview of the state of the U.S. ethanol industry and to outline the major forces that will affect the development of the industry over the next decade.

  11. Ectopic pregnancy: current clinical trends, a fifteen year study.

    Science.gov (United States)

    Weekes, L R

    1981-09-01

    This paper reviews the clinical recognition, diagnosis, and management of ectopic pregnancy at the Queen of Angels Hospital for the past 15 years. The incidence of ectopic pregnancy to deliveries is 1:195. Pain is the cardinal symptom of ectopic pregnancy, and amenorrhea of some degree was present in all cases. Pelvic inflammatory disease is a factor in the development of tubal pregnancy in some women. A careful history and thorough physical examination are important in making a careful diagnosis. The only laboratory procedures which are of any value are the blood type and the Rh determination. While examination of endometrial tissue obtained by biopsy or curettage has proved useful in ectopic pregnancy diagnosis, it is not totally decisive. Culdocentesis has proved to be the diagnostic procedure of the greatest value in recognizing intraperitoneal hemorrhage and it increases the correct preoperative diagnosis from 65-70% to 95%. Laparoscopy is useful when the physician is in doubt about the nature of the problem and it has produced an increase in the number of ectopic pregnancies diagnosed. Ultrasound is another useful tool in confirming a diagnosis of ectopic pregnancy; its accuracy ranges from 70-92%. A newly developed pregnancy test is more sensitive than conventional pregnancy tests and would be positive for pregnancy. Women who have had a previous ectopic pregnancy have a higher subsequent incidence of persistent infertility, recurrent ectopic pregnancy, and pregnancy wastage; the risk of another ectopic pregnancy increases 30-50 fold. While extopic pregnancy does recur, it is true that about 1/3 of those women do have successful pregnancies. Where previous induced abortion has occurred, there is a 10-fold increased risk of ectopic pregnancy. Women who become pregnant accidentally with an IUD in place have a greater likelihood of experiencing an extrauterine pregnancy. Abdominal pregnancy is often encountered as an aborting ectopic pregnancy during the 1st

  12. Dysphagia: A Short Review of the Current State

    Science.gov (United States)

    Koidou, Irene; Kollias, Nikolaos; Sdravou, Katerina; Grouios, George

    2013-01-01

    Dysphagia is the clinical expression of disruption of the synchronized activity surrounding the normal swallowing mechanism. It results from a large number of causes including neurologic, myopathic, metabolic, inflammatory/autoimmune, infectious, structural, iatrogenic, and psychiatric diseases. It can have a significant impact on social and…

  13. Current state and future of Paediatric Allergology in Europe

    DEFF Research Database (Denmark)

    Tsilochristou, Olympia; Maggina, Paraskevi; Zolkipli, Zaraquiza

    2018-01-01

    The history of pediatric allergology (PA) in Europe is relatively youthful, dating back to 1984, when a small group of pediatricians founded the European Working Group on Pediatric Allergy and Immunology - later giving rise to ESPACI (European Society on Pediatric Allergology and Clinical...

  14. [Pathological gambling and computergame-addiction. Current state of research regarding two subtypes of behavioural addiction].

    Science.gov (United States)

    Wölfling, K; Müller, K W

    2010-04-01

    Behavioral addictions, like pathological gambling and computer game addiction (or internet addiction), have become a growing concern in research and public interest. Currently similarities between behavioral addictions and substance dependency are controversially discussed in the scientific community. Unfortunately a mismatch exists between the large number of people seeking treatment and the small number of scientific studies on pathological gambling and computer game addiction. Prevalence of pathological gambling among the German population is estimated to be 0.2-0.5%. These estimations are comparable to prevalence rates reported for drug dependency. Latest research states that about 3% of German adolescents and young adults are believed to suffer from computer game addiction. Therefore, it is important to enhance investigations regarding the clinical and neuroscientific basis of computer game addiction. This review offers a summary of current results of research regarding pathological gambling and internet addiction. The phenomenological description of these two disorders is meant to allow a deeper understanding of behavioral addictions.

  15. Pediatric endocrine society survey of diabetes practices in the United States: What is the current state?

    Science.gov (United States)

    Guttmann-Bauman, I; Thornton, P; Adhikari, S; Reifschneider, K; Wood, M A; Hamby, T; Rubin, K

    2018-03-26

    The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Business process compliance checking : current state and future challenges

    NARCIS (Netherlands)

    El Kharbili, M.; Alves De Medeiros, A.K.; Stein, S.; Aalst, van der W.M.P.; Loos, P.; Nüttgens, M.; Turowski, K.; Werth, D.

    2008-01-01

    Regulatory compliance sets new requirements for business process management (BPM). Companies seek to enhance their corporate governance processes and are required to put in place measures for ensuring compliance to regulations. In this sense, this position paper (i) reviews the current work in the

  17. Procoagulant State in Current and Former Anabolic Androgenic Steroid Abusers

    DEFF Research Database (Denmark)

    Chang, Simon; Rasmussen, Jon J; Frandsen, Mikkel N

    2018-01-01

    BACKGROUND:  Anabolic androgenic steroid (AAS) abusers are considered at increased risk of cardiovascular morbidity and mortality. We hypothesized that current and former AAS abuse would induce a procoagulant shift in the haemostatic balance. METHODS:  Men 18 to 50 years of age were included...

  18. Methodological Approaches in Conducting Overviews: Current State in HTA Agencies

    Science.gov (United States)

    Pieper, Dawid; Antoine, Sunya-Lee; Morfeld, Jana-Carina; Mathes, Tim; Eikermann, Michaela

    2014-01-01

    Objectives: Overviews search for reviews rather than for primary studies. They might have the potential to support decision making within a shorter time frame by reducing production time. We aimed to summarize available instructions for authors intending to conduct overviews as well as the currently applied methodology of overviews in…

  19. The Current Status of Medical Marijuana in the United States

    OpenAIRE

    McKenna, Gerald J

    2014-01-01

    Medical marijuana is currently a controversial issue in medicine. There are strong pro and con opinions but relatively little scientific data on which to base medical decisions. The unfortunate scheduling of marijuana in class I has limited research and only serves to fuel the controversy.

  20. Current state of the art of HNF based composite propellants

    NARCIS (Netherlands)

    Ciucci, A.; Frota, O.; Welland, W.H.M.; Heijden, A.E.D.M. van der; Leeming, B.; Bellerby, J.M.; Brotzu, A.

    2004-01-01

    The main activities currently performed for the development of HNF-based propellants are presented. The objectives and approach adopted are described. The results obtained on the HNF decomposition mechanism and on the re- and co-crystallisation of HNF with potential propellant ingredients are

  1. Solid state dye-sensitized solar cells. Current state of the art. Challenges and opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Lenzmann, F.O.; Olson, C.L.; Goris, M.J.A.A.; Kroon, J.M. [ECN Solar Energy, Petten (Netherlands)

    2008-09-15

    The first generation of dye-sensitized solar cell technology is based on a liquid electrolyte component. Today, this technology is on the verge of commercialization. The step towards the market and real applications is supported by the prospect of low manufacturing costs, good efficiency as well as the expectation that the current stability level of this technology is at least sufficient for applications in mobile electronics. These favorable developments may be reinforced and accelerated even further, if the corrosive liquid electrolyte could be replaced by a non-corrosive solid, since this would ease a number of stringent requirements in the production process. A successful exchange of the liquid electrolyte by a solid-state holeconductor requires to at least maintain, preferably improve, the most relevant technical parameters of the solar cell (efficiency, stability, cost). First pioneering work with solid-state hole conductors was carried out 10 years ago with an initial efficiency level below 1%. Until 2007, the record efficiency could be improved to 5%. This paper gives an overview of the solid-state concept as an early stage approach with good perspectives for the mid-term future (5-10 years)

  2. The Current State Of Secondary Resource Usage In Ukraine

    OpenAIRE

    Julia Makovetska

    2011-01-01

    The state and the perspectives of the development of secondary resource usage in Ukraine have been analyzed in the article. The level of the main types recyclable materials as paper and cardboard, glass, plastics, waste tires are considered. Priority directions of development of the secondary resources usage have been defined.

  3. English Learners with Learning Disabilities: What Is the Current State?

    Science.gov (United States)

    Rodríguez, Ashley; Rodríguez, Diane

    2017-01-01

    As the demographics across the United States continues to change, specifically with increases in school age English Learners who speak a home language other than English, it is imperative that schools meet the diverse needs of these children. This article summarizes studies about English Learners with learning disabilities. It reports on the…

  4. [The current state and prospect of Chinese medicine gastroenterology].

    Science.gov (United States)

    Zhang, Sheng-Sheng; Zhou, Tao

    2012-03-01

    The progress and existent problems of Chinese medicine (CM) gastroenterology since the National Eleventh Five-Year Plan were discussed in this article in terms of theory innovation, formulation of clinical pathway and diagnosis-treatment consensus, efficacy assessment, formulation of efficacy assessment scale, advantage diseases, and exploration of the syndrome standardization, progress in science research, academic exchange, and the construction of study platform, and so on. Meanwhile, the development of CM gastroenterology was prospected in the following five aspects: to enhance the theory inheritance and innovation, the construction of discipline standardization; to establish scientific clinical efficacy assessment methods and the standard system; to expend treatment technologies and feature therapies; and to clarify the modern scientific connotation of CM theory and treatment.

  5. Advanced Imaging in Femoroacetabular Impingement: Current State and Future Prospects

    OpenAIRE

    Bittersohl, Bernd; Hosalkar, Harish S.; Hesper, Tobias; Tiderius, Carl Johan; Zilkens, Christoph; Krauspe, R?diger

    2015-01-01

    Symptomatic femoroacetabular impingement (FAI) is now a known precursor of early osteoarthritis (OA) of the hip. In terms of clinical intervention, the decision between joint preservation and joint replacement hinges on the severity of articular cartilage degeneration. The exact threshold during the course of disease progression when the cartilage damage is irreparable remains elusive. The intention behind radiographic imaging is to accurately identify the morphology of osseous structural abn...

  6. WE-D-BRB-03: Current State of Volumetric Image Guidance for Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hua, C. [St. Jude Children’s Research Hospital (United States)

    2016-06-15

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  7. WE-D-BRB-03: Current State of Volumetric Image Guidance for Proton Therapy

    International Nuclear Information System (INIS)

    Hua, C.

    2016-01-01

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  8. [Physiotherapeutic care marketing research: current state-of-the art].

    Science.gov (United States)

    Babaskin, D V

    2011-01-01

    Successful introduction of modern technologies into the national health care systems strongly depends on the current pharmaceutical market situation. The present article is focused on the peculiarities of marketing research with special reference to physiotherapeutic services and commodities. Analysis of the structure and sequence of marketing research processes is described along with the methods applied for the purpose including their support by the use of Internet resources and technologies.

  9. The current state of FPGA technology in the nuclear domain

    Energy Technology Data Exchange (ETDEWEB)

    Ranta, J.

    2012-07-01

    Field programmable gate arrays are a form of programmable electronic device used in various applications including automation systems. In recent years, there has been a growing interest in the use of FPGA-based systems also for safety automation of nuclear power plants. The interest is driven by the need for reliable new alternatives to replace, on one hand, the aging technology currently in use and, on the other hand, microprocessor and software-based systems, which are seen as overly complex from the safety evaluation point of view. This report presents an overview of FPGA technology, including hardware aspects, the application development process, risks and advantages of the technology, and introduces some of the current systems. FPGAs contain an interesting combination of features from software-based and fully hardware-based systems. Application development has a great deal in common with software development, but the final product is a hardware component without the operating system and other platform functions on which software would execute. Currently the number of FPGA-based applications used for safety functions of nuclear power plants is rather limited, but it is growing. So far there is little experience or common solid understanding between different parties on how FPGAs should be evaluated and handled in the licensing process. (orig.)

  10. Current State of the Art Historic Building Information Modelling

    Science.gov (United States)

    Dore, C.; Murphy, M.

    2017-08-01

    In an extensive review of existing literature a number of observations were made in relation to the current approaches for recording and modelling existing buildings and environments: Data collection and pre-processing techniques are becoming increasingly automated to allow for near real-time data capture and fast processing of this data for later modelling applications. Current BIM software is almost completely focused on new buildings and has very limited tools and pre-defined libraries for modelling existing and historic buildings. The development of reusable parametric library objects for existing and historic buildings supports modelling with high levels of detail while decreasing the modelling time. Mapping these parametric objects to survey data, however, is still a time-consuming task that requires further research. Promising developments have been made towards automatic object recognition and feature extraction from point clouds for as-built BIM. However, results are currently limited to simple and planar features. Further work is required for automatic accurate and reliable reconstruction of complex geometries from point cloud data. Procedural modelling can provide an automated solution for generating 3D geometries but lacks the detail and accuracy required for most as-built applications in AEC and heritage fields.

  11. The current state of FPGA technology in the nuclear domain

    International Nuclear Information System (INIS)

    Ranta, J.

    2012-01-01

    Field programmable gate arrays are a form of programmable electronic device used in various applications including automation systems. In recent years, there has been a growing interest in the use of FPGA-based systems also for safety automation of nuclear power plants. The interest is driven by the need for reliable new alternatives to replace, on one hand, the aging technology currently in use and, on the other hand, microprocessor and software-based systems, which are seen as overly complex from the safety evaluation point of view. This report presents an overview of FPGA technology, including hardware aspects, the application development process, risks and advantages of the technology, and introduces some of the current systems. FPGAs contain an interesting combination of features from software-based and fully hardware-based systems. Application development has a great deal in common with software development, but the final product is a hardware component without the operating system and other platform functions on which software would execute. Currently the number of FPGA-based applications used for safety functions of nuclear power plants is rather limited, but it is growing. So far there is little experience or common solid understanding between different parties on how FPGAs should be evaluated and handled in the licensing process. (orig.)

  12. Current environmental situation in the new Federal States. Pt. 1

    International Nuclear Information System (INIS)

    Haury, H.J.; Koller, U.; Assmann, G.

    1992-01-01

    'Information on Environment' organised the first part of a seminar for jounalists on the present environmental situation in the now federal states in Berlin on the 3rd and 4th of December. More than 50 participants from radios, TV, daily and special press attended this ninth event of 'Information on Environment' in Berlin. Leading scientists from research institutes of the former GDR, the Federal Environmental Agency and the GSF-research centre for environment and heath gave papers on the predominant environmental problems in the new federal states. This first part deals with water pollution, waste water treatment, drinking water supply, environmental problems of lignite mining, radiation pollution in the Erzgebirge; forest damage research and special armament wastes and waste problems in general. (orig.) [de

  13. Consensus of best current management: the starting point for clinical quality assessment

    International Nuclear Information System (INIS)

    Hanks, G.E.; Kramer, S.

    1984-01-01

    Consensus of best current management developed by a rational and deliberative process can provide the basis for clinical quality assessment. When it is possible to arrive at consensus in a specific disease, this consensus should detail appropriate pretreatment evaluation and the details of the treatment. Committees of experts for each specific disease site can formulate the consensus and must document their decision based on information from the current world literature. The authors have observed that individuals formulating consensus of best current management do not strictly follow their own criteria, and that compliance in various strata of practice throughout the United States shows a greater deviation from consensus than anticipated and indeed this deviation crosses all types of practice. The authors have observed quite different outcomes for two groups of patients with Hodgkin's disease treated with the same processes (i.e., mantle field technology and adequate radiation dose, etc.). They were unable to identify the reason for an increased failure rate in one group of these patients until they looked at each individual mantle port film from the two groups of patients. They identified that one facility was not including the Hodgkin's disease in the treatment portal due to poor technical performance. This program of process verification may be important in evaluating quality for any disease site

  14. Terminology of economics in Albanian: Current state, problems and tasks

    OpenAIRE

    Mulaj, Isa

    2012-01-01

    The primary aim of this paper was to analyze the state of terminology of economics in Albanian language, and depending on the problems identified, to address some recommendations as tasks that are deemed necessary for future research that would contribute to its standardization. The paper begun from the hypothesis that the terminology in question is relatively rich, but finds that academic and scientific research are very limited or largely neglected, thus creating a vacuum in its broader and...

  15. Humble beginnings: Current trends, state perspectives, and hallmarks of humility

    OpenAIRE

    Chancellor, J; Lyubomirsky, S

    2013-01-01

    After decades of neglect, research in humility is finally turning a corner. Within the past few years, investigators have articulated two promising strategies to overcome methodological concerns - namely, using personality judgments and designing humility "stress tests" to elicit humility-relevant behavior. We also highlight an alternative perspective of humility that has not yet gained much attention: the investigation of humility as a state, which helps to understand what humility actually ...

  16. Nanoimaging in cardiovascular diseases: Current state of the art

    Directory of Open Access Journals (Sweden)

    Suryyani Deb

    2015-01-01

    Full Text Available Nanotechnology has been integrated into healthcare system in terms of diagnosis as well as therapy. The massive impact of imaging nanotechnology has a deeper intervention in cardiology i.e. as contrast agents , to target vulnerable plaques with site specificity and in a theranostic approach to treat these plaques, stem cell delivery in necrotic myocardium, etc. Thus cardiovascular nanoimaging is not limited to simple diagnosis but also can help real time tracking during therapy as well as surgery. The present review provides a comprehensive description of the molecular imaging techniques for cardiovascular diseases with the help of nanotechnology and the potential clinical implications of nanotechnology for future applications.

  17. Current state of the absorbable metallic (magnesium) stent.

    Science.gov (United States)

    Waksman, Ron

    2009-12-15

    BIOTRONIK's absorbable metal stent technology is based ona magnesium alloy that offers superior stent mechanics and biocompatibility. The first generation (AMS-1) showed promising results regarding mechanical properties as well as feasibility and safety in several human applications (150 cases). The second generation (AMS-2.1) shows improved scaffolding and efficacy in animals due to a more slowly degrading magnesium alloy and an optimised stent design. The preclinical results of the drug-eluting AMS-3 are encouraging and the clinical investigational program will resume in 2010.

  18. Isavuconazole for the treatment of invasive aspergillosis and mucormycosis: current evidence, safety, efficacy, and clinical recommendations

    Directory of Open Access Journals (Sweden)

    Natesan SK

    2016-12-01

    Full Text Available Suganthini Krishnan Natesan,1,2 Pranatharthi H Chandrasekar1 1Division of Infectious Diseases, Department of Internal Medicine, Wayne State University, 2John D Dingell VA Medical Center, Detroit, MI, USA Abstract: The majority of invasive mold infections diagnosed in immunocompromised cancer patients include invasive aspergillosis (IA and mucormycosis. Despite timely and effective therapy, mortality remains considerable. Antifungal agents currently available for the management of these serious infections include triazoles, polyenes, and echinocandins. Until recently, posaconazole has been the only triazole with a broad spectrum of anti-mold activity against both Aspergillus sp. and mucorales. Other clinically available triazoles voriconazole and itraconazole, with poor activity against mucorales, have significant drug interactions in addition to a side effect profile inherent for all triazoles. Polyenes including lipid formulations pose a problem with infusion-related side effects, electrolyte imbalance, and nephrotoxicity. Echinocandins are ineffective against mucorales and are approved as salvage therapy for refractory IA. Given that all available antifungal agents have limitations, there has been an unmet need for a broad-spectrum anti-mold agent with a favorable profile. Following phase III clinical trials that started in 2006, isavuconazole (ISZ seems to fit this profile. It is the first novel triazole agent recently approved by the United States Food and Drug Administration (FDA for the treatment of both IA and mucormycosis. This review provides a brief overview of the salient features of ISZ, its favorable profile with regard to spectrum of antifungal activity, pharmacokinetic and pharmacodynamic parameters, drug interactions and tolerability, clinical efficacy, and side effects. Keywords: isavuconazole, aspergillosis, mucormycosis, efficacy, antifungal therapy, novel azole, tolerability, drug interactions

  19. The current state of bearing surfaces in total hip replacement.

    Science.gov (United States)

    Rajpura, A; Kendoff, D; Board, T N

    2014-02-01

    We reviewed the literature on the currently available choices of bearing surface in total hip replacement (THR). We present a detailed description of the properties of articulating surfaces review the understanding of the advantages and disadvantages of existing bearing couples. Recent technological developments in the field of polyethylene and ceramics have altered the risk of fracture and the rate of wear, although the use of metal-on-metal bearings has largely fallen out of favour, owing to concerns about reactions to metal debris. As expected, all bearing surface combinations have advantages and disadvantages. A patient-based approach is recommended, balancing the risks of different options against an individual's functional demands.

  20. Azelaic acid in dermatological treatment – current state of knowledge

    Directory of Open Access Journals (Sweden)

    Radomir Reszke

    2016-09-01

    Full Text Available Azelaic acid (AZA is a naturally occurring substance produced by Malassezia furfur which exerts various effects on the skin. Azelaic acid has antibacterial, anti-inflammatory, keratolytic, comedolytic, sebostatic and tyrosinase-inhibiting properties. Topical application of AZA as 20% cream or 15% gel is a well-established therapeutic method in various common dermatoses, mainly acne vulgaris, rosacea and disorders associated with hyperpigmentation. Azelaic acid is used as a component of chemical peels as well. The paper summarizes the most relevant issues concerning AZA application in dermatological treatment based on current knowledge.

  1. Current state of the art of blood cell labeling

    International Nuclear Information System (INIS)

    Srivastava, S.C.; Straub, R.F.; Meinken, G.E.; Gil, M.C.

    1985-01-01

    An update on some recent developments in the area of blood cell labeling is provided. Specific topics covered include red cell labeling with /sup 99m/Tc, platelet labeling using an antiplatelet monoclonal antibody, and the labeling of leukocytes with /sup 99m/Tc. Mechanistic information, where available, is discussed. A critical evaluation of current techniques, their pitfalls as well as advantages, and the problems that remain to be resolved, is presented. The promise shown by recent results using the antibody approach for cell labeling is emphasized. An assessment of the progress made in these areas is presented. 38 refs., 10 figs., 6 tabs

  2. Current state of knowledge about nutritional care of pregnant women

    Directory of Open Access Journals (Sweden)

    Luciana Barretto

    2014-12-01

    Full Text Available Pregnancy involves a significant anabolic activity that leads to increased nutritional needs relative to the preconception period. This paper aims to review the current understanding of the energy needs of macro and micronutrients during pregnancy as well as guidelines to address common gastrointestinal disorders during pregnancy, the issue of pica and anthropometric assessment to ensure an optimum weight gain. With the exception of iron, most of the nutrients needed by the pregnancy can be provided by a complete and balanced diet. Currently the scientific evidence shows that routine supplementation with iron and folic acid during pregnancy is a practice that prevents iron deficiency anemia, neural tube disorders and preterm births. Intermittent iron supplementation can also be an appropriated intervention. If the diet does not guarantee and adequate support, iodine, vitamin B12 and vitamin D supplements should also be necessaries. The anthropometric assessment by the pattern of weight gain should be present at each prenatal care visit to prevent maternal and fetal complications. In situations where the mother’s weight cannot be assessed, arm muscle circumference is possible to make an overall assessment as it correlates with maternal weight gain alternative. Measurements of biceps, triceps and subscapular skinfolds are another alternative that is useful to evaluate the fatty deposits and their location, in a complementary way to gain weight.

  3. Congenital nephrogenic diabetes insipidus: the current state of affairs.

    Science.gov (United States)

    Wesche, Daniel; Deen, Peter M T; Knoers, Nine V A M

    2012-12-01

    The anti-diuretic hormone arginine vasopressin (AVP) is released from the pituitary upon hypovolemia or hypernatremia, and regulates water reabsorption in the renal collecting duct principal cells. Binding of AVP to the arginine vasopressin receptor type 2 (AVPR2) in the basolateral membrane leads to translocation of aquaporin 2 (AQP2) water channels to the apical membrane of the collecting duct principal cells, inducing water permeability of the membrane. This results in water reabsorption from the pro-urine into the medullary interstitium following an osmotic gradient. Congenital nephrogenic diabetes insipidus (NDI) is a disorder associated with mutations in either the AVPR2 or AQP2 gene, causing the inability of patients to concentrate their pro-urine, which leads to a high risk of dehydration. This review focuses on the current knowledge regarding the cell biological aspects of congenital X-linked, autosomal-recessive and autosomal-dominant NDI while specifically addressing the latest developments in the field. Based on deepened mechanistic understanding, new therapeutic strategies are currently being explored, which we also discuss here.

  4. [Video game and internet addiction. The current state of research].

    Science.gov (United States)

    Rehbein, F; Mößle, T; Arnaud, N; Rumpf, H-J

    2013-05-01

    The use of interactive screen media is widespread and for some users leads to pathological symptoms that are phenomenologically similar to signs of addictive disorders. Addictive use of computer games and other Internet applications, such as social media can be distinguished. In the past standard criteria to classify this new disorder were lacking. In DSM-5, nine criteria are proposed for diagnosing Internet gaming disorder. The focus is currently on video games as most studies have been done in this field. Prevalence estimations are difficult to interpret due to the lack of standard diagnostic measures and result in a range of the frequency of Internet addiction between 1 % and 4.2 % in the general German population. Rates are higher in younger individuals. For computer game addiction prevalence rates between 0.9 % and 1.7  % can be found in adolescents. Despite substantial comorbidity among those affected current research points to addictive media use as a stand-alone disorder.

  5. Economic security of modern Russia: the current state and prospects

    Directory of Open Access Journals (Sweden)

    Karanina Elena

    2018-01-01

    Full Text Available In the conditions of instability of the world economy and the introduction of sanctions against Russia by a number of countries, the problem of ensuring national economic security has become particularly relevant. This topic also has a high scientific, practical and social significance, as it allows to identify possible gaps in the economic security of modern Russia and timely develop mechanisms to eliminate them to protect the national interests of the state. The purpose of this article is to determine the state and prospects of improving the economic security of modern Russia. This can be achieved by solving the following tasks: review of existing methods to evaluate the economic security of country, conduct a SWOT analysis of economic security of modern Russia, the development of suggestions for its improvement. This research analyzes various aspects of the economic security of modern Russia. As a result, the author developed an integrated method to ensuring the economic security of the country, as well as a matrix of economic security within this method. The way of increase of economic security of modern Russia is offered. Thus, to overcome the threats for the economic security of modern Russia, it is necessary to implement the recommendations developed by the authors, including the establishment of their own production and the construction of an innovatively oriented model of the economy. This will ensure the economic security of modern Russia and its stable development in the future.

  6. Apoptosis imaging: current state of the art and future perspective

    International Nuclear Information System (INIS)

    Wang Feng; Wang Zizheng

    2007-01-01

    This review provides a critical and thorough overview of the radionpharmaceutical development and in vivo evaluation of all apoptosis-detecting radioligands that emerged so far, along with these possible applications in nuclear medicine. Radiolabelled annexin bears the promise of becoming a clinically applied radio-pharmaceutical with potential applications in cardiology and oncology. Visualization of cell death is important in pathologies such as myocardial infarction, atherosclerosis, and cancer. Furthermore, radiolabelled annexin may be developed as a tool for monitoring cell death-induceing or cell death-preventing therapies. Some future perspective are presented with the aim of promoting the development of potential new strategies in pursuit of the idealcell death-detecting radioligand. (authors)

  7. 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

  8. The current state of wind energy development in Tanzania

    International Nuclear Information System (INIS)

    Kainkwa, R.M.

    2007-01-01

    Wind Energy is one of the renewable power sources that is currently used in a commercial scale for various end-uses such as pumping water deep wells and electricity generation. A precise knowledge of wind speed characteristics is an essential for the efficient planning and implementation of any wind energy project. In Tanzania the use of wind energy in generating electricity has not yet taken place due to lack of knowledge on prospective sites with high wind energy potential. The main objective of this paper is to review some attempts that have been made to explore the wind energy potential in Tanzania and the corresponding prospective sites that have been earmarked so far. (author)

  9. The current state of the challenges for VET in Denmark

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms

    The aim of this report is to analyse the way the Danish VET system has been coping with four challenges in the last decades. First the report describes key features of the institutional architecture of the current Danish VET-system. In the next two sections priority is given to the challenges....... The report examines how the VET systems connects with the labour market and explores the patterns of transition of the students from VET to the labour market and describes indications of their mobility and employability. In the following section the report focusses on the second challenge for vocational...... the suc-cess of subsequent reforms of VET in improving the connections between VET and higher educa-tion, latest with the reform in 2013. The next challenge to be examined is that of social inclusion. This is mainly a question of raising the retention of students in the vocational programmes, where...

  10. [The current state of the brain-computer interface problem].

    Science.gov (United States)

    Shurkhay, V A; Aleksandrova, E V; Potapov, A A; Goryainov, S A

    2015-01-01

    It was only 40 years ago that the first PC appeared. Over this period, rather short in historical terms, we have witnessed the revolutionary changes in lives of individuals and the entire society. Computer technologies are tightly connected with any field, either directly or indirectly. We can currently claim that computers are manifold superior to a human mind in terms of a number of parameters; however, machines lack the key feature: they are incapable of independent thinking (like a human). However, the key to successful development of humankind is collaboration between the brain and the computer rather than competition. Such collaboration when a computer broadens, supplements, or replaces some brain functions is known as the brain-computer interface. Our review focuses on real-life implementation of this collaboration.

  11. Renewable energy sources in Bulgaria: Current state and trends

    Science.gov (United States)

    Kolev, K.

    The over-dependency of Bulgaria on imported fuel stressed the importance of developing a new energy strategy based on energy saving which includes also using renewable energy sources (RES). The target is the substitution of at least 2 percent of the real primary energy consumption with RES by 2010. The author gives a generalized analysis of the available RES in Bulgaria -solar, wind, geothermal, biomass and mini-hydraulic. The potentialities of each source for its usage as a suitable energy supply are pointed out, as well as the current status of research and implementation work, problems connected with legislation, financing and production of particular facilities. The governmental policy concerning RES is considered briefly. A description is given to the project 'Technical and Economical Assessment of Possibilities for Expansion of the RES-part in the Energy Balance of the Country' developed and started in 1994 in the framework of the PHARE program.

  12. Cyanobactins from Cyanobacteria: Current Genetic and Chemical State of Knowledge.

    Science.gov (United States)

    Martins, Joana; Vasconcelos, Vitor

    2015-11-13

    Cyanobacteria are considered to be one of the most promising sources of new, natural products. Apart from non-ribosomal peptides and polyketides, ribosomally synthesized and post-translationally modified peptides (RiPPs) are one of the leading groups of bioactive compounds produced by cyanobacteria. Among these, cyanobactins have sparked attention due to their interesting bioactivities and for their potential to be prospective candidates in the development of drugs. It is assumed that the primary source of cyanobactins is cyanobacteria, although these compounds have also been isolated from marine animals such as ascidians, sponges and mollusks. The aim of this review is to update the current knowledge of cyanobactins, recognized as being produced by cyanobacteria, and to emphasize their genetic clusters and chemical structures as well as their bioactivities, ecological roles and biotechnological potential.

  13. Current state and trend of radiation regulation system in Japan

    International Nuclear Information System (INIS)

    Yonehara, Hidenori

    2004-01-01

    Japanese regulation system for safety against radiation essentially started from 'Atomic Energy Basic Law' enacted in 1955 and 'Law Concerning Prevention of Radiation Hazards due to Radioisotopes, etc' enacted in 1957, has been regarded as a central rule for radiation protection and safety. Related laws and regulations have been enacted together with their revision. Radiation Council, established in the Science and Technology Agency in 1962 and now belonging to the Ministry of Education, Culture, Sports, Science and Technology, has deliberated basically on International Commission of Radiological Protection (ICRP) statements for legal revision and has set up working groups for current problems. Activities of the groups have concerned ICRP Publication 60 (1990) and later related publications for incorporating the principle into laws as to concepts of dose limits, effective dose, and then of exemption and exclusion. International status of the Japanese regulation, problems and tasks in the regulation are also commented. (N.I.)

  14. Modeling microcirculatory blood flow: current state and future perspectives.

    Science.gov (United States)

    Gompper, Gerhard; Fedosov, Dmitry A

    2016-01-01

    Microvascular blood flow determines a number of important physiological processes of an organism in health and disease. Therefore, a detailed understanding of microvascular blood flow would significantly advance biophysical and biomedical research and its applications. Current developments in modeling of microcirculatory blood flow already allow to go beyond available experimental measurements and have a large potential to elucidate blood flow behavior in normal and diseased microvascular networks. There exist detailed models of blood flow on a single cell level as well as simplified models of the flow through microcirculatory networks, which are reviewed and discussed here. The combination of these models provides promising prospects for better understanding of blood flow behavior and transport properties locally as well as globally within large microvascular networks. © 2015 Wiley Periodicals, Inc.

  15. The concept of electronegativity. The current state of the problem

    International Nuclear Information System (INIS)

    Cherkasov, Artem R; Galkin, Vladimir I; Zueva, Ekaterina M; Cherkasov, Rafael A

    1998-01-01

    A systematic account is given of the current ideas about atomic and group electronegativities and the trends in the development of the concept of electronegativity are analysed. Attention is concentrated on the latest approaches to the definition of electronegativity - the concept of 'orbital' electronegativities and the density functional theory. A procedure is proposed for the determination of 'inductive' electronegativities, which permits a correct theoretical calculation of the electronegativity of a substituent from the electronegativities of individual atoms and the steric structure. It is shown that the approach developed has a series of important advantages - for example, it makes it possible to calculate the group electronegativities of isomeric substituents avoiding the principle of the equalisation of electronegativities. A survey of literature data and generalisation of the method proposed by the authors have made it possible to formulate the concept of electronegativity as an unchanging fundamental immanent characteristic of a chemical element. The bibliography includes 222 references.

  16. Rapid Detection Strategies for the Global Threat of Zika Virus: Current State, New Hypotheses and Limitations

    Directory of Open Access Journals (Sweden)

    Shruti Shukla

    2016-10-01

    Full Text Available The current scenario regarding the widespread Zika virus (ZIKV has resulted in numerous diagnostic studies, specifically in South America and in locations where there is frequent entry of travelers returning from ZIKV-affected areas, including pregnant women with or without clinical symptoms of ZIKV infection. The World Health Organization, WHO, announced that millions of cases of ZIKV are likely to occur in the United States of America in the near future. This situation has created an alarming public health emergency of international concern requiring the detection of this life-threatening viral candidate due to increased cases of newborn microcephaly associated with ZIKV infection. Hence, this review reports possible methods and strategies for the fast and reliable detection of ZIKV with particular emphasis on current updates, knowledge and new hypotheses that might be helpful for medical professionals in poor and developing countries that urgently need to address this problem. In particular, we emphasize liposome-based biosensors. Although these biosensors are currently among the less popular tools for human disease detection, they have become useful tools for the screening and detection of pathogenic bacteria, fungi and viruses because of their versatile advantageous features compared to other sensing devices. This review summarizes the currently available methods employed for the rapid detection of ZIKV and suggests an innovative approach involving the application of a liposome-based hypothesis for the development of new strategies for ZIKV detection and their use as effective biomedicinal tools.

  17. E-LEARNING: CURRENT STATE, TRENDS AND FUTURE PROSPECTS

    Directory of Open Access Journals (Sweden)

    Г А Краснова

    2017-12-01

    Full Text Available The article is devoted to the main trends of development of e-learning in formal and non-formal education in different countries. The article discusses the main quantitative and qualitative characteristics of the market of e-learning education. The authors define main reasons the development of e-learning education in higher education. The authors note that the demand for e-learning by various groups of users will push the education authorities and educational institutions to develop different forms of e-learning and implement new business models of universities. In most universities in Europe and the United States adopted or will be adopted for the institutional strategy of development of e-learning.

  18. Computer-assisted Orthopaedic Surgery: Current State and Future Perspective

    Directory of Open Access Journals (Sweden)

    Guoyan eZheng

    2015-12-01

    Full Text Available Introduced about two decades ago, computer-assisted orthopaedic surgery (CAOS has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopaedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

  19. Precarious Employment in the Vologda Oblast: Current State and Trends

    Directory of Open Access Journals (Sweden)

    Aleksandr Mikhailovich Panov

    2016-09-01

    Full Text Available The paper is devoted to the study of the phenomenon of precarious employment in Russian regions. Today, the socio-economic sciences lack a single concept of precarious employment applicable to Russian conditions. Despite the considerable amount of scientific and practical works of domestic and foreign authors on the issue of precarious employment, the criteria of its statistical evaluation as applied to Russian conditions have not been determined. At the same time, the development of precarious employment threatens the country’s socio-economic welfare, because it creates the risk of unwanted effects such as poor employment, hidden and open unemployment, lower labor productivity, degradation of human capital, etc. The paper provides a brief review of research on the problem stated, and defines precarious employment. The author makes an attempt to determine and substantiate the list of indicators available in official statistics for assessing precarious employment in the region. The study allocates three blocks of indicators: indicators of institutional regulation, conditions of employment and functioning of the labor market. Based on these indicators, the author analyzes the status and trends of precarious work in the Vologda Oblast in the period from 2001 to 2015. In some cases, the author presents a comparative analysis of the data for the Russian Federation and Northwestern Federal District. The analysis has helped identify positive and negative changes in the field of precarious employment in the Vologda Oblast. In particular, the author identifies the following problems: an increase in the share of those employed in the informal sector, a relative increase in the number of the working poor, an almost three-fold growth of overdue debts on wages in comparable prices per worker. On the basis of this analysis, the author identifies the directions of the state policy that can help reduce precarious employment: development of information

  20. Current state of epidemiological studies in Belarus about Chernobyl sufferers

    Energy Technology Data Exchange (ETDEWEB)

    Matsko, V.P. [Institute of Radiobiology, Academy Sciences of Belarus, Minsk (Belarus)

    1998-03-01

    The present paper is an analysis of the results of epidemiological studies in Belarus about the after-effects of the accident at the Chernobyl atomic power station (ChAPS), based on published data at scientific institutes, organs and institutions of Ministry of Health. In the last years the affected population showed thereby more significant - as compared with republican indices - growth of incidence in the majority of diseases (first of all: digestion, urogenital, nervous, endocrine systems, diseases of ear, throat, nose both among adults and among children). Aggravation of health state continues in the participants of liquidation of the ChAPS accident consequences and the evacuees from the alienation zone which have obtained considerable radiation load to organism (rise of incidence of diseases of endocrine, cardiovascular, nervous system etc.). Considerable growth of thyroid cancer incidence is registered in Belarus children and adolescents, especially in the Gomel and Brest regions. This is conditioned by dose commitments on thyroid gland due to iodine radionuclides in first period after the accident, incorrect iodine prophylaxy, and goitre endemic. The rise of hereditary pathology is registered too. An expressed increase of oncological diseases is observed therewith mainly in the Gomel region, especially in the districts with high level of radiocontamination and, consequently, significant radiation load. First of all, this relates to the growth of incidence of cancer of lungs, mammary gland, bladder. The analysis of epidemiological studies performed in Belarus after the ChAPS catastrophe and comparison of them with data obtained in the pre-Chernobyl period testify to the aggravation of health state of Belarus population. The specialists unambiguously recognize the direct influence of radioactive pollution in the environment on rise of thyroid pathologies, hereditary and congenial diseases, and cancers of different localizations. There is no unique opinion

  1. 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.

  2. The Current State of Additive Manufacturing in Wind Energy Systems

    Energy Technology Data Exchange (ETDEWEB)

    Mann, Margaret [National Renewable Energy Lab. (NREL), Golden, CO (United States); Palmer, Sierra [Worcester Polytechnic Institute (WPI), , Worcester, MA (United States); Lee, Dominic [National Renewable Energy Lab. (NREL), Golden, CO (United States); Kurup, Parthiv [National Renewable Energy Lab. (NREL), Golden, CO (United States); Remo, Timothy [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jenne, Dale Scott [National Renewable Energy Lab. (NREL), Golden, CO (United States); Richardson, Bradley S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Love, Lonnie J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Post, Brian K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-12-01

    Wind power is an inexhaustible form of energy that is being captured throughout the U.S. to power the engine of our economy. A robust, domestic wind industry promises to increase U.S. industry growth and competitiveness, strengthen U.S. energy security independence, and promote domestic manufacturing nationwide. As of 2016, ~82GW of wind capacity had been installed, and wind power now provides more than 5.5% of the nation’s electricity and supports more than 100,000 domestic jobs, including 500 manufacturing facilities in 43 States. To reach the U.S. Department of Energy’s (DOE’s) 2015 Wind Vision study scenario of wind power serving 35% of the nation's end-use demand by 2050, significant advances are necessary in all areas of wind technologies and market. An area that can greatly impact the cost and rate of innovation in wind technologies is the use of advanced manufacturing, with one of the most promising areas being additive manufacturing (AM). Considering the tremendous promise offered by advanced manufacturing, it is the purpose of this report to identify the use of AM in the production and operation of wind energy systems. The report has been produced as a collaborative effort for the DOE Wind Energy Technology Office (WETO), between Oak Ridge National Laboratory (ORNL) and the National Renewable Energy Laboratory (NREL).

  3. Current state of seagrass ecosystem services: Research and policy integration

    KAUST Repository

    Ruiz-Frau, A.

    2017-10-12

    Seagrasses contribute to the maintenance of human wellbeing. However certain aspects of their role as ecosystem service (ES) providers remain understudied. Here, we synthesise the state of seagrass ES (SGES) research and policy implications. Additionally, we recommend ways in which SGES research can be integrated in to policy design, by drawing lessons from the case of Blue Carbon (BC). SGES research suffers from three main biases: a geographical bias, SGES has been restricted to chartered seagrass areas; a type of service research bias, provisioning and regulating services have received extensive attention while cultural services remain understudied; a type of discipline bias, the ecological aspects of SGES have been well documented while economic and social aspects remain in comparison understudied. These are particularly important, as an understanding of the social and economic considerations of the provision of ES is fundamental to facilitate its integration into policy frameworks. Lessons drawn from the operationalization process of BC show the reoccurrence of certain aspects that have enabled the integration of BC into policy. These aspects are grouped under 4 different categories. From the analysis of these elements we draw lessons that could facilitate the operationalization of other ecosystem services and their incorporation into management policy frameworks.

  4. Current state of spent fuel management in the Russian Federation

    International Nuclear Information System (INIS)

    Makarchuk, T.F.; Spichev, V.V.; Tikhonov, N.S.; Simanovsky, V.M.; Tokarenko, A.I.; Bespalov, V.N.

    1998-01-01

    Twenty nine power units of nine nuclear power plants of total installed capacity 22 GW(e) are now in operation in the Russian Federation. They produce approximately 12% of electric power in the country. The annual spent fuel arising is about 790 tU. The spent fuel from VVER-440 and BN-600 is reprocessed at the RT-1 plant near Chelyabinsk. The VVER-1000 spent fuel is planned to be reprocessed at the reprocessing plant RT-2 which is under construction near Krasnoyarsk. The RBMK-1000 spent fuel is not reprocessed because of its low fissile content. It is meant to be stored in intermediate storage facilities at the NPP sites and in a centralized storage facility during a period not less than 50 years and then to be disposed of in geological formations. State of the art of spent fuel reprocessing, storage and transportation is considered in the paper. Problems of nuclear fuel cycle back-end in Russia are taken into account. (author)

  5. The French Accelerometer Network (RAP): Current state in 2007

    International Nuclear Information System (INIS)

    Gueguen, P.; Bard, P.-Y.; Pequegnat, C.; Souriau, A.; Dominique, P.; Regnier, M.

    2007-01-01

    France is a country of moderate seismicity but, due to dense urbanized and industrial areas, the seismic risk is significant. Furthermore, recent developments in numerical and semi-empirical methods requires a good knowledge of several parameters. The mission of the French accelerometer network programme (RAP-Reseau Accelerometrique Permanent) is to expand and modernize significantly the acquisition and application of French accelerometer data (both strong and weak motion) in order to improve earthquake related research and public safety from earthquakes. This network is the result of co-operative efforts including academic institutions (INSU-CNRS, Universities of Grenoble, Nice, Strasbourg, Toulouse, IPG Paris) and several state agencies (BRGM, CEA, IRSN, LCPC). Since 1995, around 120 stations have been installed in some seismic areas of France. This network also includes specific research actions (site effects, building monitoring, deep borehole). Other French accelerometer stations devoted to strong motion recording are also associated to the network. All data are archived and freely distributed in a database center, data being available in SAC, ASCII and SEED format. (authors)

  6. The current and future state of companion diagnostics

    Science.gov (United States)

    Agarwal, Amit; Ressler, Dan; Snyder, Glenn

    2015-01-01

    Companion diagnostics are an indispensable part of personalized medicine and will likely continue to rapidly increase in number and application to disease areas. The first companion diagnostics were launched in the 1980s and in the face of significant initial skepticism from drug developers as to whether segmenting a drug’s market through a diagnostic was advisable. The commercial success of drugs such as Herceptin® (trastuzumab) and Gleevec® (imatinib), which both require testing with companion diagnostics before they can be prescribed, has moved the entire companion diagnostic field forward. From an initial start of a handful of oncology drugs with corresponding diagnostics, the field has expanded to include multiple therapeutic areas, and the number of combinations has grown by 12-fold. Based on drugs in clinical trials, the rapid growth will likely continue for the foreseeable future. This expansion of companion diagnostics will also have a global component as markets in Europe will evolve in a similar but not identical pattern as the US. One of the greatest challenges to future growth in companion diagnostics is aligning the incentives of all stakeholders. A major driver of growth will continue to be the economic incentives for drug developers to pair their products with diagnostics. However, diagnostic companies are caught between the conflicting demands of two major stakeholders, pharmaceutical companies on one hand and payers/providers on the other. Regulators are also becoming more demanding in aligning development time lines between drugs and diagnostics. In order to survive and prosper, diagnostic companies will need to think more broadly about companion diagnostics than the historical match between a specific drug and a single diagnostic. They will also have to continue the process of consolidation and global expansion that the industry has already begun. Despite these potential obstacles, companion diagnostics have become one of the hottest areas

  7. Current state of prostate cancer treatment in Jamaica.

    Science.gov (United States)

    Morrison, Belinda F; Aiken, William D; Mayhew, Richard

    2014-01-01

    Prostate cancer is the commonest cancer in Jamaica as well as the leading cause of cancer-related deaths. One report suggested that Jamaica has the highest incidence rate of prostate cancer in the world, with an age-standardised rate of 304/100,000 per year. The Caribbean region is reported to have the highest mortality rate of prostate cancer worldwide. Prostate cancer accounts for a large portion of the clinical practice for health-care practitioners in Jamaica. The Jamaica Urological Society is a professional body comprising 19 urologists in Jamaica who provide most of the care for men with prostate cancer in collaboration with medical oncologists, radiation oncologists, and a palliative care physician. The health-care system is structured in two tiers in Jamaica: public and private. The urologist-to-patient ratio is high, and this limits adequate urological care. Screening for prostate cancer is not a national policy in Jamaica. However, the Jamaica Urological Society and the Jamaica Cancer Society work synergistically to promote screening as well as to provide patient education for prostate cancer. Adequate treatment for localised prostate cancer is available in Jamaica in the forms of active surveillance, nerve-sparing radical retropubic prostatectomy, external beam radiation, and brachytherapy. However, there is a geographic maldistribution of centres that provide prostate cancer treatment, which leads to treatment delays. Also, there is difficulty in affording some treatment options in the private health-care sectors. Androgen deprivation therapy is available for treatment of locally advanced and metastatic prostate cancer and is subsidised through a programme called the National Health Fund. Second-line hormonal agents and chemotherapeutic agents are available but are costly to most of the population. The infrastructure for treatment of prostate cancer in Jamaica is good, but it requires additional technological advances as well as additional specialist

  8. Pulp-dentin Regeneration: Current State and Future Prospects.

    Science.gov (United States)

    Cao, Y; Song, M; Kim, E; Shon, W; Chugal, N; Bogen, G; Lin, L; Kim, R H; Park, N-H; Kang, M K

    2015-11-01

    The goal of regenerative endodontics is to reinstate normal pulp function in necrotic and infected teeth that would result in reestablishment of protective functions, including innate pulp immunity, pulp repair through mineralization, and pulp sensibility. In the unique microenvironment of the dental pulp, the triad of tissue engineering would require infection control, biomaterials, and stem cells. Although revascularization is successful in resolving apical periodontitis, multiple studies suggest that it alone does not support pulp-dentin regeneration. More recently, cell-based approaches in endodontic regeneration based on pulpal mesenchymal stem cells (MSCs) have demonstrated promising results in terms of pulp-dentin regeneration in vivo through autologous transplantation. Although pulpal regeneration requires the cell-based approach, several challenges in clinical translation must be overcome-including aging-associated phenotypic changes in pulpal MSCs, availability of tissue sources, and safety and regulation involved with expansion of MSCs in laboratories. Allotransplantation of MSCs may alleviate some of these obstacles, although the long-term stability of MSCs and efficacy in pulp-dentin regeneration demand further investigation. For an alternative source of MSCs, our laboratory developed induced MSCs (iMSCs) from primary human keratinocytes through epithelial-mesenchymal transition by modulating the epithelial plasticity genes. Initially, we showed that overexpression of ΔNp63α, a major isoform of the p63 gene, led to epithelial-mesenchymal transition and acquisition of stem characteristics. More recently, iMSCs were generated by transient knockdown of all p63 isoforms through siRNA, further simplifying the protocol and resolving the potential safety issues of viral vectors. These cells may be useful for patients who lack tissue sources for endogenous MSCs. Further research will elucidate the level of potency of these iMSCs and assess their

  9. [Pain care in Austrian health care centers: Questionnaire study on the current status of Austrian pain clinics].

    Science.gov (United States)

    Szilagyi, I-S; Bornemann-Cimenti, H; Messerer, B; Vittinghoff, M; Sandner-Kiesling, A

    2015-12-01

    Pain clinics provide interdisciplinary therapy to treat chronic pain patients and to increase the return-to-work rate. In recent years and due to increased economic pressure in health care, a change in the management of pain in Austrian health care centers has been observed. For the analysis of the current situation, two surveys addressing all Austrian pain clinics were performed. In total, 133 heads of Austrian Anesthesia Departments were interviewed online and personally. The data from the first interview were confirmed by an additional telephone survey that was performed by one anesthetist per Austrian state (n = 9). Currently, 44 Austrian pain clinics are active. During the last 5 years, 9 pain clinics closed. Adding the current active pain clinics together, they represent a total of 17.5 full-time-operated clinics. The most common reasons for closing the pain clinics were lack of personnel (47%), lack of time resources (26%), lack of space resources (11%), and financial difficulties (11%). A reduction of >50% of operating hours during the last 3 years was reported by 9 hospitals. The reasons for not running a pain clinic were lack of personnel (36%), lack of time (25%) and department too small (16%). Estimates between actual and required clinics indicate that 49.5 full-time-operating pain clinics are lacking in Austria, resulting in 74% of the Austrian chronic pain patients not receiving interdisciplinary pain management. Our survey confirmed the closure of 9 pain clinics during the last 5 years due to lack of personnel and time. Pain clinics appear to provide the simplest economic saving potential. This development is a major concern. Although running a pain clinic seems to be expensive at the first sight, it reduces pain, sick leave, complications, and potential legal issues against health care centers, while simultaneously increasing the hospital's competitiveness. Our results show that 74% of Austrian chronic pain patients do not have access to an

  10. Nabarlek Traditional Owners' perspective on the current state of revegetation

    International Nuclear Information System (INIS)

    Lewis, B.

    2001-01-01

    Aboriginal people derive their identity from an ancestral relationship to land mediated through a traditional form of land title. This relationship to country determines a group or individual's place in the complex of law, ceremony, culture, responsibility, status, marriage, income etc (often collectively termed 'culture'), that is the essential corollary of traditional land tenure. In effect, country bestows upon Traditional Owners a place in the scheme of things as do social and occupational status, racial origin, financial position etc upon the Westerner. It is a critical link in the preservation of Aboriginal society, and pressure on or erosion of this relationship imposes further strain on the significant burden to Traditional Owners of cultural maintenance. In order that disenfranchisement does not occur because of the mining process, Traditional Owners must have a guarantee that the country will be returned to a pre-mining state as far as possible. This is certainly a significant part of the initial discussion of any consent (under the Aboriginal Land Rights (Northern Territory) Act, 1976). Among the worst outcomes for Aboriginal people involved in the mining process is the return to them of degraded lands, an indication to them that the Westerners who initially placed such great value on it no longer do so. These people are left with the mess or the scraps and perhaps for them the least traumatic course is to walk away, to pretend that the mined-out country is of no importance to them and that there is no pain. The rehabilitation of Nabarlek is in some ways a special case. There was a fairly long period from 1988 to 1994 in which nothing happened. At the final decision to close the operation much of the infrastructure was no longer useable. Initially there was ascribed certain value to plant and equipment items that did not really eventuate for Traditional Owners. Significant portions of the remnant infrastructure was handed back to Traditional Owners

  11. Corporatism In Western Europe: Current State And Prospects For Evolution

    Directory of Open Access Journals (Sweden)

    Р. Ja. Feldman

    2018-01-01

    Full Text Available The article conducts a political analysis of the Western European institutions of corporatism. The main task of the author is the study of the policy of harmonizing the interests of labor and capital (trade unions and employers’ associations, which is implemented in countries such as the UK, Germany, France, Italy, Norway, Sweden, Denmark etc. Dynamics of political processes unfolding in the space of Western Europe, suggests that the mechanisms of articulation and political representation of social and labour interests have significantly transformed over the past 30 years. The use of institutional and systemic approaches along with the empirical methods, leads to the conclusion that the most developed European countries are moving from the classical model of corporatism to a more pluralistic forms of interaction between the state, labour and capital. Social partnership as an instrument of collective bargaining between employees and employers is displaced from the political sphere to the sectoral and organizational levels. The typical institutions of democratic corporatism (tripartite commissions, socio-economic councils, etc., who played a crucial role in rebuilding post-war Europe, become rudimentary organs of the national political systems. In addition, there is a tendency to weaken the political influence of trade unions, who successfully struggled for the satisfaction of collective demands of workers in the beginning of XX century. Large multinational companies prefer to influence the political decision-making centers autonomously, ignoring the associative membership in the guild organizations. As a consequence, corporatist bargaining is being replaced by direct and indirect lobbying, Government Relations and election fundraising. When accounting for identified trends, the author presents a hypothesis that the evolution of corporatism in Western Europe will lead to its gradual degeneration. Taking into account the identified trends, the

  12. Current state and future prospects of remedial soil protection. Background

    Energy Technology Data Exchange (ETDEWEB)

    Frauenstein, Joerg

    2009-08-15

    The legal basis for soil protection in the Federal Republic of Germany is: -The Act on Protection against Harmful Changes to Soil and on Rehabilitation of Contaminated Sites (Federal Soil Protection Act) (Bundes-Bodenschutzgesetz - BBodSchG) of 1998 [1] -The Federal Soil Protection and Contaminated Sites Ordinance (BBodSchV) of 1999 [2]. In Germany, the Federal Government has legislative competence in the field of soil protection. The Lander (German federal states), in turn, are responsible for enforcement of the BBodSchG and the BBodSchV; they may also issue supplementary procedural regulations. According to Article 1 BBodschG, the purpose of the Act is inter alia to protect and restore the functions of the soil on a permanent sustainable basis. These actions shall include prevention of harmful soil changes as well as rehabilitating soil, contaminated sites and waters contaminated by such sites in such a way that any contamination remains permanently below the hazard threshold. Whilst prevention aims to protect and preserve soil functions on a long-term basis, the object of remediation is mainly to avert concrete hazards in a spatial, temporal and manageable causative context. ''Remedial soil protection'' encompasses a tiered procedure in which a suspicion is verified successively and with least-possible effort and in which the circumstances of the individual case at hand are taken into account in deciding whether or not a need for remediation exists. It comprises the systematic stages of identifying, investigating and assessing suspect sites and sites suspected of being contaminated with a view to their hazard potential, determining whether remediation is necessary, remediating identified harmful soil changes and contaminated sites, and carrying out, where necessary, aftercare measures following final inspection of the remedial measure. (orig.)

  13. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy.

    Science.gov (United States)

    Dreischulte, Tobias; Fernandez-Llimos, Fernando

    2016-12-01

    Background The definitions that are being used for the terms 'clinical pharmacy' and 'pharmaceutical care' seem to have a certain overlap. Responsibility for therapy outcomes seems to be especially linked to the latter term. Both terms need clarification before a proper definition of clinical pharmacy can be drafted. Objective To identify current disagreements regarding the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care' and to assess to which extent pharmacists with an interest in Clinical Pharmacy are willing to accept responsibility for drug therapy outcomes. Setting The membership of the European Society of Clinical Pharmacy. Methods A total of 1,285 individuals affiliated with the European Society of Clinical Pharmacy were invited by email to participate in an online survey asking participants to state whether certain professional activities, providers, settings, aims and general descriptors constituted (a) 'Clinical Pharmacy only', (b) 'Pharmaceutical Care only', (c) 'both' or (d) 'neither'. Further questions examined pharmacists' willingness to accept ethical or legal responsibility for drug therapy outcomes, under current and ideal working conditions. Main outcome measures Level of agreement with a number of statements. Results There was disagreement (responsibility under current/ideal working conditions were: safety (32.7%/64.3%), effectiveness (17.9%/49.2%), patient-centeredness (17.1%/46.2%), cost-effectiveness (20.3%/44.0%). Conclusions The survey identified key disagreements around the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care', which future discussions around a harmonised definition of 'Clinical Pharmacy' should aim to resolve. Further research is required to understand barriers and facilitators to pharmacists accepting responsibility for drug therapy outcomes.

  14. 42 CFR 457.80 - Current State child health insurance coverage and coordination.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

  15. [Position paper of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the German Society of Phoniatrics and Pediatric Audiology - current state of clinical and endoscopic diagnostics, evaluation, and therapy of swallowing disorders in children and adults].

    Science.gov (United States)

    Arens, C; Herrmann, I F; Rohrbach, S; Schwemmle, C; Nawka, T

    2015-03-01

    Position Paper of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the German Society of Phoniatrics and Pediatric Audiology - Current State of Clinical and Endoscopic Diagnostics, Evaluation, and Therapy of Swallowing Disorders in Children and AdultsSwallowing disorders are frequent. The main concern is mortality due to aspiration induced pneumonia and malnutrition. On the other hand quality of life is severely affected. The demographic trend indicates an increase of dysphagia in the future. Neurodegenerative diseases, tumors of the digestive tract and sequelae of tumor treatment in the head and neck region are the main pathologic entities.Predominantly ENT physicians and phoniatrists, are asked for diagnostics and therapy who will coordinate the interdisciplinary treatment according to the endoscopic findings.A differentiated approach in history, diagnostics, and symptom oriented treatment is necessary for the mostly complex disorders. The integration of non-medical personnel such as logopeds (speech language pathologists), physiotherapists, and occupational therapists in planning and executing an effective therapy expands and completes the patient-oriented care. Conservative treatment by these therapists is an important pillar in the treatment. Parts of the specific diagnostics can be taken over by them in close cooperation.In particular an interdisciplinary cooperation with the staff from intensive care medicine is indispensable.The diagnostic procedures of specific endoscopy as described in this position paper are part of the primary and fundamental tasks of ENT specialists and phoniatrists.Endoscopy is a medical service that is basically not delegable. Consequently substitution of the physician is precluded. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Current state and perspectives of spent fuel storage in Russia

    International Nuclear Information System (INIS)

    Kurnosov, V.A.; Tichonov, N.S.; Makarchuk, T.F.

    1999-01-01

    Twenty-nine power units at nine nuclear power plants, having a total installed capacity of 22 GW(e), are now in operation in the Russian Federation. They produce approximately 12% of the generated electricity in the country. The annual spent fuel arising is approximately 790 tU. The concept of the closed fuel cycle was adopted as the basis for nuclear power development in the Russian Federation, but until now this concept is only implemented for the fuel cycles of WWER-440 and BN-600 reactors. The WWER-1000 spent fuel is planned to be reprocessed at the reprocessing plant RT-2 which is under construction near Krasnoyarsk. The RBMK-1000 spent fuel is not reprocessed. It is meant to be stored in intermediate storage facilities at the NPP sites. The status of the spent fuel (SF) stored in the storage facilities is given in the paper. The principal characteristics of the fuel cycles of the Russian NPPs in the period up to 2015 is also given in the report. The key variant of the current spent fuel management at RBMK-1000 NPPs is storage in at-reactor and in away-from-reactor wet storage facilities at the power plant site with a capacity of 2,000 W. The storage capacity at the operating RBMKs (including the increase due to denser fuel assembly arrangement) will provide SF reception from the NPPs only up to 2005. For RBMK spent fuel, intermediate dry storage is foreseen at power plant sites in metallic concrete casks and thereafter transportation to the central storage facility at the RT-2 plant for long-term storage. The SF will be reprocessing after completion of the reprocessing plant at RT-2. In the Programme of Nuclear Power Development in the Russian Federation for the period 1998 to 2005 and for the period until 2010 year, provisions are made for the construction of a central dry storage facility before 2010. The facility will have a design capacity of 30,000 tU for WWER-1000 and RBMK-1000 spent fuel and is part of the reprocessing plant RT-2. The paper considers

  17. Advanced robotics for medical rehabilitation current state of the art and recent advances

    CERN Document Server

    Xie, Shane

    2016-01-01

    Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

  18. Qualitative ergonomics/human factors research in health care: Current state and future directions.

    Science.gov (United States)

    Valdez, Rupa Sheth; McGuire, Kerry Margaret; Rivera, A Joy

    2017-07-01

    The objective of this systematic review was to understand the current state of Ergonomics/Human Factors (E/HF) qualitative research in health care and to draw implications for future efforts. This systematic review identified 98 qualitative research papers published between January 2005 and August 2015 in the seven journals endorsed by the International Ergonomics Association with an impact factor over 1.0. The majority of the studies were conducted in hospitals and outpatient clinics, were focused on the work of formal health care professionals, and were classified as cognitive or organizational ergonomics. Interviews, focus groups, and observations were the most prevalent forms of data collection. Triangulation and data archiving were the dominant approaches to ensuring rigor. Few studies employed a formal approach to qualitative inquiry. Significant opportunities remain to enhance the use of qualitative research to advance systems thinking within health care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. 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.

  20. Voltage and Current Regulators Design of Power Converters in Islanded Microgrids based on State Feedback Decoupling

    DEFF Research Database (Denmark)

    Federico, de Bosio; de Sousa Ribeiro, Luiz Antonio; Freijedo Fernandez, Francisco Daniel

    2016-01-01

    In stand-alone microgrids based on voltage source inverters state feedback coupling between the capacitor voltage and inductor current degrades significantly the dynamics performance of voltage and current regulators. The decoupling of the controlled states is proposed, considering the limitations...

  1. Veterinarian-Client Communication Skills: Current State, Relevance, and Opportunities for Improvement.

    Science.gov (United States)

    McDermott, Michael P; Tischler, Victoria A; Cobb, Malcolm A; Robbé, Iain J; Dean, Rachel S

    2015-01-01

    Communication is increasingly recognized as a core skill for veterinary practitioners, and in recent years, attention to communication competency and skills training has increased. To gain an up-to-date assessment of the current state of veterinary communication skills and training, we conducted a survey among veterinary practitioners in the United Kingdom and United States in 2012/2013. The questionnaire was used to assess the current state, relevance, and adequacy of veterinary communication skills among veterinary practitioners, to assess interest in further training, and to understand perceived challenges in communicating with clients. There was an overall response rate of 29.6% (1,774 of 6,000 recipients), with a higher response rate for UK-based practitioners (39.7%) than practitioners in the US (19.5%). Ninety-eight percent of respondents agreed that communication skills were as important as or more important than clinical knowledge. Forty-one percent of respondents had received formal veterinary communication skills training during veterinary school, and 47% had received training post-graduation. Thirty-five percent said their veterinary communication skills training during veterinary school prepared them well or very well for communicating with clients about the health of their pets, compared to 61% of those receiving post-graduate training. Forty percent said they would be interested in further veterinary communication skills training, with the preferred methods being simulated consultations and online training. While there has been increased emphasis on communication skills training during and after veterinary school, there is a need for more relevant and accessible training.

  2. Clinical proteomics-driven precision medicine for targeted cancer therapy: current overview and future perspectives.

    Science.gov (United States)

    Zhou, Li; Wang, Kui; Li, Qifu; Nice, Edouard C; Zhang, Haiyuan; Huang, Canhua

    2016-01-01

    Cancer is a common disease that is a leading cause of death worldwide. Currently, early detection and novel therapeutic strategies are urgently needed for more effective management of cancer. Importantly, protein profiling using clinical proteomic strategies, with spectacular sensitivity and precision, offer excellent promise for the identification of potential biomarkers that would direct the development of targeted therapeutic anticancer drugs for precision medicine. In particular, clinical sample sources, including tumor tissues and body fluids (blood, feces, urine and saliva), have been widely investigated using modern high-throughput mass spectrometry-based proteomic approaches combined with bioinformatic analysis, to pursue the possibilities of precision medicine for targeted cancer therapy. Discussed in this review are the current advantages and limitations of clinical proteomics, the available strategies of clinical proteomics for the management of precision medicine, as well as the challenges and future perspectives of clinical proteomics-driven precision medicine for targeted cancer therapy.

  3. Tuning of tunneling current noise spectra singularities by localized states charging

    OpenAIRE

    Mantsevich, V. N.; Maslova, N. S.

    2008-01-01

    We report the results of theoretical investigations of tunneling current noise spectra in a wide range of applied bias voltage. Localized states of individual impurity atoms play an important role in tunneling current noise formation. It was found that switching "on" and "off" of Coulomb interaction of conduction electrons with two charged localized states results in power law singularity of low-frequency tunneling current noise spectrum ($1/f^{\\alpha}$) and also results on high frequency com...

  4. 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…

  5. Multiday Transcranial Direct Current Stimulation Causes Clinically Insignificant Changes in Childhood Dystonia: A Pilot Study.

    Science.gov (United States)

    Bhanpuri, Nasir H; Bertucco, Matteo; Young, Scott J; Lee, Annie A; Sanger, Terence D

    2015-10-01

    Abnormal motor cortex activity is common in dystonia. Cathodal transcranial direct current stimulation may alter cortical activity by decreasing excitability while anodal stimulation may increase motor learning. Previous results showed that a single session of cathodal transcranial direct current stimulation can improve symptoms in childhood dystonia. Here we performed a 5-day, sham-controlled, double-blind, crossover study, where we measured tracking and muscle overflow in a myocontrol-based task. We applied cathodal and anodal transcranial direct current stimulation (2 mA, 9 minutes per day). For cathodal transcranial direct current stimulation (7 participants), 3 subjects showed improvements whereas 2 showed worsening in overflow or tracking error. The effect size was small (about 1% of maximum voluntary contraction) and not clinically meaningful. For anodal transcranial direct current stimulation (6 participants), none showed improvement, whereas 5 showed worsening. Thus, multiday cathodal transcranial direct current stimulation reduced symptoms in some children but not to a clinically meaningful extent, whereas anodal transcranial direct current stimulation worsened symptoms. Our results do not support transcranial direct current stimulation as clinically viable for treating childhood dystonia. © The Author(s) 2015.

  6. Pancreatic cancer clinical trials and accrual in the United States.

    Science.gov (United States)

    Hoos, William A; James, Porsha M; Rahib, Lola; Talley, Anitra W; Fleshman, Julie M; Matrisian, Lynn M

    2013-09-20

    Pancreatic cancer clinical trials open in the United States and their accrual were examined to identify opportunities to accelerate progress in the treatment of pancreatic cancer. Pancreatic cancer-specific clinical trials open in the United States in the years 2011 and 2012 were obtained from the Pancreatic Cancer Action Network database. Accrual information was obtained from trial sponsors. The portfolio of pancreatic cancer clinical trials identified by type (adenocarcinoma or neuroendocrine), phase, disease stage, and treatment approach is reported. More than half of trials for patients with pancreatic ductal adenocarcinoma applied biologic insights to new therapeutic approaches, and 38% focused on optimization of radiation or chemotherapy delivery or regimens. In 2011, pancreatic cancer trials required total enrollment of 11,786 patients. Actual accrual to 93.2% of trials was 1,804 patients, an estimated 4.57% of the patients with pancreatic cancer alive in that year. The greatest need was for patients with resectable cancer. Trials open in 2011 enrolled an average of 15% of their total target accrual. Physician recommendations greatly influenced patients' decision to enroll or not enroll onto a clinical trial. Matching to a clinical trial within a 50-mile radius and identifying trials for recurrent/refractory disease were documented as challenges for patient accrual. Overall trial enrollment indicates that pancreatic cancer trials open in 2011 would require 6.7 years on average to complete accrual. These results suggest that harmonizing patient supply and demand for clinical trials is required to accelerate progress toward improving survival in pancreatic cancer.

  7. Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

    Science.gov (United States)

    Abbott, Lisa M; Magnusson, Roger S; Gibbs, Emma; Smith, Saxon D

    2018-05-01

    Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession. © 2017 The Australasian College of Dermatologists.

  8. Current status and future prospects of the development of clinical Pharmacy in China: A SWOT analysis.

    Science.gov (United States)

    Rao, Yuefeng; Zhao, Qingwei; Zhang, Xiangyi; Yang, Hongyu; Lou, Yan; Zhang, Xingguo

    2016-03-01

    In many industrialized countries, clinical pharmacy has developed into a separate discipline and become a vital part of inpatient care in hospitals. However, as compared to many established branches of medicine, clinical pharmacy is still in its infancy, with much room for growth, improvement, and recognition by both the medical community and patients. In this study, a widely-recognized development strategy analysis tool, Strength, Weakness, Opportunity and Threat (SWOT), was used to systematically address several key issues to the development of clinical pharmacy in China. This analysis aims to provide feasible recommendations for the development of clinical pharmacy in China by identifying current problems and growth opportunities. Full development of clinical pharmacy as a mature clinical discipline will help promote the rational use of drugs by both clinicians and patients and lead to enhanced drug efficacy and safety.

  9. Cervical spondylotic myelopathy: the clinical phenomenon and the current pathobiology of an increasingly prevalent and devastating disorder.

    Science.gov (United States)

    Kalsi-Ryan, Sukhvinder; Karadimas, Spyridon K; Fehlings, Michael G

    2013-08-01

    Cervical spondylotic myelopathy (CSM) is a common disorder involving chronic progressive compression of the cervical spinal cord due to degenerative disc disease, spondylosis, or other degenerative pathology. CSM is the most common form of spinal cord impairment and causes functional decline leading to reduced independence and quality of life. Despite a sound understanding of the disease process, clinical presentation and management, a universal definition of CSM and a standardized index of severity are not currently used universally. Work is required to develop a definition and establish clinical predictors of progression to improve management of CSM. Despite advances in decompressive and reconstructive surgery, patients are often left with residual disability. Gaps in knowledge of the pathobiology of CSM have limited therapeutic advances to complement surgery. Although the histopathologic and pathophysiologic similarities between CSM and traumatic spinal cord injury have long been acknowledged, the unique pathomechanisms of CSM remain unexplored. Increased efforts to elucidate CSM pathobiology could lead to the discovery of novel therapeutic targets for human CSM and other spinal cord diseases. Here, the natural history of CSM, epidemiology, clinical presentation, and current methods of clinical management are reported, along with the current state of basic scientific research in the field.

  10. The Current State of Poison Control Centers in Pakistan and the Need for Capacity Building

    Directory of Open Access Journals (Sweden)

    Nadeem Khan

    2014-03-01

    Full Text Available Background: Chemical exposure is a major health problem globally. Poison control centers (PCCs play a leading role both in developed and developing countries in the prevention and control of poisonous chemical exposures. In this study, we aimed to assess the current state of PCCs in Pakistan and highlight capacity building needs in these centers. Methods: A cross-sectional survey of the two registered PCCs was done during August – December 2011. Necessary services of the PCCs were evaluated and the data were recorded on a predesigned checklist. Results: Both PCCs are affiliated to a tertiary care hospital. Clinical services to poisoned patients were available 24 hours a day / 7 days a week. Information on common local products was available to poison center staff. Both centers were involved in undergraduate and post graduate teaching. Telephone poison information service was not available in either of centers. There was a limited capacity for qualitative and analytical toxicology. Common antidotes were available. There were limited surveillance activities to capture toxic risks existing in the community and also a deficiency was observed in chemical disaster planning. Conclusion: PCCs in Pakistan need capacity building for specialized training in toxicology, toxicovigilance, chemical disaster planning, analytical laboratory tests and telephone service for consultation in poisoning cases.   How to cite this article: Khan NU, Mir MU, Khan UR, Khan AR, Ara J, Raja K, et al. The Current State of Poison Control Centers in Pakistan and the Need for Capacity Building. Asia Pac J Med Toxicol 2014;3:31-5.

  11. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Rim, Chai Hong; Seong, Jin Sil [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

  12. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    International Nuclear Information System (INIS)

    Rim, Chai Hong; Seong, Jin Sil

    2016-01-01

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy

  13. Current therapeutic interventions in the glycation pathway: evidence from clinical studies.

    Science.gov (United States)

    Engelen, L; Stehouwer, C D A; Schalkwijk, C G

    2013-08-01

    The increased formation of advanced glycation endproducts (AGEs) constitutes a potential mechanism of hyperglycaemia-induced micro- and macrovascular disease in diabetes. In vitro and animal experiments have shown that various interventions can inhibit formation and/or actions of AGEs, in particular the specific AGE inhibitor aminoguanidine and the AGEs crosslink breaker alagebrium, and the B vitamins pyridoxamine and thiamine, and the latter's synthetic derivative, benfotiamine. The potential clinical value of these interventions, however, remains to be established. The present review provides, from the clinical point of view, an overview of current evidence on interventions in the glycation pathway relating to (i) the clinical benefits of specific AGE inhibitors and AGE breakers and (ii) the potential AGE-inhibiting effects of therapies developed for purposes unrelated to the glycation pathway. We found that safety and/or efficacy in clinical studies with the specific AGE inhibitor, aminoguanidine and the AGE breaker, alagebrium, appeared to be a concern. The clinical evidence on the potential AGE-inhibiting effects of B vitamins is still limited. Finally, current evidence for AGE inhibition by therapies developed for purposes unrelated to glycation is limited due to a large heterogeneity in study designs and/or measurement techniques, which have often been sub-optimal. We conclude that, clinical evidence on interventions to inhibit formation and/or action of AGEs is currently weak and unconvincing. © 2012 Blackwell Publishing Ltd.

  14. The Role of Clinical Cardiac Magnetic Resonance Imaging in China: Current Status and the Future

    Directory of Open Access Journals (Sweden)

    Shi Chen, MD

    2016-12-01

    Full Text Available Cardiac magnetic resonance (CMR imaging plays an important role in the diagnosis and management of cardiovascular diseases. The state-of-the-art CMR imaging has many advantages in cardiac imaging, including excellent spatial and temporal resolution, unrestricted imaging field, no exposure to ionizing radiation, excellent tissue contrast, and unique myocardial tissue characterization. Clinical CMR imaging is used during the cardiovascular diagnostic workup in the United States and some European countries. Use of CMR imaging is emerging in hospitals in China and has a promising future. This review briefly describes the real-world clinical application of CMR imaging in China and discuss obstacles for its future development.

  15. Current globalization of drug interventional clinical trials: characteristics and associated factors, 2011-2013.

    Science.gov (United States)

    Jeong, Sohyun; Sohn, Minji; Kim, Jae Hyun; Ko, Minoh; Seo, Hee-Won; Song, Yun-Kyoung; Choi, Boyoon; Han, Nayoung; Na, Han-Sung; Lee, Jong Gu; Kim, In-Wha; Oh, Jung Mi; Lee, Euni

    2017-06-21

    Clinical trial globalization is a major trend for industry-sponsored clinical trials. There has been a shift in clinical trial sites towards emerging regions of Eastern Europe, Latin America, Asia, the Middle East, and Africa. Our study objectives were to evaluate the current characteristics of clinical trials and to find out the associated multiple factors which could explain clinical trial globalization and its implications for clinical trial globalization in 2011-2013. The data elements of "phase," "recruitment status," "type of sponsor," "age groups," and "design of trial" from 30 countries were extracted from the ClinicalTrials.gov website. Ten continental representative countries including the USA were selected and the design elements were compared to those of the USA. Factors associated with trial site distribution were chosen for a multilinear regression analysis. The USA, Germany, France, Canada, and United Kingdom were the "top five" countries which frequently held clinical trials. The design elements from nine continental representative countries were quite different from those of the USA; phase 1 trials were more prevalent in India (OR 1.517, p globalization of clinical trials in the emerging regions of Asia, South Africa, and Eastern Europe developed in parallel with the factors of economic drive, population for recruitment, and regulatory constraints.

  16. 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

  17. Determination of the Steady State Leakage Current in Structures with Ferroelectric Ceramic Films

    Science.gov (United States)

    Podgornyi, Yu. V.; Vorotilov, K. A.; Sigov, A. S.

    2018-03-01

    Steady state leakage currents have been investigated in capacitor structures with ferroelectric solgel films of lead zirconate titanate (PZT) formed on silicon substrates with a lower Pt electrode. It is established that Pt/PZT/Hg structures, regardless of the PZT film thickness, are characterized by the presence of a rectifying contact similar to p-n junction. The steady state leakage current in the forward direction increases with a decrease in the film thickness and is determined by the ferroelectric bulk conductivity.

  18. Limiting stable states of high-Tc superconductors in the alternating current modes

    International Nuclear Information System (INIS)

    Romanovskii, V.R.; Watanabe, K.; Awaji, S.

    2014-01-01

    The limiting current-carrying capacity of high-T c superconductor and superconducting tape has been studied in the alternating current states. The features that are responsible for their stable formation have been investigated under the conduction-cooled conditions when the operating peak values of the electric field and the current may essentially exceed the corresponding critical values of superconductor. Besides, it has been proved that these peak values are higher than the values of the electric field and the current, which lead to the thermal runaway phenomenon when the current instability onset occurs in the operating modes with direct current. As a result, the stable extremely high heat generation exists in these operating states, which can be called as overloaded states. The limiting stable peak values of charged currents and stability conditions have been determined taking into account the flux creep states of superconductors. The analysis performed has revealed that there exist characteristic times defining the corresponding time windows in the stable development of overloaded states of the alternating current. In order to explain their existence, the basic thermo-electrodynamics mechanisms have been formulated, which have allowed to explain the high stable values of the temperature and the induced electric field before the onset of alternating current instability. In general, it has been shown that the high-T c superconductors may stably operate in the overloaded alternating current states even under the not intensive cooling conditions at a very high level of heat generation, which is not considered in the existing theory of losses. (authors)

  19. A clinical trial with combined transcranial direct current stimulation and alcohol approach bias retraining

    NARCIS (Netherlands)

    den Uyl, T.E.; Gladwin, T.E.; Rinck, M.; Lindenmeyer, J.; Wiers, R.W.

    2017-01-01

    Two studies showed an improvement in clinical outcomes after alcohol approach bias retraining, a form of Cognitive Bias Modification (CBM). We investigated whether transcranial direct current stimulation (tDCS) could enhance effects of CBM. TDCS is a neuromodulation technique that can increase

  20. Delivering Communication Strategy Training for People with Aphasia: What Is Current Clinical Practice?

    Science.gov (United States)

    Beckley, Firle; Best, Wendy; Beeke, Suzanne

    2017-01-01

    Background: Communication strategy training (CST) is a recognized part of UK speech and language therapists' (SLTs) role when working with a person with aphasia. Multiple CST interventions have been published but, to date, there are no published studies exploring clinical practice in this area. Aims: To investigate UK SLTs' current CST practices.…

  1. Current clinical magnetoencephalography practice across Europe: Are we closer to use MEG as an established clinical tool?

    Science.gov (United States)

    De Tiège, Xavier; Lundqvist, Daniel; Beniczky, Sándor; Seri, Stefano; Paetau, Ritva

    2017-08-01

    This comprehensive survey aims at characterizing the current clinical use of magnetoencephalography (MEG) across European MEG centres. Forty-four MEG centres across Europe were contacted in May 2015 via personalized e-mail to contribute to survey. The web-based survey was available on-line for 1 month and the MEG centres that did not respond were further contacted to maximize participation. Among the 57% of responders, 12 centres from 10 different countries reported to use MEG for clinical applications. A total of 524 MEG investigations were performed in 2014 for the pre-surgical evaluation of epilepsy, while in the same period 244 MEG investigations were performed for pre-surgical functional brain mapping. Seven MEG centres located in different European countries performed ≥50 MEG investigations for epilepsy mapping in 2014, both in children and adults. In those centres, time from patient preparation to MEG data reporting tends to be lower than those investigating a lower annual number of patients. This survey demonstrates that there is in Europe an increasing and widespread expertise in the field of clinical MEG. These findings should serve as a basis to harmonize clinical MEG procedures and promote the clinical added value of MEG across Europe. MEG should now be considered in Europe as a mature clinical neurophysiological technique that should be used routinely in two specific clinical indications, i.e, the pre-surgical evaluation of refractory focal epilepsy and functional brain mapping. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  2. The Current State and Path Forward For Enterprise Image Viewing: HIMSS-SIIM Collaborative White Paper.

    Science.gov (United States)

    Roth, Christopher J; Lannum, Louis M; Dennison, Donald K; Towbin, Alexander J

    2016-10-01

    Clinical specialties have widely varied needs for diagnostic image interpretation, and clinical image and video image consumption. Enterprise viewers are being deployed as part of electronic health record implementations to present the broad spectrum of clinical imaging and multimedia content created in routine medical practice today. This white paper will describe the enterprise viewer use cases, drivers of recent growth, technical considerations, functionality differences between enterprise and specialty viewers, and likely future states. This white paper is aimed at CMIOs and CIOs interested in optimizing the image-enablement of their electronic health record or those who may be struggling with the many clinical image viewers their enterprises may employ today.

  3. State Higher Education Funding Models: An Assessment of Current and Emerging Approaches

    Science.gov (United States)

    Layzell, Daniel T.

    2007-01-01

    This article provides an assessment of the current and emerging approaches used by state governments in allocating funding for higher education institutions and programs. It reviews a number of desired characteristics or outcomes for state higher education funding models, including equity, adequacy, stability, and flexibility. Although there is…

  4. High-voltage, high-current, solid-state closing switch

    Science.gov (United States)

    Focia, Ronald Jeffrey

    2017-08-22

    A high-voltage, high-current, solid-state closing switch uses a field-effect transistor (e.g., a MOSFET) to trigger a high-voltage stack of thyristors. The switch can have a high hold-off voltage, high current carrying capacity, and high time-rate-of-change of current, di/dt. The fast closing switch can be used in pulsed power applications.

  5. Assessment of Energy Production Potential from Ocean Currents along the United States Coastline

    Energy Technology Data Exchange (ETDEWEB)

    Haas, Kevin A. [Georgia Inst. of Technology, Atlanta, GA (United States)

    2013-10-03

    Increasing energy consumption and depleting reserves of fossil fuels have resulted in growing interest in alternative renewable energy from the ocean. Ocean currents are an alternative source of clean energy due to their inherent reliability, persistence and sustainability. General ocean circulations exist in the form of large rotating ocean gyres, and feature extremely rapid current flow in the western boundaries due to the Coriolis Effect. The Gulf Stream system is formed by the western boundary current of the North Atlantic Ocean that flows along the east coastline of the United States, and therefore is of particular interest as a potential energy resource for the United States.

  6. MRI for solitary pulmonary nodule and mass assessment: Current state of the art.

    Science.gov (United States)

    Ohno, Yoshiharu; Kauczor, Hans-Ulrich; Hatabu, Hiroto; Seo, Joon Beom; van Beek, Edwin J R

    2018-03-23

    Since the clinical introduction of magnetic resonance imaging (MRI), the chest has been one of its most challenging applications, and many physicists and radiologists have tried since the 1980s to use MR for assessment of different lung diseases as well as mediastinal and pleural diseases. Since then, however, technical advances in sequencing, scanners, and coils, adaptation of parallel imaging techniques, utilization of contrast media, and development of postprocessing tools have been reported by many basic and clinical researchers. As a result, state-of-the-art thoracic MRI is now substituted for traditional imaging techniques and/or plays a complementary role in the management of patients with various chest diseases, and especially in the detection of pulmonary nodules and in thoracic oncology. In addition, MRI has continued to be developed to help overcome the limitations of computed tomography (CT) and nuclear medicine examinations. It can currently provide not only morphological, but also functional, physiological, pathophysiological, and molecular information at 1.5T with a gradual shift from 1.5T to 3T MR systems. In this review, we focus on these recent advances in MRI for pulmonary nodule detection and pulmonary nodule and mass evaluation by using noncontrast-enhanced and contrast-enhanced techniques as well as new molecular imaging methods such as chemical exchange saturation transfer imaging for a comparison with other modalities such as single or multidetector row CT, 18F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET), and/or PET/CT. 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018. © 2018 International Society for Magnetic Resonance in Medicine.

  7. High ion charge states in a high-current, short-pulse, vacuum ARC ion sources

    International Nuclear Information System (INIS)

    Anders, A.; Brown, I.; MacGill, R.; Dickinson, M.

    1996-01-01

    Ions of the cathode material are formed at vacuum arc cathode spots and extracted by a grid system. The ion charge states (typically 1-4) depend on the cathode material and only little on the discharge current as long as the current is low. Here the authors report on experiments with short pulses (several μs) and high currents (several kA); this regime of operation is thus approaching a more vacuum spark-like regime. Mean ion charge states of up to 6.2 for tungsten and 3.7 for titanium have been measured, with the corresponding maximum charge states of up to 8+ and 6+, respectively. The results are discussed in terms of Saha calculations and freezing of the charge state distribution

  8. High ion charge states in a high-current, short-pulse, vacuum arc ion source

    International Nuclear Information System (INIS)

    Anders, A.; Brown, I.; MacGill, R.; Dickinson, M.

    1995-09-01

    Ions of the cathode material are formed at vacuum arc cathode spots and extracted by a grid system. The ion charge states (typically 1--4) depend on the cathode material and only little on the discharge current as long as the current is low. Here the authors report on experiments with short pulses (several micros) and high currents (several kA); this regime of operation is thus approaching a more vacuum spark-like regime. Mean ion charge states of up to 6.2 for tungsten and 3.7 for titanium have been measured, with the corresponding maximum charge states of up to 8+ and 6+, respectively. The results are discussed in terms of Saha calculations and freezing of the charge state distribution

  9. Limitations Of The Current State Space Modelling Approach In Multistage Machining Processes Due To Operation Variations

    Science.gov (United States)

    Abellán-Nebot, J. V.; Liu, J.; Romero, F.

    2009-11-01

    The State Space modelling approach has been recently proposed as an engineering-driven technique for part quality prediction in Multistage Machining Processes (MMP). Current State Space models incorporate fixture and datum variations in the multi-stage variation propagation, without explicitly considering common operation variations such as machine-tool thermal distortions, cutting-tool wear, cutting-tool deflections, etc. This paper shows the limitations of the current State Space model through an experimental case study where the effect of the spindle thermal expansion, cutting-tool flank wear and locator errors are introduced. The paper also discusses the extension of the current State Space model to include operation variations and its potential benefits.

  10. Screening mammography among nursing home residents in the United States: Current guidelines and practice.

    Science.gov (United States)

    Mack, Deborah S; Epstein, Mara M; Dubé, Catherine; Clark, Robin E; Lapane, Kate L

    2018-06-04

    United States (US) guidelines regarding when to stop routine breast cancer screening remain unclear. No national studies to-date have evaluated the use of screening mammography among US long-stay nursing home residents. This cross-sectional study was designed to identify prevalence, predictors, and geographic variation of screening mammography among that population in the context of current US guidelines. Screening mammography prevalence, identified with Physician/Supplier Part B claims and stratified by guideline age classification (65-74, ≥75 years), was estimated for all women aged ≥65 years residing in US Medicare- and Medicaid- certified nursing homes (≥1 year) with an annual Minimum Data Set (MDS) 3.0 assessment, continuous Medicare Part B enrollment, and no clinical indication for screening mammography as of 2011 (n = 389,821). The associations between resident- and regional- level factors, and screening mammography, were estimated by crude and adjusted prevalence ratios from robust Poisson regressions clustered by facility. Women on average were 85.4 (standard deviation ±8.1) years old, 77.9% were disabled, and 76.3% cognitively impaired. Screening mammography prevalence was 7.1% among those aged 65-74 years (95% Confidence Interval (CI): 6.8%-7.3%) and 1.7% among those ≥75 years (95% CI, 1.7%-1.8%), with geographic variation observed. Predictors of screening in both age groups included race, cognitive impairment, frailty, hospice, and some comorbidities. These results shed light on the current screening mammography practices in US nursing homes. Thoughtful consideration about individual screening recommendations and the implementation of more clear guidelines for this special population are warranted to prevent overscreening. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

    DEFF Research Database (Denmark)

    O'Brien, P.J.; Fournel-Fleury, C.; Bolliger, Adrian Marc

    2007-01-01

    congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges......After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP)was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has......; currently there are 18 resident trainingprograms inEurope; 3) administration of 3 annual board-certifying examinations thus far,with an overall pass rate of 70%; 4) European consensus criteria for assessing the continuing education of specialists every 5 ears; 5) organization of 8 annual scientific...

  12. Current Role for Biomarkers in Clinical Diagnosis of Alzheimer Disease and Frontotemporal Dementia.

    Science.gov (United States)

    Sheikh-Bahaei, Nasim; Sajjadi, Seyed Ahmad; Pierce, Aimee L

    2017-11-14

    Purpose of review Alzheimer's disease (AD) and frontotemporal dementia can often be diagnosed accurately with careful clinical history, cognitive testing, neurological examination, and structural brain MRI. However, there are certain circumstances wherein detection of specific biomarkers of neurodegeneration or underlying AD pathology will impact the clinical diagnosis or treatment plan. We will review the currently available biomarkers for AD and frontotemporal dementia (FTD) and discuss their clinical importance. Recent findings With the advent of 18 F-labeled tracers that bind amyloid plaques, amyloid PET is now clinically available for the detection of amyloid pathology and to aid in a biomarker-supported diagnosis of AD or mild cognitive impairment (MCI) due to AD. It is not yet possible to test for the specific FTD pathologies (tau or TDP-43); however, a diagnosis of FTD may be "imaging supported" based upon specific MRI or FDG-PET findings. Cerebrospinal fluid measures of amyloid-beta, total-tau, and phospho-tau are clinically available and allow detection of both of the cardinal pathologies of AD: amyloid and tau pathology. Summary It is appropriate to pursue biomarker testing in cases of MCI and dementia when there remains diagnostic uncertainty and the result will impact diagnosis or treatment. Practically speaking, due to the rising prevalence of amyloid positivity with advancing age, measurement of biomarkers in cases of MCI and dementia is most helpful in early-onset patients, patients with atypical clinical presentations, or when considering referral for AD clinical trials.

  13. Standardization of calibration of clinic dosemeters using electric currents and charges

    International Nuclear Information System (INIS)

    Peres, Marcos Antonio de Lima

    1999-09-01

    Clinical dosimeters used in radiotherapy are calibrated in Latin American countries, including Brazil, as a complete 'system, i.e., ionization chamber and electrometer together. Some countries, as European ones, and USA calibrate them by component, i.e., ionisation chamber apart from electrometer. This method is more advantageous than the previous one, since it makes possible the automation of the calibration process, allowing the acquisition of data related to the chamber and the electrometer measurements independently, as well as the substitution of one of the components, in case of failure. This work proposes a method for standardisation of low intensity electric charge and currents in order to implement electric calibration of electrometers. This will make possible the implementation of a by components calibration technique, by components, of clinical dosimeters in Brazil. The results obtained with the calibration by components prove that the proposed method of standardisation of low electric charges and currents is viable. The difficulties found for the generation and measurement of low intensity electric charges and currents and the procedures adopted for the calibration by components are presented. Additionally, a current source was built to yield reference electric charges that will make possible the quality control clinical dosimeters. This source will also allow the user to identify the defective components of the dosimeters, through a simple verification test. (author)

  14. Clinical Research with Transcranial Direct Current Stimulation (tDCS): Challenges and Future Directions

    Science.gov (United States)

    Brunoni, Andre Russowsky; Nitsche, Michael A.; Bolognini, Nadia; Bikson, Marom; Wagner, Tim; Merabet, Lotfi; Edwards, Dylan J.; Valero-Cabre, Antoni; Rotenberg, Alexander; Pascual-Leone, Alvaro; Ferrucci, Roberta; Priori, Alberto; Boggio, Paulo; Fregni, Felipe

    2011-01-01

    Background Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past ten years, tDCS physiological mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodological, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them. Methods We convened a workgroup of researchers in the field to review, discuss and provide updates and key challenges of neuromodulation use for clinical research. Main Findings/Discussion We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (i) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (ii) methodological aspects related to the clinical research of tDCS as divided according to study phase (i.e., preclinical, phase I, phase II and phase III studies); (iii) ethical and regulatory concerns; (iv) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS. PMID:22037126

  15. Radiotherapy for pediatric brain tumors: Standard of care, current clinical trials, and new directions

    International Nuclear Information System (INIS)

    Kun, Larry E.

    1996-01-01

    Objectives: To review the clinical characteristics of childhood brain tumors, including neurologic signs, neuroimaging and neuropathology. To critically assess indications for therapy relevant to presenting characteristics, age, and disease status. To discuss current management strategies including neurosurgery, radiation therapy, and chemotherapy. To analyze current clinical trials and future directions of clinical research. Brain tumors account for 20% of neoplastic diseases in children. The most common tumors include astrocytoma and malignant gliomas, medulloblastoma and supratentorial PNET's, ependymoma, craniopharyngioma, and intracranial germ cell tumors. Tumor type and clinical course are often correlated with age at presentation and anatomic site. The clinical characteristics and disease extent largely determine the relative merits of available 'standard' and investigational therapeutic approaches. Treatment outcome, including disease control and functional integrity, is dependent upon age at presentation, tumor type, and disease extent. An understanding of the clinical, neuroimaging, and histologic characteristics as they relate to decisions regarding therapy is critical to the radiation oncologist. Appropriate radiation therapy is central to curative therapy for a majority of pediatric brain tumor presentations. Technical advances in neurosurgery provide greater safety for 'gross total resection' in a majority of hemispheric astrocytomas and medulloblastomas. The relative roles of 'standard' radiation therapy and evolving chemotherapy for centrally located astrocytomas (e.g., diencephalic, optic pathway) need to be analyzed in the context of initial and overall disease control, neurotoxicities, and potential modifications in the risk:benefit ratio apparent in the introduction of precision radiation techniques. Modifications in radiation delivery are fundamental to current investigations in medulloblastoma; the rationale for contemporary and projected

  16. Research on State-of-Charge (SOC) estimation using current integration based on temperature compensation

    Science.gov (United States)

    Yin, J.; Shen, Y.; Liu, X. T.; Zeng, G. J.; Liu, D. C.

    2017-11-01

    The traditional current integral method for the state-of-charge (SOC) estimation has an unusable estimation accuracy because of the current measuring error. This paper proposed a closed-loop temperature compensation method to improve the SOC estimation accuracy of current integral method by eliminating temperature drift. Through circuit simulation result in Multisim, the stability of current measuring accuracy is improved by more than 10 times. In a designed 70 charge-discharge experimental circle, the SOC estimation error with temperature compensation had 30 times less than error in normal situation without compensation.

  17. The influence of current mood state, number of previous affective episodes and predominant polarity on insight in bipolar disorder.

    Science.gov (United States)

    de Assis da Silva, Rafael; Mograbi, Daniel C; Camelo, Evelyn Vieira Miranda; Peixoto, Ursula; Santana, Cristina Maria Teixeira; Landeira-Fernandez, Jesus; Morris, Robin G; Cheniaux, Elie

    2017-11-01

    Although many studies have explored the effect of current affective episodes on insight into bipolar disorder, the potential interaction between current mood state and previous affective episodes has not been consistently investigated. To explore the influence of dominant polarity, number of previous affective episodes and current affective state on insight in bipolar disorder patients in euthymia or mania. A total of 101 patients with bipolar disorder were recruited for the study, including 58 patients in euthymia (30 with no defined predominant polarity and 28 with manic predominant polarity) and 43 in mania (26 with no defined predominant polarity and 17 with manic predominant polarity). Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. Bipolar disorder patients in mania had worse insight than those in euthymia, with no effect of dominant polarity. In addition, positive psychotic symptoms showed a significant effect on insight and its inclusion as a covariate eliminated differences related to mood state. Finally, the number of previous manic or depressive episodes did not correlate with insight level. Mania is a predictor of loss of insight into bipolar disorder. However, it is possible that its contribution is linked to the more frequent presence of psychotic symptoms in this state. Dominant polarity and number/type of previous affective episodes have a limited impact on insight.

  18. Investigation of unstable periodic space-time states in distributed active system with supercritical current

    International Nuclear Information System (INIS)

    Koronovskij, A.A.; Rempen, I.S.; Khramov, A.E.

    2003-01-01

    The set of the unstable periodic space-time states, characterizing the chaotic space-time dynamics of the electron beam with the supercritical current in the Pierce diode is discussed. The Lyapunov indicators of the revealed instable space-time states of the chaotic dynamics of the distributed self-excited system are calculated. It is shown that change in the set of the unstable periodic states in dependence on the Pierce parameter is determined by change in the various orbits stability, which is demonstrated by the values of senior Lyapunov unstable state index [ru

  19. Atopic Dermatitis in Children: Current Clinical Guidelines for Diagnosis and Therapy

    Directory of Open Access Journals (Sweden)

    Leyla S. Namazova-Baranova

    2016-01-01

    Full Text Available Atopic dermatitis is a chronic multifactorial skin disease that is common enough in childhood. The article presents the current data on epidemiology and dynamics of incidence of pathological symptoms, pathogenesis basics, and key factors of the disease development, shows the current classification of the disease. The authors consider in detail the key principles of the diagnosis and peculiarities of a clinical aspect depending on age. Algorithms of a therapeutic approach, as well as basics of an individual hypoallergenic diet are proposed. General recommendations and possible prognosis for pediatric patients with atopic dermatitis are given.

  20. Integrated and Inclusive Higher Education in Vladimir State University: Current State and Development Perspectives

    Directory of Open Access Journals (Sweden)

    Yegorov I.N.,

    2017-08-01

    Full Text Available The paper summarizes the many years of experience in methodological support and training at the Center of Professional Education for the Disabled and at the “Inclusive Education” Research and Educational Center of the Vladimir State University. At these centers the work is aimed at establishing a system of continuous higher inclusive education for persons with hearing and visual impairments. The paper focuses on the issues concerning the organization of educational process and the adaptation of learning materials for students with hearing and visual impairments; it addresses the problem of creating a system of academic support for students with disabilities and providing psychological and educational assistance to individuals with hearing and visual impairments in the system of higher education.

  1. 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.

  2. Clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation

    Directory of Open Access Journals (Sweden)

    Dmitry ePinchuk

    2013-03-01

    Full Text Available The clinical effectiveness of headache treatment by transcranial direct current stimulation with various locations of stimulating electrodes on the scalp was analyzed retrospectively. The results of the treatment were analyzed in 90 patients aged from 19 to 54 years (48 patients had migraine without aura, 32 – frequent episodic tension-type headaches, 10 – chronic tension-type headaches and in 44 adolescents aged 11 – 16 years with chronic posttraumatic headaches after a mild head injury. Clinical effectiveness of tDCS with 70 – 150 µA current for 30 – 45 minutes via 6.25 cm2 stimulating electrodes is comparable to that of modern pharmacological drugs, with no negative side effects. The obtained result has been maintained on average from 5 to 9 months. It has been demonstrated that effectiveness depends on localization of stimulating electrodes used for different types of headaches.

  3. Deep Venous Thrombosis Prophylaxis in Anterior Cruciate Ligament Reconstructive Surgery: What Is the Current State of Practice?

    Science.gov (United States)

    Keller, Robert A; Moutzouros, Vasilios; Dines, Joshua S; Bush-Joseph, Charles A; Limpisvasti, Orr

    Venous thromboembolism (VTE) is a significant perioperative risk with many common orthopaedic procedures. Currently, there is no standardized recommendation for the use of VTE prophylaxis during anterior cruciate ligament (ACL) reconstruction. This study sought to evaluate the current prophylactic practices of fellowship-trained sports medicine orthopaedic surgeons in the United States. Very few surgeons use perioperative VTE prophylaxis for ACL reconstructive surgery. Survey. Surveys were emailed to the alumni networks of 4 large ACGME-accredited sports medicine fellowship programs. Questions were focused on their current use of chemical and nonchemical VTE prophylaxis. Surveys were completed by 142 surgeons in the United States, yielding a response rate of 32%. Of those who responded, 50.7% stated that they routinely use chemical prophylaxis, with 95.5% of those using aspirin (acetylsalicylic acid [ASA]). There was no standardized dosing protocol, with respondents using ASA 325 mg once (46%) or twice daily (26%) or ASA 81 mg once (18%) or twice (10%) daily. The most common reason for not including chemical prophylaxis within the reconstruction procedure was that it is unnecessary given the low risk of VTE. Physicians also based their prophylaxis regimen more on their own clinical experience than concern for litigation. Half of all sports medicine fellowship-trained surgeons surveyed routinely use chemical VTE prophylaxis after ACL reconstruction, with more than 90% of those using ASA. Of those using ASA, there was no prevailing dosing protocol. For those not using chemical prophylaxis, the most important reason was that it was felt to be unnecessary due to the risks outweighing the benefits. Those who do not regularly use chemical prophylaxis would be willing to, however, if a patient had a personal or family history of clotting disorder or is currently on birth control. Additionally, clinical experience was the primary driver for a current prophylaxis protocol

  4. Radiotherapy for pediatric brain tumors: Standard of care, current clinical trials and new directions

    International Nuclear Information System (INIS)

    Kun, Larry E.

    1997-01-01

    Objectives: To review the clinical characteristics of childhood brain tumors, including neurologic signs, neuroimaging and neuropathology. To critically assess indications for therapy relevant to presenting characteristics, age, and disease status. To discuss current management strategies including neurosurgery, radiation therapy, and chemotherapy. To analyze current clinical trials and future directions of clinical research. Brain tumors account for 20% of neoplastic diseases in children. The most common tumors include astrocytoma and malignant gliomas, medulloblastoma and supratentorial PNET's, ependymoma, craniopharyngioma, and intracranial germ cell tumors. The clinical characteristics and disease extent largely determine the relative merits of available 'standard' and investigational therapeutic approaches. Treatment outcome, including disease control and functional integrity, is dependent upon tumor type and site, age at presentation, and disease extent. An understanding of the clinical, neuroimaging, and histologic characteristics as they relate to decisions regarding therapy is critical to the radiation oncologist. Appropriate radiation therapy is central to curative therapy for a majority of pediatric brain tumor presentations. Technical advances in neurosurgery provide greater safety for 'gross total resection' in a majority of hemispheric astrocytomas and medulloblastomas. The relative roles of radiation therapy and chemotherapy for centrally located astrocytomas (e.g., diencephalic, optic pathway) need to be analyzed in the context of initial and overall disease control, neurotoxicities, and potential modifications in the risk:benefit ratio apparent in the introduction of 3-dimensional radiation techniques. Modifications in radiation delivery are important components of current investigations in medulloblastoma; the rationale for contemporary cooperative group trials will be presented as well as the background data re surgical, radiotherapeutic, and

  5. The Off-Campus Clinical Program of the College of Optometry, Ferris State College.

    Science.gov (United States)

    Paramore, James E.

    1982-01-01

    The clinical education program at Ferris State College, College of Optometry, and the various clinics affiliated with the college are described. To ensure quality, all individuals with the responsibility of teaching the students are faculty of Ferris State. (MLW)

  6. 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.

  7. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    International Nuclear Information System (INIS)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng

    2011-01-01

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  8. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng (Univ. of Florida Proton Therapy Inst., Jacksonville, Florida (United States)), e-mail: menden@shands.ufl.edu

    2011-08-15

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  9. The role of hybrid SPECT-CT in oncology: current and emerging clinical applications

    International Nuclear Information System (INIS)

    Chowdhury, F.U.; Scarsbrook, A.F.

    2008-01-01

    Single photon emission computed tomography - computed tomography (SPECT-CT) is an emerging dual-modality imaging technique with many established and potential clinical applications in the field of oncology. To date, there has been a considerable emphasis on the benefits of integrated positron emission tomography - computed tomography (PET-CT) in oncology, but relatively little focus on the clinical utility of SPECT-CT. As with PET-CT, accurate co-registration of anatomical and functional data from a combined SPECT-CT camera often provides complementary diagnostic information. Both sensitivity (superior disease localization) and specificity (exclusion of false-positives due to physiological tracer uptake) are improved, and the functional significance of indeterminate lesions detected on cross-sectional imaging can be defined. This article will review the scope of hybrid SPECT-CT in oncology and illustrate both current and emerging clinical applications

  10. Preemptive clinical pharmacogenetics implementation: current programs in five US medical centers.

    Science.gov (United States)

    Dunnenberger, Henry M; Crews, Kristine R; Hoffman, James M; Caudle, Kelly E; Broeckel, Ulrich; Howard, Scott C; Hunkler, Robert J; Klein, Teri E; Evans, William E; Relling, Mary V

    2015-01-01

    Although the field of pharmacogenetics has existed for decades, practioners have been slow to implement pharmacogenetic testing in clinical care. Numerous publications describe the barriers to clinical implementation of pharmacogenetics. Recently, several freely available resources have been developed to help address these barriers. In this review, we discuss current programs that use preemptive genotyping to optimize the pharmacotherapy of patients. Array-based preemptive testing includes a large number of relevant pharmacogenes that impact multiple high-risk drugs. Using a preemptive approach allows genotyping results to be available prior to any prescribing decision so that genomic variation may be considered as an inherent patient characteristic in the planning of therapy. This review describes the common elements among programs that have implemented preemptive genotyping and highlights key processes for implementation, including clinical decision support.

  11. 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.

  12. Developing genomic knowledge bases and databases to support clinical management: current perspectives.

    Science.gov (United States)

    Huser, Vojtech; Sincan, Murat; Cimino, James J

    2014-01-01

    Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward.

  13. Clinical and Laboratory Features of the Nocardia spp. Based on Current Molecular Taxonomy

    Science.gov (United States)

    Brown-Elliott, Barbara A.; Brown, June M.; Conville, Patricia S.; Wallace, Richard J.

    2006-01-01

    The recent explosion of newly described species of Nocardia results from the impact in the last decade of newer molecular technology, including PCR restriction enzyme analysis and 16S rRNA sequencing. These molecular techniques have revolutionized the identification of the nocardiae by providing rapid and accurate identification of recognized nocardiae and, at the same time, revealing new species and a number of yet-to-be-described species. There are currently more than 30 species of nocardiae of human clinical significance, with the majority of isolates being N. nova complex, N. abscessus, N. transvalensis complex, N. farcinica, N. asteroides type VI (N. cyriacigeorgica), and N. brasiliensis. These species cause a wide variety of diseases and have variable drug susceptibilities. Accurate identification often requires referral to a reference laboratory with molecular capabilities, as many newer species are genetically distinct from established species yet have few or no distinguishing phenotypic characteristics. Correct identification is important in deciding the clinical relevance of a species and in the clinical management and treatment of patients with nocardial disease. This review characterizes the currently known pathogenic species of Nocardia, including clinical disease, drug susceptibility, and methods of identification. PMID:16614249

  14. Clinical data management: Current status, challenges, and future directions from industry perspectives

    Directory of Open Access Journals (Sweden)

    Zhengwu Lu

    2010-06-01

    Full Text Available Zhengwu Lu1, Jing Su21Smith Hanley Consulting, Houston, Texas; 2Department of Chemical Engineering, University of Massachusetts, Amherst, MA, USAAbstract: To maintain a competitive position, the biopharmaceutical industry has been facing the challenge of increasing productivity both internally and externally. As the product of the clinical development process, clinical data are recognized to be the key corporate asset and provide critical evidence of a medicine’s efficacy and safety and of its potential economic value to the market. It is also well recognized that using effective technology-enabled methods to manage clinical data can enhance the speed with which the drug is developed and commercialized, hence enhancing the competitive advantage. The effective use of data-capture tools may ensure that high-quality data are available for early review and rapid decision-making. A well-designed, protocol-driven, standardized, site workflow-oriented and documented database, populated via efficient data feed mechanisms, will ensure regulatory and commercial questions receive rapid responses. When information from a sponsor’s clinical database or data warehouse develops into corporate knowledge, the value of the medicine can be realized. Moreover, regulators, payer groups, patients, activist groups, patient advocacy groups, and employers are becoming more educated consumers of medicine, requiring monetary value and quality, and seeking out up-todate medical information supplied by biopharmaceutical companies. All these developments in the current biopharmaceutical arena demand that clinical data management (CDM is at the forefront, leading change, influencing direction, and providing objective evidence. Sustaining an integrated database or data repository for initial product registration and subsequent postmarketing uses is a long-term process to maximize return on investment for organizations. CDM should be the owner of driving clinical data

  15. [Clinical research outside of teaching hospitals: Current situation in north-eastern France].

    Science.gov (United States)

    Goetz, C; Dupoux, A; Déloy, L; Hertz, C; Jeanmaire, T; Parneix, N

    2015-04-01

    Most clinical research in France takes place in teaching hospitals. There are, however, many advantages to developing it in other hospitals: access to innovative treatments, improvement in healthcare quality, attractiveness of hospitals, increased trial inclusion rates and reduced selection bias. The objectives of our study were to report on the current situation of clinical research outside teaching hospitals. A three-stage survey was conducted between January 2012 and May 2013 in non-teaching hospitals of north-eastern France. First, questionnaires were sent to administrative and medical boards of all hospitals with more than 100 beds, then to head doctors of every department in hospitals with more than 300 beds and finally meetings were organized with members of 20 selected hospitals. The administrative and medical boards of 85 hospitals participated in the first stage of the survey; half of these hospitals were engaged in clinical research activities and for 10 the internal structuring was cross-disciplinary. Answers from 178 departments were obtained during the second stage; 47% reported a clinical research activity. Meetings with research teams in 20 hospitals allowed us to identify difficulties concerning research funding, transversal organization and sponsoring. Clinical research existed in more than half of the respondent non-teaching hospitals. Obstacles to its development can be grouped in three categories: 1) internal structuring of clinical research, 2) access to information and knowledge of how clinical research functions and to interlocutors outside the hospital and 3) access to skills necessary to sponsor clinical research. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Including Alternative Resources in State Renewable Portfolio Standards: Current Design and Implementation Experience

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.; Bird, L.

    2012-11-01

    Currently, 29 states, the District of Columbia, and Puerto Rico have instituted a renewable portfolio standard (RPS). An RPS sets a minimum threshold for how much renewable energy must be generated in a given year. Each state policy is unique, varying in percentage targets, timetables, and eligible resources. This paper examines state experience with implementing renewable portfolio standards that include energy efficiency, thermal resources, and non-renewable energy and explores compliance experience, costs, and how states evaluate, measure, and verify energy efficiency and convert thermal energy. It aims to gain insights from the experience of states for possible federal clean energy policy as well as to share experience and lessons for state RPS implementation.

  17. Education technology with continuous real time monitoring of the current functional and emotional students' states

    Science.gov (United States)

    Alyushin, M. V.; Kolobashkina, L. V.

    2017-01-01

    The education technology with continuous monitoring of the current functional and emotional students' states is suggested. The application of this technology allows one to increase the effectiveness of practice through informed planning of the training load. For monitoring the current functional and emotional students' states non-contact remote technologies of person bioparameters registration are encouraged to use. These technologies are based on recording and processing in real time the main person bioparameters in a purely passive mode. Experimental testing of this technology has confirmed its effectiveness.

  18. High magnetic field science and its application in the United States current status and future directions

    CERN Document Server

    National Research Council of the National Academies

    2013-01-01

    The Committee to Assess the Current Status and Future Direction of High Magnetic Field Science in the United States was convened by the National Research Council in response to a request by the National Science Foundation. This report answers three questions: (1) What is the current state of high-field magnet science, engineering, and technology in the United States, and are there any conspicuous needs to be addressed? (2) What are the current science drivers and which scientific opportunities and challenges can be anticipated over the next ten years? (3) What are the principal existing and planned high magnetic field facilities outside of the United States, what roles have U.S. high field magnet development efforts played in developing those facilities, and what potentials exist for further international collaboration in this area? A magnetic field is produced by an electrical current in a metal coil. This current exerts an expansive force on the coil, and a magnetic field is "high" if it challenges the str...

  19. What is the current state of scientific knowledge with regard to seasonal and decadal forecasting?

    International Nuclear Information System (INIS)

    Smith, Doug M; Scaife, Adam A; Kirtman, Ben P

    2012-01-01

    Environmental factors, such as the frequency, intensity and duration of extreme weather events, are important drivers of migration and displacement of people. There is therefore a growing need for regional climate predictions for the coming seasons to decades. This paper reviews the current state of the art of seasonal to decadal climate prediction, focusing on the potential sources of skill, forecasting techniques, current capability and future prospects. (letter)

  20. Current state of methodological and decisions for radiation treatment of blood, its components and products

    OpenAIRE

    Gordeev A.V.; Naumova L.A.; Kharitonov S.V.

    2014-01-01

    This article presents currently used blood transfusion media — components and blood products, therapeutic effects, reactions and complications of blood transfusion, use of radiation treatment for blood transfusion fluids. There had been discussed in detail the practice of radiation processing of blood components and for the prevention of reaction "graft versus host" and studies of plasma radiation treatment for its infectious safety. There was presented the current state of techniques and tec...

  1. Nicotine at clinically relevant concentrations affects atrial inward rectifier potassium current sensitive to acetylcholine.

    Science.gov (United States)

    Bébarová, Markéta; Matejovič, Peter; Švecová, Olga; Kula, Roman; Šimurdová, Milena; Šimurda, Jiří

    2017-05-01

    Nicotine abuse is associated with variety of diseases including arrhythmias, most often atrial fibrillation (AF). Altered inward rectifier potassium currents including acetylcholine-sensitive current I K(Ach) are known to be related to AF pathogenesis. Since relevant data are missing, we aimed to investigate I K(Ach) changes at clinically relevant concentrations of nicotine. Experiments were performed by the whole cell patch clamp technique at 23 ± 1 °C on isolated rat atrial myocytes. Nicotine was applied at following concentrations: 4, 40 and 400 nM; ethanol at 20 mM (∼0.09%). Nicotine at 40 and 400 nM significantly activated constitutively active component of I K(Ach) with the maximum effect at 40 nM (an increase by ∼100%); similar effect was observed at -110 and -50 mV. Changes at 4 nM nicotine were negligible on average. Coapplication of 40 nM nicotine and 20 mM ethanol (which is also known to activate this current) did not show cumulative effect. In the case of acetylcholine-induced component of I K(Ach) , a dual effect of nicotine and its correlation with the current magnitude in control were apparent: the current was increased by nicotine in the cells showing small current in control and vice versa. The effect of 40 and 400 nM nicotine on acetylcholine-induced component of I K(Ach) was significantly different at -110 and -50 mV. We conclude that nicotine at clinically relevant concentrations significantly increased constitutively active component of I K(Ach) and showed a dual effect on its acetylcholine-induced component, similarly as ethanol. Synchronous application of nicotine and ethanol did not cause additive effect.

  2. CpG Methylation Analysis—Current Status of Clinical Assays and Potential Applications in Molecular Diagnostics

    Science.gov (United States)

    Sepulveda, Antonia R.; Jones, Dan; Ogino, Shuji; Samowitz, Wade; Gulley, Margaret L.; Edwards, Robin; Levenson, Victor; Pratt, Victoria M.; Yang, Bin; Nafa, Khedoudja; Yan, Liying; Vitazka, Patrick

    2009-01-01

    Methylation of CpG islands in gene promoter regions is a major molecular mechanism of gene silencing and underlies both cancer development and progression. In molecular oncology, testing for the CpG methylation of tissue DNA has emerged as a clinically useful tool for tumor detection, outcome prediction, and treatment selection, as well as for assessing the efficacy of treatment with the use of demethylating agents and monitoring for tumor recurrence. In addition, because CpG methylation occurs early in pre-neoplastic tissues, methylation tests may be useful as markers of cancer risk in patients with either infectious or inflammatory conditions. The Methylation Working Group of the Clinical Practice Committee of the Association of Molecular Pathology has reviewed the current state of clinical testing in this area. We report here our summary of both the advantages and disadvantages of various methods, as well as the needs for standardization and reporting. We then conclude by summarizing the most promising areas for future clinical testing in cancer molecular diagnostics. PMID:19541921

  3. Minimal invasive single-site surgery in colorectal procedures: Current state of the art

    Directory of Open Access Journals (Sweden)

    Diana Michele

    2011-01-01

    Full Text Available Background: Minimally invasive single-site (MISS surgery has recently been applied to colorectal surgery. We aimed to assess the current state of the art and the adequacy of preliminary oncological results. Methods: We performed a systematic review of the literature using Pubmed, Medline, SCOPUS and Web of Science databases. Keywords used were "Single Port" or "Single-Incision" or "LaparoEndoscopic Single Site" or "SILS™" and "Colon" or "Colorectal" and "Surgery". Results: Twenty-nine articles on colorectal MISS surgery have been published from July 2008 to July 2010, presenting data on 149 patients. One study reported analgesic requirement. The final incision length ranged from 2.5 to 8 cm. Only two studies reported fascial incision length. There were two port site hernias in a series of 13 patients (15.38%. Two "fully laparoscopic" MISS procedures with preparation and achievement of the anastomosis completely intracorporeally are reported. Future site of ileostomy was used as the sole access for the procedures in three studies. Lymph node harvesting, resection margins and length of specimen were sufficient in oncological cases. Conclusions: MISS colorectal surgery is a challenging procedure that seems to be safe and feasible, but the existing clinical evidence is limited. In selected cases, and especially when an ileostomy is planned, colorectal surgery may be an ideal indication for MISS surgery leading to a no-scar surgery. Despite preliminary oncological results showing the feasibility of MISS surgery, we want to stress the need to standardize the technique and carefully evaluate its application in oncosurgery under ethical committee control.

  4. Current Epidemiology of Revision Total Knee Arthroplasty in the United States.

    Science.gov (United States)

    Delanois, Ronald E; Mistry, Jaydev B; Gwam, Chukwuweike U; Mohamed, Nequesha S; Choksi, Ujval S; Mont, Michael A

    2017-09-01

    Revision surgery for failed total knee arthroplasty (TKA) continues to pose a substantial burden for the United States healthcare system. The predominant etiology of TKA failure has changed over time and may vary between studies. This report aims to update the current literature on this topic by using a large national database. Specifically, we analyzed: (1) etiologies for revision TKA; (2) frequencies of revision TKA procedures; (3) various demographics including payer type and region; and (4) the length of stay (LOS) and total charges based on type of revision TKA procedure. The Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database was used to identify all revision TKA procedures performed between 2009 and 2013. Clinical, economic, and demographic data were collected and analyzed for 337,597 procedures. Patients were stratified according to etiology of failure, age, sex, race, US census region, and primary payor class. The mean LOS and total charges were also calculated. Infection was the most common etiology for revision TKA (20.4%), closely followed by mechanical loosening (20.3%). The most common revision TKA procedure performed was all component revision (31.3%). Medicare was the primary payor for the greatest proportion of revisions (57.7%). The South census region performed the most revision TKAs (33.2%). The overall mean LOS was 4.5 days, with arthrotomy for removal of prosthesis without replacement procedures accounting for the longest stays (7.8 days). The mean total charge for revision TKAs was $75,028.07. Without appropriate measures in place, the burden of revision TKAs may become overwhelming and pose a strain on providers and institutions. Continued insight into the etiology and epidemiology of revision TKAs may be the principle step towards improving outcomes and mitigating the need for future revisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Finite element model predicts current density distribution for clinical applications of tDCS and tACS

    Directory of Open Access Journals (Sweden)

    Toralf eNeuling

    2012-09-01

    Full Text Available Transcranial direct current stimulation (tDCS has been applied in numerous scientific studies over the past decade. However, the possibility to apply tDCS in therapy of neuropsychiatric disorders is still debated. While transcranial magnetic stimulation (TMS has been approved for treatment of major depression in the United States by the Food and Drug Administration (FDA, tDCS is not as widely accepted. One of the criticisms against tDCS is the lack of spatial specificity. Focality is limited by the electrode size (35 cm2 are commonly used and the bipolar arrangement. However, a current flow through the head directly from anode to cathode is an outdated view. Finite element (FE models have recently been used to predict the exact current flow during tDCS. These simulations have demonstrated that the current flow depends on tissue shape and conductivity. Toface the challenge to predict the location, magnitude and direction of the current flow induced by tDCS and transcranial alternating current stimulation (tACS, we used a refined realistic FE modeling approach. With respect to the literature on clinical tDCS and tACS, we analyzed two common setups for the location of the stimulation electrodes which target the frontal lobe and the occipital lobe, respectively. We compared lateral and medial electrode configuration with regard to theirusability. We were able to demonstrate that the lateral configurations yielded more focused stimulation areas as well as higher current intensities in the target areas. The high resolution of our simulation allows one to combine the modeled current flow with the knowledge of neuronal orientation to predict the consequences of tDCS and tACS. Our results not only offer a basis for a deeper understanding of the stimulation sites currently in use for clinical applications but also offer a better interpretation of observed effects.

  6. Levitation of current carrying states in the lattice model for the integer quantum Hall effect.

    Science.gov (United States)

    Koschny, T; Potempa, H; Schweitzer, L

    2001-04-23

    The disorder driven quantum Hall to insulator transition is investigated for a two-dimensional lattice model. The Hall conductivity and the localization length are calculated numerically near the transition. For uncorrelated and weakly correlated disorder potentials the current carrying states are annihilated by the negative Chern states originating from the band center. In the presence of correlated disorder potentials with correlation length larger than approximately half the lattice constant the floating up of the critical states in energy without merging is observed. This behavior is similar to the levitation scenario proposed for the continuum model.

  7. Detection of defect states responsible for leakage current in ultrathin tantalum pentoxide (Ta2O5) films by zero-bias thermally stimulated current spectroscopy

    International Nuclear Information System (INIS)

    Lau, W.S.; Zhong, L.; Lee, A.; See, C.H.; Han, T.; Sandler, N.P.; Chong, T.C.

    1997-01-01

    Defect states responsible for leakage current in ultrathin (physical thickness 2 O 5 ) films were measured with a novel zero-bias thermally stimulated current technique. It was found that defect states A, whose activation energy was estimated to be about 0.2 eV, can be more efficiently suppressed by using N 2 O rapid thermal annealing (RTA) instead of using O 2 RTA for postdeposition annealing. The leakage current was also smaller for samples with N 2 O RTA than those with O 2 RTA for postdeposition annealing. Hence, defect states A are quite likely to be important in causing leakage current. copyright 1997 American Institute of Physics

  8. Translating state-of-the-art spinal cord MRI techniques to clinical use: A systematic review of clinical studies utilizing DTI, MT, MWF, MRS, and fMRI

    Directory of Open Access Journals (Sweden)

    Allan R. Martin

    2016-01-01

    Conclusions: State-of-the-art spinal cord MRI techniques are emerging with great potential to improve the diagnosis and management of various spinal pathologies, but the current body of evidence has only showed limited clinical utility to date. Among these imaging tools DTI is the most mature, but further work is necessary to standardize and validate its use before it will be adopted in the clinical realm. Large, well-designed studies with a priori hypotheses, standardized acquisition methods, detailed clinical data collection, and robust automated analysis techniques are needed to fully demonstrate the potential of these rapidly evolving techniques.

  9. Current clinical practice: differential management of uveal melanoma in the era of molecular tumor analyses

    Directory of Open Access Journals (Sweden)

    Aaberg Jr TM

    2014-12-01

    Full Text Available Thomas M Aaberg Jr,1 Robert W Cook,2 Kristen Oelschlager,2 Derek Maetzold,2 P Kumar Rao,3 John O Mason III41Michigan State University Medical School and Retina Specialists of Michigan, Grand Rapids, MI, 2Castle Biosciences, Friendswood, TX, 3Washington University School of Medicine in St Louis, St Louis, MO, 4Retina Consultants of Alabama and University of Alabama Birmingham, Birmingham, AL, USA Objective: Assess current clinical practices for uveal melanoma (UM and the impact of molecular prognostic testing on treatment decisions.Design: Cross-sectional survey and sequential medical records review.Participants: Ophthalmologists who treat UM.Methods: (A Medical records review of all Medicare beneficiaries tested by UM gene expression profile in 2012, conducted under an institutional review board-approved protocol. (B 109 ophthalmologists specializing in the treatment of UM were invited to participate in 24-question survey in 2012; 72 were invited to participate in a 23-question survey in 2014.Main outcome measures: Responses analyzed by descriptive statistics, frequency analyses (percentages, Tukey, histograms, and Fisher’s exact test. Descriptive presentation of essay answers.Results: The review of Medicare medical records included 191 evaluable patients, 88 (46% with documented medical treatment actions or institutional policies related to surveillance plans. Of these 88, all gene expression profiling (GEP Class 1 UM patients were treated with low-intensity surveillance. All GEP Class 2 UM patients were treated with high-intensity surveillance (P<0.0001 versus Class 1. There were 36 (19% with information concerning referrals after initial diagnosis. Of these 36, all 23 Class 2 patients were referred to medical oncology; however, none of the 13 Class 1 patients were referred (P<0.0001 versus Class 1. Only Class 2 patients were recommended for adjunctive treatment regimens. 2012 survey: 50 respondents with an annual median of 35 new UM

  10. Current State of History of Psychology Teaching and Education in Argentina: An Empirical Bibliometric Investigation

    Science.gov (United States)

    Fierro, Catriel; Ostrovsky, Ana Elisa; Di Doménico, María Cristina

    2018-01-01

    This study is an empirical analysis of the field's current state in Argentinian universities. Bibliometric parameters were used to retrieve the total listed texts (N = 797) of eight undergraduate history courses' syllabi from Argentina's most populated public university psychology programs. Then, professors in charge of the selected courses (N =…

  11. The State of Knowledge of Outdoor Orientation Programs: Current Practices, Research, and Theory

    Science.gov (United States)

    Bell, Brent J.; Gass, Michael A.; Nafziger, Christopher S.; Starbuck, J. David

    2014-01-01

    Outdoor orientation programs represent a prominent area of experiential education with over 25,000 participants annually. More than 191 outdoor orientation programs currently operate in the United States and Canada. The research examining outdoor orientation programs consists of 25 peer-reviewed published studies and 11 dissertations. A new theory…

  12. Globalization of Gerontology Education: Current Practices and Perceptions for Graduate Gerontology Education in the United States

    Science.gov (United States)

    Mwangi, Samuel M.; Yamashita, Takashi; Ewen, Heidi H.; Manning, Lydia K.; Kunkel, Suzanne R.

    2012-01-01

    The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level…

  13. Comment on: "Current-voltage characteristics and zero-resistance state in 2DEG"

    OpenAIRE

    Cheremisin, M. V.

    2003-01-01

    We demonstrate that N(S)-shape current-voltage characteristics proposed to explain zero-resistance state in Corbino(Hall bar) geometry 2DEG (cond-mat/0302063, cond-mat/0303530) cannot account essential features of radiation-induced magnetoresistance oscillations experiments.

  14. Evaluation of current state of amplification-based DDoS attacks

    NARCIS (Netherlands)

    Bohte, Edgar; Stamatogiannakis, Manolis; Bos, Herbert

    2018-01-01

    Amplification-based DDoS attacks are still a big threat to the availability of the internet. In quite some time there is no new paper published that gave an update on the current state of amplification DDoS attacks, taken into consideration it was a huge problem a few years ago. We performed

  15. The Current State of Empirical Support for the Pharmacological Treatment of Selective Mutism

    Science.gov (United States)

    Carlson, John S.; Mitchell, Angela D.; Segool, Natasha

    2008-01-01

    This article reviews the current state of evidence for the psychopharmacological treatment of children diagnosed with selective mutism within the context of its link to social anxiety disorder. An increased focus on potential medication treatment for this disorder has resulted from significant monetary and resource limitations in typical practice,…

  16. Atlas of current and potential future distributions of common trees of the eastern United States

    Science.gov (United States)

    Louis R. Iverson; Anantha M. Prasad; Betsy J. Hale; Elaine Kennedy Sutherland

    1999-01-01

    This atlas documents the current and possible future distribution of 80 common tree species in the Eastern United States and gives detailed information on environmental characteristics defining these distributions. Also included are outlines of life history characteristics and summary statistics for these species. Much of the data are derived from Forest Inventory and...

  17. Cryptography in the Cloud Computing: the Current State and Logical Tasks

    OpenAIRE

    Sergey Nikolaevich Kyazhin; Andrey Vladimirovich Moiseev

    2013-01-01

    The current state of the cloud computing (CC) information security is analysed and logical problems of storage and data transmission security at CC are allocated. Cryptographic methods of data security in CC, in particular, lightweight cryptography and the cryptography based on bilinear pairings are described.

  18. Cryptography in the Cloud Computing: the Current State and Logical Tasks

    Directory of Open Access Journals (Sweden)

    Sergey Nikolaevich Kyazhin

    2013-09-01

    Full Text Available The current state of the cloud computing (CC information security is analysed and logical problems of storage and data transmission security at CC are allocated. Cryptographic methods of data security in CC, in particular, lightweight cryptography and the cryptography based on bilinear pairings are described.

  19. Planning for Development in the Arab Gulf States: A content Analysis of Current Development Plans

    DEFF Research Database (Denmark)

    Hvidt, Martin

    2012-01-01

    Abstract: This paper analyses current development plans published by the GCC states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) in order to explore the region’s future growth trajectory: what barriers to growth are foreseen and how can they be anticipated; what...

  20. Educational Attainment in the United States: 2015. Population Characteristics. Current Population Reports. P20-578

    Science.gov (United States)

    Ryan, Camille L.; Bauman, Kurt

    2016-01-01

    This report provides a portrait of educational attainment in the United States based on data collected from the Current Population Survey (CPS). The report examines educational attainment of the adult population by demographic and social characteristics such as age, sex, race and Hispanic origin, and disability status, as well as differences in…

  1. Educational Attainment in the United States: 2009. Population Characteristics. Current Population Reports. P20-566

    Science.gov (United States)

    Ryan, Camille L.; Siebens, Julie

    2012-01-01

    This report provides a portrait of educational attainment in the United States based on data collected in the 2009 American Community Survey (ACS) and the 2005-2009 ACS 5-year estimates. It also uses data from the Annual Social and Economic Supplement (ASEC) to the Current Population Survey (CPS) collected in 2009 and earlier, as well as monthly…

  2. Early Childhood Inclusion in the United States: Goals, Current Status, and Future Directions

    Science.gov (United States)

    Guralnick, Michael J.; Bruder, Mary Beth

    2016-01-01

    The current status and future directions of early childhood inclusion in the United States are discussed from the perspective of 4 key goals: access, accommodations and feasibility, developmental progress, and social integration. Recommendations are put forward to promote inclusion goals emphasizing administrative structures, personnel…

  3. Short-rotation coppicing in France. Current state of research and prospects for future development

    Energy Technology Data Exchange (ETDEWEB)

    Bonduelle, P. (Association Foret Cellulose, Trelaze (France)); Bouvarel, L. (Institut National de la Recherche Agronomique, Olivet (France). Unite Experimentale Biomasse, Forestiere et Foret Paysanne); Petit, H. (Association pour la Rationalisation et la Mecanisation de l' Exploitation Forestiere, Fontainebleau (France)); Pierson, J. (Cellulose des Ardennes, Montemedy (France)); Savanne, D. (Agence de l' Environnement et de la Maitrise de l' Energie, 75 - Paris (France)); Sourie, J.C. (Institut National de la Recherche Agronomique, Grignon (France). Station d' Economie et de Sociologie Rurales)

    1992-01-01

    This article analyzes the current context and the prospects for crop development as well as offering a number of examples of short rotation coppicing projects. The industrial outlets created through state aid remain the primary driving force behind plantations at this time. (author)

  4. Dominant male song performance reflects current immune state in a cooperatively breeding songbird

    NARCIS (Netherlands)

    York, Jenny E.; Radford, Andrew N.; Groothuis, Ton G.; Young, Andrew J.

    Conspicuous displays are thought to have evolved as signals of individual quality, though precisely what they encode remains a focus of debate. While high quality signals may be produced by high quality individuals due to good genes or favourable early-life conditions, whether current immune state

  5. Current computational modelling trends in craniomandibular biomechanics and their clinical implications.

    Science.gov (United States)

    Hannam, A G

    2011-03-01

    Computational models of interactions in the craniomandibular apparatus are used with increasing frequency to study biomechanics in normal and abnormal masticatory systems. Methods and assumptions in these models can be difficult to assess by those unfamiliar with current practices in this field; health professionals are often faced with evaluating the appropriateness, validity and significance of models which are perhaps more familiar to the engineering community. This selective review offers a foundation for assessing the strength and implications of a craniomandibular modelling study. It explores different models used in general science and engineering and focuses on current best practices in biomechanics. The problem of validation is considered at some length, because this is not always fully realisable in living subjects. Rigid-body, finite element and combined approaches are discussed, with examples of their application to basic and clinically relevant problems. Some advanced software platforms currently available for modelling craniomandibular systems are mentioned. Recent studies of the face, masticatory muscles, tongue, craniomandibular skeleton, temporomandibular joint, dentition and dental implants are reviewed, and the significance of non-linear and non-isotropic material properties is emphasised. The unique challenges in clinical application are discussed, and the review concludes by posing some questions which one might reasonably expect to find answered in plausible modelling studies of the masticatory apparatus. © 2010 Blackwell Publishing Ltd.

  6. Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

    Science.gov (United States)

    Bilal, Arebu Issa; Tilahun, Zelalem; Gebretekle, Gebremedhin Beedemariam; Ayalneh, Belete; Hailemeskel, Bisrat; Engidawork, Ephrem

    2017-05-19

    Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to

  7. Clinical Risk Assessment in the Antiphospholipid Syndrome: Current Landscape and Emerging Biomarkers.

    Science.gov (United States)

    Chaturvedi, Shruti; McCrae, Keith R

    2017-07-01

    Laboratory criteria for the classification of antiphospholipid syndrome include the detection of a lupus anticoagulant and/or anticardiolipin and anti-β2-glycoprotein I antibodies. However, the majority of patients who test positive in these assays do not have thrombosis. Current risk-stratification tools are largely limited to the antiphospholipid antibody profile and traditional thrombotic risk factors. Novel biomarkers that correlate with disease activity and potentially provide insight into future clinical events include domain 1 specific anti-β 2 GPI antibodies, antibodies to other phospholipids or phospholipid/protein antigens (such as anti-PS/PT), and functional/biological assays such as thrombin generation, complement activation, levels of circulating microparticles, and annexin A5 resistance. Clinical risk scores may also have value in predicting clinical events. Biomarkers that predict thrombosis risk in patients with antiphospholipid antibodies have been long sought, and several biomarkers have been proposed. Ultimately, integration of biomarkers with established assays and clinical characteristics may offer the best chance of identifying patients at highest risk of APS-related complications.

  8. The current role of on-line extraction approaches in clinical and forensic toxicology.

    Science.gov (United States)

    Mueller, Daniel M

    2014-08-01

    In today's clinical and forensic toxicological laboratories, automation is of interest because of its ability to optimize processes, to reduce manual workload and handling errors and to minimize exposition to potentially infectious samples. Extraction is usually the most time-consuming step; therefore, automation of this step is reasonable. Currently, from the field of clinical and forensic toxicology, methods using the following on-line extraction techniques have been published: on-line solid-phase extraction, turbulent flow chromatography, solid-phase microextraction, microextraction by packed sorbent, single-drop microextraction and on-line desorption of dried blood spots. Most of these published methods are either single-analyte or multicomponent procedures; methods intended for systematic toxicological analysis are relatively scarce. However, the use of on-line extraction will certainly increase in the near future.

  9. Current Status of Immunomodulatory and Cellular Therapies in Preclinical and Clinical Islet Transplantation

    Science.gov (United States)

    Chhabra, Preeti; Brayman, Kenneth L.

    2011-01-01

    Clinical islet transplantation is a β-cell replacement strategy that represents a possible definitive intervention for patients with type 1 diabetes, offering substantial benefits in terms of lowering daily insulin requirements and reducing incidences of debilitating hypoglycemic episodes and unawareness. Despite impressive advances in this field, a limiting supply of islets, inadequate means for preventing islet rejection, and the deleterious diabetogenic and nephrotoxic side effects associated with chronic immunosuppressive therapy preclude its wide-spread applicability. Islet transplantation however allows a window of opportunity for attempting various therapeutic manipulations of islets prior to transplantation aimed at achieving superior transplant outcomes. In this paper, we will focus on the current status of various immunosuppressive and cellular therapies that promote graft function and survival in preclinical and clinical islet transplantation with special emphasis on the tolerance-inducing capacity of regulatory T cells as well as the β-cells regenerative capacity of stem cells. PMID:22046502

  10. Current Status of Immunomodulatory and Cellular Therapies in Preclinical and Clinical Islet Transplantation

    Directory of Open Access Journals (Sweden)

    Preeti Chhabra

    2011-01-01

    Full Text Available Clinical islet transplantation is a -cell replacement strategy that represents a possible definitive intervention for patients with type 1 diabetes, offering substantial benefits in terms of lowering daily insulin requirements and reducing incidences of debilitating hypoglycemic episodes and unawareness. Despite impressive advances in this field, a limiting supply of islets, inadequate means for preventing islet rejection, and the deleterious diabetogenic and nephrotoxic side effects associated with chronic immunosuppressive therapy preclude its wide-spread applicability. Islet transplantation however allows a window of opportunity for attempting various therapeutic manipulations of islets prior to transplantation aimed at achieving superior transplant outcomes. In this paper, we will focus on the current status of various immunosuppressive and cellular therapies that promote graft function and survival in preclinical and clinical islet transplantation with special emphasis on the tolerance-inducing capacity of regulatory T cells as well as the -cells regenerative capacity of stem cells.

  11. Heating and current drive requirements towards steady state operation in ITER

    Energy Technology Data Exchange (ETDEWEB)

    Poli, F. M.; Kessel, C. E.; Gorelenkova, M. [Princeton Plasma Physics Laboratory, Princeton, NJ 08543 (United States); Bonoli, P. T. [MIT Plasma Science and Fusion Center, Cambridge, MA 02139 (United States); Batchelor, D. B. [Oak Ridge National Laboratory, Oak Ridge, TN 37831-6169 (United States); Harvey, B.; Petrov, Y. [CompX, Box 2672, Del Mar, CA 92014 (United States)

    2014-02-12

    Steady state scenarios envisaged for ITER aim at optimizing the bootstrap current, while maintaining sufficient confinement and stability to provide the necessary fusion yield. Non-inductive scenarios will need to operate with Internal Transport Barriers (ITBs) in order to reach adequate fusion gain at typical currents of 9 MA. However, the large pressure gradients associated with ITBs in regions of weak or negative magnetic shear can be conducive to ideal MHD instabilities, reducing the no-wall limit. The E × B flow shear from toroidal plasma rotation is expected to be low in ITER, with a major role in the ITB dynamics being played by magnetic geometry. Combinations of H/CD sources that maintain weakly reversed magnetic shear profiles throughout the discharge are the focus of this work. Time-dependent transport simulations indicate that, with a trade-off of the EC equatorial and upper launcher, the formation and sustainment of quasi-steady state ITBs could be demonstrated in ITER with the baseline heating configuration. However, with proper constraints from peeling-ballooning theory on the pedestal width and height, the fusion gain and the maximum non-inductive current are below the ITER target. Upgrades of the heating and current drive system in ITER, like the use of Lower Hybrid current drive, could overcome these limitations, sustaining higher non-inductive current and confinement, more expanded ITBs which are ideal MHD stable.

  12. Heating and current drive requirements towards steady state operation in ITER

    Science.gov (United States)

    Poli, F. M.; Bonoli, P. T.; Kessel, C. E.; Batchelor, D. B.; Gorelenkova, M.; Harvey, B.; Petrov, Y.

    2014-02-01

    Steady state scenarios envisaged for ITER aim at optimizing the bootstrap current, while maintaining sufficient confinement and stability to provide the necessary fusion yield. Non-inductive scenarios will need to operate with Internal Transport Barriers (ITBs) in order to reach adequate fusion gain at typical currents of 9 MA. However, the large pressure gradients associated with ITBs in regions of weak or negative magnetic shear can be conducive to ideal MHD instabilities, reducing the no-wall limit. The E × B flow shear from toroidal plasma rotation is expected to be low in ITER, with a major role in the ITB dynamics being played by magnetic geometry. Combinations of H/CD sources that maintain weakly reversed magnetic shear profiles throughout the discharge are the focus of this work. Time-dependent transport simulations indicate that, with a trade-off of the EC equatorial and upper launcher, the formation and sustainment of quasi-steady state ITBs could be demonstrated in ITER with the baseline heating configuration. However, with proper constraints from peeling-ballooning theory on the pedestal width and height, the fusion gain and the maximum non-inductive current are below the ITER target. Upgrades of the heating and current drive system in ITER, like the use of Lower Hybrid current drive, could overcome these limitations, sustaining higher non-inductive current and confinement, more expanded ITBs which are ideal MHD stable.

  13. Analysis of transient state in HTS tapes under ripple DC load current

    Science.gov (United States)

    Stepien, M.; Grzesik, B.

    2014-05-01

    The paper concerns the analysis of transient state (quench transition) in HTS tapes loaded with the current having DC component together with a ripple component. Two shapes of the ripple were taken into account: sinusoidal and triangular. Very often HTS tape connected to a power electronic current supply (i.e. superconducting coil for SMES) that delivers DC current with ripples and it needs to be examined under such conditions. Additionally, measurements of electrical (and thermal) parameters under such ripple excitation is useful to tape characterization in broad range of load currents. The results presented in the paper were obtained using test bench which contains programmable DC supply and National Instruments data acquisition system. Voltage drops and load currents were measured vs. time. Analysis of measured parameters as a function of the current was used to tape description with quench dynamics taken into account. Results of measurements were also used to comparison with the results of numerical modelling based on FEM. Presented provisional results show possibility to use results of measurements in transient state to prepare inverse models of superconductors and their detailed numerical modelling.

  14. Radiation-induced off-state leakage current in commercial power MOSFETs

    International Nuclear Information System (INIS)

    Dodd, Paul Emerson; Shaneyfelt, Marty Ray; Draper, Bruce Leroy; Felix, James Andrew; Schwank, James Ralph; Dalton, Scott Matthew

    2005-01-01

    The total dose hardness of several commercial power MOSFET technologies is examined. After exposure to 20 krad(SiO 2 ) most of the n- and p-channel devices examined in this work show substantial (2 to 6 orders of magnitude) increases in off-state leakage current. For the n-channel devices, the increase in radiation-induced leakage current follows standard behavior for moderately thick gate oxides, i.e., the increase in leakage current is dominated by large negative threshold voltage shifts, which cause the transistor to be partially on even when no bias is applied to the gate electrode. N-channel devices biased during irradiation show a significantly larger leakage current increase than grounded devices. The increase in leakage current for the p-channel devices, however, was unexpected. For the p-channel devices, it is shown using electrical characterization and simulation that the radiation-induced leakage current increase is related to an increase in the reverse bias leakage characteristics of the gated diode which is formed by the drain epitaxial layer and the body. This mechanism does not significantly contribute to radiation-induced leakage current in typical p-channel MOS transistors. The p-channel leakage current increase is nearly identical for both biased and grounded irradiations and therefore has serious implications for long duration missions since even devices which are usually powered off could show significant degradation and potentially fail.

  15. Patient centric approach for clinical trials: Current trend and new opportunities.

    Science.gov (United States)

    Sharma, Neha Shankar

    2015-01-01

    The clinical research industry today is undergoing a major facelift. Companies are continuously looking to adopt and implement effective and innovative ways to accelerate drug launches in the market. Companies today are more open and do not view patients as mere "subjects" who generate data, - but as informed collaborators whose participation is "core" to the overall success of trials leading to the emergence of the concept of "patient-centric trials." This paper is intended to highlight the current trends and new opportunities that can be seen in industry -indicative of crucial role patients today play in their own health care using technology, social media and self education.

  16. Patient centric approach for clinical trials: Current trend and new opportunities

    Directory of Open Access Journals (Sweden)

    Neha Shankar Sharma

    2015-01-01

    Full Text Available The clinical research industry today is undergoing a major facelift. Companies are continuously looking to adopt and implement effective and innovative ways to accelerate drug launches in the market. Companies today are more open and do not view patients as mere "subjects" who generate data, - but as informed collaborators whose participation is "core" to the overall success of trials leading to the emergence of the concept of "patient-centric trials." This paper is intended to highlight the current trends and new opportunities that can be seen in industry -indicative of crucial role patients today play in their own health care using technology, social media and self education.

  17. The use of psychometrists in clinical neuropsychology: history, current status, and future directions.

    Science.gov (United States)

    Malek-Ahmadi, Michael; Erickson, Tom; Puente, Antonio E; Pliskin, Neil; Rock, Rachel

    2012-01-01

    In recent years, the National Academy of Neuropsychology and other professional neuropsychological organizations have published a number of articles and position papers regarding the use, education, and training of psychometrists ("technicians"). Although these documents provide guidelines for the suggested qualifications and training procedures of psychometrists, none make any mention of the need for a standardized credentialing process, which is commonly required of technicians in similar fields, especially in medical settings. Given the recent changes in current procedural Terminology codes used to bill for neuropsychological services and the interpretation of legislation disallowing the use of psychometrists in New York, the need for a standard credential for psychometrists is apparent. This article will review the history and current use of psychometrists in clinical neuropsychology and highlight the need and rationale for the credentialing of psychometrists.

  18. Preparing nursing students for enhanced roles in primary care: The current state of prelicensure and RN-to-BSN education.

    Science.gov (United States)

    Wojnar, Danuta M; Whelan, Ellen Marie

    With the current emphasis on including registered nurses (RNs) on the primary care teams, it is essential that nursing programs prepare students for employment in these settings. This study explored the current state of prelicensure and RN-to-Bachelor of Science in Nursing (BSN) online education regarding the implementation of primary care content in the curricula. A sample of 1,409 schools and/or colleges from across the United States was invited to participate in an online survey. About 529 surveys were returned for an overall response rate of 37.5%. Summative content analysis was used to analyze survey data. Although most respondents have implemented some primary care content, some found it challenging and others have demurred from incorporating primary care content altogether. Nursing leaders and faculty in academia must collaborate with clinical partners to design and expand didactic and clinical learning experiences that emphasize primary care content in the prelicensure and RN-to-BSN education. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Adherence to clinic recommendations among patients with phenylketonuria in the United States.

    Science.gov (United States)

    Jurecki, E R; Cederbaum, S; Kopesky, J; Perry, K; Rohr, F; Sanchez-Valle, A; Viau, K S; Sheinin, M Y; Cohen-Pfeffer, J L

    2017-03-01

    Assess current management practices of phenylketonuria (PKU) clinics across the United States (US) based on the key treatment metrics of blood phenylalanine (Phe) concentrations and blood Phe testing frequency, as well as patient adherence to their clinic's management practice recommendations. An online survey was conducted with medical professionals from PKU clinics across the US from July to September 2015. Forty-four clinics participated in the survey and account for approximately half of PKU patients currently followed in clinics in the US (Berry et al., 2013). The majority of PKU clinics recommended target blood Phe concentrations to be between 120 and 360μM for all patients; the upper threshold was relaxed by some clinics for adult patients (from 360 to 600μM) and tightened for patients who are pregnant/planning to become pregnant (to 240μM). Patient adherence to these recommendations (percentage of patients with blood Phe below the upper recommended threshold) was age-dependent, decreasing from 88% in the 0-4years age group to 33% in adults 30+ years. Patient adherence to recommendations for blood testing frequency followed a similar trend. Higher staffing intensity (specialists per 100 PKU patients) was associated with better patient adherence to clinics' blood Phe concentrations recommendations. Clinic recommendations of target blood Phe concentrations in the US are now stricter compared to prior years, and largely reflect recent guidelines by the American College of Medical Genetics and Genomics (Vockley et al., 2014). Adherence to recommended Phe concentrations remains suboptimal, especially in older patients. However, despite remaining above the guidelines, actual blood Phe concentrations in adolescents and adults are lower than those reported in the past (Walter et al., 2002; Freehauf et al., 2013). Continued education and support for PKU patients by healthcare professionals, including adequate clinic staffing, are needed to improve adherence

  20. The Current Status of the State Financial Audit in Ukraine and Prospects of its Development

    Directory of Open Access Journals (Sweden)

    Dolbneva Deniza V.

    2017-11-01

    Full Text Available The article is aimed at studying the current status and determining the main results of conducting the State financial audit by the State audit service in Ukraine, as well as developing proposals as to ways of its improvement in view of the experience of the world’s leading countries and the requirements of international standards in this sphere of relations. The main indicators and results, which characterize the status of conducting by bodies of the State Audit Service of the State financial audit on key directions, were considered. The obtained data indicate that the State financial audit is taking place in the direction corresponding to international practice. Today, however, because of a number of problems and declarative provisions related to the organization and conduct of the State financial audit, it cannot fully implement all its functional capabilities and tasks. Directions of improvement and transformation of the State financial audit have been proposed. The prospect for further research is development of a holistic mechanism for the functioning of the State financial audit, which will unite all its directions at different levels and its participants.

  1. Clinical Characteristics and Current Treatment of Age-Related Macular Degeneration

    Science.gov (United States)

    Yonekawa, Yoshihiro; Kim, Ivana K.

    2015-01-01

    Age-related macular degeneration (AMD) is a multifactorial degeneration of photoreceptors and retinal pigment epithelium. The societal impact is significant, with more than 2 million individuals in the United States alone affected by advanced stages of AMD. Recent progress in our understanding of this complex disease and parallel developments in therapeutics and imaging have translated into new management paradigms in recent years. However, there are many unanswered questions, and diagnostic and prognostic precision and treatment outcomes can still be improved. In this article, we discuss the clinical features of AMD, provide correlations with modern imaging and histopathology, and present an overview of treatment strategies. PMID:25280900

  2. The clinical endocrinology workforce: current status and future projections of supply and demand.

    Science.gov (United States)

    Vigersky, Robert A; Fish, Lisa; Hogan, Paul; Stewart, Andrew; Kutler, Stephanie; Ladenson, Paul W; McDermott, Michael; Hupart, Kenneth H

    2014-09-01

    Many changes in health care delivery, health legislation, and the physician workforce that affect the supply and demand for endocrinology services have occurred since the first published workforce study of adult endocrinologists in 2003. The objective of the study was to assess the current adult endocrinology workforce data and provide the first analysis of the pediatric endocrinology workforce and to project the supply of and demand for endocrinologists through 2025. A workforce model was developed from an analysis of proprietary and publicly available databases, consultation with a technical expert panel, and the results of an online survey of board-certified endocrinologists. The Endocrine Society commissioned The Lewin Group to estimate current supply and to project gaps between supply and demand for endocrinologists. A technical expert panel of senior endocrinologists provided context, clinical information, and direction. The following were measured: 1) the current adult and pediatric endocrinology workforce and the supply of and demand for endocrinologists through 2025 and 2) the number of additional entrants into the endocrinology work pool that would be required to close the gap between supply and demand. Currently there is a shortage of approximately 1500 adult and 100 pediatric full-time equivalent endocrinologists. The gap for adult endocrinologists will expand to 2700 without an increase in the number of fellows trained. An increase in the prevalence of diabetes mellitus further expands the demand for adult endocrinologists. The gap can be closed in 5 and 10 years by increasing the number of fellowship positions by 14.4% and 5.5% per year, respectively. The gap between supply and demand for pediatric endocrinologists will close by 2016, and thereafter an excess supply over demand will develop at the current rate of new entrants into the work force. There are insufficient adult endocrinologists to satisfy current and future demand. A number of proactive

  3. Effect of ethanol at clinically relevant concentrations on atrial inward rectifier potassium current sensitive to acetylcholine.

    Science.gov (United States)

    Bébarová, Markéta; Matejovič, Peter; Pásek, Michal; Hořáková, Zuzana; Hošek, Jan; Šimurdová, Milena; Šimurda, Jiří

    2016-10-01

    Alcohol intoxication tends to induce arrhythmias, most often the atrial fibrillation. To elucidate arrhythmogenic mechanisms related to alcohol consumption, the effect of ethanol on main components of the ionic membrane current is investigated step by step. Considering limited knowledge, we aimed to examine the effect of clinically relevant concentrations of ethanol (0.8-80 mM) on acetylcholine-sensitive inward rectifier potassium current I K(Ach). Experiments were performed by the whole-cell patch clamp technique at 23 ± 1 °C on isolated rat and guinea-pig atrial myocytes, and on expressed human Kir3.1/3.4 channels. Ethanol induced changes of I K(Ach) in the whole range of concentrations applied; the effect was not voltage dependent. The constitutively active component of I K(Ach) was significantly increased by ethanol with the maximum effect (an increase by ∼100 %) between 8 and 20 mM. The changes were comparable in rat and guinea-pig atrial myocytes and also in expressed human Kir3.1/3.4 channels (i.e., structural correlate of I K(Ach)). In the case of the acetylcholine-induced component of I K(Ach), a dual ethanol effect was apparent with a striking heterogeneity of changes in individual cells. The effect correlated with the current magnitude in control: the current was increased by eth-anol in the cells showing small current in control and vice versa. The average effect peaked at 20 mM ethanol (an increase of the current by ∼20 %). Observed changes of action potential duration agreed well with the voltage clamp data. Ethanol significantly affected both components of I K(Ach) even in concentrations corresponding to light alcohol consumption.

  4. Existence of non-unique steady state solutions to the RMF current drive equations

    Energy Technology Data Exchange (ETDEWEB)

    Hugrass, W N [Flinders Univ. of South Australia, Bedford Park. School of Physical Sciences

    1985-05-04

    It is shown that the value of the d.c. current driven in a plasma cylinder by means of a rotating magnetic field (RMF) is not unique for R/delta >= 6 and eBsub(..omega..)/..nu..sub(ei)m approx.R/delta, where R is the radius of the plasma cylinder, delta is the classical skin depth, ..nu..sub(ei) is the electron-ion momentum transfer collision frequency, Bsub(..omega..) is the magnitude of the rotating magnetic field, e is the electron charge and m is the electron mass. This effect is predicted using three distinct approaches: (i) a steady state anaysis which ignores the second and higher harmonics of the fields and currents; (ii) a qualitative model which utilizes the analogy between the RMF current drive technique and the operation of the induction motor; (iii) a solution of the initial boundary value equations describing the RMF current drive in cylindrical plasmas.

  5. Complex state variable- and disturbance observer-based current controllers for AC drives

    DEFF Research Database (Denmark)

    Dal, Mehmet; Teodorescu, Remus; Blaabjerg, Frede

    2013-01-01

    In vector-controlled AC drives, the design of current controller is usually based on a machine model defined in synchronous frame coordinate, where the drive performance may be degraded by both the variation of the machine parameters and the cross-coupling between the d- and q-axes components...... of the stator current. In order to improve the current control performance an alternative current control strategy was proposed previously aiming to avoid the undesired cross-coupling and non-linearities between the state variables. These effects are assumed as disturbances arisen in the closed-loop path...... of the parameter and the cross-coupling effect. Moreover, it provides a better performance, smooth and low noisy operation with respect to the complex variable controller....

  6. Clinical reappraisal and state of the art of nephropexy.

    Science.gov (United States)

    Mogorovich, Andrea; Selli, Cesare; De Maria, Maurizio; Manassero, Francesca; Durante, Jacopo; Urbani, Lucio

    2018-04-01

    The diffusion of minimally invasive techniques for renal surgery has prompted a renewed interest in nephropexy which is indicated to prevent nephroptosis in symptomatic patients and to mobilize the upper ureter downward in order to bridge a ureteral defect. Recent publications have been reviewed to present the state of the art of the diagnosis and management of these two challenging conditions and to try to foresee the next steps. The evaluation of patients with mobile kidney can be made relying on diagnostic criteria such as ultrasound with color Doppler and measurement of resistive index, conventional upright X-ray frames after a supine uro-computerized tomography scan and both static and dynamic nuclear medicine scans, always with evaluation in the sitting or erect position. Laparoscopic nephropexy emerges as the current treatment option combining both objectively controlled repositioning of the kidney and resolution of symptoms with minimal invasiveness, low morbidity, and short hospital stay. The use of robotics is presently limited by its higher cost, but may increase in the future. Downward renal mobilization and nephropexy is a safe and versatile technique which has been adopted as a unique strategy or more often in combination with other surgical maneuvers in order to cope with complex ureteral reconstruction.

  7. Lower bounds for ballistic current and noise in non-equilibrium quantum steady states

    Directory of Open Access Journals (Sweden)

    Benjamin Doyon

    2015-03-01

    Full Text Available Let an infinite, homogeneous, many-body quantum system be unitarily evolved for a long time from a state where two halves are independently thermalized. One says that a non-equilibrium steady state emerges if there are nonzero steady currents in the central region. In particular, their presence is a signature of ballistic transport. We analyze the consequences of the current observable being a conserved density; near equilibrium this is known to give rise to linear wave propagation and a nonzero Drude peak. Using the Lieb–Robinson bound, we derive, under a certain regularity condition, a lower bound for the non-equilibrium steady-state current determined by equilibrium averages. This shows and quantifies the presence of ballistic transport far from equilibrium. The inequality suggests the definition of “nonlinear sound velocities”, which specialize to the sound velocity near equilibrium in non-integrable models, and “generalized sound velocities”, which encode generalized Gibbs thermalization in integrable models. These are bounded by the Lieb–Robinson velocity. The inequality also gives rise to a bound on the energy current noise in the case of pure energy transport. We show that the inequality is satisfied in many models where exact results are available, and that it is saturated at one-dimensional criticality.

  8. Implications of rf current drive theory for next step steady-state tokamak design

    International Nuclear Information System (INIS)

    Schultz, J.H.

    1985-06-01

    Two missions have been identified for a next-step tokamak experiment in the United States. The more ambitious Mission II device would be a superconducting tokamak, capable of doing long-pulse ignition demonstrations, and hopefully capable of also being able to achieve steady-state burn. A few interesting lines of approach have been identified, using a combination of logical design criteria and parametric system scans [SC85]. These include: (1) TIBER: A point-design suggested by Lawrence Livermore, that proposes a machine with the capability of demonstrating ignition, high beta (10%) and high Q (=10), using high frequency, fast-wave current drive. The TIBER topology uses moderate aspect ratio and high triangularity to achieve high beta. (2) JET Scale-up. (3) Magic5: It is argued here that an aspect ratio of 5 is a magic number for a good steady-state current drive experiment. A moderately-sized machine that achieves ignition and is capable of high Q, using either fast wave or slow wave current drive is described. (4) ET-II: The concept of a highly elongated tokamak (ET) was first proposed as a low-cost approach to Mission I, because of the possibility of achieving ohmic ignition with low-stress copper magnets. We propose that its best application is really for commercial tokamaks, using fast-wave current drive, and suggest a Mission II experiment that would be prototypical of such a reactor

  9. Study of the nonequilibrium state of superconductors by large quasiparticle injection from an external current source

    International Nuclear Information System (INIS)

    Iguchi, I.

    1977-01-01

    We have studied the nonequilibrium state of superconductors by injecting large numbers of quasiparticles from an external current source into a superconducting film of a tunnel junction with low tunnel resistance (typically 0.1--1 Ω for junction area approx. = 10 -4 cm 2 ). It was observed that there was a critical tunnel current density at which a voltage appeared locally in the part of a superconducting film confined to the junction area. Its values ranged from 10 2 to 10 3 A/cm 2 for bath temperatures well below T/sub c/. Followed by this voltage onset, a transition region corresponding to the nonequilibrium intermediate resistive state was also observed. For further increase of the tunnel current, the local film resistance developed beyond the value of its normal resistance, suggesting that the nonequilibrium state extends far beyond the voltage onset point. A theory based on the modified Rothwarf-Taylor equations and Parker's T* model is presented to compare with the experimental results. The calculated critical current density yielded almost the same order of magnitude as those found experimentally. The detailed behavior, however, deviates from the theoretical predictions although the film makes a second-order transition in the broad range of temperatures. It is also shown using four-terminal analysis that our observations and those by Wong, Yeh, and Langenberg are essentially the same

  10. The Current Mental State of School Students in Online Learning Conditions

    Directory of Open Access Journals (Sweden)

    Kovalevskaya E.V.,

    2015-08-01

    Full Text Available This article discusses the results of a study of actual mental state of high school students who are active subjects of career self-determination in terms of interactive learning. There are four groups of methods of interactive training: psychological training, art therapy, cognitive, and game training. The main task, which is solved by a researcher in a formative experiment with the use of each of these methods, is to establish significant differences in health, activity and mood as the indicators of current mental state of students in the classroom. As a result, we found that the most significant improvements in the current mental state takes place when using art and game therapy, so these techniques should be used in groups of students with low motivation to work, as well as in the adverse psychological climate. Less significant was the improvement of the current mental state after psychological training due to the fact that this method allow to update and seek solutions to the most important intrapersonal issues and require the implementation of a deeper reflection

  11. Clinical predictors of acute response to transcranial direct current stimulation (tDCS) in major depression.

    Science.gov (United States)

    D'Urso, Giordano; Dell'Osso, Bernardo; Rossi, Rodolfo; Brunoni, Andre Russowsky; Bortolomasi, Marco; Ferrucci, Roberta; Priori, Alberto; de Bartolomeis, Andrea; Altamura, Alfredo Carlo

    2017-09-01

    Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressed patients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressed patients. Clinical data from 3 independent tDCS trials on 171 depressed patients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response. Depression severity and the underlying clinical dimensions were measured using the Hamilton Depression Rating Scale (HDRS) at baseline and after the tDCS treatment. Age, gender and diagnosis (bipolar/unipolar depression) were also investigated as predictors of response. Linear mixed models were fitted in order to ascertain which HDRS factors were associated with response to tDCS. Age, gender and diagnosis did not show any association with response to treatment. The reduction in HDRS scores after tDCS was strongly associated with the baseline values of "Cognitive Disturbances" and "Retardation" factors, whilst the "Anxiety/Somatization" factor showed a mild association with the response. Open-label design, the lack of control group, and minor differences in stimulation protocols. No differences in response to tDCS were found between unipolar and bipolar patients, suggesting that tDCS is effective for both conditions. "Cognitive disturbance", "Retardation", and "Anxiety/Somatization", were identified as potential clinical predictors of response to tDCS. These findings point to the pre-selection of the potential responders to tDCS, therefore optimizing the clinical use of this technique and the overall cost-effectiveness of the psychiatric intervention for depressed patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Critical-state model for the determination of critical currents in disk-shaped superconductors

    International Nuclear Information System (INIS)

    Frankel, D.J.

    1979-01-01

    A series of experiments has been carried out on the flux trapping and shielding capabilities of a flat strip of Nb-Ti/Cu composite material. A circular piece of material from the strip was tested in a uniform field directed perpendicularly to the surface of the sample. Profiles of the normal component of the field along the sample diameter were measured. The critical-state model was adapted for this geometry and proved capable of reproducing the measured field profiles. Model curves agreed well with experimental field profiles generated when the full sample was in the critical state, when only a portion of the sample was in the critical state, and when profiles were obtained after the direction of the rate change of the magnetic field was reversed. The adaption of the critical-state model to disk geometry provides a possible method either to derive values of the critical current from measurements of field profiles above thin flat samples, or to predict the trapping and shielding behavior of such samples if the critical current is already known. This method of determining critical currents does not require that samples be formed into narrow strips or wires, as is required for direct measurements of J/sub c/, or into tubes or cylinders, as is usually required for magnetization-type measurements. Only a relatively small approximately circular piece of material is needed. The method relies on induced currents, so there is no need to pass large currents into the sample. The field-profile measurements are easily performed with expensive Hall probes and do not require detection of the resistive transition of the superconductor

  13. Representing delayed force feedback as a combination of current and delayed states.

    Science.gov (United States)

    Avraham, Guy; Mawase, Firas; Karniel, Amir; Shmuelof, Lior; Donchin, Opher; Mussa-Ivaldi, Ferdinando A; Nisky, Ilana

    2017-10-01

    To adapt to deterministic force perturbations that depend on the current state of the hand, internal representations are formed to capture the relationships between forces experienced and motion. However, information from multiple modalities travels at different rates, resulting in intermodal delays that require compensation for these internal representations to develop. To understand how these delays are represented by the brain, we presented participants with delayed velocity-dependent force fields, i.e., forces that depend on hand velocity either 70 or 100 ms beforehand. We probed the internal representation of these delayed forces by examining the forces the participants applied to cope with the perturbations. The findings showed that for both delayed forces, the best model of internal representation consisted of a delayed velocity and current position and velocity. We show that participants relied initially on the current state, but with adaptation, the contribution of the delayed representation to adaptation increased. After adaptation, when the participants were asked to make movements with a higher velocity for which they had not previously experienced with the delayed force field, they applied forces that were consistent with current position and velocity as well as delayed velocity representations. This suggests that the sensorimotor system represents delayed force feedback using current and delayed state information and that it uses this representation when generalizing to faster movements. NEW & NOTEWORTHY The brain compensates for forces in the body and the environment to control movements, but it is unclear how it does so given the inherent delays in information transmission and processing. We examined how participants cope with delayed forces that depend on their arm velocity 70 or 100 ms beforehand. After adaptation, participants applied opposing forces that revealed a partially correct representation of the perturbation using the current and the

  14. External heating and current drive source requirements towards steady-state operation in ITER

    Science.gov (United States)

    Poli, F. M.; Kessel, C. E.; Bonoli, P. T.; Batchelor, D. B.; Harvey, R. W.; Snyder, P. B.

    2014-07-01

    Steady state scenarios envisaged for ITER aim at optimizing the bootstrap current, while maintaining sufficient confinement and stability to provide the necessary fusion yield. Non-inductive scenarios will need to operate with internal transport barriers (ITBs) in order to reach adequate fusion gain at typical currents of 9 MA. However, the large pressure gradients associated with ITBs in regions of weak or negative magnetic shear can be conducive to ideal MHD instabilities, reducing the no-wall limit. The E × B flow shear from toroidal plasma rotation is expected to be low in ITER, with a major role in the ITB dynamics being played by magnetic geometry. Combinations of heating and current drive (H/CD) sources that sustain reversed magnetic shear profiles throughout the discharge are the focus of this work. Time-dependent transport simulations indicate that a combination of electron cyclotron (EC) and lower hybrid (LH) waves is a promising route towards steady state operation in ITER. The LH forms and sustains expanded barriers and the EC deposition at mid-radius freezes the bootstrap current profile stabilizing the barrier and leading to confinement levels 50% higher than typical H-mode energy confinement times. Using LH spectra with spectrum centred on parallel refractive index of 1.75-1.85, the performance of these plasma scenarios is close to the ITER target of 9 MA non-inductive current, global confinement gain H98 = 1.6 and fusion gain Q = 5.

  15. Steady-state configurations of Dzyaloshinskii domain walls driven by field and current

    Energy Technology Data Exchange (ETDEWEB)

    Sánchez-Tejerina, L., E-mail: luis.st@ee.uva.es [Departamento de Electricidad y Electrónica, Facultad de Ciencias, Universidad de Valladolid, 47011 Valladolid (Spain); Departamento de Física Aplicada, Facultad de Ciencias, Universidad de Salamanca, 37011 Salamanca (Spain); Alejos, O. [Departamento de Electricidad y Electrónica, Facultad de Ciencias, Universidad de Valladolid, 47011 Valladolid (Spain); Martínez, E. [Departamento de Física Aplicada, Facultad de Ciencias, Universidad de Salamanca, 37011 Salamanca (Spain)

    2017-02-01

    The dynamics of Dzyaloshinskii domain walls (DDW) in ultrathin ferromagnetic strips with perpendicular magnetic anisotropy, for different values of both perpendicular field and longitudinal current excitation associated to the Spin-Hall effect, has been studied, taking into account different values of the interfacial Dzyaloshinskii-Moriya interaction (DMI). This study has been carried out with the help of the q-Φ one-dimensional model and micromagnetic simulations. We have found that Walker breakdown may be avoided by applying a certain threshold current, even though the inverse effect is also possible. We have also found that, for particular values of field and current, the magnetization within the DDW experiences an abrupt change of orientation, which provokes a change on the contribution of current to the terminal DDW velocity. This effect disappears for sufficiently strong DMI, as it is expected from the model. - Highlights: • Steady-state configurations of Dzyaloshinskii domain walls driven by field and current have been reported. • Field-like torques and Slonczewskii-like torques due to spin-orbit interactions have been considered. • The response is associated with the rotation of the domain wall inner magnetization. • An asymmetric behavior arising from the existence of degenerate states is shown. • The asymmetry results in different travelled distances and/or terminal speeds.

  16. Steady-state configurations of Dzyaloshinskii domain walls driven by field and current

    International Nuclear Information System (INIS)

    Sánchez-Tejerina, L.; Alejos, O.; Martínez, E.

    2017-01-01

    The dynamics of Dzyaloshinskii domain walls (DDW) in ultrathin ferromagnetic strips with perpendicular magnetic anisotropy, for different values of both perpendicular field and longitudinal current excitation associated to the Spin-Hall effect, has been studied, taking into account different values of the interfacial Dzyaloshinskii-Moriya interaction (DMI). This study has been carried out with the help of the q-Φ one-dimensional model and micromagnetic simulations. We have found that Walker breakdown may be avoided by applying a certain threshold current, even though the inverse effect is also possible. We have also found that, for particular values of field and current, the magnetization within the DDW experiences an abrupt change of orientation, which provokes a change on the contribution of current to the terminal DDW velocity. This effect disappears for sufficiently strong DMI, as it is expected from the model. - Highlights: • Steady-state configurations of Dzyaloshinskii domain walls driven by field and current have been reported. • Field-like torques and Slonczewskii-like torques due to spin-orbit interactions have been considered. • The response is associated with the rotation of the domain wall inner magnetization. • An asymmetric behavior arising from the existence of degenerate states is shown. • The asymmetry results in different travelled distances and/or terminal speeds.

  17. The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-03-02

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%-25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

  18. The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients. PMID:26950113

  19. Current role of liquid chromatography coupled to mass spectrometry in clinical toxicology screening methods.

    Science.gov (United States)

    Viette, Véronique; Fathi, Marc; Rudaz, Serge; Hochstrasser, Denis; Veuthey, Jean-Luc

    2011-07-01

    Abstract Toxicological screening is the analysis of a biological specimen to detect and identify compounds in patients admitted to the hospital with acute intoxication of unknown origin. The screening of a wide range of toxicologically relevant compounds in biological samples is a serious challenge for clinical laboratories. The high selectivity and sensitivity of liquid chromatography coupled to mass spectrometry or tandem mass spectrometry technology provides an attractive alternative to the current methods. For these reasons, an increasing number of applications for multi-target screening or general screening of unknown compounds in biological matrices are being published. This paper is an overview of sample clean-up, chromatographic separation and mass spectrometry detection procedures which can be combined to obtain screening methods adapted to the constraints and needs of various laboratories, and none specifically in clinical toxicology. Currently the techniques are in the hands of specialists, principally in academic institutes. However, the evolution in technology should allow application of the techniques as a tool in toxicology laboratories and thus more widespread exploitation of their potential.

  20. Clinical decision support systems in hospital care using ubiquitous devices: Current issues and challenges.

    Science.gov (United States)

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

    2017-11-01

    Supporting clinicians in decision making using advanced technologies has been an active research area in biomedical engineering during the past years. Among a wide range of ubiquitous systems, smartphone applications have been increasingly developed in healthcare settings to help clinicians as well as patients. Today, many smartphone applications, from basic data analysis to advanced patient monitoring, are available to clinicians and patients. Such applications are now increasingly integrating into healthcare for clinical decision support, and therefore, concerns around accuracy, stability, and dependency of these applications are rising. In addition, lack of attention to the clinicians' acceptability, as well as the low impact on the medical professionals' decision making, are posing more serious issues on the acceptability of smartphone applications. This article reviews smartphone-based decision support applications, focusing on hospital care settings and their overall impact of these applications on the wider clinical workflow. Additionally, key challenges and barriers of the current ubiquitous device-based healthcare applications are identified. Finally, this article addresses current challenges, future directions, and the adoption of mobile healthcare applications.

  1. Inhaled therapies in patients with moderate COPD in clinical practice: current thinking

    Science.gov (United States)

    Ariel, Amnon; Altraja, Alan; Belevskiy, Andrey; Boros, Piotr W; Danila, Edvardas; Fležar, Matjaz; Koblizek, Vladimir; Fridlender, Zvi G; Kostov, Kosta; Krams, Alvils; Milenkovic, Branislava; Somfay, Attila; Tkacova, Ruzena; Tudoric, Neven; Ulmeanu, Ruxandra; Valipour, Arschang

    2018-01-01

    COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is required to reduce symptoms, preserve lung function, quality of life, and exercise capacity, and prevent exacerbations. However, current clinical practice frequently differs from published guidelines on the management of COPD. This review focuses on the current scientific evidence and expert opinion on the management of moderate COPD: the symptoms arising from moderate airflow obstruction and the burden these symptoms impose, how physical activity can improve disease outcomes, the benefits of dual bronchodilation in COPD, and the limited evidence for the benefits of inhaled corticosteroids in this disease. We emphasize the importance of maximizing bronchodilation in COPD with inhaled dual-bronchodilator treatment, enhancing patient-related outcomes, and enabling the withdrawal of inhaled corticosteroids in COPD in well-defined patient groups. PMID:29317810

  2. 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.

  3. A cross-cultural comparison of clinical supervision in South Korea and the United States.

    Science.gov (United States)

    Son, Eunjung; Ellis, Michael V

    2013-06-01

    We investigated similarities and differences in clinical supervision in two cultures: South Korea and the United States The study had two parts: (1) a test of the cross-cultural equivalence of four supervision measures; and (2) a test of two competing models of cultural differences in the relations among supervisory style, role difficulties, supervisory working alliance, and satisfaction with supervision. Participants were 191 South Korean and 187 U.S. supervisees currently engaged in clinical supervision. The U.S. measures demonstrated sufficient measurement equivalence for use in South Korea. Cultural differences moderated the relations among supervisory styles, role difficulties, supervisory working alliance, and supervision satisfaction. Specifically, the relations among these variables were significantly stronger for U.S. than for South Korean supervisees. Implications for theory, research, and practice were discussed.

  4. Current state of methodological and decisions for radiation treatment of blood, its components and products

    Directory of Open Access Journals (Sweden)

    Gordeev A.V.

    2014-12-01

    Full Text Available This article presents currently used blood transfusion media — components and blood products, therapeutic effects, reactions and complications of blood transfusion, use of radiation treatment for blood transfusion fluids. There had been discussed in detail the practice of radiation processing of blood components and for the prevention of reaction "graft versus host" and studies of plasma radiation treatment for its infectious safety. There was presented the current state of techniques and technical solutions of radiation treatment of transfusion-transmissible environments. There were also considered an alternative to radiation treatment of blood.

  5. A simulation study on burning profile tailoring of steady state, high bootstrap current tokamaks

    International Nuclear Information System (INIS)

    Nakamura, Y.; Takei, N.; Tobita, K.; Sakamoto, Y.; Fujita, T.; Fukuyama, A.; Jardin, S.C.

    2007-01-01

    From the aspect of fusion burn control in steady state DEMO plant, the significant challenges are to maintain its high power burning state of ∝3-5 GW without burning instability, hitherto well-known as ''thermal stability'', and also to keep its desired burning profile relevant with internal transport barrier (ITB) that generates high bootstrap current. The paper presents a simulation modeling of the burning stability coupled with the self-ignited fusion burn and the structure-formation of the ITB. A self-consistent simulation, including a model for improved core energy confinement, has pointed out that in the high power fusion DEMO plant there is a close, nonlinear interplay between the fusion burnup and the current source of non-inductive, ITB-generated bootstrap current. Consequently, as much distinct from usual plasma controls under simulated burning conditions with lower power (<<1 GW), the selfignited fusion burn at a high power burning state of ∝3-5 GW becomes so strongly selforganized that any of external means except fuelling can not provide the effective control of the stable fusion burn.It is also demonstrated that externally applied, inductive current perturbations can be used to control both the location and strength of ITB in a fully noninductive tokamak discharge. We find that ITB structures formed with broad noninductive current sources such as LHCD are more readily controlled than those formed by localized sources such as ECCD. The physics of the inductive current is well known. Consequently, we believe that the controllability of the ITB is generic, and does not depend on the details of the transport model (as long as they can form an ITB for sufficiently reversed magnetic shear q-profile). Through this external control of the magnetic shear profile, we can maintain the ITB strength that is otherwise prone to deteriorate when the bootstrap current increases. These distinguishing capabilities of inductive current perturbation provide steady

  6. Current drive efficiency requirements for an attractive steady-state reactor

    Energy Technology Data Exchange (ETDEWEB)

    Tonon, G

    1994-12-31

    The expected values of the figure of merit and the electrical efficiency of various non-inductive current drive methods are considered. The main experimental results achieved today with neutral beams and radiofrequency systems are summarized. Taking into account the simplified energy flow diagram of a steady state reactor, the figure of merit and the electrical efficiency values which are necessary in order to envisage an attractive steady-state reactor are determined. These values are compared to the theoretical predictions. (author). 16 refs., 11 figs., 2 tabs.

  7. CURRENT STATE AND DEVELOPMENT OF THE FISHERIES SECTOR OF UKRAINE IN THE CRISIS

    Directory of Open Access Journals (Sweden)

    І. Hrytsyniak

    2015-03-01

    Full Text Available Purpose. Fisheries has a strategic importance for supplying the population with food, while the sectors of the national economy with raw materials, for strengthening the country’s position in the international arena, for preserving spatial and national integrity of Ukraine, plays an important role in the restoration of natural resources and in the increase in employment. In recent years, fisheries sector of Ukraine is in a severe, protracted economic crisis. Considering its socio-economic and strategic importance for the state, there is a task for developing an effective policy for fisheries development in Ukraine that defines the relevance of the research and practical importance of its results. Thus, a compilation and analysis of the existing information on the current state and development of fisheries sector in the crisis period will allow a deeper understanding of problems in the fisheries sector in Ukraine and finding quick solutions. The main goal of the state policy in the field of fisheries in Ukraine has to be meeting the needs of the population in fish and fish products by creating conditions for effective operations and development of aquaculture and fishing enterprises. Findings. The article reviews the current state of the development of fisheries sector in Ukraine, consumption, catch, processing of fish and seafood, dynamics of fish product exports and imports, legislative and regulatory framework of fisheries sector, state of the implementation of WTO and EU requirements, as well as finding ways for the fisheries sector out from the crisis. Originality. This work is a compilation of the information on the current state of fisheries sector development in Ukraine. The information is provided in the form of a coherent presentation of information on the current state of fisheries sector in Ukraine, both in the domestic and foreign markets. Practical Value. The fact that the fisheries sector of Ukraine is still in a depressive state

  8. CURRENT STATE OF WATER BIORESOURCES OF THE VOLGA AND CASPIAN SEA BASIN

    Directory of Open Access Journals (Sweden)

    L. M. Vasileva

    2012-01-01

    Full Text Available The article considers the issues of current degraded state of aquatic biological resources of the Volga-Caspian Sea basin and provides specific data on commercial stocks of fish. The main reasons for decrease in natural stocks of ichthyofauna are regulation and pollution of the spawning rivers, adverse hydrological conditions, injudicious hunting, poaching pressure. To improve the state of natural stocks of fish it is necessary to increase their reproduction and implement measures to restore and rational exploitation of aquatic bioresources of the Volga- Caspian Sea basin.

  9. Current State-of-the-Art MRI for Comprehensive Evaluation of Potential Living Liver Donors.

    Science.gov (United States)

    Jhaveri, Kartik S; Guo, Lijun; Guimarães, Luís

    2017-07-01

    This review focuses on the role of state-of-the-art MRI-based techniques for comprehensive evaluation of living donors providing single-visit assessment of the liver vasculature via MR angiography, of the biliary tract via conventional T2-weighted MR cholangiography and T1-weighted gadoxetate disodium-enhanced MR cholangiography, and of hepatic steatosis via T2*-corrected multiecho chemical shift-based water-fat separation MRI and high-speed T2-corrected multiecho MR spectroscopy. By using current state-of-the-art techniques, MRI can provide a one-stop-shop method for evaluation of the potential living liver donors.

  10. Current drive efficiency requirements for an attractive steady-state reactor

    International Nuclear Information System (INIS)

    Tonon, G.

    1994-01-01

    The expected values of the figure of merit and the electrical efficiency of various non-inductive current drive methods are considered. The main experimental results achieved today with neutral beams and radiofrequency systems are summarized. Taking into account the simplified energy flow diagram of a steady state reactor, the figure of merit and the electrical efficiency values which are necessary in order to envisage an attractive steady-state reactor are determined. These values are compared to the theoretical predictions. (author). 16 refs., 11 figs., 2 tabs

  11. The association between current unemployment and clinically determined poor oral health.

    Science.gov (United States)

    Al-Sudani, Fouad Y H; Vehkalahti, Miira M; Suominen, Anna L

    2015-08-01

    The aim of this study was to assess whether current unemployment was associated with poor oral health and whether there was a difference in oral health according to the duration of the current unemployment. As part of the Health 2000 Survey in Finland (a nationwide comprehensive health examination survey), we used its data based on interviews, questionnaires, and clinical oral examinations of the 30- to 63-year-old respondents (n = 4773). Current employment status was measured in its dichotomous form, employed versus unemployed, and length of current unemployment was classified into four categories. We measured oral health in terms of numbers of missing teeth, of sound teeth, of filled teeth, of decayed teeth, and of teeth with deepened periodontal pockets (≥4 mm, ≥6 mm). Poisson regression models were fitted for all oral health outcomes except number of decayed teeth, for which negative binomial regression model was used. Oral health-related behaviors and sociodemographic and socioeconomic factors were added to the analyses. The unemployed subjects had higher numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets than the employed ones. The association remained consistent even after adjustments. Oral health-related behaviors seemed to mediate the association. We found no association between unemployment and number of sound teeth. Current long-term unemployment showed stronger association with poor oral health than short-term among women. The unemployed can be considered as a risk group for poor oral health. Oral healthcare should be reoriented toward those who are unemployed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Cutaneous leishmaniasis in Syria: clinical features, current status and the effects of war.

    Science.gov (United States)

    Hayani, Kinan; Dandashli, Anwar; Weisshaar, Elke

    2015-01-01

    Cutaneous leishmaniasis (CL) is a worldwide disease caused by an infection with the protozoan parasite Leishmania transmitted via sand flies. It is endemic in many of the poorest countries of all continents. "Aleppo boil" is one of the recognised names given to this disease in the medical literature. Although CL used to be well-controlled and well-documented in Syria, its incidence has dramatically increased since the beginning of the war; however, there is lack of documentation. Here, we present the past and current epidemiological situation of the disease in Syria. We also draw attention to gross and highly unusual clinical variants of CL presented to the Department of Dermatology in Aleppo covering the important differential clinical diagnoses, since this disease is already known to mimic other conditions. Diagnostic procedures and treatment as well as prevention are summarised. Due to the increased ability to travel, and especially the flight of Syrians to neighbouring countries, as well as to Europe, CL may become a new threat in formerly unaffected regions. Through this account, we hope to give weight to the aspiration that CL does not remain a neglected and often clinically overlooked tropical dermatosis.

  13. [Security Management in Clinical Laboratory Departments and Facilities: Current Status and Issues].

    Science.gov (United States)

    Ishida, Haku; Nakamura, Junji; Yoshida, Hiroshi; Koike, Masaru; Inoue, Yuji

    2014-11-01

    We conducted a questionnaire survey regarding the current activities for protecting patients' privacy and the security of information systems (IS) related to the clinical laboratory departments of university hospitals, certified training facilities for clinical laboratories, and general hospitals in Yamaguchi Prefecture. The response rate was 47% from 215 medical institutions, including three commercial clinical laboratory centers. The results showed that there were some differences in management activities among facilities with respect to continuing education, the documentation or regulation of operational management for paper records, electronic information, remaining samples, genetic testing, and laboratory information for secondary use. They were suggested to be caused by differences in functions between university and general hospitals, differences in the scale of hospitals, or whether or not hospitals have received accreditation or ISO 15189. Regarding the IS, although the majority of facilities had sufficiently employed the access control to IS, there was some room for improvement in the management of special cases such as VIPs and patients with HIV infection. Furthermore, there were issues regarding the login method for computers shared by multiple staff, the showing of the names of personnel in charge of reports, and the risks associated with direct connections to systems and the Internet and the use of portable media such as USB memory sticks. These results indicated that further efforts are necessary for each facility to continue self-assessment and make improvements.

  14. Imaging of Mucosal Inflammation: Current Technological Developments, Clinical Implications, and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Maximilian J. Waldner

    2017-10-01

    Full Text Available In recent years, various technological developments markedly improved imaging of mucosal inflammation in patients with inflammatory bowel diseases. Although technological developments such as high-definition-, chromo-, and autofluorescence-endoscopy led to a more precise and detailed assessment of mucosal inflammation during wide-field endoscopy, probe-based and stationary confocal laser microscopy enabled in vivo real-time microscopic imaging of mucosal surfaces within the gastrointestinal tract. Through the use of fluorochromes with specificity against a defined molecular target combined with endoscopic techniques that allow ultrastructural resolution, molecular imaging enables in vivo visualization of single molecules or receptors during endoscopy. Molecular imaging has therefore greatly expanded the clinical utility and applications of modern innovative endoscopy, which include the diagnosis, surveillance, and treatment of disease as well as the prediction of the therapeutic response of individual patients. Furthermore, non-invasive imaging techniques such as computed tomography, magnetic resonance imaging, scintigraphy, and ultrasound provide helpful information as supplement to invasive endoscopic procedures. In this review, we provide an overview on the current status of advanced imaging technologies for the clinical non-invasive and endoscopic evaluation of mucosal inflammation. Furthermore, the value of novel methods such as multiphoton microscopy, optoacoustics, and optical coherence tomography and their possible future implementation into clinical diagnosis and evaluation of mucosal inflammation will be discussed.

  15. Current status and clinical association of beta-catenin with juvenile nasopharyngeal angiofibroma.

    Science.gov (United States)

    Mishra, A; Singh, V; Verma, V; Pandey, S; Trivedi, R; Singh, H P; Kumar, S; Dwivedi, R C; Mishra, S C

    2016-10-01

    A possible role of the APC/beta-catenin pathway in the pathogenesis of sporadic juvenile nasopharyngeal angiofibroma has been suggested. This paper presents its current status and clinical association in our patients. A prospective observational study was conducted at King George Medical University and Central Drug Research Institute, in Lucknow, India. Western blot analysis was undertaken in 16 cases to examine beta-catenin expression. The clinical details were recorded along with follow up observations, to determine associations. Up-regulation of beta-catenin expression was seen in 69 per cent of cases. The clinical variables did not reveal significant differences between patients with extremes of expression (extreme under- vs over-expression). However, absent expression was shown exclusively in young adults aged over 18 years, while enhanced expression was associated with an altered facial profile. Although a beta-catenin association was seen in a subset of our sporadic juvenile nasopharyngeal angiofibroma cases, its expression was not homogeneous. This is in contrast to the Western literature that suggests a universal (homogenous) enhanced expression in the majority. Hence, further research is required to better define its molecular cascade.

  16. Current status and future prospects of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) clinical trials in ovarian cancer.

    Science.gov (United States)

    Cowan, Renee A; O'Cearbhaill, Roisin E; Zivanovic, Oliver; Chi, Dennis S

    2017-08-01

    The natural history of advanced-stage epithelial ovarian cancer is one of clinical remission after surgery and platinum/taxane-based intravenous (IV) and/or intraperitoneal (IP) chemotherapy followed by early or late recurrence in the majority of patients. Prevention of progression and recurrence remains a major hurdle in the management of ovarian cancer. Recently, many investigators have evaluated the use of normothermic and hyperthermic intraoperative IP drug delivery as a management strategy. This is a narrative review of the current status of clinical trials of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in ovarian cancer and the future directions for this treatment strategy. The existing studies on HIPEC in patients with epithelial ovarian cancer are mostly retrospective in nature, are heterogeneous with regards to combined inclusion of primary and recurrent disease and lack unbiased data. Until data are available from evidence-based trials, it is reasonable to conclude that surgical cytoreduction and HIPEC is a rational and interesting, though still investigative, approach in the management of epithelial ovarian cancer, whose use should be employed within prospective clinical trials.

  17. 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

  18. Localized excitations in nonlinear complex systems current state of the art and future perspectives

    CERN Document Server

    Cuevas-Maraver, Jesús; Frantzeskakis, Dimitri; Karachalios, Nikos; Kevrekidis, Panayotis; Palmero-Acebedo, Faustino

    2014-01-01

    The study of nonlinear localized excitations is a long-standing challenge for research in basic and applied science, as well as engineering, due to their importance in understanding and predicting phenomena arising in nonlinear and complex systems, but also due to their potential for the development and design of novel applications. This volume is a compilation of chapters representing the current state-of-the-art on the field of localized excitations and their role in the dynamics of complex physical systems.

  19. Investigation of current redistribution in superstabilized superconducting winding when switching to the normal resistive state

    International Nuclear Information System (INIS)

    Devred, A.

    1989-01-01

    We have investigated the electromagnetic behavior of a layer of superstabilized superconductive composite conductors when switching instantaneously and uniformly to the normal resistive state. The Laplace transform was used to solve the current diffusion equation in the superstabilizing material. The value of power dissipated per unit volume, averaged over the layer thickness, was then computed using the ''pseudo''-convolution theorem in the complex plane. Last, we present a simple interpretation of the phenomenon with the help of two time constants

  20. THE CURRENT STATE OF LEGAL INSTITUTIONS PROTECTING THE RIGHTS OF JUVENILES IN RUSSIA

    OpenAIRE

    Yulia Hafizovna DAVYDOVA

    2015-01-01

    The article highlights the current state of the legislation on protection of the rights of under-aged. Much attention is paid to the formation of the juvenile justice system in the Russian Federation. We present problems related to law infringements by teenagers in various fields and their solutions, highlight the work and the development of juvenile courts in Russia, sum up the results of the implementation of juvenile technologies and their significance, gives the definition of the term «co...

  1. Current state and controversies in fertility preservation in women with breast cancer

    OpenAIRE

    Taylan, Enes; Oktay, Kutluk H

    2017-01-01

    On average, over 25000 women are diagnosed with breast cancer under the age of 45 annually in the United States. Because an increasing number of young women delay childbearing to later life for various reasons, a growing population of women experience breast cancer before completing childbearing. In this context, preservation of fertility potential of breast cancer survivors has become an essential concept in modern cancer care. In this review, we will outline the currently available fertilit...

  2. State of Corporate Social Responsibility in India – Current scenario, Approach and Drivers

    OpenAIRE

    Nagpal, Kshitij

    2016-01-01

    Purpose – The aim of the study is to examine the state of Corporate Social Responsibility (CSR)in India. The report attempts to investigate the current scenario of CSR ctivities and examine how corporations in India interpret CSR. The study also seeks to identify the reported driving forces behind implementation of CSR practices by firms in India. Methodology – CSR personnel from 3O companies that are obligated to spend on CSR activities under the Companies Act, 2013 were surveyed. To cr...

  3. Current and potential sustainable corn stover feedstock for biofuel production in the United States

    Science.gov (United States)

    Tan, Zhengxi; Liu, Shu-Guang; Tieszen, Larry L.; Bliss, Norman

    2012-01-01

    Increased demand for corn (Zea mays L.) stover as a feedstock for cellulosic ethanol raises concerns about agricultural sustainability. Excessive corn stover harvesting could have long-term impacts on soil quality. We estimated current and future stover production and evaluated the potential harvestable stover amount (HSA) that could be used for biofuel feedstock in the United States by defining the minimum stover requirement (MSR) associated with the current soil organic carbon (SOC) content, tillage practices, and crop rotation systems. Here we show that the magnitude of the current HSA is limited (31 Tg y−1, dry matter) due to the high MSR for maintaining the current SOC content levels of soils that have a high carbon content. An alternative definition of MSR for soils with a moderate level of SOC content could significantly elevate the annual HSA to 68.7 Tg, or even to 132.2 Tg if the amount of currently applied manure is counted to partially offset the MSR. In the future, a greater potential for stover feedstock could come from an increase in stover yield, areal harvest index, and/or the total planted area. These results suggest that further field experiments on MSR should be designed to identify differences in MSR magnitude between maintaining SOC content and preventing soil erosion, and to understand the role of current SOC content level in determining MSR from soils with a wide range of carbon contents and climatic conditions.

  4. Macroscopic quantum effects in the zero voltage state of the current biased Josephson junction

    International Nuclear Information System (INIS)

    Clarke, J.; Devoret, M.H.; Martinis, J.; Esteve, D.

    1985-05-01

    When a weak microwave current is applied to a current-biased Josephson tunnel junction in the thermal limit the escape rate from the zero voltage state is enhanced when the microwave frequency is near the plasma frequency of the junction. The resonance curve is markedly asymmetric because of the anharmonic properties of the potential well: this behavior is well explained by a computer simulation using a resistively shunted junction model. This phenomenon of resonant activation enables one to make in situ measurements of the capacitance and resistance shunting the junction, including contributions from the complex impedance presented by the current leads. For the relatively large area junctions studied in these experiments, the external capacitive loading was relatively unimportant, but the damping was entirely dominated by the external resistance

  5. LHCD current profile control experiments towards steady state improved confinement on JT-60U

    International Nuclear Information System (INIS)

    Ide, S.; Naito, O.; Oikawa, T.; Fujita, T.; Kondoh, T.; Seki, M.; Ushigusa, K.

    2001-01-01

    In JT-60U lower hybrid current drive (LHCD) experiments, a reversed magnetic shear configuration that was accompanied by the internal transport barriers was successfully maintained by means of LHCD almost in the full current drive quasi-steady state for 4.7 s. The normalized beta was kept near 1 and the neutron emission rate was almost steady as well indicating no accumulation of impurities into the plasma. Diagnostics data showed that all the profiles of the electron and ion temperatures, the electron density and the current profile were almost unchanged during the LHCD phase. Moreover, capability of LHCD in H-mode plasmas has been also investigated. It was found that the lower hybrid waves can be coupled to an H-mode edge plasma even with the plasma wall distance of about 14 cm. The maximum coupling distance was found to depend on the edge recycling. (author)

  6. Embedded Ag Grid Electrodes as Current Collector for Ultraflexible Transparent Solid-State Supercapacitor.

    Science.gov (United States)

    Xu, Jian-Long; Liu, Yan-Hua; Gao, Xu; Sun, Yilin; Shen, Su; Cai, Xinlei; Chen, Linsen; Wang, Sui-Dong

    2017-08-23

    Flexible transparent solid-state supercapacitors have attracted immerse attention for the power supply of next-generation flexible "see-through" or "invisible" electronics. For fabrication of such devices, high-performance flexible transparent current collectors are highly desired. In this paper, the utilization of embedded Ag grid transparent conductive electrodes (TCEs) fabricated by a facile soft ultraviolet imprinting lithography method combined with scrap techniques, as the current collector for flexible transparent solid-state supercapacitors, is demonstrated. The embedded Ag grid TCEs exhibit not only excellent optoelectronic properties (R S ∼ 2.0 Ω sq -1 and T ∼ 89.74%) but also robust mechanical properties, which could meet the conductivity, transparency, and flexibility needs of current collectors for flexible transparent supercapacitors. The obtained supercapacitor exhibits large specific capacitance, long cycling life, high optical transparency (T ∼ 80.58% at 550 nm), high flexibility, and high stability. Owing to the embedded Ag grid TCE structure, the device shows a slight capacitance loss of 2.6% even after 1000 cycles of repetitive bending for a bending radius of up to 2.0 mm. This paves the way for developing high-performance current collectors and thus flexible transparent energy storage devices, and their general applicability opens up opportunities for flexible transparent electronics.

  7. SSAT State-of-the-Art Conference: Current Surgical Management of Gastric Tumors.

    Science.gov (United States)

    Norton, Jeffrey A; Kim, Teresa; Kim, Joseph; McCarter, Martin D; Kelly, Kaitlyn J; Wong, Joyce; Sicklick, Jason K

    2018-01-01

    The current era of gastric surgery is marked by low morbidity and mortality rates, innovative strategies to approach resections with a minimally invasive fashion or hyperthermic intraperitoneal chemotherapy (HIPEC), as well as improved understanding of the biology of sporadic and hereditary stromal, neuroendocrine, and epithelial malignancies. In 2017, the Society for Surgery of the Alimentary Tract convened a State-of-the-Art Conference on Current Surgical Management of Gastric Tumors with both international experts and emerging leaders in the field of gastric surgery. Martin D. McCarter, MD of the University of Colorado discussed the current management of gastric gastrointestinal stromal tumors (GIST). Kaitlyn J. Kelly, MD of the University of California, San Diego discussed the management of gastric carcinoid tumors. Jeffrey A. Norton of Stanford University discussed recent advances in the management of gastric adenocarcinoma including a focus on hereditary diffuse gastric cancer (HDGC). Joseph Kim, MD of Stony Brook University discussed a systematic approach to minimally invasive gastrectomy for cancer. Joyce Wong, MD of Pennsylvania State University discussed the role for cytoreductive surgery (CRS) and HIPEC for gastric adenocarcinoma. This review provides gastrointestinal surgeons with a concise update on the current surgical management of gastric tumors.

  8. System and method for generating steady state confining current for a toroidal plasma fusion reactor

    International Nuclear Information System (INIS)

    Fisch, N.J.

    1981-01-01

    A system for generating steady state confining current for a toroidal plasma fusion reactor providing steady-state generation of the thermonuclear power. A dense, hot toroidal plasma is initially prepared with a confining magnetic field with toroidal and poloidal components. Continuous wave rf energy is injected into said plasma to establish a spectrum of traveling waves in the plasma, where the traveling waves have momentum components substantially either all parallel, or all anti-parallel to the confining magnetic field. The injected rf energy is phased to couple to said traveling waves with both a phase velocity component and a wave momentum component in the direction of the plasma traveling wave components. The injected rf energy has a predetermined spectrum selected so that said traveling waves couple to plasma electrons having velocities in a predetermined range delta . The velocities in the range are substantially greater than the thermal electron velocity of the plasma. In addition, the range is sufficiently broad to produce a raised plateau having width delta in the plasma electron velocity distribution so that the plateau electrons provide steady-state current to generate a poloidal magnetic field component sufficient for confining the plasma. In steady state operation of the fusion reactor, the fusion power density in the plasma exceeds the power dissipated in the plasma

  9. System and method for generating steady state confining current for a toroidal plasma fusion reactor

    International Nuclear Information System (INIS)

    Bers, A.

    1981-01-01

    A system for generating steady state confining current for a toroidal plasma fusion reactor providing steady-state generation of the thermonuclear power. A dense, hot toroidal plasma is initially prepared with a confining magnetic field with toroidal and poloidal components. Continuous wave rf energy is injected into said plasma to estalish a spectrum of traveling waves in the plasma, where the traveling waves have momentum components substantially either all parallel, or all anti-parallel to the confining magnetic field. The injected rf energy is phased to couple to said traveling waves with both a phase velocity component and a wave momentum component in the direction of the plasma traveling wave components. The injected rf energy has a predetermined spectrum selected so that said traveling waves couple to plasma electrons having velocities in a predetermined range delta . The velocities in the range are substantially greater than the thermal electron velocity of the plasma. In addition, the range is sufficiently broad to produce a raised plateau having width delta in the plasma electron velocity distribution so that the plateau electrons provide steady-state current to generate a poloidal magnetic field component sufficient for confining the plasma. In steady state operation of the fusion reactor, the fusion power density in the plasma exceeds the power dissipated inthe plasma

  10. Important configurations in six-quark N-N states. II. Current quark model

    International Nuclear Information System (INIS)

    Stancu, F.; Wilets, L.

    1989-01-01

    Quark basis states constructed from molecular-type orbitals were shown previously to be more convenient to use than cluster model states for N-N processes. The usual cluster model representation omits configurations which emerge naturally in a molecular basis which contains the same number of spatial functions. The importance of the omitted states was demonstrated for a constituent quark model. The present work extends the study to the prototypical current quark model, namely the MIT bag. In order to test the expansion for short-range N-N interactions, the eigenstates and eigenenergies of six quarks in a spherical bag, including one-gluon exchange, are calculated. The lowest eigenenergies are lowered significantly with respect to the usual cluster model. This reaffirms the importance of dynamics for obtaining the needed short-range repulsion

  11. The current status of artisanal cannabis for the treatment of epilepsy in the United States.

    Science.gov (United States)

    Sulak, Dustin; Saneto, Russell; Goldstein, Bonni

    2017-05-01

    The widespread patient use of artisanal cannabis preparations has preceded quality validation of cannabis use for epilepsy. Neurologists and cannabinoid specialists are increasingly in a position to monitor and guide the use of herbal cannabis in epilepsy patients. We report the retrospective data on efficacy and adverse effects of artisanal cannabis in Patients with medically refractory epilepsy with mixed etiologies in Washington State, California, and Maine. Clinical considerations, including potential risks and benefits, challenges related to artisanal preparations, and cannabinoid dosing, are discussed. Of 272 combined patients from Washington State and California, 37 (14%) found cannabis ineffective at reducing seizures, 29 (15%) experienced a 1-25% reduction in seizures, 60 (18%) experienced a 26-50% reduction in seizures, 45 (17%) experienced a 51-75% reduction in seizures, 75 (28%) experienced a 76-99% reduction in seizures, and 26 (10%) experienced a complete clinical response. Overall, adverse effects were mild and infrequent, and beneficial side effects such as increased alertness were reported. The majority of patients used cannabidiol (CBD)-enriched artisanal formulas, some with the addition of delta-9-tetrahydrocannabinol (THC) and tetrahydrocannabinolic acid (THCA). Four case reports are included that illustrate clinical responses at doses prevention, the use of THC for seizure rescue, and the synergy of cannabinoids and terpenoids in artisanal preparations. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy". Copyright © 2017 Elsevier Inc. All rights reserved.

  12. [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.

  13. Tissue engineered vascular grafts: Origins, development, and current strategies for clinical application.

    Science.gov (United States)

    Benrashid, Ehsan; McCoy, Christopher C; Youngwirth, Linda M; Kim, Jina; Manson, Roberto J; Otto, James C; Lawson, Jeffrey H

    2016-04-15

    Since the development of a dependable and durable synthetic non-autogenous vascular conduit in the mid-twentieth century, the field of vascular surgery has experienced tremendous growth. Concomitant with this growth, development in the field of bioengineering and the development of different tissue engineering techniques have expanded the armamentarium of the surgeon for treating a variety of complex cardiovascular diseases. The recent development of completely tissue engineered vascular conduits that can be implanted for clinical application is a particularly exciting development in this field. With the rapid advances in the field of tissue engineering, the great hope of the surgeon remains that this conduit will function like a true blood vessel with an intact endothelial layer, with the ability to respond to endogenous vasoactive compounds. Eventually, these engineered tissues may have the potential to supplant older organic but not truly biologic technologies, which are used currently. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Improving performance in golf: current research and implications from a clinical perspective.

    Science.gov (United States)

    Evans, Kerrie; Tuttle, Neil

    2015-01-01

    Golf, a global sport enjoyed by people of all ages and abilities, involves relatively long periods of low intensity exercise interspersed with short bursts of high intensity activity. To meet the physical demands of full swing shots and the mental and physical demands of putting and walking the course, it is frequently recommended that golfers undertake golf-specific exercise programs. Biomechanics, motor learning, and motor control research has increased the understanding of the physical requirements of the game, and using this knowledge, exercise programs aimed at improving golf performance have been developed. However, while it is generally accepted that an exercise program can improve a golfer's physical measurements and some golf performance variables, translating the findings from research into clinical practice to optimise an individual golfer's performance remains challenging. This paper discusses how biomechanical and motor control research has informed current practice and discusses how emerging sophisticated tools and research designs may better assist golfers improve their performance.

  15. SHORT OVERVIEW OF CLINICAL TRIALS WITH CURRENT IMMUNOTHERAPEUTIC TOOLS FOR CANCER TREATMENT

    Directory of Open Access Journals (Sweden)

    T. S. Nepomnyashchikh

    2017-01-01

    Full Text Available Over last decade, a substantial progress has been made, with respect to understanding of cancer biology and its interplay with the host immune system. Different immunotherapeutic drugs based on recombinant cytokines and monoclonal antibodies are widely used in cancer therapy, and a large number of experimental cancer treatments have been developed, many of which are currently undergoing various stages of clinical trials. Recent endorsement of a recombinant oncolytic herpesvirus T-VEC for the treatment of melanoma was an important step towards a more safe and efficient anticancer therapeutics. In this review, we shall mention only some of the most promising cancer immunotherapy strategies, namely, immune checkpoint inhibitors, cellular therapy and oncolytic viruses. 

  16. Regulations in the United States for cell transplantation clinical trials in neurological diseases

    Institute of Scientific and Technical Information of China (English)

    He Zhu; Yuanqing Tan; Qi Gu; Weifang Han; Zhongwen Li; Jason S Meyer; Baoyang Hu

    2015-01-01

    Objective: This study aimed to use a systematic approach to evaluate the current utilization, safety, and effectiveness of cell therapies for neurological diseases in human. And review the present regulations, considering United States (US) as a representative country, for cell transplantation in neurological disease and discuss the challenges facing the field of neurology in the coming decades. Methods:A detailed search was performed in systematic literature reviews of cellular‐based therapies in neurological diseases, using PubMed, web of science, and clinical trials. Regulations of cell therapy products used for clinical trials were searched from the Food and Drug Administration (FDA) and the National Institutes of Health (NIH). Results: Seven most common types of cell therapies for neurological diseases have been reported to be relatively safe with varying degrees of neurological recovery. And a series of regulations in US for cellular therapy was summarized including preclinical evaluations, sourcing material, stem cell manufacturing and characterization, cell therapy product, and clinical trials. Conclusions:Stem cell‐based therapy holds great promise for a cure of such diseases and will value a growing population of patients. However, regulatory permitting activity of the US in the sphere of stem cells, technologies of regenerative medicine and substitutive cell therapy are selective, theoretical and does not fit the existing norm and rules. Compiled well‐defined regulations to guide the application of stem cell products for clinical trials should be formulated.

  17. Current Evidence for Clinical Efficacy of Platelet Rich Plasma in Aesthetic Surgery: A Systematic Review.

    Science.gov (United States)

    Frautschi, Russell S; Hashem, Ahmed M; Halasa, Brianna; Cakmakoglu, Cagri; Zins, James E

    2017-03-01

    Platelet rich plasma (PRP) has attracted attention in a number of surgical fields due to a wide variety of potential clinical benefits. Yet PRP has not gained wide popularity in aesthetic surgery as a result of uncertainty surrounding objective clinical evidence. We aim to describe the current applications, define preparation and activation, explore effectiveness, and propose a classification system to facilitate comparisons across studies. A comprehensive review of the literature regarding the use of platelet rich plasma in aesthetic surgery was performed. Data gathered included: PRP application, study type, subject number, centrifugation, anticoagulation, activation, PRP composition, and outcomes. Thirty-eight reports were identified. Applications included injection into aging skin (29%), scalp alopecia (26%), lipofilling (21%), fractional laser (13%), and facial surgery (11%). The majority of studies (53%) were case series without controls. Leucocytes were sparsely defined (32%). The concentration of injected and/or baseline platelets was rarely clarified (18%). The mechanism of activation was described in 27 studies (71%), while anticoagulation was uncommonly elucidated (47%). While most studies (95%) claim effectiveness, objective measures were only utilized in 17 studies (47%). Current studies produce context-dependent results with a lack of consistent reporting of PRP preparation, composition, and activation in aesthetic applications, making meaningful meta-analysis unrealistic. Thus the method of PRP preparation warrants increased attention. We recommend a set of descriptors, FIT PAAW (described below), to produce scientifically grounded conclusions, facilitating a clearer understanding of the situations in which PRP is effective. 4 © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  18. Effect of localized states on the current-voltage characteristics of metal-semiconductor contacts with thin interfacial layer

    Science.gov (United States)

    Chattopadhyay, P.

    1994-10-01

    The role of discrete localized states on the current-voltage characteristics of metal-semiconductor contact is examined. It is seen that, because of these localized states, the logarithmic current vs voltage characteristics become nonlinear. Such nonlinearity is found sensitive to the temperature, and the energy and density of the localized states. The predicted temperature dependence of barrier height and the current-voltage characteristics are in agreement with the experimental results of Aboelfotoh [ Phys. Rev. B39, 5070 (1989)].

  19. On the structure of intermediate state created by the direct current

    International Nuclear Information System (INIS)

    Kan, Ya.S.; Frolov, V.A.

    1974-01-01

    Observations were made of the structure of an intermediate state formed at the destruction of superconductivity of a cylindrical tin sample by an electric current through it. For this purpose, there was determined the nature of the dependence of the magnetic permeability averaged over a section normal with the sample axis on the position of this section relative to the axis. the quantity actually measured was the inductance of a short (0.5 mm) superconductive probe coil embracing the sample and moving along the axis of the latter. In order the inductance were representatative of the magnetic permeability in the depth of a thick (5 mm in diameter) sample, measurements were made with a direct current by means of the device specially designed for this purpose; the operating principle and method for checking of this device being briefly described in the paper. The curves of oscillations of the inductance of the probe with the latter being moved along the sample suggested a conclusion that the structure of the intermediate state had a periodic nature (of the London type) with a period of 1.3 mm. The reduction of the oscillation amplitude and the increase of their average level while an increase of the current passing through the sample above the critical value (at constant temperature) indicated the reduction of the diameter of the core, being in the intermediate state, and an increase of the thickness of a normal layer. Measurements were made at temperatures (13-17)x10 -3 deg K below Tsub(k) with a current of 2-3 A in the sample

  20. The current state and trends of the development of universities in Ukraine

    Directory of Open Access Journals (Sweden)

    O.B. Morhulets

    2015-09-01

    Full Text Available Education is the basis of social, political, economic, spiritual, and cultural development. Therefore, the study of the current state and trends of the development of Ukrainian universities is a significant factor of social and economic progress of the country.The paper reflects the general state of universities in Ukraine, in particular, the trends in dynamics: the number of students in terms of entry/graduation, sources of financing, education fields; the number of universities in the context of accreditation, types and forms of ownership; the number of outbound Ukrainian and inbound foreign students; quantitative and qualitative characteristics of teaching staff; spending on higher education and the cost of funding per student compared with other countries. The purpose of the study is the assessment of economic activity of higher educational establishments in Ukraine, the identification of problems and tendencies of their development in the context of national transformational processes in education and formation of the society of knowledge. The methodical base used in the study is analysis and synthesis, methods of comparison and generalization, extrapolation, index and graphical methods. The practical value of the study is based on the results of a thorough analysis of university activities. Such results reveal the current state and trends of the development of universities under conditions of higher education transformation in Ukraine and its integration into the European educational area. The results of research improve understanding of the state and problems of the universities and provide the foundations for further research in the field of the national education system development and for improving of the quality of young professionals’ training. The trends of the university development indicate that the reorganization of higher education which is being currently taken place, already results in the emergence of new competencies of

  1. State of malaria diagnostic testing at clinical laboratories in the United States, 2010: a nationwide survey

    Directory of Open Access Journals (Sweden)

    Abanyie Francisca A

    2011-11-01

    Full Text Available Abstract Background The diagnosis of malaria can be difficult in non-endemic areas, such as the United States, and delays in diagnosis and errors in treatment occur too often. Methods A nationwide survey of laboratories in the United States and its nine dependent territories was conducted in 2010 to determine factors that may contribute to shortcomings in the diagnosis of malaria. This survey explored the availability of malaria diagnostic tests, techniques used, and reporting practices. Results The survey was completed by 201 participants. Ninety percent reported that their laboratories had at least one type of malaria diagnostic test available on-site. Nearly all of the respondents' laboratories performed thick and thin smears on-site; approximately 50% had access to molecular testing; and only 17% had access to rapid diagnostic tests on-site. Seventy-three percent reported fewer than five confirmed cases of malaria in their laboratory during the 12-month period preceding the survey. Twenty-eight percent stated that results of species identification took more than 24 hours to report. Only five of 149 respondents that performed testing 24 hours a day, 7 days a week complied with all of the Clinical and Laboratory Standards Institute (CLSI guidelines for analysis and reporting of results. Conclusion Although malaria diagnostic testing services were available to a majority of U.S. laboratories surveyed, very few were in complete compliance with all of the CLSI guidelines for analysis and reporting of results, and most respondents reported very few cases of malaria annually. Laboratories' difficulty in adhering to the rigorous CLSI guidelines and their personnel's lack of practice and proficiency may account for delays and errors in diagnosis. It is recommended that laboratories that infrequently process samples for malaria seek opportunities for practice and proficiency training annually and take advantage of available resources to assist in

  2. Flux nucleation in the current-induced resistive state of a constricted type I superconductor

    International Nuclear Information System (INIS)

    Selig, K.P.; Huebener, R.P.

    1981-01-01

    The current-induced resistive state in a constricted type I superconductor is characterized by a train of flux tubes traversing the sample perpendicular to the direction of the applied current following its nucleation at the sample edge. The temporal structure of the nucleation process can be investigated by attempting to synchronize this process with small periodic current pulses superimposed on the direct bias current. The resistive dc voltage is then to be measured as a function of the pulse parameters such as frequency and width. We have performed such experiments at 4.2 K on constricted Pb films of 6--8 μm thickness and 100 μm width. Simultaneously with the electrical measurements the dynamic behavior of the flux tubes was directly observed using a stroboscopic magnetooptical method for magnetic flux detection. Our electrical measurements clearly show how the size of the nucleated flux tubes varies with the direct bias current and the nucleation frequency. The positive wall energy in the Pb films results in a lower limit for this size as expected. The influence of the preceding flux tubes still existing within the constriction upon the flux nucleation process is revealed in detail. All observations can be understood from a consideration of the energy balance during the flux nucleation process

  3. Current drive studies for the ARIES steady-state tokamak reactors

    International Nuclear Information System (INIS)

    Mau, T.K.; Ehst, D.A.; Mandrekas, J.

    1994-01-01

    Steady-state plasma operating scenarios are designed for three versions of the ARIES reactor, using non-inductive current drive techniques that have an established database. R.f. waves, including fast and lower hybrid waves, are the reference drivers for the D-T burning ARIES-I and ARIES-II/IV, while neutral beam injection is employed for ARIES-III which burns D- 3 He. Plasma equilibria with a high bootstrap-current component have been used, in order to minimize the recirculating power fraction and cost of electricity. To maintain plasma stability, the driven current profile has been aligned with that of equilibrium by proper choices of the plasma profiles and power launch parameters. Except for ARIES-III, the current-drive power requirements and the relevant technology developments are found to be quite reasonable. The wave-power spectrum and launch requirements are also considered achievable with a modest development effort. Issues such as an improved database for fast-wave current drive, lower-hybrid power coupling to the plasma edge, profile control in the plasma core, and access to the design point of operation remain to be addressed. ((orig.))

  4. Mass transport and the bootstrap current from Ohm's law in steady-state tokamaks

    International Nuclear Information System (INIS)

    Kim, J.-S.; Greene, J.M.

    1989-01-01

    The consequences of mass conservation and Ohm's law are examined for steady state Tokamaks. In a Tokamak, magnetofluid-dynamic waves rapidly equilibrate pressure and toroidal field along magnetic surfaces. As a result, the detailed current distribution is determined by the flux surface averaged poloidal and toroidal currents. The electrons that carry the plasma current are impeded in their motion by interactions with ions, which is resistivity and its generalizations, and by interactions with electrons, which is viscosity and its generalizations. The important viscous terms arise from the interaction between trapped and untrapped electrons, and so viscosity acts by impeding poloidal current. properly chosen, the results of neoclassical theory are The neoclassical viscous coefficient is here regarded as less likely than Spitzer conductivity to be experimentally relevant in a turbulent Tokamak. Thus, the toroidal Ohm's law is regarded as being more reliable than the poloidal Ohm's law. A combination of toroidal and poloidal Ohm's law, namely the component parallel to the magnetic field, eliminates the influence of plasma fueling, and directly relates the bootstrap current and the pressure gradient. The latter is the usual relation, but, since i

  5. Human iPS Cell-Derived Germ Cells: Current Status and Clinical Potential

    Directory of Open Access Journals (Sweden)

    Tetsuya Ishii

    2014-10-01

    Full Text Available Recently, fertile spermatozoa and oocytes were generated from mouse induced pluripotent (iPS cells using a combined in vitro and in vivo induction system. With regard to germ cell induction from human iPS cells, progress has been made particularly in the male germline, demonstrating in vitro generation of haploid, round spermatids. Although iPS-derived germ cells are expected to be developed to yield a form of assisted reproductive technology (ART that can address unmet reproductive needs, genetic and/or epigenetic instabilities abound in iPS cell generation and germ cell induction. In addition, there is still room to improve the induction protocol in the female germline. However, rapid advances in stem cell research are likely to make such obstacles surmountable, potentially translating induced germ cells into the clinical setting in the immediate future. This review examines the current status of the induction of germ cells from human iPS cells and discusses the clinical potential, as well as future directions.

  6. The Current Status of The Clinical Application of Radioisotope in Korea

    International Nuclear Information System (INIS)

    Lee, Myung Chul

    1987-01-01

    The medical application of radioisotope started in the western countries in the 1920's but the first successful clinical use of Nuclear Medicine in Korea was made in June, 1959, through the treatment of a patient with hyperthyroidism using radioactive iodine. However, keeping pace with the brilliant international development of nuclear medicine, nuclear medicine in Korea has remarkably grown scientifically; The Korean Society of Nuclear Medicine was organized in 1961, The Radiology Science Institute attached to the Korea Atomic Energy Research Institute, the predecessor of the Korea Cancer Center Hospital, was established in 1963, and The Korean Journal of Nuclear Medicine published its first issue in 1967. Furthermore, the active studies using radioisotopes and the vigorous interchanges of information with foreign countries had increased so steadily and remarkably that we could hold the 3rd Asia and Oceania Congress of Nuclear Medicine in 1984. In Korea, Nuclear Medicine has now settled as a field of a science which interests lots of medical doctors and scientists. However, I cannot deny the fact that the progress of the development of Nuclear Medicine in Korea tends to defer relatively to that of the western countries, which is naturally a very active one, in many respects. I here would like to analyze the current status of clinical application of radioisotope in Korea, find the problems and present their solutions

  7. Bipolar disorder and complementary medicine: current evidence, safety issues, and clinical considerations.

    Science.gov (United States)

    Sarris, Jerome; Lake, James; Hoenders, Rogier

    2011-10-01

    Bipolar disorder (BD) is a debilitating syndrome that is often undiagnosed and undertreated. Population surveys show that persons with BD often self-medicate with complementary and alternative medicine (CAM) or integrative therapies in spite of limited research evidence supporting their use. To date, no review has focused specifically on nonconventional treatments of BD. The study objectives were to present a review of nonconventional (complementary and integrative) interventions examined in clinical trials on BD, and to offer provisional guidelines for the judicious integrative use of CAM in the management of BD. PubMed, CINAHL,(®) Web of Science, and Cochrane Library databases were searched for human clinical trials in English during mid-2010 using Bipolar Disorder and CAM therapy and CAM medicine search terms. Effect sizes (Cohen's d) were also calculated where data were available. Several positive high-quality studies on nutrients in combination with conventional mood stabilizers and antipsychotic medications in BD depression were identified, while branched-chain amino acids and magnesium were effective (small studies) in attenuating mania in BD. In the treatment of bipolar depression, evidence was mixed regarding omega-3, while isolated studies provide provisional support for a multinutrient formula, n-acetylcysteine, and l-tryptophan. In one study, acupuncture was found to have favorable but nonsignificant effects on mania and depression outcomes. Current evidence supports the integrative treatment of BD using combinations of mood stabilizers and select nutrients. Other CAM or integrative modalities used to treat BD have not been adequately explored to date; however, some early findings are promising. Select CAM and integrative interventions add to established conventional treatment of BD and may be considered when formulating a treatment plan. It is hoped that the safety issues and clinical considerations addressed in this article may encourage the practice

  8. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies

    Energy Technology Data Exchange (ETDEWEB)

    England, Christopher G. [University of Wisconsin School of Medicine and Public Health, Department of Medical Physics, Madison, WI (United States); Rui, Lixin [University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center, Madison, WI (United States); Cai, Weibo [University of Wisconsin School of Medicine and Public Health, Department of Medical Physics, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States)

    2017-03-15

    Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future. (orig.)

  9. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies

    International Nuclear Information System (INIS)

    England, Christopher G.; Rui, Lixin; Cai, Weibo

    2017-01-01

    Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future. (orig.)

  10. REMOTE DIAGNOSTICS OF TURNOUTS STATE ON TIMING AND SPECTRAL COMPOSITION IN CURRENT CURVE

    Directory of Open Access Journals (Sweden)

    S. Yu. Buryak

    2015-03-01

    Full Text Available Purpose. Development and implementation the points system diagnostics that would allow determining remotely the current state of turnout with all possible faults, gradual and sudden failures, damages, and in real time to report about their appearance. Methodology. State diagnostics on the values analysis of turnout main parameters is proposed to carry out with the help of a computer and analog-to-digital converter (ADC. Connecting measurements performance is advisable to produce to a shunt ammeter, installed in the working circuit of the point feed panel. ADC converts the analog signal of lost volts at the shunt into digital form and transmits it to a computer which stores the received data on its own recording medium for their further processing and storage. There is special software that is capable to reconnect signal and construct its temporal characteristic as well as decompose it on the spectral components. Using it one can analyze the obtained data, which allows diagnosing state of points upon change the nature, values and composition of the current curve. Findings. The computer diagnosis method was confirmed in practice for possible indications of problems that are associated with both the mechanical part of the turnout and the electrical part of it, while controlling parameters such as the amount of current normal transition, when working on frictions, the duration of the transition, properly adjusted headset and attachment points, the state of the motor. Originality. The use of computer technology in the diagnosis of the state of turnouts during their operation to monitor the current values of technical indicators, analysis and storage for all types of electric switches with different types of engines both DC and AC occurs through digitization and recording signal from measuring shunt of point feeder panel. Practical value. The proposed method enables timely, still in the early stages of defect parts, damages or failures of nodes

  11. Current reversals and metastable states in the infinite Bose-Hubbard chain with local particle loss

    Science.gov (United States)

    Kiefer-Emmanouilidis, M.; Sirker, J.

    2017-12-01

    We present an algorithm which combines the quantum trajectory approach to open quantum systems with a density-matrix renormalization-group scheme for infinite one-dimensional lattice systems. We apply this method to investigate the long-time dynamics in the Bose-Hubbard model with local particle loss starting from a Mott-insulating initial state with one boson per site. While the short-time dynamics can be described even quantitatively by an equation of motion (EOM) approach at the mean-field level, many-body interactions lead to unexpected effects at intermediate and long times: local particle currents far away from the dissipative site start to reverse direction ultimately leading to a metastable state with a total particle current pointing away from the lossy site. An alternative EOM approach based on an effective fermion model shows that the reversal of currents can be understood qualitatively by the creation of holon-doublon pairs at the edge of the region of reduced particle density. The doublons are then able to escape while the holes move towards the dissipative site, a process reminiscent—in a loose sense—of Hawking radiation.

  12. Status and current spent fuel storage practices in the United States

    International Nuclear Information System (INIS)

    Lake, W.H.

    1999-01-01

    Brief discussions are presented on the history and state of spent fuel generation by utilities that comprise the United States commercial nuclear power industry, the current situation regarding the Federal government's nuclear waste policy, and evolving spent fuel storage practices. These evolving spent fuel storage practices are the result of private sector initiatives, but appear to be influenced by various external factors. The paper is not intended to provide a comprehensive appraisal of the storage initiatives being conducted by the private sector. The focus, instead, is on the Federal government's role and activities related to spent fuel management. Although the Federal government has adopted a policy calling for deep geological disposal of spent fuel, the US Congress has recently begun to consider expanding that policy to include a centralized interim storage facility. In the absence of such an expanded policy, the Department of Energy has performed some preliminary activities that would expedite development of a centralized interim storage facility, if Congress were to enact such a policy. The Department's current activities with regard to developing a centralized interim storage facility, which are consistent with the current policy, are described in the paper. The paper also describes two important technical development activities that have been conducted by the Department of Energy to support improved efficiency in spent fuel management. The Department's activities regarding development of a burnup credit methodology, and a dry transfer system are summarized. (author)

  13. [Are we still our patients' keepers?: James Drane's contribution to clinical ethics in the current context].

    Science.gov (United States)

    Herreros, B; Real de Asua, D; Palacios, G

    The current article analyzes the figure of the American bioethicist James Drane (1930). Drane not only played a crucial role in the birth of Bioethics in the United States, but was also instrumental in the inception and development of the field in Spain and Latin America. His «sliding scale» was the first dynamic tool encouraging a systematic evaluation of a patient's capacity to make healthcare-related decisions. However Drane's major contribution to the field was his application of virtue Ethics to the doctor-patient relationship. His proposal rests on the physician's compromise with the patient in all his/her dimensions. This goal will guide the physician's character and serve as compass, with which to exercise a virtuous practice, since only by exercising these virtues can doctors become truly good. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Current status of investigations in the field of solid state science in central Kazakstan region

    International Nuclear Information System (INIS)

    Kuketaev, T.A.

    1999-01-01

    Investigations in the field of solid state science were initiated together with foundation of University in Karaganda. Historically general investigations in this field were conducted for scientific directions related to optical, luminescent and radiation properties of wide gap insulator. This activity was carried out according to appropriate plans of coordination counsels en-gaged in the physics of insulators, luminescent and radiation physics at the Academy of Science USSR and in the Committee on sciences and engineering of the Counsel of Ministers of the USSR. A number of works were coordinated by the Academy of Sciences of Kazakhstan Republic. Investigations in the field of solid state science, con-ducted in the Central Kazakstan and coordinated by the Institute of Physics and Engineering of Kazakhstan National Academy of Sciences, can be currently distinguished according to scientific directions. Currently, the following scientific directions in the field of solid state science exist in the Central Kazakstan: influence of polymorph phase transitions on electron excitation in wide-gap crystals, radiation malformation and recombination, dielectric spectroscopy of crystals with hydrogen link, spectral and luminescent properties and energy migration processes in disordered and partly ordered systems of organic molecules. It is necessary to note that all investigated objects, described in this report, were recovered by investigators. That is, the relevant hardware is available

  15. Fed-state gastric media and drug analysis techniques: Current status and points to consider.

    Science.gov (United States)

    Baxevanis, Fotios; Kuiper, Jesse; Fotaki, Nikoletta

    2016-10-01

    Gastric fed state conditions can have a significant effect on drug dissolution and absorption. In vitro dissolution tests with simple aqueous media cannot usually predict drugs' in vivo response, as several factors such as the meal content, the gastric emptying and possible interactions between food and drug formulations can affect drug's pharmacokinetics. Good understanding of the effect of the in vivo fed gastric conditions on the drug is essential for the development of biorelevant dissolution media simulating the gastric environment after the administration of the standard high fat meal proposed by the FDA and the EMA in bioavailability/bioequivalence (BA/BE) studies. The analysis of drugs in fed state media can be quite challenging as most analytical protocols currently employed are time consuming and labour intensive. In this review, an overview of the in vivo gastric conditions and the biorelevant media used for their in vitro simulation are described. Furthermore an analysis of the physicochemical properties of the drugs and the formulations related to food effect is given. In terms of drug analysis, the protocols currently used for the fed state media sample treatment and analysis and the analytical challenges and needs emerging for more efficient and time saving techniques for a broad spectrum of compounds are being discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Assessment of Energy Production Potential from Ocean Currents along the United States Coastline

    Energy Technology Data Exchange (ETDEWEB)

    Haas, Kevin

    2013-09-15

    Increasing energy consumption and depleting reserves of fossil fuels have resulted in growing interest in alternative renewable energy from the ocean. Ocean currents are an alternative source of clean energy due to their inherent reliability, persistence and sustainability. General ocean circulations exist in the form of large rotating ocean gyres, and feature extremely rapid current flow in the western boundaries due to the Coriolis Effect. The Gulf Stream system is formed by the western boundary current of the North Atlantic Ocean that flows along the east coastline of the United States, and therefore is of particular interest as a potential energy resource for the United States. This project created a national database of ocean current energy resources to help advance awareness and market penetration in ocean current energy resource assessment. The database, consisting of joint velocity magnitude and direction probability histograms, was created from data created by seven years of numerical model simulations. The accuracy of the database was evaluated by ORNL?s independent validation effort documented in a separate report. Estimates of the total theoretical power resource contained in the ocean currents were calculated utilizing two separate approaches. Firstly, the theoretical energy balance in the Gulf Stream system was examined using the two-dimensional ocean circulation equations based on the assumptions of the Stommel model for subtropical gyres with the quasi-geostrophic balance between pressure gradient, Coriolis force, wind stress and friction driving the circulation. Parameters including water depth, natural dissipation rate and wind stress are calibrated in the model so that the model can reproduce reasonable flow properties including volume flux and energy flux. To represent flow dissipation due to turbines additional turbine drag coefficient is formulated and included in the model. Secondly, to determine the reasonableness of the total power

  17. Shallow Lunar Seismic Activity and the Current Stress State of the Moon

    Science.gov (United States)

    Watters, Thomas R.; Weber, Renee C.; Collins, Geoffrey C.; Johnson, Catherine L.

    2017-01-01

    A vast, global network of more than 3200 lobate thrust fault scarps has been revealed in high resolution Lunar Reconnaissance Orbiter Camera (LROC) images. The fault scarps are very young, less than 50 Ma, based on their small scale and crisp appearance, crosscutting relations with small-diameter impact craters, and rates of infilling of associated small, shallow graben and may be actively forming today. The population of young thrust fault scarps provides a window into the recent stress state of the Moon and offers insight into the origin of global lunar stresses. The distribution of orientations of the fault scarps is non-random, inconsistent with isotropic stresses from late-stage global contraction as the sole source of stress. Modeling shows that tidal stresses contribute significantly to the current stress state of the lunar crust. Tidal stresses (orbital recession and diurnal tides) superimposed on stresses from global contraction result in non-isotropic compressional stress and may produce thrust faults consistent with lobate scarp orientations. At any particular point on the lunar surface, peak compressive stress will be reached at a certain time in the diurnal cycle. Coseismic slip events on currently active thrust faults are expected to be triggered when peak stresses are reached. Analysis of the timing of the 28 the shallow moonquakes recorded by the Apollo seismic network shows that 19 indeed occur when the Moon is closer to apogee, while only 9 shallow events occur when the Moon is closer to perigee. Here we report efforts to refine the model for the current stress state of the Moon by investigating the contribution of polar wander. Progress on relocating the epicentral locations of the shallow moonquakes using an algorithm designed for sparse networks is also reported.

  18. Current-State Constrained Filter Bank for Wald Testing of Spacecraft Conjunctions

    Science.gov (United States)

    Carpenter, J. Russell; Markley, F. Landis

    2012-01-01

    We propose a filter bank consisting of an ordinary current-state extended Kalman filter, and two similar but constrained filters: one is constrained by a null hypothesis that the miss distance between two conjuncting spacecraft is inside their combined hard body radius at the predicted time of closest approach, and one is constrained by an alternative complementary hypothesis. The unconstrained filter is the basis of an initial screening for close approaches of interest. Once the initial screening detects a possibly risky conjunction, the unconstrained filter also governs measurement editing for all three filters, and predicts the time of closest approach. The constrained filters operate only when conjunctions of interest occur. The computed likelihoods of the innovations of the two constrained filters form a ratio for a Wald sequential probability ratio test. The Wald test guides risk mitigation maneuver decisions based on explicit false alarm and missed detection criteria. Since only current-state Kalman filtering is required to compute the innovations for the likelihood ratio, the present approach does not require the mapping of probability density forward to the time of closest approach. Instead, the hard-body constraint manifold is mapped to the filter update time by applying a sigma-point transformation to a projection function. Although many projectors are available, we choose one based on Lambert-style differential correction of the current-state velocity. We have tested our method using a scenario based on the Magnetospheric Multi-Scale mission, scheduled for launch in late 2014. This mission involves formation flight in highly elliptical orbits of four spinning spacecraft equipped with antennas extending 120 meters tip-to-tip. Eccentricities range from 0.82 to 0.91, and close approaches generally occur in the vicinity of perigee, where rapid changes in geometry may occur. Testing the method using two 12,000-case Monte Carlo simulations, we found the

  19. Tidal Stream Generators, current state and potential opportunities for condition monitoring

    DEFF Research Database (Denmark)

    Kappatos, Vassilios; Georgoulas, George; Avdelidis, Nicolas

    2016-01-01

    Tidal power industry has made significant progress towards commercialization over the past decade. Significant investments from sector leaders, strong technical progress and positive media coverage have established the credibility of this specific renewable energy source. However, its progress...... is being retarded by operation and maintenance problems, which results in very low operational availability times, as low as 25 %. This paper presents a literature review of the current state of tidal device operators as well as some commercial tidal turbine condition monitoring solutions. Furthermore......, an overview is given of the global tidal activity status (tidal energy market size and geography), the key industry activity and the regulations-standards related with tidal energy industry. Therefore, the main goal of this paper is to provide a bird’s view of the current status of the tidal power industry...

  20. Overview of steady-state tokamak operation and current drive experiments in TRIAM-1M

    International Nuclear Information System (INIS)

    Zushi, H.; Nakamura, K.; Hanada, K.

    2005-01-01

    Experiments aiming at 'day long operation at high performance' have been carried out. The record value of the discharge duration was updated to 5 h and 16 min. Steady-state tokamak operation (SSTO) is studied under the localized PWI conditions. The distributions of the heat load, the particle recycling flux and impurity source are investigated to understand the co-deposition and wall pumping. Formation and sustainment of an internal transport barrier ITB in enhanced current drive mode (ECD) has been investigated by controlling the lower hybrid driven current profile by changing the phase spectrum. An ITER relevant remote steering antenna for electron cyclotron wave ECW injection was installed and a relativistic Doppler resonance of the oblique propagating extraordinary wave with energetic electrons driven by lower hybrid waves was studied. (author)

  1. The History of Liquid Ear Acupuncture and the Current Scientific State of the Art

    Directory of Open Access Journals (Sweden)

    Daniela Litscher

    2016-06-01

    Full Text Available This short review article presents a current overview of existing publications and scientific results regarding liquid (ear acupuncture. The injection of liquids into defined acupuncture points of the ear is not a method commonly used in the Western world. The term liquid acupuncture has different definitions, which makes understanding each definition and differentiating one from the other difficult. General terms like pharmacopuncture, homeosiniatry, and liquid acupuncture, which all describe the method of injecting different kinds of drugs into a defined body acupuncture point, are used. This article presents the history of liquid acupuncture, as well as the current scientific state of the art, from the point of view of two European researchers. Some articles are discussed and a few practical examples are presented.

  2. Current State and Future Perspectives of Energy Sources for Totally Implantable Cardiac Devices.

    Science.gov (United States)

    Bleszynski, Peter A; Luc, Jessica G Y; Schade, Peter; PhilLips, Steven J; Tchantchaleishvili, Vakhtang

    There is a large population of patients with end-stage congestive heart failure who cannot be treated by means of conventional cardiac surgery, cardiac transplantation, or chronic catecholamine infusions. Implantable cardiac devices, many designated as destination therapy, have revolutionized patient care and outcomes, although infection and complications related to external power sources or routine battery exchange remain a substantial risk. Complications from repeat battery replacement, power failure, and infections ultimately endanger the original objectives of implantable biomedical device therapy - eliminating the intended patient autonomy, affecting patient quality of life and survival. We sought to review the limitations of current cardiac biomedical device energy sources and discuss the current state and trends of future potential energy sources in pursuit of a lifelong fully implantable biomedical device.

  3. Analysis of Steady-State Error in Torque Current Component Control of PMSM Drive

    Directory of Open Access Journals (Sweden)

    BRANDSTETTER, P.

    2017-05-01

    Full Text Available The paper presents dynamic properties of a vector controlled permanent magnet synchronous motor drive supplied by a voltage source inverter. The paper deals with a control loop for the torque producing stator current. There is shown fundamental mathematical description for the vector control structure of the permanent magnet synchronous motor drive with respect to the current control for d-axis and q-axis of the rotor rotating coordinate system. The derivations of steady-state deviation for schemes with and without decoupling circuits are described for q-axis. The properties of both schemes are verified by MATLAB-SIMULINK program considering a lower and a higher value of inertia and by experimental measurements in our laboratory. The simulation and experimental results are presented and discussed at the end of the paper.

  4. An In-Rush Current Suppression Technique for the Solid-State Transfer Switch System

    Science.gov (United States)

    Cheng, Po-Tai; Chen, Yu-Hsing

    More and more utility companies provide dual power feeders as a premier service of high power quality and reliability. To take advantage of this, the solid-state transfer switch (STS) is adopted to protect the sensitive load against the voltage sag. However, the fast transfer process may cause in-rush current on the load-side transformer due to the resulting DC-offset in its magnetic flux as the load-transfer is completed. The in-rush current can reach 2∼6 p.u. and it may trigger the over-current protections on the power feeder. This paper develops a flux estimation scheme and a thyristor gating scheme based on the impulse commutation bridge STS (ICBSTS) to minimize the DC-offset on the magnetic flux. By sensing the line voltages of both feeders, the flux estimator can predict the peak transient flux linkage at the moment of load-transfer and evaluate a suitable moment for the transfer to minimize the in-rush current. Laboratory test results are presented to validate the performance of the proposed system.

  5. Nanomedicine applications in the treatment of breast cancer: current state of the art

    Directory of Open Access Journals (Sweden)

    Wu D

    2017-08-01

    Full Text Available Di Wu, Mengjie Si, Hui-Yi Xue, Ho-Lun Wong Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA, USA Abstract: Breast cancer is the most common malignant disease in women worldwide, but the current drug therapy is far from optimal as indicated by the high death rate of breast cancer patients. Nanomedicine is a promising alternative for breast cancer treatment. Nanomedicine products such as Doxil® and Abraxane® have already been extensively used for breast cancer adjuvant therapy with favorable clinical outcomes. However, these products were originally designed for generic anticancer purpose and not specifically for breast cancer treatment. With better understanding of the molecular biology of breast cancer, a number of novel promising nanotherapeutic strategies and devices have been developed in recent years. In this review, we will first give an overview of the current breast cancer treatment and the updated status of nanomedicine use in clinical setting, then discuss the latest important trends in designing breast cancer nanomedicine, including passive and active cancer cell targeting, breast cancer stem cell targeting, tumor microenvironment-based nanotherapy and combination nanotherapy of drug-resistant breast cancer. Researchers may get insight from these strategies to design and develop nanomedicine that is more tailored for breast cancer to achieve further improvements in cancer specificity, antitumorigenic effect, antimetastasis effect and drug resistance reversal effect. Keywords: nanomedicine, breast cancer, targeted delivery, drug therapy, drug resistance, tumor microenvironment 

  6. Nanomedicine applications in the treatment of breast cancer: current state of the art.

    Science.gov (United States)

    Wu, Di; Si, Mengjie; Xue, Hui-Yi; Wong, Ho-Lun

    2017-01-01

    Breast cancer is the most common malignant disease in women worldwide, but the current drug therapy is far from optimal as indicated by the high death rate of breast cancer patients. Nanomedicine is a promising alternative for breast cancer treatment. Nanomedicine products such as Doxil ® and Abraxane ® have already been extensively used for breast cancer adjuvant therapy with favorable clinical outcomes. However, these products were originally designed for generic anticancer purpose and not specifically for breast cancer treatment. With better understanding of the molecular biology of breast cancer, a number of novel promising nanotherapeutic strategies and devices have been developed in recent years. In this review, we will first give an overview of the current breast cancer treatment and the updated status of nanomedicine use in clinical setting, then discuss the latest important trends in designing breast cancer nanomedicine, including passive and active cancer cell targeting, breast cancer stem cell targeting, tumor microenvironment-based nanotherapy and combination nanotherapy of drug-resistant breast cancer. Researchers may get insight from these strategies to design and develop nanomedicine that is more tailored for breast cancer to achieve further improvements in cancer specificity, antitumorigenic effect, antimetastasis effect and drug resistance reversal effect.

  7. Life cycle impacts and costs of photovoltaic systems: Current state of the art and future outlooks

    Energy Technology Data Exchange (ETDEWEB)

    Raugei, Marco [Environmental Management Research Group, Escola Superior de Commerc Internacional-Universitat Pompeu Fabra, Passeig Pujades 1, 08003 Barcelona (Spain); Frankl, Paolo [Renewable Energy Unit, International Energy Agency, Rue de la Federation 9, 75739 Paris Cedex 15 (France)

    2009-03-15

    The photovoltaic energy sector is rapidly expanding and technological specification for PV has improved dramatically in the last two decades. This paper sketches the current state of the art and drafts three alternative scenarios for the future, in terms of costs, market penetration and environmental performance. According to these scenarios, if economic incentives are supported long enough into the next ten to twenty years, PV looks set for a rosy future, and is likely to play a significant role in the future energy mix, while at the same time contributing to reduce the environmental impact of electricity supply. (author)

  8. Learning Styles of Pilots Currently Qualified in United States Air Force Aircraft

    Science.gov (United States)

    Kanske, Craig A.

    2001-01-01

    Kolb's Learning Style Inventory was used to identify the predominant learning styles of pilots currently qualified in United States Air Force aircraft. The results indicate that these pilots show a significant preference for facts and things over people and feelings. By understanding the preferred learning styles of the target population, course material can be developed that take advantage of the strengths of these learning styles. This information can be especially useful in the future design of cockpit resource management training. The training program can be developed to demonstrate both that there are different learning styles and that it is possible to take advantage of the relative strengths of each of these learning styles.

  9. Life cycle impacts and costs of photovoltaic systems: Current state of the art and future outlooks

    International Nuclear Information System (INIS)

    Raugei, Marco; Frankl, Paolo

    2009-01-01

    The photovoltaic energy sector is rapidly expanding and technological specification for PV has improved dramatically in the last two decades. This paper sketches the current state of the art and drafts three alternative scenarios for the future, in terms of costs, market penetration and environmental performance. According to these scenarios, if economic incentives are supported long enough into the next ten to twenty years, PV looks set for a rosy future, and is likely to play a significant role in the future energy mix, while at the same time contributing to reduce the environmental impact of electricity supply. (author)

  10. International conference. Mental health consequences of the Chernobyl disaster: current state and future prospects

    International Nuclear Information System (INIS)

    Nyagu, A.I.

    1995-01-01

    Proceedings of the International Conference on the mental health consequences of the Chernobyl disaster: current state and future prospects was introduced.The questions connected with: 1. Mental health disorders biological basis after ionizing radiation influence; 2. Psychiatric aspects of the Chernobyl disaster; 3. Social stress following contradictory information: ways for its overcoming; 4. Rehabilitation and prophylactic measures for mental and nervous disorders. Psycho social rehabilitation of survivors; 5. Psychosomatic effects and somato-neurological consequences of the Chernobyl disaster; 6. Psychosomatic health of children and adolescents survivors of the Chernobyl disaster; 7. Brain damage as result of prenatal irradiation

  11. Passive measurement of flux nucleation in the current-induced resistive state of type I superconductors

    International Nuclear Information System (INIS)

    Selig, K.P.; Chimenti, D.E.; Huebener, R.P.

    1978-01-01

    Flux-tube nucleation rates have been measured in the current-induced resistive state of type I superconducting In films between 1.5 and 2.0 K by a completely passive technique. Indication of periodic nucleation is observed only in narrow regions of sample voltage drop, whose position is a sensitive function of temperature. Frequency bandwidth measurements of the nucleation rate yield a spectral purity of one part in 10 4 within the narrow regions where an experimental signal can be detected. (orig.) [de

  12. Globalization of Gerontology Education: Current Practices and Perceptions for Graduate Gerontology Education in the United States

    Science.gov (United States)

    MWANGI, SAMUEL M.; YAMASHITA, TAKASHI; EWEN, HEIDI H.; MANNING, LYDIA K.; KUNKEL, SUZANNE R.

    2013-01-01

    The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education. PMID:22490075

  13. Fractal-Based Methods and Inverse Problems for Differential Equations: Current State of the Art

    Directory of Open Access Journals (Sweden)

    Herb E. Kunze

    2014-01-01

    Full Text Available We illustrate, in this short survey, the current state of the art of fractal-based techniques and their application to the solution of inverse problems for ordinary and partial differential equations. We review several methods based on the Collage Theorem and its extensions. We also discuss two innovative applications: the first one is related to a vibrating string model while the second one considers a collage-based approach for solving inverse problems for partial differential equations on a perforated domain.

  14. Current state and controversies in fertility preservation in women with breast cancer.

    Science.gov (United States)

    Taylan, Enes; Oktay, Kutluk H

    2017-06-10

    On average, over 25000 women are diagnosed with breast cancer under the age of 45 annually in the United States. Because an increasing number of young women delay childbearing to later life for various reasons, a growing population of women experience breast cancer before completing childbearing. In this context, preservation of fertility potential of breast cancer survivors has become an essential concept in modern cancer care. In this review, we will outline the currently available fertility preservation options for women with breast cancer of reproductive age, discuss the controversy behind hormonal suppression for gonadal protection against chemotherapy and highlight the importance of timely referral by cancer care providers.

  15. Film-induced Tourism in Finland : Its Current State and Opportunities

    OpenAIRE

    Anul, Kezban

    2013-01-01

    The goal of this paper was to evaluate the current state of film-induced tourism in Finland and to create suggestions for further development in the context of international markets. To the knowledge of the author, a comprehensive study about film-induced tourism in Finland has not been undertaken yet. Therefore, the thesis was designed in the form of an exploratory research with the aim to deliver some initial insights and key issues for the broad topic. The paper starts with a general ...

  16. Current State of Agile Methodologies Worldwide and in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Martin Tománek

    2015-06-01

    Full Text Available The objective of this research paper is to compare the current state of agile methodologies in the world and in the Czech Republic. The comparison is executed as the comparative analysis of two publicly available researches conducted in 2013 and published in 2014. The comparison is further enriched by the results of the unpublished survey in the global logistics company which was conducted also in 2013. The potential trend for agile methodologies in the Czech Republic is also discussed with regard to the worldwide trend.

  17. Metrology positronic issuers for nuclear medicine in Cuba: current state and development prospects

    International Nuclear Information System (INIS)

    Oropesa Verdecia, Pilar; Serra Águila, Rolando A.; García Rodríguez, Lourdes; Moreno León, Yecenia; Bell Hechavarría, Ailec; Jénez Magaña, Yoel

    2016-01-01

    At work the current state of metrology positronic issuers for nuclear medicine in Cuba is presented. the main achievements in the implementation of measurement standards and issues affecting the uncertainty of measurements at different levels of hierarchy of the existing chain of traceability for determinations of the activity of F-18 and Ga-68 is described, the main radionuclides expected to be used in the short term in PET and PET / CT applications in the country. Immediate prospects development of measurement standards positronic emitters for use in nuclear medicine in Cuba, in particular the possibilities of establishing equivalence between Cuban standards and national and international standards are also set. (author)

  18. Globalization of gerontology education: current practices and perceptions for graduate gerontology education in the United States.

    Science.gov (United States)

    Mwangi, Samuel M; Yamashita, Takashi; Ewen, Heidi H; Manning, Lydia K; Kunkel, Suzanne R

    2012-01-01

    The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education.

  19. 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

  20. Clinical cardiac positron emission tomography: State of the art

    International Nuclear Information System (INIS)

    Gould, K.L.

    1991-01-01

    Cardiac positron emission tomography (PET) has evolved rapidly from a relatively esoteric research tool into clinical applications providing unique, quantitative information on myocardial perfusion, metabolism, and cell membrane function and having a potentially significant impact on cardiovascular medicine. Although there are many different positron radionuclides for imaging diverse myocardial behavior, three radionuclides have reached accepted clinical utility. Cardiac PET using nitrogen-13-ammonia, rubidium-82, and fluoro-18-deoxyglucose has proved accurate and definitive in multiple university and private-practice sites for diagnosing and assessing severity and location of coronary artery disease in symptomatic or asymptomatic patients, for identifying injured but viable myocardium potentially salvageable by revascularization, and for ruling out clinically significant coronary artery stenosis with a high specificity in patients who might otherwise undergo coronary arteriography to document the absence of significant disease. 89 references

  1. Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.

    Science.gov (United States)

    Russo, Ethan B

    2016-01-01

    Medicine continues to struggle in its approaches to numerous common subjective pain syndromes that lack objective signs and remain treatment resistant. Foremost among these are migraine, fibromyalgia, and irritable bowel syndrome, disorders that may overlap in their affected populations and whose sufferers have all endured the stigma of a psychosomatic label, as well as the failure of endless pharmacotherapeutic interventions with substandard benefit. The commonality in symptomatology in these conditions displaying hyperalgesia and central sensitization with possible common underlying pathophysiology suggests that a clinical endocannabinoid deficiency might characterize their origin. Its base hypothesis is that all humans have an underlying endocannabinoid tone that is a reflection of levels of the endocannabinoids, anandamide (arachidonylethanolamide), and 2-arachidonoylglycerol, their production, metabolism, and the relative abundance and state of cannabinoid receptors. Its theory is that in certain conditions, whether congenital or acquired, endocannabinoid tone becomes deficient and productive of pathophysiological syndromes. When first proposed in 2001 and subsequently, this theory was based on genetic overlap and comorbidity, patterns of symptomatology that could be mediated by the endocannabinoid system (ECS), and the fact that exogenous cannabinoid treatment frequently provided symptomatic benefit. However, objective proof and formal clinical trial data were lacking. Currently, however, statistically significant differences in cerebrospinal fluid anandamide levels have been documented in migraineurs, and advanced imaging studies have demonstrated ECS hypofunction in post-traumatic stress disorder. Additional studies have provided a firmer foundation for the theory, while clinical data have also produced evidence for decreased pain, improved sleep, and other benefits to cannabinoid treatment and adjunctive lifestyle approaches affecting the ECS.

  2. CLINICAL AND FUNCTIONAL FEATURES OF PANCREAS STATE IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    O. O. Basieva

    2000-01-01

    Full Text Available Aim of study: complex pancreas study in rheumatoid arthritis (RA. Material and methods: 120 RA pts were examined clinically Pancreas US-and biochemical study (level of a-amylase and lipase of blood serum by kinetic-calorimetric method was performed in this grouh. Results: 50.8% of pts demonstrated increase of pancreas echo, in 23.3%- widened Wirsung s duct, in 45%- single small focal indurations, more often in the body and cauda pancreatis. Decrease of lipolitic and amylolytic pancreas activity is characteristic for RA, especially in systemic process and long-term disease. Clinical and functional disturbances are connected with morphological changes.

  3. Physical therapists' perceptions of sexual boundaries in clinical practice in the United States.

    Science.gov (United States)

    Roush, Susan E; Cox, Kenneth; Garlick, John; Kane, Molly; Marchand, Lauren

    2015-07-01

    Physical therapists' perceptions of sexual boundaries in clinic settings in the United States have not been studied. Given the magnitude of potential consequences of sexual boundary violations, examination of this topic is imperative. The purpose of this study was to describe the perceptions of sexual boundaries among licensed physical therapists in the United States. Licensed physical therapists from Arkansas, Kansas, Maine, Ohio, and Oregon were contacted by email and asked to complete a sexual boundaries questionnaire via Survey Monkey™; 967 surveys (7.3%) were returned. While most physical therapists practice within the profession's Code of Ethics, there are practitioners who date current and former patients, and condone patients' sexual banter in the clinic. Almost half (42%) of the participants acknowledged feeling sexually attracted to a patient. While gender differences were seen throughout the analyses, generally, the demographic and professional variables did not account for meaningful variance. Results were similar to previous research on physiotherapists in other countries. Sexuality is part of the physical therapy practice environment and physical therapists' understanding of sexual boundaries is ambiguous. These data can inform professional conversation on sexual boundaries in physical therapy practice leading to greater understanding and decreased potential for violations.

  4. Otolaryngology in the medical school curriculum: Current trends in the United States.

    Science.gov (United States)

    Boscoe, Elizabeth F; Cabrera-Muffly, Cristina

    2017-02-01

    To identify trends in medical school otolaryngology curriculum requirements. Survey of United States allopathic medical schools. A survey was sent to deans of curriculum at allopathic medical schools. We identified opportunities for medical students to learn basic concepts in otolaryngology during their undergraduate medical training. The opportunities were classified into preclinical and clinical as well as elective and mandatory rotations. Of the schools surveyed, 60% responded. Mean class size was 149 students. Sixty-eight percent of surveyed schools noted that 75% to 100% of their students participated in preclinical otolaryngology experiences, with 59% reporting a mandatory preclinical otolaryngology module for all students. Eighty-nine percent of schools offered otolaryngology as a clinical elective rotation, with a mean of 12 students participating yearly. Only 7% of schools required a mandatory otolaryngology clinical rotation. Our data suggest that medical students do not receive sufficient exposure to otolaryngology during medical school. Increased requirements for otolaryngology curriculum may be beneficial to all medical students, regardless of their specialty choice. NA. Laryngoscope, 00:000-000, 2016 127:346-348, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Global women's health: current clinical trials in low- and middle-income countries.

    Science.gov (United States)

    Merriel, A; Harb, H M; Williams, H; Lilford, R; Coomarasamy, A

    2015-01-01

    Clinical trials in low- and middle-income countries (LMICs) are necessary to develop evidence-based approaches to improve women's health. Understanding what research is currently being conducted will allow the identification of research gaps, avoidance of duplication, planning of future studies, collaboration amongst research groups, and geographical targeting for research investments. To provide an overview of active women's health trials in LMICs. The World Health Organization's International Clinical Trials Registry Platform was searched for trials registered between 1 April 2012 and 31 March 2014. Selected trials were randomised, conducted in LMICs, active, and with a women's health intervention or a significant outcome for the woman. Two reviewers extracted data. Analysis included geographical spread, speciality areas, pre-enrolment registration, study size, and funders. Of the 8966 records, 509 were eligible for inclusion. Gynaecology trials made up 57% of the research, whereas the remaining 43% of trials were in obstetrics. Research activity focused on fertility (17%), the antenatal period (15%), benign gynaecology (14%), intrapartum care (9%), and pre-invasive disease and cancers (8%). The majority of trials (84%) took place in middle-income countries (MICs). In low-income countries (LICs) 83% of research investigated obstetrics, and in MICs 60% of research investigated gynaecology. Most trials (80%) had a sample size of 500 or fewer participants. The median size of trials in LICs was 815 compared with 128 in MICs. Pre-enrolment registration occurred in 54% of trials. The majority (62%) of trials were funded locally. Many LMICs are active in women's health research. The majority of registered trials are located in MICs; however, the trials in LICs are often larger. The focus of research in MICs may be driven by local priorities and funding, with fertility being highly researched. In LICs, pregnancy is the focus, perhaps reflecting the international

  6. Clinical experimentation with aerosol antibiotics: current and future methods of administration

    Directory of Open Access Journals (Sweden)

    Zarogoulidis P

    2013-10-01

    Full Text Available Paul Zarogoulidis,1,2 Ioannis Kioumis,1 Konstantinos Porpodis,1 Dionysios Spyratos,1 Kosmas Tsakiridis,3 Haidong Huang,4 Qiang Li,4 J Francis Turner,5 Robert Browning,6 Wolfgang Hohenforst-Schmidt,7 Konstantinos Zarogoulidis1 1Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Department of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany; 3Cardiothoracic Surgery Department, Saint Luke Private Hospital of Health Excellence, Thessaloniki, Greece; 4Department of Respiratory Diseases, Shanghai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai, People’s Republic of China; 5Pulmonary Medicine, University of Nevada School of Medicine, National Supercomputing Center for Energy and the Environment University of Nevada, Las Vegas, NV, USA; 6Pulmonary and Critical Care Medicine, Interventional Pulmonology, National Naval Medical Center, Walter Reed Army Medical Center, Bethesda, MD, USA; 7II Medical Department, Regional Clinic of Coburg, University of Wuerzburg, Coburg, Germany Abstract: Currently almost all antibiotics are administered by the intravenous route. Since several systems and situations require more efficient methods of administration, investigation and experimentation in drug design has produced local treatment modalities. Administration of antibiotics in aerosol form is one of the treatment methods of increasing interest. As the field of drug nanotechnology grows, new molecules have been produced and combined with aerosol production systems. In the current review, we discuss the efficiency of aerosol antibiotic studies along with aerosol production systems. The different parts of the aerosol antibiotic methodology are presented. Additionally, information regarding the drug molecules used is presented and future applications of this method are discussed

  7. Haematology outreach clinics in the Free State and Northern Cape

    African Journals Online (AJOL)

    They repeatedly have to travel hundreds of kilometres, at ... To limit travel, we often monitor patients between their clinic visits with the help of their general practitioners. However, this is not optimal for all conditions and we were looking for alternatives. At the .... Approximately 10% of the patients had medical insurance.

  8. [Current status of job burnout in clinical nurses in a grade A tertiary hospital and related influencing factors].

    Science.gov (United States)

    Ye, L Y; Fan, C L; Wang, L G; Tao, T; Gao, W B; Li, Y H

    2017-10-20

    Objective: To investigate the current status of job burnout in clinical nurses in a grade A tertiary hospitalin Shaoxing,China and related influencing factors. Methods: In October 2016, the Nursing Burnout Scale (NBS)was used for the investigation of 304 clinical nurses in a grade A tertiary hospital.The contents of the investigation included general data(including age,education background,working years,marital status, frequency of night shifts,professional title, and way of employment), characteristics of working environment,burnout, personality characteristics,coping strategy,and psychosomatic symptoms.SPSS 18.0 was used to conduct Pearson correlation analysis of the scores of each dimension of NBS. A multivariate regression analysis was performed with the demographic features of clinical nurses as the independent variable and the scores of each dimension of NBS as the dependent variable. Results: Among the clinical nurses in this grade A tertiary hospital, the incidence rate of severe burnout was 74%.The Pearson correlation analysis showed that burnout,pessimistic personality,negative coping,and psychosomatic symptoms were positively correlated with working environment( r =0.530,0.316,0.116,and 0.502); pessimistic personality and psychosomatic symptoms were positively correlated with burnout( r =0.618 and 0.675); psychosomatic symptoms were positively correlated withpessimistic personality( r =0.540); negative coping was negatively correlated with pessimistic personality( r =-0.145).The multivariate linear regression analysis showed that department(Department of Internal Medicine or Department of Surgery, B =-0.364 and -0.428)and frequency of night shifts(burnout; 1 - 3 working years( B =-0.238)was an influencing factor for the score of pessimistic personality; married state,1 - 3 working years,and department (Department of Internal Medicine or Department of Surgery)were influencing factors for the score of psychosomatic symptoms( B =0.263,-0.301,-0.322,and -0

  9. Current status and prospect of plasma control system for steady-state operation on QUEST

    International Nuclear Information System (INIS)

    Hasegawa, Makoto; Nakamura, Kazuo; Zushi, Hideki; Hanada, Kazuaki; Fujisawa, Akihide; Tokunaga, Kazutoshi; Idei, Hiroshi; Nagashima, Yoshihiko; Kawasaki, Shoji; Nakashima, Hisatoshi; Higashijima, Aki

    2016-01-01

    Highlights: • Overall configuration of plasma control system on QUEST are presented. • Multi core system and reflective memories are used for the real-time control. • Hall sensors are used for the identification of plasma current and its position. • Repetitive gas fueling with the feed-back control of Hα signal is implemented. - Abstract: The plasma control system (PCS) of QUEST is developed according to the progress of QUEST project. Since one of the critical goals of the project is to achieve the steady-state operation with high temperature vacuum vessel wall, the PCS is also required to have the capability to control the plasma for a long period. For the increase of the loads to processing power of the PCS, the PCS is decentralized with the use of reflective memories (RFMs). The PCS controls the plasma edge position with the real-time identification of plasma current and its position. This identification is done with not only flux loops but also hall sensors. The gas fueling method by piezo valve with monitoring the Hα signal filtered by a digital low-pass filter are proposed and suitable for the steady-state operation on QUEST. The present status and prospect of the PCS are presented with recent topics.

  10. Mobile Healthcare and People with Disabilities: Current State and Future Needs

    Directory of Open Access Journals (Sweden)

    Michael Jones

    2018-03-01

    Full Text Available Significant health disparities exist between the general population and people with disabilities, particularly with respect to chronic health conditions. Mobile healthcare—the delivery of healthcare via mobile communication devices—is witnessing tremendous growth and has been touted as an important new approach for management of chronic health conditions. At present, little is known about the current state of mobile healthcare for people with disabilities. Early evidence suggests they are not well represented in the growth of mobile healthcare, and particularly the proliferation of mobile health software applications (mHealth apps for smartphones. Their omission in mHealth could lead to further health disparities. This article describes our research investigating the current state of mHealth apps targeting people with disabilities. Based on a multi-modal approach (literature review, Internet search, survey of disabled smartphone users, we confirm that people with disabilities are under-represented in the growth of mHealth. We identify several areas of future research and development needed to support the inclusion of people with disabilities in the mHealth revolution.

  11. Mobile Healthcare and People with Disabilities: Current State and Future Needs.

    Science.gov (United States)

    Jones, Michael; Morris, John; Deruyter, Frank

    2018-03-14

    Significant health disparities exist between the general population and people with disabilities, particularly with respect to chronic health conditions. Mobile healthcare-the delivery of healthcare via mobile communication devices-is witnessing tremendous growth and has been touted as an important new approach for management of chronic health conditions. At present, little is known about the current state of mobile healthcare for people with disabilities. Early evidence suggests they are not well represented in the growth of mobile healthcare, and particularly the proliferation of mobile health software applications (mHealth apps) for smartphones. Their omission in mHealth could lead to further health disparities. This article describes our research investigating the current state of mHealth apps targeting people with disabilities. Based on a multi-modal approach (literature review, Internet search, survey of disabled smartphone users), we confirm that people with disabilities are under-represented in the growth of mHealth. We identify several areas of future research and development needed to support the inclusion of people with disabilities in the mHealth revolution.

  12. Current status and prospect of plasma control system for steady-state operation on QUEST

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Makoto, E-mail: hasegawa@triam.kyushu-u.ac.jp; Nakamura, Kazuo; Zushi, Hideki; Hanada, Kazuaki; Fujisawa, Akihide; Tokunaga, Kazutoshi; Idei, Hiroshi; Nagashima, Yoshihiko; Kawasaki, Shoji; Nakashima, Hisatoshi; Higashijima, Aki

    2016-11-15

    Highlights: • Overall configuration of plasma control system on QUEST are presented. • Multi core system and reflective memories are used for the real-time control. • Hall sensors are used for the identification of plasma current and its position. • Repetitive gas fueling with the feed-back control of Hα signal is implemented. - Abstract: The plasma control system (PCS) of QUEST is developed according to the progress of QUEST project. Since one of the critical goals of the project is to achieve the steady-state operation with high temperature vacuum vessel wall, the PCS is also required to have the capability to control the plasma for a long period. For the increase of the loads to processing power of the PCS, the PCS is decentralized with the use of reflective memories (RFMs). The PCS controls the plasma edge position with the real-time identification of plasma current and its position. This identification is done with not only flux loops but also hall sensors. The gas fueling method by piezo valve with monitoring the Hα signal filtered by a digital low-pass filter are proposed and suitable for the steady-state operation on QUEST. The present status and prospect of the PCS are presented with recent topics.

  13. Current State of Technology of Fuel Cell Power Systems for Autonomous Underwater Vehicles

    Directory of Open Access Journals (Sweden)

    Alejandro Mendez

    2014-07-01

    Full Text Available Autonomous Underwater Vehicles (AUVs are vehicles that are primarily used to accomplish oceanographic research data collection and auxiliary offshore tasks. At the present time, they are usually powered by lithium-ion secondary batteries, which have insufficient specific energies. In order for this technology to achieve a mature state, increased endurance is required. Fuel cell power systems have been identified as an effective means to achieve this endurance but no implementation in a commercial device has yet been realized. This paper summarizes the current state of development of the technology in this field of research. First, the most adequate type of fuel cell for this application is discussed. The prototypes and design concepts of AUVs powered by fuel cells which have been developed in the last few years are described. Possible commercial and experimental fuel cell stack options are analyzed, examining solutions adopted in the analogous aerial vehicle applications, as well as the underwater ones, to see if integration in an AUV is feasible. Current solutions in oxygen and hydrogen storage systems are overviewed and energy density is objectively compared between battery power systems and fuel cell power systems for AUVs. A couple of system configuration solutions are described including the necessary lithium-ion battery hybrid system. Finally, some closing remarks on the future of this technology are given.

  14. Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study.

    Science.gov (United States)

    Vallejo, Karin Papapietro; Martínez, Carolina Méndez; Matos Adames, Alfredo A; Fuchs-Tarlovsky, Vanessa; Nogales, Guillermo Carlos Contreras; Paz, Roger Enrique Riofrio; Perman, Mario Ignacio; Correia, Maria Isabel Toulson Davisson; Waitzberg, Dan Linetzky

    2017-08-25

    Malnutrition in critically ill adults in the intensive care unit (ICU) is associated with a significantly elevated risk of mortality. Adequate nutrition therapy is crucial to optimise outcomes. Currently, there is a paucity of such data in Latin America. Our aims were to characterise current clinical nutrition practices in the ICU setting in Latin America and evaluate whether current practices meet caloric and protein requirements in critically ill patients receiving nutrition therapy. We conducted a cross-sectional, retrospective, observational study in eight Latin American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Panama, and Peru). Eligible patients were critically ill adults hospitalised in the ICU and receiving enteral nutrition (EN) and/or parenteral nutrition (PN) on the Screening Day and the previous day (day -1). Caloric and protein balance on day -1, nutritional status, and prescribed nutrition therapy were recorded. Multivariable logistic regression analysis was performed to identify independent predictors of reaching daily caloric and protein targets. The analysis included 1053 patients from 116 hospitals. Evaluation of nutritional status showed that 74.1% of patients had suspected/moderate or severe malnutrition according to the Subjective Global Assessment. Prescribed nutrition therapy included EN alone (79.9%), PN alone (9.4%), and EN + PN (10.7%). Caloric intake met >90% of the daily target in 59.7% of patients on day -1; a caloric deficit was present in 40.3%, with a mean (±SD) daily caloric deficit of -688.8 ± 455.2 kcal. Multivariable logistic regression analysis showed that combined administration of EN + PN was associated with a statistically significant increase in the probability of meeting >90% of daily caloric and protein targets compared with EN alone (odds ratio, 1.56; 95% confidence interval, 1.02-2.39; p = 0.038). In the ICU setting in Latin America, malnutrition was highly prevalent and caloric

  15. Progress Toward Steady State Tokamak Operation Exploiting the high bootstrap current fraction regime

    Science.gov (United States)

    Ren, Q.

    2015-11-01

    Recent DIII-D experiments have advanced the normalized fusion performance of the high bootstrap current fraction tokamak regime toward reactor-relevant steady state operation. The experiments, conducted by a joint team of researchers from the DIII-D and EAST tokamaks, developed a fully noninductive scenario that could be extended on EAST to a demonstration of long pulse steady-state tokamak operation. Fully noninductive plasmas with extremely high values of the poloidal beta, βp >= 4 , have been sustained at βT >= 2 % for long durations with excellent energy confinement quality (H98y,2 >= 1 . 5) and internal transport barriers (ITBs) generated at large minor radius (>= 0 . 6) in all channels (Te, Ti, ne, VTf). Large bootstrap fraction (fBS ~ 80 %) has been obtained with high βp. ITBs have been shown to be compatible with steady state operation. Because of the unusually large ITB radius, normalized pressure is not limited to low βN values by internal ITB-driven modes. βN up to ~4.3 has been obtained by optimizing the plasma-wall distance. The scenario is robust against several variations, including replacing some on-axis with off-axis neutral beam injection (NBI), adding electron cyclotron (EC) heating, and reducing the NBI torque by a factor of 2. This latter observation is particularly promising for extension of the scenario to EAST, where maximum power is obtained with balanced NBI injection, and to a reactor, expected to have low rotation. However, modeling of this regime has provided new challenges to state-of-the-art modeling capabilities: quasilinear models can dramatically underpredict the electron transport, and the Sauter bootstrap current can be insufficient. The analysis shows first-principle NEO is in good agreement with experiments for the bootstrap current calculation and ETG modes with a larger saturated amplitude or EM modes may provide the missing electron transport. Work supported in part by the US DOE under DE-FC02-04ER54698, DE-AC52-07NA

  16. Current challenges in adherence to clinical guidelines for antibiotic prophylaxis in surgery.

    Science.gov (United States)

    Khan, Sohail Ahmad; Rodrigues, Gabrial; Kumar, Pramod; Rao, Padma G M

    2006-06-01

    To study the impact of guidelines on surgical antibiotic prophylaxis in clinical practice, barriers involved in adherence to guidelines and how to overcome the same. Literature pertaining to prophylactic antibiotic usage was searched. Medscape, Medline, Cochrane, Surgical Infection Prevention (SIP) project databases were reviewed. Recent articles from relevant journals, texts, and standard guidelines were also studied. Local guidelines seem more likely to be accepted and followed than those developed nationally. Major barriers involved in adherence to guidelines include lack of awareness about the guidelines, general perception of guideline as a bureaucratic rather than educational tool. Some practitioners perceive guidelines as "cookbook medicine" that does not permit them to make their own medical decisions. Other barriers are complex, multi-step systems that create confusion, decrease accountability. Methods for guideline adherence include surveillance and data analysis, new systems to facilitate documentation and improving workflow, education regarding current evidence-based guidelines and promoting the development of local guidelines or protocol, development and implementation of reminders to facilitate adherence to the local guidelines. A multidisciplinary steering team of surgeons, infectious disease specialists, pharmacists, anesthesiologists, microbiologists and nurses should develop local guidelines suitable to their institution and methods for adherence to prevent the surgical site infections. The gap between evidence-based guidelines and practice must be addressed in order to achieve optimal practice in this domain.

  17. A survey of current clinical practice in permanent and temporary prostate brachytherapy: 2010 update.

    Science.gov (United States)

    Buyyounouski, Mark K; Davis, Brian J; Prestidge, Bradley R; Shanahan, Thomas G; Stock, Richard G; Grimm, Peter D; Demanes, D Jeffrey; Zaider, Marco; Horwitz, Eric M

    2012-01-01

    To help establish patterns of care and standards of care of interstitial permanent low-dose-rate (LDR) and temporary high-dose-rate brachytherapy for prostate cancer and to compare the results with a similar 1998 American Brachytherapy Society (ABS) survey. A comprehensive questionnaire intended to survey specific details of current clinical brachytherapy practice was provided to the participants of the seventh ABS Prostate Brachytherapy School. Responses were tabulated and descriptive statistics are reported. Sixty-five brachytherapy practitioners responded to the survey. Eighty-nine percent (89%) of respondents performed LDR and 49% perform high-dose-rate brachytherapy. The median number of years of experience for LDR brachytherapists increased from 5 to 10 years over the course of the 12 years since the preceding survey. Compared with the first ABS, a smaller proportion of respondents received formal brachytherapy residency training (43% vs. 56%) or formal "hands-on" brachytherapy training (15% vs. 63%). There has been a marked decline in the utilization of the Mick applicator (Mick Radio-Nuclear Instruments, Inc., Mount Vernon, NY, USA) (60% vs. 28%) and an increase in the use of stranded seeds (40% vs. 11%). Compliance with postimplant dosimetry was higher in the 2010 survey. This survey does suggest an evolution in the practice of LDR brachytherapy since 1998 and aids in identifying aspects that require further progress or investigation. ABS guidelines and other practice recommendations appear to impact the practice of brachytherapy. Copyright © 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. HIV Surveillance Among Pregnant Women Attending Antenatal Clinics: Evolution and Current Direction.

    Science.gov (United States)

    Dee, Jacob; Garcia Calleja, Jesus M; Marsh, Kimberly; Zaidi, Irum; Murrill, Christopher; Swaminathan, Mahesh

    2017-12-05

    Since the late 1980s, human immunodeficiency virus (HIV) sentinel serosurveillance among pregnant women attending select antenatal clinics (ANCs) based on unlinked anonymous testing (UAT) has provided invaluable information for tracking HIV prevalence and trends and informing global and national HIV models in most countries with generalized HIV epidemics. However, increased coverage of HIV testing, prevention of mother-to-child transmission (PMTCT), and antiretroviral therapy has heightened ethical concerns about UAT. PMTCT programs now routinely collect demographic and HIV testing information from the same pregnant women as serosurveillance and therefore present an alternative to UAT-based ANC serosurveillance. This paper reports on the evolution and current direction of the global approach to HIV surveillance among pregnant women attending ANCs, including the transition away from traditional UAT-based serosurveillance and toward new guidance from the World Health Organization and the Joint United Nations Programme on HIV/AIDS on the implementation of surveillance among pregnant women attending ANCs based on routine PMTCT program data. ©Jacob Dee, Jesus M Garcia Calleja, Kimberly Marsh, Irum Zaidi, Christopher Murrill, Mahesh Swaminathan. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 05.12.2017.

  19. Current understanding on pharmacokinetics, clinical efficacy and safety of progestins for treating pain associated to endometriosis.

    Science.gov (United States)

    Barra, Fabio; Scala, Carolina; Ferrero, Simone

    2018-04-01

    Endometriosis is a chronic estrogen and progestogen responsive inflammatory disease associated with pain symptoms and infertility. The medical therapy of endometriosis aims to induce decidualization within the hormonally dependent ectopic endometrium, and it is often administered to ameliorate women' pain symptoms or to prevent post-surgical disease recurrence. A variety of progestins have been used in monotherapy for the medical management of women with endometriosis. Areas covered: This review aims to offer the reader a complete overview of pharmacokinetic (PK) and clinical efficacy of progestins for the treatment of endometriosis. Expert opinion: Each progestin has a distinct PK parameters and pharmacodynamics affinity not only for progesterone receptor, but also for other steroid receptors, such as estrogen, androgen, and glucocorticoid. Moreover, progestins can also be delivered in different formulations. All these characteristics influence their final biological effect. Randomized, controlled, non-blinded studies support the use of oral progestin-only treatment for pelvic pain associated with endometriosis. Currently, the only two progestins approved by Food and Drug Administration (FDA) for the treatment of endometriosis are norethindrone acetate (NETA) and depot medroxyprogesterone acetate (DMPA).

  20. Current good manufacturing practice and investigational new drugs intended for use in clinical trials. Final rule.

    Science.gov (United States)

    2008-07-15

    The Food and Drug Administration (FDA) is amending the current good manufacturing practice (CGMP) regulations for human drugs, including biological products, to exempt most phase 1 investigational drugs from complying with the regulatory CGMP requirements. FDA will continue to exercise oversight of the manufacture of these drugs under FDA's general statutory CGMP authority and through review of the investigational new drug applications (IND). In addition, elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document entitled "Guidance for Industry: CGMP for Phase 1 Investigational Drugs" dated November 2007 (the companion guidance). This guidance document sets forth recommendations on approaches to compliance with statutory CGMP for the exempted phase 1 investigational drugs. FDA is taking this action to focus a manufacturer's effort on applying CGMP that is appropriate and meaningful for the manufacture of the earliest stage investigational drug products intended for use in phase 1 clinical trials while ensuring safety and quality. This action will also streamline and promote the drug development process.

  1. Pioneering a new role: the beginning, current practice and future of the Clinical Nurse Leader.

    Science.gov (United States)

    Poulin-Tabor, Danielle; Quirk, Rebecca L; Wilson, Lauri; Orff, Sonja; Gallant, Paulette; Swan, Nina; Manchester, Nicole

    2008-07-01

    To discuss the development of a new nursing role in response to the health care crisis in the United States. The nursing shortage and fragmentation of care has contributed to the need for nurses who are prepared to laterally integrate care, bring evidence-based practice to the bedside and provide continuity of care to patients and families. The CNLs review the literature, share their experiences, and discuss outcomes related to improved quality of care. Having clinical nurses with a global perspective acting as facilitators and integrators of care is essential to maintaining a high standard of care. Organizational and management support is critical. The more CNLs that can be embedded in an institution, the more successful the role can be. The varied utilization of the CNLs in this practice setting has proven its value in a short period of time and facilitated better communication and collaboration among patients and their health care team. The flexibility and broad scope of this role allows for its use in any practice setting to realize gains in quality outcomes, cost savings, improved patient flow, increased safety, nurse satisfaction and increasing organizational capacity.

  2. Lignite mining and electricity generation in Poland: The current state and future prospects

    International Nuclear Information System (INIS)

    Widera, Marek; Kasztelewicz, Zbigniew; Ptak, Miranda

    2016-01-01

    This opinion paper presents the current state and future scenarios of Polish lignite mining. For many years, over 1/3 of domestic electricity, that is about 53–55 TWh, has been generated by lignite-fired power plants. Currently, with 63–66 million tons of extraction, Poland is the fourth lignite producer worldwide and the second in the European Union. There are three possible scenarios for the development of lignite mining in Poland by 2050. Unfortunately, despite the huge lignite resources, amounting to more than 23.5 billion tons, and great potential of the mining industry, the future of Polish lignite mining does not look optimistic from the economic point of view. This is associated with social and environmental problems, including the European Union's climate and energy policy. However, this may change in the event of a global economic crisis and unstable geopolitical conditions. Therefore, a new energy doctrine for Poland at least by 2050 is urgently needed. - Highlights: •Poland is one of the leaders in lignite production in the European Union. •Energy policy in Poland assumes a key role of lignite in energy mix. •Almost one-third of Polish electricity is currently generated from lignite. •For Polish lignite mining exist pessimistic, realistic and optimistic scenarios. •Extraction of lignite in Poland will gradually decrease in the coming decades.

  3. Determining the Impact of Steady-State PV Fault Current Injections on Distribution Protection

    Energy Technology Data Exchange (ETDEWEB)

    Seuss, John [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reno, Matthew J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Broderick, Robert Joseph [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Grijalva, Santiago [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-05-01

    This report investigates the fault current contribution from a single large PV system and the impact it has on existing distribution overcurrent protection devices. Assumptions are made about the modeling of the PV system under fault to perform exhaustive steady - state fault analyses throughout distribution feeder models. Each PV interconnection location is tested to determine how the size of the PV system affects the fault current measured by each protection device. This data is then searched for logical conditions that indicate whether a protection device has operated in a manner that will cause more customer outages due to the addition of the PV system. This is referred to as a protection issue , and there are four unique types of issues that have been identified in the study. The PV system size at which any issues occur are recorded to determine the feeder's PV hosting capacity limitations due to interference with protection settings. The analysis is carried out on six feeder models. The report concludes with a discussion of the prevalence and cause of each protection issue caused by PV system fault current.

  4. MHz repetition rate solid-state driver for high current induction accelerators

    International Nuclear Information System (INIS)

    Brooksby, C; Caporaso, G; Goerz, D; Hanks, R; Hickman, B; Kirbie, H; Lee, B; Saethre, R.

    1999-01-01

    A research team from the Lawrence Livermore National Laboratory and Bechtel Nevada Corporation is developing an all solid-state power source for high current induction accelerators. The original power system design, developed for heavy-ion fusion accelerators, is based on the simple idea of using an array of field effect transistors to switch energy from a pre-charged capacitor bank to an induction accelerator cell. Recently, that idea has been expanded to accommodate the greater power needs of a new class of high-current electron accelerators for advanced radiography. For this purpose, we developed a 3-stage induction adder that uses over 4,000 field effect transistors to switch peak voltages of 45 kV at currents up to 4.8 kA with pulse repetition rates of up to 2 MHz. This radically advanced power system can generate a burst of five or more pulses that vary from 200 ns to 2 ampersand micro;s at a duty cycle of up to 25%. Our new source is precise, robust, flexible, and exceeds all previous drivers for induction machines by a factor of 400 in repetition rate and a factor of 1000 in duty cycle

  5. Haematology outreach clinics in the Free State and Northern Cape

    African Journals Online (AJOL)

    patients' domicile, how they were referred, types of diagnoses and ... The intention was to offer a more accessible and affordable service to more patients in the Free State and Northern Cape, in accordance with provincial policy.' The Departments of ... The cost would have been higher if consultants had had to stay over.

  6. ANALYSIS OF THE CURRENT STATE OF INCOME AND EXPENDITURE STRUCTURE OF THE POPULATION IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Svitlana Sliusar

    2017-09-01

    Full Text Available The article is a study of the current state of the income and expenditure structure of the population in Ukraine, in particular, the level of income and expenditure in the context of national integration into the world economy. The purpose of the study in the article is to analyse the current state of the income and expenditure structure of the population in Ukraine in the context of national integration into the world economy. The object of the research is the financial provision of the population of Ukraine; the subject is the dynamics of the structure of incomes and expenditures of the population of Ukraine. Methodology. During the writing of the article, the following research methods are used: the search for available methodological and scientific literature, comparison, clarification of causal relationships, systematization, analysis of documentation and results of researchers’ work on the problem of the conducted research and expert evaluation. Results. During the research, it is observed that social security and wages rank one of the most important places in the income structure. So they are stressed. Social security includes pensions and various types of benefits (temporary disability, pregnancy and childbirth, child care up to 3 years of age, caring for a sick child, burial, assistance for disabled people whose income is less than the established limit of low income, etc.. Social security also provides for the provision of assistance in kind (care for the disabled, elderly people in specialized institutions – at boarding houses and at home. In Soviet times, all social payments were made exclusively by the state. It is established that sources of financing social protection services and social security, in accordance with the Budget Code of Ukraine, are state and local budgets. Expenditures of social orientation include expenditures on health care, spiritual and physical development, education, social protection and social security

  7. Medicinal use of cannabis in the United States: historical perspectives, current trends, and future directions.

    Science.gov (United States)

    Aggarwal, Sunil K; Carter, Gregory T; Sullivan, Mark D; ZumBrunnen, Craig; Morrill, Richard; Mayer, Jonathan D

    2009-01-01

    Cannabis (marijuana) has been used for medicinal purposes for millennia, said to be first noted by the Chinese in c. 2737 BCE. Medicinal cannabis arrived in the United States much later, burdened with a remarkably checkered, yet colorful, history. Despite early robust use, after the advent of opioids and aspirin, medicinal cannabis use faded. Cannabis was criminalized in the United States in 1937, against the advice of the American Medical Association submitted on record to Congress. The past few decades have seen renewed interest in medicinal cannabis, with the National Institutes of Health, the Institute of Medicine, and the American College of Physicians, all issuing statements of support for further research and development. The recently discovered endocannabinoid system has greatly increased our understanding of the actions of exogenous cannabis. Endocannabinoids appear to control pain, muscle tone, mood state, appetite, and inflammation, among other effects. Cannabis contains more than 100 different cannabinoids and has the capacity for analgesia through neuromodulation in ascending and descending pain pathways, neuroprotection, and anti-inflammatory mechanisms. This article reviews the current and emerging research on the physiological mechanisms of cannabinoids and their applications in managing chronic pain, muscle spasticity, cachexia, and other debilitating problems.

  8. Current state of commercial radiation detection equipment for homeland security applications

    International Nuclear Information System (INIS)

    Klann, R.T.; Shergur, J.; Mattesich, G.

    2009-01-01

    With the creation of the U.S. Department of Homeland Security (DHS) came the increased concern that terrorist groups would attempt to manufacture and use an improvised nuclear device or radiological dispersal device. As such, a primary mission of DHS is to protect the public against the use of these devices and to assist state and local responders in finding, locating, and identifying these types of devices and materials used to manufacture these devices. This assistance from DHS to state and local responders comes in the form of grant money to procure radiation detection equipment. In addition to this grant program, DHS has supported the development of American National Standards Institute standards for radiation detection equipment and has conducted testing of commercially available instruments. This paper identifies the types and kinds of commercially available equipment that can be used to detect and identify radiological material - for use in traditional search applications as well as primary and secondary screening of personnel, vehicles, and cargo containers. In doing so, key considerations for the conduct of operations are described as well as critical features of the instruments for specific applications. The current state of commercial instruments is described for different categories of detection equipment including personal radiation detectors, radioisotope identifiers, man-portable detection equipment, and radiation portal monitors. In addition, emerging technologies are also discussed, such as spectroscopic detectors and advanced spectroscopic portal monitors

  9. CURRENT STATE ANALYSIS OF AUTOMATIC BLOCK SYSTEM DEVICES, METHODS OF ITS SERVICE AND MONITORING

    Directory of Open Access Journals (Sweden)

    A. M. Beznarytnyy

    2014-01-01

    Full Text Available Purpose. Development of formalized description of automatic block system of numerical code based on the analysis of characteristic failures of automatic block system and procedure of its maintenance. Methodology. For this research a theoretical and analytical methods have been used. Findings. Typical failures of the automatic block systems were analyzed, as well as basic reasons of failure occur were found out. It was determined that majority of failures occurs due to defects of the maintenance system. Advantages and disadvantages of the current service technology of automatic block system were analyzed. Works that can be automatized by means of technical diagnostics were found out. Formal description of the numerical code of automatic block system as a graph in the state space of the system was carried out. Originality. The state graph of the numerical code of automatic block system that takes into account gradual transition from the serviceable condition to the loss of efficiency was offered. That allows selecting diagnostic information according to attributes and increasing the effectiveness of recovery operations in the case of a malfunction. Practical value. The obtained results of analysis and proposed the state graph can be used as the basis for the development of new means of diagnosing devices for automatic block system, which in turn will improve the efficiency and service of automatic block system devices in general.

  10. The Implementation Of Solid State Switches In A Parallel Configuration To Gain Output Current Capacity In A High Current Capacitive Discharge Unit (CDU).

    Energy Technology Data Exchange (ETDEWEB)

    Chaves, Mario Paul [Univ. of New Mexico, Albuquerque, NM (United States)

    2017-07-01

    For my project I have selected to research and design a high current pulse system, which will be externally triggered from a 5V pulse. The research will be conducted in the region of paralleling the solid state switches for a higher current output, as well as to see if there will be any other advantages in doing so. The end use of the paralleled solid state switches will be used on a Capacitive Discharge Unit (CDU). For the first part of my project, I have set my focus on the design of the circuit, selection of components, and simulation of the circuit.

  11. 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.

  12. The scope and impact of mobile health clinics in the United States: a literature review.

    Science.gov (United States)

    Yu, Stephanie W Y; Hill, Caterina; Ricks, Mariesa L; Bennet, Jennifer; Oriol, Nancy E

    2017-10-05

    As the U.S. healthcare system transforms its care delivery model to increase healthcare accessibility and improve health outcomes, it is undergoing changes in the context of ever-increasing chronic disease burdens and healthcare costs. Many illnesses disproportionately affect certain populations, due to disparities in healthcare access and social determinants of health. These disparities represent a key area to target in order to better our nation's overall health and decrease healthcare expenditures. It is thus imperative for policymakers and health professionals to develop innovative interventions that sustainably manage chronic diseases, promote preventative health, and improve outcomes among communities disenfranchised from traditional healthcare as well as among the general population. This article examines the available literature on Mobile Health Clinics (MHCs) and the role that they currently play in the U.S. healthcare system. Based on a search in the PubMed database and data from the online collaborative research network of mobile clinics MobileHealthMap.org , the authors evaluated 51 articles with evidence on the strengths and weaknesses of the mobile health sector in the United States. Current literature supports that MHCs are successful in reaching vulnerable populations, by delivering services directly at the curbside in communities of need and flexibly adapting their services based on the changing needs of the target community. As a link between clinical and community settings, MHCs address both medical and social determinants of health, tackling health issues on a community-wide level. Furthermore, evidence suggest that MHCs produce significant cost savings and represent a cost-effective care delivery model that improves health outcomes in underserved groups. Even though MHCs can fulfill many goals and mandates in alignment with our national priorities and have the potential to help combat some of the largest healthcare challenges of this era, there

  13. Clinical significance of nutritional status in patients with atrial fibrillation: An overview of current evidence.

    Science.gov (United States)

    Anaszewicz, Marzena; Budzyński, Jacek

    2017-05-01

    Obesity is a well-known atherosclerosis risk factor; however, its role and the importance of undernutrition in atrial fibrillation (AF) pathogenesis are still not well understood. The aim of this study was to present the current state of knowledge on this issue in different groups of patients. Systematic review of papers published between 1980 and 2016. The literature shows contradicting views regarding the impact of nutritional status on the risk, course, and complications of AF. On the one hand, it has been revealed that overweight, obesity, and high birth mass increase the risk of AF, and that their reduction is linked to an improved course of AF and reduced all-cause and cardiovascular mortality. On the other hand, a so-called obesity paradox has been found, which shows lower all-cause mortality in overweight patients with AF compared to those of normal weight or who are underweight. It has also been shown, although based on a small number of studies, that the relationship between nutritional status and risk of AF and its complication may be U-shaped, which means that not only patients with obesity, but also individuals with underweight, cachexia, and low birth weight may have an increased risk and poor outcome of AF. The relationship between patients' nutritional status and the course of AF has become clearer but it requires further studies examining the importance of weight reduction on AF course. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  14. Current status of palliative care--clinical implementation, education, and research.

    Science.gov (United States)

    Grant, Marcia; Elk, Ronit; Ferrell, Betty; Morrison, R Sean; von Gunten, Charles F

    2009-01-01

    Palliative and end-of-life care is changing in the United States. This dynamic field is improving care for patients with serious and life-threatening cancer through creation of national guidelines for quality care, multidisciplinary educational offerings, research endeavors, and resources made available to clinicians. Barriers to implementing quality palliative care across cancer populations include a rapidly expanding population of older adults who will need cancer care and a decrease in the workforce available to give care. Methods of integrating current palliative care knowledge into care of patients include multidisciplinary national education and research endeavors, and clinician resources. Acceptance of palliative care as a recognized medical specialty provides a valuable resource for improvement of care. Although compilation of evidence for the importance of palliative care specialities is in its initial stages, national research grants have provided support to build the knowledge necessary for appropriate palliative care. Opportunities are available to clinicians for understanding and applying appropriate palliative and end-of-life care to patients with serious and life-threatening cancers. (c) 2009 American Cancer Society, Inc.

  15. Landscape of current and emerging cell therapy clinical trials in the UK: current status, comparison to global trends and future perspectives.

    Science.gov (United States)

    Bisson, Isabelle; Green, Emma; Sharpe, Michaela; Herbert, Chris; Hyllner, Johan; Mount, Natalie

    2015-01-01

    Cell Therapy Clinical Trial and Preclinical Research databases have been established by the Cell Therapy Catapult to document current and future cell therapy clinical trials in the UK. We identified 41 ongoing trials in April 2014, an increase of seven trials from April 2013. In addition, we identified 45 late-stage preclinical research projects. The majority of the clinical trials are early phase, primarily led by academic groups. The leading therapeutic areas are cancer, cardiology and neurology. The trends in the UK are also seen globally. As the field matures, more later phase and commercial studies will emerge and the challenges will likely evolve into how to manufacture sufficient cell quantities, manage complex logistics for multi-center trials and control cost.

  16. Current state of biosimilars in Mexico: The position of the Mexican College of Rheumatology, 2016.

    Science.gov (United States)

    Xibille, Daniel; Carrillo, Sandra; Huerta-Sil, Gabriela; Hernández, Ramiro; Limón, Leonardo; Olvera-Soto, Guadalupe; Jara-Quezada, Luis Javier; Esquivel, Abdieel; Pérez-Rodríguez, Marcela

    The present document is a position statement of the Mexican College of Rheumatology on the use of biosimilars in rheumatic diseases. This position considers that biosimilars should be considered as interchangeable, that automatic substitution without previous notice in stable patients during follow-up is not ethical, that the approval of a biosimilar should only be given after exhaustive review of preclinical and clinical data marked by Mexican regulations, that it should be clearly stated in the nomenclature of biologic drugs which is the innovator and which is the biosimilar, that it is not correct to choose a biosimilar as treatment based only on economic reasons or extrapolate indications based only on the approval of the innovator and in the absence of safety and efficacy data for the biosimilar. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  17. Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice

    International Nuclear Information System (INIS)

    Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko

    2014-01-01

    In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retrospectively collected. Planar V/Q images were interpreted according to 0.5 segment mismatch criteria and revised PIOPED II criteria and perfusion scans according to PISA-PED criteria. V/Q SPECT images were interpreted according to the criteria suggested in EANM guidelines. Final diagnosis of PE was based on the clinical decision of an attending physician and evaluation of a 12 months follow-up period. Using 0.5 segment mismatch criteria and revised PIOPED II, planar V/Q scans were diagnostic in 93% and 84% of cases, respectively. Among the diagnostic planar scans readings specificity for 0.5 segment mismatch criteria was 98%, and 99% for revised PIOPED II criteria. V/Q SPECT showed a sensitivity of 100% and a specificity of 98%, without any non-diagnostic cases. In patients with low pretest probability for PE, planar V/Q scans assessed by 0.5 segment mismatch criteria were diagnostic in 92%, and in 85% using revised PIOPED II criteria, while perfusion scintigraphy without ventilation scans was diagnostic in 80%. Lung scintigraphy yielded diagnostically definitive results and is reliable in ruling out PE in patients from ED. V/Q SPECT has excellent specificity and sensitivity without any non-diagnostic results. Percentage of non-diagnostic results in planar lung scintigraphy is considerably smaller when 0.5 segment mismatch criteria instead of revised PIOPED II criteria are used. Diagnostic value of perfusion scintigraphy according to PISA-PED criteria is inferior to combined V/Q scintigraphy; the difference is

  18. History and current state of immunotherapy in glioma and brain metastasis.

    Science.gov (United States)

    McGranahan, Tresa; Li, Gordon; Nagpal, Seema

    2017-05-01

    Malignant brain tumors such as glioblastoma (GBM) and brain metastasis have poor prognosis despite conventional therapies. Successful use of vaccines and checkpoint inhibitors in systemic malignancy has increased the hope that immune therapies could improve survival in patients with brain tumors. Manipulating the immune system to fight malignancy has a long history of both modest breakthroughs and pitfalls that should be considered when applying the current immunotherapy approaches to patients with brain tumors. Therapeutic vaccine trials for GBM date back to the mid 1900s and have taken many forms; from irradiated tumor lysate to cell transfer therapies and peptide vaccines. These therapies were generally well tolerated without significant autoimmune toxicity, however also did not demonstrate significant clinical benefit. In contrast, the newer checkpoint inhibitors have demonstrated durable benefit in some metastatic malignancies, accompanied by significant autoimmune toxicity. While this toxicity was not unexpected, it exceeded what was predicted from pre-clinical studies and in many ways was similar to the prior trials of immunostimulants. This review will discuss the history of these studies and demonstrate that the future use of immune therapy for brain tumors will likely need a personalized approach that balances autoimmune toxicity with the opportunity for significant survival benefit.

  19. Cost-Effective Screening for Breast Cancer Worldwide: Current State and Future Directions

    Directory of Open Access Journals (Sweden)

    A. Sarvazyan

    2008-01-01

    Full Text Available Affordability of healthcare is highly limited by its skyrocketing cost. Access to screening and diagnostic medical equipment and medicine in developing countries is inadequate for the majority of the population. There is a tremendous worldwide need to detect breast cancer at its earliest stage. These needs must be balanced by the ability of countries to provide breast cancer screening technology to their populations. We reviewed the diagnostic accuracy, procedure cost and cost-effectiveness of currently available technique for breast screening and diagnosis including clinical breast examination, mammography, ultrasound, magnetic resonance imaging, biopsy and a new modality for cancer diagnostics termed elasticity imaging that has emerged in the last decade. Clinical results demonstrate that elasticity imaging even in its simplest and least sophisticated versions, like tactile imaging, has significant diagnostic potential comparable and exceeding that of conventional imaging techniques. In view of many countries with limited resources, effective yet less expensive modes of screening must be considered worldwide. The tactile imaging is one method that has the potential to provide cost-effective breast cancer screening and diagnostics.

  20. Gravity currents in rotating channels. Part 1. Steady-state theory

    Science.gov (United States)

    Hacker, J. N.; Linden, P. F.

    2002-04-01

    A theory is developed for the speed and structure of steady-state non-dissipative gravity currents in rotating channels. The theory is an extension of that of Benjamin (1968) for non-rotating gravity currents, and in a similar way makes use of the steady-state and perfect-fluid (incompressible, inviscid and immiscible) approximations, and supposes the existence of a hydrostatic ‘control point’ in the current some distance away from the nose. The model allows for fully non-hydrostatic and ageostrophic motion in a control volume V ahead of the control point, with the solution being determined by the requirements, consistent with the perfect-fluid approximation, of energy and momentum conservation in V, as expressed by Bernoulli's theorem and a generalized flow-force balance. The governing parameter in the problem, which expresses the strength of the background rotation, is the ratio W = B/R, where B is the channel width and R = (g[prime prime or minute]H)1/2/f is the internal Rossby radius of deformation based on the total depth of the ambient fluid H. Analytic solutions are determined for the particular case of zero front-relative flow within the gravity current. For each value of W there is a unique non-dissipative two-layer solution, and a non-dissipative one-layer solution which is specified by the value of the wall-depth h0. In the two-layer case, the non-dimensional propagation speed c = cf(g[prime prime or minute]H)[minus sign]1/2 increases smoothly from the non-rotating value of 0.5 as W increases, asymptoting to unity for W [rightward arrow] [infty infinity]. The gravity current separates from the left-hand wall of the channel at W = 0.67 and thereafter has decreasing width. The depth of the current at the right-hand wall, h0, increases, reaching the full depth at W = 1.90, after which point the interface outcrops on both the upper and lower boundaries, with the distance over which the interface slopes being 0.881R. In the one-layer case, the wall