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Sample records for delayed treatment condition

  1. Classical conditioning for preserving the effects of short melatonin treatment in children with delayed sleep: a pilot study

    Directory of Open Access Journals (Sweden)

    van Maanen A

    2017-03-01

    Full Text Available Annette van Maanen,1 Anne Marie Meijer,1 Marcel G Smits,2 Frans J Oort1 1Research Institute Child Development and Education, University of Amsterdam, Amsterdam, 2Centre for Sleep-Wake Disorders and Chronobiology, Hospital Gelderse Vallei, Ede, the Netherlands Abstract: Melatonin treatment is effective in treating sleep onset problems in children with delayed melatonin onset, but effects usually disappear when treatment is discontinued. In this pilot study, we investigated whether classical conditioning might help in preserving treatment effects of melatonin in children with sleep onset problems, with and without comorbid attention deficit hyperactivity disorder (ADHD or autism. After a baseline week, 16 children (mean age: 9.92 years, 31% ADHD/autism received melatonin treatment for 3 weeks and then gradually discontinued the treatment. Classical conditioning was applied by having children drink organic lemonade while taking melatonin and by using a dim red light lamp that was turned on when children went to bed. Results were compared with a group of 41 children (mean age: 9.43 years, 34% ADHD/autism who received melatonin without classical conditioning. Melatonin treatment was effective in advancing dim light melatonin onset and reducing sleep onset problems, and positive effects were found on health and behavior problems. After stopping melatonin, sleep returned to baseline levels. We found that for children without comorbidity in the experimental group, sleep latency and sleep start delayed less in the stop week, which suggests an effect of classical conditioning. However, classical conditioning seems counterproductive in children with ADHD or autism. Further research is needed to establish these results and to examine other ways to preserve melatonin treatment effects, for example, by applying morning light. Keywords: melatonin, classical conditioning, children, delayed sleep

  2. Classic conditioning in aged rabbits: delay, trace, and long-delay conditioning.

    Science.gov (United States)

    Solomon, P R; Groccia-Ellison, M E

    1996-06-01

    Young (0.5 years) and aged (2+, 3+, and 4+ years) rabbits underwent acquisition of the classically conditioned nictitating membrane response in a delay (500-ms conditioned stimulus [CS], 400-ms interstimulus interval [ISI]), long-delay (1,000-ms CS, 900-ms ISI), or trace (500-ms CS, 400-ms stimulus-free period) paradigm. Collapsing across age groups, there is a general tendency for animals to acquire trace conditioning more slowly than delay conditioning. Collapsing across conditioning paradigms, there is a general tendency for aged animals to acquire more slowly than younger animals. Of greater significance, however, are the age differences in the different conditioning paradigms. In the delay and long-delay paradigms, significant conditioning deficits first appeared in the 4(+)-year-old group. In the trace conditioning paradigm, significant conditioning deficits became apparent in the 2(+)-year-old animals.

  3. Efficacy of a store-based environmental change intervention compared with a delayed treatment control condition on store customers' intake of fruits and vegetables.

    Science.gov (United States)

    Ayala, Guadalupe X; Baquero, Barbara; Laraia, Barbara A; Ji, Ming; Linnan, Laura

    2013-11-01

    The present store-based intervention was designed to promote sales of fruits and vegetables (F&V) to increase intake among store customers--specifically customers of tiendas, small-to-medium-sized Latino food stores. Four tiendas were randomized to a 2-month environmental change intervention or a delayed treatment control condition. Employees and managers were trained to promote F&V sales, including how to implement a food marketing campaign and installing store equipment to promote fresh fruits and vegetables. The primary outcome was self-reported daily intake of F&V among a convenience sample of customers (at least forty per store) collected at baseline prior to randomization and then 4 months later. In addition, changes in availability of F&V in the tiendas, using unobtrusive observational methods, provided evidence of intervention fidelity. Tiendas in central North Carolina. Participants included 179 customers who were recent immigrants from Mexico and Central America. A group-by-time interaction approached significance on daily servings of F&V; intervention customers reported an increase in F&V intake over time and as a function of the intervention (P customers’ reported F&V intake. Such strategies can have a public health impact on underserved populations.

  4. Improving Delay-Range-Dependent Stability Condition for Systems with Interval Time-Varying Delay

    Directory of Open Access Journals (Sweden)

    Wei Qian

    2013-01-01

    Full Text Available This paper discusses the delay-range-dependent stability for systems with interval time-varying delay. Through defining the new Lyapunov-Krasovskii functional and estimating the derivative of the LKF by introducing new vectors, using free matrices and reciprocally convex approach, the new delay-range-dependent stability conditions are obtained. Two well-known examples are given to illustrate the less conservatism of the proposed theoretical results.

  5. HAMLET treatment delays bladder cancer development.

    Science.gov (United States)

    Mossberg, Ann-Kristin; Hou, Yuchuan; Svensson, Majlis; Holmqvist, Bo; Svanborg, Catharina

    2010-04-01

    HAMLET is a protein-lipid complex that kills different types of cancer cells. Recently we observed a rapid reduction in human bladder cancer size after intravesical HAMLET treatment. In this study we evaluated the therapeutic effect of HAMLET in the mouse MB49 bladder carcinoma model. Bladder tumors were established by intravesical injection of MB49 cells into poly L-lysine treated bladders of C57BL/6 mice. Treatment groups received repeat intravesical HAMLET instillations and controls received alpha-lactalbumin or phosphate buffer. Effects of HAMLET on tumor size and putative apoptotic effects were analyzed in bladder tissue sections. Whole body imaging was used to study HAMLET distribution in tumor bearing mice compared to healthy bladder tissue. HAMLET caused a dose dependent decrease in MB49 cell viability in vitro. Five intravesical HAMLET instillations significantly decreased tumor size and delayed development in vivo compared to controls. TUNEL staining revealed selective apoptotic effects in tumor areas but not in adjacent healthy bladder tissue. On in vivo imaging Alexa-HAMLET was retained for more than 24 hours in the bladder of tumor bearing mice but not in tumor-free bladders or in tumor bearing mice that received Alexa-alpha-lactalbumin. Results show that HAMLET is active as a tumoricidal agent and suggest that topical HAMLET administration may delay bladder cancer development. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  6. A new delay-independent condition for global robust stability of neural networks with time delays.

    Science.gov (United States)

    Samli, Ruya

    2015-06-01

    This paper studies the problem of robust stability of dynamical neural networks with discrete time delays under the assumptions that the network parameters of the neural system are uncertain and norm-bounded, and the activation functions are slope-bounded. By employing the results of Lyapunov stability theory and matrix theory, new sufficient conditions for the existence, uniqueness and global asymptotic stability of the equilibrium point for delayed neural networks are presented. The results reported in this paper can be easily tested by checking some special properties of symmetric matrices associated with the parameter uncertainties of neural networks. We also present a numerical example to show the effectiveness of the proposed theoretical results. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Delays in presentation and treatment of breast cancer in Enugu ...

    African Journals Online (AJOL)

    To assess the delays and define the causes of delay in presentation and treatment of breast cancer patients inEnugu,Nigeria. Across-sectional survey of breast cancer patients using a semi structured questionnaire. SurgicalOncology unit,University ofNigeriaTeachingHospitalEnugu, (UNTH-E),Nigeria. 164 consecutively ...

  8. Determinants of patient delay in seeking treatment among ...

    African Journals Online (AJOL)

    Patients delay in seeking care increases the transmission of pulmonary tuberculosis and hence the burden of the disease. This study investigates the pattern and determinants of patients delay in seeking treatment among pulmonary tuberculosis cases attending a Government Chest Clinic in Ibadan, Nigeria. A descriptive ...

  9. Treatment delay and radiological errors in patients with bone metastases

    International Nuclear Information System (INIS)

    Ichinohe, K.; Takahashi, M.; Tooyama, N.

    2003-01-01

    During routine investigations, we are surprised to find that therapy for bone metastases is sometimes delayed for a considerable period of time. To determine the extent of this delay and its causes, we reviewed the medical records of symptomatic patients seen at our hospital who had been recently diagnosed as having bone metastases for the last four years. The treatment delay was defined as the interval between presentation with symptoms and definitive treatment for bone metastases. The diagnostic delay was defined as the interval between presentation with symptoms and diagnosis of bone metastases. The results of diagnostic radiological examinations were also reviewed for errors. The study population included 76 males and 34 females with a median age of 66 years. Most bone metastases were diagnosed radiologically. Over 75% of patients were treated with radiotherapy. The treatment delay ranged from 2 to 307 days, with a mean of 53.3 days. In 490 radiological studies reviewed, we identified 166 (33.9%) errors concerning 62 (56.4%) patients. The diagnostic delay was significantly longer for patients with radiological errors than for patients without radiological errors (P < 0.001), and much of it was due to radiological errors. In conclusion, the treatment delay in patients with symptomatic bone metastases was much longer than expected, and much of it was caused by radiological errors. Considerable efforts should therefore be made to more carefully examine the radiological studies in order to ensure prompt treatment of bone metastases. (author)

  10. Do health systems delay the treatment of poor children?

    DEFF Research Database (Denmark)

    Samuelsen, Helle; Tersbøl, Britt Pinkowski; Mbuyita, Selemani Said

    2013-01-01

    Child mortality remains one of the major public-health problems in Tanzania. Delays in receiving and accessing adequate care contribute to these high rates. The literature on public health often focuses on the role of mothers in delaying treatment, suggesting that they contact the health system too...... late and that they prefer to treat their children at home, a perspective often echoed by health workers. Using the three-delay methodology, this study focus on the third phase of the model, exploring the delays experienced in receiving adequate care when mothers with a sick child contact a health......-care facility. The overall objective is to analyse specific structural factors embedded in everyday practices at health facilities in a district in Tanzania which cause delays in the treatment of poor children and to discuss possible changes to institutions and social technologies....

  11. ATFM airborne delays without extra fuel consumption in wind conditions

    OpenAIRE

    Delgado, L.; Prats, X.

    2012-01-01

    Air Traffic Flow Management (ATFM) regulations, such as ground holdings, are often canceled before their initially planned ending time. The ground delays impact on the cost of recovering part of the delay if the regulation is canceled, as aircraft are still at the origin airport. In previous publications, the authors have suggested a speed reduction strategy to split the assigned ATFM delay between ground delay and airborne delay. By flying at the the minimum speed that g...

  12. Lifetime treatment contact and delay in treatment seeking after first onset of a mental disorder

    NARCIS (Netherlands)

    ten Have, M.; de Graaf, R.; van Dorsselaer, S.; Beekman, A.T.F.

    2013-01-01

    Objective: This study examined lifetime treatment contact and delays in treatment seeking, including rates for receipt of helpful treatment, after the onset of specific mental disorders and evaluated factors that predicted treatment seeking and delays in treatment seeking. Methods: Data were from

  13. Delayed bracket placement in orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Chandra Wigati

    2008-12-01

    Full Text Available Background: Beside bracket position, the timing of bracket placement is one of the most essential in orthodontic treatment with fixed appliances. Even it seems simple the timing of bracket placement can be crucial and significantly influence the result of orthodontic treatment. However it is often found brackets are placed without complete understanding of its purpose and effects, which could be useless and even detrimental for the case. Purpose: The aim of this case report is to show that the timing of bracket placement could be different depending on the cases. Case: Five different cases are presented here with different timing of bracket placement. Case management: On these cases, brackets were placed on the upper arch first, on the lower arch first, or even only on some teeth first. Good and efficient orthodontic treatment results were achieved. Conclusion: For every orthodontic case, from the very beginning of treatment, bracket should be placed with the end result in mind. If brackets are correctly placed at a correct time, better treatment result could be achieved without unnecessary round tripping tooth movement.

  14. Necessary and sufficient conditions for Hopf bifurcation in tri-neuron equation with a delay

    International Nuclear Information System (INIS)

    Liu Xiaoming; Liao Xiaofeng

    2009-01-01

    In this paper, we consider the delayed differential equations modeling three-neuron equations with only a time delay. Using the time delay as a bifurcation parameter, necessary and sufficient conditions for Hopf bifurcation to occur are derived. Numerical results indicate that for this model, Hopf bifurcation is likely to occur at suitable delay parameter values.

  15. Accounting for treatment delays when treating highly proliferative tumours

    International Nuclear Information System (INIS)

    Jones, L.; Metcalfe, P.; Hoban, P.

    1999-01-01

    This study was undertaken to investigate the possibility of increasing the dose per fraction or increasing the number of fractions to account for treatment delays occurring during radiotherapy treatments for highly proliferative tumours. The linear quadratic model with time was used to determine the difference in biological effective dose (BED) for the original schedule and the schedule including a treatment delay. Tables of extra fractions and extra dose per fraction required to account for a number of possible delays have been determined. It has been shown that for tumours with very short potential doubling times it is best to deliver the extra dose as an increase in dose per fraction rather than an increase in the number of fractions, while for tumours with moderately short potential doubling times (above 7 days) the reverse is true. The equivalent uninterrupted schedules, which would have delivered the same effects to the tumour, have also been determined. (author)

  16. Delay to first treatment contact for alcohol use disorder.

    Science.gov (United States)

    Chapman, Cath; Slade, Tim; Hunt, Caroline; Teesson, Maree

    2015-02-01

    This study explored the patterns and correlates of time to first treatment contact among people with alcohol use disorder (AUD) in Australia. Specifically it examined the relationship between sex, birth cohort, onset of AUD symptoms, severity, comorbidity, symptom type and time to first treatment contact (treatment delay) among those with alcohol abuse and dependence in a large population sample. Data came from the 2007 Australian National Survey of Mental Health and Wellbeing (N=8841). A modified version of the World Health Organization's Composite International Diagnostic Interview was used to determine the presence and age of onset of DSM-IV AUD and other mental disorders and the age at which respondents first sought treatment for alcohol or other drug-related problems. Median time to first treatment contact for an AUD was 18 years (14 years dependence, 23 years abuse). Projected lifetime treatment rates were 78.1% for alcohol dependence and 27.5% for abuse. Those with earlier onset and from older cohorts reported longer delay and were less likely to ever seek treatment compared to those with later onset or from more recent cohorts. Those with comorbid anxiety but not mood disorder, or who reported alcohol-related role disruption or recurrent interpersonal problems were more likely to ever seek treatment and reported shorter delay compared to those who did not report these symptoms. Treatment delay for alcohol use disorder in Australia is substantial. Those with earlier onset and those with comorbid mood disorder should be a target for earlier treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Determinants of patient delay in seeking treatment among ...

    African Journals Online (AJOL)

    lmboera

    A descriptive cross sectional study was employed. A face to .... Face validation of the instrument was done through peer review and pretesting. In this ..... patient delay for Christians was about 3.3 fold higher compared with Muslims. ... Grover, A., Kumar, R. & Jindal, K. (2006) Socio-demographic determinants of treatment.

  18. Delays in switching patients onto second-line antiretroviral treatment ...

    African Journals Online (AJOL)

    Background: South Africa has one of the largest antiretroviral treatment (ART) programmes globally. In addition to increasing access to ART, it is important that the health system also focuses on the appropriate management of patients who fail first-line ART. Delays in switching patients onto second-line ART can adversely ...

  19. Choice between delayed food and immediate opioids in rats: treatment effects and individual differences.

    Science.gov (United States)

    Panlilio, Leigh V; Secci, Maria E; Schindler, Charles W; Bradberry, Charles W

    2017-11-01

    Addiction involves maladaptive choice behavior in which immediate drug effects are valued more than delayed nondrug rewards. To model this behavior and extend our earlier work with the prescription opioid oxycodone, we allowed rats to choose between immediate intravenous delivery of the short-acting opioid remifentanil and delayed delivery of highly palatable food pellets. Treatment drugs were tested on a baseline where remifentanil was preferred over food. Treatment with a high dose of the opioid antagonist naltrexone decreased but did not reverse the preference for remifentanil. Treatment with the serotonin 5-HT 2C agonist lorcaserin decreased remifentanil and food self-administration nonselectively. Across conditions in which the alternative to delayed food was either a moderate dose of oxycodone, a moderate or high dose of remifentanil, a smaller more immediate delivery of food, or timeout with no primary reinforcement, choice was determined by both the length of the delay and the nature of the alternative option. Delayed food was discounted most steeply when the alternative was a high dose of remifentanil, which was preferred over food when food was delayed by 30 s or more. Within-subject comparisons showed no evidence for trait-like impulsivity or sensitivity to delay across these conditions. Choice was determined more by the current contingencies of reinforcement than by innate individual differences. This finding suggests that people might develop steep delay-discounting functions because of the contingencies in their environment, and it supports the use of contingency management to enhance the relative value of delayed nondrug reinforcers.

  20. Factors that influence treatment delay in patients with colorectal cancer

    Science.gov (United States)

    Zarcos-Pedrinaci, Irene; Fernández-López, Alberto; Téllez, Teresa; Rivas-Ruiz, Francisco; Rueda A, Antonio; Suarez-Varela, María Manuela Morales; Briones, Eduardo; Baré, Marisa; Escobar, Antonio; Sarasqueta, Cristina; de Larrea, Nerea Fernández; Aguirre, Urko; Quintana, José María; Redondo, Maximino

    2017-01-01

    A prospective study was performed of patients diagnosed with colorectal cancer (CRC), distinguishing between colonic and rectal location, to determine the factors that may provoke a delay in the first treatment (DFT) provided. 2749 patients diagnosed with CRC were studied. The study population was recruited between June 2010 and December 2012. DFT is defined as time elapsed between diagnosis and first treatment exceeding 30 days. Excessive treatment delay was recorded in 65.5% of the cases, and was more prevalent among rectal cancer patients. Independent predictor variables of DFT in colon cancer patients were a low level of education, small tumour, ex-smoker, asymptomatic at diagnosis and following the application of screening. Among rectal cancer patients, the corresponding factors were primary school education and being asymptomatic. We conclude that treatment delay in CRC patients is affected not only by clinicopathological factors, but also by sociocultural ones. Greater attention should be paid by the healthcare provider to social groups with less formal education, in order to optimise treatment attention. PMID:27888636

  1. Patient Delay, Diagnosis Delay and Treatment Delay for Breast Cancer: Comparison of the Pattern between Patients in Public and Private Health Sectors

    Directory of Open Access Journals (Sweden)

    Iraj Harirchi

    2015-05-01

    Full Text Available Background: The purpose of this study was to compare patient delay, diagnosis delay and treatment delay in breast cancer patients of selected public and private health centers in Tehran, Iran.Methods: In this cross-sectional study, female patients with newly diagnosed breast cancer in a public medical complex and a private breast clinic within one year were included. Patient delay was considered positive, if the interval between the detection of the first symptom by the patient and the first visit to a health care provider took longer than one month. Delay in diagnosis was defined as the period of more than one week between the first medical visit for the symptoms and the diagnosis of breast cancer. Following the confirmed diagnosis of breast malignancy, if the medical treatment was initiated later than one week, treatment delay had occurred. The potential reasons for patient, diagnosis and treatment delay according to the patients’ reports were also recorded.Results: Overall, 385 patients were included of whom 52.7% were recruited from the public hospitals and 47.3% from a private clinic. The prevalence of patient delay, diagnosis delay and treatment delay were 31.7%, 17.9% and 28.3%, respectively. Patient delay was significantly more common among patients with lower socio-economic status and those recruited from the public hospitals. All the patients with diagnosis delay were in the group recruited from the public hospitals.Conclusions: Gaps between women of different socio-economic levels of the society need to be addressed in order to decrease patient, diagnosis and treatment delay.

  2. Speech and Language Delay

    Science.gov (United States)

    ... OTC Relief for Diarrhea Home Diseases and Conditions Speech and Language Delay Condition Speech and Language Delay Share Print Table of Contents1. ... Treatment6. Everyday Life7. Questions8. Resources What is a speech and language delay? A speech and language delay ...

  3. Predicting memory performance under conditions of proactive interference: immediate and delayed judgments of learning.

    Science.gov (United States)

    Wahlheim, Christopher N

    2011-07-01

    Four experiments examined the monitoring accuracy of immediate and delayed judgments of learning (JOLs) under conditions of proactive interference (PI). PI was produced using paired-associate learning tasks that conformed to variations of classic A-B, A-D paradigms. Results revealed that the relative monitoring accuracy of interference items was better for delayed than for immediate JOLs. However, delayed JOLs were overconfident for interference items, but not for items devoid of interference. Intrusions retrieved prior to delayed JOLs produced inflated predictions of performance. These results show that delayed JOLs enhance monitoring accuracy in PI situations, except when intrusions are mistaken for target responses.

  4. Delayed complications of radiotherapy treatment for nasopharyngeal carcinoma: imaging findings

    International Nuclear Information System (INIS)

    King, A.D.; Ahuja, A.T.; Yeung, D.K.; Wong, J.K.T.; Lee, Y.Y.P.; Lam, W.W.M.; Ho, S.S.M.; Yu, S.C.H.; Leung, S.-F.

    2007-01-01

    Radiotherapy is used to treat a wide variety of head and neck tumours that arise in and around the skull base. The delayed effects of radiation damages a range of structures, including the nervous system, bone, major vessels, mucus membranes, pituitary and salivary glands, as well as increasing the risk of radiation-induced neoplasms. In this review the complications resulting from radiation treatment for nasopharyngeal carcinoma (NPC), a cancer treated with a high dose of radiation to a fairly large region, are illustrated. Many patients with NPC have a long-term survival, so are at risk of developing delayed radiation effects, and hence may demonstrate a wide range of complications on imaging. Other tumours around the skull base treated with radiotherapy include meningiomas, chordomas, chondrosarcomas, pituitary adenomas, paranasal sinus and nasal cavity tumours. In these cases similar complications may be encountered on imaging, although the severity, incidence and location will vary

  5. Interaction of low-dose irradiation with subsequent mutagenic treatment. Role of mitotic delay

    International Nuclear Information System (INIS)

    Salone, B.; Pretazzoli, V.; Bosi, A.; Olivieri, G.

    1996-01-01

    Experiments were carried out with human lymphocytes to test whether there was any relation between the changes that conditioning treatment can produce in cell progression or in mitotic delay induced by the challenge dose and the presence of an 'adaptive response' (AR). In experiments in which the cells were successively fixed after the challenge dose, the interaction between conditioning treatment and challenge was of the same sign for all the fixation times: therefore it is likely that modifications of the cytogenetic damage in primed cells is not a mere reflection of stage sensitivity. In experiments in which using 1 Gy as conditioning treatment we induced a drastic extension of G 2 , we did not observe any AR; therefore, even if conditioning treatment can induce modifications in the cell-cycle phases before and/or after challenge, there is probably no link between these modifications and the presence of an AR

  6. Patient delay is the main cause of treatment delay in acute limb ischemia: an investigation of pre- and in-hospital time delay

    DEFF Research Database (Denmark)

    Londero, Louise Skovgaard; Nørgaard, Birgitte; Houlind, Kim Christian

    2014-01-01

    Abstract BACKGROUND: The prognosis of acute limb ischemia is severe, with amputation rates of up to 25% and in-hospital mortality of 9-15%. Delay in treatment increases the risk of major amputation and may be present at different stages, including patient delay, doctors´ delay and waiting time...... in the emergency department. It is important to identify existing problems in order to reduce time delay. The aim of this study was to collect data for patients with acute limb ischemia and to evaluate the time delay between the different events from onset of symptoms to specialist evaluation and further treatment...... (median (range)) was identified. From onset of symptoms to first contact with a doctor the time for all patients were 24 (0-1200) hours. Thirty patients needed immediate intervention. In the group of fourteen patients who had immediate operation, the median time from vascular evaluation...

  7. Delayed access to treatments for rare diseases: who's to blame?

    Science.gov (United States)

    Feltmate, Karen; Janiszewski, Peter M; Gingerich, Sheena; Cloutier, Michael

    2015-04-01

    The development and commercialization of drugs for rare diseases, termed 'orphan drugs', has historically been economically unattractive. However, because of the introduction of legislation that provides financial and regulatory incentives for the development of orphan drugs, new developments are making their way through the regulatory approval processes. Unfortunately, delays in availability of new drugs for treating rare disease continue to persist. This paper reviews the approach of several regulatory jurisdictions to orphan drugs in an effort to determine their relative effectiveness in providing patient access. Generally speaking, regulatory authorities across jurisdictions have recognized the need to enhance timely access to safe, effective treatment for patients with rare diseases and have been able to shift the approval timelines for access to new care. The greater impediment to orphan drug access appears to be funding, particularly in publicly sponsored health-care systems. Redundancies in federal and provincial reviews of orphan drugs can result in significant delays in access to new drugs. Clearly, more must be done to accelerate access to the treatments so desperately needed by patients. Public payers must be held accountable for their process and decisions--especially for rare disease therapies. © 2015 Asian Pacific Society of Respirology.

  8. Karrikins delay soybean seed germination by mediating abscisic acid and gibberellin biogenesis under shaded conditions

    Science.gov (United States)

    Meng, Yongjie; Chen, Feng; Shuai, Haiwei; Luo, Xiaofeng; Ding, Jun; Tang, Shengwen; Xu, Shuanshuan; Liu, Jianwei; Liu, Weiguo; Du, Junbo; Liu, Jiang; Yang, Feng; Sun, Xin; Yong, Taiwen; Wang, Xiaochun; Feng, Yuqi; Shu, Kai; Yang, Wenyu

    2016-01-01

    Karrikins (KAR) are a class of signal compounds, discovered in wildfire smoke, which affect seed germination. Currently, numerous studies have focused on the model plant Arabidopsis in the KAR research field, rather than on crops. Thus the regulatory mechanisms underlying KAR regulation of crop seed germination are largely unknown. Here, we report that KAR delayed soybean seed germination through enhancing abscisic acid (ABA) biosynthesis, while impairing gibberellin (GA) biogenesis. Interestingly, KAR only retarded soybean seed germination under shaded conditions, rather than under dark and white light conditions, which differs from in Arabidopsis. Phytohormone quantification showed that KAR enhanced ABA biogenesis while impairing GA biosynthesis during the seed imbibition process, and subsequently, the ratio of active GA4 to ABA was significantly reduced. Further qRT-PCR analysis showed that the transcription pattern of genes involved in ABA and GA metabolic pathways are consistent with the hormonal measurements. Finally, fluridone, an ABA biogenesis inhibitor, remarkably rescued the delayed-germination phenotype of KAR-treatment; and paclobutrazol, a GA biosynthesis inhibitor, inhibited soybean seed germination. Taken together, these evidences suggest that KAR inhibit soybean seed germination by mediating the ratio between GA and ABA biogenesis. PMID:26902640

  9. Karrikins delay soybean seed germination by mediating abscisic acid and gibberellin biogenesis under shaded conditions.

    Science.gov (United States)

    Meng, Yongjie; Chen, Feng; Shuai, Haiwei; Luo, Xiaofeng; Ding, Jun; Tang, Shengwen; Xu, Shuanshuan; Liu, Jianwei; Liu, Weiguo; Du, Junbo; Liu, Jiang; Yang, Feng; Sun, Xin; Yong, Taiwen; Wang, Xiaochun; Feng, Yuqi; Shu, Kai; Yang, Wenyu

    2016-02-23

    Karrikins (KAR) are a class of signal compounds, discovered in wildfire smoke, which affect seed germination. Currently, numerous studies have focused on the model plant Arabidopsis in the KAR research field, rather than on crops. Thus the regulatory mechanisms underlying KAR regulation of crop seed germination are largely unknown. Here, we report that KAR delayed soybean seed germination through enhancing abscisic acid (ABA) biosynthesis, while impairing gibberellin (GA) biogenesis. Interestingly, KAR only retarded soybean seed germination under shaded conditions, rather than under dark and white light conditions, which differs from in Arabidopsis. Phytohormone quantification showed that KAR enhanced ABA biogenesis while impairing GA biosynthesis during the seed imbibition process, and subsequently, the ratio of active GA4 to ABA was significantly reduced. Further qRT-PCR analysis showed that the transcription pattern of genes involved in ABA and GA metabolic pathways are consistent with the hormonal measurements. Finally, fluridone, an ABA biogenesis inhibitor, remarkably rescued the delayed-germination phenotype of KAR-treatment; and paclobutrazol, a GA biosynthesis inhibitor, inhibited soybean seed germination. Taken together, these evidences suggest that KAR inhibit soybean seed germination by mediating the ratio between GA and ABA biogenesis.

  10. Early identification and delay to treatment in myocardial infarction and stroke: differences and similarities

    Directory of Open Access Journals (Sweden)

    Herlitz Johan

    2010-09-01

    Full Text Available Abstract Background The two major complications of atherosclerosis are acute myocardial infarction (AMI and acute ischemic stroke. Both are life-threatening conditions characterised by the abrupt cessation of blood flow to respective organs, resulting in an infarction. Depending on the extent of the infarction, loss of organ function varies considerably. In both conditions, it is possible to limit the extent of infarction with early intervention. In both conditions, minutes count. This article aims to describe differences and similarities with regard to the way patients, bystanders and health care providers act in the acute phase of the two diseases with the emphasis on the pre-hospital phase. Method A literature search was performed on the PubMed, Embase (Ovid SP and Cochrane Library databases. Results In both conditions, symptoms vary considerably. Patients appear to suspect AMI more frequently than stroke and, in the former, there is a gender gap (men suspect AMI more frequently than women. With regard to detection of AMI and stroke at dispatch centre and in Emergency Medical Service (EMS there is room for improvement in both conditions. The use of EMS appears to be higher in stroke but the overall delay to hospital admission is shorter in AMI. In both conditions, the fast track concept has been shown to influence the delay to treatment considerably. In terms of diagnostic evaluation by the EMS, more supported instruments are available in AMI than in stroke. Knowledge of the importance of early treatment has been reported to influence delays in both AMI and stroke. Conclusion Both in AMI and stroke minutes count and therefore the fast track concept has been introduced. Time to treatment still appears to be longer in stroke than in AMI. In the future improvement in the early detection as well as further shortening to start of treatment will be in focus in both conditions. A collaboration between cardiologists and neurologists and also between

  11. Treatment for delayed brain injury after pituitary irradiation

    International Nuclear Information System (INIS)

    Fujii, Takashi; Misumi, Shuzoh; Shibasaki, Takashi; Tamura, Masaru; Kunimine, Hideo; Hayakawa, Kazushige; Niibe, Hideo; Miyazaki, Mizuho; Miyagi, Osamu.

    1988-01-01

    Treatment for delayed brain injury after pituitary irradiation is discussed. Six cases with delayed brain injury were treated with a combination of dexamethasone or betamethasone, with heparin, glycerol, dextran 40 and some vasodilators. Two cases with temporal lobe syndrome were treated in the early stages of brain injury for a period of over 12 months were almost completely cured, another two cases with chiasma syndrome were treated in the relatively late stages, showed a partial improvement. One case which was irradiated 120 GY during 13 years did not improve. The final case treated with steroids for a short period also resulted in failure and the patient underwent an operation for the removal of the necrotic mass three years after the radiotherapy. Steroid therapy started in the early stages of brain injury after irradiation for over the 12 months is thought to be effective. Heparin therapy was also effective in one out of three cases, but in one of the cases subarachnoid hemorrhage from a traumatic aneurysm occurred during the therapy. In an acute phase, showing edematous change of the injured brain, the administration of glycerol is also thought to be useful. But the effectiveness of the other medicines containing some vasodilators was obscure or doubtful. We propose the following : (1) A meticulous observation is essential for the patients who received high doses of irradiation to diagnose brain injury in the early reversible stage. (2) Steroids should be given immediately in this reversible stage of brain injury before the irreversible ''necrosis'' occurs. (3) Steroids should be maintained for a long period over 12 months. (4) Heparin therapy is also thought to be effective, but careful precautions to avoid hemorrhagic complications before the therapy should be scheduled. This recommended plan may also be used for the treatment of brain injuries after cranial irradiation for other intracranial tumors. (author)

  12. Delays in diagnosis and treatment of extrapulmonary tuberculosis in Guatemala.

    Science.gov (United States)

    Shah, Pooja Ajay; Coj, Merida; Rohloff, Peter

    2017-10-09

    A 23-year-old indigenous Guatemalan man presented in 2016 to our clinic in Sololá, Guatemala, with 10 months of recurrent neck swelling, fevers, night sweats and weight loss. Previously, he had sought care in three different medical settings, including a private physician-run clinic, a tertiary private cancer treatment centre and, finally, a rural government health post. With assistance from our institution's accompaniment staff, the patient was admitted to a public tertiary care hospital for work-up. Rifampin-susceptible tuberculosis was diagnosed, and appropriate treatment was begun. The case illustrates how low tuberculosis recognition among community health workers and health system segmentation creates obstacles to appropriate care, especially for patients with limited means. As a result, significant diagnostic and treatment delays can occur, increasing the public health burden of tuberculosis. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Immediate versus delayed treatment for recently symptomatic carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Vladimir Vasconcelos

    Full Text Available ABSTRACT BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days compared with delayed treatment (after two days for people with recently symptomatic carotid artery stenosis. METHODS: Search methods: We searched the Cochrane Stroke Group Trials Register in January 2016, the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1, MEDLINE (1948 to 26 January 2016, EMBASE (1974 to 26 January 2016, LILACS (1982 to 26 January 2016, and trial registers (from inception to 26 January 2016. We also handsearched conference proceedings and journals, and searched reference lists. There were no language restrictions. We contacted colleagues and pharmaceutical companies to identify further studies and unpublished trials Selection criteria: All completed, truly randomized trials (RCT that compared very early cerebral revascularization (within two days with delayed treatment (after two days for people with recently symptomatic carotid artery stenosis. Data collection and analysis: We independently selected trials for inclusion according to the above criteria, assessed risk of bias for each trial, and performed data extraction. We utilized an intention-to-treat analysis strategy. MAIN RESULTS: We identified one RCT that involved 40 participants, and addressed the timing of surgery for people with recently symptomatic carotid artery stenosis. It compared very early surgery with surgery performed after 14 days of

  14. Globally exponential stability condition of a class of neural networks with time-varying delays

    International Nuclear Information System (INIS)

    Liao, T.-L.; Yan, J.-J.; Cheng, C.-J.; Hwang, C.-C.

    2005-01-01

    In this Letter, the globally exponential stability for a class of neural networks including Hopfield neural networks and cellular neural networks with time-varying delays is investigated. Based on the Lyapunov stability method, a novel and less conservative exponential stability condition is derived. The condition is delay-dependent and easily applied only by checking the Hamiltonian matrix with no eigenvalues on the imaginary axis instead of directly solving an algebraic Riccati equation. Furthermore, the exponential stability degree is more easily assigned than those reported in the literature. Some examples are given to demonstrate validity and excellence of the presented stability condition herein

  15. The Amygdala Is Critical for Trace, Delay, and Contextual Fear Conditioning

    Science.gov (United States)

    Kochli, Daniel E.; Thompson, Elaine C.; Fricke, Elizabeth A.; Postle, Abagail F.; Quinn, Jennifer J.

    2015-01-01

    Numerous investigations have definitively shown amygdalar involvement in delay and contextual fear conditioning. However, much less is known about amygdala contributions to trace fear conditioning, and what little evidence exists is conflicting as noted in previous studies. This discrepancy may result from selective targeting of individual nuclei…

  16. Retention and Extinction of Delay Eyeblink Conditioning Are Modulated by Central Cannabinoids

    Science.gov (United States)

    Steinmetz, Adam B.; Freeman, John H.

    2011-01-01

    Rats administered the cannabinoid agonist WIN55,212-2 or the antagonist SR141716A exhibit marked deficits during acquisition of delay eyeblink conditioning, as noted by Steinmetz and Freeman in an earlier study. However, the effects of these drugs on retention and extinction of eyeblink conditioning have not been assessed. The present study…

  17. An improved condition for master-slave synchronization of Lur'e systems with time delay

    International Nuclear Information System (INIS)

    Xiang, Ji; Li, Yanjun; Wei, Wei

    2007-01-01

    In this Letter, a new sufficient condition is proposed for master-slave synchronization of Lur'e system with time delay. This condition is constructed on the new integral inequality method such that the obtained result is much sharper than that in [M.E.Y. Yalcin, J.A.K. Suykens, J. Vandewalle, Int. J. Bifur. Chaos 11 (2001) 1707

  18. Treatment delay of bone tumours, compilation of a sociodemographic risk profile: A retrospective study

    International Nuclear Information System (INIS)

    Schnurr, Christoph; Pippan, Mathias; Stuetzer, Hartmut; Delank, Karl S; Michael, Joern WP; Eysel, Peer

    2008-01-01

    Bone tumours are comparatively rare tumours and delays in diagnosis and treatment are common. The purpose of this study was to analyse sociodemographic risk factors for bone tumour patients in order to identify those at risk of prolonged patients delay (time span from first symptoms to consultation), professional delay (from consultation to treatment) or symptom interval (from first symptoms to treatment). Understanding these relationships might enable us to shorten time to diagnosis and therapy. We carried out a retrospective analysis of 265 patients with bone tumours documenting sociodemographic factors, patient delay, professional delay and symptom interval. A multivariate explorative Cox model was performed for each delay. Female gender was associated with a prolonged patient delay. Age under 30 years and rural living predisposes to a prolonged professional delay and symptom interval. Early diagnosis and prompt treatment are required for successful management of most bone tumour patients. We succeeded in identifying the histology independent risk factors of age under 30 years and rural habitation for treatment delay in bone tumour patients. Knowing about the existence of these risk groups age under 30 years and female gender could help the physician to diagnose bone tumours earlier. The causes for the treatment delays of patients living in a rural area have to be investigated further. If the delay initiates in the lower education of rural general physicians, further training about bone tumours might advance early detection. Hence the outcome of patients with bone tumours could be improved

  19. Delayed puberty and hypogonadotropic hypogonadism. Differential diagnosis and treatment

    NARCIS (Netherlands)

    Snoep, Marinus Cornelis

    1978-01-01

    This thesis describes a method enabling a prospecrive differential diagnosis to be made berween delayed puberty (DP) and hypogonadotropic hypogonadism (HH). The influence of androgen administration on the gonadal feedback sysrem of patients with delayed puberty was also studied. ... Zie: Summary

  20. Sharp conditions for global stability of Lotka-Volterra systems with distributed delays

    Science.gov (United States)

    Faria, Teresa

    We give a criterion for the global attractivity of a positive equilibrium of n-dimensional non-autonomous Lotka-Volterra systems with distributed delays. For a class of autonomous Lotka-Volterra systems, we show that such a criterion is sharp, in the sense that it provides necessary and sufficient conditions for the global asymptotic stability independently of the choice of the delay functions. The global attractivity of positive equilibria is established by imposing a diagonal dominance of the instantaneous negative feedback terms, and relies on auxiliary results showing the boundedness of all positive solutions. The paper improves and generalizes known results in the literature, namely by considering systems with distributed delays rather than discrete delays.

  1. Treatment seeking behaviour and prevalence of treatment delay among malaria patients along Thailand-Myanmar border in Tak province

    Directory of Open Access Journals (Sweden)

    Krit Sonkong

    2015-04-01

    Full Text Available Objective: To investigate treatment seeking behaviour and the prevalence of treatment delay of malaria patients. Methods: A cross-sectional study was conducted with malaria patients along the ThailandMyanmar border in Tak province, Thailand. Results: Most of patients (70.0% were treated for fever before receiving treatment at a malaria clinic or public hospital. The sources of initial treatments were self-treatment (64.0%, malaria clinics (20.0%, public hospital (11.0%, sub-district health promotion hospital (3.3%, and malaria posts (1.1%. Prevalence of patients delayed more than one day after onset of symptoms was 79.4%, but doctor delay of more than one day occurred in only 1.3%. The prevalence of treatment delay (total delay of more than one day was 79.6%. Patient delay and treatment delay were found to be significantly higher among hill tribe than Thai subjects (P=0.004 and 0.003, respectively but, there was no significant association between ethnicity and doctor delay (P=0.669. Conclusion: Patient delay in seeking treatment is a major problem along the ThailandMyanmar border in Tak province, especially in hill tribe people. Self-treatment accounted for most of initial treatment sought by patients.

  2. Delay in treatment seeking of smear positive tuberculous patients

    International Nuclear Information System (INIS)

    Bhatti, A.T.; Zahid, M.

    2010-01-01

    To assess and identify the causes and circumstances leading to delays in health seeking and diagnosis of tuberculosis patients as they often present with advance disease resulting in increased morbidity and mortality. Settings Department of Tuberculosis, DOTS clinic DHQ Hospital, Vehari. Methodology One (author) inspiration diagnosed smear positive pulmonary tuberculosis patients were included. Information was gathered through interviews and from TB-01 card. Results Maximum patients were in age group of 16-40 years. Median patient delay was 4-6 months; jobless, homeless personnel had longer delay. The main reason for delay was that the symptoms were not considered serious enough. Delay in presentation of smear positive cases may be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and awareness campaigns targeted at the population and involvement of private sector will improve TB control in Vehari. (author)

  3. Synchronization of Reaction-Diffusion Neural Networks With Dirichlet Boundary Conditions and Infinite Delays.

    Science.gov (United States)

    Sheng, Yin; Zhang, Hao; Zeng, Zhigang

    2017-10-01

    This paper is concerned with synchronization for a class of reaction-diffusion neural networks with Dirichlet boundary conditions and infinite discrete time-varying delays. By utilizing theories of partial differential equations, Green's formula, inequality techniques, and the concept of comparison, algebraic criteria are presented to guarantee master-slave synchronization of the underlying reaction-diffusion neural networks via a designed controller. Additionally, sufficient conditions on exponential synchronization of reaction-diffusion neural networks with finite time-varying delays are established. The proposed criteria herein enhance and generalize some published ones. Three numerical examples are presented to substantiate the validity and merits of the obtained theoretical results.

  4. Variation formulae for the solutions of delay differential equations with discontinuous initial conditions

    International Nuclear Information System (INIS)

    Kharatishvili, G L; Tadumadze, T A

    2005-01-01

    Variation formulae are proved for solutions of non-linear differential equations with variable delays and discontinuous initial conditions. The discontinuity of the initial condition means that at the initial moment of time the values of the initial function and the trajectory, generally speaking, do not coincide. The formulae obtained contain a new summand connected with the discontinuity of the initial condition and the variation of the initial moment.

  5. Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan.

    Science.gov (United States)

    Abu-Helalah, Ahmad Munir; Alshraideh, Hussam Ahmad; Al-Hanaqtah, Mo'tasem; Da'na, Moh'd; Al-Omari, Asim; Mubaidin, Rasmi

    2016-01-01

    Breast cancer is the most common cancer, and one of the leading causes of death for females in Jordan and many countries in the world. Studies have shown that delay in symptoms presentation, diagnosis or treatment would result in poor prognosis. There has been no published study from Jordan on delays in patient presentation, delays in diagnosis, or delays in treatment. Therefore, we conducted this study to assess these important quality indicators aiming to improve prognosis for breast cancer patients in Jordan. This project was a cross-sectional study on female breast cancer patients in Jordan. The total number of participants was 327. The proportion of patients with presentation delay, diagnosis delay, and treatment delay was 32.2%, 49.1%, or 32.4%, respectively. The main reported reasons for delay in presentation were ignorance of the nature of the problem (65.6%), limited/lack of knowledge that symptoms were suggestive of cancer diagnosis (16.7%), and misdiagnosis (16.7%). Predictors of delay and mean time for presentation, diagnosis, and treatment were identified. Our results reveal that breast cancer patients in Jordan are experiencing delays in presentation, diagnosis, and treatment. This could justify the advanced stages at diagnosis and poor outcomes for breast cancer patients in Jordan. We recommend revising the current early detection and down-staging programs in Jordan. © 2015 Wiley Periodicals, Inc.

  6. Antibiotic treatment delay and outcome in acute bacterial meningitis

    DEFF Research Database (Denmark)

    Køster-Rasmussen, Rasmus; Korshin, André; Meyer, Christian N

    2008-01-01

    OBJECTIVES: To identify to what degree in-hospital delay of antibiotic therapy correlated to outcome in community acquired bacterial meningitis. METHODS: All cases of culture-positive cerebrospinal fluids in east Denmark from 2002 to 2004 were included. Medical records were collected retrospectiv......OBJECTIVES: To identify to what degree in-hospital delay of antibiotic therapy correlated to outcome in community acquired bacterial meningitis. METHODS: All cases of culture-positive cerebrospinal fluids in east Denmark from 2002 to 2004 were included. Medical records were collected......=1.30/h, CI: 1.08-1.57). The median delay to the first dose of adequate antibiotics was 1h and 39min (1h and 14min in children vs. 2h in adults, pmeningitis. CONCLUSION: The delay in antibiotic therapy correlated...

  7. Why trace and delay conditioning are sometimes (but not always) hippocampal dependent: A computational model

    Science.gov (United States)

    Moustafa, Ahmed A.; Wufong, Ella; Servatius, Richard J.; Pang, Kevin C. H.; Gluck, Mark A.; Myers, Catherine E.

    2013-01-01

    A recurrent-network model provides a unified account of the hippocampal region in mediating the representation of temporal information in classical eyeblink conditioning. Much empirical research is consistent with a general conclusion that delay conditioning (in which the conditioned stimulus CS and unconditioned stimulus US overlap and co-terminate) is independent of the hippocampal system, while trace conditioning (in which the CS terminates before US onset) depends on the hippocampus. However, recent studies show that, under some circumstances, delay conditioning can be hippocampal-dependent and trace conditioning can be spared following hippocampal lesion. Here, we present an extension of our prior trial-level models of hippocampal function and stimulus representation that can explain these findings within a unified framework. Specifically, the current model includes adaptive recurrent collateral connections that aid in the representation of intra-trial temporal information. With this model, as in our prior models, we argue that the hippocampus is not specialized for conditioned response timing, but rather is a general-purpose system that learns to predict the next state of all stimuli given the current state of variables encoded by activity in recurrent collaterals. As such, the model correctly predicts that hippocampal involvement in classical conditioning should be critical not only when there is an intervening trace interval, but also when there is a long delay between CS onset and US onset. Our model simulates empirical data from many variants of classical conditioning, including delay and trace paradigms in which the length of the CS, the inter-stimulus interval, or the trace interval is varied. Finally, we discuss model limitations, future directions, and several novel empirical predictions of this temporal processing model of hippocampal function and learning. PMID:23178699

  8. Delayed onset muscle soreness : treatment strategies and performance factors.

    Science.gov (United States)

    Cheung, Karoline; Hume, Patria; Maxwell, Linda

    2003-01-01

    Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted.A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of

  9. Children with autism spectrum disorders show abnormal conditioned response timing on delay, but not trace, eyeblink conditioning

    Science.gov (United States)

    Oristaglio, Jeff; West, Susan Hyman; Ghaffari, Manely; Lech, Melissa S.; Verma, Beeta R.; Harvey, John A.; Welsh, John P.; Malone, Richard P.

    2013-01-01

    Children with autism spectrum disorder (ASD) and age-matched typically-developing (TD) peers were tested on two forms of eyeblink conditioning (EBC), a Pavlovian associative learning paradigm where subjects learn to execute an appropriately-timed eyeblink in response to a previously neutral conditioning stimulus (CS). One version of the task, trace EBC, interposes a stimulus-free interval between the presentation of the CS and the unconditioned stimulus (US), a puff of air to the eye which causes subjects to blink. In delay EBC, the CS overlaps in time with the delivery of the US, usually with both stimuli terminating simultaneously. ASD children performed normally during trace EBC, exhibiting no differences from typically-developing (TD) subjects with regard to learning rate or the timing of the CR. However, when subsequently tested on delay EBC, subjects with ASD displayed abnormally-timed conditioned eye blinks that began earlier and peaked sooner than those of TD subjects, consistent with previous findings. The results suggest an impaired ability of children with ASD to properly time conditioned eye blinks which appears to be specific to delay EBC. We suggest that this deficit may reflect a dysfunction of cerebellar cortex in which increases in the intensity or duration of sensory input can temporarily disrupt the accuracy of motor timing over short temporal intervals. PMID:23769889

  10. High mortality during tuberculosis treatment does not indicate long diagnostic delays in Vietnam: a cohort study

    Directory of Open Access Journals (Sweden)

    Sy Dinh N

    2007-08-01

    Full Text Available Abstract Background Delay in tuberculosis diagnosis and treatment initiation may increase disease severity and mortality. In evaluations of tuberculosis control programmes high fatality rates during tuberculosis treatment, are used as an indicator of long delays in low HIV-prevalence settings. However, data for this presumed association between delay and fatality are lacking. We assessed the association between diagnostic delay and mortality of new smear-positive pulmonary tuberculosis patients in Vietnam. Methods Follow-up of a patient cohort included in a survey of diagnostic delay in 70 randomly selected districts. Data on diagnosis and treatment were extracted from routine registers. Patients who had died during the course of treatment were compared to those with reported cure, completed treatment or failure (survivors. Results Complete data were available for 1881/2093 (89.9% patients, of whom 82 (4.4% had died. Fatality was 4.5% for patients with ≤ 4 weeks delay, 5.0% for 5- ≤ 8 weeks delay (aOR 1.11, 95%CI 0.67–1.84 and 3.2% for > 9 weeks delay (aOR 0.69, 95%CI 0.37–1.30. Fatality tended to decline with increasing delay but this was not significant. Fatality was not associated with median diagnostic delay at district level (Spearman's rho = -0.08, P = 0.5. Conclusion Diagnostic delay is not associated with treatment mortality in Vietnam at individual nor district level, suggesting that high case fatality should not be used as an indicator of long diagnostic delay in national tuberculosis programmes.

  11. [Delayed reactions of active avoidance in white rats under conditions of an alternative choice].

    Science.gov (United States)

    Ioseliani, T K; Sikharulidze, N I; Kadagishvili, A Ia; Mitashvili, E G

    1995-01-01

    It was shown that if the rats had been learned and then tested using conventional pain punishment of erroneous choice they were able to solve the problem of alternative choice only in the period of immediate action of conditioned stimuli. If the pain punishment for erroneously chosen compartment had not been applied in animal learning and testing, rats successfully solved the problem of alternative choice even after 5-second delay. Introduction of pain punishment led to the frustration of earlier elaborated delayed avoidance reactions. Analysis of the obtained results allows us to argue that the apparent incapability of white rats for solving the problems of delayed avoidance is caused by simultaneous action of two different mechanisms, i.e., those of the active and passive avoidance rather than short-term memory deficit.

  12. Impact of delay to treatment upon survival in 1067 patients with breast-cancer.

    Science.gov (United States)

    Rabinovich, M; Vallejo, C; Perez, J; Rodriguez, R; Cuevas, M; Machiavelli, M; Lacava, J; Leone, B; Romero, A; Mickiewicz, E; Chacon, R; Estevez, R

    1993-02-01

    The medical records of 1067 patients with breast cancer were reviewed to evaluate the influence of delay between first symptom and first treatment upon survival. Three delay intervals were considered: 6 months. At a follow-up of 120 months, survival analyses identified a statistically significant difference (p=0.029) favoring patients with 3 months delay between first symptom and first treatment. Better survival rate for patients with a short delay would obey to a greater number of patients in favorable stages and a higher proportion of women aged 50 or older in this group.

  13. Factors associated with delays in treatment initiation after tuberculosis diagnosis in two districts of India.

    Directory of Open Access Journals (Sweden)

    Durba Paul

    Full Text Available BACKGROUND: Excessive time between diagnosis and initiation of tuberculosis (TB treatment contributes to ongoing TB transmission and should be minimized. In India, Revised National TB Control Programme (RNTCP focuses on indicator start of treatment within 7 days of diagnosis for patients with sputum smear-positive PTB for monitoring DOTS implementation. OBJECTIVES: To determine length of time between diagnosis and initiation of treatment and factors associated with delays of more than 7 days in smear-positive pulmonary TB. METHODS: Using existing programme records such as the TB Register, treatment cards, and the laboratory register, we conducted a retrospective cohort study of all patients with smear-positive pulmonary TB registered from July-September 2010 in two districts in India. A random sample of patients with pulmonary TB who experienced treatment delay of more than 7 days was interviewed using structured questionnaire. RESULTS: 2027 of 3411 patients registered with pulmonary TB were smear-positive. 711(35% patients had >7 days between diagnosis and treatment and 262(13% had delays >15 days. Mean duration between TB diagnosis and treatment initiation was 8 days (range = 0-128 days. Odds of treatment delay >7 days was 1.8 times more likely among those who had been previously treated (95% confidence interval [CI] 1.5-2.3 and 1.6 (95% CI 1.3-1.8 times more likely among those diagnosed in health facilities without microscopy centers. The main factors associated with a delay >7 days were: patient reluctance to start a re-treatment regimen, patients seeking second opinions, delay in transportation of drugs to the DOT centers and delay in initial home visits. To conclude, treatment delay >7 days was associated with a number of factors that included history of previous treatment and absence of TB diagnostic services in the local health facility. Decentralized diagnostic facilities and improved referral procedures may reduce such treatment

  14. Short-term total sleep deprivation alters delay-conditioned memory in the rat.

    Science.gov (United States)

    Tripathi, Shweta; Jha, Sushil K

    2016-06-01

    Short-term sleep deprivation soon after training may impair memory consolidation. Also, a particular sleep stage or its components increase after learning some tasks, such as negative and positive reinforcement tasks, avoidance tasks, and spatial learning tasks, and so forth. It suggests that discrete memory types may require specific sleep stage or its components for their optimal processing. The classical conditioning paradigms are widely used to study learning and memory but the role of sleep in a complex conditioned learning is unclear. Here, we have investigated the effects of short-term sleep deprivation on the consolidation of delay-conditioned memory and the changes in sleep architecture after conditioning. Rats were trained for the delay-conditioned task (for conditioning, house-light [conditioned stimulus] was paired with fruit juice [unconditioned stimulus]). Animals were divided into 3 groups: (a) sleep deprived (SD); (b) nonsleep deprived (NSD); and (c) stress control (SC) groups. Two-way ANOVA revealed a significant interaction between groups and days (training and testing) during the conditioned stimulus-unconditioned stimulus presentation. Further, Tukey post hoc comparison revealed that the NSD and SC animals exhibited significant increase in performances during testing. The SD animals, however, performed significantly less during testing. Further, we observed that wakefulness and NREM sleep did not change after training and testing. Interestingly, REM sleep increased significantly on both days compared to baseline more specifically during the initial 4-hr time window after conditioning. Our results suggest that the consolidation of delay-conditioned memory is sleep-dependent and requires augmented REM sleep during an explicit time window soon after training. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Yimer Solomon

    2005-12-01

    Full Text Available Abstract Background Delayed diagnosis and treatment of tuberculosis (TB results in severe disease and a higher mortality. It also leads to an increased period of infectivity in the community. The objective of this study was to determine the length of delays, and analyze the factors affecting the delay from onset of symptoms of pulmonary tuberculosis (PTB until the commencement of treatment. Methods In randomly selected TB management units (TBMUs, i.e. government health institutions which have diagnosing and treatment facilities for TB in Amhara Region, we conducted a cross sectional study from September 1-December 31/2003. Delay was analyzed from two perspectives, 1. Period between onset of TB symptoms to first visit to any health provider (health seeking period, and from the first health provider visit to initiation of treatment (health providers' delay, and 2. Period between onset of TB symptoms to first visit to a medical provider (patients' delay, and from this visit to commencement of anti-TB treatment (health systems' delay. Patients were interviewed on the same date of diagnosis using a semi-structured questionnaire. Logistics regression analysis was applied to analyze the risk factors of delays. Results A total of 384 new smear positive PTB patients participated in the study. The median total delay was 80 days. The median health-seeking period and health providers' delays were 15 and 61 days, respectively. Conversely, the median patients' and health systems' delays were 30 and 21 days, respectively. Taking medical providers as a reference point, we found that forty eight percent of the subjects delayed for more than one month. Patients' delays were strongly associated with first visit to non-formal health providers and self treatment (P Conclusion Delay in the diagnosis and treatment of PTB is unacceptably high in Amhara region. Health providers' and health systems' delays represent the major portion of the total delay. Accessing a

  16. Diclofenac delays micropore closure following microneedle treatment in human subjects.

    Science.gov (United States)

    Brogden, Nicole K; Milewski, Mikolaj; Ghosh, Priyanka; Hardi, Lucia; Crofford, Leslie J; Stinchcomb, Audra L

    2012-10-28

    Drugs absorbed poorly through the skin are commonly delivered via injection with a hypodermic needle, which is painful and increases the risk of transmitting infectious diseases. Microneedles (MNs) selectively and painlessly permeabilize the outermost skin layer, allowing otherwise skin-impermeable drugs to cross the skin through micron-sized pores and reach therapeutic concentrations. However, rapid healing of the micropores prevents further drug delivery, blunting the clinical utility of this unique transdermal technique. We present the first human study demonstrating that micropore lifetime can be extended following MN treatment. Subjects received one-time MN treatment and daily topical application of diclofenac sodium. Micropore closure was measured with impedance spectroscopy, and area under the admittance-time curve (AUC) was calculated. AUC was significantly higher at MN+diclofenac sodium sites vs. placebo, suggesting slower rates of micropore healing. Colorimetry measurements confirmed the absence of local erythema and irritation. This mechanistic human proof-of-concept study demonstrates that micropore lifetime can be prolonged with simple topical administration of a non-specific cyclooxygenase inhibitor, suggesting the involvement of subclinical inflammation in micropore healing. These results will allow for longer patch wear time with MN-enhanced delivery, thus increasing patient compliance and expanding the transdermal field to a wider variety of clinical conditions. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Diclofenac delays micropore closure following microneedle treatment in human subjects

    Science.gov (United States)

    Brogden, Nicole K.; Milewski, Mikolaj; Ghosh, Priyanka; Hardi, Lucia; Crofford, Leslie J.; Stinchcomb, Audra L.

    2013-01-01

    Drugs absorbed poorly through the skin are commonly delivered via injection with a hypodermic needle, which is painful and increases the risk of transmitting infectious diseases. Microneedles (MNs) selectively and painlessly permeabilize the outermost skin layer, allowing otherwise skin-impermeable drugs to cross the skin through micron-sized pores and reach therapeutic concentrations. However, rapid healing of the micropores prevents further drug delivery, blunting the clinical utility of this unique transdermal technique. We present the first human study demonstrating that micropore lifetime can be extended following MN treatment. Subjects received one-time MN treatment and daily topical application of diclofenac sodium. Micropore closure was measured with impedance spectroscopy, and area under the admittance–time curve (AUC) was calculated. AUC was significantly higher at MN + diclofenac sodium sites vs. placebo, suggesting slower rates of micropore healing. Colorimetry measurements confirmed the absence of local erythema and irritation. This mechanistic human proof-of-concept study demonstrates that micropore lifetime can be prolonged with simple topical administration of a non-specific cyclooxygenase inhibitor, suggesting the involvement of subclinical inflammation in micropore healing. These results will allow for longer patch wear time with MN-enhanced delivery, thus increasing patient compliance and expanding the transdermal field to a wider variety of clinical conditions. PMID:22929967

  18. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in Bale Zone, Southeast Ethiopia

    Directory of Open Access Journals (Sweden)

    Hussen Awol

    2012-06-01

    Full Text Available Abstract Background Tuberculosis (TB is a major public health problem in Africa with Ethiopia being the most affected. Treatment delay is an important indicator of access to TB diagnosis and treatment. However, little is known about factors associated with treatment delay of pulmonary TB among pastoralists. Health facility based cross sectional study was conducted on 129 pulmonary TB patients in pastoralist community. The study was conducted in three health centers and a hospital. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay, and the time between first visits to the professional health care provider to the date of diagnosis (provider's delay were analyzed using SPSS 16.0 statistical software. Findings A total of 129 new smear positive pulmonary TB patients participated in the study. The median total delay was 97 days. The median patient and health provider delays were 63 and 34 days, respectively. Ninety six percent of the patients were delayed for more than the twenty one days cutoff point. Patient delay was positively associated with first visit to traditional healer/private clinic/drug shop, rural residence, being illiterate, living in more than 10 kilometers from health facility; severity of illness at first presentation to health facility. Provider delay was positively associated with rural residence, being illiterate, patient with good functional status, patients in contact with more than two health providers, and place of first visit being traditional healer/private clinic/drug shop. Conclusions This study showed that majority of smear positive patients delayed either for diagnosis or treatment, thus continue to serve as reservoirs of infection. This indicates that there is a need for intervention to decrease patient and provider delays. Effort to reduce delays in pastoralist communities should focus on improving access to services in rural communities, engaging traditional and

  19. Local Stability of AIDS Epidemic Model Through Treatment and Vertical Transmission with Time Delay

    Science.gov (United States)

    Novi W, Cascarilla; Lestari, Dwi

    2016-02-01

    This study aims to explain stability of the spread of AIDS through treatment and vertical transmission model. Human with HIV need a time to positively suffer AIDS. The existence of a time, human with HIV until positively suffer AIDS can be delayed for a time so that the model acquired is the model with time delay. The model form is a nonlinear differential equation with time delay, SIPTA (susceptible-infected-pre AIDS-treatment-AIDS). Based on SIPTA model analysis results the disease free equilibrium point and the endemic equilibrium point. The disease free equilibrium point with and without time delay are local asymptotically stable if the basic reproduction number is less than one. The endemic equilibrium point will be local asymptotically stable if the time delay is less than the critical value of delay, unstable if the time delay is more than the critical value of delay, and bifurcation occurs if the time delay is equal to the critical value of delay.

  20. Delays in the diagnosis and treatment of tuberculosis patients in Vietnam: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Khanh Vu T

    2007-06-01

    Full Text Available Abstract Background Treatment delay is an important indicator of access to tuberculosis diagnosis and treatment. Analyses of patient delay (i.e. time interval between onset of symptoms and first consultation of a health care provider and health care delay (i.e. time interval between first consultation and start of treatment can inform policies to improve access. This study assesses the patient, health care provider and total delay in diagnosis and treatment of new smear-positive pulmonary tuberculosis patients, and the risk factors for long delay, in Vietnam. Methods A cross-sectional survey of new patients treated by the National Tuberculosis Control Programme was conducted in 70 randomly selected districts in Vietnam. All consecutively registered patients in one quarter of 2002 were interviewed using a pre-coded structured questionnaire. Results Median (range delay was 4 weeks (1–48 for total, 3 (1–48 weeks for patient and 1 (0–25 week for health care delay. Patients with long total delay (≥ 12 weeks, 15% accounted for 49% of the cumulative number of delay-weeks. Independent risk factors (p 5 km distance from a health facility or in the northern area. For long health care delay (≥ 6 weeks this was urban setting, residence in the central area and initial visit to a communal health post, TB hospital or the private sector. Conclusion Analyses of patient and treatment delays can indicate target groups and areas for health education and strengthening of the referral system, in particular between the private sector and the NTP.

  1. Well-posedness and exponential stability for a wave equation with nonlocal time-delay condition

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Raposo

    2017-11-01

    Full Text Available Well-posedness and exponential stability of nonlocal time-delayed of a wave equation with a integral conditions of the 1st kind forms the center of this work. Through semigroup theory we prove the well-posedness by the Hille-Yosida theorem and the exponential stability exploring the dissipative properties of the linear operator associated to damped model using the Gearhart-Huang-Pruss theorem.

  2. A novel design for randomized immuno-oncology clinical trials with potentially delayed treatment effects

    Directory of Open Access Journals (Sweden)

    Pei He

    2015-10-01

    Full Text Available The semi-parametric proportional hazards model is widely adopted in randomized clinical trials with time-to-event outcomes, and the log-rank test is frequently used to detect a potential treatment effect. Immuno-oncology therapies pose unique challenges to the design of a trial as the treatment effect may be delayed, which violates the proportional hazards assumption, and the log-rank test has been shown to markedly lose power under the non-proportional hazards setting. A novel design and analysis approach for immuno-oncology trials is proposed through a piecewise treatment effect function, which is capable of detecting a potentially delayed treatment effect. The number of events required for the trial will be determined to ensure sufficient power for both the overall log-rank test without a delayed effect and the test beyond the delayed period when such a delay exists. The existence of a treatment delay is determined by a likelihood ratio test with resampling. Numerical results show that the proposed design adequately controls the Type I error rate, has a minimal loss in power under the proportional hazards setting and is markedly more powerful than the log-rank test with a delayed treatment effect.

  3. Necessary optimality conditions of the second oder in a stochastic optimal control problem with delay argument

    Directory of Open Access Journals (Sweden)

    Rashad O. Mastaliev

    2016-12-01

    Full Text Available The optimal control problem of nonlinear stochastic systems which mathematical model is given by Ito stochastic differential equation with delay argument is considered. Assuming that the concerned region is open for the control by the first and the second variation (classical sense of the quality functional we obtain the necessary optimality condition of the first and the second order. In the particular case we receive the stochastic analog of the Legendre—Clebsch condition and some constructively verified conclusions from the second order necessary condition. We investigate the Legendre–Clebsch conditions for the degeneration case and obtain the necessary conditions of optimality for a special control, in the classical sense.

  4. Delay discounting, treatment motivation and treatment retention among substance-dependent individuals attending an in inpatient detoxification program

    NARCIS (Netherlands)

    Stevens, Laura; Verdejo-García, Antonio; Roeyers, Herbert; Goudriaan, Anna E.; Vanderplasschen, Wouter

    2015-01-01

    Recent studies consistently indicate high rates of delay discounting in drug users, which refers to a strong tendency to devaluate delayed rewards. Many addiction treatment programs however, place high demands on the ability to postpone immediate gratification. Therefore, these programs may be

  5. Successful treatment of delayed refractory chylothorax after irradiation with octreotide

    International Nuclear Information System (INIS)

    Kuroda, Hiroaki; Kawamura, Masafumi; Izumi, Yotaro; Horinouchi, Hirohisa; Matsumura, Shin-ichiro; Horiguchi, Hayanori

    2009-01-01

    A 15-year-old male, with a past history of splenic hemangioma treated with radiotherapy in his infancy, was diagnosed with idiopathic left chylothorax. Ligation of the thoracic duct at the level of Th7 was not effective, and he was admitted to our hospital. Ligation at the level of the diaphragm resulted in bilateral pleural effusion and ascites. Based on his past history, lymphangiography showing multiple points of leakage from the diaphragm and intraoperative findings of lymph proliferation along the mediastinal pleura, delayed chylothorax due to irradiation was diagnosed. Octreotide was administered for 30 days. Pleural effusions and ascites gradually decreased, and meals were started without reappearance. (author)

  6. Classical conditioning in the treatment of psoriasis.

    Science.gov (United States)

    Ader, R

    2000-11-01

    It has been argued that the placebo effect represents a learned response. Research is suggested to address the utility of applying principles derived from classical (Pavlovian) conditioning to the design of drug treatment protocols. In the present instance, it is hypothesized that, by capitalizing on conditioned pharmacotherapeutic responses, it may be possible to reduce the cumulative amount of corticosteroid medication used in the treatment of psoriasis.

  7. Predicting delay to treatment of urinary incontinence among urban community-dwelling women in China

    Directory of Open Access Journals (Sweden)

    Chen Wu

    2015-03-01

    Conclusion: Women who were older, had lower subjective UI severity, and who reported only stress or urgency UI tended to delay treatment longer; such patients should be targeted for health education and intervention regarding UI in urban communities.

  8. Why Irish women delay seeking treatment for urinary incontinence : a focus group study

    OpenAIRE

    Ni Aileasa, Mairead

    2011-01-01

    non-peer-reviewed Background: Urinary Incontinence is defined as "any involuntary leakage of urine" (Abrams et al, 2002). Living with incontinence can effect one's life greatly. Many women delay seeking treatment and often do not seek any help (Dolan et al, 1999), despite physiotherapy being an effective treatment (Neumann et al, 2005). Therefore, there is a need to discover why women delay seeking help, such as physiotherapy and continue to live with incontinence. Objectives: To establ...

  9. Delay in the diagnosis and treatment of pulmonary tuberculosis in Uzbekistan: a cross-sectional study.

    Science.gov (United States)

    Belkina, Tatiana V; Khojiev, Doniyor S; Tillyashaykhov, Mirzagaleb N; Tigay, Zinaida N; Kudenov, Marat U; Tebbens, Jurjen Duintjer; Vlcek, Jiri

    2014-11-25

    Early diagnosis and prompt effective therapy are crucial for the prevention of tuberculosis (TB) transmission, particularly in regions with high levels of multi-drug resistant TB. This study aimed to evaluate the extent of delay in diagnosis and treatment of TB in Uzbekistan and identify associated risk factors. A cross-sectional study was performed on hospital patients with newly diagnosed TB. The time between the onset of respiratory symptoms and initiation of anti-TB treatment was assessed and delays were divided into patient, health system and total delays. Univariable and multivariable logistic regression analysis was used to evaluate determinants of diagnostic and treatment delay. Among 538 patients enrolled, the median delay from onset of symptoms until treatment with anti-TB drugs was 50 days. Analysis of the factors affecting health-seeking behaviour and timely treatment showed the presence of the patient factor. Self-medication was the first health-seeking action for 231 (43%) patients and proved to be a significant predictor of delay (p = 0.005), as well as coughing (p = 0.009), loss of weight (p = 0.001), and visiting private and primary healthcare facilities (p = 0.03 and p = 0.02, respectively). TB diagnostic and treatment delay was mainly contributed to by patient delay and should be reduced through increasing public awareness of TB symptoms and improving public health-seeking behaviour for timely initiation of anti-TB treatment. Efforts should be made to minimise irrational use of antibiotics and support interventions to restrict over-the-counter availability of antibiotics.

  10. Open lung ventilation preserves the response to delayed surfactant treatment in surfactant-deficient newborn piglets

    NARCIS (Netherlands)

    van Veenendaal, Mariëtte B.; van Kaam, Anton H.; Haitsma, Jack J.; Lutter, René; Lachmann, Burkhard

    2006-01-01

    OBJECTIVE: Delayed surfactant treatment (>2 hrs after birth) is less effective than early treatment in conventionally ventilated preterm infants with respiratory distress syndrome. The objective of this study was to evaluate if this time-dependent efficacy of surfactant treatment is also present

  11. The neurobiology of thalamic amnesia: Contributions of medial thalamus and prefrontal cortex to delayed conditional discrimination.

    Science.gov (United States)

    Mair, Robert G; Miller, Rikki L A; Wormwood, Benjamin A; Francoeur, Miranda J; Onos, Kristen D; Gibson, Brett M

    2015-07-01

    Although medial thalamus is well established as a site of pathology associated with global amnesia, there is uncertainty about which structures are critical and how they affect memory function. Evidence from human and animal research suggests that damage to the mammillothalamic tract and the anterior, mediodorsal (MD), midline (M), and intralaminar (IL) nuclei contribute to different signs of thalamic amnesia. Here we focus on MD and the adjacent M and IL nuclei, structures identified in animal studies as critical nodes in prefrontal cortex (PFC)-related pathways that are necessary for delayed conditional discrimination. Recordings of PFC neurons in rats performing a dynamic delayed non-matching-to position (DNMTP) task revealed discrete populations encoding information related to planning, execution, and outcome of DNMTP-related actions and delay-related activity signaling previous reinforcement. Parallel studies recording the activity of MD and IL neurons and examining the effects of unilateral thalamic inactivation on the responses of PFC neurons demonstrated a close coupling of central thalamic and PFC neurons responding to diverse aspects of DNMTP and provide evidence that thalamus interacts with PFC neurons to give rise to complex goal-directed behavior exemplified by the DNMTP task. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. AD/HD and the Capture of Attention by Briefly Exposed Delay-Related Cues: Evidence from a Conditioning Paradigm

    Science.gov (United States)

    Sonuga-Barke, Edmund J. S.; De Houwer, Jan; De Ruiter, Karen; Ajzenstzen, Michal; Holland, Sarah

    2004-01-01

    Background: The selective attention of children with attention deficit/hyperactivity disorder (AD/HD) to briefly exposed delay-related cues was examined in two experiments using a dot-probe conditioning paradigm. Method: Colour cues were paired with negatively (i.e., imposition of delay) and positively valenced cues (i.e., escape from or avoidance…

  13. Factors affecting professional delay in diagnosis and treatment of oral cancer in Iran.

    Science.gov (United States)

    Esmaelbeigi, Farhad; Hadji, Maryam; Harirchi, Iraj; Omranipour, Ramesh; vand Rajabpour, Mojtaba; Zendehdel, Kazem

    2014-04-01

    Oral cancer is the most common malignant tumor among head and neck cancers. Delay in diagnosis affects the treatment and prognosis of oral cancer. We measured the professional delay in the diagnosis and its attributes in the Cancer Institute of Iran, the largest referral center for oral cancer patients in the country.  We interviewed oral cancer patients to measure the delay and used case-control approach to study association of various prognostic factors with professional delay and tumor stage. Out of 206 patients, 71.4% were diagnosed at the advanced stage. The median of the patient, professional and total delays were 45, 86 and 140 day, receptively. In the univariate model, prescription of medicines like analgesics (OR = 5.3, 95% CI 2.2-12.9) and history of dental procedure (OR=6.8, 95% CI 1.7-26.9) were associated with higher risk of delay compared to patient who were biopsied from the beginning. History of loose teeth increased risk of delay 4 times (OR = 4.0, 95% CI 1.6-9.8). Patients with primary education had 70% lower risk of delay compared to the illiterate patients (OR = 0.3, 95% CI 0.1-0.7) and the risk was lower among patients who had diploma (OR = 0.04, 95% CI 0-0.7) and college education (OR = 0.1, 95% CI 0-0.4). The delayed patients were diagnosed in more advanced stage compared to the patients without delay (OR = 2.1, 95% CI 1.0-4.4). Development of a national guideline for follow-up of oral lesions, training and awareness of health care professionals about oral cancer diagnosis may decrease the delay and improve the oral cancer outcome in Iran.

  14. Hot water treatments delay cold-induced banana peel blackening

    NARCIS (Netherlands)

    Promyou, S.; Ketsa, S.; Doorn, van W.G.

    2008-01-01

    Banana fruit of cv. Gros Michel (Musa acuminata, AAA Group, locally called cv. Hom Thong) and cv. Namwa (Musa x paradisiaca, ABB Group) were immersed for 5, 10 and 15 min in water at 42 degrees C, or in water at 25 degrees C (control), and were then stored at 4 degrees C. Hot water treatment for 15

  15. Delayed Microbial Cure of Lymphogranuloma Venereum Proctitis with Doxycycline Treatment

    NARCIS (Netherlands)

    de Vries, H.J.C.; Smelov, V.; Middelburg, J.G.; Pleijster, J.; Speksnijder, A.G.; Morré, S.A.

    2009-01-01

    Microbial cure of chlamydia proctitis (lymphogranuloma venereum [LGV] and non-LGV) with doxycycline treatment was evaluated by chlamydia DNA and RNA persistence in anal swab specimens. In LGV proctitis, RNA persisted for up to 16 days. In non-LGV chlamydia proctitis, DNA was undetectable after 7

  16. Radiation treatment of painful degenerative skeletal conditions

    International Nuclear Information System (INIS)

    Schaefer, U.; Micke, O.; Willich, N.

    1996-01-01

    The study reported was intended to present own experience with irradiation for treatment of painful degenerative skeletal conditions and examine the long-term effects of this treatment. A retrospective study was performed covering the period from 1985 until 1991, examining 157 patients suffering from painful degenerative skeletal conditions who entered information on the success of their radiation treatment in a questionnaire. 94 of the questionnaires could be used for evaluation. Pain anamnesis revealed periods of more than one year in 45% of the cases. 74% of the patients had been treated without success with drug or orthopedic therapy. Immediately after termination of the radiotherapy, 38% of the patients said to be free of pain or to feel essentially relieved, while at the time the questionnaire was distributed, the percentage was 76%. Thus in our patient material, radiotherapy for treatment of painful degenerative skeletal lesions was successful in 76% of the cases and for long post-treatment periods, including those cases whith long pain anamnesis and unsuccessful conventional pre-treatment. (orig./MG) [de

  17. Cumulative or delayed nephrotoxicity after cisplatin (DDP) treatment.

    Science.gov (United States)

    Pinnarò, P; Ruggeri, E M; Carlini, P; Giovannelli, M; Cognetti, F

    1986-04-30

    The present retrospective study reports data regarding renal toxicity in 115 patients (63 males, 52 females; median age, 56 years) who received cumulative doses of cisplatin (DDP) greater than or equal to 200 mg/m2. DDP was administered alone or in combination at a dose of 50-70 mg/m2 in 91 patients, and at a dose of 100 mg/m2 in 22 patients. Two patients after progression of ovarian carcinoma treated with conventional doses of DDP received 4 and 2 courses, respectively, of high-dose DDP (40 mg/m2 for 5 days) in hypertonic saline. The median number of DDP courses was 6 (range 2-14), and the median cumulative dose was 350 mg/m2 (range, 200-1200). Serum creatinine and urea nitrogen were determined before initiating the treatment and again 13-16 days after each administration. The incidence of azotemia (creatinina levels that exceeded 1.5 mg/dl) was similar before (7.8%) and after (6.1%) DDP doses of 200 mg/m2. Azotemia appears to be related to the association of DDP with other potentially nephrotoxic antineoplastic drugs (methotrexate) more than to the dose per course of DDP. Of 59 patients followed for 2 months or more after discontinuing the DDP treatment, 3 (5.1%) presented creatinine values higher than 1.5 mg/dl. The data deny that the incidence of nephrotoxicity is higher in patients receiving higher cumulative doses of DDP and confirm that increases in serum creatinine levels may occur some time after discontinuation of the drug.

  18. Time Delay and Associated Factors in Diagnosis and Treatment of Pulmonary Tuberculosis in Markazi Province

    Directory of Open Access Journals (Sweden)

    Aliasghar Farazi

    2012-07-01

    Full Text Available Introduction: Delay in the diagnosis of tuberculosis increases the risk of death and enhances the transmission of disease in the community. This study aims to determine the patient and health service delay and factors affecting it in tuberculosis diagnosis. Materials & Methods: A cross-sectional survey that included all the public health centers was conducted in Markazi province from March 2009 till June 2011. Patients were interviewed after diagnosis by using a structured questionnaire. Results: One hundred and sixty-six patients aged between 9 and 87 (median; 66 years were included in the study. They comprised 87 (52.4% females and 79 (47.6% males. The median and mean of patient delay was 35 and 62 days, respectively; the median and mean of health system diagnosis delay was 34 and 53 days, respectively; the median and mean of health system treatment delay was 5 and 6 days, respectively; The median and mean of total delays were 86 and 121 days, respectively for all patients. The main determinants of delay were non education, poor economic, private sector, female gender and age≥55. Conclusion: The results of this review suggest that there is a need for revising case-finding strategies and reduction of infectious cases for better control of tuberculosis.

  19. PEMF as treatment for delayed healing of foot and ankle arthrodesis.

    Science.gov (United States)

    Saltzman, Charles; Lightfoot, Andrew; Amendola, Annunziato

    2004-11-01

    Arthrodesis is the most common surgical treatment for foot and ankle arthritis. In adults, these procedures are associated with a 5% to 10% rate of nonunion. Pulsed electromagnetic field (PEMF) stimulation was approved by the Federal Drug Administration (FDA) for treatment of delayed unions after long-bone fractures and joint arthrodesis. The purpose of this study was to examine the results of PEMF treatment for delayed healing after foot and ankle arthrodesis. Three hundred and thirty-four foot and ankle arthrodeses were done. Nineteen resulted in delayed unions that were treated with a protocol of immobilization, limited weightbearing, and PEMF stimulation for a median of 7 (range 5 to 27) months. All patients were followed clinically and radiographically. The use of PEMF, immobilization, and limited weightbearing to treat delayed union after foot and ankle arthrodesis was successful in 5 of 19 (26%) patients. Of the other 14 patients with nonunions, nine had revision surgery with autogenous grafting, continued immobilization, and PEMF stimulation. Seven of these eventually healed at a median of 5.5 (range 2 to 26) months and two did not heal. One patient had a below-knee amputation, and four refused further treatment. The protocol of PEMF, immobilization, and limited weightbearing had a relatively low success rate in this group of patients. We no longer use this protocol alone to treat delayed union after foot and ankle arthrodesis.

  20. Delayed conifer mortality after fuel reduction treatments: Interactive effects of fuel, fire intensity, and bark beetles

    Science.gov (United States)

    Youngblood, A.; Grace, J.B.; Mciver, J.D.

    2009-01-01

    Many low-elevation dry forests of the western United States contain more small trees and fewer large trees, more down woody debris, and less diverse and vigorous understory plant communities compared to conditions under historical fire regimes. These altered structural conditions may contribute to increased probability of unnaturally severe wildfires, susceptibility to uncharacteristic insect outbreaks, and drought-related mortality. Broad-scale fuel reduction and restoration treatments are proposed to promote stand development on trajectories toward more sustainable structures. Little research to date, however, has quantified the effects of these treatments on the ecosystem, especially delayed and latent tree mortality resulting directly or indirectly from treatments. In this paper, we explore complex hypotheses relating to the cascade of effects that influence ponderosa pine (Pinus ponderosa) and Douglas-fir (Pseudotsuga menziesii) mortality using structural equation modeling (SEM). We used annual census and plot data through six growing seasons after thinning and four growing seasons after burning from a replicated, operational-scale, completely randomized experiment conducted in northeastern Oregon, USA, as part of the national Fire and Fire Surrogate study. Treatments included thin, burn, thin followed by burn (thin+burn), and control. Burn and thin+burn treatments increased the proportion of dead trees while the proportion of dead trees declined or remained constant in thin and control units, although the density of dead trees was essentially unchanged with treatment. Most of the new mortality (96%) occurred within two years of treatment and was attributed to bark beetles. Bark beetle-caused tree mortality, while low overall, was greatest in thin + burn treatments. SEM results indicate that the probability of mortality of large-diameter ponderosa pine from bark beetles and wood borers was directly related to surface fire severity and bole charring, which in

  1. Delayed unpaired extinction as a treatment for hyperarousal of the rabbit nictitating membrane response and its implications for treating PTSD.

    Science.gov (United States)

    Schreurs, Bernard G; Smith-Bell, Carrie A; Burhans, Lauren B

    2018-04-01

    Treatment for PTSD (Post-traumatic stress disorder) is rarely available immediately after trauma and often delayed for weeks or months after an event. In a rabbit eyeblink conditioning model of PTSD, we have previously shown that presentations of a tone conditioned stimulus (CS) and shock unconditioned stimulus (US) in an explicitly unpaired manner known as unpaired extinction is effective in reducing CS responding and US hyperarousal even if shock intensity is reduced eight-fold and elicits only minimal responding. Here we determined if delayed delivery of unpaired extinction would still be effective in extinguishing hyperarousal. Rabbits were tested for sensitivity to shock before CS-US pairings and after six days of unpaired extinction presented a day, a week or a month after CS-US pairings. Hyperarousal was extinguished a day and a week after conditioning but not after a month suggesting a significant delay in "treatment" can make hyperarousal persist. We next assessed if this persistence of hyperarousal was associative by comparing rabbits given CS-US pairings to those given explicitly unpaired CS and US presentations, measuring hyperarousal a day and a month later, followed by unpaired extinction and hyperarousal assessment. After four weeks, there was an increase in responding for all rabbits but only rabbits receiving CS-US pairings showed a significant increase in associatively-mediated hyperarousal. Importantly, both paired and unpaired groups showed increased levels of responding after unpaired extinction suggesting treatment delayed for too long may no longer be effective and could cause generalized hyperarousal. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Immediate Extinction Causes a Less Durable Loss of Performance than Delayed Extinction following Either Fear or Appetitive Conditioning

    Science.gov (United States)

    Woods, Amanda M.; Bouton, Mark E.

    2008-01-01

    Five experiments with rat subjects compared the effects of immediate and delayed extinction on the durability of extinction learning. Three experiments examined extinction of fear conditioning (using the conditioned emotional response method), and two experiments examined extinction of appetitive conditioning (using the food-cup entry method). In…

  3. Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system

    Directory of Open Access Journals (Sweden)

    Han Ruolan

    2008-04-01

    Full Text Available Abstract Background Cancer treatment with a variety of chemotherapeutic agents often is associated with delayed adverse neurological consequences. Despite their clinical importance, almost nothing is known about the basis for such effects. It is not even known whether the occurrence of delayed adverse effects requires exposure to multiple chemotherapeutic agents, the presence of both chemotherapeutic agents and the body's own response to cancer, prolonged damage to the blood-brain barrier, inflammation or other such changes. Nor are there any animal models that could enable the study of this important problem. Results We found that clinically relevant concentrations of 5-fluorouracil (5-FU; a widely used chemotherapeutic agent were toxic for both central nervous system (CNS progenitor cells and non-dividing oligodendrocytes in vitro and in vivo. Short-term systemic administration of 5-FU caused both acute CNS damage and a syndrome of progressively worsening delayed damage to myelinated tracts of the CNS associated with altered transcriptional regulation in oligodendrocytes and extensive myelin pathology. Functional analysis also provided the first demonstration of delayed effects of chemotherapy on the latency of impulse conduction in the auditory system, offering the possibility of non-invasive analysis of myelin damage associated with cancer treatment. Conclusions Our studies demonstrate that systemic treatment with a single chemotherapeutic agent, 5-FU, is sufficient to cause a syndrome of delayed CNS damage and provide the first animal model of delayed damage to white-matter tracts of individuals treated with systemic chemotherapy. Unlike that caused by local irradiation, the degeneration caused by 5-FU treatment did not correlate with either chronic inflammation or extensive vascular damage and appears to represent a new class of delayed degenerative damage in the CNS.

  4. Rare Neural Correlations Implement Robotic Conditioning with Delayed Rewards and Disturbances

    Science.gov (United States)

    Soltoggio, Andrea; Lemme, Andre; Reinhart, Felix; Steil, Jochen J.

    2013-01-01

    Neural conditioning associates cues and actions with following rewards. The environments in which robots operate, however, are pervaded by a variety of disturbing stimuli and uncertain timing. In particular, variable reward delays make it difficult to reconstruct which previous actions are responsible for following rewards. Such an uncertainty is handled by biological neural networks, but represents a challenge for computational models, suggesting the lack of a satisfactory theory for robotic neural conditioning. The present study demonstrates the use of rare neural correlations in making correct associations between rewards and previous cues or actions. Rare correlations are functional in selecting sparse synapses to be eligible for later weight updates if a reward occurs. The repetition of this process singles out the associating and reward-triggering pathways, and thereby copes with distal rewards. The neural network displays macro-level classical and operant conditioning, which is demonstrated in an interactive real-life human-robot interaction. The proposed mechanism models realistic conditioning in humans and animals and implements similar behaviors in neuro-robotic platforms. PMID:23565092

  5. A general formula considering one group delayed neutron under nonequilibrium condition

    International Nuclear Information System (INIS)

    Li Haofeng; Chen Wenzhen; Zhu Qian; Luo Lei

    2008-01-01

    A general neutron breeder formula is developed when the reactor does not reach the steady state and the reactivity changes in phase. This formula can be used to calculate the results of six groups delayed neutron model through a way of amending λ in one group delayed neutron model. The analysis shows that the solution of amended single group delayed neutron model is approximately equal to that of six-group delayed neutron model, and the amended model meets the engineering accuracy. (authors)

  6. Delay of Treatment Initiation Does Not Adversely Affect Survival Outcome in Breast Cancer.

    Science.gov (United States)

    Yoo, Tae-Kyung; Han, Wonshik; Moon, Hyeong-Gon; Kim, Jisun; Lee, Jun Woo; Kim, Min Kyoon; Lee, Eunshin; Kim, Jongjin; Noh, Dong-Young

    2016-07-01

    Previous studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment. This study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups. A total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS. Our results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.

  7. [Impact of care pathway on the delay for initiation of antituberculosis treatment in Conakry, Guinea].

    Science.gov (United States)

    Camara, A; Bah-Sow, O Y; Baldé, N M; Camara, L M; Barry, I S; Bah, B; Diallo, M; Chaperon, J; Riou, F

    2009-06-01

    Complex care pathways can result in detrimental treatment delay particularly in tuberculosis patients. The purpose of this retrospective study was to assess the care pathways followed by tuberculosis patients prior to diagnosis and to assess impact on the delay for initiation of treatment in Conakry, Guinea. A total of 112 patients were interviewed at the time of first admission for pulmonary tuberculosis with positive bacilloscopy. Based on interview data, pathways were classified as conventional (use of health care facilities only) and mixed (use of health care facilities, self-medication, and traditional medicine). The correlation between patient characteristics and type of pathway was assessed by univariate and multivariate analysis and the two groups, i.e., conventional vs. mixed, were compared with regard to delay for initiation of treatment. The care pathway was classified as mixed in two out of three patients. Multivariate analysis showed that this type of pathway was only correlated with schooling (p=0.02). The mean delay for treatment was similar, i.e., 13.4 and 12.8 weeks for conventional and mixed pathways respectively (p<0.68). The percentage of pathways including three consultations at health care facilities was significantly higher in the conventional than mixed group (72% vs. 30%, p<0.001). The main reasons given for delayed use of health care facilities were poor knowledge of tuberculosis symptoms (26%) and high cost of care (12%). The findings of this study indicate that tuberculosis patients follow a variety of care pathways that can lead to delayed treatment. An information campaign is needed to increase awareness among the population and care providers.

  8. BDNFval66met affects neural activation pattern during fear conditioning and 24 h delayed fear recall.

    Science.gov (United States)

    Lonsdorf, Tina B; Golkar, Armita; Lindström, Kara M; Haaker, Jan; Öhman, Arne; Schalling, Martin; Ingvar, Martin

    2015-05-01

    Brain-derived neurotrophic factor (BDNF), the most abundant neutrophin in the mammalian central nervous system, is critically involved in synaptic plasticity. In both rodents and humans, BDNF has been implicated in hippocampus- and amygdala-dependent learning and memory and has more recently been linked to fear extinction processes. Fifty-nine healthy participants, genotyped for the functional BDNFval66met polymorphism, underwent a fear conditioning and 24h-delayed extinction protocol while skin conductance and blood oxygenation level dependent (BOLD) responses (functional magnetic resonance imaging) were acquired. We present the first report of neural activation pattern during fear acquisition 'and' extinction for the BDNFval66met polymorphism using a differential conditioned stimulus (CS)+ > CS- comparison. During conditioning, we observed heightened allele dose-dependent responses in the amygdala and reduced responses in the subgenual anterior cingulate cortex in BDNFval66met met-carriers. During early extinction, 24h later, we again observed heightened responses in several regions ascribed to the fear network in met-carriers as opposed to val-carriers (insula, amygdala, hippocampus), which likely reflects fear memory recall. No differences were observed during late extinction, which likely reflects learned extinction. Our data thus support previous associations of the BDNFval66met polymorphism with neural activation in the fear and extinction network, but speak against a specific association with fear extinction processes. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  9. Global exponential stability and periodicity of reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions

    International Nuclear Information System (INIS)

    Lu Junguo

    2008-01-01

    In this paper, the global exponential stability and periodicity for a class of reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions are addressed by constructing suitable Lyapunov functionals and utilizing some inequality techniques. We first prove global exponential converge to 0 of the difference between any two solutions of the original reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions, the existence and uniqueness of equilibrium is the direct results of this procedure. This approach is different from the usually used one where the existence, uniqueness of equilibrium and stability are proved in two separate steps. Furthermore, we prove periodicity of the reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions. Sufficient conditions ensuring the global exponential stability and the existence of periodic oscillatory solutions for the reaction-diffusion delayed recurrent neural networks with Dirichlet boundary conditions are given. These conditions are easy to check and have important leading significance in the design and application of reaction-diffusion recurrent neural networks with delays. Finally, two numerical examples are given to show the effectiveness of the obtained results

  10. Division delay after low x-ray doses and treatment with cyclohexionide

    International Nuclear Information System (INIS)

    Schneiderman, M.H.; Braby, L.A.; Roesch, W.C.

    1977-01-01

    Radiation-induced division delay of Chinese hamster ovary cells located in G 2 , and in G 2 between the cycloheximide and x-ray transition points, was measured by the mitotic cell selection technique. The mitotic yield (number of mitotic cells after treatment expressed as a fraction of the control) decreased with increasing radiation dose (4.5 to 34 rad). However, either because some cells were not delayed or because delayed cells recovered rapidly, the mitotic yield did not fall to zero. When cycloheximide was combined with radiation to prevent repair of the radiation damage, only cells which were past the cycloheximide transition point and not delayed by the radiation were selected. The location of the transition points determined from the combined drug plus low-dose radiation (4.5 to 34 rad) experiments indicate a dose-dependent relationship, with more cells delayed as the dose was increased. In addition, the transition point for cells treated with cycloheximide plus 150 rad of x rays was closer to division than the 150 rad of x rays alone. These results are discussed in light of a recent model for radiation-induced division delay proposed by Dewey and Highfield

  11. Early-Onset Bipolar Disorder and Treatment Delay Are Risk Factors for Poor Outcome in Adulthood

    NARCIS (Netherlands)

    Post, Robert M.; Leverich, Gabriele S.; Kupka, Ralph W.; Keck, Paul E.; McElroy, Susan L.; Altshuler, Lori L.; Frye, Mark A.; Luckenbaugh, David A.; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Nolen, Willem A.

    Objective: We examined the influence of age at onset of illness and the delay in time to first treatment on morbidity in adulthood. Method: 529 adult outpatients with a mean age of 42 years, who entered our research network from 1996 through 2001 and who were diagnosed with bipolar disorder

  12. A favorable outcome despite a 39-hour treatment delay for arterial gas embolism: case report.

    Science.gov (United States)

    Covington, Derek; Bielawski, Anthony; Sadler, Charlotte; Latham, Emi

    2016-01-01

    Cerebral arterial gas embolism (CAGE) occurs when gas enters the cerebral arterial vasculature. CAGE can occur during sitting craniotomies, cranial trauma or secondary to gas embolism from the heart. A far less common cause of CAGE is vascular entrainment of gas during endoscopic procedures. We present the case of a 49-year-old male who developed a CAGE following an esophagoduodenoscopy (EGD) biopsy. Due to a delay in diagnosis, the patient was not treated with hyperbaric oxygen (HBO₂) therapy until 39 hours after the inciting event. Despite presenting to our institution non-responsive and with decorticate posturing, the patient was eventually discharged to a rehabilitation facility, with only mild left upper extremity weakness. This delay in HBO₂ treatment represents the longest delay in treatment to our knowledge for a patient suffering from CAGE secondary to EGD. In addition to the clinical case report, we discuss the etiology of CAGE and the evidence supporting early HBO₂ treatment, as well as the data demonstrating efficacy even after considerable treatment delay. Copyright© Undersea and Hyperbaric Medical Society.

  13. Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

    Directory of Open Access Journals (Sweden)

    Wei-Teng Yang

    2014-01-01

    Full Text Available Background. Tuberculosis (TB remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52% and delays (42%, 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0% and longer delays (presentation to diagnosis: 45% versus 0% than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  14. Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?

    Science.gov (United States)

    Yang, Wei-Teng; Gounder, Celine R; Akande, Tokunbo; De Neve, Jan-Walter; McIntire, Katherine N; Chandrasekhar, Aditya; de Lima Pereira, Alan; Gummadi, Naveen; Samanta, Santanu; Gupta, Amita

    2014-01-01

    Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  15. Immediate extinction causes a less durable loss of performance than delayed extinction following either fear or appetitive conditioning

    OpenAIRE

    Woods, Amanda M.; Bouton, Mark E.

    2008-01-01

    Five experiments with rat subjects compared the effects of immediate and delayed extinction on the durability of extinction learning. Three experiments examined extinction of fear conditioning (using the conditioned emotional response method), and two experiments examined extinction of appetitive conditioning (using the food-cup entry method). In all experiments, conditioning and extinction were accomplished in single sessions, and retention testing took place 24 h after extinction. In both f...

  16. Effect of Processing Delay and Storage Conditions on Urine Albumin-to-Creatinine Ratio.

    Science.gov (United States)

    Herrington, William; Illingworth, Nicola; Staplin, Natalie; Kumar, Aishwarya; Storey, Ben; Hrusecka, Renata; Judge, Parminder; Mahmood, Maria; Parish, Sarah; Landray, Martin; Haynes, Richard; Baigent, Colin; Hill, Michael; Clark, Sarah

    2016-10-07

    Because there is substantial biologic intraindividual variation in albumin excretion, randomized trials of albuminuria-reducing therapies may need multiple urine samples to estimate daily urinary albumin excretion. Mailing spot urine samples could offer a convenient and cost-effective method to collect multiple samples, but urine albumin-to-creatinine ratio stability in samples stored at ambient temperatures for several days is unknown. Patients with kidney disease provided fresh urine samples in two tubes (with and without boric acid preservative). Reference aliquots from each participant were analyzed immediately, whereas remaining aliquots were subject to different handling/storage conditions before analysis, including delayed processing for up to 7 days at three different storage temperatures (4°C, 18°C, and 30°C), multiple freeze-thaw cycles, and long-term frozen storage at -80°C, -40°C, and -20°C. We calculated the mean percentage change in urine albumin-to-creatinine ratio for each condition, and we considered samples stable if the 95% confidence interval was within a ±5% threshold. Ninety-three patients provided samples with detectable albuminuria in the reference aliquot. Median (interquartile range) urine albumin-to-creatinine ratio was 87 (20-499) mg/g. The inclusion of preservative had minimal effect on fresh urine albumin-to-creatinine ratio measurements but reduced the changes in albumin and creatinine in samples subject to processing delay and storage conditions. The urine albumin-to-creatinine ratio was stable for 7 days in samples containing preservative at 4°C and 18°C and 2 days when stored at 30°C. It was also stable in samples with preservative after three freeze-thaw cycles and in frozen storage for 6 months at -80°C or -40°C but not at -20°C. Mailed urine samples collected with preservative and received within 7 days if ambient temperature is ≤18°C, or within 2 days if the temperature is higher but does not exceed 30°C, are

  17. Effect of Processing Delay and Storage Conditions on Urine Albumin-to-Creatinine Ratio

    Science.gov (United States)

    Illingworth, Nicola; Staplin, Natalie; Kumar, Aishwarya; Storey, Ben; Hrusecka, Renata; Judge, Parminder; Mahmood, Maria; Parish, Sarah; Landray, Martin; Haynes, Richard; Baigent, Colin; Hill, Michael; Clark, Sarah

    2016-01-01

    Background and objectives Because there is substantial biologic intraindividual variation in albumin excretion, randomized trials of albuminuria-reducing therapies may need multiple urine samples to estimate daily urinary albumin excretion. Mailing spot urine samples could offer a convenient and cost-effective method to collect multiple samples, but urine albumin-to-creatinine ratio stability in samples stored at ambient temperatures for several days is unknown. Design, setting, participants, & measurements Patients with kidney disease provided fresh urine samples in two tubes (with and without boric acid preservative). Reference aliquots from each participant were analyzed immediately, whereas remaining aliquots were subject to different handling/storage conditions before analysis, including delayed processing for up to 7 days at three different storage temperatures (4°C, 18°C, and 30°C), multiple freeze-thaw cycles, and long–term frozen storage at −80°C, −40°C, and −20°C. We calculated the mean percentage change in urine albumin-to-creatinine ratio for each condition, and we considered samples stable if the 95% confidence interval was within a ±5% threshold. Results Ninety-three patients provided samples with detectable albuminuria in the reference aliquot. Median (interquartile range) urine albumin-to-creatinine ratio was 87 (20–499) mg/g. The inclusion of preservative had minimal effect on fresh urine albumin-to-creatinine ratio measurements but reduced the changes in albumin and creatinine in samples subject to processing delay and storage conditions. The urine albumin-to-creatinine ratio was stable for 7 days in samples containing preservative at 4°C and 18°C and 2 days when stored at 30°C. It was also stable in samples with preservative after three freeze-thaw cycles and in frozen storage for 6 months at −80°C or −40°C but not at −20°C. Conclusions Mailed urine samples collected with preservative and received within 7 days if

  18. Impact of fluoroquinolone treatment on delay of tuberculosis diagnosis: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Catherine A Hogan

    2017-01-01

    Full Text Available Background: Fluoroquinolones are among the most commonly used antibiotics for the treatment of respiratory infections. Because fluoroquinolones show bactericidal activity against Mycobacterium tuberculosis, there is concern that their use can delay the diagnosis of tuberculosis. We conducted a systematic review and meta-analysis to assess whether empiric treatment with fluoroquinolones delays the diagnosis and treatment of tuberculosis in patients with respiratory tract infections. Objectives: The primary objective was to assess the delay in days in the diagnosis and treatment of tuberculosis, among patients who received quinolones, compared to those who received non-fluoroquinolone antibiotics. Methods: We included studies of adult patients treated with fluoroquinolones prior to a confirmed diagnosis of tuberculosis. We performed a literature search of 7 databases (including PubMed, Embase and Cochrane Library with no language restrictions. We calculated an unweighted mean of estimate of difference in delay across all studies. For the studies for which the estimate was available as a mean with standard deviation, a weighted average using a random effects meta-analysis model was estimated. Results: A total of 3983 citations were identified from the literature search; of these, 17 articles were selected for full-text review. A total of 10 studies were retained for the synthesis. These included 7 retrospective cohort studies and 3 case-control studies. Only one of these studies was from a high TB burden country, South Africa. The most commonly used fluoroquinolones were levofloxacin, gemifloxacin and moxifloxacin. The unweighted average of difference in delay between the fluoroquinolone group and non-fluoroquinolone group was 12.9 days (95% CI 6.1–19.7. When these differences were pooled using a random effects model, the weighted estimate was 10.9 days (95% CI 4.2–17.6. When stratified by acid-fast smear status, the delay was

  19. Delayed treatment of decompression sickness with short, no-air-break tables: review of 140 cases.

    Science.gov (United States)

    Cianci, Paul; Slade, John B

    2006-10-01

    Most cases of decompression sickness (DCS) in the U.S. are treated with hyperbaric oxygen using U.S. Navy Treatment Tables 5 and 6, although detailed analysis shows that those tables were based on limited data. We reviewed the development of these protocols and offer an alternative treatment table more suitable for monoplace chambers that has proven effective in the treatment of DCS in patients presenting to our facility. We reviewed the outcomes for 140 cases of DCS in civilian divers treated with the shorter tables at our facility from January 1983 through December 2002. Onset of symptoms averaged 9.3 h after surfacing. At presentation, 44% of the patients demonstrated mental aberration. The average delay from onset of symptoms to treatment was 93.5 h; median delay was 48 h. Complete recovery in the total group of 140 patients was 87%. When 30 patients with low probability of DCS were excluded, the recovery rate was 98%. All patients with cerebral symptoms recovered. Patients with the highest severity scores showed a high rate of complete recovery (97.5%). Short oxygen treatment tables as originally described by Hart are effective in the treatment of DCS, even with long delays to definitive recompression that often occur among civilian divers presenting to a major Divers Alert Network referral center.

  20. Delay in Diagnosis and Treatment of Breast Cancer among Women Attending a Reference Service in Brazil

    Science.gov (United States)

    Romeiro Lopes, Tiara Cristina; Gravena, Angela Andréia França; Demitto, Marcela de Oliveira; Borghesan, Deise Helena Pelloso; Dell`Agnolo, Cátia Millene; Brischiliari, Sheila Cristina Rocha; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa

    2017-11-26

    Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group. Creative Commons Attribution License

  1. Factors associated with patient and provider delays for tuberculosis diagnosis and treatment in Asia: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jing Cai

    Full Text Available Delays in tuberculosis (TB diagnosis and treatment is a major barrier to effective management of the disease. Determining the factors associated with patient and provider delay of TB diagnosis and treatment in Asia may contribute to TB prevention and control.We searched the PubMed, EMBASE and Web of Science for studies that assessed factors associated with delays in care-seeking, diagnosis, or at the beginning of treatment, which were published from January 1992 to September 2014. Two reviewers independently identified studies that were related to our meta-analysis and extracted data from each study. Independent variables were categorized in separate tables for patient and provider delays.Among 45 eligible studies, 40 studies assessed patient delay whereas 30 assessed provider delay. Cross-sectional surveys were used in all but two articles, which included 17 countries and regions. Socio-demographic characteristics, TB-related symptoms and medical examination, and conditions of seeking medical care in TB patients were frequently reported. Male patients and long travel time/distance to the first healthcare provider led to both shorter patient delays [odds ratio (OR (95% confidence intervals, CI = 0.85 (0.78, 0.92; 1.39 (1.08, 1.78] and shorter provider delays [OR (95%CI = 0.96 (0.93, 1.00; 1.68 (1.12, 2.51]. Unemployment, low income, hemoptysis, and positive sputum smears were consistently associated with patient delay [ORs (95%CI = 1.18 (1.07, 1.30, 1.23 (1.02, 1.49, 0.64 (0.40, 1.00, 1.77 (1.07, 2.94, respectively]. Additionally, consultation at a public hospital was associated with provider delay [OR (95%CI = 0.43 (0.20, 0.91].We propose that the major opportunities to reduce delays involve enabling socio-demographic factors and medical conditions. Male, unemployed, rural residence, low income, hemoptysis, positive sputum smear, and long travel time/distance significantly correlated with patient delay. Male, long travel time/distance and

  2. Gender differences in reasons patients delay in seeking treatment for acute myocardial infarction symptoms.

    Science.gov (United States)

    Moser, Debra K; McKinley, Sharon; Dracup, Kathleen; Chung, Misook L

    2005-01-01

    Patients (n = 194) with confirmed acute myocardial infarction (AMI) were interviewed to determine sociodemographic, clinical, social, behavioral, cognitive and emotional factors that contribute to delay in seeking treatment for their symptoms. Initial symptom experience was similar for men and women: both were most commonly at home when symptoms began; both were most commonly in the presence of their spouse or other family member; few patients (trouble others, and prior knowledge of thrombolytics. There was no difference in delay between men and women (median 3.08 versus 3.10 h), but there are important gender differences in the reasons patients delay and in their patterns of decision-making that may assist clinicians trying to tailor interventions.

  3. Delayed treatment of basilar thrombosis in a patient with a basilar aneurysm: a case report

    Directory of Open Access Journals (Sweden)

    Fakhouri T

    2008-11-01

    Full Text Available Abstract Introduction Acute occlusion of the basilar artery is a neurological emergency that has a high risk of severe disability and mortality. Delayed thrombolysis or endovascular therapy has been performed with some success in patients who present after 3 hours of symptom onset. Here we present the first case of delayed intra-arterial thrombolysis of a basilar artery thrombosis associated with a large saccular aneurysm. Case presentation A 73-year-old Caucasian man with a history of smoking and alcohol abuse presented to the Emergency Department complaining of diplopia and mild slurred speech and who progressed over 12 hours to coma and quadriparesis. He was found to have a large basilar tip aneurysm putting him at high risk for hemorrhage with lytic treatment. Conclusion The treatment options for basilar thrombosis are discussed. Aggressive treatment options should be considered despite long durations of clinical symptoms in basilar thrombosis, even in extremely high risk patients.

  4. Factors contributing to delay in diagnosis and start of treatment of leprosy

    DEFF Research Database (Denmark)

    Nicholls, P.G.; Chhina, N; Aaen, Karen Bro

    2005-01-01

    The objective of our research was to identify factors contributing to delay in diagnosis and start of treatment in leprosy, focussing on patients' narratives of help-seeking behaviour. Our research took place in Purulia, West Bengal, India and in Nilphamari, northern Bangladesh. Between January...... and August 2000, we conducted semi-structured interviews with 104 patients that explored each individual's narrative of help-seeking behaviour and the context of beliefs and attitudes towards leprosy. Subsequently we surveyed 356 patients currently receiving treatment for leprosy and recorded specific...... aspects of each help-seeking action and their reports of local beliefs and attitudes towards leprosy. Delay was estimated from time of first symptoms through to start of effective treatment (mean 18 months, median 9 months in Purulia and mean 20 months, median 12 months in Nilphamari). The number of help...

  5. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial

    Science.gov (United States)

    Grinsztejn, Beatriz; Hosseinipour, Mina C; Ribaudo, Heather J; Swindells, Susan; Eron, Joseph; Chen, Ying Q; Wang, Lei; Ou, San-San; Anderson, Maija; McCauley, Marybeth; Gamble, Theresa; Kumarasamy, Nagalingeshwaran; Hakim, James G; Kumwenda, Johnstone; Pilotto, Jose H S; Godbole, Sheela V; Chariyalertsak, Suwat; de Melo, Marineide Gonçalves; Mayer, Kenneth H; Eshleman, Susan H; Piwowar-Manning, Estelle; Makhema, Joseph; Mills, Lisa A; Panchia, Ravindre; Sanne, Ian; Gallant, Joel; Hoffman, Irving; Taha, Taha E; Nielsen-Saines, Karin; Celentano, David; Essex, Max; Havlir, Diane; Cohen, Myron S

    2014-01-01

    Summary Background Use of antiretroviral treatment for HIV-1 infection has decreased AIDS-related morbidity and mortality and prevents sexual transmission of HIV-1. However, the best time to initiate antiretroviral treatment to reduce progression of HIV-1 infection or non-AIDS clinical events is unknown. We reported previously that early antiretroviral treatment reduced HIV-1 transmission by 96%. We aimed to compare the effects of early and delayed initiation of antiretroviral treatment on clinical outcomes. Methods The HPTN 052 trial is a randomised controlled trial done at 13 sites in nine countries. We enrolled HIV-1-serodiscordant couples to the study and randomly allocated them to either early or delayed antiretroviral treatment by use of permuted block randomisation, stratified by site. Random assignment was unblinded. The HIV-1-infected member of every couple initiated antiretroviral treatment either on entry into the study (early treatment group) or after a decline in CD4 count or with onset of an AIDS-related illness (delayed treatment group). Primary events were AIDS clinical events (WHO stage 4 HIV-1 disease, tuberculosis, and severe bacterial infections) and the following serious medical conditions unrelated to AIDS: serious cardiovascular or vascular disease, serious liver disease, end-stage renal disease, new-onset diabetes mellitus, and non-AIDS malignant disease. Analysis was by intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT00074581. Findings 1763 people with HIV-1 infection and a serodiscordant partner were enrolled in the study; 886 were assigned early antiretroviral treatment and 877 to the delayed treatment group (two individuals were excluded from this group after randomisation). Median CD4 counts at randomisation were 442 (IQR 373–522) cells per μL in patients assigned to the early treatment group and 428 (357–522) cells per μL in those allocated delayed antiretroviral treatment. In the delayed group

  6. Selective attention affects implicit and explicit memory for familiar pictures at different delay conditions.

    Science.gov (United States)

    Ballesteros, Soledad; Reales, José M; García, Eulalio; Carrasco, Marisa

    2006-02-01

    Three experiments investigated the effects of two variables -selective attention during encoding and delay between study and test- on implicit (picture fragment completion and object naming) and explicit (free recall and recognition) memory tests. Experiments 1 and 2 consistently indicated that (a) at all delays (immediate to 1 month), picture-fragment identification threshold was lower for the attended than the unattended pictures; (b) the attended pictures were recalled and recognized better than the unattended; and (c) attention and delay interacted in both memory tests. For implicit memory, performance decreased as delay increased for both attended and unattended pictures, but priming was more pronounced and lasted longer for the attended pictures; it was still present after a 1-month delay. For explicit memory, performance decreased as delay increased for attended pictures, but for unattended pictures performance was consistent throughout delay. By using a perceptual object naming task, Experiment 3 showed reliable implicit and explicit memory for attended but not for unattended pictures. This study indicates that picture repetition priming requires attention at the time of study and that neither delay nor attention dissociate performance in explicit and implicit memory tests; both types of memory require attention, but explicit memory does so to a larger degree.

  7. The Effects of Four-Hour Delay of PUnishment under Two Conditions of Verbal Instruction

    Science.gov (United States)

    Verna, Gary B.

    1977-01-01

    The effects of 4-hour delay of punishment (withdrawal of reward) on response inhibition was studied with 24 fourth-grade children. Results showed that verbal expression of the punishment contingency allows the 10-year-old child to profit from 4-hour delayed punishment as much as immediate punishment. (Author/JMB)

  8. The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting.

    Science.gov (United States)

    Palli, Swetha Rao; Grabner, Michael; Quimbo, Ralph A; Rugo, Hope S

    2015-01-01

    To determine the incidence of chemotherapy-induced nausea/vomiting (CINV) and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT3 RA) antiemetics. This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC) or moderately EC (MEC) regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. We identified 1,832 palonosetron and 2,387 other 5-HT3 RA ("other") patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026), and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, PHEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019) and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019). Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with other agents in this real-world setting. Additionally, patients receiving palonosetron had better adherence and fewer treatment delays than patients receiving other 5-HT3 RAs.

  9. Early versus delayed hormonal treatment in locally advanced or asymptomatic metastatic prostatic cancer patient dilemma.

    Science.gov (United States)

    Prezioso, Domenico; Iacono, Fabrizio; Romeo, Giuseppe; Ruffo, Antonio; Russo, Nicola; Illiano, Ester

    2014-06-01

    The objective of this work is to compare the effectiveness of hormonal treatment (luteinizing hormone-releasing hormone agonists and/or antiandrogens) as an early or as a deferred intervention for patients with locally advanced prostate cancer (LAPC) and/or asymptomatic metastasis. Systematic review of trials published in 1950-2007. Sources included MEDLINE and bibliographies of retrieved articles. Eligible trials included adults with a history of LAPC who are not suitable for curative local treatment of prostate cancer. We retrieved 22 articles for detailed review, of which 8 met inclusion criteria. The Veterans Administration Cooperative Urological Research Group suggested that delaying hormonal therapy did not compromise overall survival and that many of the patients died of causes other than prostate cancer. In European Organisation for Research and Treatment of Cancer (EORTC) 30846 trial, the median survival for delayed endocrine treatment was 6.1 year, and for immediate treatment 7.6 year, the HR for survival on delayed versus immediate treatment was 1.23 (95 % CI 0.88-1.71), indicating a 23 % nonsignificant trend in favour of early treatment. In EORTC 30891, the immediate androgen deprivation resulted in a modest but statistically significant increase in overall survival. The protocol SAKK 08/88 showed the lack of any major advantage of immediate compared with deferred hormonal treatment regarding quality of life or overall survival. The early intervention with hormonal treatment for patients with LAPC provides important reductions in all-cause mortality, prostate cancer-specific mortality, overall progression, and distant progression compared with deferring their use until standard care has failed to halt the disease.

  10. Retailer’s replenishment policies under conditions of permissible delay in payments

    Directory of Open Access Journals (Sweden)

    Huang Yung-Fu

    2004-01-01

    Full Text Available Goyal (1985 is frequently cited when the inventory systems under conditions of permissible delay in payments are discussed. Goyal implicitly assumed that: 1. The unit selling price and the unit purchasing price are equal; 2. At the end of the credit period, the account is settled. The retailer starts paying for higher interest charges on the items in stock and returns money of the remaining balance immediately when the items are sold. But these assumptions are debatable in real-life situations. The main purpose of this paper is to modify Goyal’s model to allow the unit selling price and the unit purchasing price not necessarily be equal to reflect the real-life situations. Furthermore, this paper will adopt different payment rule. We assume that the retailer uses sales revenue during the permissible credit period to make payment to the supplier at the end of the credit period. If it is not enough to pay off the purchasing cost of all items, the retailer will pay off the remaining balance by taking loan from the bank. So, the retailer starts paying for the interest charges on the amount of loan from the bank after the account is settled. Then the retailer will return money to the bank at the end of the inventory cycle. Under these conditions, we model the retailer’s inventory system as a cost minimization problem to determine the retailer’s optimal cycle time and optimal order quantity. Four cases are developed to efficiently determine the optimal cycle time and the optimal order quantity. Numerical examples are given to illustrate these cases. Comparing with Goyal’s model, we also find that the optimal cycle times in this paper are not longer than those of Goyal’s model.

  11. Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder.

    Science.gov (United States)

    Patel, Rashmi; Shetty, Hitesh; Jackson, Richard; Broadbent, Matthew; Stewart, Robert; Boydell, Jane; McGuire, Philip; Taylor, Matthew

    2015-01-01

    Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare. Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay), and time to the start of appropriate therapy (treatment delay). The median diagnostic delay was 62 days (interquartile range: 17-243) and median treatment delay was 31 days (4-122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18-3.06) and treatment delay (4.40, 3.63-5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33-0.41) and substance misuse disorders (0.44, 0.31-0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay. Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment sooner

  12. Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder.

    Directory of Open Access Journals (Sweden)

    Rashmi Patel

    Full Text Available Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare.Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM Biomedical Research Centre (BRC Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay, and time to the start of appropriate therapy (treatment delay.The median diagnostic delay was 62 days (interquartile range: 17-243 and median treatment delay was 31 days (4-122. Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18-3.06 and treatment delay (4.40, 3.63-5.62. Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33-0.41 and substance misuse disorders (0.44, 0.31-0.61. Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment

  13. Treatment and conditioning of historical radioactive waste

    International Nuclear Information System (INIS)

    Dogaru, Ghe.; Dragolici, F.; Ionascu, L.; Rotarescu, Ghe.

    2009-01-01

    The paper describes the management of historical radioactive waste from the storage facility of Radioactive Waste Treatment Plant. The historical waste stored into storage facility of IFIN-HH consists of spent sealed radioactive sources, empty contaminated containers, wooden radioactive waste, low specific activity radioactive waste, contaminated waste as well as radioactive waste from operation of WWR-S research reactor. After decommissioning of temporary storage facility about 5000 packages with radioactive waste were produced and transferred to the disposal facility. A large amount of packages have been transferred and disposed of to repository but at the end of 2000 there were still about 800 packages containing cement conditioned radioactive waste in an advanced state of degradation declared by authorities as 'historical waste'. During the management of historical waste campaign there were identified: radium spent radioactive sources, containers containing other spent sealed radioactive sources, packages containing low specific activity waste consist of thorium scrap allow, 30 larger packages (316 L), packages with activity lower than activity limit for disposal, packages with activity higher than activity limit for disposal. At the end of 2008, the whole amount of historical waste which met the waste acceptance criteria has been conditioned and transferred to disposal facility. (authors)

  14. Backscatter Correction Algorithm for TBI Treatment Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Nieto, B.; Sanchez-Doblado, F.; Arrans, R.; Terron, J.A. [Dpto. Fisiología Médica y Biofísica, Universidad de Sevilla, Avda. Sánchez Pizjuán, 4. E-41009, Sevilla (Spain); Errazquin, L. [Servicio Oncología Radioterápica, Hospital Univ.V. Macarena. Dr. Fedriani, s/n. E-41009, Sevilla (Spain)

    2015-01-15

    The accuracy requirements in target dose delivery is, according to ICRU, ±5%. This is so not only in standard radiotherapy but also in total body irradiation (TBI). Physical dosimetry plays an important role in achieving this recommended level. The semi-infinite phantoms, customarily used for dosimetry purposes, give scatter conditions different to those of the finite thickness of the patient. So dose calculated in patient’s points close to beam exit surface may be overestimated. It is then necessary to quantify the backscatter factor in order to decrease the uncertainty in this dose calculation. The backward scatter has been well studied at standard distances. The present work intends to evaluate the backscatter phenomenon under our particular TBI treatment conditions. As a consequence of this study, a semi-empirical expression has been derived to calculate (within 0.3% uncertainty) the backscatter factor. This factor depends lineally on the depth and exponentially on the underlying tissue. Differences found in the qualitative behavior with respect to standard distances are due to scatter in the bunker wall close to the measurement point.

  15. Survival of Primates in Lethal Septic Shock Following Delayed Treatment with Steroid.

    Science.gov (United States)

    1981-02-26

    TECHNICAL REPORT NO. 142 SURVIVAL OF PRIMATES IN LETHAL SEPTIC SHOCK FOLLOWING DELAYED TREAMENT WIn STEROID L. B. Hinshaw, L. T. Archer, B. K. Belier ...2. Schumer W: Steroids in the treatment of clinical septic shock. Ann Surg 184:333-341, 1976. 3. Hinshaw LB, Belier PK, Archer LT, Flournoy DJ, White...not preventable by antibiotic alone. Infect Immun ZS:538-5)7, 1979. 6. Hinshaw LB, Archer LT, Belier -Todd BK, Coalson .JJ, Flournoy DL, Passey R

  16. Diagnosis and treatment delays among elderly breast cancer patients with pre-existing mental illness.

    Science.gov (United States)

    Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw

    2017-11-01

    This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis. Patients were classified as having no mental illness, anxiety, depression, anxiety and depression, or severe mental illness (bipolar disorder, schizophrenia, and other psychotic disorder). Multivariable binomial regression was used to assess the association between mental illness and delays of ≥60 and ≥90 days after adjustment for confounders. Patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition (RR 1.11; 95% CI 1.00, 1.23), and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis (RR 1.36; 95% CI 1.06, 1.74). Patients with any mental illness experienced an increased risk for adjuvant chemotherapy delay of ≥90 days from last operation (RR 1.13; 95% CI 1.01, 1.26) and each category of mental illness, except depression, showed a non-significant trend for this association. Breast cancer patients with mental illness should be closely managed by a cross-functional care team, including a psychiatrist, a primary care physician, and an oncologist, to ensure adequate care is received within an appropriate timeframe.

  17. Hippocampal lesions impair performance on a conditional delayed matching and non-matching to position task in the rat.

    Science.gov (United States)

    Sloan, Hazel L; Döbrössy, Màtè; Dunnett, Stephen B

    2006-08-10

    The hippocampus is thought to be involved in a range of cognitive processes, from the ability to acquire new memories, to the ability to learn about spatial relationships. Humans and monkeys with damage to the hippocampus are typically impaired on delayed matching to sample tasks, of which the operant delayed matching to position task (DMTP) is a rat analogue. The reported effects of hippocampal damage on DMTP vary, ranging from delay-dependent deficits to no deficit whatsoever. The present study investigates a novel memory task; the conditional delayed matching/non-matching to position task (CDM/NMTP) in the Skinner box. CDM/NMTP uses the presence of specific stimulus cues to signify whether a particular trial is matching or non-matching in nature. Thus, it incorporates both the task contingencies within one session, and supplements the requirement for remembering the side of the lever in the sample phase with attending to the stimulus and remembering the conditional discrimination for the rule. Rats were trained preoperatively and the effects of bilateral excitotoxic lesions of the hippocampus were examined on postoperative retention of the task. Rats with lesions of the hippocampus incurred a significant impairment on the task that was manifest at all delays intervals. Despite a bias towards matching during training, trials of either type were performed with equivalent accuracy and neither rule was affected differentially by the lesion. This task may prove useful in determining the cognitive roles of a range of brain areas.

  18. Role of surgery in delayed local treatment for INSS 4 neuroblastoma.

    Science.gov (United States)

    Uehara, Shuichiro; Yoneda, Akihiro; Oue, Takaharu; Nakahata, Kengo; Zenitani, Masahiro; Miyamura, Takako; Hashii, Yoshiko; Fukuzawa, Masahiro; Okuyama, Hiroomi

    2017-09-01

    The aim of the present study was to compare the efficacy, complications and outcomes of the following two surgical strategies for delayed local treatment for International Neuroblastoma Staging System (INSS) 4 neuroblastoma (NB): complete resection (CR; period A); and gross total resection/subtotal resection (GTR/STR) with local irradiation (period B). We retrospectively analyzed 17 patients with INSS 4 NB who received delayed local treatment (period A, n = 11; period B, n = 6). Eleven patients in period A received CR. Two patients underwent GTR and four patients underwent STR in period B. The amount of blood loss in period A was significantly greater than that in period B. Postoperative complications were observed in eight patients in period A (73%), but in only one patient in period B (17%; P < 0.01). Recurrence was observed in five patients in period A and in one patient in period B (45.4% vs 16.6%; P = n.s.). Distant metastasis at recurrence was observed in four patients in period A and in one patient in period B. Gross total resection/subtotal resection with local irradiation may be a safe and effective delayed local treatment for INSS 4 NB. © 2017 Japan Pediatric Society.

  19. The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Palli SR

    2015-06-01

    Full Text Available Swetha Rao Palli,1 Michael Grabner,1 Ralph A Quimbo,1 Hope S Rugo2 1HealthCore, Wilmington, DE, 2University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA Purpose: To determine the incidence of chemotherapy-induced nausea/vomiting (CINV and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT3 RA antiemetics. Materials and methods: This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC or moderately EC (MEC regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. Results: We identified 1,832 palonosetron and 2,387 other 5-HT3 RA (“other” patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026, and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, P<0.0001; MEC, 17.0% versus 26.8%, P<0.0001. Compared with the other cohort, patients receiving palonosetron were significantly more adherent to the index chemotherapy regimen with respect to the recommended time frame (HEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019 and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019. Conclusion: Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with

  20. Predictors of delay in starting radiation treatment for patients with early stage breast cancer

    International Nuclear Information System (INIS)

    Benk, Veronique; Ho, Vivian; Fortin, Paul R.; Zhang, G.; Levinton, Carey; Freeman, C.R.

    1998-01-01

    Purpose: To describe the factors predicting waiting time for radiation treatment in early breast cancer. Materials and Methods: Between January 1992 and December 1993, 739 patients with Stage I and II breast cancer were treated with conservative treatment at three McGill University Hospitals. Waiting time was defined as the interval between the date of surgery and the date of the first radiation treatment. Delay was defined as a waiting time of more than 7 weeks for women who did not receive chemotherapy (Group NC, n 478), and as a waiting time of more than 24 weeks for those who received chemotherapy (Group C, n = 261). We analyzed predictive factors related to the patient (age, stage, treatment on protocol, income by postal code) and to the referring hospital (university or community hospital). Results: For the entire population, 54% of patients were delayed, 72% in Group NC and 21.4% in Group C. Univariate analysis showed an impact of referring hospital in both groups, and of stage and treatment on protocol in Group C (all p = 0.001). Multivariate analysis showed that delays were significantly less in Group NC for women referred from a community hospital (p = 0.001) and in Group C for women with Stage I disease (p = 0.06), those treated on protocol, and those referred from a university hospital (p = 0.001). Conclusion: More than half of patients with early breast cancer waited more than the recommended intervals for radiation therapy. However, lower income breast cancer patients did not wait longer for treatment than higher income patients, possibly a result of the Canadian Medicare system which provides universal access to health care

  1. Remote ischemic conditioning: A treatment for vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    David C Hess

    2015-01-01

    Full Text Available There is a strong link between hypoperfusion and white matter (WM damage in patients with leukoaraiosis and vascular cognitive impairment (VCI. Other than management of vascular risk factors, there is no treatment for WM damage and VCI that delays progression of the disease process to dementia. Observational studies suggest that exercise may prevent or slow down the progression of Alzheimer′s disease (AD and VCI. However, getting patients to exercise is challenging, especially with advancing age and disability. Remote ischemic conditioning, an "exercise equivalent," allows exercise to be given with a "device" at home for long periods of time. Since remote ischemic conditioning (RIC increases cerebral blood flow (CBF in preclinical studies and in humans, RIC may be an ideal therapy to treat VCI and WM disease and perhaps even sporadic AD. By using magnetic resonance imaging (MRI imaging of WM progression, a sample size in the range of about 100 subjects per group could determine if RIC has activity in WM disease and VCI.

  2. Treatment and conditioning of radioactive organic liquids

    International Nuclear Information System (INIS)

    1992-07-01

    Liquid organic radioactive wastes are generated from the use of radioisotopes in nuclear research centres and in medical and industrial applications. The volume of these wastes is small by comparison with aqueous radioactive wastes, for example; nevertheless, a strategy for the effective management of these wastes is necessary in order to ensure their safe handling, processing, storage and disposal. A aqueous radioactive wastes may be discharged to the environment after the radioactivity has decayed or been removed. By contrast, organic radioactive wastes require management steps that not only take account of their radioactivity, but also of their chemical content. This is because both the radioactivity and the organic chemical nature can have detrimental effects on health and the environment. Liquid radioactive wastes from these applications typically include vacuum pump oil, lubricating oil and hydraulic fluids, scintillation cocktails from analytical laboratories, solvents from solvent extraction research and uranium refining, and miscellaneous organic solvents. The report describes the factors which should be considered in the development of appropriate strategies for managing this class of wastes from generation to final disposal. Waste sources and characterization, treatment and conditioning processes, packaging, interim storage and the required quality assurance are all discussed. The report is intended to provide guidance to developing Member States which do not have nuclear power generation. A range of processes and procedures is presented, though emphasis is given to simple, easy-to-operate processes requiring less sophisticated and relatively inexpensive equipment. 31 refs, 16 figs, 3 tabs

  3. Emergency or Delayed Surgical Treatment of Unstable Supracondylar Humeral Fractures in Children?

    Directory of Open Access Journals (Sweden)

    Stefanovic Branko

    2017-06-01

    Full Text Available Supracondylar humeral fractures (SCHF are the most common elbow fractures in children, representing 3% of all paediatric fractures. Treatment options for SCHF in children are based on the Gartland classification. Treatment of non-displaced fractures (type I is non-operative. Plaster immobilization for 3 to 4 weeks is recommended, depending on the age of the child and fracture healing. Treatments of displaced supracondylar fractures (type II and III of the humerus in children are still undefined in clinical practice. Because of divided opinions, the aim of this study was to evaluate whether delayed or immediate surgical treatment has an advantage in the treatment of supracondylar fractures in children. This is a prospective – retrospective clinical study. This study included 64 patients from 5 to 15 years old; 47 (73.4% were boys and 17 (26.6% were girls. The most common age range (59.4% in this study was 5-8 years old. All patients were diagnosed with supracondylar fractures at the Institute for Orthopaedic Surgery “Banjica”. We analysed 17 parameters, which were obtained either from direct patient interviews or from their medical history. All patients were divided into two groups with matched characteristics. Group I consisted of 26 patients who had immediate operations. Group II consisted of 38 patients who had delayed operations.

  4. Improved Stabilization Conditions for Nonlinear Systems with Input and State Delays via T-S Fuzzy Model

    Directory of Open Access Journals (Sweden)

    Chang Che

    2018-01-01

    Full Text Available This paper focuses on the problem of nonlinear systems with input and state delays. The considered nonlinear systems are represented by Takagi-Sugeno (T-S fuzzy model. A new state feedback control approach is introduced for T-S fuzzy systems with input delay and state delays. A new Lyapunov-Krasovskii functional is employed to derive less conservative stability conditions by incorporating a recently developed Wirtinger-based integral inequality. Based on the Lyapunov stability criterion, a series of linear matrix inequalities (LMIs are obtained by using the slack variables and integral inequality, which guarantees the asymptotic stability of the closed-loop system. Several numerical examples are given to show the advantages of the proposed results.

  5. Operative treatment of the midshaft fractures of the clavicle – does delay matter?

    Directory of Open Access Journals (Sweden)

    Matej Andoljšek

    2007-11-01

    Full Text Available Background: Fractures of the clavicle are common injuries and mostly treated non-operatively. Nearly always the fracture is clinically united within three to four weeks and functional recovery should be completed within two months. Traditionally thinking has been that operative treatment is indicated exceptionaly and that delayed surgery is less successful. In retrospective comparative study authors have asked – whether delay of surgery in middle-third clavicular fractures negatively affects functional results and – whether after delayed surgery complications are more frequent.Patients and methods: Thirty-seven of 733 fractures of the clavicle were treated operatively. Among these, 11 were fresh Allman Type I fractures (early procedure, 9 delayed- or non-unions and one malunion (late procedure. All fractures were fixed with plates and screws. In none of the reconstructive procedures composite bone grafting was performed, twice spongiotic bone graft and twice morsilized calus grafts were used. DASH and Constant scores were used for outcome evaluation.Results: Twenty-one of 22 patients were evaluated (one foreign turist missed on average 21 month after surgery. Average DASH scores for early operated patients were 14.4 and for late operated 18.5; an average Quich DASH were 16.4 and 20.5 respectively. Average Constant scores were 85.6 and 76.0. Statistically differences are not important. Three patients had early complications (two from early, one from late group. Five patients had late complications (four skin paresthesias, one non-union.Conclusions: In retrospective study, functional results of surgically treated fresh Type I fractures and after reconstructive surgery for delayed-, non- and mal-union of the midshaft of the clavicle were comparable. No significant differences in complication rates were confirmed.

  6. [Usefulness of endovascular treatment for delayed massive epistaxis following endoscopic endonasal transsphenoidal surgery: a case report].

    Science.gov (United States)

    Oka, Tetsuo; Sugiu, Kenji; Ishida, Joji; Hishikawa, Tomohito; Ono, Shigeki; Tokunaga, Koji; Date, Isao

    2012-01-01

    We report here a case of massive nasal bleeding from the sphenopalatine artery three weeks after endonasal transsphenoidal surgery. This 66-year-old male suffered from massive nasal bleeding with the status of hypovolemic shock. Under general anesthesia, an emergent angiography revealed an extravasation from the sphenopalatine artery. Trans-arterial embolization using coil and n-butyl-cyanoacrylate (NBCA) was performed following the diagnostic angiography. Complete occlusion of the injured artery was achieved. The patient showed good recovery from general anesthesia. Delayed nasal bleeding after endonasal transsphenoidal surgery is a rare but important complication. The sphenopalatine artery and its branch are located in the hidden inferior lateral corner of the sphenoid sinus and may be injured during enlargement of the sphenoid opening. When massive delayed nasal bleeding follows transsphenoidal surgery and damage of the internal carotid artery has been ruled out, endovascular treatment of the external carotid artery should be considered.

  7. Somaclonal variation and irradiation in sugarcane calli for selection against red rot, water-logged conditions and delayed or non-flowering characters

    International Nuclear Information System (INIS)

    Samad, M.A.; Begum, S.; Majid, M.A.

    2001-01-01

    A protocol for callus induction and plant regeneration from primordial leaf culture was established in sugarcane cv. 'Isd-16'. The regenerated (R 1 ) plants were grown in field, and the subsequent propagations (R 2 -R 4 ) were screened for resistance to red rot disease and waterlogged conditions. Three clones showed moderate resistance (MR) to red rot and 3 clones were tolerant to water-logging in R 4 . In another experiment, callus cultures were irradiated with 2 to 10 Gy gamma rays. The maximum regeneration was obtained from 3 Gy treatment. Of the 768 R 1 plants, 50 survived to maturity. R 2 and R 3 populations were selected for delayed or non-flowering types. Five R 3 canes showed delayed flowering. (author)

  8. determining treatment levels of comorbid psychiatric conditions

    African Journals Online (AJOL)

    SITWALA COMPUTERS

    This low treatment rate may contribute to poor treatment outcomes. INTRODUCTION ... significance was set at p ≤ 0.05 for all statistical analyses. All confidence .... psychotropic effects , it is strongly associated with birth defects when used in ...

  9. Patient characteristics associated with self-presentation, treatment delay and survival following primary percutaneous coronary intervention.

    Science.gov (United States)

    Austin, David; Yan, Andrew T; Spratt, James C; Kunadian, Vijay; Edwards, Richard J; Egred, Mohaned; Bagnall, Alan J

    2014-09-01

    Delayed arrival to a primary percutaneous coronary intervention (PPCI)-capable hospital following ST-elevation myocardial infarction (STEMI) is associated with poorer outcome. The influence of patient characteristics on delayed presentation during STEMI is unknown. This was a retrospective observational study. Patients presenting for PPCI from March 2008 to November 2011 in the north of England (Northumbria, Tyne and Wear) were included. The outcomes were self-presentation to a non-PPCI-capable hospital, symptom to first medical contact (STFMC) time, total ischaemic time and mortality during follow-up. STEMI patients included numbered 2297; 619 (26.9%) patients self-presented to a non-PPCI-capable hospital. STFMC of >30 min and total ischaemic time of >180 min was present in 1521 (70.7%) and 999 (44.9%) cases, respectively. Self-presentation was the strongest predictor of prolonged total ischaemic time (odds ratio, OR (95% confidence interval, CI): 5.05 (3.99-6.39)). Married patients (OR 1.38 (1.10-1.74)) and patients living closest to an Emergency Room self-presented more commonly (driving time (vs. ≤10 min) 11-20 min OR 0.66 (0.52-0.83), >20 minutes OR 0.46 (0.33-0.64). Unmarried females waited longest to call for help (OR vs. married males 1.89 (1.29-2.78) and experienced longer total ischaemic times (OR 1.51 (1.10-2.07)). Married patients had a borderline association with lower mortality (hazard ratio 0.75 (0.53-1.05), p=0.09). Unmarried female patients had the longest treatment delays. Married patients and those living closer to an Emergency Room self-present more frequently. Early and exclusive use of the ambulance service may reduce treatment delay and improve STEMI outcome. © The European Society of Cardiology 2014.

  10. The impact of 5-hydroxytryptamine-receptor antagonists on chemotherapy treatment adherence, treatment delay, and nausea and vomiting

    International Nuclear Information System (INIS)

    Palli, Swetha Rao; Grabner, Michael; Quimbo, Ralph A; Rugo, Hope S

    2015-01-01

    To determine the incidence of chemotherapy-induced nausea/vomiting (CINV) and chemotherapy treatment delay and adherence among patients receiving palonosetron versus other 5-hydroxytryptamine receptor antagonist (5-HT 3 RA) antiemetics. This retrospective claims analysis included adults with primary malignancies who initiated treatment consisting of single-day intravenous highly emetogenic chemotherapy (HEC) or moderately EC (MEC) regimens. Treatment delay was defined as a gap in treatment at least twice the National Comprehensive Cancer Network-specified cycle length, specific to each chemotherapy regimen. Treatment adherence was determined by the percentage of patients who received the regimen-specific recommended number of chemotherapy cycles within the recommended time frame. We identified 1,832 palonosetron and 2,387 other 5-HT 3 RA (“other”) patients who initiated HEC therapy, and 1,350 palonosetron users and 1,379 patients on other antiemetics who initiated MEC therapy. Fewer patients receiving palonosetron experienced CINV versus other (HEC, 27.5% versus 32.2%, P=0.0011; MEC, 36.1% versus 41.7%, P=0.0026), and fewer treatment delays occurred among patients receiving palonosetron versus other (HEC, 3.2% versus 6.0%, P<0.0001; MEC, 17.0% versus 26.8%, P<0.0001). Compared with the other cohort, patients receiving palonosetron were significantly more adherent to the index chemotherapy regimen with respect to the recommended time frame (HEC, 74.7% versus 69.7%, P=0.0004; MEC, 43.1% versus 37.3%, P=0.0019) and dosage (HEC, 27.3% versus 25.8%, P=0.0004; MEC, 15.0% versus 12.6%, P=0.0019). Palonosetron more effectively reduced occurrence of CINV in patients receiving HEC or MEC compared with other agents in this real-world setting. Additionally, patients receiving palonosetron had better adherence and fewer treatment delays than patients receiving other 5-HT 3 RAs

  11. Maternal Immune-Mediated Conditions, Autism Spectrum Disorders, and Developmental Delay

    Science.gov (United States)

    Lyall, Kristen; Ashwood, Paul; Van de Water, Judy; Hertz-Picciotto, Irva

    2014-01-01

    The maternal immune system may play a role in offspring neurodevelopment. We examined whether maternal autoimmune disease, asthma, and allergy were associated with child autism spectrum disorder (ASD) and developmental delay without autism (DD) using 560 ASD cases, 391 typically developing controls, and 168 DD cases from the CHildhood Autism Risk…

  12. Optimal control problems with delay, the maximum principle and necessary conditions

    NARCIS (Netherlands)

    Frankena, J.F.

    1975-01-01

    In this paper we consider a rather general optimal control problem involving ordinary differential equations with delayed arguments and a set of equality and inequality restrictions on state- and control variables. For this problem a maximum principle is given in pointwise form, using variational

  13. Treatment and conditioning of metallic intermediate level waste

    International Nuclear Information System (INIS)

    Lidar, Per; Larsson, Arne; Huutoniemi, Tommi; Blank, Eva; Elfwing, Mattias

    2014-01-01

    In 2011 SKB started an R and D program for evaluating different disposal concepts for LL-LILW. The purpose was to develop alternative repository concepts and conditioning methods for LL-LILW and to evaluate and compare them from a range of parameters. The goal is to present a comparison between identified repository concepts by 2013. The material should be of such a quality that SKB can make decisions of which concepts that are to be further investigated in a safety analysis. As a part of the R and D program for the LL-LILW disposal facility, Studsvik was assigned to investigate whether melting of metallic LL-LILW is technically feasible and, if so, what the requirements are to build and operate such a facility. Specific concern was given to the following metallic components: - Core components and reactor internals from both boiling water reactors (BWRs) and pressurized water reactors (PWRs). - Reactor pressure vessels from PWRs. The paper presents a feasibility study of a melting facility for core components and reactor internals. An overview is given of how such a facility for treatment of intermediate level waste might be designed, constructed and operated and highlights both the possibilities and challenges. A cost estimate and a risk analysis are presented in order to make a conclusion of the technical feasibility of such a facility. Based on the Studsvik authors' experience in operating a low level waste melting facility, their conclusion is presented in the paper, considering cost of constructing and operating such a facility, in conjunction with the radio-logical risks associated with operation and the benefits to disposal and long term safety. Studsvik also investigated alternative techniques for embedding of metallic ILW components. Embedding of radioactive metallic ILW components protects the component from corrosion and leakage of radionuclides from repository to biosphere can thereby be both delayed and decreased. Conditioning by embedding has

  14. Extracorporeal shock wave treatment of non- or delayed union of proximal metatarsal fractures.

    Science.gov (United States)

    Alvarez, Richard G; Cincere, Brandon; Channappa, Chandra; Langerman, Richard; Schulte, Robert; Jaakkola, Juha; Melancon, Keith; Shereff, Michael; Cross, G Lee

    2011-08-01

    Nonunion or delayed union of fractures in the proximal aspect of metatarsals 1 to 4 and Zone 2 of the fifth metatarsal were treated by high energy extracorporeal shock wave treatment (ESWT) to study the safety and efficacy of this method of treatment in a FDA study of the Ossatron device. In a prospective single-arm, multi-center study, 34 fractures were treated in 32 patients (two subjects had two independent fractures) with ESWT. All fractures were at least 10 (range, 10 to 833) weeks after injury, with a median of 23 weeks. ESWT application was conducted using a protocol totaling 2,000 shocks for a total energy application of approximately 0.22 to 0.51 mJ/mm2 per treatment. The mean ESWT application time for each of the treatments was 24.6 +/- 16.6 minutes, and anesthesia time averaged 27.1 +/- 10.4 minutes. All subjects were followed for 1 year after treatment at intervals of 12 weeks, 6, 9, and 12 months. The overall success rate at the 12-week visit was 71% with low complications, significant pain improvement as well as improvement on the SF-36. The success/fail criteria was evaluated again at the 6- and 12-month followup, showing treatment success rates of 89% (23/26) and 90% (18/20), respectively. The most common adverse event was swelling in the foot, reported by five subjects (15.6%). High-energy ESWT appears to be effective and safe in patients for treatment of nonunion or a delayed healing of a proximal metatarsal, and in fifth metatarsal fractures in Zone 2.

  15. Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour.

    Science.gov (United States)

    Bugg, George J; Siddiqui, Farah; Thornton, Jim G

    2013-06-23

    Slow progress in the first stage of spontaneous labour is associated with an increased caesarean section rate and fetal and maternal morbidity. Oxytocin has long been advocated as a treatment for slow progress in labour but it is unclear to what extent it improves the outcomes for that labour and whether it actually reduces the caesarean section rate or maternal and fetal morbidity. This review will address the use of oxytocin and whether it improves the outcomes for women who are progressing slowly in labour compared to situations where it is not used or where its administration is delayed. To determine if the use of oxytocin for the treatment of slow progress in the first stage of spontaneous labour is associated with a reduction in the incidence of caesarean sections, or maternal and fetal morbidity compared to situations where it is not used or where its administration is delayed. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (23 February 2013) and bibliographies of relevant papers. Randomised controlled trials which compared oxytocin with either placebo, no treatment or delayed oxytocin in the active stage of spontaneous labour in low-risk women at term. Two authors independently assessed studies for inclusion, assessed risk of bias and extracted data. We sought additional information from trial authors. We included eight studies in the review involving a total of 1338 low-risk women in the first stage of spontaneous labour at term. Two comparisons were made; 1) the use of oxytocin versus placebo or no treatment (three trials); 2) the early use of oxytocin versus its delayed use (five trials). There were no significant differences in the rates of caesarean section or instrumental vaginal delivery in either comparison. Early use of oxytocin resulted in an increase in uterine hyperstimulation associated with fetal heart changes. However, the early use of oxytocin versus its delayed use resulted in no significant differences in a range

  16. Stressful life events predict delayed functional recovery following treatment for mania in bipolar disorder.

    Science.gov (United States)

    Yan-Meier, Leslie; Eberhart, Nicole K; Hammen, Constance L; Gitlin, Michael; Sokolski, Kenneth; Altshuler, Lori

    2011-04-30

    Identifying predictors of functional recovery in bipolar disorder is critical to treatment efforts to help patients re-establish premorbid levels of role adjustment following an acute manic episode. The current study examined the role of stressful life events as potential obstacles to recovery of functioning in various roles. 65 patients with bipolar I disorder participated in a longitudinal study of functional recovery following clinical recovery from a manic episode. Stressful life events were assessed as predictors of concurrent vs. delayed recovery of role functioning in 4 domains (friends, family, home duties, work/school). Despite clinical recovery, a subset of patients experienced delayed functional recovery in various role domains. Moreover, delayed functional recovery was significantly associated with presence of one or more stressors in the prior 3 months, even after controlling for mood symptoms. Presence of a stressor predicted longer time to functional recovery in life domains, up to 112 days in work/school. Interventions that provide monitoring, support, and problem-solving may be needed to help prevent or mitigate the effects of stress on functional recovery. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  17. Posterior treatment of delayed traumatic atlantoaxial joint dislocation with apofix internal fixation

    International Nuclear Information System (INIS)

    Qing Wei; Jiang Weimin; Shi Jinhui; Li Xuefeng; Yang Huilin; Tang Tiansi

    2010-01-01

    Objective: To assess the effect of posterior fixation and fusion with Apofix device for the treatment of delayed traumatic atlantoaxial joint dislocation. Methods: Eighteen patients with delayed traumatic atlantoaxial joint dislocation were included. Posterior fixation and fusion with Apofix device were performed. First step was one or two week skull traction. After the atlantoaxial joint dislocation had been reduced, the posterior fixation and fusion with Apofix was performed. Using local anaesthesia, atlantoaxial interval and posterior structure of atlas and dentata were exposed by midline operative approach. Apofix interlaminar clamps were placed at posterior arch of atlas and odontoid vertebral laminae, autologous iliac bone graft was placed for fusion. Then the device to proper position was pressurized and items locked. Results: All of the patients were followed up, the mean follow-up period was 38 months (13 ∼ 84 months). Fifteen patients obtained complete reduction, the others were partial reduction. Seventeen patients had successful fusion after 3 or 4 months, only 1 patient who had partial reduction had internal fixation loose and nonfusion, leading to recurrence of atlantoaxial joint dislocation. An occipitocervical fusion surgery was performed on this patient. As to neurological assessment, 16 patients had neurological deficit before operation, while 6 of them recovered completely after operation, another 10 patients' neurological status improved significantly. JOA score was improved from 9.5 pre-operative to 15.8 post-operative. Conclusion: Apofix internal fixation and fusion seems to be feasible in treatment of delayed traumatic atlantoaxial joint dislocation. Successful reduction before operation and proper treatment after operation is also important. (authors)

  18. Enhancement of delay eyelid conditioning by microcurrent electrical stimulation of the medial prefrontal cortex is triggered by the expression of Fos protein in guinea pigs

    OpenAIRE

    ZHENG, YA-JUAN; DONG, YU-CHEN; ZHU, CHAO; ZHAO, MEI-SHENG

    2016-01-01

    Eyelid conditioning, including delay eyelid conditioning and trace eyelid conditioning, has been used extensively to study neural structures and mechanisms of learning and memory as a form of associative learning. In the present study, microcurrent electrical stimulation was used to stimulate the medial prefrontal cortex (mPFC) to induce delay eyelid conditioning in guinea pigs. The acquisition rate and relative latency of the conditioned eyelid response (CR) and the startle eyelid response (...

  19. Delays and Refusal in Treatment for Breast Cancer Among Native American and Hispanic Women with Breast Cancer

    National Research Council Canada - National Science Library

    Saavedra, Elba

    2000-01-01

    ..., attitudinal, spiritual and demographic variables associated with delays and refusals in breast cancer treatment The focus of the semi-structured interview is to encourage the women in story-telling...

  20. Karrikins delay soybean seed germination by mediating abscisic acid and gibberellin biogenesis under shaded conditions

    OpenAIRE

    Meng, Yongjie; Chen, Feng; Shuai, Haiwei; Luo, Xiaofeng; Ding, Jun; Tang, Shengwen; Xu, Shuanshuan; Liu, Jianwei; Liu, Weiguo; Du, Junbo; Liu, Jiang; Yang, Feng; Sun, Xin; Yong, Taiwen; Wang, Xiaochun

    2016-01-01

    Karrikins (KAR) are a class of signal compounds, discovered in wildfire smoke, which affect seed germination. Currently, numerous studies have focused on the model plant Arabidopsis in the KAR research field, rather than on crops. Thus the regulatory mechanisms underlying KAR regulation of crop seed germination are largely unknown. Here, we report that KAR delayed soybean seed germination through enhancing abscisic acid (ABA) biosynthesis, while impairing gibberellin (GA) biogenesis. Interest...

  1. Visual Localisation of Mobile Devices in an Indoor Environment under Network Delay Conditions

    OpenAIRE

    Fernández, Alberto Alonso; Fres, Omar Álvarez; Alonso, Ignacio González; Hu, Huosheng

    2011-01-01

    Current progresses in home automation and service robotic environment have highlighted the need to develop interoperability mechanisms that allow a standard communication between the two systems. During the development of the DHCompliant protocol, the problem of locating mobile devices in an indoor environment has been investigated. The communication of the device with the location service has been carried out to study the time delay that web services offer in front of the sockets. The import...

  2. 'Lost to follow up': rethinking delayed and interrupted HIV treatment among married Swazi women.

    Science.gov (United States)

    Dlamini-Simelane, Thandeka T T; Moyer, Eileen

    2017-03-01

    Through various campaigns and strategies, more women are being tested for HIV in countries with a high prevalence of the virus. Despite the ready availability of treatment at government clinics in sub-Saharan African countries like Swaziland, women consistently report difficulty in maintaining access to treatment. Drawing on two individual case studies selected from a larger study of the so-called leaky cascade in Swaziland, we illustrate the protracted journeys married women undertake to initiate treatment. We demonstrate how women manoeuvre tactically after diagnosis, highlight factors that influence their decisions related to initiating treatment, and detail the actors involved in the decision-making process. Our research shows the persistence of structural factors that inhibit access, including economic constraints, gender inequality and patriarchal social norms. Patients referred as ‘lost to follow up’ are in many cases actively pursuing treatment within a context that includes the biomedical health system, but also extends well beyond it. We argue that the phrase ‘lost to follow up’ conceals the complex social navigation required by women to initiate and maintain access to treatment. Further, we suggest that many of the logistical challenges of monitoring and tracking people with HIV can be better addressed by taking into account the structural and social aspects of delayed treatment initiative.

  3. Exponential synchronization of delayed neutral-type neural networks with Lévy noise under non-Lipschitz condition

    Science.gov (United States)

    Ma, Shuo; Kang, Yanmei

    2018-04-01

    In this paper, the exponential synchronization of stochastic neutral-type neural networks with time-varying delay and Lévy noise under non-Lipschitz condition is investigated for the first time. Using the general Itô's formula and the nonnegative semi-martingale convergence theorem, we derive general sufficient conditions of two kinds of exponential synchronization for the drive system and the response system with adaptive control. Numerical examples are presented to verify the effectiveness of the proposed criteria.

  4. [Re-bleeding predictors in patients with aneurysmal subarachnoid haemorrhage and delayed neurosurgical treatment].

    Science.gov (United States)

    Rivero Rodríguez, Dannys; Scherle Matamoros, Claudio; Fernández Cúe, Leda; Miranda Hernández, José Luis; Pernas Sánchez, Yanelis; Pérez Nellar, Jesús

    2016-01-01

    To evaluate the re-bleeding predictors in patients with delayed treatment of aneurysmal subarachnoid hemorrhage. A prospective cohort study enrolled 261 patients with aneurysmal subarachnoid hemorrhage, attending in Hermanos Ameijeiras Hospital from October 2005, and June 2014. An increased re-bleeding risk in the multivariate analysis was associated with grade III (OR 2.01; 95% CI; 1.06-3.84) and grade IV (OR 3.84; 95% CI; 2.06-7.31) on World Federation Neurological Surgeon (WFNS) scale; grade III (OR 2.04; 95% CI; 1.01-4.13) and grade IV (OR 2.12, 95% CI; 1.05-4.28) on the Fischer scale, aneurism location in posterior circulation (OR 2.45, 95% CI; 1.33-4.44), and anterior communicant artery (OR 1.57, 95% CI;1.00-2.46). Hypertension history was present in 60.9% (159 patients) and was also associated with risk of re-bleeding (OR 2.70, 95% CI; 1.00-7.30). Blood pressure, haematocrit, glycemic, aneurysm size, multiple aneurysms, and location in the middle cerebral artery, do not show any relationship. Hypertension history, poor grade (III and IV) on WFNS and Fisher scale and aneurysm location were independent risks factors of re-bleeding in patients with delayed aneurysmal treatment. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  5. Delayed brain radiation necrosis: pathological review and new molecular targets for treatment.

    Science.gov (United States)

    Furuse, Motomasa; Nonoguchi, Naosuke; Kawabata, Shinji; Miyatake, Shin-Ichi; Kuroiwa, Toshihiko

    2015-12-01

    Delayed radiation necrosis is a well-known adverse event following radiotherapy for brain diseases and has been studied since the 1930s. The primary pathogenesis is thought to be the direct damage to endothelial and glial cells, particularly oligodendrocytes, which causes vascular hyalinization and demyelination. This primary pathology leads to tissue inflammation and ischemia, inducing various tissue protective responses including angiogenesis. Macrophages and lymphocytes then infiltrate the surrounding areas of necrosis, releasing inflammatory cytokines such as interleukin (IL)-1α, IL-6, and tumor necrosis factor (TNF)-α. Microglia also express these inflammatory cytokines. Reactive astrocytes play an important role in angiogenesis, expressing vascular endothelial growth factor (VEGF). Some chemokine networks, like the CXCL12/CXCR4 axis, are upregulated by tissue inflammation. Hypoxia may mediate the cell-cell interactions among reactive astrocytes, macrophages, and microglial cells around the necrotic core. Recently, bevacizumab, an anti-VEGF antibody, has demonstrated promising results as an alternative treatment for radiation necrosis. The importance of VEGF in the pathophysiology of brain radiation necrosis is being recognized. The discovery of new molecular targets could facilitate novel treatments for radiation necrosis. This literature review will focus on recent work characterizing delayed radiation necrosis in the brain.

  6. Ovarian reaction and estrus manifestation in delayed puberty gilts after treatment with equine chorionic gonadotropin

    Directory of Open Access Journals (Sweden)

    Stančić Ivan B

    2012-08-01

    Full Text Available Abstract Background Prolonged pre-insemination anestrus (i.e. delayed puberty is a major contributing factor for culling up to 30% of the replacement gilts at large breeding farm units in Vojvodina. It is imperative to determine if these gilts are acyclic (prepubertal or cyclic, but just fail to exhibit behavioural estrus. Recent investigations demonstrate that treatment with equine chorionic gonadotropin (eCG can increase the diestrous phase duration in sexually mature gilts. Based on these finding, the aim of the present studies was to determine the reproductive status of delayed puberty gilts following injection with eCG. Methods Two experiments were conducted on a swine breeding farm in Vojvodina. In Exp. 1, 20 prepubertal (acyclic gilts, and 120 sexually mature (cyclic gilts were injected with a single injection of 400 IU eCG + 200 IU human chorionic gonadotropin (hCG or with 1000 IU eCG (cyclic gilts, at d5, d11 or d17 after spontaneous estrus detection, to determine their ovarian reaction and induced estrus manifestation. In Exp. 2, sixty delayed puberty gilts (estrus not detected until 8 month of age, av. 258 days were culled from breeding herd and slaughtered to determine their reproductive status based on ovarian anatomical features. The second group of gilts (n = 60 was treated with a single 1000 IU eCG injection to determine their reproductive status, based on the interval between eCG injection to estrus detection and duration. The data were analyzed by descriptive statistics, t-test, analysis of variance and Duncan’s test in the software package Statistics 10th. Results Ovulations were induced in 90% of acyclic (sexually immature and, on average, 93.3% of cyclic (sexually mature gilts after the eCG injection. On average, 4 days after the eCG injection, estrus was detected in 85% of the treated acyclic (sexually immature gilts and in 95% (19/20 of the cyclic (sexually mature gilts, treated with eCG on day 17

  7. Surgical treatment of delayed radiation effects in the skin and its indication

    International Nuclear Information System (INIS)

    Tilkorn, H.; Drepper, H.

    1987-01-01

    Since 1960 a total of 1200 patients with skin disease as delayed radiation effects were treated at the Hornheide special clinic, 40% of whom received plastic surgery. This requires knowledge of the type of radiation applied and when it was applied, additional harmful influences, exposure, differentiation in cases of ulcers between primary, cumulative, and combination effect, early radiation effects, and late radiation effects. Secondary factors leading possibly to necrosis may be: recidivation of the primary tumours, benign or malignant neoplasms, traumatic injuries such as injections, sampling, tight clothing, chemical factors like therapeuticals for local application, allergies, infections of the skin with bacteria or fungi, osteomyelitis, non-infections skin disease, and internal disease. A precondition for successful dermatological and surgical treatment are a careful review of the previous case history and exact diagnosis. Some clinical cases serve to illustrate the theoretical explanations and point out possibilities for surgical treatment. (TRV) [de

  8. New exponential stability conditions for linear delayed systems of differential equations

    Directory of Open Access Journals (Sweden)

    Leonid Berezansky

    2016-08-01

    where $t\\ge 0$, $m$ and $r_{ij}$, $i,j=1,\\dots,m$ are natural numbers, $a_{ij}^{k}\\colon [0,\\infty\\to\\mathbb{R}$ are measurable coefficients, and $h_{ij}^{k}\\colon [0,\\infty\\to\\mathbb{R}$ are measurable delays. The progress was achieved by using a new technique making it possible to replace the constant $1$ by the constant $1+{1}/{\\mathrm{e}}$ on the right-hand sides of crucial inequalities ensuring exponential stability.

  9. Rapid Disease Progression With Delay in Treatment of Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Mohammed, Nasiruddin; Kestin, Larry Llyn; Grills, Inga Siiner; Battu, Madhu; Fitch, Dwight Lamar; Wong, Ching-yee Oliver; Margolis, Jeffrey Harold; Chmielewski, Gary William; Welsh, Robert James

    2011-01-01

    Purpose: To assess rate of disease progression from diagnosis to initiation of treatment for Stage I-IIIB non-small-cell lung cancer (NSCLC). Methods and Materials: Forty patients with NSCLC underwent at least two sets of computed tomography (CT) and 18-fluorodeoxyglucose positron emission tomography (PET) scans at various time intervals before treatment. Progression was defined as development of any new lymph node involvement, site of disease, or stage change. Results: Median time interval between first and second CT scans was 13.4 weeks, and between first and second PET scans was 9.0 weeks. Median initial primary maximum tumor dimension (MTD) was 3.5 cm (0.6-8.5 cm) with a median standardized uptake value (SUV) of 13.0 (1.7-38.5). The median MTD increased by a median of 1.0 cm (mean, 1.6 cm) between scans for a median relative MTD increase of 35% (mean, 59%). Nineteen patients (48%) progressed between scans. Rate of any progression was 13%, 31%, and 46% at 4, 8, and 16 weeks, respectively. Upstaging occurred in 3%, 13%, and 21% at these intervals. Distant metastasis became evident in 3%, 13%, and 13% after 4, 8, and 16 weeks, respectively. T and N stage were associated with progression, whereas histology, grade, sex, age, and maximum SUV were not. At 3 years, overall survival for Stage III patients with vs. without progression was 18% vs. 67%, p = 0.05. Conclusions: With NSCLC, treatment delay can lead to disease progression. Diagnosis, staging, and treatment initiation should be expedited. After 4-8 weeks of delay, complete restaging should be strongly considered.

  10. On-demand SSRI treatment of premature ejaculation: pharmacodynamic limitations for relevant ejaculation delay and consequent solutions.

    Science.gov (United States)

    Waldinger, Marcel D; Schweitzer, Dave H; Olivier, Berend

    2005-01-01

    Recently, the idea has emerged that on-demand use of serotonin reuptake inhibitors (SSRIs), particularly short half-life, should be equally effective in delaying ejaculation as daily SSRI treatment of premature ejaculation. To provide evidence that SSRI-induced ejaculation delay is mainly dependent on pharmacodynamic properties of the drug and hardly on pharmacokinetic factors, and that combined SSRI administration with specific 5-hydroxytryptamine (5-HT) receptor antagonism leads acutely to stronger ejaculation delay than acute SSRI monoadministration. We performed a detailed analysis of serotonin neurotransmission and reviewed animal studies with 5-HT(1A) receptor antagonists. In addition, we critically reviewed existing on-demand SSRI treatments publications and the current debate on a definition of premature ejaculation. Intravaginal ejaculation latency time (IELT). Acute SSRI administration leads to only a mild or no increase of 5-HT neurotransmission and concomitant stimulation of postsynaptic 5-HT receptors. Existing on-demand SSRI treatment studies suffer from methodological insufficiencies, and the reported high-fold increases of ejaculation time contradict with neuropharmacological insights from serotonin metabolism. Animal studies show that SSRI coadministration with 5-HT(1A) receptor antagonists significantly increases the ejaculation time acutely compared to acute SSRI monoadministration. On-demand SSRI treatment has less ejaculation-delaying effects than daily SSRI treatment. SSRIs with a short half-life are likely leading to much less ejaculation delay than current registered SSRIs. Combined use of SSRIs with 5-HT(1A) receptor antagonists increases the likelihood of clinically relevant ejaculation delay after on-demand treatment. On-demand SSRIs with short half-life that insufficiently delay ejaculation in men with IELTs less than 1 minute should be called ejaculation-delaying drugs rather than drugs against premature ejaculation.

  11. Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

    Science.gov (United States)

    Ali, Syed Mustafa; Naureen, Farah; Noor, Arif; Fatima, Irum; Viney, Kerri; Ishaq, Muhammad; Anjum, Naveed; Rashid, Aamna; Haider, Ghulam Rasool; Khan, Muhammad Aamir; Aamir, Javariya

    2018-03-09

    Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and treatment delay in private sector health care facilities in Pakistan. This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were collected using an online questionnaire prepared in ODK Collect, for the period October 2015 to March 2016. Data were analysed using SPSS. We calculated the: (1) number and proportion of patients who were lost to follow-up during the diagnostic period, (2) number and proportion of patients with pre-treatment loss to follow-up, and (3) the number of days between diagnosis and initiation of treatment. One thousand five hundred ninety-six persons with presumptive TB were referred to the laboratory. Of these, 96% (n = 1538) submitted an on-the-spot sputum sample. Of the 1538 people, 1462 (95%) people subsequently visited the laboratory to submit the early morning (i.e. the second) sample. Hence, loss to follow-up during the diagnostic process was 8% overall (n = 134). Of the 1462 people who submitted both sputum samples, 243 (17%) were diagnosed with sputum smear-positive pulmonary TB and 231 were registered for anti-TB treatment, hence, loss in the pre-treatment phase was 4.9% (n = 12). 152 persons with TB (66%) initiated TB treatment either on the day of TB diagnosis or the next day. A further 79 persons with TB (34%) commenced TB treatment within a mean time of 7 days (range 2 to 64 days). Concentrated efforts should be made by the National TB Control Programme to retain TB patients and innovative methods such as text reminders and behavior change communication may need to be used and tested.

  12. Early versus delayed postoperative radiotherapy for treatment of low-grade gliomas

    Science.gov (United States)

    Sarmiento, J Manuel; Venteicher, Andrew S; Patil, Chirag G

    2015-01-01

    Background In most people with low-grade gliomas (LGG), the primary treatment regimen remains a combination of surgery followed by postoperative radiotherapy. However, the optimal timing of radiotherapy is controversial. It is unclear whether to use radiotherapy in the early postoperative period, or whether radiotherapy should be delayed until tumour progression occurs. Objectives To assess the effects of early postoperative radiotherapy versus radiotherapy delayed until tumour progression for low-grade intracranial gliomas in people who had initial biopsy or surgical resection. Search methods We searched up to September 2014 the following electronic databases: the Cochrane Register of Controlled Trials (CENTRAL, Issue 8, 2014), MEDLINE (1948 to Aug week 3, 2014), and EMBASE (1980 to Aug week 3, 2014) to identify trials for inclusion in this Cochrane review. Selection criteria We included randomised controlled trials (RCTs) that compared early versus delayed radiotherapy following biopsy or surgical resection for the treatment of people with newly diagnosed intracranial LGG (astrocytoma, oligodendroglioma, mixed oligoastrocytoma, astroblastoma, xanthoastrocytoma, or ganglioglioma). Radiotherapy may include conformal external beam radiotherapy (EBRT) with linear accelerator or cobalt-60 sources, intensity-modulated radiotherapy (IMRT), or stereotactic radiosurgery (SRS). Data collection and analysis Three review authors independently assessed the trials for inclusion and risk of bias, and extracted study data. We resolved any differences between review authors by discussion. Adverse effects were also extracted from the study report. We performed meta-analyses using a random-effects model with inverse variance weighting. Main results We included one large, multi-institutional, prospective RCT, involving 311 participants; the risk of bias in this study was unclear. This study found that early postoperative radiotherapy is associated with an increase in time to

  13. Effect of Aegle marmelos and Murraya koenigii in treatment of delayed pubertal buffaloes heifers

    Directory of Open Access Journals (Sweden)

    Mohan M. Baitule

    2016-12-01

    Full Text Available Aim: This study aims to study the estrus induction, ovulation, and conception rate of delayed puberty in buffaloes heifers by feeding a herbal plants Aegle marmelos (bael/bili/bhel leaf and Murraya koenigii (Curry leaf. Materials and Methods: Totally, 24 buffalo heifers with delayed puberty were selected for the present study and divided randomly in four equal groups (n=6. Before experiment, all animals were dewormed with albendazole at 10 mg/kg body weight to prevent them from the stress of parasitism. In the present experiment, four group taken and Group I (n=6 treated with A. marmelos, Group II (n=6 treated with M. koenigii, Group III (n=6 treated with mixture of A. marmelos and M. koenigii and fed for 9 days. Group IV (n=6 considered as control and fed with concentrate only. The blood samples were collected from all the animals on day 0 (before treatment, 4, 9 (during treatment, on the day of estrus and day 8 after the onset of estrus. The 10 ml blood was collected from the jugular vein of all the experimental animals for estimation of serum calcium, inorganic phosphorus, and progesterone (P4. The estrus response, ovulation, conception rate along with serum calcium, inorganic phosphorus, and progesterone level were determined by the standard protocol. Results: From Group III 4 heifers, from Group II 3 heifers, and from Group I and IV (Control 2 heifers each, exhibited the estrus. The estrus response was recorded as 33.33%, 50.00%, 75.00%, and 33.33% in Group I, Group II, Group III, and Group IV, respectively. In treatment Group III, serum calcium found significantly more (p<0.05 on day 8 post-estrus as compared to other groups at a similar interval. Inorganic phosphorus and progesterone show no significant difference between groups. The ovulation and conception rates are comparatively better in Group III (75% buffalo heifers than other groups. Conclusion: Herbal supplementation of A. marmelos and M. koenigii in combination, as well as M

  14. No Evidence of Delayed Parasite Clearance after Oral Artesunate Treatment of Uncomplicated Falciparum Malaria in Mali

    Science.gov (United States)

    Maiga, Amelia W.; Fofana, Bakary; Sagara, Issaka; Dembele, Demba; Dara, Antoine; Traore, Oumar Bila; Toure, Sekou; Sanogo, Kassim; Dama, Souleymane; Sidibe, Bakary; Kone, Aminatou; Thera, Mahamadou A.; Plowe, Christopher V.; Doumbo, Ogobara K.; Djimde, Abdoulaye A.

    2012-01-01

    Plasmodium falciparum resistance to artemisinins by delayed parasite clearance is present in Southeast Asia. Scant data on parasite clearance after artemisinins are available from Africa, where transmission is high, burden is greatest, and artemisinin use is being scaled up. Children 1–10 years of age with uncomplicated malaria were treated with 7 days of artesunate and followed for 28 days. Blood smears were done every 8 hours until negative by light microscopy. Results were compared with a similar study conducted in the same village in 2002–2004. The polymerase chain reaction-corrected cure rate was 100%, identical to 2002–2004. By 24 hours after treatment initiation, 37.0% of participants had cleared parasitemia, compared with 31.9% in 2002–2004 (P = 0.5). The median parasite clearance time was 32 hours. Only one participant still had parasites at 48 hours and no participant presented parasitemia at 72 hours. Artesunate was highly efficacious, with no evidence of delayed parasite clearance. We provide baseline surveillance data for the emergence or dissemination of P. falciparum resistance in sub-Saharan Africa. PMID:22764287

  15. Delayed Toxicity Associated with Soluble Anthrax Toxin Receptor Decoy-Ig Fusion Protein Treatment

    Science.gov (United States)

    Cote, Christopher; Welkos, Susan; Manchester, Marianne; Young, John A. T.

    2012-01-01

    Soluble receptor decoy inhibitors, including receptor-immunogloubulin (Ig) fusion proteins, have shown promise as candidate anthrax toxin therapeutics. These agents act by binding to the receptor-interaction site on the protective antigen (PA) toxin subunit, thereby blocking toxin binding to cell surface receptors. Here we have made the surprising observation that co-administration of receptor decoy-Ig fusion proteins significantly delayed, but did not protect, rats challenged with anthrax lethal toxin. The delayed toxicity was associated with the in vivo assembly of a long-lived complex comprised of anthrax lethal toxin and the receptor decoy-Ig inhibitor. Intoxication in this system presumably results from the slow dissociation of the toxin complex from the inhibitor following their prolonged circulation. We conclude that while receptor decoy-Ig proteins represent promising candidates for the early treatment of B. anthracis infection, they may not be suitable for therapeutic use at later stages when fatal levels of toxin have already accumulated in the bloodstream. PMID:22511955

  16. Delay to Reconstruction of the Adolescent Anterior Cruciate Ligament: The Socioeconomic Impact on Treatment.

    Science.gov (United States)

    Newman, Justin T; Carry, Patrick M; Terhune, Elizabeth B; Spruiell, Murray; Heare, Austin; Mayo, Meredith; Vidal, Armando F

    2014-08-01

    A delay in pediatric and adolescent anterior cruciate ligament (ACL) reconstruction is associated with an increase in the number of concomitant meniscal and chondral injuries. Factors that contribute to this delay have not been well described. Socioeconomic and demographic factors are related to ACL surgery timing. Cohort study; Level of evidence, 3. All subjects who underwent primary ACL reconstruction at a single tertiary pediatric hospital between 2005 and 2012 were retrospectively reviewed. Variables included concomitant knee injuries (cartilage or meniscus injuries requiring additional operative treatment) and chronologic, demographic, and socioeconomic factors. Multivariable Cox proportional-hazards analyses were used to identify factors related to ACL surgery timing. The mean age of the 272 subjects was 15.2 ± 2.12 years. Time to surgery was significantly different among subjects who required multiple additional surgical procedures at time of ACL reconstruction (median, 3.3 months) compared with subjects with 1 (median, 2.0 months) or no additional injuries (median, 1.6 months). Subjects underwent ACL reconstruction significantly sooner if they were older at the time of injury (hazard ratio [HR], 1.2 per 1 year; 95% CI, 1.1-1.2; P socioeconomic and demographic factors and ACL surgery timing to optimize outcomes.

  17. Time-delayed contrast-enhanced MRI improves detection of brain metastases and apparent treatment volumes.

    Science.gov (United States)

    Kushnirsky, Marina; Nguyen, Vinh; Katz, Joel S; Steinklein, Jared; Rosen, Lisa; Warshall, Craig; Schulder, Michael; Knisely, Jonathan P S

    2016-02-01

    Contrast-enhanced MRI is the preeminent diagnostic test for brain metastasis (BM). Detection of BMs for stereotactic radiosurgery (SRS) planning may improve with a time delay following administration of a high-relaxivity agent for 1.5-T and 3-T imaging systems. Metastasis detection with time-delayed MRI was evaluated in this study. Fifty-three volumetric MRI studies from 38 patients undergoing SRS for BMs were evaluated. All studies used 0.1-mmol/kg gadobenate dimeglumine (MultiHance; Bracco Diagnostics) immediately after injection, followed by 2 more axial T1-weighted sequences after 5-minute intervals (final image acquisition commenced 15 minutes after contrast injection). Two studies were motion limited and excluded. Two hundred eighty-seven BMs were identified. The studies were randomized and examined separately by 3 radiologists, who were blinded to the temporal sequence. Each radiologist recorded the number of BMs detected per scan. A Wilcoxon signed-rank test compared BM numbers between scans. One radiologist determined the scan on which BMs were best defined. All confirmed, visible tumors were contoured using iPlan RT treatment planning software on each of the 3 MRI data sets. A linear mixed model was used to analyze volume changes. The interclass correlations for Scans 1, 2, and 3 were 0.7392, 0.7951, and 0.7290, respectively, demonstrating excellent interrater reliability. At least 1 new lesion was detected in the second scan as compared with the first in 35.3% of subjects (95% CI 22.4%-49.9%). The increase in BM numbers between Scans 1 and 2 ranged from 1 to 10. At least 1 new lesion was detected in the third scan as compared with the second in 21.6% of subjects (95% CI 11.3%-35.3%). The increase in BM numbers between Scans 2 and 3 ranged from 1 to 9. Between Scans 1 and 3, additional tumors were seen on 43.1% of scans (increase ranged from 1 to 14). The median increase in tumor number for all comparisons was 1. There was a significant increase in number

  18. Herbs and natural supplements in the prevention and treatment of delayed-onset muscle soreness

    Directory of Open Access Journals (Sweden)

    Abbas Meamarbashi

    2017-01-01

    Full Text Available Objective:  Unaccustomed and intense eccentric exercise is a common cause of delayed-onset muscle soreness (DOMS. There are multiple remedies for the treatment of DOMS, but its clinical and laboratory pieces of evidence are scarce. Currently, the treatments proposed for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and other alternatives. To find a holistic treatment with effective pain relief and minimum side effects, complementary and alternative medicine, including herbal therapies, plays a main role.Methods: In this review, the existing published studies investigating the efficacy of herbal and natural supplementation therapies for the prevention or treatment of side effects, symptoms, and signs of DOMS are summarized.Results: Previous studies have documented the efficacy of herbal therapies to treat pain, inflammation, as well as laboratory and clinical side effects of DOMS.Conclusion: The use of herbs in DOMS seems safer and has lower side effects than pharmacotherapy. However, the potential for side effects and drug interactions should be considered.

  19. Global exponential stability and periodicity of reaction-diffusion recurrent neural networks with distributed delays and Dirichlet boundary conditions

    International Nuclear Information System (INIS)

    Lu Junguo; Lu Linji

    2009-01-01

    In this paper, global exponential stability and periodicity of a class of reaction-diffusion recurrent neural networks with distributed delays and Dirichlet boundary conditions are studied by constructing suitable Lyapunov functionals and utilizing some inequality techniques. We first prove global exponential convergence to 0 of the difference between any two solutions of the original neural networks, the existence and uniqueness of equilibrium is the direct results of this procedure. This approach is different from the usually used one where the existence, uniqueness of equilibrium and stability are proved in two separate steps. Secondly, we prove periodicity. Sufficient conditions ensuring the existence, uniqueness, and global exponential stability of the equilibrium and periodic solution are given. These conditions are easy to verify and our results play an important role in the design and application of globally exponentially stable neural circuits and periodic oscillatory neural circuits.

  20. An integrated supply chain model for deteriorating items considering delay in payments, imperfect quality and inspection errors under inflationary conditions

    DEFF Research Database (Denmark)

    Mahmoudinezhad, Mahvash; Mirzazadeh, Abolfazl; Ghoreishi, Maryam

    2017-01-01

    of the manufacturer is not perfect and makes inspection errors of Type 1 and Type 2. The second-stage inspection of the manufacturer is at the end of production period without inspection errors. Also, the demand is linear function of time. Once the retailer receives the lot, a 100% screening process of the lot......In this article, an integrated production–distribution model is presented for a manufacturer and retailer supply chain under inflationary conditions, permissible delay in payments, deterioration, imperfect production process and inspection errors. We assume that the first-stage inspection...

  1. [Early versus delayed physiotherapy in the treatment of post-prostatectomy male urinary incontinence].

    Science.gov (United States)

    Tarcía Kahihara, Carina; Ferreira, Ubirajora; Nardi Pedro, Renato; Matheus, Wagner Eduardo; Rodrigues Netto, Nelson

    2006-10-01

    To analyze the importance of the starting time for pelvic floor physiotherapy in patients with post radical prostatectomy urinary incontinence. Between May 2003 and February 2004 18 patients with the diagnosis of post radical prostatectomy urinary incontinence underwent physiotherapy of the pelvic floor. Each patient received 12 sessions using kinesotherapy and electric stimulation on a weekly basis. Patients were divided into two groups: Group 1 included eight patients that started therapy within the first six months after surgery; Group 2 included 10 patients starting therapy after the sixth post operative month. All patients were evaluated by the pad test and number of incontinence pads per day. Evaluating pad tests before and after treatment, six patients in group 1 had a reduction of the amount of urine leak in comparison to seven patients in group 2. The statistical analysis showed significant differences before and after treatment for both groups (group 1: p = 0.028; group 2: p = 0.018). The evaluation of the number of pads showed: Group 1: all eight patients using pods had a reduction in the number of pads. Group 2: 5 of the eight patients using pads had a reduction and the other three continued using the same number. Statistical analysis comparing the number of pads per day before and after treatment showed a significant difference in group 1 (p = 0.004). There was no statistically significant difference in the number of pads per day before and after physiotherapy in group 2, although half of the patients showed a diminishment in the number of pads required after treatment. Results demonstrate that early indication of physiotherapy for the treatment of post radical prostatectomy urinary incontinence is better than delayed treatment. New works may be developed in the future to confirm our results.

  2. Delayed Ejaculation

    Science.gov (United States)

    ... cases, it is due to a combination of physical and psychological concerns. Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions Relationship problems due to stress, poor communication ...

  3. Behavior Problems in Toddlers with and without Developmental Delays: Comparison of Treatment Outcomes

    Science.gov (United States)

    Holtz, Casey A.; Carrasco, Jennifer M.; Mattek, Ryan J.; Fox, Robert A.

    2009-01-01

    The purpose of this study is to examine the effectiveness of an in-home parent management program for toddlers with behavior problems and developmental delays by comparing outcomes for a group of toddlers with developmental delays (n = 27) and a group of toddlers without developmental delays (n = 27). The majority of children lived in single…

  4. A STUDY OF IMPACT OF DETERMINANTS OF PATIENTS AND HEALTH SYSTEM DELAY ON TUBERCULOSIS DIAGNOSIS AND TREATMENT IN BANGALORE

    Directory of Open Access Journals (Sweden)

    Jagadish Siddalinga Devaru

    2013-01-01

    Full Text Available Setting: TU/DMCs of Bangalore city. India. All new sputum positive patients registered to the selected TU/DMCs were interviewed. A total of 468 patients aged above 20 years were enrolled. The study period was from January to June 2009. Objectives: To track the delay in diagnosis and treatment of patients reporting to tuberculosis units and microscopy centers. Design: A cross sectional study. TU/DMCs were randomly selected. A pretested questionnaire was administered to collect data. Results: The study population had 326 (69.7% males. The mean age of study population was 38.5 years. 74.4% were married, 20.7% were illiterates, 27.8% were daily wagers, 10.5% were unemployed. The median and mean total delays from development of cough to diagnosis were 41 days and 36.04 days; the median and mean patient delay was 24 days and 20.7 days, and health system delay was 18 and 15.31 days respectively. There was a significant difference among the different age group of patients with older people having longer patient delay (p<0.0001. Lower income, illiteracy, unemployment, showed significant association with patients delay (p<0.0001. Alcohol intake and smoking habit among the male patients had significant association for longer patient delay (p=0.00004. Health seeking behavior like self medication, also had longer patient delay. Other socio demographic factors had no significant influence on the patient delay. Longer health system delay was found among patients who visited general practitioners and Ayurvedic medicine. Conclusion: More specific and effective health education of the general public on tuberculosis and seeking of appropriate medical consultation are likely to improve case detection.

  5. A STUDY OF IMPACT OF DETERMINANTS OF PATIENTS AND HEALTH SYSTEM DELAY ON TUBERCULOSIS DIAGNOSIS AND TREATMENT IN BANGALORE

    Directory of Open Access Journals (Sweden)

    Jagadish Siddalinga Devaru

    2012-12-01

    Full Text Available Setting: TU/DMCs of Bangalore city. India. All new sputum positive patients registered to the selected TU/DMCs were interviewed. A total of 468 patients aged above 20 years were enrolled. The study period was from January to June 2009. Objectives: To track the delay in diagnosis and treatment of patients reporting to tuberculosis units and microscopy centers. Design: A cross sectional study. TU/DMCs were randomly selected. A pretested questionnaire was administered to collect data. Results: The study population had 326 (69.7% males. The mean age of study population was 38.5 years. 74.4% were married, 20.7% were illiterates, 27.8% were daily wagers, 10.5% were unemployed. The median and mean total delays from development of cough to diagnosis were 41 days and 36.04 days; the median and mean patient delay was 24 days and 20.7 days, and health system delay was 18 and 15.31 days respectively. There was a significant difference among the different age group of patients with older people having longer patient delay (p<0.0001. Lower income, illiteracy, unemployment, showed significant association with patients delay (p<0.0001. Alcohol intake and smoking habit among the male patients had significant association for longer patient delay (p=0.00004. Health seeking behavior like self medication, also had longer patient delay. Other socio demographic factors had no significant influence on the patient delay. Longer health system delay was found among patients who visited general practitioners and Ayurvedic medicine. Conclusion: More specific and effective health education of the general public on tuberculosis and seeking of appropriate medical consultation are likely to improve case detection.

  6. Treatment and conditioning of radioactive solid wastes

    International Nuclear Information System (INIS)

    1992-07-01

    Radioactive materials are extensively used in industrial and research activities mainly related to medical, agricultural, environmental and other studies and applications. During the application and production of radioisotopes, significant amounts of radioactive wastes will inevitably arise, which must be managed (i.e. handled, treated, conditioned, intermediately stored and finally disposed of) with particular care. Serious efforts to minimize and appropriately segregate the waste arisings during the application of radioisotopes are the most important first step in waste management. The essential objective of the management of radioactive waste is the protection of mankind, the biosphere and the environment from the detrimental effects of nuclear radiation both now and in the future. This report deals with radioactive wastes outside the nuclear fuel cycle and it is directed primarily to countries without nuclear power programmes, e.g. countries belonging to the Groups A, B and C. Group A includes Member States which utilize radioisotopes at a few hospital locations, universities and industries. Group B includes Member States which have multi-use of radioisotopes in hospitals and other institutional areas and need a central collection and processing system. Group C includes Member States which have multi-use of radioisotopes and a nuclear research centre which is capable of indigenous production of several radioisotopes. When developing a waste management strategy, consideration should be given to the entire sequence of waste management operations from waste sources to disposal and all the related issues: every aspect of waste generation, processing, transportation, storage and disposal, including regulatory, socio-political and economic issues. The interaction of all these aspects must be analysed and understood before the entire waste management system can be properly built up and safely managed. 16 refs, 13 figs, 5 tabs

  7. Anoxia Treatment for Delaying Skin Browning, Inhibiting Disease Development and Maintaining the Quality of Litchi Fruit

    Directory of Open Access Journals (Sweden)

    Yueming Jiang

    2004-01-01

    Full Text Available Litchi fruit has a very short shelf life after harvest, so marketers and consumers alike desire longer periods of storage, transportation and distribution. To extend shelf life, anoxia treatments were used for the fruit. Litchi fruit were exposed to pure N2 for 0, 3, 6, 12 or 24 h. They were then kept individually in closed but vented containers for 6 days in the dark at 20 °C and 95–100 % relative humidity. Exposure of litchi fruit to N2 for 3 or 6 h markedly delayed skin browning, reduced rot development and maintained higher concentrations of total soluble solids, titratable acidity and ascorbic acid after 6 days of storage. Anoxia treatment for 24 h reduced browning index, but it accelerated disease development, compared to the control. Thus, a pre-storage pure N2 treatment for 3 or 6 h can be an effective means of reducing rotting while maintaining the physical quality of the fruit.

  8. A novel stabilization condition for T-S polynomial fuzzy system with time-delay:A sum-of-squares approach

    OpenAIRE

    Tsai, Shun Hung; Chen, Yu-An; Chen, Yu-Wen; Lo, Ji-Chang; Lam, Hak-Keung

    2017-01-01

    A novel stabilization problem for T-S polynomial fuzzy system with time-delay is investigated in this paper. Firstly, a polynomial fuzzy controller for T-S polynomial fuzzy system with time-delay is proposed. In addition, based on polynomial Lyapunov-Krasovskii function and the developed polynomial slack variable matrices, a novel stabilization condition for T-S polynomial fuzzy system with time-delay is presented in terms of sum-of-square (SOS) form. Lastly, nonlinear system with time-delay ...

  9. Power conditioning accessories. Construction of a delayed drop-out relay and test of constant voltage transformers

    International Nuclear Information System (INIS)

    Keroe, E.; Kaufmann, H.; Koeck, J.; Scarpatetti, R.; Vuister, P.

    1983-10-01

    A delayed drop-out relay aimed to protect electronic measuring equipment during voltage fluctuations and power failures and transients is described. The results of a test on the performance of three resonant voltage transformers (GOULD GT 3000, CVT Isoreg 15-025 and Philips 1412/00) coupled with this relay, are presented. It is found that with this set-up, instrument malfunction and breakdown can be effectively prevented under the normal power conditions met in European countries or the USA. Under more severe conditions, usually met in the developing countries, a more careful selection has to be made; the test recommends the Philips transformer. It is also recommended that for best results the constant voltage transformers should be used at 75-80% of their rated power

  10. Treatment-time-dependence models of early and delayed radiation injury in rat small intestine

    International Nuclear Information System (INIS)

    Denham, James W.; Hauer-Jensen, Martin; Kron, Tomas; Langberg, Carl W.

    2000-01-01

    Background: The present study modeled data from a large series of experiments originally designed to investigate the influence of time, dose, and fractionation on early and late pathologic endpoints in rat small intestine after localized irradiation. The objective was to obtain satisfactory descriptions of the regenerative response to injury together with the possible relationships between early and late endpoints. Methods: Two- and 26-week pathologic radiation injury data in groups of Sprague-Dawley rats irradiated with 27 different fractionation schedules were modeled using the incomplete repair (IR) version of the linear-quadratic model with or without various time correction models. The following time correction models were tested: (1) No time correction; (2) A simple exponential (SE) regenerative response beginning at an arbitrary time after starting treatment; and (3) A bi-exponential response with its commencement linked to accumulated cellular depletion and fraction size (the 'intelligent response model' [INTR]). Goodness of fit of the various models was assessed by correlating the predicted biological effective dose for each dose group with the observed radiation injury score. Results: (1) The incomplete repair model without time correction did not provide a satisfactory description of either the 2- or 26-week data. (2) The models using SE time correction performed better, providing modest descriptions of the data. (3) The INTR model provided reasonable descriptions of both the 2- and 26-week data, confirming a treatment time dependence of both early and late pathological endpoints. (4) The most satisfactory descriptions of the data by the INTR model were obtained when the regenerative response was assumed to cease 2 weeks after irradiation rather than at the end of irradiation. A fraction-size-dependent delay of the regenerative response was also suggested in the best fitting models. (5) Late endpoints were associated with low-fractionation sensitivity

  11. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

    Directory of Open Access Journals (Sweden)

    Nerges Mistry

    Full Text Available Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai.A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values.The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days and retreatment patients (25 days. Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation.Achieving positive behavioural changes in providers (especially non-allopaths and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics

  12. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

    Science.gov (United States)

    Mistry, Nerges; Rangan, Sheela; Dholakia, Yatin; Lobo, Eunice; Shah, Shimoni; Patil, Akshaya

    2016-01-01

    Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB) in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai. A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values. The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days) and retreatment patients (25 days). Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation. Achieving positive behavioural changes in providers (especially non-allopaths) and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics would be

  13. Sodium butyrate into the insular cortex during conditioned taste-aversion acquisition delays aversive taste memory extinction.

    Science.gov (United States)

    Núñez-Jaramillo, Luis; Reyes-López, Julian; Miranda, María Isabel

    2014-04-16

    Histone acetylation is one mechanism that promotes gene expression, and it increases during learning of various tasks. Specifically, novel taste consumption produces an increased acetylation of histone lysine residues in the insular cortex (IC), where protein synthesis is crucial during memory consolidation of conditioned taste aversion (CTA). However, the role of this elevated histone acetylation during CTA learning has not been examined directly. Thus, the present study investigated the effects of sodium butyrate (NaBu), a histone deacetylase inhibitor, injected into the IC during CTA acquisition. Male Wistar rats, IC bilaterally implanted, were injected 60 min before saccharine presentation, with a total volume of 0.5 µl of NaBu solution (100, 500, and 10 µg/0.5 µl) or saline; 30 min later animals were injected intraperitoneally with lithium chloride, a malaise-inducing drug. The next day, CTA retrieval was tested. No effects of NaBu were observed during acquisition or retrieval, but during extinction trials, a significant delay in aversive memory extinction was observed in the group injected with the lowest NaBu dose. This result indicates that NaBu in the IC strengthens CTA and delays aversive memory extinction, and suggests that histone acetylation could increase long-term taste-aversive memory strength.

  14. The identification of risk factors associated with patient and healthcare system delays in the treatment of tuberculosis in Tabriz, Iran.

    Science.gov (United States)

    Ebrahimi Kalan, Mohammad; Yekrang Sis, Hassan; Kelkar, Vinaya; Harrison, Scott H; Goins, Gregory D; Asghari Jafarabadi, Mohammad; Han, Jian

    2018-01-24

    Tuberculosis (TB) is a serious health concern, particularly in developing countries. Various delays, such as patient delay (PD) and healthcare system delay (HSD) in the TB process, are exacerbating the disease burden and increasing the rates of transmission and mortality in various global communities. Therefore, the aim of this study is to identify risk factors associated with PD and HSD in TB patients in Tabriz, Iran. A cross-sectional study was conducted on 173 TB patients in Tabriz, Iran from 2012 to 2014. Patients were interviewed with a semi-structured questionnaire. Frequencies and percentages were reported for patient categories of sex, age, and education. The median and interquartile range (IQR) were reported for the time intervals of delays. Univariate and multivariate logistic regressions of delay in respect to socio-demographic and clinical variables were performed. Statistical significance was set at p patients during their initial visit to the health care facilities. The knowledge generated from this study will be helpful for prioritizing and developing strategies for minimizing delays, initiating early treatment to TB patients, and improving TB-related training programs and healthcare systems in Tabriz, Iran.

  15. Effects of Samorin Treatment and Delayed Infection on the Establishment of Trypanosomes in Glossina Pallidipes

    Energy Technology Data Exchange (ETDEWEB)

    Okoth, S; Mukiria, P; Tinega, G; Murilla, G [Trypanosomiasis Research Centre, Kenya Agricultural Research Institute (TRC-KARI), Box 362, Kikuyu (Kenya)

    2012-07-15

    The protective role of Samorin (isometamidium chloride) when given with the bloodmeal, and the effect of the age of flies at infective feed, on the establishment of Trypanosoma congolense and Trypanosoma vivax in Glossina pallidipes Austen was evaluated. G. pallidipes was fed on fresh bovine blood containing 0, 6, 8, 10, 12 and 14 {mu}g of Samorin/mL of blood on day 0. A control group was fed in vivo on an infected goat as first feed on the same day (day 0). On day 3 post-Samorin treatment, the flies were infected in vivo by feeding them on a goat infected with either T. congolense or T. vivax. Similar procedures were followed for the experimental groups infected 5, 10 and 20 days post-Samorin treatment. Thereafter flies were maintained on rabbits for 15 and 20 days for the T. vivax and T. congolense groups, respectively. Fly survival was assessed, and the flies were dissected to determine infection rates. Results showed that the age of a fly at infection significantly affected the refractoriness of G. pallidipes to T. congolense ( F{sub 4,20} = 5.241; P=0.0047) and T. vivax ( F{sub 4,20} = 5.410; P=0.0040) infections. However, the effect of Samorin treatment on infection per se was not shown to be significant (F{sub 5,19} = 2.383; P=0733 and F{sub 4,20} = 1.106; P=0.3900) for T. congolense and T. vivax, respectively. The age of flies at infection significantly reduced tsetse survival (F{sub 4,20} = 7.584; P<0.001 and F{sub 4,20} = 10.755; P=0.0001) for T. congolense and T. vivax groups, respectively. However, Samorin treatment did not significantly reduce survival in both Trypanosoma groups (F{sub 5,19} = 0.642; P>0.67 and F{sub 5,19} = 0.485; P=0.783). These results indicated that, for T. congolense and T. vivax, combining Samorin treatment at a concentration of at least 8 {mu}g/mL, and delaying exposure of tsetse to infective feed for at least 3 days post emergence, induces sufficient refractoriness that may counter the increased challenge posed by the mass

  16. Soil aquifer treatment of artificial wastewater under saturated conditions

    KAUST Repository

    Essandoh, H. M K; Tizaoui, Chedly; Mohamed, Mostafa H A; Amy, Gary L.; Brdjanovic, Damir

    2011-01-01

    A 2000 mm long saturated laboratory soil column was used to simulate soil aquifer treatment under saturated conditions to assess the removal of chemical and biochemical oxygen demand (COD and BOD), dissolved organic carbon (DOC), nitrogen

  17. Effects of certain burning treatments on veld condition in Giant's ...

    African Journals Online (AJOL)

    Effects of certain burning treatments on veld condition in Giant's Castle Game Reserve. ... Keywords: above-ground standing crop; basal cover; burning; composition change; giant's castle game reserve; natal ... AJOL African Journals Online.

  18. 6. Endovascular treatment for acute traumatic transection of the thoracic aorta: The safety of delayed stenting

    Directory of Open Access Journals (Sweden)

    Adil H. Al Kindi

    2015-10-01

    Conclusion: The delayed approach has been safe with no patients lost during the waiting period. Patients with ATT who make it to the hospital and are stable from the aortic point of view may be managed safely with delayed TEVAR if immediate therapy is not available or possible.

  19. Delayed versus immediate treatment for patients with acute hepatitis C: a randomised controlled non-inferiority trial.

    Science.gov (United States)

    Deterding, Katja; Grüner, Norbert; Buggisch, Peter; Wiegand, Johannes; Galle, Peter R; Spengler, Ulrich; Hinrichsen, Holger; Berg, Thomas; Potthoff, Andrej; Malek, Nisar; Großhennig, Anika; Koch, Armin; Diepolder, Helmut; Lüth, Stefan; Feyerabend, Sandra; Jung, Maria Christina; Rogalska-Taranta, Magdalena; Schlaphoff, Verena; Cornberg, Markus; Manns, Michael P; Wedemeyer, Heiner

    2013-06-01

    Early treatment of acute hepatitis C virus (HCV) infection with interferon alfa monotherapy is very effective, with cure rates of greater than 85%. However, spontaneous clearance of HCV occurs in 10-50% of cases. We aimed to assess an alternative treatment strategy of delayed antiviral therapy in patients who do not eliminate the virus spontaneously compared with immediate treatment. In our open-label phase 3 non-inferiority trial, we enrolled adults (≥18 years) with acute hepatitis C but no HIV or hepatitis B co-infection at 72 centres in Germany. We randomly allocated patients with symptomatic acute hepatitis C (1:1) to receive immediate pegylated interferon alfa-2b treatment for 24 weeks or delayed treatment with pegylated interferon alfa-2b plus ribavirin (for 24 weeks) starting 12 weeks after randomisation if HCV RNA remained positive. We used a computer-generated randomisation sequence and block sizes of eight, stratified by bilirubin concentration. We assigned all asymptomatic patients to immediate treatment with pegylated interferon alfa-2b for 24 weeks. The primary endpoint was sustained HCV RNA negativity in all randomly allocated participants who completed screening (intention-to-treat analysis), with a non-inferiority margin of 10%. For the primary analysis, we calculated the virological response of patients in the immediate and delayed treatment groups and an absolute risk difference stratified by bilirubin status. The trial was stopped early on advice from the study advisory committee because of slow recruitment of participants. This study is registered, number ISRCTN88729946. Between April, 2004, and February, 2010, we recruited 107 symptomatic and 25 asymptomatic patients. 37 (67%) of 55 symptomatic patients randomly allocated to receive immediate treatment and 28 (54%) of 52 symptomatic patients randomly allocated to receive delayed treatment had a sustained virological response (difference 13·7%, 95% CI -4·6 to 32·0; p=0·071). 18 (72%) of 25

  20. Outcome measures in studies on the use of oxytocin for the treatment of delay in labour: A systematic review.

    LENUS (Irish Health Repository)

    Begley, Cecily M

    2014-07-01

    to identify primary and secondary outcome measures in randomised trials, and systematic reviews of randomised trials, measuring effectiveness of oxytocin for treatment of delay in the first and second stages of labour, and to identify any positive health-focussed outcomes used.

  1. Clonidine treatment delays postnatal motor development and blocks short-term memory in young mice.

    Directory of Open Access Journals (Sweden)

    Cristina Calvino-Núñez

    Full Text Available During the development of the nervous system, the perinatal period is particularly sensitive as neuronal connections are still forming in the brain of the neonate. Alpha2-adrenergic receptors are overexpressed temporarily in proliferative zones in the developing brain, reaching a peak during the first postnatal week of life. Both stimulation and blocking of these receptors during this period alter the development of neural circuits, affecting synaptic connectivity and neuronal responses. They even affect motor and cognitive skills later on in the adult. It's especially important to look for the early neurological consequences resulting from such modifications, because they may go unnoticed. The main objective of the present study has been to reaffirm the importance of the maturation of alpha-adrenergic system in mice, by carrying out a comprehensive examination of motor, behavioral and cognitive effects in neonates, during early postnatal development, following chronic administration of the drug Clonidine, an alpha2 adrenergic system agonist. Our study shows that mice treated postnatally with clonidine present a temporal delay in the appearance of developmental markers, a slow execution of vestibular reflexes during first postnatal week of life and a blockade of the short term memory in the novel object recognition task. Shortly after the treatment the startle response is hyperreactive.

  2. Treatment and conditioning of solid and liquid raw

    International Nuclear Information System (INIS)

    Jakubec, R.

    2015-01-01

    Jadrova a vyradovacia spolocnost, a.s. (JAVYS) implements activities within the processes of treatment and conditioning of radioactive waste (RAW) at two nuclear facilities, one of them located in Bohunice - Technologies for treatment and conditioning of RAW. This nuclear facility includes: Bohunice RAW treatment centre, bituminization lines, waste water purification station and technologies for sorting, fragmentation and decontamination of metallic RAW. The Bohunice RAW treatment centre (BRTC) in Bohunice processes and conditions liquid and solid radioactive waste produced during the A1 NPP and V1 NPP decommissioning, waste from the operation of V2 NPP in Bohunice as well as from the operation of NPP EMO 1,2 in Mochovce. The BRTC includes the following technological facilities: sorting, high-pressure compaction, incineration, concentration and cementation. Treatment of radioactive wastes in the BRTC is described. (authors)

  3. Qualitative study of men's perceptions of why treatment delays occur in the UK for those with testicular cancer.

    Science.gov (United States)

    Chapple, Alison; Ziebland, Sue; McPherson, Ann

    2004-01-01

    Many studies (but not all) have shown that for men with testicular cancer a longer treatment delay is associated with additional treatments, greater morbidity, and shorter survival. This paper explores patients' perspectives on why treatment delays occur. Qualitative study using narrative interviews Interviews in patient's homes throughout the United Kingdom (UK). Interviews with a maximum variation sample of 45 men with testicular cancer, recruited through general practitioners (GPs), urologists, support groups, and charities. Those who sought help relatively quickly responded to symptoms, had heard about testicular cancer in the media, had seen leaflets in GPs' surgeries, or knew others with this disease. Men delayed because they did not recognise signs and symptoms; feared appearing weak, a hypochondriac, or lacking in masculinity; recalled past illness or painful examinations; were embarrassed; feared the consequences of treatment; or lacked time to consult their doctors. Beliefs about symptoms and pessimistic associations with cancer also led to delay. Treatment delays also resulted from misdiagnosis or waiting lists. Whether or not men should be taught to examine themselves routinely to check for testicular cancer is much debated. This study suggests that it is important that men are aware of the normal shape and feel of their testicles, and may benefit from information about signs and symptoms of testicular cancer and the excellent cure rate. Information, provided in surgeries where men feel welcome, might encourage men to seek help promptly when a problem arises. Our study also suggests that GPs may need to accept a low threshold for ultrasound investigation of testicular symptoms and that the ultrasound service needs to be improved. These measures may further reduce mortality and morbidity.

  4. Acute and delayed deferoxamine treatment attenuates long-term sequelae after germinal matrix hemorrhage in neonatal rats.

    Science.gov (United States)

    Klebe, Damon; Krafft, Paul R; Hoffmann, Clotilde; Lekic, Tim; Flores, Jerry J; Rolland, William; Zhang, John H

    2014-08-01

    This study investigated if acute and delayed deferoxamine treatment attenuates long-term sequelae after germinal matrix hemorrhage (GMH). Bacterial collagenase (0.3 U) was infused intraparenchymally into the right hemispheric ganglionic eminence in P7 rat pups to induce GMH. GMH animals received either deferoxamine or vehicle twice a day for 7 consecutive days. Deferoxamine administration was initiated at either 1 hour or 72 hours post-GMH. Long-term neurocognitive deficits and motor coordination were assessed using Morris water maze, rotarod, and foot fault tests between day 21 to 28 post-GMH. At 28 days post-GMH, brain morphology was assessed and extracellular matrix protein (fibronectin and vitronectin) expression was determined. Acute and delayed deferoxamine treatment improved long-term motor and cognitive function at 21 to 28 days post-GMH. Attenuated neurofunction was paralleled with improved overall brain morphology at 28 days post-GMH, reducing white matter loss, basal ganglia loss, posthemorrhagic ventricular dilation, and cortical loss. GMH resulted in significantly increased expression of fibronectin and vitronectin, which was reversed by acute and delayed deferoxamine treatment. Acute and delayed deferoxamine administration ameliorated long-term sequelae after GMH. © 2014 American Heart Association, Inc.

  5. Delayed effects of obese and overweight population conditions on all-cause adult mortality rate in the USA

    Directory of Open Access Journals (Sweden)

    Albert A Okunade

    2016-09-01

    Full Text Available Currently, there are few studies separating the linkage of pathological obese and overweight body mass indices (BMI to the all-cause mortality rate in adults. Consequently, this paper, using annual Behavioral Risk Factor Surveillance System (BRFSS data of the 50 US states and the District of Columbia (DC estimates empirical regression models linking the US adult population overweight and obesity rates separately to the all-cause mortality rate. The biochemistry of multi-period cumulative adiposity (saturated fatty acid from unexpended caloric intakes (net energy storage provides the natural theoretical foundation for tracing unhealthy BMI to all-cause mortality. Cross-sectional and panel data regression models are separately estimated for the delayed effects of obese and overweight BMIs on the all-cause mortality rate. Controlling for the independent effects of economic, socio-demographic and other factors on the all-cause mortality rate, our findings confirm that the estimated panel data models are more appropriate. The panel data regression results reveal that the obesity-mortality link strengthens significantly after multiple years in the condition. The faster mortality response to obesity detected here is conjectured to arise from the significantly more obese. Compared with past studies postulating a static (rather than delayed effects, the statistically significant lagged effects of adult population BMI pathology in this study are novel and insightful. And, as expected, these lagged effects are more severe in the obese than overweight population segment. Public health policy implications of this social science study findings agree with those of the clinical sciences literature advocating timely lifestyle modification interventions (e.g., smoking cessation to slow premature mortality linked to unhealthy BMIs.

  6. Delayed treatment with ADAMTS13 ameliorates cerebral ischemic injury without hemorrhagic complication.

    Science.gov (United States)

    Nakano, Takafumi; Irie, Keiichi; Hayakawa, Kazuhide; Sano, Kazunori; Nakamura, Yoshihiko; Tanaka, Masayoshi; Yamashita, Yuta; Satho, Tomomitsu; Fujioka, Masayuki; Muroi, Carl; Matsuo, Koichi; Ishikura, Hiroyasu; Futagami, Kojiro; Mishima, Kenichi

    2015-10-22

    Tissue plasminogen activator (tPA) is the only approved therapy for acute ischemic stroke. However, delayed tPA treatment increases the risk of cerebral hemorrhage and can result in exacerbation of nerve injury. ADAMTS13, a von Willebrand factor (VWF) cleaving protease, has a protective effect against ischemic brain injury and may reduce bleeding risk by cleaving VWF. We examined whether ADAMTS13 has a longer therapeutic time window in ischemic stroke than tPA in mice subjected to middle cerebral artery occlusion (MCAO). ADAMTS13 (0.1mg/kg) or tPA (10mg/kg) was administered i.v., immediately after reperfusion of after 2-h or 4-h MCAO for comparison of the therapeutic time windows in ischemic stroke. Infarct volume, hemorrhagic volume, plasma high-mobility group box1 (HMGB1) levels and cerebral blood flow were measured 24h after MCAO. Both ADAMTS13 and tPA improved the infarct volume without hemorrhagic complications in 2-h MCAO mice. On the other hand, ADAMTS13 reduced the infarct volume and plasma HMGB1 levels, and improved cerebral blood flow without hemorrhagic complications in 4-h MCAO mice, but tPA was not effective and these animals showed massive intracerebral hemorrhage. These results indicated that ADAMTS13 has a longer therapeutic time window in ischemic stroke than tPA, and ADAMTS13 may be useful as a new therapeutic agent for ischemic stroke. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Overview of Treatment and Conditioning Practices in Goesgen NPP

    International Nuclear Information System (INIS)

    Aebi, Patrick

    2008-01-01

    Radioactive waste of the Goesgen Nuclear Power Plant is collected and stored in an appropriate form for external conditioning or for direct in-house conditioning procedures. Different waste treatment and conditioning technologies have been used since plant start up in 1979. The main conditioning technology used in-house is bituminization. Reactor internal components, contaminated filter elements of cooling circuits or radioactive sludge from the liquid waste tanks have been treated by dedicated equipment and methods. These methods are under water cutting and manipulation of core components, remote dismantling and compressing of filter elements into cartridges or filtration of sludge with a one-chamber filtration system. (authors)

  8. The effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early intervention in psychotic disorders.

    Science.gov (United States)

    Albert, Nikolai; Melau, Marianne; Jensen, Heidi; Hastrup, Lene Halling; Hjorthøj, Carsten; Nordentoft, Merete

    2017-09-26

    The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first-episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study, we investigate whether DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. For this specific study participants were dichotomized based on DUP, treatment delay, and time from first symptom until start of SEI treatment. The groups were analyzed with regard to treatment response on psychopathology, level of functioning, and cognitive functioning. The participants with a short DUP had a tendency to respond better to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment for participants with a short total treatment delay could mean that prolonged SEI treatment is more beneficial than treatment as usual (TAU) so long as it is provided in the early years of illness and not just in the early years after diagnosis. THE EARLIER THE BETTER: The duration of untreated psychosis influences the long-term outcomes of treatment. Nikolai Albert, at the Copenhagen Mental Health Centre, and a team of Danish researchers have investigated the effects of a specialized early intervention program (OPUS) in 400 patients diagnosed with schizophrenia spectrum disorders and compared the effects of OPUS after two and five years. Their findings suggest that five years of specialized early intervention was most beneficial when the total duration from symptom start to

  9. Healthcare-seeking behavior, treatment delays and its determinants among pulmonary tuberculosis patients in rural Nigeria: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ukwaja Kingsley N

    2013-01-01

    Full Text Available Abstract Background Nigeria ranks fourth among 22 high tuberculosis (TB burden countries. Although it reached 99% DOTS coverage in 2008, current case detection rate is 40%. Little is known about delays before the start of TB therapy and health-seeking behaviour of TB patients in rural resource-limited settings. We aimed to: 1 assess healthcare-seeking behaviour and delay in treatment of pulmonary TB patients, 2 identify the determinants of the delay in treatment of pulmonary TB. Methods We conducted a cross-sectional study of adult new pulmonary TB patients notified to the National Tuberculosis Control Programme (NTP by three rural (two mission/one public hospitals. Data on health-seeking and delays were collected using a standardised questionnaire. We defined patient delay as the interval (weeks between the onset of cough and the first visit to any health provider, and health system delay as the time interval (weeks between patient's first attendance to any health provider, and the onset of treatment. Total delay is the sum of both delays. Multiple linear regression models using nine exposure variables were built to identify determinants of delays. Results Of 450 patients (median age 30 years enrolled, most were males (55%, subsistent farmers (49%, rural residents (78%; and 39% had no formal education. About 84% of patients reported first consulting a non-NTP provider. For such patients, the first facilities visited after onset of symptoms were drug shops (79%, traditional healers (10%, and private hospitals (10%. The median total delay was 11 (IQR 9–16 weeks, patient delay 8 (IQR 8–12 and health system (HS delay 3 (IQR 1–4 weeks. Factors associated with increased patient delay were older age (P Conclusion Overall, TB treatment delays were high; and needs to be reduced in Nigeria. This may be achieved through improved access to care, further education of patients, engagement of informal care providers, and strengthening of existing public

  10. Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches.

    Science.gov (United States)

    Xue, Youdi; Zhang, Hui; Pei, Fuxing; Tu, Chongqi; Song, Yueming; Fang, Yue; Liu, Lei

    2014-01-01

    Treatment of talar neck fractures is challenging. Various surgical approaches and fixation methods have been documented. Clinical outcomes are often dissatisfying due to inadequate reduction and fixation with high rates of complications. Obtaining satisfactory clinical outcomes with minimum complications remains a hard task for orthopaedic surgeons. In the period from May 2007 to September 2010, a total of 31 cases with closed displaced talar neck fractures were treated surgically in our department. Injuries were classified according to the Hawkins classification modified by Canale and Kelly. Under general anaesthesia with sufficient muscle relaxation, urgent closed reduction was initiated once the patients were admitted; if the procedure failed, open reduction and provisional stabilisation with Kirschner wires through an anteromedial approach with tibiometatarsal external fixation were performed. When the soft tissue had recovered, definitive fixation was performed with plate and screws through dual approaches. The final follow-up examination included radiological analysis, clinical evaluation and functional outcomes which were carried out according to the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS), patient satisfaction and SF-36. Twenty-eight patients were followed up for an average of 25 months (range 18-50 months) after the injury. Only two patients had soft tissue complications, and recovery was satisfactory with conservative treatment. All of the fractures healed anatomically without malunion and nonunion, and the average union time was 14 weeks (range 12-24 weeks). Post-traumatic arthritis developed in ten cases, while six patients suffered from avascular necrosis of the talus. Secondary procedures included three cases of subtalar arthrodesis, one case of ankle arthrodesis and one case of total ankle replacement. The mean AOFAS hindfoot score was 78 (range 65-91). According to the SF-36, the average score of the

  11. Severe trimming and enhanced competition of laterals as a tool to delay ripening in Tempranillo vineyards under semiarid conditions

    Directory of Open Access Journals (Sweden)

    Luis Gonzaga Santesteban

    2017-05-01

    Significance and impact of the study: this study proves the potentiality of the joint use of trimming and increased irrigation to delay ripening, although it is necessary to analyze the implications the obtained delay has on other quality aspects. The lower anthocyanin and phenolic values observed in trimmed vines were not solely due to delayed ripening, as lower values were observed even when data were compared for a given total soluble solid content.

  12. Overview of treatment and conditioning of low-level wastes

    International Nuclear Information System (INIS)

    Trevorrow, L.

    1986-01-01

    The consideration of alternative technologies in low-level waste management is assumed to be partly a response to current demands for lower risk in waste disposal. One of the determinants of risk in waste disposal is the set of characteristics of the materials placed into disposal cells, i.e., the products of treatment and conditioning operations. The treatment and conditioning operations that have been applied to waste streams are briefly examined. Three operations are the most important determinants of the stability that will contribute to reducing risk at the disposal cell: compaction, high-integrity containers, and solidification. The status of these three operations is reviewed

  13. The Long-Term Outcome Comparison of Different Time-Delayed Kallikrein Treatments in a Mouse Cerebral Ischemic Model

    Directory of Open Access Journals (Sweden)

    Yaohui Ni

    2018-01-01

    Full Text Available Delayed administration of kallikrein after cerebral infarction can improve neurological function. However, the appropriate kallkrein treatment time after ischemic stroke has not been illuminated. In this study, we compared the long-term outcome among three kallikrein therapeutic regimens starting at different time points following mouse cerebral ischemia. Furthermore, the protective mechanisms involving neurogenesis, angiogenesis, and AKT-GSK3β-VEGF signaling pathway were analyzed. Human tissue kallikrein was injected through the tail vein daily starting at 8 h, 24 h, or 36 h after right middle cerebral artery occlusion (MCAO until the 28th day. Three therapeutic regimens all protected against neurological dysfunction, but kallikrein treatment starting at 8 h after MCAO had the best efficacy. Additionally, kallikrein treatment at 8 h after MCAO significantly enhanced cell proliferation including neural stem cell and induced differentiation of neural stem cell into mature neuron. Kallikrein treatment starting at 8 h also promoted more angiogenesis than other two treatment regimens, which was associated with AKT-GSK3β-VEGF signaling pathway. Thus, we confirm that three delayed kallikrein treatments provide protection against cerebral infarction and furthermore suggest that kallikrein treatment starting at 8 h had a better effect than that at 24 h and 36 h. These findings provide the experimental data contributing to better clinical application of exogenous kallikrein.

  14. Treatment with Docosahexaenoic Acid, but Not Eicosapentaenoic Acid, Delays Ca2+-Induced Mitochondria Permeability Transition in Normal and Hypertrophied Myocardium

    OpenAIRE

    Khairallah, Ramzi J.; O'Shea, Karen M.; Brown, Bethany H.; Khanna, Nishanth; Des Rosiers, Christine; Stanley, William C.

    2010-01-01

    Intake of fish oil containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) prevents heart failure; however, the mechanisms are unclear. Mitochondrial permeability transition pore (MPTP) opening contributes to myocardial pathology in cardiac hypertrophy and heart failure, and treatment with DHA + EPA delays MPTP opening. Here, we assessed: 1) whether supplementation with both DHA and EPA is needed for optimal prevention of MPTP opening, and 2) whether this benefit occurs in hyper...

  15. Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study.

    Science.gov (United States)

    Gross, Wibke; Linden, Ulrike; Ostermann, Thomas

    2010-07-21

    Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic and supportive therapy for children with delayed speech development

  16. Developmental delay

    Science.gov (United States)

    Nutrition support is essential for the care of the child with developmental delay. After a thorough evaluation, an individualized intervention plan that accounts for the child’s nutrition status, feeding ability, and medical condition may be determined. Nutrition assessments may be performed at leas...

  17. Chronic psychosocial stress causes delayed extinction and exacerbates reinstatement of ethanol-induced conditioned place preference in mice.

    Science.gov (United States)

    Bahi, Amine; Dreyer, Jean-Luc

    2014-01-01

    We have shown previously, using an animal model of voluntary ethanol intake and ethanol-conditioned place preference (EtOH-CPP), that exposure to chronic psychosocial stress induces increased ethanol intake and EtOH-CPP acquisition in mice. Here, we examined the impact of chronic subordinate colony (CSC) exposure on EtOH-CPP extinction, as well as ethanol-induced reinstatement of CPP. Mice were conditioned with saline or 1.5 g/kg ethanol and were tested in the EtOH-CPP model. In the first experiment, the mice were subjected to 19 days of chronic stress, and EtOH-CPP extinction was assessed during seven daily trials without ethanol injection. In the second experiment and after the EtOH-CPP test, the mice were subjected to 7 days of extinction trials before the 19 days of chronic stress. Drug-induced EtOH-CPP reinstatement was induced by a priming injection of 0.5 g/kg ethanol. Compared to the single-housed colony mice, CSC mice exhibited increased anxiety-like behavior in the elevated plus maze (EPM) and the open field tests. Interestingly, the CSC mice showed delayed EtOH-CPP extinction. More importantly, CSC mice showed increased alcohol-induced reinstatement of the EtOH-CPP behavior. Taken together, this study indicates that chronic psychosocial stress can have long-term effects on EtOH-CPP extinction as well as drug-induced reinstatement behavior and may provide a suitable model to study the latent effects of chronic psychosocial stress on extinction and relapse to drug abuse.

  18. Effect of Temperature, Pressure and Equivalence Ratio on Ignition Delay in Ignition Quality Tester (IQT): Diesel,n-Heptane, andiso-Octane Fuels under Low Temperature Conditions

    KAUST Repository

    Yang, Seung Yeon

    2015-11-02

    Effects of temperature, pressure and global equivalence ratio on total ignition delay time in a constant volume spray combustion chamber were investigated for diesel fuel along with the primary reference fuels (PRFs) of n-heptane and iso-octane in relatively low temperature conditions to simulate unsteady spray ignition behavior. A KAUST Research ignition quality tester (KR-IQT) was utilized, which has a feature of varying temperature, pressure and equivalence ratio using a variable displacement fuel pump. A gradient method was adopted in determining the start of ignition in order to compensate pressure increase induced by low temperature heat release. Comparison of this method with other existing methods was discussed. Ignition delay times were measured at various equivalence ratios (0.5-1.7) with the temperatures of initial charge air in the range from 698 to 860 K and the pressures in the range of 1.5 to 2.1 MPa, pertinent to low temperature combustion (LTC) conditions. An attempt to scale the effect of pressure on total ignition delay was undertaken and the equivalence ratio exponent and activation energy in the Arrhenius expression of total ignition delay were determined. Ignition delay results indicated that there were strong correlations of pressure, temperature, and equivalence ratio under most conditions studied except at relatively low pressures. Diesel (DCN 52.5) and n-heptane (DCN 54) fuels exhibited reasonably similar ignition delay characteristics, while iso-octane showed a distinct behavior under low temperature regime having a two-stage ignition, which substantiate the adoption of the gradient method in determining ignition delay.

  19. A laboratory assessment of various treatment conditions affecting ...

    African Journals Online (AJOL)

    conditions affecting the ammoniation of wheat straw by urea. 1. The effect of temperature, moisture level ... levels of 250 and 375 g/kg wheat straw and treatment periods of 0;. 1; 2; 4; 6 and 8 weeks. Dependent variables .... chloride solution containing 5 mg phenyl mercury acetate per litre. In vitro organic matter digestibility ...

  20. Osteoarthritis treatment using autologous conditioned serum after placebo

    NARCIS (Netherlands)

    Rutgers, Marijn; Creemers, Laura B; Auw Yang, Kiem Gie; Raijmakers, Natasja J H; Dhert, Wouter J A; Saris, Daniel B F

    BACKGROUND AND PURPOSE: Autologous conditioned serum (ACS) is a disease-modifying drug for treatment of knee osteoarthritis, and modest superiority over placebo was reported in an earlier randomized controlled trial (RCT). We hypothesized that when given the opportunity, placebo-treated patients

  1. Delayed Tension Pneumothorax - Identification and Treatment in Traumatic Bronchial Injury: An Interesting Presentation.

    Science.gov (United States)

    Gupta, Amit; Rattan, Amulya; Kumar, Sunil; Rathi, Vinita

    2017-09-01

    A 13-year-old girl, who did not receive any treatment for few hours following Road Traffic Injury (RTI), reported to the Casualty Department and found to have patent airway with clinically normal C spine, air-hunger (RR 42/minute), trachea deviated to left, distended neck veins and absent breath sounds on the right side. The chest X-ray she carried, done immediately after the injury, showed right sided tension pneumothorax. She was put on oxygen at 11 L/minute and an Intercostal chest tube drainage (ICD) was inserted on right side. Her oxygen saturation (40%) failed to improve. ICD bag showed continuous bubbling and air entry remained absent on the right side. An urgent right thoracotomy was done which revealed right main bronchus tear; the tear was repaired using interrupted Prolene ® sutures. Patient recovered well and was discharged 10 days later in a stable condition.

  2. Chronic sleep reduction in adolescents with Delayed Sleep Phase Disorder and effects of melatonin treatment

    NARCIS (Netherlands)

    van Maanen, Annette; Dewald-Kaufmann, Julia F.; Smits, Marcel G.; Oort, Frans J.; Meijer, Anne Marie

    2013-01-01

    Homeostatic and circadian changes that occur during adolescence can result in chronic sleep reduction. This may particularly be true for adolescents with Delayed Sleep Phase Disorder (DSPD), which is associated with late Dim Light Melatonin Onset (DLMO). This study assessed the influence of

  3. THE TREATMENT OF INTERSEX AND THE PROBLEM OF DELAY: THE AUSTRALIAN SENATE INQUIRY INTO INTERSEX SURGERY AND CONFLICTING HUMAN RIGHTS FOR CHILDREN.

    Science.gov (United States)

    O'Connor, Mike

    2016-03-01

    When a child is born with indeterminate genitalia (so-called intersex or disordered sex development), it becomes very difficult to balance the child's right to determine their own sexual future against the problems of living as a child with an indeterminate gender. Moreover, the initial assignment of gender may prove to be inappropriate and major psychological disturbances in the recipient can arise during adolescence and adult life. The problems of these children were explained to the Australian Senate Committee during its inquiry into intersex surgery in 2013. As a result, the Committee made a number of recommendations, including a proposal that all surgery be deferred until the child is able to consent to treatment. The author argues that the Committee's proposal to delay all modifications of indeterminate genitalia is impractical. The inclusion in the definition of intersex of common conditions (such as hypospadias in genetic male infants) means that necessary and uncontroversial surgery will be delayed until after puberty. This delay may be harmful and adverse to some children's best interests.

  4. Total Delay Is Associated with Unfavorable Treatment Outcome among Pulmonary Tuberculosis Patients in West Gojjam Zone, Northwest Ethiopia: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Senedu Bekele Gebreegziabher

    Full Text Available delay in diagnosis and treatment of tuberculosis (TB may worsen the disease, increase mortality and enhance transmission in the community. This study aimed at assessing the association between total delay and unfavorable treatment outcome among newly diagnosed pulmonary TB (PTB patients.A prospective cohort study was conducted in West Gojjam Zone, Amhara Region of Ethiopia from October 2013 to May 2015. Newly diagnosed PTB patients who were ≥15 years of age were consecutively enrolled in the study from 30 randomly selected public health facilities. Total delay (the time period from onset of TB symptoms to first start of anti-TB treatment was measured. Median total delay was calculated. Mixed effect logistics regression was used to analyze factors associated with unfavorable treatment outcome.Seven hundred six patients were enrolled in the study. The median total delay was 60 days. Patients with total delay of > 60 days were more likely to have unfavorable TB treatment outcome than patients with total delay of ≤ 60 days (adjusted odds ratio [AOR], 2.33; 95% confidence interval [CI], 1.04-5.26. Human immunodeficiency virus (HIV positive TB patients were 8.46 times more likely to experience unfavorable treatment outcome than HIV negative TB patients (AOR, 8.46; 95% CI, 3.14-22.79.Long total delay and TB/HIV coinfection were associated with unfavorable treatment outcome. Targeted interventions that can reduce delay in diagnosis and treatment of TB, and early comprehensive management of TB/HIV coinfection are needed to reduce increased risk of unfavorable treatment outcome.

  5. Delayed Encephalopathy of Carbon Monoxide Intoxication and Treatment with Hyperbaric Oxygen: A Case Report

    Directory of Open Access Journals (Sweden)

    Fatma Polat

    2012-09-01

    Full Text Available Delayed encephalopathy (DE is a neuropsychiatric syndrome that can arise generally within 20 days of acute carbon monoxide (CO intoxication after apparent recovery and involves variable degrees of cognitive deficits, personality changes, movement disorders and focal neurologic deficits. We report a 35-year-old female patient with delayed encephalopathy due to CO intoxication, presenting with cognitive impairment and mild parkinsonism despite receiving hyberbaric oxigen therapy (HBO. Magnetic resonance imaging showed abnormal signal intensity and decreased diffusivity at both caudate nuclei and globus pallidus. She continued to receive additional HBO therapy and complete recovery was reached within six months. The positive effect of early HBO therapy of selected patients in reversing the acute effects of CO intoxication is appearant. We here also review the beneficial effect of HBO in preventing or limitating the late neurocognitive deficits associated with severe CO intoxication

  6. Experience of Comamonas Acidovorans Keratitis with Delayed Onset and Treatment Response in Immunocompromised Cornea

    OpenAIRE

    Lee, Sang Mok; Kim, Mee Kum; Lee, Jae Lim; Wee, Won Ryang; Lee, Jin Hak

    2008-01-01

    Purpose To report 2 cases of Comamonas Acidovorans keratitis in immunocompromised cornea. Methods A complete review of the medical records of the two cases of Comamonas acidovorans keratitis. Results We found some similarities in clinical courses of two cases. Both of them showed development of keratitis during the management with corticosteroids, delayed onset, slow response to antibiotics, and relatively less affected corneal epithelium. Conclusions Comamonas Acidovorans is known as a less ...

  7. Effect of Delayed Reinforcement on Skill Acquisition during Discrete-Trial Instruction: Implications for Treatment-Integrity Errors in Academic Settings

    Science.gov (United States)

    Carroll, Regina A.; Kodak, Tiffany; Adolf, Kari J.

    2016-01-01

    We used an adapted alternating treatments design to compare skill acquisition during discrete-trial instruction using immediate reinforcement, delayed reinforcement with immediate praise, and delayed reinforcement for 2 children with autism spectrum disorder. Participants acquired the skills taught with immediate reinforcement; however, delayed…

  8. G-CSF in solid tumor chemotherapy: a tailored regimen reduces febrile neutropenia, treatment delays and direct costs.

    Science.gov (United States)

    Tsavaris, Nicolas; Kosmas, Christos; Gouveris, Panagiotis; Vadiak, Maria; Dimitrakopoulos, Antonis; Karadima, Dimitra; Pagouni, Efterpi; Panagiotakopoulos, George; Tzima, Evanthia; Ispoglou, Sevasti; Sakelariou, Dimitris; Koufos, Christos

    2004-02-01

    Current guidelines do not recommend G-CSF for patients with risk factors for neutropenia. One-hundred patients undergoing chemotherapy were randomized to treatment with G-CSF at 5 Kg/kg for established febrile neutropenia (ANC <1000/microl) (Group A) or G-CSF at 263 Kg/day if ANC was 1500/microl or less on the day of the expected nadir, with the duration of treatment determined by the severity of neutropenia (Group B). The number of doses of G-CSF was similar in the two groups. There were 34 cases of febrile neutropenia in Group A, but none in Group B (p=0.0001). Hospital admission for febrile neutropenia, antibiotic use and delays in chemotherapy were all significantly more common in Group A. Total direct costs were estimated to be 66, 646 for Group A and 47, 119 for Group B. Tailoring treatment does not increase G-CSF use, but significantly reduces febrile neutropenia and treatment delays and lowers direct costs.

  9. Delayed xenon post-conditioning mitigates spinal cord ischemia/reperfusion injury in rabbits by regulating microglial activation and inflammatory factors.

    Science.gov (United States)

    Yang, Yan-Wei; Wang, Yun-Lu; Lu, Jia-Kai; Tian, Lei; Jin, Mu; Cheng, Wei-Ping

    2018-03-01

    The neuroprotective effect against spinal cord ischemia/reperfusion injury in rats exerted by delayed xenon post-conditioning is stronger than that produced by immediate xenon post-conditioning. However, the mechanisms underlying this process remain unclear. Activated microglia are the main inflammatory cell type in the nervous system. The release of pro-inflammatory factors following microglial activation can lead to spinal cord damage, and inhibition of microglial activation can relieve spinal cord ischemia/reperfusion injury. To investigate how xenon regulates microglial activation and the release of inflammatory factors, a rabbit model of spinal cord ischemia/reperfusion injury was induced by balloon occlusion of the infrarenal aorta. After establishment of the model, two interventions were given: (1) immediate xenon post-conditioning-after reperfusion, inhalation of 50% xenon for 1 hour, 50% N 2 /50%O 2 for 2 hours; (2) delayed xenon post-conditioning-after reperfusion, inhalation of 50% N 2 /50%O 2 for 2 hours, 50% xenon for 1 hour. At 4, 8, 24, 48 and 72 hours after reperfusion, hindlimb locomotor function was scored using the Jacobs locomotor scale. At 72 hours after reperfusion, interleukin 6 and interleukin 10 levels in the spinal cord of each group were measured using western blot assays. Iba1 levels were determined using immunohistochemistry and a western blot assay. The number of normal neurons at the injury site was quantified using hematoxylin-eosin staining. At 72 hours after reperfusion, delayed xenon post-conditioning remarkably enhanced hindlimb motor function, increased the number of normal neurons at the injury site, decreased Iba1 levels, and inhibited interleukin-6 and interleukin-10 levels in the spinal cord. Immediate xenon post-conditioning did not noticeably affect the above-mentioned indexes. These findings indicate that delayed xenon post-conditioning after spinal cord injury improves the recovery of neurological function by reducing

  10. External fixation combined with delayed internal fixation in treatment of tibial plateau fractures with dislocation.

    Science.gov (United States)

    Tao, Xingguang; Chen, Nong; Pan, Fugen; Cheng, Biao

    2017-10-01

    The aim of this study was to evaluate the clinical efficacy of external fixation, delayed open reduction, and internal fixation in treating tibial plateau fracture with dislocation.Clinical data of 34 patients diagnosed with tibial plateau fracture complicated with dislocation between January 2009 and May 2015 were retrospectively analyzed. Fifteen patients in group A underwent early calcaneus traction combined with open reduction and internal fixation and 19 in group B received early external fixation combined with delayed open reduction and internal fixation. Operation time, postoperative complication, bone healing time, knee joint range of motion, initial weight-bearing time, Rasmussen tibial plateau score, and knee function score (HSS) were statistically compared between 2 groups.The mean follow-up time was 18.6 months (range: 5-24 months). The mean operation time in group A was 96 minutes, significantly longer than 71 minutes in group B (P  .05). In group A, initial weight-bearing time in group A was (14.0 ± 3.6) weeks, significantly differing from (12.9 ± 2.8) weeks in group B (P  0.05). Rasmussen tibial plateau score in group A was slightly lower than that in group B (P > .05). The excellent rate of knee joint function in group A was 80% and 84.21% in group B (P > .05).External fixation combined with delayed open reduction and internal fixation is a safer and more efficacious therapy of tibial plateau fracture complicated with dislocation compared with early calcaneus traction and open reduction and internal fixation.

  11. Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach?

    Science.gov (United States)

    Morreale, Manuela; Marchione, Pasquale; Pili, Antonio; Lauta, Antonella; Castiglia, Stefano F; Spallone, Aldo; Pierelli, Francesco; Giacomini, Patrizia

    2016-02-01

    Early/intensive mobilization may improve functional recovery after stroke but it is not clear which kind of "mobilization" is more effective. Proprioceptive neuromuscular facilitation (PNF) and cognitive therapeutic exercise (CTE) are widespread applied in post-stroke rehabilitation but their efficacy and safety have not been systematically investigated. To compare PNF and CTE methods in a two different time setting (early versus standard approach) in order to evaluate different role of time and techniques in functional recovery after acute ischemic stroke. We designed a prospectical multicenter blinded interventional study of early versus standard approach with two different methods by means of both PNF and CTE. A discrete stroke-dedicated area for out-of-thrombolysis patients, connected with two different comprehensive stroke centres in two different catchment areas. Three hundred and forty consecutive stroke patient with first ever sub-cortical ischemic stroke in the mean cerebral artery (MCA) territory and contralateral hemiplegia admitted within 6 and 24 hours from symptoms onset. All patients were randomly assigned by means of a computer generated randomization sequence in blocks of 4 to one to the 4 interventional groups: early versus delayed rehabilitation programs with Kabat's schemes or Perfetti's technique. Patients in both delayed group underwent to a standard protocol in the acute phase. disability at 3-12 months. Disability measures: modified Rankin Score and Barthel Index. Safety outcome: immobility-related adverse events. Six-Minute Walking Test, Motricity Index, Mini-Mental State Examination, Beck Depression Inventory. Disability was not different between groups at 3 months but Barthel Index significantly changed between early versus delayed groups at 12 months (P=0.01). Six-Minute Walking Test (P=0.01) and Motricity Index in both upper (P=0.01) and lower limbs (P=0.001) increased in early versus delayed groups regardless rehabilitation schedule. A

  12. Experience of Comamonas acidovorans keratitis with delayed onset and treatment response in immunocompromised cornea.

    Science.gov (United States)

    Lee, Sang Mok; Kim, Mee Kum; Lee, Jae Lim; Wee, Won Ryang; Lee, Jin Hak

    2008-03-01

    To report 2 cases of Comamonas acidovorans keratitis in immunocompromised cornea. A complete review of the medical records of the two cases of Comamonas acidovorans keratitis. We found some similarities in clinical courses of two cases. Both of them showed development of keratitis during the management with corticosteroids, delayed onset, slow response to antibiotics, and relatively less affected corneal epithelium. Comamonas acidovorans is known as a less virulent organism. However it can cause an indolent infection that responds slowly even to adequate antibiotics therapy in immunocompromised corneas.

  13. Radioactive sodium waste treatment and conditioning. Review of main aspects

    International Nuclear Information System (INIS)

    2007-01-01

    This publication reviews the main aspects relating to the treatment and conditioning of radioactive sodium waste. This waste arises from the operation of liquid metal fast reactors (LMFRs). In this type of reactor, sodium (Na) or sodium-potassium alloys (NaK) are used as a low-effect neutron moderating coolant medium for extracting and transferring thermal energy from the core and they represent a significant technical and safety challenge during operation and decommissioning. This publication provides the reader with technologically oriented information on the present status of sodium waste management approaches and recent achievements related to treatment and conditioning, with the objective of facilitating planning and preparatory work for the decommissioning of LMFRs. This publication provides a comprehensive review of the hazards associated with sodium waste management. Given the large quantities of sodium waste arising during decommissioning or reactor refurbishment, as well as the challenges and varied techniques associated with removal of 100% of all sodium and NaK bulk quantities and residues during decommissioning, a hazards review and analysis is a critical component in planning the dismantling and waste management activities. Roughly half of this publication focuses on sodium waste generating, handling and treatment processes. This includes draining sodium and NaK from plant systems; in situ treatment of residual sodium; cutting techniques for pumps, valves, piping and other components; cleaning of components; potential reuse of sodium; and removal of selected radionuclides from sodium waste with the objective of reducing the waste classification or converting it to exempt waste. The focus is on proven techniques and technologies, and each discussed method includes a review of the associated principle or theory, practical applications, advantages and disadvantages, limitations, industry experience, and final waste products. A review is provided of final

  14. "What time is my next meal?" delay-discounting individuals choose smaller portions under conditions of uncertainty.

    Science.gov (United States)

    Zimmerman, Annie R; Ferriday, Danielle; Davies, Sarah R; Martin, Ashley A; Rogers, Peter J; Mason, Alice; Brunstrom, Jeffrey M

    2017-09-01

    'Dietary' delay discounting is typically framed as a trade-off between immediate rewards and long-term health concerns. Our contention is that prospective thinking also occurs over shorter periods, and is engaged to select portion sizes based on the interval between meals (inter-meal interval; IMI). We sought to assess the extent to which the length of an IMI influences portion-size selection. We predicted that delay discounters would show 'IMI insensitivity' (relative lack of concern about hunger or fullness between meals). In particular, we were interested in participants' sensitivity to an uncertain IMI. We hypothesized that when meal times were uncertain, delay discounters would be less responsive and select smaller portion sizes. Participants (N = 90) selected portion sizes for lunch. In different trials, they were told to expect dinner at 5pm, 9pm, and either 5pm or 9pm (uncertain IMI). Individual differences in future-orientation were measured using a monetary delay-discounting task. Participants chose larger portions when the IMI was longer (p relationship between BMI and smaller portion selection in uncertainty (p < 0.05). This is the first study to report an association between delay discounting and IMI insensitivity. We reason that delay discounters selected smaller portions because they were less sensitive to the uncertain IMI, and overlooked concerns about potential future hunger. These findings are important because they illustrate that differences in discounting are expressed in short-term portion-size decisions and suggest that IMI insensitivity increases when meal timings are uncertain. Further research is needed to confirm whether these findings generalise to other populations. Copyright © 2017. Published by Elsevier Ltd.

  15. Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study

    Science.gov (United States)

    2010-01-01

    Background Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. Methods A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Results Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. Conclusions This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic and supportive therapy for

  16. Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study

    Directory of Open Access Journals (Sweden)

    Linden Ulrike

    2010-07-01

    Full Text Available Abstract Background Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. Methods A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Results Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. Conclusions This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic

  17. Delayed cerebral radiation necrosis following treatment for a plasmacytoma of the skull.

    Science.gov (United States)

    Chambless, Lola B; Angel, Federica B; Abel, Ty W; Xia, Fen; Weaver, Kyle D

    2010-10-25

    Cerebral radiation necrosis is a relatively common complication of radiation therapy for intracranial malignancies which can also rarely be encountered after radiation of extracranial lesions of the head and neck. We present the first reported case of cerebral radiation necrosis in a patient who underwent radiation therapy for a plasmacytoma of the skull. A 68-year-old male with multiple myeloma presented with an enhancing right frontal mass, 8 years after receiving radiation therapy for a plasmacytoma of the left frontal skull. The patient underwent a diagnostic and therapeutic craniotomy for a presumed neoplastic lesion. The pathologic diagnosis made in this case was delayed radiation necrosis. The patient was followed for over a year during which this process continued to evolve before the ultimate resolution of his clinical symptoms and radiographic abnormality. This case highlights the importance of considering radiation necrosis in the differential diagnosis of any patient with an intracranial mass and a history of radiation for an extracranial head and neck malignancy, regardless of timing and laterality. This case also provides unique insights into the ongoing debate regarding the role of the aberrant immune response in the pathogenesis of delayed cerebral radiation necrosis.

  18. Diabetes guidelines may delay timely adjustments during treatment and might contribute to clinical inertia.

    Science.gov (United States)

    Pimazoni-Netto, Augusto; Zanella, Maria Teresa

    2014-11-01

    Clinical inertia and poor knowledge by many physicians play an important role in delaying diabetes control. Among other guidelines, the Position Statement of the American Diabetes Association/European Association for the Study of Diabetes on Management of Hyperglycemia in Type 2 Diabetes is a respected guideline with high impact on this subject in terms of influencing physicians in the definition of strategic approach to overcome poor glycemic control. But, on the other hand, it carries a recommendation that might contribute to clinical inertia because it can delay the needed implementation of more vigorous, intensive, and effective strategies to overcome poor glycemic control within a reasonable time frame during the evolution of the disease. The same is true with other respected algorithms from different diabetes associations. Together with pharmacological interventions, diabetes education and more intensive blood glucose monitoring in the initial phases after the diagnosis are key strategies for the effective control of diabetes. The main reason why a faster glycemic control should be implemented in an effective and safe way is to boost the confidence and the compliance of the patient to the recommendations of the diabetes care team. Better and faster results in glycemic control can only be safely achieved with educational strategies, structured self-monitoring of blood glucose, and adequate pharmacological therapy in the majority of cases.

  19. Delayed Stimulus-Specific Improvements in Discourse Following Anomia Treatment Using an Intentional Gesture

    Science.gov (United States)

    Altmann, Lori J. P.; Hazamy, Audrey A.; Carvajal, Pamela J.; Benjamin, Michelle; Rosenbek, John C.; Crosson, Bruce

    2014-01-01

    Purpose: In this study, the authors assessed how the addition of intentional left-hand gestures to an intensive treatment for anomia affects 2 types of discourse: picture description and responses to open-ended questions. Method: Fourteen people with aphasia completed treatment for anomia comprising 30 treatment sessions over 3 weeks. Seven…

  20. Cerebellar Norepinephrine Modulates Learning of Delay Classical Eyeblink Conditioning: Evidence for Post-Synaptic Signaling via PKA

    Science.gov (United States)

    Fister, Mathew; Bickford, Paula C.; Cartford, M. Claire; Samec, Amy

    2004-01-01

    The neurotransmitter norepinephrine (NE) has been shown to modulate cerebellar-dependent learning and memory. Lesions of the nucleus locus coeruleus or systemic blockade of noradrenergic receptors has been shown to delay the acquisition of several cerebellar-dependent learning tasks. To date, no studies have shown a direct involvement of…

  1. Enhancement of delay eyelid conditioning by microcurrent electrical stimulation of the medial prefrontal cortex is triggered by the expression of Fos protein in guinea pigs.

    Science.gov (United States)

    Zheng, Ya-Juan; Dong, Yu-Chen; Zhu, Chao; Zhao, Mei-Sheng

    2016-03-01

    Eyelid conditioning, including delay eyelid conditioning and trace eyelid conditioning, has been used extensively to study neural structures and mechanisms of learning and memory as a form of associative learning. In the present study, microcurrent electrical stimulation was used to stimulate the medial prefrontal cortex (mPFC) to induce delay eyelid conditioning in guinea pigs. The acquisition rate and relative latency of the conditioned eyelid response (CR) and the startle eyelid response (SR) were analyzed. The mPFC sites in the guinea pigs were examined under a light microscope following Nissl staining. In addition, the expression of Fos protein in neurons was detected using immunohistochemistry and western blot analysis. The results indicated that the acquisition rates of CR and SR were increased significantly (Pmicrocurrent electrical stimulation of the mPFC in guinea pigs was triggered by the expression of Fos protein. The observations of the present study further expand the understanding of conditioned reflexes and may aid future investigations into the formation of eyelid conditioning and the mechanisms underlying the circuit in various conditions.

  2. Effects of OEF/OIF-Related Physical and Emotional Co-Morbidities on Associative Learning: Concurrent Delay and Trace Eyeblink Classical Conditioning

    Directory of Open Access Journals (Sweden)

    Regina E. McGlinchey

    2014-03-01

    Full Text Available This study examined the performance of veterans and active duty personnel who served in Operation Enduring Freedom and/or Operation Iraqi Freedom (OEF/OIF on a basic associative learning task. Eighty-eight individuals participated in this study. All received a comprehensive clinical evaluation to determine the presence and severity of posttraumatic stress disorder (PTSD and traumatic brain injury (TBI. The eyeblink conditioning task was composed of randomly intermixed delay and trace conditioned stimulus (CS and unconditioned stimulus (US pairs (acquisition followed by a series of CS only trials (extinction. Results revealed that those with a clinical diagnosis of PTSD or a diagnosis of PTSD with comorbid mTBI acquired delay and trace conditioned responses (CRs to levels and at rates similar to a deployed control group, thus suggesting intact basic associative learning. Differential extinction impairment was observed in the two clinical groups. Acquisition of CRs for both delay and trace conditioning, as well as extinction of trace CRs, was associated with alcoholic behavior across all participants. These findings help characterize the learning and memory function of individuals with PTSD and mTBI from OEF/OIF and raise the alarming possibility that the use of alcohol in this group may lead to more significant cognitive dysfunction.

  3. A "Shark Encounter": Delayed Primary Closure and Prophylactic Antibiotic Treatment of a Great White Shark Bite.

    Science.gov (United States)

    Popa, Daniel; Van Hoesen, Karen

    2016-11-01

    Shark bites are rare but sensational injuries that are covered in the lay press but are not well described in the medical literature. We present the case of a 50-year-old man who sustained two deep puncture wounds to his thigh from a great white shark in the waters surrounding Isla de Guadalupe off the coast of Baja California, Mexico, during a caged SCUBA dive. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We discuss our strategy of closing the wounds in a delayed primary fashion 24 hours after injury, our antibiotic choices, and the patient's course and review marine pathogens and appropriate antibiotic coverage. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Distribution of intraarterially administered papaverine in endovascular treatment of delayed cerebral vasospasm

    Energy Technology Data Exchange (ETDEWEB)

    Touho, Hajime; Fukuoka, Norihiko; Karasawa, Jun [Osaka Neurological Inst., Toyonaka (Japan)

    1997-02-01

    The distribution of selectively administered papaverine was determined in nine patients with delayed cerebral vasospasm in the territories of the anterior (ACA) and/or middle cerebral arteries (MCA) secondary to aneurysmal subarachnoid hemorrhage by simultaneous infusion with technetium-99m-hexamethyl-propyleneamine oxime ({sup 99m}Tc-HMPAO). Four of the nine patients had a ruptured anterior communicating artery aneurysm, four had an internal carotid artery aneurysm, and the remaining one had a MCA aneurysm. Trapping of anterior communicating artery was carried out in one case and clipping of aneurysms in other eight cases. Neurological deterioration with hemiparesis, paraparesis, and/or somnolence appeared between postsurgical days 8 and 13 due to delayed cerebral vasospasm in all patients. Intraarterial infusion of 40 mg of papaverine containing 37 MBq of {sup 99m}Tc-HMPAO was performed from the C{sub 1} segment in seven of the nine patients and from the C{sub 4} segment in the other two patients. {sup 99m}Tc-HMPAO was distributed in the territories of the ACA and MCA in the two patients who were treated with intraarterial infusion of papaverine from the C{sub 4} segment, but was distributed only to the territory of the ACA in four patients who were treated with intraarterial infusion of papaverine from the C{sub 1} segment at 1 ml/min. In contrast, {sup 99m}Tc-HMPAO was distributed in the territories of the ACA and MCA in the three patients who were treated with papaverine from the C{sub 1} segment at 2 ml/min, although most {sup 99m}Tc-HMPAO was distributed in the territory of the ACA. Vasospasm of the ACA can be treated by intraarterial infusion of papaverine from the C{sub 1} segment at 1 ml/min when selective catheterization to the ACA is difficult to perform. (author)

  5. Hybrid protocols plus natural treatments for inflammatory conditions.

    Science.gov (United States)

    1998-01-01

    Hybrid protocols combine one, two, or three pharmaceutical drugs with several nutritional or immune-based therapies. These protocols are not limited solely to FDA-approved drugs or strictly to alternative therapies. The rationale for using a hybrid protocol is to find an effective antiviral regimen that also restores immune function. The goal is to obtain the benefits of protease inhibitors without viral resistance and side effects which include problems with fat metabolism and cholesterol levels. Natural treatments for inflammatory conditions are also described. Options include licorice root, ginger root, and slippery elm.

  6. Treatment and final conditioning of solid radioactive wastes

    International Nuclear Information System (INIS)

    Cerre, J.

    1960-01-01

    The storage of solid radioactive wastes on a site is so cumbersome and dangerous that we have developed a method of treatment and conditioning by means of which the volume of waste is considerably reduced and very long-lasting shielding can be provided. This paper describes the techniques adopted at Saclay, where the wastes are sheared, compressed and enveloped in concrete of variable thickness. The main part of the report is devoted to a description of the corresponding remote handling installation. (author) [fr

  7. Binge-Eating Disorder and Comorbid Conditions: Differential Diagnosis and Implications for Treatment.

    Science.gov (United States)

    Citrome, Leslie

    2017-01-01

    Many patients with symptoms of binge-eating disorder (BED) are not diagnosed. Perhaps the biggest obstacles are the failure of physicians to recognize BED as a distinct disorder and the lack of awareness among patients that binge-eating is a well-studied abnormal behavior that is amenable to treatment. In addition, patients may avoid seeking treatment because they feel a general sense of shame over their eating habits and do not want to bring up these symptoms during visits with their physicians. In general, negative attitudes and biases regarding overweight and obesity are common. The presence of medical and psychiatric comorbidities also contributes to the challenge of diagnosis, as many doctors focus on treating those comorbidities, thereby delaying treatment for the BED and leading to suboptimal care. Once BED is diagnosed along with any comorbid conditions, medications for the treatment of the comorbidities must be carefully considered so that BED symptoms are not exacerbated. © Copyright 2017 Physicians Postgraduate Press, Inc.

  8. An Intervention That Delays Institutionalization of Alzheimer's Disease Patients: Treatment of Spouse-Caregivers.

    Science.gov (United States)

    Mittelman, Mary S.; And Others

    1993-01-01

    Randomly assigned spouse-caregivers of Alzheimer's disease patients to treatment group (individual and family counseling, support group participation, and ad hoc consultation) or control group (only routine support). Treatment group had less than half as many nursing home placements as control group. Placement also was affected by patient's need…

  9. The budget impact of introducing delayed-release dimethyl fumarate for treatment of relapse-remitting multiple sclerosis in Canada.

    Science.gov (United States)

    Dorman, Emily; Kansal, Anuraag R; Sarda, Sujata

    2015-01-01

    Multiple sclerosis (MS) causes significant disability globally and is especially prevalent in Canada. Delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) is an orally administered disease-modifying treatment (DMT) for patients with relapsing-remitting MS (RRMS) that is currently on the market in the US, Australia, Canada, and Europe. A budget impact model (BIM) was developed to assess the financial consequences of introducing DMF for treatment of RRMS in Canada. A BIM calculated the financial consequences of introducing DMF in Canada over 3 years based on RRMS prevalence, treatment market share, and clinical effects. RRMS prevalence in Canada was derived from published literature and natural relapse rates, and disease state distribution from clinical trial data. It was conservatively assumed that 100% of RRMS patients were treated with a DMT. DMF was assumed to absorb market share proportionally from the following current treatments: interferon beta-1a-IM, interferon beta-1a-SC, interferon beta-1b, and glatiramer acetate. Treatment efficacy, in terms of relapse rate reductions and treatment discontinuation rates, was determined from mixed treatment comparison. Treatment costs (including costs of acquisition, monitoring, and administration) and cost of relapse were considered. Deterministic one-way sensitivity analyses were conducted to assess the most sensitive input parameters. Over 3 years, the introduction of DMF resulted in an average annual increase of CAD417 per treated patient per year, with reductions in costs associated with relapses (CAD192/patient/year) partially offsetting increased drug acquisition costs (CAD602/patient/year). On a population level, the average annual cost increase was CAD24,654,237, a CAD 0.68 increase per population covered by the Canadian healthcare system. The main drivers of budget impact were drop-out rates, proportion of RRMS patients treated, and market share assumptions. The acquisition costs of DMF for

  10. Adverse events in diabetic foot infections: a case control study comparing early versus delayed medical treatment after home remedies

    Directory of Open Access Journals (Sweden)

    Cawich SO

    2014-11-01

    outcomes when patients delay conventional medical therapy in favour of home remedies to treat diabetic foot infections. These treatments need not be mutually exclusive. We encourage persons with diabetes who wish to try home remedies to seek medical advice in addition as a part of holistic care. Keywords: diabetic foot infections, adverse events, medical treatment, home remedies

  11. Continuous quality improvement process pin-points delays, speeds STEMI patients to life-saving treatment.

    Science.gov (United States)

    2011-11-01

    Using a multidisciplinary team approach, the University of California, San Diego, Health System has been able to significantly reduce average door-to-balloon angioplasty times for patients with the most severe form of heart attacks, beating national recommendations by more than a third. The multidisciplinary team meets monthly to review all cases involving patients with ST-segment-elevation myocardial infarctions (STEMI) to see where process improvements can be made. Using this continuous quality improvement (CQI) process, the health system has reduced average door-to-balloon times from 120 minutes to less than 60 minutes, and administrators are now aiming for further progress. Among the improvements instituted by the multidisciplinary team are the implementation of a "greeter" with enough clinical expertise to quickly pick up on potential STEMI heart attacks as soon as patients walk into the ED, and the purchase of an electrocardiogram (EKG) machine so that evaluations can be done in the triage area. ED staff have prepared "STEMI" packets, including items such as special IV tubing and disposable leads, so that patients headed for the catheterization laboratory are prepared to undergo the procedure soon after arrival. All the clocks and devices used in the ED are synchronized so that analysts can later review how long it took to complete each step of the care process. Points of delay can then be targeted for improvement.

  12. Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Toft, Nina; Birgens, Henrik; Abrahamsson, Jonas

    2016-01-01

    OBJECTIVES: Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine...... the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. METHODS: We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1......-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. RESULTS: No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high...

  13. Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment.

    Science.gov (United States)

    Sinha, Sanjeev; Shekhar, Rahul C; Singh, Gurjeet; Shah, Nipam; Ahmad, Hafiz; Kumar, Narendra; Sharma, Surendra K; Samantaray, J C; Ranjan, Sanjai; Ekka, Meera; Sreenivas, Vishnu; Mitsuyasu, Ronald T

    2012-07-31

    For antiretroviral therapy (ART) naive human immunodeficiency virus (HIV) infected adults suffering from tuberculosis (TB), there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART) after starting antituberculosis treatment (ATT), in order to minimize mortality, HIV disease progression, and adverse events. In a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS) for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART. A total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART) and 62 after 8-12 weeks (delayed ART) of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045). Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05). Rates of adverse events were similar. Early initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability. CTRI/2011/12/002260.

  14. Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment

    Directory of Open Access Journals (Sweden)

    Sinha Sanjeev

    2012-07-01

    Full Text Available Abstract Background For antiretroviral therapy (ART naive human immunodeficiency virus (HIV infected adults suffering from tuberculosis (TB, there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART after starting antituberculosis treatment (ATT, in order to minimize mortality, HIV disease progression, and adverse events. Methods In a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART. Findings A total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART and 62 after 8-12 weeks (delayed ART of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045. Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05. Rates of adverse events were similar. Interpretation Early initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability. Trial registration CTRI/2011/12/002260

  15. Innovative waste treatment and conditioning technologies at nuclear power plants

    International Nuclear Information System (INIS)

    2006-05-01

    The objective of this publication is to provide Member States with information on the most innovative technologies and strategies used in waste treatment and conditioning. At present, some of those technologies and strategies might not be widely implemented at nuclear power plants (NPP), but they have an important potential for their use as part of the long range NPP, utility, or national strategy. Thus, the target audience is those decision makers at the national and organizational level responsible for selecting waste processing technologies and strategies over a period of three to ten years. Countries and individual nuclear plants have limited financial resources which can be applied toward radioactive waste processing (treatment and conditioning). They are challenged to determine which of the many available technologies and strategies are best suited to meet national or local needs. This publication reduces the selection of processes for wastes generated by nuclear power plants to those technologies and strategies which are considered innovative. The report further identifies the key benefits which may derive from the adoption of those technologies, the different waste streams to which each technology is relevant, and the limitations of the technologies. The technologies and strategies identified have been evaluated to differentiate between (1) predominant technologies (those that are widely practiced in multiple countries or a large number of nuclear plants), and (2) innovative technologies (those which are not so widely used but are considered to offer benefits which make them suitable for broader application across the industry). Those which fall into the second category are the primary focus of this report. Many IAEA publications address the technical aspects of treatment and conditioning for radioactive wastes, covering research, technological advances, and safety issues. These studies and reports primarily target the research and technical staff of a

  16. Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: histomorphometric analysis in rats.

    Science.gov (United States)

    Sottovia, André Dotto; Sonoda, Celso Koogi; Poi, Wilson Roberto; Panzarini, Sônia Regina; Lauris, José Roberto Pereira

    2006-04-01

    In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8), had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin- embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (p<0.05). All groups were affected by root resorption but the treatment performed in group III was the least effective for its control. The treatment accomplished in groups I and II yielded similar results to each other.

  17. Delay in treatment of biliary disease during pregnancy increases morbidity and can be avoided with safe laparoscopic cholecystectomy.

    Science.gov (United States)

    Muench, J; Albrink, M; Serafini, F; Rosemurgy, A; Carey, L; Murr, M M

    2001-06-01

    Recent reports indicate that laparoscopic cholecystectomy in pregnancy is safe. The aim of this study was to evaluate whether delays in definitive treatment of symptomatic cholelithiasis increase morbidity. We reviewed the records of 16 women who underwent laparoscopic cholecystectomy during pregnancy between 1992 and 1999. Mean age was 24 +/- 5 years (mean +/- standard error). Symptom onset was during the first trimester in nine patients, second trimester in six patients, and third trimester in one patient. Patients had abdominal pain (93%), nausea (93%), emesis (80%), and fever (66%) for a median of 45 days (range 1-195 days) before cholecystectomy. Nine of 11 women who underwent cholecystectomy more than 5 weeks after onset of symptoms experienced recurrent attacks necessitating 15 hospital admissions and four emergency room visits. Moreover four women who developed symptoms in the first and second trimesters but whose operations were delayed to the third trimester had 11 hospital admissions and four emergency room visits; three of those four (75%) women developed premature contractions necessitating tocolytics. Cholecystectomy was completed laparoscopically in 14 women. There was no hospital infant or maternal mortality or morbidity. We recommend prompt laparoscopic cholecystectomy in pregnant women with symptomatic biliary disease because it is safe and it reduces hospital admissions and frequency of premature labor.

  18. Effects of operating conditions on compositional characteristics and reaction kinetics of liquid derived by delayed coking of nigerian petroleum residue

    Directory of Open Access Journals (Sweden)

    O. O. Bello

    2006-09-01

    Full Text Available The thermal upgrading of Nigerian petroleum residue was studied at relatively low pressure in a delayed coking reactor system. In this work, the intent was to investigate the effects of process variables such as reaction temperature (200(0C to 600(0C, reaction time (0 to 120min, additive concentration loading and additive-to-residue ratio on the amounts and quality of organic liquid product (OLP. The liquid products derived from the delayed coking process were characterized by means of instrumental analysis of gas-liquid chromatography. Results obtained from the analyses of the OLP revealed an upward trend of the conversion process and the selectivity of the aromatic compounds with additive-to-residue ratio (ARR and increase in temperature. This led to maximum yield of 37.2% achieved with ARR of 5 compared to 31% achieved with ordinary thermal conversion. The selectivity for aromatic hydrocarbons was maximum at 83.1wt% the selectivity towards aromatics and aliphatic hydrocarbons were highest for methanol-potassium hydroxide and methanol respectively. In all additive system cases, maximum OLP was produced at an optimum reaction temperature of 370(0C in the delayed coking reactor and at higher residence time. The gaseous product consisted of carbon monoxide and carbon dioxide and C1 - C6 hydrocarbons, which amounted to about 20 to 30 wt% of liquid distillate. The information obtained in this study show that the organic liquid products are amenable to characterization procedure and provided the basis for the identification of processes for upgrading Nigerian petroleum residue and such other starting materials such as bitumen or fossil fuel coal liquids.

  19. Influence of Reaction Conditions on Lignin Hydrothermal Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Erdocia, Xabier; Prado, Raquel; Corcuera, M. Ángeles; Labidi, Jalel, E-mail: jalel.labidi@ehu.es [Chemical and Environmental Engineering Department, University of the Basque Country, San Seabastian (Spain)

    2014-04-01

    Organosolv lignin, obtained from olive tree pruning under optimized conditions, was subjected to a hydrothermal depolymerization process catalyzed by sodium hydroxide. The depolymerization of lignin was carried out at 300°C using different reaction times (20, 40, 60, 70, 80, 90, and 100 min) in order to study the influence of this parameter on lignin depolymerization. The resulting products (oil and residual lignin) were measured and analyzed by different techniques (GC/MS, high-performance size-exclusion chromatography, and pyrolysis–GC/MS) in order to determine their nature and composition. Coke was also formed, at a lower quantity, uncompetitive repolymerization reactions during the lignin hydrothermal treatment. The maximum oil yield and concentration of monomeric phenolic compounds was obtained after 80 min of reaction time. The highest reaction time studied (100 min) had the worst results with the lowest oil yield and highest coke production.

  20. Combination of butylphthalide with umbilical mesenchymal stem cells for the treatment of delayed encephalopathy after carbon monoxide poisoning.

    Science.gov (United States)

    Wang, Huanjun; Li, Yan; Wu, Qiang; Xu, Chenglong; Liu, Qingran

    2016-12-01

    Delayed encephalopathy after carbon monoxide (CO) poisoning (DEACMP) is still a clinical challenge. This study aimed to investigate the efficacy of combined therapy of mesenchymal stem cell (MSC) transplantation and butylphthalide in DEACMP patients.Forty-two DEACMP patients were treated with 1 of the 3 therapies: combined therapy of MSC transplantation and butylphthalide; MSC transplantation alone; or hyperbaric oxygen therapy. The MSCs were alternatively injected into the subarachnoid space and the carotid artery using a self-made high-pressure injector. The Mini-Mental State Examination and the Barthel index of activities of daily living were administered before the treatment, and at 1 month, 3 months, and 6 months after the treatment. Computed tomography and magnetic resonance imaging results before and after the treatment were compared.At 1 month, 3 months, and 6 months after the treatment, the Mini-Mental State Examination scores and the Barthl scores were significantly higher in patients with the combined therapy of MSC transplantation and butylphthalide than those in patients with MSC transplantation alone or hyperbaric oxygen therapy (all P < 0.0001). No significant adverse events occurred.The combination of MSC transplantation and butylphthalide is safe and effective in treating DEACMP.

  1. Medial Canthoplasty Combined with Conjunctivodacryocystorhinostomy for the Treatment of Delayed Medial Telecanthal Deformity

    Directory of Open Access Journals (Sweden)

    Hua Sun

    2017-01-01

    Conclusions: Medial canthoplasty combined with CDCR is an effective surgical method for treatment of patients with medial telecanthal deformity and lacrimal drainage system obstruction. The study indicates that medial canthoplasty combined with CDCR surgery rebuilds normal appearance of eyelid and contour of the medial canthus and successfully repairs the function of the lacrimal drainage system.

  2. ‘Lost to follow up’ : Rethinking delayed and interrupted HIV treatment among married Swazi women

    NARCIS (Netherlands)

    Dlamini-Simelane, T.T.T.; Moyer, E.

    2017-01-01

    Through various campaigns and strategies, more women are being tested for HIV in countries with a high prevalence of the virus. Despite the ready availability of treatment at government clinics in sub-Saharan African countries like Swaziland, women consistently report difficulty in maintaining

  3. Soil aquifer treatment of artificial wastewater under saturated conditions

    KAUST Repository

    Essandoh, H. M K

    2011-05-01

    A 2000 mm long saturated laboratory soil column was used to simulate soil aquifer treatment under saturated conditions to assess the removal of chemical and biochemical oxygen demand (COD and BOD), dissolved organic carbon (DOC), nitrogen and phosphate, using high strength artificial wastewater. The removal rates were determined under a combination of constant hydraulic loading rates (HLR) and variable COD concentrations as well as variable HLR under a constant COD. Within the range of COD concentrations considered (42 mg L-1-135 mg L-1) it was found that at fixed hydraulic loading rate, a decrease in the influent concentrations of dissolved organic carbon (DOC), biochemical oxygen demand (BOD), total nitrogen and phosphate improved their removal efficiencies. At the high COD concentrations applied residence times influenced the redox conditions in the soil column. Long residence times were detrimental to the removal process for COD, BOD and DOC as anoxic processes and sulphate reduction played an important role as electron acceptors. It was found that total COD mass loading within the range of 911 mg d-1-1780 mg d-1 applied as low COD wastewater infiltrated coupled with short residence times would provide better effluent quality than the same mass applied as a COD with higher concentration at long residence times. The opposite was true for organic nitrogen where relatively high concentrations coupled with long residence time gave better removal efficiency. © 2011.

  4. Geodesic curve-of-sight formulae for the cosmic microwave background: a unified treatment of redshift, time delay, and lensing

    International Nuclear Information System (INIS)

    Saito, Ryo; Naruko, Atsushi; Hiramatsu, Takashi; Sasaki, Misao

    2014-01-01

    In this paper, we introduce a new approach to a treatment of the gravitational effects (redshift, time delay and lensing) on the observed cosmic microwave background (CMB) anisotropies based on the Boltzmann equation. From the Liouville's theorem in curved spacetime, the intensity of photons is conserved along a photon geodesic when non-gravitational scatterings are absent. Motivated by this fact, we derive a second-order line-of-sight formula by integrating the Boltzmann equation along a perturbed geodesic (curve) instead of a background geodesic (line). In this approach, the separation of the gravitational and intrinsic effects are manifest. This approach can be considered as a generalization of the remapping approach of CMB lensing, where all the gravitational effects can be treated on the same footing

  5. Chitosan Coating: A Postharvest Treatment to Delay Oxidative Stress in Loquat Fruits during Cold Storage

    Directory of Open Access Journals (Sweden)

    Giuseppina Adiletta

    2018-04-01

    Full Text Available Loquat is a non-climacteric fruit consumed fresh for its essential nutrients and phytochemical compounds. In this study, the effects of chitosan coating (1% w/v on changes in the enzymatic antioxidant and membrane damage in three loquat selections (CREAFRC-S18; CREAFRC-S35 and CREAFRC-S36 and three loquat cultivars (Golden Nugget, Algerie and Nespolone rosso di Trabia stored at 7 °C over 21 days were evaluated. Chitosan treatment enhanced the activities of superoxide dismutase, catalase and ascorbate peroxidase. Moreover, this treatment inhibited polyphenol oxidase and guaiacol peroxidase activities, extending the storage life of loquat. Chitosan also preserved membrane integrity by inhibiting lipoxygenase activity and malondialdehyde accumulation. Principal component analysis provided a global view of the responses of both loquat selections and cultivars to the postharvest chitosan coating and storage temperature. These findings suggest that chitosan treatment could be a valid tool for improving the activity of antioxidant enzymes, preserving the enzymatic browning of loquat fruits.

  6. Termination of short term melatonin treatment in children with delayed Dim Light Melatonin Onset: effects on sleep, health, behavior problems, and parenting stress

    NARCIS (Netherlands)

    van Maanen, Annette; Meijer, Anne Marie; Smits, Marcel G.; Oort, Frans J.

    2011-01-01

    To investigate the effects of termination of short term melatonin treatment on sleep, health, behavior, and parenting stress in children with delayed Dim Light Melatonin Onset. Forty-one children (24 boys, 17 girls; mean age=9.43 years) entered melatonin treatment for 3 weeks and then discontinued

  7. Delayed pan-hypopituitarism as a complication following endovascular treatment of bilateral internal carotid artery aneurysms. A case report and review.

    Science.gov (United States)

    Hall, Jonathan; Caputo, Carmela; Chung, Carlos; Holt, Michael; Wang, Yi Yuen

    2015-04-01

    Pan-hypopituitarism has been reported in patients who are subsequently found to have a cerebral aneurysm and there have been reports of pituitary dysfunction immediately following both surgical and endovascular treatment. The authors report a rare case of delayed pan-hypopituitarism following endovascular treatment of bilateral internal carotid artery aneurysms with coil embolisation and flow-diverting stents.

  8. The 808 nm Laser-Assisted Surgery as an Adjunct to Orthodontic Treatment of Delayed Tooth Eruption.

    Science.gov (United States)

    Seifi, Massoud; Vahid-Dastjerdi, Elahe; Ameli, Nazila; Badiee, Mohammad-Reza; Younessian, Farnaz; Amdjadi, Parisa

    2013-01-01

    Failure of teeth to erupt from gingival tissues at usual developmental time is called delayed tooth eruption (DTE). Delayed tooth eruption lead to prolonged fixed orthodontic treatment and its eventual complications. The purpose of the present study was to evaluate the effect of laser-assisted (808 nm) surgical uncovering, on the tooth emergence and orthodontic treatment of DTE. A total of 16 orthodontic patients were included in this study and were equally assigned to an experimental and a control group. Subjects for experiment consisted of eight patients (6 girls and 2 boys) with a mean age of 14±0.9 years. All patients exhibited delayed second premolar eruption. The laser wavelength was 810 nm and it was set in a continuous wave mode at a power output of 1.6 watt with a 0.3-mm diameter fiber tip. When the target tissue was sufficiently anesthetized, the tip was directed at an angle of 10 to 20 degrees to the tissue (light contact mode); and was applied continuously for approximately 12 Seconds until an acceptable tooth exposure area was visible. The facial axis of the clinical crown (FACC) line represents the most prominent portion of the facial central lobe for premolars. All orthodontic brackets are aligned along this reference and are located on FA (Facial Axis) point. The standard for adequate tooth eruption was the accessibility of facial axis of the clinical crown (FACC) for bonding the brackets. Data gathered from the patients were statistically surveyed and compared by means of Tukey's Test and Analysis of Variance (ANOVA). All patients showed good gingival status, no significant bleeding during or immediately after the surgery, and acceptable level of healing after laser surgery. The biologic width of the teeth was preserved and no violation of this important periodontal parameter was observed. The average time for accessing the FA point in experimental group was 11±1.1 weeks and the mentioned period was increased to 25±1.8 weeks in control group

  9. Deep cerebellar nuclei play an important role in two-tone discrimination on delay eyeblink conditioning in C57BL/6 mice.

    Directory of Open Access Journals (Sweden)

    Toshiro Sakamoto

    Full Text Available Previous studies have shown that deep cerebellar nuclei (DCN-lesioned mice develop conditioned responses (CR on delay eyeblink conditioning when a salient tone conditioned stimulus (CS is used, which suggests that the cerebellum potentially plays a role in more complicated cognitive functions. In the present study, we examined the role of DCN in tone frequency discrimination in the delay eyeblink-conditioning paradigm. In the first experiment, DCN-lesioned and sham-operated mice were subjected to standard simple eyeblink conditioning under low-frequency tone CS (LCS: 1 kHz, 80 dB or high-frequency tone CS (HCS: 10 kHz, 70 dB conditions. DCN-lesioned mice developed CR in both CS conditions as well as sham-operated mice. In the second experiment, DCN-lesioned and sham-operated mice were subjected to two-tone discrimination tasks, with LCS+ (or HCS+ paired with unconditioned stimulus (US, and HCS- (or LCS- without US. CR% in sham-operated mice increased in LCS+ (or HCS+ trials, regardless of tone frequency of CS, but not in HCS- (or LCS- trials. The results indicate that sham-operated mice can discriminate between LCS+ and HCS- (or HCS+ and LCS-. In contrast, DCN-lesioned mice showed high CR% in not only LCS+ (or HCS+ trials but also HCS- (or LCS- trials. The results indicate that DCN lesions impair the discrimination between tone frequency in eyeblink conditioning. Our results suggest that the cerebellum plays a pivotal role in the discrimination of tone frequency.

  10. Percutaneous treatment of delayed post-atherectomy superficial femoral artery pseudoaneurysm.

    Science.gov (United States)

    Akkus, Nuri Ilker; Fay, Matt; Varma, Jai

    2012-10-01

    SilverHawk atherectomy is commonly used in lower extremity percutaneous interventions. Minor perforations during SilverHawk atherectomy procedures are reported at a range of 0.8%. There are few reported cases in the literature about very late pseuodoaneursym formation after SilverHawk atherectomy. Herein we report a very unusual, late, concealed, acute rupture of superficial femoral artery with a large, painful pseuodoaneursym formation, 1 week after Silver- Hawk atherectomy and its treatment with Viabahn stent graft (W.L. Gore & Associates).

  11. Conservative treatment of an ankylosed tooth after delayed replantation: a case report.

    Science.gov (United States)

    Díaz, Jaime Andrés; Sandoval, Hector Paulo; Pineda, Patricia Irene; Junod, Pablo Antonio

    2007-10-01

    An 8-year-old boy sustained avulsion of his upper right maxillary central incisor and lateral luxation of his upper left maxillary incisors. Subsequently, the upper right maxillary central incisor developed replacement resorption, and both upper left maxillary incisors developed pulpal canal obliteration. In the ankylosed tooth, decoronation procedure was performed, and in the 44-month follow-up period the involved alveolar site showed vertical apposition of bone and continuing replacement resorption. Decoronation is a surgical procedure that allows preservation of the bone volume for the future, avoiding aesthetic disturbances and more aggressive treatments in cases where other therapeutic alternatives are not feasible.

  12. Prefrontocortical dopamine loss in rats delays long-term extinction of contextual conditioned fear, and reduces social interaction without affecting short-term social interaction memory.

    Science.gov (United States)

    Fernandez Espejo, Emilio

    2003-03-01

    Prefrontal dopamine loss delays extinction of cued fear conditioning responses, but its role in contextual fear conditioning has not been explored. Medial prefrontal lesions also enhance social interaction in rats, but the role of prefrontal dopamine loss on social interaction memory is not known. Besides, a role for subcortical accumbal dopamine on mnesic changes after prefrontal dopamine manipulation has been proposed but not explored. The objective was to study the involvement of dopaminergic neurotransmission in the medial prefrontal cortex (mPFC) and nucleus accumbens in two mnesic tasks: contextual fear conditioning and social interaction memory. For contextual fear conditioning, short- and long-term freezing responses after an electric shock were studied, as well as extinction retention. Regarding social interaction memory, the recognition of a juvenile, a very sensitive short-term memory test, was used. Dopamine loss was carried out by injection of 6-hydroxydopamine, and postmortem catecholamine levels were analyzed by high-performance liquid chromatography. Prefrontocortical dopamine loss (>76%) led to a reactive enhancement of accumbal dopamine content (ploss. In lesioned rats, long-term extinction of contextual fear conditioning was significantly delayed and extinction retention was impaired without changes in acquisition and short-term contextual fear conditioning and, on the other hand, acquisition and short-term social interaction memory were not affected, although time spent on social interaction was significantly reduced. Added dopamine loss in the nucleus accumbens (>76%) did not alter these behavioral changes. In summary, the results of the present study indicate that the dopaminergic network in the mPFC (but not in the nucleus accumbens) coordinates the normal long-term extinction of contextual fear conditioning responses without affecting their acquisition, and it is involved in time spent on social interaction, but not acquisition and short

  13. Delayed Diagnosis of Vesicouterine Fistula After Treatment for Mixed Urinary Incontinence: Menstrual Cup Management and Diagnosis.

    Science.gov (United States)

    Goldberg, Leah; Elsamra, Sammy; Hutchinson-Colas, Juana; Segal, Saya

    2016-01-01

    A vesicouterine fistula is a rare form of urogenital fistula, yet there is increasing prevalence in the United States because of the rising rate of cesarean deliveries. Vesicouterine fistulas have various presentations including menouria, hematuria, or urinary incontinence. A 39-year-old multiparous woman presented with urine leakage after her third cesarean delivery. She had been treated for mixed urinary incontinence with overactive bladder medications and a midurethral sling with continued complaints of urine leakage. The patient noticed her symptoms of urine leakage improved during menses when she used a menstrual cup. After confirmation of vesicouterine fistula, the patient underwent robotic-assisted surgery and her symptoms of insensible urine leakage resolved. When evaluating women with urinary incontinence and a history of cesarean deliveries, use of menstrual cup may aid in the diagnosis of vesicouterine fistula. Robotic-assisted laparoscopic repair with tissue interposition flap is an efficacious minimally invasive method for treatment of vesicouterine fistula.

  14. Delayed surgical treatment for neglected or mal-reduced talar fractures.

    Science.gov (United States)

    Huang, Peng-Ju; Cheng, Yuh-Min

    2005-10-01

    From 1993 to 2002, we treated nine patients for neglected or mal-reduced talar fractures. Average patient age was 39 (20-64) years and average follow-up 53 months. The time interval between injury and index operation ranged from 4 weeks to 4 years. Surgical procedures included open reduction with or without bone grafting in six cases, open reduction combined with ankle fusion in one case, talar neck osteotomy in one case, and talar neck osteotomy combined with subtalar fusion in one case. All cases had solid bone union. One patient developed avascular necrosis of the talus needing subsequent ankle arthrodesis. In six patients, adjacent hindfoot arthrosis occurred. The overall AOFAS ankle-hindfoot score was in average 77.4. We conclude that in neglected and mal-reduced talar fractures, surgical treatment can lead to a favourable outcome if the hindfoot joints are not arthritic.

  15. Diabetic foot infections: Current treatment and delaying the 'post-antibiotic era'.

    Science.gov (United States)

    Lipsky, Benjamin A

    2016-01-01

    Treatment for diabetic foot infections requires properly diagnosing infection, obtaining an appropriate specimen for culture, assessing for any needed surgical procedures and selecting an empiric antibiotic regimen. Therapy will often need to be modified based on results of culture and sensitivity testing. Because of excessive and inappropriate use of antibiotics for treating diabetic foot infections, resistance to the usually employed bacteria has been increasing to alarming levels. This article reviews recommendations from evidence-based guidelines, informed by results of systematic reviews, on treating diabetic foot infections. Data from the pre-antibiotic era reported rates of mortality of about 9% and of high-level leg amputations of about 70%. Outcomes have greatly improved with appropriate antibiotic therapy. While there are now many oral and parenteral antibiotic agents that have demonstrated efficacy in treating diabetic foot infections, the rate of infection with multidrug-resistant pathogens is growing. This problem requires a multi-focal approach, including providing education to both clinicians and patients, developing robust antimicrobial stewardship programmes and using new diagnostic and therapeutic technologies. Recently, new methods have been developed to find novel antibiotic agents and to resurrect old treatments, like bacteriophages, for treating these difficult infections. Medical and political leaders have recognized the serious global threat posed by the growing problem of antibiotic resistance. By a multipronged approach that includes exerting administrative pressure on clinicians to do the right thing, investing in new technologies and encouraging the profitable development of new antimicrobials, we may be able to stave off the coming 'post-antibiotic era'. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Analysis of contamination conditions of the Joyo Waste Treatment Facility

    International Nuclear Information System (INIS)

    Yoshizawa, S.; Ishijima, N.; Tanimoto, K.

    1999-08-01

    Decontamination methods have been studied for decommissioning of Joyo Waste Treatment Facility whose operation has been stopped in 1994. In this study, we analyzed samples of its system piping, whose dose rate was relatively low, to determine conditions of contamination. We also study appropriate decontamination methods for them. Results are as follows. 1. The inner surfaces of piping were covered with a very thin clad that was less than 1 micrometer in thickness and had many vacancies, looked like particle detachment, which were about 20 micrometers in depth. Something like corrosion product was observed near the surface and it was 440 micrometers in depth. 2. Radioactive contamination was considered to settle on a lower part of the piping and to be buried in the clad. A kind of dominant contamination nuclide was 60 Co. 3. Hot nitric acid process will be suitable for system decontamination to reduce dose rate before dismantling. But its feasibility tests are indispensable using samples of main system components that have high dose rate. Rubber lining tanks requires another methods because of its difficulty of decontamination. 4. Analyses and decontamination tests using main system are required to decide through decontamination methods according to the clearance level. (author)

  17. Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer

    DEFF Research Database (Denmark)

    Iachina, Maria; Jakobsen, Erik; Fallesen, Anne Kudsk

    2017-01-01

    with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis......BACKGROUND: Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested...... and incomplete data on the dates of referral, diagnosis and treatment were excluded. RESULTS: A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68-0.96)) and in total time from referral to treatment (HR 0...

  18. Reducing treatment delay for early intervention: evaluation of a community based crisis helpline

    Directory of Open Access Journals (Sweden)

    Shrivastava Amresh K

    2012-07-01

    Full Text Available Abstract Background A limited number of studies have assessed the pathways to care of patients experiencing psychosis for the first time. Helpline/clinic programs may offer patients who are still functional but have potential for crisis an alternative that is free from judgment. Methods In this study we report on patient calling a round-the-clock crisis helpline for suicide prevention supported by psychiatric facilities in Mumbai, India. Chi-square and test of mean differences were used to compare outcomes between first-episode patients and those with a previous history. Results Within five years, the helpline received 15,169 calls. Of those callers, 2341 (15.4% experienced suicidal ideation. Two hundred and thirty four patients opting for counseling lasting 12 months agreed to a psychiatric assessment. Of those, 32 were fist time psychosis sufferers, whereas, 54 had previously been psychotic. Of all psychiatric assessments, the clinic received 94 patients with ‘first-episode psychosis’. We found that the duration of illness was significantly shorter (17 vs. 28 months and suicide attempts were fewer (16 vs. 21 in first-time psychosis sufferers compared to those with a treatment history. Conclusions We conclude that some first-episode patients of schizophrenia and other disorders do access services by using helplines. We also argue that helplines may be somewhat immune to stigma, allowing patients a safe alternative when finding help.

  19. Electrophysiologic changes following treatment with organophosphorus-induced delayed neuropathy-producing agents in the adult hen.

    Science.gov (United States)

    Robertson, D G; Schwab, B W; Sills, R D; Richardson, R J; Anderson, R J

    1987-03-15

    Although clinical, pathological, and biochemical effects of organophosphorus-induced delayed neuropathy (OPIDN) have been intensively investigated in the adult hen, detailed electrophysiological studies are lacking. Adult white leghorn hens were treated with a single oral dose of either 30 mg/kg tri-2-cresyl phosphate (TOCP), 750 mg/kg TOCP, 4 mg/kg di-n-butyl-2,2-dichlorovinyl phosphate (DBCV), or 30 mg/kg di-n-butyl-2,2-dichlorovinyl phosphinate (DBCV-P). The 750 mg/kg TOCP and DBCV, but not the 30 mg/kg TOCP and DBCV-P, treatments resulted in clinical signs of OPIDN and mild to marked damage of the tibial nerve 21 days after dose. Twenty-four hr lymphocyte neurotoxic esterase (NTE) inhibition was used as an index of brain NTE inhibition for the various organophosphorus compound (OP) treatment. Twenty-four hr lymphocyte NTE inhibition for 30 mg/kg TOCP, 750 mg/kg TOCP, DBCV, and DBCV-P was 54.1, 87.1, 84.8, and 68.3%, respectively. Twenty-one days after dose, the TOCP-treated hens exhibited some abnormalities in conduction velocity and action potential duration in the tibial or sciatic nerves. No abnormalities were observed in action potential parameters of either the DBCV or DBCV-P treatments. Neurotoxic OP (TOCP and DBCV) treatment resulted in decreased refractoriness in the tibial nerve, increased refractoriness in the sciatic nerve, and elevated strength duration threshold for both nerves. These changes were not present in nerves from DBCV-P (a non-neurotoxic NTE inhibitor)-treated hens. These results suggest that refractory period and strength duration abnormalities in peripheral nerve correlate well with the production of OPIDN and are evident without coincident clinical signs or histopathology.

  20. Delayed release pancrelipase for treatment of pancreatic exocrine insufficiency associated with chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Devi Mukkai Krishnamurty

    2009-07-01

    Full Text Available Devi Mukkai Krishnamurty,1 Atoosa Rabiee,2 Sanjay B Jagannath,1 Dana K Andersen2Johns Hopkins University School of Medicine; 1Department of Medicine; 2Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA; 2Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USAAbstract: Pancreatic enzyme supplements (PES are used in chronic pancreatitis (CP for correction of pancreatic exocrine insufficiency (PEI as well as pain and malnutrition. The use of porcine pancreatic enzymes for the correction of exocrine insufficiency is governed by the pathophysiology of the disease as well as pharmacologic properties of PES. Variability in bioequivalence of PES has been noted on in vitro and in vivo testing and has been attributed to the differences in enteric coating and the degree of micro-encapsulation. As a step towards standardizing pancreatic enzyme preparations, the Food and Drug Administration now requires the manufacturers of PES to obtain approval of marketed formulations by April 2010. In patients with treatment failure, apart from evaluating drug and dietary interactions and compliance, physicians should keep in mind that patients may benefit from switching to a different formulation. The choice of PES (enteric coated versus non-enteric coated and the need for acid suppression should be individualized. There is no current standard test for evaluating adequacy of therapy in CP patients and studies have shown that optimization of therapy based on symptoms may be inadequate. Goals of therapy based on overall patient presentation and specific laboratory tests rather than mere correction of steatorrhea are needed.Keywords: pancreatic exocrine insufficiency, chronic pancreatitis, pancreatic enzyme supplement

  1. Delayed release dexlansoprazole in the treatment of GERD and erosive esophagitis

    Directory of Open Access Journals (Sweden)

    Eric T Wittbrodt

    2009-11-01

    Full Text Available Eric T Wittbrodt1, Charles Baum2, David A Peura31Takeda Pharmaceuticals North America, Inc., 2Takeda Pharmaceuticals International, Inc., Deerfield, IL, USA; 3University of Virginia, School of Medicine, Charlottesville, VA, USAAbstract: Although proton pump inhibitors (PPI have a record of remarkable effectiveness and safety in the management of gastroesophageal reflux disease (GERD, several treatment challenges with PPI have emerged. Dexlansoprazole MR is the (R-enantiomer of lansoprazole contained in a formulation that produces two distinct releases of drug and significantly extends the duration of active plasma concentrations and % time pH > 4 beyond that of conventional singlerelease PPI. Dexlansoprazole MR can be administered without regard to meals or the timing of meals in most patients. Dexlansoprazole MR 60 mg demonstrated similar efficacy for healing of erosive esophagitis at 8 weeks compared with lansoprazole 30 mg, and dexlansoprazole MR 30 mg was superior to placebo for maintenance of healed erosive esophagitis at 6 months with 99% of nights and 96% of days heartburn-free over 6 months in patients taking dexlansoprazole MR 30 mg. Superior relief of heartburn occurred in patients taking dexlansoprazole MR 30 mg (55% heartburn-free 24-hour periods vs placebo (14% for symptomatic nonerosive GERD. The safety profile of dexlansoprazole MR is similar to that of lansoprazole. The extended pharmacodynamic effects, added convenience, and efficacy and safety of dexlansoprazole MR offer a novel approach to gastric pH control in patients with acid-related disorders.Keywords: dexlansoprazole MR, gastroesophageal reflux disease, GERD, erosive esophagitis, TAK-390MR

  2. Systemic treatment with CAR-engineered T cells against PSCA delays subcutaneous tumor growth and prolongs survival of mice

    International Nuclear Information System (INIS)

    Hillerdal, Victoria; Ramachandran, Mohanraj; Leja, Justyna; Essand, Magnus

    2014-01-01

    Adoptive transfer of T cells genetically engineered with a chimeric antigen receptor (CAR) has successfully been used to treat both chronic and acute lymphocytic leukemia as well as other hematological cancers. Experimental therapy with CAR-engineered T cells has also shown promising results on solid tumors. The prostate stem cell antigen (PSCA) is a protein expressed on the surface of prostate epithelial cells as well as in primary and metastatic prostate cancer cells and therefore a promising target for immunotherapy of prostate cancer. We developed a third-generation CAR against PSCA including the CD28, OX-40 and CD3 ζ signaling domains. T cells were transduced with a lentivirus encoding the PSCA-CAR and evaluated for cytokine production (paired Student’s t-test), proliferation (paired Student’s t-test), CD107a expression (paired Student’s t-test) and target cell killing in vitro and tumor growth and survival in vivo (Log-rank test comparing Kaplan-Meier survival curves). PSCA-CAR T cells exhibit specific interferon (IFN)-γ and interleukin (IL)-2 secretion and specific proliferation in response to PSCA-expressing target cells. Furthermore, the PSCA-CAR-engineered T cells efficiently kill PSCA-expressing tumor cells in vitro and systemic treatment with PSCA-CAR-engineered T cells significantly delays subcutaneous tumor growth and prolongs survival of mice. Our data confirms that PSCA-CAR T cells may be developed for treatment of prostate cancer

  3. Acetylcholinesterase inhibitor treatment alleviated cognitive impairment caused by delayed encephalopathy due to carbon monoxide poisoning: Two case reports and a review of the literature.

    Science.gov (United States)

    Yanagiha, Kumi; Ishii, Kazuhiro; Tamaoka, Akira

    2017-02-01

    Delayed encephalopathy due to carbon monoxide (CO) poisoning can even occur in patients with mild symptoms of acute CO poisoning. Some cases taking conventional hyperbaric oxygen (HBO) therapy or steroid-pulse therapy may be insufficient, and AchEI may be effective. We report two cases of delayed encephalopathy after acute CO poisoning involving two women aged 69 (Case 1) and 60 years (Case 2) whose cognitive function improved with acetylcholinesterase inhibitor (AchEI) treatment. Delayed encephalopathy occurred 25 and 35 days after acute CO poisoning in Case 1 and Case 2, respectively. Both patients demonstrated cognitive impairment, apathy, and hypokinesia on admission. Although hyperbaric oxygen therapy did not yield any significant improvements, cognitive dysfunction improved substantially. This was evidenced by an improved Mini-Mental State Examination score ffom 9 to 28 points in Case 1 and an improved Hasegawa's dementia rating scale score from 4 to 25 points in Case 2 after administration of an AchEI. In Case 1, we administered galantamine hydrobromide, which was related with improved white matter lesions initially detected on brain magnetic resonance imaging. However, in Case 2 white matter lesions persisted despite AchEI treatment. AchEI treatment may result in improved cognitive and frontal lobe function by increasing low acetylcholine concentrations in the hippocampus and frontal lobe caused by decreased nicotinic acetylcholine receptor levels in delayed encephalopathy after CO poisoning. Physicians should consider AchEIs for patients demonstrating delayed encephalopathy due to CO poisoning.

  4. Economic impact of antidepressant treatment duration in naturalistic conditions.

    Science.gov (United States)

    Tournier, M; Crott, R; Gaudron, Y; Verdoux, H

    2013-05-01

    To assess the economic impact of the duration of antidepressant drug treatment in a real-life setting. A historical fixed cohort study included 27 917 patients aged 18 and over with a new antidepressant treatment registered in the national insurance database. The economic impact concerned healthcare expenditure in the first 3 months after treatment discontinuation. Generalized linear models were used to compare two groups of treatment duration: adjustment for care costs before and during treatment episode, gender, age, chronic diseases, welfare and prescriber specialty, total healthcare costs (in log) [-0.06 (-0.14;0.01) P = 0.11] and psychiatric care costs (in square root) [-0.08 (-0.41;0.25) P = 0.6] were similar in both groups. Non-psychiatric care costs were significantly lower in the 'long treatment duration' group compared with the 'short treatment duration' group [-11.4 (-15.8; -7.0) P costs over the antidepressant treatment episode were larger in the 'long treatment duration' group compared with the 'short treatment duration' group. With regard to healthcare costs and global health, antidepressant drug treatments of short duration appear less effective than treatment of recommended duration. © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  5. Patient perspectives on delays in diagnosis and treatment of cancer: a qualitative analysis of free-text data.

    Science.gov (United States)

    Parsonage, Rachel K; Hiscock, Julia; Law, Rebecca-Jane; Neal, Richard D

    2017-01-01

    Earlier cancer diagnosis is crucial in improving cancer survival. The International Cancer Benchmarking Partnership Module 4 (ICBP4) is a quantitative survey study that explores the reasons for delays in diagnosis and treatment of breast, colorectal, lung, and ovarian cancer. To further understand the associated diagnostic processes, it is also important to explore the patient perspectives expressed in the free-text comments. To use the free-text data provided by patients completing the ICBP4 survey to augment the understanding of patients' perspectives of their diagnostic journey. Qualitative analysis of the free-text data collected in Wales between October 2013 and December 2014 as part of the ICBP4 survey. Newly-diagnosed patients with either breast, ovarian, colorectal, or lung cancer were identified from registry data and then invited by their GPs to participate in the survey. A thematic framework was used to analyse the free-text comments provided at the end of the ICBP4 survey. Of the 905 patients who returned a questionnaire, 530 included comments. The free-text data provided information about patients' perspectives of the diagnostic journey. Analysis identified factors that acted as either barriers or facilitators at different stages of the diagnostic process. Some factors, such as screening, doctor-patient familiarity, and private treatment, acted as both barriers and facilitators depending on the context. Factors identified in this study help to explain how existing models of cancer diagnosis (for example, the Pathways to Treatment Model) work in practice. It is important that clinicians are aware of how these factors may interact with individual clinical cases and either facilitate, or act as a barrier to, subsequent cancer diagnosis. Understanding and implementing this knowledge into clinical practice may result in quicker cancer diagnoses. © British Journal of General Practice 2017.

  6. Conditioned Side Effects Induced by Cancer Chemotherapy: Prevention Through Behavioral Treatment.

    Science.gov (United States)

    Burish, Thomas G.; And Others

    1987-01-01

    Studied cancer patients (N=24) in order to determine whether conditioned nausea and vomiting could be delayed or prevented. Indicated that patients receiving progressive muscle relaxation training and guided imagery had significantly less nausea and vomiting and significanty lower blood pressures, pulse rates, and dysphoria, especially anxiety,…

  7. Treatment with 24 h-delayed normo- and hyperbaric oxygenation in severe sepsis induced by cecal ligation and puncture in rats

    DEFF Research Database (Denmark)

    Bærnthsen, Nina Falcon; Hansen, Marco Bo; Wahl, Anna Mygind

    2017-01-01

    uncertain. We investigated the effects of 24 h delayed normobaric oxygen (NBO2) and HBO2treatment on the endogenous production of the inflammatory markers interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10, and on mortality in rats with cecal ligation and puncture (CLP) induced sepsis. Method...

  8. Psychosocial and cultural reasons for delay in seeking help and nonadherence to treatment in Indonesian women with breast cancer: A qualitative study.

    NARCIS (Netherlands)

    Iskandarsyah, A.; Klerk, C.D.; Suardi, D.R.; Soemitro, M.P.; Sadarjoen, S.S.; Passchier, J.

    2014-01-01

    Objective: The aim of this study was to explore reasons for delay in seeking medical help and nonadherence to treatment in Indonesian women with breast cancer. Method: Semistructured interviews were conducted by purposive sampling, using a consecutive sample of 50 breast cancer patients who were

  9. On the form of the forgetting function: the effects of arithmetic and logarithmic distributions of delays.

    Science.gov (United States)

    Sargisson, Rebecca J; White, K Geoffrey

    2003-11-01

    Forgetting functions with 18 delay intervals were generated for delayed matching-to-sample performance in pigeons. Delay interval variation was achieved by arranging five different sets of five delays across daily sessions. In different conditions, the delays were distributed in arithmetic or logarithmic series. There was no convincing evidence for different effects on discriminability of the distributions of different delays. The mean data were better fitted by some mathematical functions than by others, but the best-fitting functions depended on the distribution of delays. In further conditions with a fixed set of five delays, discriminability was higher with a logarithmic distribution of delays than with an arithmetic distribution. This result is consistent with the treatment of the forgetting function in terms of generalization decrement.

  10. Treatment with a non-toxic, self-replicating anti-prion delays or prevents prion disease in vivo.

    Science.gov (United States)

    Diaz-Espinoza, R; Morales, R; Concha-Marambio, L; Moreno-Gonzalez, I; Moda, F; Soto, C

    2018-03-01

    Transmissible spongiform encephalopathies (TSEs) are fatal neurological disorders caused by prions, which are composed of a misfolded protein (PrP Sc ) that self-propagates in the brain of infected individuals by converting the normal prion protein (PrP C ) into the pathological isoform. Here, we report a novel experimental strategy for preventing prion disease based on producing a self-replicating, but innocuous PrP Sc -like form, termed anti-prion, which can compete with the replication of pathogenic prions. Our results show that a prophylactic inoculation of prion-infected animals with an anti-prion delays the onset of the disease and in some animals completely prevents the development of clinical symptoms and brain damage. The data indicate that a single injection of the anti-prion eliminated ~99% of the infectivity associated to pathogenic prions. Furthermore, this treatment caused significant changes in the profile of regional PrP Sc deposition in the brains of animals that were treated, but still succumbed to the disease. Our findings provide new insights for a mechanistic understanding of prion replication and support the concept that prion replication can be separated from toxicity, providing a novel target for therapeutic intervention.

  11. Effects of source, water conditioning and thermal treatment on ...

    African Journals Online (AJOL)

    at 15 % moisture content amounting to 61.3 MJ was the optimum thermal treatment for achieving germination of 69 %. R. heudelotii seeds soaked in water for 15 days at moisture content of 24 % over dry weight followed by thermal treatment improved germination by 22 %. The highest germination of 79 % was obtained for ...

  12. Determining treatment levels of comorbid psychiatric conditions in ...

    African Journals Online (AJOL)

    Background: Psychiatric co-morbidities occur more frequently in patients with epilepsy but are usually undertreated. Treatment of these disorders is key to reducing mortality via suicide and other causes. This study determined the levels of treatment of psychiatric comorbidities at clinics in Lusaka, Zambia. Methodology: This ...

  13. Delayed orgasm and anorgasmia.

    Science.gov (United States)

    Jenkins, Lawrence C; Mulhall, John P

    2015-11-01

    Delayed orgasm/anorgasmia defined as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress. Delayed orgasm and anorgasmia are associated with significant sexual dissatisfaction. A focused medical history can shed light on the potential etiologies, which include medications, penile sensation loss, endocrinopathies, penile hyperstimulation, and psychological etiologies. Unfortunately, there are no excellent pharmacotherapies for delayed orgasm/anorgasmia, and treatment revolves largely around addressing potential causative factors and psychotherapy. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

    Directory of Open Access Journals (Sweden)

    Deribew Amare

    2010-11-01

    Full Text Available Abstract Background Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done. Results A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34, who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36, who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42 and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45 were more likely to be late for the treatment of malaria in under-five children. Conclusion Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment.

  15. Pseudotumoral delayed cerebral radionecrosis

    International Nuclear Information System (INIS)

    Ciaudo-Lacroix, C.; Lapresle, J.

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. γEG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed [fr

  16. Pseudotumoral delayed cerebral radionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Ciaudo-Lacroix, C; Lapresle, J [Centre Hospitalier de Bicetre, 94 - Le Kremlin-Bicetre (France)

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. ..gamma..EG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed.

  17. Cognitive factors that influence delayed decision to seek treatment among older patients with acute myocardial infarction in Korea.

    Science.gov (United States)

    Hwang, Seon Young; Jeong, Myung Ho

    2012-06-01

    The incidence of acute myocardial infarction (AMI) is rapidly increasing among older adults in Korea. However, the factors associated with a delayed decision to visit a hospital and the reasons for this delay have not been explored adequately among older patients. To determine factors predicting a prehospital delay time of > 6 h and to identify the cognitive barriers in the delayed decision of AMI patients aged ≥ 65 years. This study adopted a mixed methodological approach using quantitative and qualitative analyses. The sample included 94 male and 71 female patients hospitalized for first-time AMI at a university hospital in Korea. Thematic content analysis was used to identify the themes from the qualitative interview data, and multiple logistic regression analysis was used to predict delayed hospital presentation by > 6 h. The median prehospital delay time was 12 h. Low education level, presence of preinfarction angina pain, and attribution of symptoms to a non-cardiac origin were found to be the predicting factors. From the qualitative data, four meaningful themes including 10 subthemes that influenced the delayed decision were identified. Some culturally peculiar themes were found in this Korean sample. Educational strategies that focus on these cognitive decision-making barriers should be planned for elderly Korean at high risk for AMI.

  18. Periodontal Condition and Treatment Needs of Some Pregnant ...

    African Journals Online (AJOL)

    been reported to have effects on periodontal health include ... hormonal imbalance as seen during pregnancy, which if that is the case, should resolve following childbirth .... tissue destruction, which will require a chronic inflammatory condition ...

  19. Repeated exposure to conditioned fear stress increases anxiety and delays sleep recovery following exposure to an acute traumatic stressor

    Directory of Open Access Journals (Sweden)

    Benjamin N Greenwood

    2014-10-01

    Full Text Available Repeated stressor exposure can sensitize physiological responses to novel stressors and facilitate the development of stress-related psychiatric disorders including anxiety. Disruptions in diurnal rhythms of sleep-wake behavior accompany stress-related psychiatric disorders and could contribute to their development. Complex stressors that include fear-eliciting stimuli can be a component of repeated stress experienced by humans, but whether exposure to repeated fear can prime the development of anxiety and sleep disturbances is unknown. In the current study, adult male F344 rats were exposed to either control conditions or repeated contextual fear conditioning for 22 days followed by exposure to either no, mild (10, or severe (100 acute uncontrollable tail shock stress. Exposure to acute stress produced anxiety-like behavior as measured by a reduction in juvenile social exploration and exaggerated shock-elicited freezing in a novel context. Prior exposure to repeated fear enhanced anxiety-like behavior as measured by shock-elicited freezing, but did not alter social exploratory behavior. The potentiation of anxiety produced by prior repeated fear was temporary; exaggerated fear was present 1 day but not 4 days following acute stress. Interestingly, exposure to acute stress reduced REM and NREM sleep during the hours immediately following acute stress. This initial reduction in sleep was followed by robust REM rebound and diurnal rhythm flattening of sleep / wake behavior. Prior repeated fear extended the acute stress-induced REM and NREM sleep loss, impaired REM rebound, and prolonged the flattening of the diurnal rhythm of NREM sleep following acute stressor exposure. These data suggest that impaired recovery of sleep / wake behavior following acute stress could contribute to the mechanisms by which a history of prior repeated stress increases vulnerability to subsequent novel stressors and stress-related disorders.

  20. General treatment of a non-linear gauge condition

    International Nuclear Information System (INIS)

    Malleville, C.

    1982-06-01

    A non linear gauge condition is presented in the frame of a non abelian gauge theory broken with the Higgs mechanism. It is shown that this condition already introduced for the standard SU(2) x U(1) model can be generalized for any gauge model with the same type of simplification, namely the suppression of any coupling of the form: massless gauge boson, massive gauge boson, unphysical Higgs [fr

  1. Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study

    OpenAIRE

    Linden Ulrike; Groß Wibke; Ostermann Thomas

    2010-01-01

    Abstract Background Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. Methods A total of 18 childr...

  2. Experimental condition in the preparation of catalysts for Hydro treatment

    International Nuclear Information System (INIS)

    Gomez P, Alvaro

    1998-01-01

    In this work, by means of an exhaustive bibliographical revision and in a methodical way, they seek to settle down, the characteristics of the catalysts for Hydro treatment (HDT) on those that it is necessary to act with the purpose of obtaining more active, selective and resistant catalysts to the deactivation

  3. Effects Of Desensitization Treatment On Core-Condition Training

    Science.gov (United States)

    Fry, P. S.

    1973-01-01

    Pre- and posttest ratings on measures of helping skills such as empathy, respect, concreteness, and genuineness were obtained in the preliminary and advanced training. A significant training effect was obtained for both groups. Desensitization treatment was a significant source of variance for the experimental subjects in training. (Author/LA)

  4. Tanezumab in the treatment of chronic musculoskeletal conditions.

    Science.gov (United States)

    Jayabalan, Prakash; Schnitzer, Thomas J

    2017-02-01

    The management of pain associated with chronic musculoskeletal conditions represents a significant challenge for the clinician. There remains a need for novel medications that have a significant analgesic benefit and are also safe and well tolerated. Both pre-clinical and clinical data have provided evidence of the role of nerve growth factor (NGF) in a multitude of pain eliciting conditions. Therefore, the development of monoclonal antibodies to NGF for chronic painful musculoskeletal conditions has generated interest. Areas covered: This manuscript is a review that examines both the pharmacological properties and clinical studies of tanezumab, the most widely studied antibody to NGF, for management of osteoarthritis (OA) and low back pain. In addition, the safety and tolerability profile and development history of tanezumab are also discussed. Expert opinion: Most studies provide strong support for the ability of tanezumab to provide clinically meaningful pain relief in individuals with these conditions, with longer-term studies suggesting durability of effect. The adverse event profile appears favorable, assuming the risk mitigation strategies are effective at reducing the incidence of joint-related side effects. Further data are being collected to define the optimal dose and dosing strategy in both OA and chronic low back pain.

  5. Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions.

    Science.gov (United States)

    Hawk, Cheryl; Minkalis, Amy L; Khorsan, Raheleh; Daniels, Clinton J; Homack, Dennis; Gliedt, Jordan A; Hartman, Julie A; Bhalerao, Shireesh

    2017-06-01

    The purpose of this review was to evaluate the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder. The review was conducted from March 2016 to November 2016 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered with PROSPERO. Eligibility criteria included randomized controlled trials (RCTs), systematic reviews, or meta-analyses studying adult patients with a shoulder diagnosis. Interventions qualified if they did not involve prescription medication or surgical procedures, although these could be used in the comparison group or groups. At least 2 independent reviewers assessed the quality of each study using the Scottish Intercollegiate Guidelines Network checklists. Shoulder conditions addressed were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs), adhesive capsulitis (AC), and nonspecific shoulder pain. Twenty-five systematic reviews and 44 RCTs met inclusion criteria. Low- to moderate-quality evidence supported the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for SIS and AC. For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions. The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for modalities used for common shoulder conditions. Copyright © 2017. Published by Elsevier Inc.

  6. Treatment conditions for the removal of contaminants from road runoff

    OpenAIRE

    Hallberg, Magnus

    2007-01-01

    The pollutant load in road runoff is related to traffic densities and road maintenance activities. Inurbanised areas treatment of road runoff is common and often considered necessary. The pollutantsare partitioned between the particulate and dissolved matter. However, the contaminantstend to have an affinity to the particulate material. Sedimentation, the predominant treatmentmethod for road runoff uses various types of ponds. Design tools used for stormwater treatmentsystems are based on ext...

  7. The treatment and conditioning of solid radioactive waste (1962)

    International Nuclear Information System (INIS)

    Cerre, P.; Mestre, E.

    1962-01-01

    Previous studies, the results of which have been confirmed by experiments, have led us to build a semi-industrial plant for the treatment and coating of solid radioactive waste. This report details the means at our disposal in a pilot plant which, apart from being used for tests, was also routine-operated. It is thus possible to give also an appreciation of its operation in this report. (authors) [fr

  8. Delayed fission

    Energy Technology Data Exchange (ETDEWEB)

    Hatsukawa, Yuichi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1997-07-01

    Delayed fission is a nuclear decay process that couples {beta} decay and fission. In the delayed fission process, a parent nucleus undergoes {beta} decay and thereby populates excited states in the daughter. If these states are of energies comparable to or greater than the fission barrier of the daughter, then fission may compete with other decay modes of the excited states in the daughter. In this paper, mechanism and some experiments of the delayed fission will be discussed. (author)

  9. Maternal prepregnancy obesity and insulin treatment during pregnancy are independently associated with delayed lactogenesis in women with recent gestational diabetes mellitus.

    Science.gov (United States)

    Matias, Susana L; Dewey, Kathryn G; Quesenberry, Charles P; Gunderson, Erica P

    2014-01-01

    The timely onset of stage II lactogenesis (OL) is important for successful breastfeeding and newborn health. Several risk factors for delayed OL are common in women with a history of gestational diabetes mellitus (GDM), which may affect their chances for successful breastfeeding outcomes. We investigated the prevalence and risk factors associated with delayed OL in a racially and ethnically diverse cohort of postpartum women with recent GDM. We analyzed data collected in the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy (SWIFT), which is a prospective cohort of women diagnosed with GDM who delivered at Kaiser Permanente Northern California hospitals from 2008 to 2011. At 6-9 wk postpartum, delayed OL was assessed by maternal report of breast fullness and defined as occurring after 72 h postpartum. We obtained data on prenatal course and postdelivery infant feeding practices from electronic medical records and in-person surveys. We used multivariable logistic regression models to estimate associations of delayed OL with prenatal, delivery, and postnatal characteristics. The analysis included 883 SWIFT participants who initiated breastfeeding and did not have diabetes at 6-9 wk postpartum. Delayed OL was reported by 33% of women and was associated with prepregnancy obesity (OR: 1.56; 95% CI: 1.07, 2.29), older maternal age (OR: 1.05; 95% CI: 1.01, 1.08), insulin GDM treatment (OR: 3.11; 95% CI: 1.37, 7.05), and suboptimal in-hospital breastfeeding (OR: 1.65; 95% CI: 1.20, 2.26). A higher gestational age was associated with decreased odds of delayed OL but only in multiparous mothers (OR: 0.79; 95% CI: 0.67, 0.94). One-third of women with recent GDM experienced delayed OL. Maternal obesity, insulin treatment, and suboptimal in-hospital breastfeeding were key risk factors for delayed OL. Early breastfeeding support for GDM women with these risk factors may be needed to ensure successful lactation. This trial was registered at clinicaltrials

  10. What role do traditional beliefs play in treatment seeking and delay for Buruli ulcer disease?--insights from a mixed methods study in Cameroon.

    Directory of Open Access Journals (Sweden)

    Koen Peeters Grietens

    Full Text Available Victims of Buruli ulcer disease (BUD frequently report to specialized units at a late stage of the disease. This delay has been associated with local beliefs and a preference for traditional healing linked to a reportedly mystical origin of the disease. We assessed the role beliefs play in determining BUD sufferers' choice between traditional and biomedical treatments.Anthropological fieldwork was conducted in community and clinical settings in the region of Ayos and Akonolinga in Central Cameroon. The research design consisted of a mixed methods study, triangulating a qualitative strand based on ethnographic research and quantitative data obtained through a survey presented to all patients at the Ayos and Akonolinga hospitals (N = 79 at the time of study and in four endemic communities (N = 73 belonging to the hospitals' catchment area.The analysis of BUD sufferers' health-seeking behaviour showed extremely complex therapeutic itineraries, including various attempts and failures both in the biomedical and traditional fields. Contrary to expectations, nearly half of all hospital patients attributed their illness to mystical causes, while traditional healers admitted patients they perceived to be infected by natural causes. Moreover, both patients in hospitals and in communities often combined elements of both types of treatments. Ultimately, perceptions regarding the effectiveness of the treatment, the option for local treatment as a cost prevention strategy and the characteristics of the doctor-patient relationship were more determinant for treatment choice than beliefs.The ascription of delay and treatment choice to beliefs constitutes an over-simplification of BUD health-seeking behaviour and places the responsibility directly on the shoulders of BUD sufferers while potentially neglecting other structural elements. While more efficacious treatment in the biomedical sector is likely to reduce perceived mystical involvement in the

  11. Alcohol Intake Increases in Adolescent C57BL/6J Mice during Intermittent Cycles of Phase-Delayed, Long-Light Conditions

    Directory of Open Access Journals (Sweden)

    Joshua J. Gamsby

    2017-08-01

    Full Text Available Adolescents naturally go to bed and awaken late, but are forced to awaken early for school and work. This leads to “social jetlag”, a state of circadian desynchrony (CD, in which internal biological rhythms are out of sync with behavioral rhythms. CD is associated with increased alcohol intake in adults, but has been less well-studied in adolescents. The goal of this study was to model adolescent alcohol intake during similar CD conditions in male C57BL/6J mice. Free access alcohol intake, water intake and wheel-running activity were measured during a normal 12HR photoperiod or during alternating photoperiod (Experiment 1: 12 h light for 4 days followed by 18 h light for 3 days, with dark (activity onset delayed 9 h during the 18HR photoperiod; Experiment 2: 12 h light for 4 days followed by 6 h light for 3 days, with dark onset delayed 3 h during the 6HR photoperiod. In Experiment 1, CD produced a small but significant increase in the total alcohol intake per day as well as in intake in bouts, with the greatest increase over controls in the hours following the 6HR dark period. Additionally, the pattern of alcohol intake in bouts shifted to increase alcohol intake during the shorter dark period. In Experiment 2, the opposite effect occurred—the longer dark cycle led to lower alcohol drinking in the second half of the dark period. However, in Experiment 2, CD produced no significant changes in either total alcohol intake or alcohol intake in bouts. Conclusion: shifts in the light cycle that disrupt the regular pattern of day and night, and increase the length of the night phase, are sufficient to increase both drinking in bouts and restricted drinking in adolescent mice, modeling increased alcohol intake in adolescents during CD.

  12. Evaluation of carbon diffusion in heat treatment of H13 tool steel under different atmospheric conditions

    OpenAIRE

    Ramezani, Maziar; Pasang, Timotius; Chen, Zhan; Neitzert, Thomas; Au, Dominique

    2015-01-01

    Although the cost of the heat treatment process is only a minor portion of the total production cost, it is arguably the most important and crucial stage on the determination of material quality. In the study of the carbon diffusion in H13 steel during austenitization, a series of heat treatment experiments had been conducted under different atmospheric conditions and length of treatment. Four austenitization atmospheric conditions were studied, i.e., heat treatment without atmospheric contro...

  13. Routine delayed voiding cystourethography after initial successful endoscopic treatment with Dextranomer/Hialuronic Acid Copolimer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary?

    Science.gov (United States)

    García-Aparicio, L; Blázquez-Gómez, E; Vila Santandreu, A; Camacho Diaz, J A; Vila-Cots, J; Ramos Cebrian, M; de Haro, I; Martin, O; Tarrado, X

    2016-12-01

    Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA. We have reviewed all medical charts of patients that underwent Dx/HA treatment from 2006 to 2010. We have selected patients with initial successful treatment and more than 3 years of radiological and clinical follow-up. We have analyzed late clinical and radiological outcomes. One hundred and sixty children with 228 refluxing ureters underwent Dx/HA endoscopic treatment with a mean follow-up of 52.13 months. Early VCUG was performed in 215 ureters with an initial successful rate of 84.1%. The group of study was 94/215 ureters with more than 3 years of follow-up with a delayed VCUG. VUR was still resolved in 79,8% of the ureters. Clinical success rate was 91.7%. The incidence of febrile urinary tract infection in those patients with cured VUR and those with a relapsed VUR was 8 and 15%, respectively; but there were no significant differences. We have not found any variable related with relapsed VUR except those ureters that initially received 2 injections (P<.05). If our objective in the treatment of VUR is to reduce the incidence of febrile urinary tract infection it is not necessary to perform a delayed VCUG even though the long-term radiological outcomes is worse than clinical outcome. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Treatment of waste salt from the advanced spent fuel conditioning process (II) : optimum immobilization condition

    International Nuclear Information System (INIS)

    Kim, Jeong Guk; Lee, Jae Hee; Yoo, Jae Hyung; Kim, Joon Hyung

    2004-01-01

    Since zeolite is known to be stable at a high temperature, it has been reported as a promising immobilization matrix for waste salt. The crystal structure of dehydrated zeolite A breaks down above 1060 K, resulting in the formation of an amorphous solid and re-crystallization to beta-Cristobalite. This structural degradation depends on the existence of chlorides. When contacted to HCl, zeolite 4A is not stable even at 473 K. The optimum consolidation condition for LiCl salt waste from the oxide fuel reduction process based on the electrochemical method (Advanced spent fuel Conditioning Process; ACP) has been studied using zeolite A since 2001. Actually the constituents of waste salt are water-soluble. And, alkali halides are known to be readily radiolyzed to yield interstitial halogens and metal colloids. For disposal in a geological repository, the waste salt must meet the acceptance criteria. For a waste form containing chloride salt, two of the more important criteria are leach resistance and waste form durability. In this work, we prepared some samples with different mixing ratios of LiCl salt to zeolite A, and then compared some characteristics such as thermal stability, salt occlusion, free chloride content, leach resistance, mixing effect, etc

  15. Evaluation of carbon diffusion in heat treatment of H13 tool steel under different atmospheric conditions

    Directory of Open Access Journals (Sweden)

    Maziar Ramezani

    2015-04-01

    Full Text Available Although the cost of the heat treatment process is only a minor portion of the total production cost, it is arguably the most important and crucial stage on the determination of material quality. In the study of the carbon diffusion in H13 steel during austenitization, a series of heat treatment experiments had been conducted under different atmospheric conditions and length of treatment. Four austenitization atmospheric conditions were studied, i.e., heat treatment without atmospheric control, heat treatment with stainless steel foil wrapping, pack carburization heat treatment and vacuum heat treatment. The results showed that stainless steel foil wrapping could restrict decarburization process, resulting in a constant hardness profile as vacuum heat treatment does. However, the tempering characteristic between these two heat treatment methods is different. Results from the gas nitrided samples showed that the thickness and the hardness of the nitrided layer is independent of the carbon content in H13 steel.

  16. Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia.

    Science.gov (United States)

    Toft, Nina; Birgens, Henrik; Abrahamsson, Jonas; Griškevičius, Laimonas; Hallböök, Helene; Heyman, Mats; Klausen, Tobias Wirenfeldt; Jónsson, Ólafur Gísli; Palk, Katrin; Pruunsild, Kaie; Quist-Paulsen, Petter; Vaitkeviciene, Goda; Vettenranta, Kim; Asberg, Ann; Helt, Louise Rold; Frandsen, Thomas; Schmiegelow, Kjeld

    2016-02-01

    Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P children, although thrombosis and avascular osteonecrosis was most common among adolescents. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Delayed growth

    Science.gov (United States)

    ... Slow rate of growth; Retarded growth and development; Growth delay Images Toddler development References Cooke DW, Divall SA, Radovick S. Normal and aberrant growth in children. In: Melmed S, Polonsky KS, Larsen PR, ...

  18. A study on stability and medical implications for a complex delay model for CML with cell competition and treatment.

    Science.gov (United States)

    Rădulescu, I R; Cândea, D; Halanay, A

    2014-12-21

    We study a mathematical model describing the dynamics of leukemic and normal cell populations (stem-like and differentiated) in chronic myeloid leukemia (CML). This model is a system of four delay differential equations incorporating three types of cell division. The competition between normal and leukemic stem cell populations for the common microenvironment is taken into consideration. The stability of one steady state is investigated. The results are discussed via their medical interpretation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Re: What is the best treatment to reduce the need for caesarean section in nulliparous women at term with delayed first stage of labour?

    DEFF Research Database (Denmark)

    Boie, Sidsel; Glavind, Julie; Uldbjerg, Niels

    2017-01-01

    The authors pose the question - What is the best treatment to reduce the need for caesarean section in nulliparous women at term with delayed first stage of labour? and state in their paper that "There is no consensus on the optimal dose regimen of oxytocin for delay in the first stage of labour...... in nulliparous women at term (37-42 weeks’ gestation) to reduce unplanned caesarean section and increase vaginal birth with minimal adverse events". However, they describe only low and high dose oxytocin regimens and fail to acknowledge that no oxytocin at all is associated with a spontaneous delivery just...... as often as when oxytocin is given (1,2) or that discontinuation of oxytocin once the active phase of labour is reached can result in higher spontaneous delivery rates than continuing oxytocin (3,4). The paper in its list of trials (box 2) only describes those addressing high and low dose oxytocin, which...

  20. Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor.

    Science.gov (United States)

    Taverna, Livia; Tremolada, Marta; Bonichini, Sabrina; Tosetto, Barbara; Basso, Giuseppe; Messina, Chiara; Pillon, Marta

    2017-01-01

    CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07-5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children's motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS's total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children's motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis' tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia.

  1. Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor.

    Directory of Open Access Journals (Sweden)

    Livia Taverna

    Full Text Available CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07-5.76, including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL, and 8.3% by acute myeloid leukemia (AML. Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS on children's motor skills and filled in the Italian Temperament Questionnaire (QUIT. VABS's total scores were converted into equivalent mental age scores (EMA. A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children's motor skills. Significant delays were found in global motor skills (56.7% as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40 than peers without HSCT (Mean rank = 31.87 and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81. Kruskal Wallis' tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia.

  2. Motor skill delays in pre-school children with leukemia one year after treatment: Hematopoietic stem cell transplantation therapy as an important risk factor

    Science.gov (United States)

    Bonichini, Sabrina; Tosetto, Barbara; Basso, Giuseppe; Messina, Chiara; Pillon, Marta

    2017-01-01

    CNS-directed therapies for the treatment of leukemia can adversely affect the acquisition of new skills, such as reading/writing and math. Two years after the end of treatments, children show gross and fine motor skill delays that may persist even when patients are considered healed. The goal of the present study was to assess motor skills difficulties in pre-school children with leukemia one year after treatment. Particular attention has been paid to those patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and to the relationship between motor delays and age bands. Participants were 60 children (median age of 5; inter quartile range: 3.07–5.76), including 31 females and 29 males, 91.7% of them were affected by acute lymphoblastic leukemia (ALL), and 8.3% by acute myeloid leukemia (AML). Five children had undergone HCST. Parents were interviewed by Vineland Adaptive Behavior Scales (VABS) on children’s motor skills and filled in the Italian Temperament Questionnaire (QUIT). VABS’s total scores were converted into equivalent mental age scores (EMA). A score difference of at least three months between current age and equivalent mental age was considered a developmental delay. Non-parametric analyses were run to understand if HSCT treatment and a specific age band influence children’s motor skills. Significant delays were found in global motor skills (56.7%) as well as in fine and gross motor domains. Mann Whitney U tests showed that children with HSCT were reported to have lower gross motor mean ranks (U = 62; p = 0.004; Mean rank = 15.40) than peers without HSCT (Mean rank = 31.87) and lower mean rank values on motor temperament scale (U = 9; p = 0.003; HSCT Mean rank = 4.75 versus no HSCT Mean rank = 27.81). Kruskal Wallis’ tests identified the high risk treatment showing that HSCT experience negatively impacted the motor skills and temperamental motor activity of pre-school children one year after the diagnosis of leukemia. PMID

  3. Immediate versus Delayed Treatment in the Anterior Maxilla Using Single Implants with a Laser-Microtextured Collar: 3-Year Results of a Case Series on Hard- and Soft-Tissue Response and Esthetics.

    Science.gov (United States)

    Guarnieri, Renzo; Belleggia, Fabrizio; Grande, Maurizio

    2016-02-01

    To compare peri-implant marginal bone loss, soft tissue response, and esthetics following single immediate implant treatment (IIT) and delayed implant treatment (DIT) in the esthetic zone of the maxilla in well-selected patients. Adequate bone volume and ideal soft tissue level/contour were considered requirements for implant therapy, with additional prerequisites for IIT of residual alveolar bone wall integrity and a thick gingival biotype. IIT included immediate placement and provisionalization, while DIT included extraction socket preservation followed by implant placement and provisionalization 4 months later. Cortical bone levels and peri-implant mucosal conditions were evaluated at regular intervals. The esthetic outcome was objectively rated after 3 years using the pink esthetic score (PES) and white esthetic score (WES). Twelve patients received an immediate Laser-Lok® implant, and 13 patients received a delayed Laser-Lok® implant. No significant differences were found between the study groups regarding survival rate (100%). The mean bone level from the implant/abutment interface was 0.35 ± 0.18 mm for IIT and 0.42 ± 0.21 mm for DIT after 3 years (p > 0.05). Mesial and distal papillae remained stable over time in DIT. A tendency for regrowth of mesial and distal papillae was found following IIT (p esthetics, DIT and IIT with single Laser-Lok® implants in the anterior maxilla are comparable and predictable options for well-selected patients. © 2015 by the American College of Prosthodontists.

  4. Mothers' perception of recovery and satisfaction with patent medicine dealers' treatment of childhood febrile conditions in rural communities.

    Science.gov (United States)

    Ibeneme, Georgian Chiaka; Nwaneri, Ada Caroline; Ibeneme, Sam Chidi; Ezenduka, Pauline; Strüver, Vanessa; Fortwengel, Gehard; Okoye, Ifeoma Joy

    2016-06-28

    Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine 'mothers' perception of recovery' and 'mothers' satisfaction' after PMD treatment of childhood febrile conditions, as likely drivers of mothers' health-seeking behaviour, which must be targeted to reverse the trend. Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15-45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21-47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p perceived that their child had delayed recovery, but were satisfied with PMDs' treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers' satisfaction with PMDs' treatment is significantly (p satisfaction with PMDs' treatment from a knowledge of mothers' perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers' perception of recovery based on knowledge of mothers' satisfaction with PMDs' treatment (lambda[A from B] = 0.4727). Mothers' satisfaction could be the key 'driver' of mothers' health-seeking behaviour and is less likely to be

  5. [Mental health of children, adolescents and young adults--part 1: prevalence, illness persistence, adversities, service use, treatment delay and consequences].

    Science.gov (United States)

    Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A

    2013-11-01

    Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences. © Georg Thieme Verlag KG Stuttgart · New York.

  6. The effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early intervention in psychotic disorders

    DEFF Research Database (Denmark)

    Albert, Nikolai; Melau, Marianne; Jensen, Heidi

    2017-01-01

    to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment......The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first-episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study, we investigate whether...... DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. For this specific study participants...

  7. Effect of magnesium treatment and glucose levels on delayed cerebral ischemia in patients with subarachnoid hemorrhage : A substudy of the Magnesium in Aneurysmal Subarachnoid Haemorrhage trial (MASH-II)

    NARCIS (Netherlands)

    Leijenaar, Jolien F.; Dorhout Mees, Sanne M.; Algra, Ale; van den Bergh, Walter M.; Rinkel, Gabriel J. E.

    2015-01-01

    Background: Magnesium treatment did not improve outcome in patients with aneurysmal subarachnoid haemorrhage in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. We hypothesized that high glucose levels may have offset a potential beneficial effect to prevent delayed cerebral ischemia.

  8. Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD

    Science.gov (United States)

    2015-10-01

    mechanism underlying the most successful treatment for PTSD, Prolonged Exposure. In animal models, sleep deprivation has been shown to impair extinction ...2. 3. 9 +Sleep and Extinction Learning  Animal models show fear conditioning:  Disrupts sleep  Disrupted sleep, in turn  Impairs extinction ...Award Number: W81XWH-11-2-0001 TITLE: “Role of Sleep Deprivation in Fear Conditioning and Extinction : Implications for Treatment of PTSD

  9. Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD

    Science.gov (United States)

    2015-12-01

    1 Award Number: W81XWH-11-2-0001 TITLE: Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD...REPORT TYPE Final 3. DATES COVERED (From - To) 1 Oct 2010 – 30 Sep 2015 4. TITLE AND SUBTITLE Role of Sleep Deprivation in Fear Conditioning and...especially adequate REM during exposure therapy may enhance efficacy and reduce remission after treatment. 15. SUBJECT TERMS PTSD, sleep deprivation , fear

  10. Oral Health Condition and Treatment Needs of a Group of Nigerian Individuals with Down Syndrome

    Science.gov (United States)

    Oredugba, Folakemi A.

    2007-01-01

    Objective: This study was carried out to determine the oral health condition and treatment needs of a group of individuals with Down syndrome in Nigeria. Method: Participants were examined for oral hygiene status, dental caries, malocclusion, hypoplasia, missing teeth, crowding and treatment needs. Findings were compared with controls across age…

  11. Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions

    Science.gov (United States)

    The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...

  12. Laryngotracheoesophageal Cleft Type 3 and Severe Laryngotracheomalacia; Delayed Surgical Repair, a Treatment Challenge with an Excellent Outcome

    Directory of Open Access Journals (Sweden)

    Ahmad Khaleghnejad

    Full Text Available Laryngotracheoesophageal clefts (LTEC are rare malformations which involve the upper respiratory and digestive tract. Surgical repair should be undertaken promptly to maintain a secure airway and prevent serious pulmonary aspiration. This paper reports the first case of LTEC type 3 with severe laryngotracheomalacia that was brought to Mofid children's hospital in late infancy with a poor health status. Delayed defect correction was our team strategy for the patient when she had achieved good weight gain. At the age of 22 months in collaboration with the pediatric surgical and otolaryngologist team, the repair of the laryngeal cleft was done with lateral open approach method. She was discharged with tracheostomy and gastrostomy. In the next six months follow up after the surgery tracheostomy decannulation and gastrostomy tube removal were done and the infant is now in regular follow-up. Keywords: Laryngotracheoesophageal clefts, Laryngotracheomalacia, Surgical repair

  13. Cognitive-Behavioral Treatment for Specific Phobias with a Child Demonstrating Severe Problem Behavior and Developmental Delays

    Science.gov (United States)

    Davis, Thompson E., III; Kurtz, Patricia F.; Gardner, Andrew W.; Carman, Nicole B.

    2007-01-01

    Cognitive-behavioral treatments (CBTs) are widely used for anxiety disorders in typically developing children; however, there has been no previous attempt to administer CBT for specific phobia (in this case study, one-session treatment) to developmentally or intellectually disabled children. This case study integrates both cognitive-behavioral and…

  14. The effect of thermal pre-treatment of titanium hydride (TiH2) powder in argon condition

    Science.gov (United States)

    Franciska P., L.; Erryani, Aprilia; Annur, Dhyah; Kartika, Ika

    2018-04-01

    Titanium hydride (TiH2) powders are used to enhance the foaming process in the formation of a highly porous metallic material with a cellular structure. But, the low temperature of hydrogen release is one of its problems. The present study, different thermal pre-treatment temperatures were employed to investigate the decomposition behavior of TiH2 to retard or delay a hydrogen gas release process during foaming. As a foaming agent, TiH2 was subjected to various heat treatments prior at 450 and 500°C during 2 hours in argon condition. To study the formation mechanism, the thermal behavior of titanium hydride and hydrogen release are investigated by thermogravimetric analysis (TGA) and differential thermal analysis (DTA). The morphology of pre-treated titanium hydride powders were examined using Scanning Electron Microscope (SEM) while unsure mapping and elemental composition of the pre-treated powders processed by Energy Dispersive Spectroscopy (EDS). To study the phase formation was characterized by X-ray diffraction analysis (XRD). In accordance with the results, an increase in pre-treatment temperature of TiH2 to higher degrees are changing the process of releasing hydrogen from titanium hydride powder. DTA/TGA results showed that thermal pre-treatment TiH2 at 450°C, released the hydrogen gas at 560°C in heat treatment when foaming process. Meanwhile, thermal pre-treatment in TiH2 at 500°C, released the hydrogen gas at 670°C when foaming process. There is plenty of direct evidence for the existence of oxide layers that showed by EDS analysis obtained in SEM. As oxygen is a light element and qualitative proof shows that the higher pre-treatment temperature produces more and thicker oxygen layers on the surface of the TiH2 powder particles. It might the thickness of oxide layer are different from different pre-treatment temperatures, which leading to the differences in the decomposition temperature. But from SEM result that oxidation of the powder does not

  15. Estimating the average treatment effect on survival based on observational data and using partly conditional modeling.

    Science.gov (United States)

    Gong, Qi; Schaubel, Douglas E

    2017-03-01

    Treatments are frequently evaluated in terms of their effect on patient survival. In settings where randomization of treatment is not feasible, observational data are employed, necessitating correction for covariate imbalances. Treatments are usually compared using a hazard ratio. Most existing methods which quantify the treatment effect through the survival function are applicable to treatments assigned at time 0. In the data structure of our interest, subjects typically begin follow-up untreated; time-until-treatment, and the pretreatment death hazard are both heavily influenced by longitudinal covariates; and subjects may experience periods of treatment ineligibility. We propose semiparametric methods for estimating the average difference in restricted mean survival time attributable to a time-dependent treatment, the average effect of treatment among the treated, under current treatment assignment patterns. The pre- and posttreatment models are partly conditional, in that they use the covariate history up to the time of treatment. The pre-treatment model is estimated through recently developed landmark analysis methods. For each treated patient, fitted pre- and posttreatment survival curves are projected out, then averaged in a manner which accounts for the censoring of treatment times. Asymptotic properties are derived and evaluated through simulation. The proposed methods are applied to liver transplant data in order to estimate the effect of liver transplantation on survival among transplant recipients under current practice patterns. © 2016, The International Biometric Society.

  16. Optimization of Saccharification Conditions of Lignocellulosic Biomass under Alkaline Pre-Treatment and Enzymatic Hydrolysis

    Directory of Open Access Journals (Sweden)

    Rafał Łukajtis

    2018-04-01

    Full Text Available Pre-treatment is a significant step in the production of second-generation biofuels from waste lignocellulosic materials. Obtaining biofuels as a result of fermentation processes requires appropriate pre-treatment conditions ensuring the highest possible degree of saccharification of the feed material. An influence of the following process parameters were investigated for alkaline pre-treatment of Salix viminalis L.: catalyst concentration (NaOH, temperature, pre-treatment time and granulation. For this purpose, experiments were carried out in accordance to the Box-Behnken design for four factors. In the saccharification process of the pre-treated biomass, cellulolytic enzymes immobilized on diatomaceous earth were used. Based on the obtained results, a mathematical model for the optimal conditions of alkaline pre-treatment prediction is proposed. The optimal conditions of alkaline pre-treatment are established as follows: granulation 0.75 mm, catalyst concentration 7%, pre-treatment time 6 h and temperature 65 °C if the saccharification efficiency and cost analysis are considered. An influence of the optimized pre-treatment on both the chemical composition and structural changes for six various lignocellulosic materials (energetic willow, energetic poplar, beech, triticale, meadow grass, corncobs was investigated. SEM images of raw and pre-treated biomass samples are included in order to follow the changes in the biomass structure during hydrolysis.

  17. Effects of Two-stage Heat Treatment on Delayed Coke and Study of Their Surface Texture Characteristics

    Science.gov (United States)

    Im, Ui-Su; Kim, Jiyoung; Lee, Seon Ho; Lee, Byung-Rok; Peck, Dong-Hyun; Jung, Doo-Hwan

    2017-12-01

    In the present study, surface texture features and chemical properties of two types of cokes, made from coal tar by either 1-stage heat treatment or 2-stage heat treatment, were researched. The relationship between surface texture characteristics and the chemical properties was identified through molecular weight distribution, insolubility of coal tar, weight loss with temperature increase, coking yield, and polarized light microscope analysis. Rapidly cleared anisotropy texture in cokes was observed in accordance with the coking temperature rise. Quinoline insolubility and toluene insolubility of coal tar increased with a corresponding increases in coking temperature. In particular, the cokes produced by the 2-stage heat treatment (2S-C) showed surface structure of needle cokes at a temperature approximately 50°C lower than the 1-stage heat treatment (1S-C). Additionally, the coking yield of 2S-C increased by approximately 14% in comparison with 1S-C.

  18. A Randomized Controlled Trial of Intensive Sleep Retraining (ISR): A Brief Conditioning Treatment for Chronic Insomnia

    Science.gov (United States)

    Harris, Jodie; Lack, Leon; Kemp, Kristyn; Wright, Helen; Bootzin, Richard

    2012-01-01

    Study Objective: To investigate the effectiveness of intensive sleep retraining in comparison and combination with traditional behavioral intervention for chronic primary insomnia. Participants: Seventy-nine volunteers with chronic sleep-onset insomnia (with or without sleep maintenance difficulties) were randomly assigned either to intensive sleep retraining (ISR), stimulus control therapy (SCT), ISR plus SCT, or the control (sleep hygiene) treatment condition. Intervention: ISR treatment consisted of 50 sleep onset trials over a 25-h sleep deprivation period. Measurements and Results: Treatment response was assessed with sleep diary, activity monitoring, and questionnaire measures. The active treatment groups (ISR, SCT, ISR+SCT) all resulted in significant improvements in sleep onset latency and sleep efficiency, with moderate to large effect sizes from pre- to post-treatment. Wake time after sleep onset decreased significantly in the SCT and ISR+SCT groups. Total sleep time increased significantly in the ISR and ISR+SCT treatment groups. Participants receiving ISR (ISR, ISR+SCT) experienced rapidly improved SOL and TST during treatment, suggesting an advantage of rapid improvements in sleep in response to ISR. Although there were few statistically significant differences between groups on individual variables, ISR+SCT resulted in consistently larger effect sizes of change than other treatments, including questionnaire measures of sleep quality, sleep self-efficacy, and daytime functioning. The combination treatment group (ISR+SCT) showed trends to outperform other active treatment groups with fewer treatment dropouts, and a greater proportion of treatment responders with 61% reaching “good sleeper” status. Treatment gains achieved at post-treatment in the active treatment groups were largely maintained throughout follow-up periods to 6 months. Conclusion: This 25-hour intensive conditioning treatment for chronic insomnia can produce rapid improvements in

  19. Natural light-micro aerobic condition for PSB wastewater treatment: a flexible, simple, and effective resource recovery wastewater treatment process.

    Science.gov (United States)

    Lu, Haifeng; Han, Ting; Zhang, Guangming; Ma, Shanshan; Zhang, Yuanhui; Li, Baoming; Cao, Wei

    2018-01-01

    Photosynthetic bacteria (PSB) have two sets of metabolic pathways. They can degrade pollutants through light metabolic under light-anaerobic or oxygen metabolic pathways under dark-aerobic conditions. Both metabolisms function under natural light-microaerobic condition, which demands less energy input. This work investigated the characteristics of PSB wastewater treatment process under that condition. Results showed that PSB had very strong adaptability to chemical oxygen demand (COD) concentration; with F/M of 5.2-248.5 mg-COD/mg-biomass, the biomass increased three times and COD removal reached above 91.5%. PSB had both advantages of oxygen metabolism in COD removal and light metabolism in resource recovery under natural light-microaerobic condition. For pollutants' degradation, COD, total organic carbon, nitrogen, and phosphorus removal reached 96.2%, 91.0%, 70.5%, and 92.7%, respectively. For resource recovery, 74.2% of C in wastewater was transformed into biomass. Especially, coexistence of light and oxygen promote N recovery ratio to 70.9%, higher than with the other two conditions. Further, 93.7% of N-removed was synthesized into biomass. Finally, CO 2 emission reduced by 62.6% compared with the traditional process. PSB wastewater treatment under this condition is energy-saving, highly effective, and environment friendly, and can achieve pollution control and resource recovery.

  20. A Transdiagnostic Minority Stress Treatment Approach for Gay and Bisexual Men’s Syndemic Health Conditions

    Science.gov (United States)

    Pachankis, John E.

    2015-01-01

    Developing and deploying separate treatments for separate conditions seems ill-suited to intervening upon the co-occurring, and possibly functionally similar, psychosocial conditions facing gay and bisexual men. This article argues for the need to create transdiagnostic interventions that reduce multiple syndemic conditions facing gay and bisexual men at the level of their shared source in minority stress pathways. This article first reviews psychosocial syndemic conditions affecting gay and bisexual men, then suggests pathways that might link minority stress to psychosocial syndemics based on recent advancements in emotion science, psychiatric nosology, and cognitive-affective neuroscience, and finally suggests cross-cutting psychosocial treatment principles to reduce minority stress–syndemic pathways among gay and bisexual men. Because minority stress serves as a common basis of all psychosocial syndemic conditions reviewed here, locating the pathways through which minority stress generates psychosocial syndemics and employing overarching treatment principles capable of simultaneously alleviating these pathways will ultimately create a transdiagnostic approach to improving gay and bisexual men’s health. Clinical research and training approaches are suggested to further validate the pathways suggested here, establish the efficacy of treatment approaches tied to those pathways, and generate effective methods for disseminating a transdiagnostic minority stress treatment approach for gay and bisexual men’s psychosocial syndemic health. PMID:26123065

  1. Job Burnout, Work Engagement and Self-reported Treatment for Health Conditions in South Africa.

    Science.gov (United States)

    de Beer, Leon T; Pienaar, Jaco; Rothmann, Sebastiaan

    2016-02-01

    The purpose of the study being reported here was to investigate the relationship of job burnout and work engagement with self-reported received treatment for health conditions (cardiovascular condition, high cholesterol, depression, diabetes, hypertension and irritable bowel syndrome), while controlling for age, gender, smoking and alcohol use. The sample comprised 7895 employees from a broad range of economic sectors in the South African working population. A cross-sectional survey design was used for the study. Structural equation modelling methods were implemented with a weighted least squares approach. The results showed that job burnout had a positive relationship with self-reported received treatment for depression, diabetes, hypertension and irritable bowel syndrome. Work engagement did not have any significant negative or positive relationships with the treatment for these health conditions. The results of this study make stakeholders aware of the relationship between job burnout, work engagement and self-reported treatment for health conditions. Evidence for increased reporting of treatment for ill-health conditions due to burnout was found. Therefore, attempts should be made to manage job burnout to prevent ill-health outcomes. Copyright © 2014 John Wiley & Sons, Ltd.

  2. Effect of redox conditions on pharmaceutical loss during biological wastewater treatment using sequencing batch reactors

    Energy Technology Data Exchange (ETDEWEB)

    Stadler, Lauren B., E-mail: lstadler@umich.edu [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States); Su, Lijuan, E-mail: lijuansu@buffalo.edu [Department of Chemistry, University at Buffalo, State University of New York, Buffalo, NY 14260 (United States); Moline, Christopher J., E-mail: christopher.moline@hdrinc.com [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States); Ernstoff, Alexi S., E-mail: alexer@dtu.dk [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States); Aga, Diana S., E-mail: dianaaga@buffalo.edu [Department of Chemistry, University at Buffalo, State University of New York, Buffalo, NY 14260 (United States); Love, Nancy G., E-mail: nglove@umich.edu [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States)

    2015-01-23

    Highlights: • Pharmaceutical fate was studied in SBRs operated at different redox conditions. • Stable carbon oxidation and nitrification occurred under microaerobic conditions. • Losses of atenolol and trimethoprim were highest under fully aerobic conditions. • Loss of sulfamethoxazole was highest under microaerobic conditions. • Deconjugation occurred during treatment to form sulfamethoxazole and desvenlafaxine. - Abstract: We lack a clear understanding of how wastewater treatment plant (WWTP) process parameters, such as redox environment, impact pharmaceutical fate. WWTPs increasingly install more advanced aeration control systems to save energy and achieve better nutrient removal performance. The impact of redox condition, and specifically the use of microaerobic (low dissolved oxygen) treatment, is poorly understood. In this study, the fate of a mixture of pharmaceuticals and several of their transformation products present in the primary effluent of a local WWTP was assessed in sequencing batch reactors operated under different redox conditions: fully aerobic, anoxic/aerobic, and microaerobic (DO concentration ≈0.3 mg/L). Among the pharmaceuticals that were tracked during this study (atenolol, trimethoprim, sulfamethoxazole, desvenlafaxine, venlafaxine, and phenytoin), overall loss varied between them and between redox environments. Losses of atenolol and trimethoprim were highest in the aerobic reactor; sulfamethoxazole loss was highest in the microaerobic reactors; and phenytoin was recalcitrant in all reactors. Transformation products of sulfamethoxazole and desvenlafaxine resulted in the reformation of their parent compounds during treatment. The results suggest that transformation products must be accounted for when assessing removal efficiencies and that redox environment influences the degree of pharmaceutical loss.

  3. Effect of redox conditions on pharmaceutical loss during biological wastewater treatment using sequencing batch reactors

    International Nuclear Information System (INIS)

    Stadler, Lauren B.; Su, Lijuan; Moline, Christopher J.; Ernstoff, Alexi S.; Aga, Diana S.; Love, Nancy G.

    2015-01-01

    Highlights: • Pharmaceutical fate was studied in SBRs operated at different redox conditions. • Stable carbon oxidation and nitrification occurred under microaerobic conditions. • Losses of atenolol and trimethoprim were highest under fully aerobic conditions. • Loss of sulfamethoxazole was highest under microaerobic conditions. • Deconjugation occurred during treatment to form sulfamethoxazole and desvenlafaxine. - Abstract: We lack a clear understanding of how wastewater treatment plant (WWTP) process parameters, such as redox environment, impact pharmaceutical fate. WWTPs increasingly install more advanced aeration control systems to save energy and achieve better nutrient removal performance. The impact of redox condition, and specifically the use of microaerobic (low dissolved oxygen) treatment, is poorly understood. In this study, the fate of a mixture of pharmaceuticals and several of their transformation products present in the primary effluent of a local WWTP was assessed in sequencing batch reactors operated under different redox conditions: fully aerobic, anoxic/aerobic, and microaerobic (DO concentration ≈0.3 mg/L). Among the pharmaceuticals that were tracked during this study (atenolol, trimethoprim, sulfamethoxazole, desvenlafaxine, venlafaxine, and phenytoin), overall loss varied between them and between redox environments. Losses of atenolol and trimethoprim were highest in the aerobic reactor; sulfamethoxazole loss was highest in the microaerobic reactors; and phenytoin was recalcitrant in all reactors. Transformation products of sulfamethoxazole and desvenlafaxine resulted in the reformation of their parent compounds during treatment. The results suggest that transformation products must be accounted for when assessing removal efficiencies and that redox environment influences the degree of pharmaceutical loss

  4. Biobreeding rat islets exhibit reduced antioxidative defense and N-acetyl cysteine treatment delays type 1 diabetes

    Science.gov (United States)

    Bogdani, Marika; Henschel, Angela M.; Kansra, Sanjay; Fuller, Jessica M.; Geoffrey, Rhonda; Jia, Shuang; Kaldunski, Mary L.; Pavletich, Scott; Prosser, Simon; Chen, Yi-Guang; Lernmark, Åke; Hessner, Martin J.

    2014-01-01

    Islet-level oxidative stress has been proposed as a trigger for type 1 diabetes (T1D), and release of cytokines by infiltrating immune cells further elevates reactive oxygen species (ROS), exacerbating β cell duress. To identify genes/mechanisms involved with diabeto-genesis at the β cell level, gene expression profiling and targeted follow-up studies were used to investigate islet activity in the biobreeding (BB) rat. Forty-day-old spontaneously diabetic lymphopenic BB DRlyp/lyp rats (before T cell insulitis) as well as nondiabetic BB DR+/+ rats, nondiabetic but lymphopenic F344lyp/lyp rats, and healthy Fischer (F344) rats were examined. Gene expression profiles of BB rat islets were highly distinct from F344 islets and under-expressed numerous genes involved in ROS metabolism, including glutathione S-transferase (GST) family members (Gstm2, Gstm4, Gstm7, Gstt1, Gstp1, and Gstk1), superoxide dismutases (Sod2 and Sod3), peroxidases, and peroxiredoxins. This pattern of under-expression was not observed in brain, liver, or muscle. Compared with F344 rats, BB rat pancreata exhibited lower GST protein levels, while plasma GST activity was found significantly lower in BB rats. Systemic administration of the antioxidant N-acetyl cysteine to DRlyp/lyp rats altered abundances of peripheral eosinophils, reduced severity of insulitis, and significantly delayed but did not prevent diabetes onset. We find evidence of β cell dysfunction in BB rats independent of T1D progression, which includes lower expression of genes related to antioxidative defense mechanisms during the pre-onset period that may contribute to overall T1D susceptibility. PMID:23111281

  5. Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients? Is this more effective than delayed rehabilitation?

    Directory of Open Access Journals (Sweden)

    Newton Robert U

    2012-09-01

    Full Text Available Abstract Background There has been substantial increase in use of androgen deprivation therapy as adjuvant management of prostate cancer. However, this leads to a range of musculoskeletal toxicities including reduced bone mass and increased skeletal fractures compounded with rapid metabolic alterations, including increased body fat, reduced lean mass, insulin resistance and negative lipoprotein profile, increased incidence of cardiovascular and metabolic morbidity, greater distress and reduced quality of life. Numerous research studies have demonstrated certain exercise prescriptions to be effective at preventing or even reversing these treatment toxicities. However, all interventions to date have been of rehabilitative intent being implemented after a minimum of 3 months since initiation of androgen deprivation, by which time considerable physical and psychological health problems have manifested. The pressing question is whether it is more efficacious to commence exercise therapy at the same time as initiating androgen deprivation, so treatment induced adverse effects can be immediately attenuated or indeed prevented. Methods/design We are proposing a multi-site randomized controlled trial with partial crossover to examine the effects of timing of exercise implementation (immediate or delayed on preserving long-term skeletal health, reversing short- and long-term metabolic and cardiovascular risk factors, and supporting mental health in men receiving androgen deprivation therapy. 124 men who are about to initiate androgen deprivation for prostate cancer will be randomized to immediate or delayed groups. Immediate will commence a 6-month exercise program within 7–10 days of their first dose. Delayed will receive usual care for 6 months and then commence the exercise program for 6 months (partial cross-over. Immediate will be free to adopt the lifestyle of their choosing following the initial 6-month intervention. Measurements for primary and

  6. Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients? Is this more effective than delayed rehabilitation?

    International Nuclear Information System (INIS)

    Newton, Robert U; Taaffe, Dennis R; Spry, Nigel; Cormie, Prue; Chambers, Suzanne K; Gardiner, Robert A; Shum, David HK; Joseph, David; Galvão, Daniel A

    2012-01-01

    There has been substantial increase in use of androgen deprivation therapy as adjuvant management of prostate cancer. However, this leads to a range of musculoskeletal toxicities including reduced bone mass and increased skeletal fractures compounded with rapid metabolic alterations, including increased body fat, reduced lean mass, insulin resistance and negative lipoprotein profile, increased incidence of cardiovascular and metabolic morbidity, greater distress and reduced quality of life. Numerous research studies have demonstrated certain exercise prescriptions to be effective at preventing or even reversing these treatment toxicities. However, all interventions to date have been of rehabilitative intent being implemented after a minimum of 3 months since initiation of androgen deprivation, by which time considerable physical and psychological health problems have manifested. The pressing question is whether it is more efficacious to commence exercise therapy at the same time as initiating androgen deprivation, so treatment induced adverse effects can be immediately attenuated or indeed prevented. We are proposing a multi-site randomized controlled trial with partial crossover to examine the effects of timing of exercise implementation (immediate or delayed) on preserving long-term skeletal health, reversing short- and long-term metabolic and cardiovascular risk factors, and supporting mental health in men receiving androgen deprivation therapy. 124 men who are about to initiate androgen deprivation for prostate cancer will be randomized to immediate or delayed groups. Immediate will commence a 6-month exercise program within 7–10 days of their first dose. Delayed will receive usual care for 6 months and then commence the exercise program for 6 months (partial cross-over). Immediate will be free to adopt the lifestyle of their choosing following the initial 6-month intervention. Measurements for primary and secondary endpoints will take place at baseline, 6

  7. Ash behavior during hydrothermal treatment for solid fuel applications. Part 2: Effects of treatment conditions on industrial waste biomass

    International Nuclear Information System (INIS)

    Mäkelä, Mikko; Yoshikawa, Kunio

    2016-01-01

    Highlights: • Effect of treatment conditions on composition and solubility of ash. • Ash dissolution and yield governed by liquid pH and calcium carbonate solubility. • Dissolution of calcium carbonate decreases ash fusion temperature during combustion. • Decreasing the ash content of sludge can weaken ash properties for combustion. - Abstract: This second half of our work on ash behavior concentrates on the effects of hydrothermal treatment conditions on paper sludge. Ash composition and solubility were determined based on treatment temperature, reactor solid load and liquid pH using experimental design and univariate regression methods. In addition, ash properties for combustion were evaluated based on recent developments on ash classification. Based on the results, all experimental variables had a statistically significant effect on ash yields. Only reactor solid load was statistically insignificant for char ash content, which increased based on increasing treatment temperature due to the decomposition of organic components. Ash dissolution and ash yield were governed by liquid pH and the generation of acids mainly due to the solubility of calcium carbonate identified as the main mineral species of paper sludge. Dissolution of calcium carbonate however decreased ash fusion temperatures more likely causing problems during char incineration. This indicated that decreasing the ash content of sludge during hydrothermal treatment can actually weaken ash properties for solid fuel applications.

  8. Delayed Puberty

    DEFF Research Database (Denmark)

    Kolby, Nanna; Busch, Alexander Siegfried; Juul, Anders

    2017-01-01

    . The underlying reasons for the large variation in the age at pubertal onset are not fully established; however, nutritional status and socioeconomic and environmental factors are known to be influencing, and a significant amount of influencing genetic factors have also been identified. The challenges...... optimal in discriminating especially CDGP from HH. Management of the delayed puberty depends on the etiology. For boys with CDGP an observational period will often reveal imminent puberty. If puberty is not progressing spontaneously, sex steroid replacement is effective in stimulating the development...

  9. Systemic conditions and treatments as risk for therapy with dental implants

    International Nuclear Information System (INIS)

    Arguedas Vega, Natalia; Alfaro Mayorga, Erika

    2013-01-01

    The possible risks for osseointegration are described in patients with specific systemic conditions, medical treatment such as radiation, cardiovascular diseases, HIV and smoking habit. The principal complications for osseointegration of diseases and systemic treatments are exposed. The review and search of the available literature are realized in databases. The scientific literature obtained from human studies has reported the survival of patients with dental implants. The implants are placed in patients with at least one of the conditions studied. The risks of the surgical procedures required for the placement of implants are analyzed in systemically compromised patients. Comparisons of patients with and without systemic conditions in controlled form have remained without analyzing. The level of evidence of absolute and relative contraindications has been low for the therapy with implants in patients with systemic diseases. The revised information is detailed according the systemic conditions, and each of them are evaluated separately [es

  10. Development of optimum conditions for modification of Kpautagi clay for application in petroleum refinery wastewater treatment

    Directory of Open Access Journals (Sweden)

    Matthew A. ONU

    2015-12-01

    Full Text Available Kautagi clay is a kaolin type deposit that is abundantly available in Niger State, Nigeria with potential for application in pollution control such as wastewater treatment. This study investigates the optimum conditions for modification of Kpautagi clay for application in refinery wastewater treatment. Sulphuric acid was used in the modification of the clay and the modification variables considered were acid concentration, activation time and temperature. To develop the optimum conditions for the modification variables, the sulphuric acid modified Kpautagi clay was applied in the treatment of refinery wastewater in column mode at a fixed flow rate and mass of adsorbent. The results obtained indicate that the optimum conditions for modification of Kpautagi clay for application in the treatment of petroleum refinery wastewater are: acid concentration of 4M; activation time of 120min and activation temperature of 100°C. Therefore, the optimum conditions developed in this study for modification of Kpautagi clay could be applied for improved performance in the treatment of petroleum refinery wastewater.

  11. Irradiation combined with Bleomycin treatment of synchronized cells in culture under oxic and hypoxic conditions

    International Nuclear Information System (INIS)

    Midander, J.; Littbrand, B.; Edsmyr, F.

    1980-01-01

    Bleomycin-treated cells are sensitized to radiation delivered under oxic conditions both in the early S and G 2 phases of the cycle, irradiated under hypoxic conditions, sensitization occurs only in the early S phase. This difference in the sensitizing effect of the drug is discussed in regard to the possible clinical advantages of a combined treatment of tumours with irradiation and Bleomycin. (Auth.)

  12. The response of substance use disorder treatment providers to changes in macroeconomic conditions.

    Science.gov (United States)

    Cantor, Jonathan; Stoller, Kenneth B; Saloner, Brendan

    2017-10-01

    To study how substance use disorder (SUD) treatment providers respond to changes in economic conditions. 2000-2012 National Survey of Substance Abuse Treatment Services (N-SSATS) which contains detailed information on specialty SUD facilities in the United States. We use fixed-effects regression to study how changes in economic conditions, proxied by state unemployment rates, impact treatment setting, accepted payment forms, charity care, offered services, special programs, and use of pharmacotherapies by specialty SUD treatment providers. Secondary data analysis in the N-SSATS. Our findings suggest a one percentage point increase in the state unemployment rate is associated with a 2.5% reduction in outpatient clients by non-profit providers and a 1.8% increase in the acceptance of private insurance as a form of payment overall. We find no evidence that inpatient treatment, the provision of charity care, offered services, or special programs are impacted by changes in the state unemployment rate. However, a one percentage point increase in the state unemployment rate leads to a 2.5% increase in the probability that a provider uses pharmacotherapies to treat addiction. Deteriorating economic conditions may increase financial pressures on treatment providers, prompting them to seek new sources of revenue or to change their care delivery models. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Role of membrane technology to achieve ALARA concept in reprocessing plant: utilization of low pressure reverse osmosis for treatment of delay tank solutions

    International Nuclear Information System (INIS)

    Pabby, Anil K.; Sonawane, J.V.; Rathore, N.S.; Gupta, S.K.; Roy, S.C.; Venugopalan, A.K.; Chagrani, R.D.; Dey, P.K.; Prabhakar, S.; Tiwari, P.K.

    2004-01-01

    Reverse osmosis is a well-developed technology. The systems have been used in industrial settings for many years with applications to separation, concentration of product streams and waste water treatment. The technology has been used for removal of the radionuclides from low-level liquid wastes, such as waste streams at nuclear power plants. Because reverse osmosis rejects nearly all contaminants from a solution the high purity product water may be recycled within the power plant, or is usually of such low activity that it is suitable for discharge to the environment. This technology will help in achieving ALARA concept which will be beneficial for the environment. In the present study, the removal of alpha and beta activities from delay tank solution is planned

  14. Delayed Treatment with a Small Pigment Epithelium Derived Factor (PEDF Peptide Prevents the Progression of Diabetic Renal Injury.

    Directory of Open Access Journals (Sweden)

    Alaa S Awad

    Full Text Available Our recent publication showed that a small bioactive pigment epithelium derived factor (PEDF peptide (P78-PEDF prevents the development of diabetic nephropathy (DN. However, its effects on the progression of established DN were not clear. Therefore, the purpose of this study was to determine the effect of P78-PEDF in the progression of DN and to compare the effects of P78-PEDF and an ACE inhibitor (ACEi, a standard of care in DN. Experiments were conducted in Ins2(Akita mice treated with P78-PEDF or captopril starting at 6 wks of age for 12 wks (early treatment or starting at 12 wks of age for 6 wks (late treatment. We first established the optimal dose of the P78-PEDF peptide to ameliorate DN in Ins2(Akita mouse for a 6 wk study period and found that the peptide was effective at 0.1- 0.5 µg/g/day. We next showed that early or late treatment with P78-PEDF resulted in protection from DN as indicated by reduced albuminuria, kidney macrophage recruitment, histological changes, inflammatory cytokines and fibrotic markers (kidney TNF-α, fibronectin, VEGFA and EGFR, and restored nephrin expression compared with vehicle-treated Ins2(Akita mice. Interestingly, only early but not late treatment with captopril was as effective as P78-PEDF in reducing most DN complications, despite its lack of effect on nephrin, VEGFA and EGFR expression. These findings highlight the importance of P78-PEDF peptide as a potential therapeutic modality in both the development and progression of diabetic renal injury.

  15. [Exposure to addictogenic substances, conditioned response and treatment of the exposure with response prevention].

    Science.gov (United States)

    Khazaal, Y; Frésard, E; Zullino, D

    2007-01-01

    Exposure to drugs or related cues is associated with psycho-physiological reactivity. These responses are conditioned during periods of active consumption. Exposure with response prevention (EPR) is a treatment established for anxiety disorder and aims to reduce anxiety by an extinction of previously conditioned responses. The conditioning recognized in additive processes has led to research into EPR's therapeutic potential for treating addiction. This paper is a review of the main studies on reactivity to cues, and EPR, particularly with respect to addiction to alcohol, opiates, cocaine and tobacco. This review is based on information from the Medline database, dealing with cue reactivity, attentional bias during exposure to cues and exposure treatment for addiction in general and, in particular, for each of the aforementioned substances. Exposure to drug-related cues is clearly associated with psycho-physiological reactivity and with attentional bias. Those phenomena are associated with craving and more difficulty in maintaining abstinence. The subject's attention is thus held by a large number of drug-related environmental stimuli. These observations are linked with conditioning phenomena and suggest the possibility of treatment by EPR conditioning extinction procedures. EPR has been most widely studied for abuse and alcohol addiction. Case reports give favourable outcomes. Results from controlled studies are less clear. Studies on patients addicted to cocaine or heroine are still limited and not conclusive. Different controlled studies on EPR for nicotine addiction have not produced conclusions in favour of this treatment. Generally, the EPR procedures used vary among studies. Studies focussing particularly on the evolution of physiological responses in a laboratory setting after EPR have demonstrated reduced autonomic nervous system activity. These results do not consistently lead to a reduction in consumption behaviour and in craving when the patient is in

  16. Comparison of steam sterilization conditions efficiency in the treatment of Infectious Health Care Waste.

    Science.gov (United States)

    Maamari, Olivia; Mouaffak, Lara; Kamel, Ramza; Brandam, Cedric; Lteif, Roger; Salameh, Dominique

    2016-03-01

    Many studies show that the treatment of Infectious Health Care Waste (IHCW) in steam sterilization devices at usual operating standards does not allow for proper treatment of Infectious Health Care Waste (IHCW). Including a grinding component before sterilization allows better waste sterilization, but any hard metal object in the waste can damage the shredder. The first objective of the study is to verify that efficient IHCW treatment can occur at standard operating parameters defined by the contact time-temperature couple in steam treatment systems without a pre-mixing/fragmenting or pre-shredding step. The second objective is to establish scientifically whether the standard operation conditions for a steam treatment system including a step of pre-mixing/fragmenting were sufficient to destroy the bacterial spores in IHCW known to be the most difficult to treat. Results show that for efficient sterilization of dialysis cartridges in a pilot 60L steam treatment system, the process would require more than 20 min at 144°C without a pre-mixing/fragmenting step. In a 720L steam treatment system including pre-mixing/fragmenting paddles, only 10 min at 144°C are required to sterilize IHCW proved to be sterilization challenges such as dialysis cartridges and diapers in normal conditions of rolling. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. [Treatment of the infected wound with exposed silver-ring vascular graft and delayed Thiersch method of skin transplant covering ].

    Science.gov (United States)

    Nenezić, Dragoslav; Pandaitan, Simon; Ilijevski, Nenad; Matić, Predrag; Gajin, Predag; Radak, Dorde

    2005-01-01

    Although the incidence of prosthetic infection is low (1%-6%), the consequences (limb loss or death) are dramatic for a patient, with high mortality rate (25%-75%) and limb loss in 40%-75% of cases. In case of Szilagyi's grade III infection, standard procedure consists of the excision of prosthesis and wound debridement. Alternative method is medical treatment. This is a case report of a patient with prosthetic infection of Silver-ring graft, used for femoropopliteal reconstruction, in whom an extreme skin necrosis developed in early postoperative period. This complication was successfully treated medically. After repeated debridement and wound-packing, the wound was covered using Thiersch skin graft.

  18. Delayed-release oral suspension of omeprazole for the treatment of erosive esophagitis and gastroesophageal reflux disease in pediatric patients: a review

    Directory of Open Access Journals (Sweden)

    Alice Monzani

    2010-03-01

    Full Text Available Alice Monzani, Giuseppina Oderda1Department of Pediatrics, Università del Piemonte Orientale, Novara, ItalyAbstract: Omeprazole is a proton-pump inhibitor indicated for gastroesophageal reflux disease and erosive esophagitis treatment in children. The aim of this review was to evaluate the efficacy of delayed-release oral suspension of omeprazole in childhood esophagitis, in terms of symptom relief, reduction in reflux index and/or intragastric acidity, and endoscopic and/or histological healing. We systematically searched PubMed, Cochrane and EMBASE (1990 to 2009 and identified 59 potentially relevant articles, but only 12 articles were suitable to be included in our analysis. All the studies evaluated symptom relief and reported a median relief rate of 80.4% (range 35%–100%. Five studies reported a significant reduction of the esophageal reflux index within normal limits (<7% in all children, and 4 studies a significant reduction of intra-gastric acidity. The endoscopic healing rate, reported by 9 studies, was 84% after 8-week treatment and 95% after 12-week treatment, the latter being significantly higher than the histological healing rate (49%. In conclusion, omeprazole given at a dose ranging from 0.3 to 3.5 mg/kg once daily (median 1 mg/kg once daily for at least 12 weeks is highly effective in childhood esophagitis.Keywords: proton pump inhibitors, children, ranitidine, H2-blockers

  19. After Some Breast Cancer Treatments, Risk for Other Health Conditions May Rise

    Science.gov (United States)

    ... Skin Care Dining & Beverage Personal Care Services Sports & Outdoors Frequently Asked Questions 25th Anniversary Campaign Donors Share ... did not track how severe the co-existing health conditions were. What ... cases, the benefit of taking these treatments outweighs the potential risk ...

  20. Influence of long-term treatment with glyceryl trinitrate on remote ischemic conditioning

    DEFF Research Database (Denmark)

    Hauerslev, Marie; Mørk, Sivagowry Rasalingam; Pryds, Kasper

    2018-01-01

    Remote ischemic conditioning (RIC) protects against sustained myocardial ischemia. Due to overlapping mechanisms this protection may be altered by glyceryl trinitrate (GTN), which is commonly used in the treatment of patients with chronic ischemic heart disease. We investigated whether long-term ...

  1. Techniques of treatment or conditioning for waste arising from 131I production

    International Nuclear Information System (INIS)

    Dellamono, J.C.

    1989-07-01

    Distillation, evaporation/crystallization, direct immobilization and some chemical like precipitation and reduction were studied as techniques of treatment or conditioning for waste arising from 131 I production. The description of all techniques studied, as well as evaluation and discussion of the results are presented. (author) [pt

  2. Fear less : Individual differences in fear conditioning and their relation to treatment outcome in anxiety disorders

    NARCIS (Netherlands)

    Duits, P.|info:eu-repo/dai/nl/412437694

    2016-01-01

    Findings from animal and human experimental studies highlight the importance of fear conditioning processes in the development and treatment of anxiety disorders. The work reported in this thesis was focused on potential abnormalities in the acquisition and extinction of fear in patients with

  3. Effect of different seed treatments on maize seed germination parameters under optimal and suboptimal temperature conditions

    Directory of Open Access Journals (Sweden)

    Vujošević Bojana

    2017-01-01

    Full Text Available The aim of this study was to determine the effect of different seed treatments on germination parameters of three maize genotypes under optimal and suboptimal temperature conditions. Seed was treated with recommended doses of three commercial pesticide formulations: metalaxyl-m 10 g/L + fludioxonil 25 g/L, metalaxyl 20 g/kg + prothioconazole 100 g/kg and thiacloprid 400 g/L. Testing was conducted at 25°C and 15°C. Results of the study indicate that there are differences in response of maize genotypes to applied seed treatments, as well as to a specific treatment at optimal and suboptimal temperatures. Some treatments, depending on the mixing partner and temperature conditions, can affect final germination. In other cases, germination rate can be accelerated or prolonged, but with no effect on final germination. In order to provide fast and uniform emergence under different temperature conditions, further examination of the response of maize genotypes to specific seed treatments would be beneficial.

  4. [Affective bipolar disorder and ambivalence in relation to the drug treatment: analyzing the causal conditions].

    Science.gov (United States)

    Miasso, Adriana Inocenti; Cassiani, Silvia Helena De Bortoli; Pedrão, Luiz Jorge

    2011-04-01

    This study was performed with an aim to understand the conditions causing the ambivalence of the person with bipolar affective disorder (BAD) regarding following the drug treatment. A qualitative approach was used, with the Grounded Theory as the methodology framework, under the light of Symbolic Interactionism. Participants were 14 individuals with BAD who were being followed at an Outpatient Clinic for Mood Disorders of a university hospital and 14 relatives they indicated. Interviews and observation were the main forms of obtaining data. Results revealed three categories that described the referred causal conditions: experiencing the crises of the disorder; needing the drug; and living with the side effects of the drugs. It was found that there is a need to change the attitude of some health professionals from blaming the patient for interrupting the treatment to one of listening, valuing their symbolic and affective universe as well as the partnership in the treatment.

  5. Patient Perception of Treatment Burden is High in Celiac Disease Compared to Other Common Conditions

    Science.gov (United States)

    Shah, Sveta; Akbari, Mona; Vanga, Rohini; Kelly, Ciaran P.; Hansen, Joshua; Theethira, Thimmaiah; Tariq, Sohaib; Dennis, Melinda; Leffler, Daniel A.

    2014-01-01

    Introduction The only treatment for celiac disease (CD) is life-long adherence to a gluten-free diet (GFD). Noncompliance is associated with signs and symptoms of celiac disease, yet long-term adherence rates are poor. It is not known how the burden of the GFD compares to other medical treatments, and there are limited data on the socio-economic factors influencing treatment adherence. In this study we compared treatment burden and health state in CD compared with other chronic illnesses and evaluated the relationship between treatment burden and adherence. Methods A survey was mailed to participants with: CD, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), hypertension (HTN), diabetes mellitus (DM), congestive heart failure (CHF), and end stage renal disease on dialysis (ESRD). Surveys included demographic information and visual analog scales measuring treatment burden, importance of treatment, disease-specific and overall health status. Results We collected surveys from 341 celiac and 368 non-celiac participants. Celiac participants reported high treatment burden, greater than participants with GERD or HTN and comparable to ESRD. Conversely, patients with CD reported the highest health state of all groups. Factors associated with high treatment burden in CD included poor adherence, concern regarding food cost, eating outside the home, higher income, lack of college education and time limitations in preparing food. Poor adherence in CD was associated with increased symptoms, income, and low perceived importance of treatment. Discussion Participants with CD have high treatment burden but also excellent overall health status in comparison with other chronic medical conditions. The significant burden of dietary therapy for celiac disease argues for the need for safe adjuvant treatment as well as interventions designed to lower the perceived burden of the GFD. PMID:24980880

  6. Arsenic in an alkaline AMD treatment sludge: Characterization and stability under prolonged anoxic conditions

    International Nuclear Information System (INIS)

    Beauchemin, Suzanne; Fiset, Jean-Francois; Poirier, Glenn; Ablett, James

    2010-01-01

    Lime treatment of acid mine drainage (AMD) generates large volumes of neutralization sludge that are often stored under water covers. The sludge consists mainly of calcite, gypsum and a widespread ferrihydrite-like Fe phase with several associated species of metal(loid) contaminants. The long-term stability of metal(loid)s in this chemically ill-defined material remains unknown. In this study, the stability and speciation of As in AMD sludge subjected to prolonged anoxic conditions is determined. The total As concentration in the sludge is 300 mg kg -1 . In the laboratory, three distinct water cover treatments were imposed on the sludge to induce different redox conditions (100%N 2 , 100%N 2 + glucose, 95%N 2 :5%H 2 ). These treatments were compared against a control of oxidized, water-saturated sludge. Electron micro-probe (EMP) analysis and spatially resolved synchrotron X-ray fluorescence (SXRF) results indicate that As is dominantly associated with Fe in the sludge. In all treatments and throughout the experiment, measured concentrations of dissolved As were less than 5 μg L -1 . Dissolved Mn concentration in the N 2 + glucose treatment increased significantly compared to other treatments. Manganese and As K-edge X-ray absorption near edge structure spectroscopy (XANES) analyses showed that Mn was the redox-active element in the solid-phase, while As was stable. Arsenic(V) was still the dominant species in all water-covered sludges after 9 months of anoxic treatments. In contrast, Mn(IV) in the original sludge was partially reduced into Mn(II) in all water-covered sludges. The effect was most pronounced in the N 2 + glucose treatment, suggesting microbial reduction. Micro-scale SXRF and XANES analysis of the treated sludge showed that Mn(II) accumulated in areas already enriched in Fe and As. Overall, the study shows that AMD sludges remain stable under prolonged anoxic conditions. External sources of chemical reductants or soluble C were needed to induce

  7. Vitamin D for the treatment of chronic painful conditions in adults.

    Science.gov (United States)

    Straube, Sebastian; Derry, Sheena; Straube, Carmen; Moore, R Andrew

    2015-05-06

    This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 1, 2010) on 'Vitamin D for the treatment of chronic painful conditions in adults'.Vitamin D is produced in the skin after exposure to sunlight and can be obtained through food. Vitamin D deficiency has been linked with a range of conditions, including chronic pain. Observational and circumstantial evidence suggests that there may be a role for vitamin D deficiency in the aetiology of chronic painful conditions. To assess the efficacy and safety of vitamin D supplementation in chronic painful conditions when tested against placebo or against active comparators. For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE to February 2015. This was supplemented by searching the reference lists of retrieved articles, reviews in the field, and online trial registries. We included studies if they were randomised double-blind trials of vitamin D supplementation compared with placebo or with active comparators for the treatment of chronic painful conditions in adults. Two review authors independently selected the studies for inclusion, assessed methodological quality, and extracted data. We did not undertake pooled analysis due to the heterogeneity of the data. Primary outcomes of interest were pain responder outcomes, and secondary outcomes were treatment group average pain outcomes and adverse events. We included six new studies (517 participants) in this review update, bringing the total of included studies to 10 (811 participants). The studies were heterogeneous with regard to study quality, the chronic painful conditions that were investigated, the dose of vitamin D given, co-interventions, and the outcome measures reported. Only two studies reported responder pain outcomes; the other studies reported treatment group average outcomes only. Overall, there was no consistent pattern that vitamin D treatment was

  8. Asymptotics of a Steady-State Condition of Finite-Difference Approximation of a Logistic Equation with Delay and Small Diffusion

    Directory of Open Access Journals (Sweden)

    S. A. Kaschenko

    2014-01-01

    Full Text Available We study the dynamics of finite-difference approximation on spatial variables of a logistic equation with delay and diffusion. It is assumed that the diffusion coefficient is small and the Malthusian coefficient is large. The question of the existence and asymptotic behavior of attractors was studied with special asymptotic methods. It is shown that there is a rich array of different types of attractors in the phase space: leading centers, spiral waves, etc. The main asymptotic characteristics of all solutions from the corresponding attractors are adduced in this work. Typical graphics of wave fronts motion of different structures are represented in the article.

  9. Effect of non-specific prophylaxis of thrombogenic complications on delayed results of combined treatment of bladder carcinoma

    International Nuclear Information System (INIS)

    Popov, A.I.

    1987-01-01

    Altogether 106 patients with bladder carcinoma (Stage T 3 N x M 0 ) after combined treatment were followed-up for 5 yrs. Nicotonic acid and aspirin at common doses were adminstrated to 51 patients (the 1st group) during pre- and postoperative radiation therapy. The other 55 patients (the 2nd group) did not receive these drugs. Relapses were noted in 33.3% of the patients of the 1st group and in 76.3% of the patients of the 2nd group. The 5-year survival in the 1st group was 72.5% and in the 2nd group 27.4%. The administration of nicotonic acid and aspirin to patients during pre- and postoperative γ-beam therapy was shown to raise the body antitumor resistance

  10. Effect of magnesium treatment and glucose levels on delayed cerebral ischemia in patients with subarachnoid hemorrhage: a substudy of the Magnesium in Aneurysmal Subarachnoid Haemorrhage trial (MASH-II).

    Science.gov (United States)

    Leijenaar, Jolien F; Dorhout Mees, Sanne M; Algra, Ale; van den Bergh, Walter M; Rinkel, Gabriel J E

    2015-10-01

    Magnesium treatment did not improve outcome in patients with aneurysmal subarachnoid haemorrhage in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. We hypothesized that high glucose levels may have offset a potential beneficial effect to prevent delayed cerebral ischemia. We investigated if magnesium treatment led to less delayed cerebral ischemia and if glucose levels interacted with magnesium treatment in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. To investigate the effect of magnesium treatment on occurrence of delayed cerebral ischemia and the interaction between glucose levels and magnesium treatment in subarachnoid hemorrhage patients. The Magnesium in Aneurysmal Subarachnoid Haemorrhage was a phase III randomized placebo-controlled trial assessing the effect of magnesium sulphate on clinical outcome in aneurysmal subarachnoid hemorrhage patients. For the current study, we included only the patients admitted to the University Medical Centre-Utrecht. We calculated hazard ratios for occurrence of delayed cerebral ischemia in patients treated with magnesium vs. placebo for the entire study population, and separately in the subgroups of patients with high and low mean fasting and mean daily glucose levels until onset of delayed cerebral ischemia. We used the cross-product of magnesium and glucose in the regression analysis to evaluate whether an interaction between magnesium and glucose existed. We included 616 patients: 307 received magnesium and 309 placebo; 156 patients had delayed cerebral ischemia. Hazard ratio for magnesium on occurrence of delayed cerebral ischemia was 1·0 (95% confidence interval: 0·7-1·4). Results were similar in patients with low or high fasting or daily glucose levels. We found no interactions between magnesium treatment and high fasting (P = 0·54) and daily glucose (P = 0·60). Magnesium treatment did not reduce the risk of delayed cerebral ischemia in patients with aneurysmal

  11. Lag synchronization of chaotic systems with time-delayed linear ...

    Indian Academy of Sciences (India)

    delayed linear terms via impulsive control is investigated. Based on the stability theory of impulsive delayed differen- tial equations, some sufficient conditions are obtained guaranteeing the synchronized behaviours between two delayed chaotic ...

  12. Effect of tillage fertilizer treatments on maize fodder yield under rainfed conditions of Pakistan

    International Nuclear Information System (INIS)

    Khaliq, P.; Cheema, N.M.; Malik, M.A.

    2012-01-01

    The effect of deep and shallow tillage and fertilizer treatments i.e., recommended dose of fertilizer (RF), farm yard manure (FYM) and recommended dose of fertilizer plus farmyard manure (RF+FYM) on maize fodder yield was studied under rainfed conditions of Pakistan. It was observed that the emergence count m-2, maize fodder biomass, plant height, number of leaves per plant and maize fodder yield enhanced, with the application of RF+FYM. However, the effect of FYM+RF and recommended dose of fertilizer was statistically non-significant and on average basis RF+FYM treatment produced higher green fodder (19971.5 kg ha/sup -1/) than fodder yield of 18349.1 kg ha/sup -1/ produced by applying recommended dose of fertilizer. However, green fodder yield produced with these two fertilizer treatments were significantly higher than that of the FYM and control treatments. The FYM treatment gave lowest fodder yield (16997 kg ha/sup -1/) and was significantly lower than the fodder yield (17278.7 kg ha/sup -1/) obtained in control treatment. The nutrient availability in RF+FYM treatment significantly increased the biomass production, however, application of FYM promoted the weed infestation that reduced the green fodder yield of maize, but it improved the overall forage yield as recorded in RF+FYM treatment. The effect of deep tillage on maize fodder yield was non-significant. (author)

  13. Treatment of Household Waste in Small Towns of China: Status, Basic Conditions and Appropriate Modes

    Directory of Open Access Journals (Sweden)

    HE Pin-jing

    2015-04-01

    Full Text Available Small town is the gateway of population migrating from rural areas to urban areas in the process of urbanization. The level of its household solid waste treatment is pivotal to the environmental and sanitary quality of surrounding rural areas. Furthermore, small town is the primary administrative center for rural districts, and will impose important influences on the solid waste management in villages. Therefore, it is necessary to investigate the effects of treatment modes on the household solid waste treatment in towns and surrounding villages. Based on the waste generation in small towns, this study analyzed the current status and existing problems for solid waste treatment, and discussed the related administrative management and financial supporting conditions in small towns. By summarizing the characteristics of the existing modes and comparing the costs for different treatment modes, the present study proposed that the most appropriate mode was“diversion in villages-diversion, transportation or treatment in towns-treatment and disposal in counties”, in which the town was the core node for the treatment of rural solid waste, so that the administrative and financial advantages of small towns could be highlighted and consequentially promoted the management of rural solid waste.

  14. Treatment outcomes for isoniazid-resistant tuberculosis under program conditions in British Columbia, Canada.

    Science.gov (United States)

    Romanowski, Kamila; Chiang, Leslie Y; Roth, David Z; Krajden, Mel; Tang, Patrick; Cook, Victoria J; Johnston, James C

    2017-09-04

    Every year, over 1 million people develop isoniazid (INH) resistant tuberculosis (TB). Yet, the optimal treatment regimen remains unclear. Given increasing prevalence, the clinical efficacy of regimens used by physicians is of interest. This study aims to examine treatment outcomes of INH resistant TB patients, treated under programmatic conditions in British Columbia, Canada. Medical charts were retrospectively reviewed for cases of culture-confirmed INH mono-resistant TB reported to the BC Centre for Disease Control (BCCDC) from 2002 to 2014. Treatment regimens, patient and strain characteristics, and clinical outcomes were analysed. One hundred sixty five cases of INH mono-resistant TB were included in analysis and over 30 different treatment regimens were prescribed. Median treatment duration was 10.5 months (IQR 9-12 months) and treatment was extended beyond 12 months for 26 patients (15.8%). Fifty six patients (22.6%) experienced an adverse event that resulted in a drug regimen modification. Overall, 140 patients (84.8%) had a successful treatment outcome while 12 (7.2%) had an unsuccessful treatment outcome of failure (n = 2; 1.2%), relapse (n = 4; 2.4%) or all cause mortality (n = 6; 3.6%). Our treatment outcomes, while consistent with findings reported from other studies in high resource settings, raise concerns about current recommendations for INH resistant TB treatment. Only a small proportion of patients completed the recommended treatment regimens. High quality studies to confirm the effectiveness of standardized regimens are urgently needed, with special consideration given to trials utilizing fluoroquinolones.

  15. Impact of antiviral treatment and hospital admission delay on risk of death associated with 2009 A/H1N1 pandemic influenza in Mexico

    Directory of Open Access Journals (Sweden)

    Chowell Gerardo

    2012-04-01

    Mexican Social Security system, April-December 2009. We considered a spectrum of disease severity encompassing outpatient visits, hospitalizations, and deaths, and recorded demographic and geographic information on individual patients. We assessed the impact of neuraminidase inhibitor treatment and hospital admission delay (≤ > 2 days after disease onset on the risk of death by multivariate logistic regression. Results Approximately 50% of all A/H1N1-positive patients received antiviral medication during the Spring and Summer 2009 pandemic waves in Mexico while only 9% of A/H1N1 cases received antiviral medications during the fall wave (P  Conclusions Our findings underscore the potential impact of decreasing admission delays and increasing antiviral use to mitigate the mortality burden of future influenza pandemics.

  16. French practice and trends in the treatment and conditioning of PWR liquid effluents and solid wastes

    International Nuclear Information System (INIS)

    Celeri, J.J.; Pottier, P.; Sousselier, Y.

    1982-01-01

    From the early stages of the development of the nuclear industry in France, it has been decided to avoid radioactive effluent release by treatment, conditioning and storage of the wastes. It was not possible, when choosing this option, to reach the optimum from the beginning for the whole management system. The selection of a treatment process requires a precise knowledge of the nature, the composition and the arisings of radioactive wastes and these data are only available when commercial size reactors are in operation. To solve this problem, a close collaboration has been developed between the nuclear station operators and the R and D laboratories in charge of studying new treatment methods. This cooperation is a fruitful permanent exchange giving precise data about the waste, results of treatment operation on the industrial units, allowing modification in the installations to improve their efficiency and sometimes, resulting in new trends for the research program

  17. Choice between delayed food and immediate oxycodone in rats.

    Science.gov (United States)

    Secci, Maria E; Factor, Julie A; Schindler, Charles W; Panlilio, Leigh V

    2016-12-01

    The choice to seek immediate drug effects instead of more meaningful but delayed rewards is a defining feature of addiction. To develop a rodent model of this behavior, we allowed rats to choose between immediate intravenous delivery of the prescription opioid oxycodone (50 μg/kg) and delayed delivery of palatable food pellets. Rats preferred food at delays up to 30 s, but they chose oxycodone and food equally at 60-s delay and preferred oxycodone over food at 120-s delay. Comparison of food-drug choice, food-only, and drug-only conditions indicated that food availability decreased drug intake, but drug availability increased food intake. In the food-only condition, food was effective as a reinforcer even when delayed by 120 s. Pre-session feeding with chow slowed acquisition of food and drug self-administration, but did not affect choice. To establish procedures for testing potential anti-addiction medications, noncontingent pre-treatment with oxycodone or naltrexone (analogous to substitution and antagonist therapies, respectively) were tested on a baseline in which oxycodone was preferred over delayed food. Naltrexone pre-treatment decreased drug intake and increased food intake. Oxycodone pre-treatment decreased drug intake, but also produced extended periods with no food or drug responding. These findings show that the contingencies that induce preference for drugs over more meaningful but less immediate rewards in humans can be modeled in rodents, and they suggest that the model could be useful for assessing the therapeutic potential of treatments and exploring the underlying behavioral and neural mechanisms involved in addiction.

  18. Chronic treatment with fluoxetine prevents the return of extinguished auditory-cued conditioned fear.

    Science.gov (United States)

    Deschaux, Olivier; Spennato, Guillaume; Moreau, Jean-Luc; Garcia, René

    2011-05-01

    We have recently shown that post-extinction exposure of rats to a sub-threshold reminder shock can reactivate extinguished context-related freezing and found that chronic treatment with fluoxetine before fear extinction prevents this phenomenon. In the present study, we examined whether these findings would be confirmed with auditory fear conditioning. Rats were initially submitted to a session of five tone-shock pairings with either a 0.7- or 0.1-mA shock and underwent, 3 days later, a session of 20 tone-alone trials. At the beginning of this latter session, we observed cue-conditioned freezing in rats that received the strong, but not the weak, shock. At the end, both groups (strong and weak shocks) displayed similar low levels of freezing, indicating fear extinction in rats exposed to the strong shock. These rats exhibited again high levels of cue-evoked freezing when exposed to three tone-shock pairings with 0.1-mA shock. This reemergence of cue-conditioned fear was completely abolished by chronic (over a 21-day period) fluoxetine treatment which spared, when administered before the initial fear conditioning, the original tone-shock association. These data extend our previous findings and suggest that chronic fluoxetine treatment favor extinction memory by dampening the reactivation of the original tone-shock association.

  19. Clinical outcome comparison of immediate blanket treatment versus a delayed pathogen-based treatment protocol for clinical mastitis in a New York dairy herd.

    Science.gov (United States)

    Vasquez, A K; Nydam, D V; Capel, M B; Eicker, S; Virkler, P D

    2017-04-01

    The purpose was to compare immediate intramammary antimicrobial treatment of all cases of clinical mastitis with a selective treatment protocol based on 24-h culture results. The study was conducted at a 3,500-cow commercial farm in New York. Using a randomized design, mild to moderate clinical mastitis cases were assigned to either the blanket therapy or pathogen-based therapy group. Cows in the blanket therapy group received immediate on-label intramammary treatment with ceftiofur hydrochloride for 5 d. Upon receipt of 24 h culture results, cows in the pathogen-based group followed a protocol automatically assigned via Dairy Comp 305 (Valley Agricultural Software, Tulare, CA): Staphylococcus spp., Streptococcus spp., or Enterococcus spp. were administered on-label intramammary treatment with cephapirin sodium for 1 d. Others, including cows with no-growth or gram-negative results, received no treatment. A total of 725 cases of clinical mastitis were observed; 114 cows were not enrolled due to severity. An additional 122 cases did not meet inclusion criteria. Distribution of treatments for the 489 qualifying events was equal between groups (pathogen-based, n = 246; blanket, n = 243). The proportions of cases assigned to the blanket and pathogen-based groups that received intramammary therapy were 100 and 32%, respectively. No significant differences existed between blanket therapy and pathogen-based therapy in days to clinical cure; means were 4.8 and 4.5 d, respectively. The difference in post-event milk production between groups was not statistically significant (blanket therapy = 34.7 kg; pathogen-based = 35.4 kg). No differences were observed in test-day linear scores between groups; least squares means of linear scores was 4.3 for pathogen-based cows and 4.2 for blanket therapy cows. Odds of survival 30 d postenrollment was similar between groups (odds ratio of pathogen-based = 1.6; 95% confidence interval: 0.7-3.7) as was odds of survival to 60 d (odds ratio

  20. Permissible Delay in Payments

    Directory of Open Access Journals (Sweden)

    Yung-Fu Huang

    2007-01-01

    Full Text Available The main purpose of this paper wants to investigate the optimal retailer's lot-sizing policy with two warehouses under partially permissible delay in payments within the economic order quantity (EOQ framework. In this paper, we want to extend that fully permissible delay in payments to the supplier would offer the retailer partially permissible delay in payments. That is, the retailer must make a partial payment to the supplier when the order is received. Then the retailer must pay off the remaining balance at the end of the permissible delay period. In addition, we want to add the assumption that the retailer's storage space is limited. That is, the retailer will rent the warehouse to store these exceeding items when the order quantity is larger than retailer's storage space. Under these conditions, we model the retailer's inventory system as a cost minimization problem to determine the retailer's optimal cycle time and optimal order quantity. Three theorems are developed to efficiently determine the optimal replenishment policy for the retailer. Finally, numerical examples are given to illustrate these theorems and obtained a lot of managerial insights.

  1. Delayed ejaculation

    Science.gov (United States)

    ... partner Conditioning caused by a habit of excessive masturbation Traumatic events (such as being discovered masturbating or ... cause. (Examples of stimulation may include wet dreams, masturbation, or intercourse.) See a therapist who specializes in ...

  2. Impact of the environmental conditions and substrate pre-treatment on whey protein hydrolysis: A review.

    Science.gov (United States)

    Cheison, Seronei Chelulei; Kulozik, Ulrich

    2017-01-22

    Proteins in solution are subject to myriad forces stemming from interactions with each other as well as with the solvent media. The role of the environmental conditions, namely pH, temperature, ionic strength remains under-estimated yet it impacts protein conformations and consequently its interaction with, and susceptibility to, the enzyme. Enzymes, being proteins are also amenable to the environmental conditions because they are either activated or denatured depending on the choice of the conditions. Furthermore, enzyme specificity is restricted to a narrow regime of optimal conditions while opportunities outside the optimum conditions remain untapped. In addition, the composition of protein substrate (whether mixed or single purified) have been underestimated in previous studies. In addition, protein pre-treatment methods like heat denaturation prior to hydrolysis is a complex phenomenon whose progression is influenced by the environmental conditions including the presence or absence of sugars like lactose, ionic strength, purity of the protein, and the molecular structure of the mixed proteins particularly presence of free thiol groups. In this review, we revisit protein hydrolysis with a focus on the impact of the hydrolysis environment and show that preference of peptide bonds and/or one protein over another during hydrolysis is driven by the environmental conditions. Likewise, heat-denaturing is a process which is dependent on not only the environment but the presence or absence of other proteins.

  3. The dominance of thermocicling treatments conditions on microplastic of spheral ground up powder beryllium

    International Nuclear Information System (INIS)

    Ivantsov, V.I.

    2003-01-01

    The dominance of thermocicling treatments conditions on structure,electrical resistance,microplastic characteristics and behavior in the microdeformation area of beryllium was investigated. It is established, that TC causes considerable structural changes in beryllium at the upper thermocicling temperature exceeding 523 K. Attached to upper TC temperature less then 523 K it is observed hardening of metal, conditioned by processes of twining and relaxation of micro stresses in overstrained micro volumes. The temperature range of TC determinate the stage evolution of the flow and the deformation hardening at different stages defined by changes in the beryllium structure caused by processing

  4. Elite athletes and pubertal delay.

    Science.gov (United States)

    Kapczuk, Karina

    2017-10-01

    Intensive physical training and participation in competitive sports during childhood and early adolescence may affect athletes' pubertal development. On the other hand, pubertal timing, early or late, may impact on an athlete selection for a particular sport. Genetic predisposition, training load, nutritional status and psychological stress determine athletes' pubertal timing. Athletes that practice esthetic sports, especially gymnasts, are predisposed to a delay in pubertal development. The growing evidence indicates that energy deficiency, not a systemic training per se, plays a crucial role in the pathogenesis of functional hypothalamic hypogonadism in female athletes. Metabolic and psychologic stress activate hypothalamic-pituitary-adrenal axis and suppress hypothalamic-pituitary-ovarian axis. Female athletes who do not begin secondary sexual development by the age of 14 or menstruation by the age of 16 warrant a comprehensive evaluation and a targeted treatment. Somatic growth and sexual maturation of elite female athletes are largely sport-specific since each sport favors a particular somatotype and requires a specific training. Chronic negative energy balance resulting from a systemic physical training and inadequate energy intake may delay pubertal development in elite athletes. Youth athletes, especially those engaged in competitive sports that emphasize prepubertal or lean appearance, are at risk of developing relative energy deficiency in sport associated with disordered eating or eating disorders. Management strategies should address the complex conditions underlying functional hypothalamic hypogonadism.

  5. Delay-dependent exponential stability of cellular neural networks with time-varying delays

    International Nuclear Information System (INIS)

    Zhang Qiang; Wei Xiaopeng; Xu Jin

    2005-01-01

    The global exponential stability of cellular neural networks (CNNs) with time-varying delays is analyzed. Two new sufficient conditions ensuring global exponential stability for delayed CNNs are obtained. The conditions presented here are related to the size of delay. The stability results improve the earlier publications. Two examples are given to demonstrate the effectiveness of the obtained results

  6. Combined heat and gamma-irradiation treatments for the control of strawberry diseases under market conditions

    International Nuclear Information System (INIS)

    Brodrick, H.T.; Thomas, A.C.; Van Tonder, A.J.; Terblanche, J.C.

    1977-02-01

    The spoilage of strawberries under local market conditions was investigated. It was confirmed that the major losses are due to 'leak' disease caused by Rhizopus stolonifer (Ehr. ex Fr.) Lind. It was also established that further fruit losses in summer are due to anthracnose caused by the fungus Colletotrichum acutatum Simmonds. This is the first time that the latter pathogen has been isolated and identified and recognised as a problem on strawberries in South Africa. Studies with R. stolonifer in culture showed that 46 degrees Celsius for 20 min (the previous international standard heat treatment for fruit) was disappointing, while a treatment at 50 degrees Celsius for 10 min effectively inhibited spore germination. Irradiation studies with cultures of R. stolonifer and C. acutatum showed that a dose of 200 and 100 krad, respectively, resulted in excellent inhibition of spore germination. However, irradiating in nitrogen gas resulted in a tenfold reduction in the effectiveness of the irradiation treatments. The use of nitrogen during irradiation, therefore, cannot be considered, especially where an effective control of the fungal pathogens is desired. Investigations with different cultivars clearly demonstrated the synergistic effect on disease control obtained when combining heat and irradiation treatments. The combination treatment (moist heat at 50-52 degrees Celsius for 10 min plus 200 krad), besides effectively controlling both diseases in strawberries, did not adversely affect berry quality. In simulated transport tests it was shown that a minimal amount of berry softening did occur with this treatment, but this adverse effect was negligible compared with the beneficial effect obtained from disease control. In semi-commercial experiments it was shown that the combination heat and irradiation treatment effectively controlled spoilage diseases for a period of several days from picking, thus allowing sufficient time to market the fruit under local market

  7. Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum.

    Science.gov (United States)

    Fejzo, Marlena S; Magtira, Aromalyn; Schoenberg, Frederic Paik; Macgibbon, Kimber; Mullin, Patrick M

    2015-06-01

    The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum (HG) and to identify prognostic factors for these disorders. Neurodevelopmental outcomes of 312 children from 203 mothers with HG were compared to neurodevelopmental outcomes from 169 children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors. Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. Children exposed in utero to HG have a 3.28-fold increase in odds of a neurodevelopmental diagnosis including attention disorders, learning delay, sensory disorders, and speech and language delay (Pneurodevelopmental delay. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder. However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role. There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Defining treatment conditions for pulsed electric field pasteurization of apple juice.

    Science.gov (United States)

    Saldaña, G; Puértolas, E; Monfort, S; Raso, J; Alvarez, I

    2011-11-15

    The influence of temperature and the presence of N(α)-lauroyl ethylester (ethyl lauroyl arginate, LAE) on the inactivation caused by continuous pulsed electric field treatments (PEF) in Escherichia coli O157:H7 suspended in apple juice have been investigated to define treatment conditions applicable at industrial scale that promote an equivalent safety level when compared with thermal processing. In the range of experimental conditions investigated (outlet temperature: 20-40 °C, electric field strength: 20-30 kV, treatment time: 5-125 μs) at outlet temperatures equal or lower than 55±1 °C, the inactivation of E. coli O157:H7 treated in apple juice ranged from 0.4 to 3.6 Log₁₀ cycles reduction and treated in apple juice supplemented with LAE (50 ppm) ranged from 0.9 to 6.7 Log₁₀ cycles reduction. An empirical mathematical model was developed to estimate the treatment time and total specific energy input to obtain 5 Log₁₀ cycles reduction in the population of E. coli O157:H7 suspended in apple juice supplemented with 50 ppm of LAE at different electric field strengths and inlet temperatures. Treatment conditions established for E. coli O157:H7 were validated with other PEF resistant Gram-positive (Listeria monocytogenes, and Staphylococcus aureus) and Gram-negative (Salmonella enterica serovar Typhimurium) strains. When the treatment was applied to the apple juice, a treatment of 25 kV/cm for 63 μs corresponding with an outlet temperature of 65 °C and input energy of 125 kJ/kg was required to achieve more than 5 Log₁₀ cycles in the four strains investigated. The addition of LAE reduced the treatment time required to obtain an equivalent inactivation (>5 Log₁₀ cycles) in the four microorganisms to 38.4 μs, the outlet temperature to 55 °C, and the input energy to 83.2 kJ/kg. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Optimisation of treatment, storage and disposal strategies for (unconditioned and conditioned) radioactive waste

    International Nuclear Information System (INIS)

    Bealby, J.

    1989-03-01

    This study examines the trade-offs involved between unconditioned and conditioned waste storage, by investigating the effects of different cost and environmental minimisation strategies on radioactive waste treatment and disposal strategies. The costs and environmental impacts from storage (unconditioned and conditioned), conditioning, transport and disposal are examined. A single generic mixed Magnox/AGR site is investigated, assuming a moderate nuclear power growth scenario over the period 1986 to 2030. Assessments have been performed for four weighting sets which cover the range of views perceived to exist about the relative importance of cost and environmental impact reduction. The base case conditioning option considers the availability of a LLW low force compaction plant in 1986 and two ILW conditioning plants (cement encapsulation and dissolution) in 1990. A base case set of disposal options considers the options of disposal to shallow land and burial facility and deep cavity facilities. The study investigates the effect of deferring the opening dates of the conditioning plants. A set of sensitivity studies show that the assessments are robust to the assumptions and impact parameters used. (author)

  10. Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: personal experience and review.

    Science.gov (United States)

    Levy, Lauren L; Emer, Jason J

    2012-01-01

    Recent studies highlighting the psychological benefits of medical treatment for dermatological skin conditions have demonstrated a clear role for medical therapy in psychological health. Skin conditions, particularly those that are overtly visible, such as those located on the face, neck, and hands, often have a profound effect on the daily functioning of those affected. The literature documents significant emotional benefits using medical therapy in conditions such as acne, psoriasis, vitiligo, and rosacea, but there is little evidence documenting similar results with the use of cosmetic camouflage. Here we present a review highlighting the practical use of cosmetic camouflage makeup in patients with facial skin conditions and review its implications for psychological health. A search of the Medline and Scopus databases was performed to identify articles documenting the emotional benefit of cosmetic camouflage. Cosmetic camouflage provides a significant emotional benefit for patients with facial skin conditions, and this is substantiated by a literature review and personal experience. More clinical studies are needed to assess and validate the findings reported here. Patients with visible skin conditions have increased rates of depression, anxiety, and decreased self-esteem. It is prudent for us to consider therapies that can offer rapid and dramatic results, such as cosmetic camouflage.

  11. Selection of hydrothermal pre-treatment conditions of waste sludge destruction using multicriteria decision-making.

    Science.gov (United States)

    Al-Shiekh Khalil, Wael; Shanableh, Abdullah; Rigby, Portia; Kokot, Serge

    2005-04-01

    The effectiveness of hydrothermal treatment for the destruction of the organic content of sludge waste was investigated. The sludge sampled in this study contained approximately 2% solids. The experimental program consisted of hydrothermal treatment experiments conducted in a batch reactor at temperatures between 100 and 250 degrees C, with the addition of an oxidant (hydrogen peroxide) in the range of 0-150% with reference to TCOD, and reaction times of up to 60 min. The results suggested that the availability of oxidant, reaction temperature and reaction time were the determining factors for COD removal. A significant fraction of the COD remaining after treatment consisted of the dissolved COD. The results confirmed that hydrothermal treatment proceeds through hydrolysis resulting in the production of dissolved organic products followed by COD removal through oxidation. Two MCDM chemometrics methods, PROMETHEE and GAIA, were applied to process the large data matrix so as to facilitate the selection of the most suitable hydrothermal conditions for sludge destruction. Two possible scenarios were produced from this analysis-one depended on the use of high temperatures and no oxidant, while the second offered a choice of compromise solutions at lower temperatures but with the use of at least some oxidant. Thus, for the final choice of operating conditions, the decision maker needs local knowledge of the costs and available infrastructure. In principle, such information could be added as further criteria to the data matrix and new rankings obtained.

  12. Studies on cement matrix materials used at the Radioactive Waste Treatment Plant for radwaste conditioning

    International Nuclear Information System (INIS)

    Dragolici, Felicia; Lungu, Laura; Nicu, Mihaela; Rotarescu, Gheorghe; Turcanu, Corneliu

    2003-01-01

    The research activities performed by Department of Radioactive Waste Management is focused on the treatment of LLAW products obtained by chemical precipitation and on the conditioning of these products by cementation. The individual mechanisms implied in the chemical precipitation processes are directly dependent on the precipitate properties and structure, which in turn are connected with the initial system composition and the precipitation procedure, i.e. reagent concentration, rate and orders of chemical addition, mixing rate and time and ageing conditions. In case of conditioning by cementation, the chemical nature and proportion of the sludges or concentrates affect both the hydrolysis of the initial cement components and the reactions of metastable hydration constituents, as well as the mechanical strength and chemical resistance of the hardened cemented matrix.Generally, the study of the precipitation products and their behaviour during cementation and the long-term disposal is extremely difficult because of the system complexity (phase composition and structure) and the lack of the non-destructive analytical methods. The experience accumulated by the countries who advanced nuclear programmes in military and socio-economic fields and which produced important volumes of radioactive wastes, leads us to study some of mineral additives to be used in the conditioning and disposal technology. Is well known that some mineral additives can diminish the leaching rate of the radionuclides in the disposal environment.The studies have the purpose to obtain the most propitious mixture of cement-bentonite and cement-volcanic tuff, which have the mechanical properties similar to the cement paste used for the conditioning of radioactive waste.Taking into account the characteristics of these mineral binders, namely a very good plasticity and capacity of adsorption, which lead at the decrease of porosity, the mixture is planned to be used in the future, at the Radioactive

  13. Delayed traumatic intracranial hematoma

    International Nuclear Information System (INIS)

    Tomita, Hiroki

    1984-01-01

    CT was performed serially within 24 hours after head injury in 64 patients having Glasgow Coma Scale of 14 or less or cranial fracture shown on roentgenogram. Delayed traumatic extradural hematoma was observed within 7-12 hours after head injury in 6 cases (9.4%). This was prominent in the frontal and occipital regions (67%). Good recovery was seen in 83.3%. Delayed traumatic intracerebral hematoma was observed within 6-24 hours after head injury in 17 cases (26.6%). This higher incidence was related to contre coup injury. Conservative treatment was possible in 14 of the 17 patients (82.4%), showing good recovery in 70%. (Namekawa, K.)

  14. Treatment with anti-C5aR mAb leads to early-onset clinical and mechanistic effects in the murine delayed-type hypersensitivity arthritis model

    DEFF Research Database (Denmark)

    Atkinson, Sara Marie; Nansen, Anneline; Usher, Pernille A.

    2015-01-01

    Blockade of the complement cascade at the C5a/C5a receptor (C5aR)-axis is believed to be an attractive treatment avenue in rheumatoid arthritis (RA). However, the effects of such interventions during the early phases of arthritis remain to be clarified. In this study we use the murine delayed-typ...

  15. Effect of magnesium treatment and glucose levels on delayed cerebral ischemia in patients with subarachnoid hemorrhage : a substudy of the Magnesium in Aneurysmal Subarachnoid Haemorrhage trial (MASH-II)

    NARCIS (Netherlands)

    Leijenaar, Jolien F.; Mees, Sanne M. Dorhout; Algra, Ale; van den Bergh, Walter M.; Rinkel, Gabriel J. E.

    2015-01-01

    BackgroundMagnesium treatment did not improve outcome in patients with aneurysmal subarachnoid haemorrhage in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. We hypothesized that high glucose levels may have offset a potential beneficial effect to prevent delayed cerebral ischemia. We

  16. Detailed Analysis of Apoptosis and Delayed Luminescence of Human Leukemia Jurkat T Cells after Proton Irradiation and Treatments with Oxidant Agents and Flavonoids

    Directory of Open Access Journals (Sweden)

    Irina Baran

    2012-01-01

    Full Text Available Following previous work, we investigated in more detail the relationship between apoptosis and delayed luminescence (DL in human leukemia Jurkat T cells under a wide variety of treatments. We used menadione and hydrogen peroxide to induce oxidative stress and two flavonoids, quercetin, and epigallocatechin gallate, applied alone or in combination with menadione or H2O2. 62 MeV proton beams were used to irradiate cells under a uniform dose of 2 or 10 Gy, respectively. We assessed apoptosis, cell cycle distributions, and DL. Menadione, H2O2 and quercetin were potent inducers of apoptosis and DL inhibitors. Quercetin decreased clonogenic survival and the NAD(PH level in a dose-dependent manner. Proton irradiation with 2 Gy but not 10 Gy increased the apoptotic rate. However, both doses induced a substantial G2/M arrest. Quercetin reduced apoptosis and prolonged the G2/M arrest induced by radiation. DL spectroscopy indicated that proton irradiation disrupted the electron flow within Complex I of the mitochondrial respiratory chain, thus explaining the massive necrosis induced by 10 Gy of protons and also suggested an equivalent action of menadione and quercetin at the level of the Fe/S center N2, which may be mediated by their binding to a common site within Complex I, probably the rotenone-binding site.

  17. Predictors of Delayed Antiretroviral Therapy Initiation, Mortality, and Loss to Followup in HIV Infected Patients Eligible for HIV Treatment: Data from an HIV Cohort Study in India

    Directory of Open Access Journals (Sweden)

    Gerardo Alvarez-Uria

    2013-01-01

    Full Text Available Studies from Sub-Saharan Africa have shown that a substantial number of HIV patients eligible for antiretroviral therapy (ART do not start treatment. However, data from other low- or middle-income countries are scarce. In this study, we describe the outcomes of 4105 HIV patients who became ART eligible from January 2007 to November 2011 in an HIV cohort study in India. After three years of ART eligibility, 78.4% started ART, 9.3% died before ART initiation, and 10.3% were lost to followup. Diagnosis of tuberculosis, being homeless, lower CD4 count, longer duration of pre-ART care, belonging to a disadvantaged community, being widowed, and not living near a town were associated with delayed ART initiation. Diagnosis of tuberculosis, being homeless, lower CD4 count, shorter duration of pre-ART care, belonging to a disadvantaged community, illiteracy, and age >45 years were associated with mortality. Being homeless, being single, not living near a town, having a CD4 count <150 cells/μL, and shorter duration of pre-ART care were associated with loss to followup. These results highlight the need to improve the timely initiation of ART in HIV programmes in India, especially in ART eligible patients with tuberculosis, low CD4 counts, living in rural areas, or having a low socioeconomic status.

  18. Apomorphine conditioning and sensitization: the paired/unpaired treatment order as a new major determinant of drug conditioned and sensitization effects.

    Science.gov (United States)

    de Matos, Liana Wermelinger; Carey, Robert J; Carrera, Marinete Pinheiro

    2010-09-01

    Repeated treatments with psychostimulant drugs generate behavioral sensitization. In the present study we employed a paired/unpaired protocol to assess the effects of repeated apomorphine (2.0 mg/kg) treatments upon locomotion behavior. In the first experiment we assessed the effects of conditioning upon apomorphine sensitization. Neither the extinction of the conditioned response nor a counter-conditioning procedure in which we paired an inhibitory treatment (apomorphine 0.05 mg/kg) with the previously established conditioned stimulus modified the sensitization response. In the second experiment, we administered the paired/unpaired protocol in two phases. In the second phase, we reversed the paired/unpaired protocol. Following the first phase, the paired group alone exhibited conditioned locomotion in the vehicle test and a sensitization response. In the second phase, the initial unpaired group which received 5 paired apomorphine trials during the reversal phase did not develop a conditioned response but developed a potentiated sensitization response. This disassociation of the conditioned response from the sensitization response is attributed to an apomorphine anti-habituation effect that can generate a false positive Pavlovian conditioned response effect. The potentiated sensitization response induced by the treatment reversal protocol points to an important role for the sequential experience of the paired/unpaired protocol in behavioral sensitization. 2010 Elsevier Inc. All rights reserved.

  19. Effect of Temperature, Pressure and Equivalence Ratio on Ignition Delay in Ignition Quality Tester (IQT): Diesel,n-Heptane, andiso-Octane Fuels under Low Temperature Conditions

    KAUST Repository

    Yang, Seung Yeon; Naser, Nimal; Chung, Suk-Ho; Cha, Junepyo

    2015-01-01

    -octane in relatively low temperature conditions to simulate unsteady spray ignition behavior. A KAUST Research ignition quality tester (KR-IQT) was utilized, which has a feature of varying temperature, pressure and equivalence ratio using a variable displacement fuel

  20. IMPORTANCE OF STORAGE CONDITIONS AND SEED TREATMENT FOR SUNFLOWER HYBRIDS SEEDS GERMINATION

    Directory of Open Access Journals (Sweden)

    Goran Krizmanić

    2014-12-01

    Full Text Available In this research we have determined germination energy and germination of seeds of sunflower hybrids ‘Luka’ and ‘Apolon’, at the beginning of storage and 6, 12 and 18 months after of storage period (2011-2012 in the floor concrete storage at two different air temperatures and humidity (S-1: air temperature 15-18°C and relative air humidity 65-70% as well as in climate chamber (S-2: air temperature 10-12°C and relative air humidity 60-65%, stored in four treatments (Control: processed-untreated seed; T-1: treated with A.I. metalaxyl-M; T-2: treated with A.I. metalaxyl-M + A.I. imidacloprid and T-3: treated with A.I. metalaxyl-M + A.I. clothianidin. Based on the obtained results we have determined that sunflower hybrid ‘Luka’, compared to hybrid ‘Apolon’, in the given storage conditions and with the same seed treatment has 5-8% higher germination energy and seed germination and that in climate chamber both hybrids have 5-7% higher germination energy. Seed treatment of both sunflower hybrids with A.I. imidacloprid maximally reduced initial germination energy and seed germination in all tested periods and conditions of storage. On the average, natural seed, after 18 months of storage did not have better seed quality compared to seed treated with A.I. metalaxyl-M while other treatments had more significant influence on reduction of germination energy and seed germination, 6-15%. On the average, compared to other variants, seeds treated with A.I. metalaxyl-M after 18 months of storage in both storage conditions had higher germination energy by 4-15%, and seed germination by 2-12%.

  1. Effect of treatment with cyclophosphamide in low doses upon the onset of delayed type hypersensitivity in mice chronically infected with Trypanosoma cruzi: involvement of heart interstitial dendritic cells

    Directory of Open Access Journals (Sweden)

    Torriceli Souza The

    2013-09-01

    Full Text Available Acute infection with Trypanosoma cruzi results in intense myocarditis, which progresses to a chronic, asymptomatic indeterminate form. The evolution toward this chronic cardiac form occurs in approximately 30% of all cases of T. cruzi infection. Suppression of delayed type hypersensitivity (DTH has been proposed as a potential explanation of the indeterminate form. We investigated the effect of cyclophosphamide (CYCL treatment on the regulatory mechanism of DTH and the participation of heart interstitial dendritic cells (IDCs in this process using BALB/c mice chronically infected with T. cruzi. One group was treated with CYCL (20 mg/kg body weight for one month. A DTH skin test was performed by intradermal injection of T. cruzi antigen (3 mg/mL in the hind-footpad and measured the skin thickness after 24 h, 48 h and 72 h. The skin test revealed increased thickness in antigen-injected footpads, which was more evident in the mice treated with CYCL than in those mice that did not receive treatment. The thickened regions were characterised by perivascular infiltrates and areas of necrosis. Intense lesions of the myocardium were present in three/16 cases and included large areas of necrosis. Morphometric evaluation of lymphocytes showed a predominance of TCD8 cells. Heart IDCs were immunolabelled with specific antibodies (CD11b and CD11c and T. cruzi antigens were detected using a specific anti-T. cruzi antibody. Identification of T. cruzi antigens, sequestered in these cells using specific anti-T. cruzi antibodies was done, showing a significant increase in the number of these cells in treated mice. These results indicate that IDCs participate in the regulatory mechanisms of DTH response to T. cruzi infection.

  2. [Multistep surgery for spondylosyndesis. Treatment concept of destructive spondylodiscitis in patients with reduced general condition].

    Science.gov (United States)

    Isenberg, J; Jubel, A; Hahn, U; Seifert, H; Prokop, A

    2005-02-01

    Retrospective assessment of multistage surgery in the treatment of progressive spondylodiscitis in patients with critical physical status. A total of 34 patients (mean age 58.6 years) with 37 progressive spondylodiscitis foci and destruction of one to three vertebral segments (1.9 mean) were recorded within an 8-year period. Time between first complaints and operative treatment was 3 months (mean). Preoperative health status was critically reduced in 11 patients (ASA IV) and poor general condition (ASA III) was seen in 23 patients when vital indication was seen preoperatively. Considerable systemic disease (n=31), further infection focus (n=18), and nosocomial trauma (n=5) were causally related. Spondylodiscitis was seen more frequently in the lumbar (n=20) and thoracolumbar than in the thoracic (n=10) and cervical spine (n=1). Staphylococcus aureus was detectable from operative specimens and hemoculture in 15 cases, MRSA in 6 of these. In cases of monosegmentary involvement (n=7) ventral debridement, biopsy, and application of antibiotic chains were followed by autologous interbody bone grafting in a second stage operation. In 29 cases with destruction of two (n=27) and three (n=3) segments, posterior instrumentation including laminectomy in 4 patients was completed by anterior debridement and application of antibiotic chains during a first surgical intervention. After stabilization of physical condition and having reached a macroscopically indisputable implant bed, the ventral fusion with autologous interbody bone grafting or cage in combination with a plate or internal fixation system was performed as the last of several surgical steps. No case of perioperative mortality was observed. Intensive care continued 9.1 days and hospitalization 49.5 days (mean). During a 37.6-month follow-up two late recurrences were observed. A multistep surgical procedure under protection of dorsal instrumentation can limit perioperative mortality in patients in critical general

  3. Experience and projects concerning treatment, conditioning and storage of all radioactive wastes from Tokai reprocessing plant

    International Nuclear Information System (INIS)

    Fukuda, G.; Matsumoto, K.; Miyahara, K.

    1984-01-01

    The active operation of Tokai reprocessing plant started in September 1977, and about 170 t U of spent fuel were reprocessed between then and December 1982. During this period, the low-level waste processing plant reduced the amount of radioactivity discharged into the environment. For radioactive liquid waste, the treatment procedures consist mainly of evaporation to keep the discharge into the sea at a low level. For combustible low-level solid waste and the solvent waste, which is of low tributyl phosphate content, incineration has been used successfully (burned: about 150 t of combined LLSW, about 50 m 3 of solvent waste, i.e. diluent waste). Most of the past R and D work was devoted to reducing the activity discharged into the environment. Current R and D work is concerned with the treatment of solvent waste, the conditioning of solid wastes, the bituminization of low-level liquid waste and the vitrification of high-level liquid waste. The paper describes present practices, R and D work and future aspects of the treatment, conditioning and storage of all radioactive wastes from Tokai reprocessing plant. (author)

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

    Science.gov (United States)

    Reed, Reiley; Ferrer, Lilian; Villegas, Natalia

    2012-01-01

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

  5. Ventilation and air conditioning system in waste treatment and storage facilities

    International Nuclear Information System (INIS)

    Kinoshita, Hirotsugu; Sugawara, Kazushige.

    1987-01-01

    So far, the measures concerning the facilities for treating and storing radioactive wastes in nuclear fuel cycle in Japan were in the state which cannot be said to be sufficient. In order to cope with this situation, electric power companies constructed and operated radioactive waste concentration and volume reduction facilities, solid waste storing facilities for drums, high level solid waste storing facilities, spent fuel cask preserving facilities and so on successively in the premises of nuclear power stations, and for the wastes expected in future, the research and the construction plan of the facilities for treating and storing low, medium and high level wastes have been advanced. The ventilation and air conditioning system for these facilities is the important auxiliary system which has the mission of maintaining safe and pleasant environment in the facilities and lowering as far as possible the release of radioactive substances to outside. The outline of waste treatment and storage facilities is explained. The design condition, ventilation and air conditioning method, the features of respective waste treatment and storage facilities, and the problems for the future are described. Hereafter, mechanical ventilation system continues to be the main system, and filters become waste, while the exchange of filters is accompanied by the radiation exposure of workers. (Kako, I.)

  6. Delayed puberty in girls

    Science.gov (United States)

    ... sexual development - girls; Pubertal delay - girls; Constitutional delayed puberty ... In most cases of delayed puberty, growth changes just begin later than usual, sometimes called a late bloomer. Once puberty begins, it progresses normally. This pattern runs ...

  7. Delayed Puberty (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Delayed Puberty KidsHealth / For Teens / Delayed Puberty What's in this ... wonder if there's anything wrong. What Is Delayed Puberty? Puberty is the time when your body grows ...

  8. Shelf life of donkey milk subjected to different treatment and storage conditions.

    Science.gov (United States)

    Giacometti, Federica; Bardasi, Lia; Merialdi, Giuseppe; Morbarigazzi, Michele; Federici, Simone; Piva, Silvia; Serraino, Andrea

    2016-06-01

    The aim of this study was to investigate the effects of different treatment conditions on microbiological indicators of donkey milk hygiene and their evolution during shelf life at 4 and 12°C from 3 to 30d, simulating a farm-scale pasteurization and packing system. Four treatment conditions were tested: no treatment (raw milk), pasteurization (65°C × 30 min), high-pressure processing (HPP), and pasteurization plus HPP. The microbiological quality of the raw donkey milk investigated was not optimal; our results highlight the importance of raw milk management with the need for animal hygiene management and good dairy farming practices on donkey farms to improve handling procedures. The raw milk treated with HPP alone showed visible alterations with flocks, making the milk unfit for sale. The microbiological risk posed by consumption of raw donkey milk was significantly reduced by heat treatment but farm-scale packing systems cannot guarantee an extended shelf life. In contrast, the pasteurization plus HPP treatment was the most effective method to maintain microbiological milk quality. Microflora growth had little effect on pH in donkey milk: pH values were significantly different only between raw milk and pasteurized and pasteurized plus HPP milk stored at 12°C for 3d. Alkaline phosphatase activity and furosine could be used as indicators of proper pasteurization and thermal processing in donkey milk. Moreover, the presence and growth of Bacillus cereus in the case of thermal abuse hamper the wide-scale marketing of donkey milk due to the potential consequences for sensitive consumers and therefore further tests with time/temperature/high-pressure protocols associated with B. cereus are needed. Finally, our study shows that an HPP treatment of pasteurized milk after packing extends the shelf life of donkey milk and assures its microbial criteria up to 30d if properly stored at 4°C until opening; therefore, combined heat treatment and storage strategies are

  9. Effect of solution treatment conditions on the sensitization of austenitic stainless steel

    Directory of Open Access Journals (Sweden)

    XIAOFEI YU

    2009-11-01

    Full Text Available In this study, the impact of the conditions of solution treatment on the degree of sensitization (DOS of austenitic stainless steel (AISI 304 was investigated in detail. The results derived from the electrochemical potentiodynamic reactivation (EPR test indicated that the DOS decreased as the solution treatment temperature and time increased. The reason for this was studied via the SEM morphologies and EDS results, which indicated that the grain size influenced the DOS. Furthermore, cellular automaton (CA was utilized to simulate grain growth, the precipitation of Cr-rich carbides and the three dimensional distribution of the chromium concentration, which vividly illuminated the effect of the grain size on the DOS and was in accordance with the experiment results.

  10. Using condition and usefulness of dental cone-beam CT in endodontic treatment

    International Nuclear Information System (INIS)

    Kimura, Yuichi; Araki, Kazuyuki; Yamada, Yoshishige; Tagaya, Atsuko; Seki, Kenji; Okano, Tomohiro; Endo, Atsushi

    2009-01-01

    This study evaluated the condition and usefulness of the dental cone-beam CT (3DX) in clinical endodontic treatments. Images from 55 examinations of 49 patients obtained using 3DX during an 11-month period were evaluated retrospectively to identify the usefulness of this modality compared with periapical or panoramic radiographs. The main indication for using of 3DX was diagnosis of root fracture in 65% of the examinations, second was the presence and expansion of periapical lesion in 22%, and third was to detect the canal system or root abnormality in 13%. The 3DX visualizes bony anatomical structures precisely and detects the presence and expansion of periapical lesions and the canal system of each root of mulirooted teeth that cannot easily be observed by intraoral radiography or panoramic radiography. The results of this study suggest that 3DX is a useful and reliable tool for endodontic treatments. (author)

  11. Sufficient conditions for optimality for a mathematical model of drug treatment with pharmacodynamics

    Directory of Open Access Journals (Sweden)

    Maciej Leszczyński

    2017-01-01

    Full Text Available We consider an optimal control problem for a general mathematical model of drug treatment with a single agent. The control represents the concentration of the agent and its effect (pharmacodynamics is modelled by a Hill function (i.e., Michaelis-Menten type kinetics. The aim is to minimize a cost functional consisting of a weighted average related to the state of the system (both at the end and during a fixed therapy horizon and to the total amount of drugs given. The latter is an indirect measure for the side effects of treatment. It is shown that optimal controls are continuous functions of time that change between full or no dose segments with connecting pieces that take values in the interior of the control set. Sufficient conditions for the strong local optimality of an extremal controlled trajectory in terms of the existence of a solution to a piecewise defined Riccati differential equation are given.

  12. Delayed entry into HIV care after diagnosis in two specialized care and treatment centres in Cameroon: the influence of CD4 count and WHO staging

    Directory of Open Access Journals (Sweden)

    Noah F. Takah

    2016-07-01

    Full Text Available Abstract Background Delayed entry into HIV care has complicated the challenges faced in sub-Saharan Africa due to the high HIV burden. A clear knowledge of the factors affecting delayed entry will be essential in directing interventions towards reducing delayed entry into HIV care. There exist very limited data on delayed entry in Cameroon despite its relevance; hence this study was conducted to determine the rate of delayed entry and its associated factors in HIV programmes in Cameroon. Methods Data used for this study was routine data obtained from the files of HIV patients who were diagnosed between January 1, 2015 and June 30, 2015 at Limbe and Buea regional hospital HIV centers in the South West region of Cameroon. Data analysis was done using SPSS version 20. Results Of the 223 patients included in the study, nearly one-quarter of patients (22.4 % delayed to enter HIV care within 3 months. Those who delayed to enter care were less likely to present at first diagnosis (using HIV rapid test with symptoms such as fever > 1 month (5 % versus 30 %, p = 0.01 and weight loss > 10 % (13 % versus 48 %, p < 0.001. Alcohol consumption, WHO stage and CD4 count levels were also associated with delayed entry in bivariate analysis. In multivariate analysis only CD4 count greater than 500cells/μl and WHO stages I and II were independently associated with delayed entry into HIV care within 3 months. Conclusion In the South West region of Cameroon, approximately 1 out of 4 patients delay to enter HIV care. This high proportion of patients who delay to enter care correlates to the findings recorded by other studies in sub Saharan Africa. Interventions tackling delayed entry into HIV care might need to be favorably directed towards patients that have high CD4 counts and are at very early WHO clinical stages.

  13. Vertical flow constructed wetlands for domestic wastewater treatment on tropical conditions: effect of several design parameters

    DEFF Research Database (Denmark)

    Bohorquez, Eliana; Paredes, Diego; Arias, Carlos Alberto

    Vertical flow constructed wetlands (VFWC) design and operation takes into account several variables which affect performance its performance. These aspects had been evaluated and documented among others in countries like USA, Denmark, Austria. In contrast, VFCW had not been studied in tropical...... countries and, specifically in Colombia, design and operation parameters are not defined yet. The objective of this study was evaluate the effects of filter medium, the feeding frequency and Heliconia psittacorum presence, a typical local plant, on the domestic wastewater treatment in tropical conditions....

  14. Rheological and fractal characteristics of unconditioned and conditioned water treatment residuals.

    Science.gov (United States)

    Dong, Y J; Wang, Y L; Feng, J

    2011-07-01

    The rheological and fractal characteristics of raw (unconditioned) and conditioned water treatment residuals (WTRs) were investigated in this study. Variations in morphology, size, and image fractal dimensions of the flocs/aggregates in these WTR systems with increasing polymer doses were analyzed. The results showed that when the raw WTRs were conditioned with the polymer CZ8688, the optimum polymer dosage was observed at 24 kg/ton dry sludge. The average diameter of irregularly shaped flocs/aggregates in the WTR suspensions increased from 42.54 μm to several hundred micrometers with increasing polymer doses. Furthermore, the aggregates in the conditioned WTR system displayed boundary/surface and mass fractals. At the optimum polymer dosage, the aggregates formed had a volumetric average diameter of about 820.7 μm, with a one-dimensional fractal dimension of 1.01 and a mass fractal dimension of 2.74 on the basis of the image analysis. Rheological tests indicated that the conditioned WTRs at the optimum polymer dosage showed higher levels of shear-thinning behavior than the raw WTRs. Variations in the limiting viscosity (η(∞)) of conditioned WTRs with sludge content could be described by a linear equation, which were different from the often-observed empirical exponential relationship for most municipal sludge. With increasing temperature, the η(∞) of the raw WTRs decreased more rapidly than that of the raw WTRs. Good fitting results for the relationships between lgη(∞)∼T using the Arrhenius equation indicate that the WTRs had a much higher activation energy for viscosity of about 17.86-26.91 J/mol compared with that of anaerobic granular sludge (2.51 J/mol) (Mu and Yu, 2006). In addition, the Bingham plastic model adequately described the rheological behavior of the conditioned WTRs, whereas the rheology of the raw WTRs fit the Herschel-Bulkley model well at only certain sludge contents. Considering the good power-law relationships between the

  15. Protozoa and metazoa relations to technological conditions of non-woven textile filters for wastewater treatment.

    Science.gov (United States)

    Spychała, Marcin; Sowińska, Aleksandra; Starzyk, Justyna; Masłowski, Adam

    2015-01-01

    The objective of this study was a preliminary identification of basic groups of micro-organisms in the cross-sectional profile of geotextile filters for septic tank effluent (STE) treatment and their relations to technological conditions. Reactors with textile filters treating wastewater were investigated on a semi-technical scale. Filters were vertically situated and STE was filtered through them under hydrostatic pressure at a wastewater surface height of 7-20 cm. Filters were made of four layers of non-woven TS 20 geotextile of 0.9 mm thickness. Various groups of organisms were observed; the most abundant group comprised free-swimming and crawling ciliates, less abundant were stalked ciliates and the least numerous were nematodes. The individual counts of all groups of micro-organisms investigated during the study were variable according to time and space. The high abundance of Opercularia, a commonly observed genus of stalked ciliates, was related to the high efficiency of wastewater treatment and dissolved oxygen concentration of about 1.0 g/m3. Numbers of free-swimming and crawling ciliates had a tendency to decrease in relation to the depth of filter cross-sectional profile. The variability in counts of particular groups of organisms could be related to the local stress conditions. No correlation between identified organism count and total mass concentration in the cross-sectional filter profile was found.

  16. Exercise as a Time-conditioning Effector in Chronic Disease: a Complementary Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Luis F. B. P. Costa Rosa

    2004-01-01

    Full Text Available Exercise has been widely believed to be a preventive and therapeutic aid in the treatment of various pathophysiological conditions such as cardiovascular disease and cancer. A common problem associated with such pathologies is cachexia, characterized by progressive weight loss and depletion of lean and fat body mass, and is linked to poor prognosis. As this syndrome comprises changes in many physiological systems, it is tempting to assume that the modulation of the psychoneuroimmunoendocrine axis could attenuate or even prevent cachexia progression in cancer patients. Cancer cachexia is characterized by a disruption in the rhythmic secretion of melatonin, an important time-conditioning effector. This hormone, secreted by the pineal gland, transmits circadian and seasonal information to all organs and cells of the body, synchronizing the organism with the photoperiod. Considering that exercise modulates the immune response through at least two different mechanisms—metabolic and neuroendocrine—we propose that the adoption of a regular exercise program as a complementary strategy in the treatment of cancer patients, with the exercise bouts regularly performed at the same time of the day, will ameliorate cachexia symptoms and increase survival and quality of life.

  17. Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

    Science.gov (United States)

    Siebenhuener, Klarissa; Eschmann, Emmanuel; Kienast, Alexander; Schneider, Dominik; Minder, Christoph E.; Saller, Reinhard; Zimmerli, Lukas; Blaser, Jürg; Battegay, Edouard

    2017-01-01

    Background Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. Methods and Findings We conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients). Data were extracted from the electronic health records and reviewed. We identified 433 hospitalizations of patients with chronic pain and analyzed their combinations of chronic conditions (multimorbidity). We then classified all analgesic prescriptions according to the World Health Organization (WHO) analgesic ladder. Furthermore, we used a Swiss drug-drug interactions knowledge base to identify potential interactions between opioids and other drug classes, in particular coanalgesics and other concomitant drugs. Chronic pain was present in 38% of patients with multimorbidity. On average, patients with chronic pain were aged 65.7 years and had a mean number of 6.6 diagnoses. Hypertension was the most common chronic condition. Chronic back pain was the most common painful condition. Almost 90% of patients were exposed to polypharmacotherapy. Of the chronic pain patients, 71.1% received opioids for moderate to severe pain, 43.4% received coanalgesics. We identified 3,186 potential drug-drug interactions, with 17% classified between analgesics (without coanalgesics). Conclusions Analgesic drugs-related DDIs, in particular opioids, in multimorbid patients are often complex and difficult to assess by using DDI knowledge bases alone. Drug-multimorbidity interactions are not sufficiently investigated and understood. Today, the scientific literature is scarce for chronic pain in combination with multiple coexisting medical conditions and medication

  18. Investigation of heat treatment conditions of structural material for blanket fabrication process

    International Nuclear Information System (INIS)

    Hirose, Takanori; Suzuki, Satoshi; Akiba, Masato; Shiba, Kiyoyuki; Sawai, Tomotsugu; Jitsukawa, Shiro

    2004-01-01

    This paper presents recent results of thermal hysteresis effects on ceramic breeder blanket structural material. Reduced activation ferritic/martensitic (RAF) steel is the leading candidates for the first wall structural materials of breeding blankets. RAF steel demonstrates superior resistance to high dose neutron irradiation, because the steel has tempered martensite structure which contains the number of sink site for radiation defects. This microstructure obtained by two-step heat treatment, first is normalizing at temperature above 1200 K and the second is tempering at temperature below 1100 K. Recent study revealed the thermal hysteresis has significant impacts on the post-irradiation mechanical properties. The breeding blanket has complicated structure, which consists of tungsten armor and thin first wall with cooling pipe. The blanket fabrication requires some high temperature joining processes. Especially hot isostatic pressing (HIP) is examined as a near-net-shape fabrication process for this structure. The process consists of heating above 1300 K and isostatic pressing at the pressure above 150 MPa followed by tempering. Moreover ceramics pebbles are packed into blanket module and the module is to be seamed by welding followed by post weld heat treatment in the final assemble process. Therefore the final microstructural features of RAFs strongly depend on the blanket fabrication process. The objective of this work is to evaluate the effects of thermal hysteresis corresponding to blanket fabrication process on RAFs microstructure in order to establish appropriate blanket fabrication process. Japanese RAFs F82H (Fe-0.1C-8Cr-2W-0.2V-0.05Ta) was investigated by metallurgical method after isochronal heat treatment up to 1473 K simulating high temperature bonding process. Although F82H showed significant grain growth after conventional solid HIP conditions (1313 K x 2 hr.), this coarse grained microstructure was refined by the post HIP normalizing at

  19. When the Battle is Lost and Won: Delayed Chest Closure After Bilateral Lung Transplantation.

    Science.gov (United States)

    Soresi, Simona; Sabashnikov, Anton; Weymann, Alexander; Zeriouh, Mohamed; Simon, André R; Popov, Aron-Frederik

    2015-10-12

    In this article we summarize benefits of delayed chest closure strategy in lung transplantation, addressing indications, different surgical techniques, and additional perioperative treatment. Delayed chest closure seems to be a valuable and safe strategy in managing patients with various conditions after lung transplantation, such as instable hemodynamics, need for high respiratory pressures, coagulopathy, and size mismatch. Therefore, this approach should be considered in lung transplant centers to give patients time to recover before the chest is closed.

  20. Melatonin treatment in spring and reproductive recovery in sheep with different body condition score and age.

    Science.gov (United States)

    Luridiana, S; Mura, M C; Daga, C; Farci, F; Di Stefano, M V; Zidda, F; Carcangiu, V

    2015-09-01

    With the aim to evaluate the effect of melatonin treatment on the advanced reproductive recovery in sheep with different body condition score (BCS) and age, 800 ewes were selected from two farms. These ewes (3-6 years old, multiparous and with BCS 2.5-4.0) were subdivided into two Groups (200 M and 200 C), balanced on their BCS and age. On 20 March, Group M was treated with one melatonin implant (18 mg). Group C was untreated. Males were introduced to the groups 35 days after treatment. Gestation was diagnosed between day 45 and 90 after mating by transabdominal ultrasonography. From day 150 to 190 after rams introduction, lambing date and newborns' number were recorded. The average time in days between male introduction and lambing resulted shorter in treated than in control ewes (166.4 ± 0.48 vs. 172.5 ± 0.50) (P scored 2.5-3.0 (166.1 ± 0.48 vs. 174.8 ± 0.51) (P < 0.05). We concluded that the ewes with BCS 3.5-4.0 and aged 5-6 years showed a better response to melatonin treatment in spring. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Sclerotial formation of Polyporus umbellatus by low temperature treatment under artificial conditions.

    Science.gov (United States)

    Xing, Yong-Mei; Zhang, Li-Chun; Liang, Han-Qiao; Lv, Jing; Song, Chao; Guo, Shun-Xing; Wang, Chun-Lan; Lee, Tae-Soo; Lee, Min-Woong

    2013-01-01

    Polyporus umbellatus sclerotia have been used as a diuretic agent in China for over two thousand years. A shortage of the natural P. umbellatus has prompted researchers to induce sclerotial formation in the laboratory. P. umbellatus cultivation in a sawdust-based substrate was investigated to evaluate the effect of low temperature conditions on sclerotial formation. A phenol-sulfuric acid method was employed to determine the polysaccharide content of wild P. umbellatus sclerotia and mycelia and sclerotia grown in low-temperature treatments. In addition, reactive oxygen species (ROS) content, expressed as the fluorescence intensity of mycelia during sclerotial differentiation was determined. Analysis of ROS generation and sclerotial formation in mycelia after treatment with the antioxidants such as diphenyleneiodonium chloride (DPI), apocynin (Apo), or vitamin C were studied. Furthermore, macroscopic and microscopic characteristics of sclerotial differentiation were observed. Sclerotia were not induced by continuous cultivation at 25°C. The polysaccharide content of the artificial sclerotia is 78% of that of wild sclerotia. In the low-temperature treatment group, the fluorescent intensity of ROS was higher than that of the room temperature (25°C) group which did not induce sclerotial formation all through the cultivation. The antioxidants DPI and Apo reduced ROS levels and did not induce sclerotial formation. Although the concentration-dependent effects of vitamin C (5-15 mg mL(-1)) also reduced ROS generation and inhibited sclerotial formation, using a low concentration of vitamin C (1 mg mL(-1)) successfully induced sclerotial differentiation and increased ROS production. Exposure to low temperatures induced P. umbellatus sclerotial morphogenesis during cultivation. Low temperature treatment enhanced ROS in mycelia, which may be important in triggering sclerotial differentiation in P. umbellatus. Moreover, the application of antioxidants impaired ROS generation

  2. Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment

    Directory of Open Access Journals (Sweden)

    Lucente V

    2017-08-01

    Full Text Available Vincent Lucente,1 Heather van Raalte,2 Miles Murphy,1 Vladimir Egorov3 1The Institute for Female Pelvic Medicine and Reconstructive Surgery, Allentown, PA, USA; 2Princeton Urogynecology, Princeton, NJ, USA; 3Artann Laboratories, Trenton, NJ, USA Background: Further progress in restoring a woman’s health may be possible if a patient with a damaged pelvic floor could undergo medical imaging and biomechanical diagnostic tests. The results of such tests could contribute to the analysis of multiple treatment options and suggest the optimal one for that patient.Aim: To develop a new approach for the biomechanical characterization of vaginal conditions, muscles, and connective tissues in the female pelvic floor.Methods: Vaginal tactile imaging (VTI allows biomechanical assessment of the soft tissue along the entire length of the anterior, posterior, and lateral vaginal walls at rest, with manually applied deflection pressures and with muscle contraction, muscle relaxation, and Valsalva maneuver. VTI allows a large body of measurements to evaluate individual variations in tissue elasticity, support defects, as well as pelvic muscle function. Presuming that 1 the female pelvic floor organs are suspended by ligaments against which muscles contract to open or close the outlets and 2 damaged ligaments weaken the support and may reduce the force of muscle contraction, we made an attempt to characterize multiple pelvic floor structures from VTI data.Results: All of the 138 women enrolled in the study were successfully examined with the VTI. The study subjects have had normal pelvic support or pelvic organ prolapse (stages I–IV. The average age of this group of subjects was 60±15 years. We transposed a set of 31 VTI parameters into a quantitative characterization of pelvic muscles and ligamentous structures. Interpretation of the acquired VTI data for normal pelvic floor support and prolapse conditions is proposed based on biomechanical assessment of the

  3. Effect of redox conditions on pharmaceutical loss during biological wastewater treatment using sequencing batch reactors

    DEFF Research Database (Denmark)

    Stadler, Lauren B.; Su, Lijuan; Moline, Christopher J.

    2015-01-01

    We lack a clear understanding of how wastewater treatment plant (WWTP) process parameters, such as redox environment, impact pharmaceutical fate. WWTPs increasingly install more advanced aeration control systems to save energy and achieve better nutrient removal performance. The impact of redox...... under different redox conditions: fully aerobic, anoxic/aerobic, and microaerobic (DO concentration ≈0.3 mg/L). Among the pharmaceuticals that were tracked during this study (atenolol, trimethoprim, sulfamethoxazole, desvenlafaxine, venlafaxine, and phenytoin), overall loss varied between them...... and between redox environments. Losses of atenolol and trimethoprim were highest in the aerobic reactor; sulfamethoxazole loss was highest in the microaerobic reactors; and phenytoin was recalcitrant in all reactors. Transformation products of sulfamethoxazole and desvenlafaxine resulted in the reformation...

  4. Autoradiography of DNA from Hela cells under normal conditions and after treatment with hydroxyurea

    International Nuclear Information System (INIS)

    Martinova, Y.S.; Angelova, P.A.; Roeva, I.G.

    1984-01-01

    The results are presented of the first stage of the elaboration of the novel autoradiographic technique for studying the replication of DNA fibers from nonsynchronized Hela cell cultures under normal conditions and after treatment with hydroxyurea. The preparations were covered with liquid nuclear emulsion Ilford L 4 . Exposure was carried out for 3 months at 4 deg C. After development, the autoradiograms were recorded quantitatively, and the length of the individual replicative segments was measured by means of an object micrometers. For each group (control and experimental) 100 segments from different cells were recorded. The results obtained were subjected to mathematical-statistical processing for determining the standard deviation. The application of hidroxyurea highly reduces the replicative elements, i.e. it actually inhibits DNA synthesis. This inhibition is due to reduction in the production of the four endogenous deoxynucleotides and affects the length of growth of the DNA chain, but the interreplicative distance as well

  5. Conditioned pain modulation: a predictor for development and treatment of neuropathic pain.

    Science.gov (United States)

    Granovsky, Yelena

    2013-09-01

    Psychophysical evaluation of endogenous pain inhibition via conditioned pain modulation (CPM) represents a new generation of laboratory tests for pain assessment. In this review we discuss recent findings on CPM in neuropathic pain and refer to psychophysical, neurophysiological, and methodological aspects of its clinical implications. Typically, chronic neuropathic pain patients express less efficient CPM, to the extent that incidence of acquiring neuropathic pain (e.g. post-surgery) and its intensity can be predicted by a pre-surgery CPM assessment. Moreover, pre-treatment CPM evaluation may assist in the correct choice of serotonin-noradrenalin reuptake inhibitor analgesic agents for individual patients. Evaluation of pain modulation capabilities can serve as a step forward in individualizing pain medicine.

  6. Risk for haematological malignancies after radiation treatment of painful benign conditions in the skeleton

    International Nuclear Information System (INIS)

    Johansson, L.; Larsson, L.G.; Damber, L.

    1999-01-01

    X-ray therapy of painful and inflammatory changes in joints and adjacent structures was very common in Sweden during the period from 1940 until the beginning of the 1960:s. These patients comprise a comprehensive material pertinent for epidemiological studies. The present study deals with a cohort of c. 27,400 patients from 3 hospitals in northern Sweden, who 1950 - 1964 received x-ray treatment for benign painful conditions. The distribution of the absorbed dose in the red marrow was estimated. The average mean absorbed dose in red bone marrow was 0.4 Gy for the total cohort. The number of leukaemia cases observed in the cohort was obtained from the Swedish Cancer Register for the period 1958 - 1995. The study indicates a slightly increased leukaemia risk with borderline statistical significance in the highest dose group. (au)

  7. Study of secondary recrystallization in grain-oriented steel treated under dynamical heat treatment conditions

    Directory of Open Access Journals (Sweden)

    V. Stoyka

    2009-04-01

    Full Text Available The present study was made to investigate secondary recrystallization in grain-oriented steels annealed at short time temperature exposures with application of dynamical heating. The investigated GO steels for experiments were taken from one industrial line after final cold rolling reduction and subsequent box annealing. It was shown that application of short time heat treatment conditions could lead to complete abnormal grain growth in the investigated GO steel. The texture and microstructure obtained in the laboratory treated material is similar to that observed in the same GO steel taken after industrial final box-annealing. However, some “parasitic” grains were observed in the secondary recrystallized matrix of the laboratory treated GO steel. These “parasitic” grains possess the unwanted from magnetic properties point of view {111} orientation components.

  8. Effects of reaction conditions on nuclear laundry water treatment in Fenton process

    International Nuclear Information System (INIS)

    Vilve, Miia; Hirvonen, Arja; Sillanpaeae, Mika

    2009-01-01

    This study presents the efficiency of Fenton process in the degradation of organic compounds of nuclear laundry water. The influence of Fe 2+ and hydrogen peroxide ratio, hydrogen peroxide dose, pH and treatment time were investigated. The degradation of non-ionic surfactant and other organic compounds was analysed as COD, TOC and molecular weight distribution (MWD). The most cost-effective degradation conditions were at H 2 O 2 /Fe 2+ stoichiometric molar ratio of 2 with 5 min mixing and H 2 O 2 dose of 1000 mg l -1 . With the initial pH of 6, the reductions of COD and TOC were 85% and 69%, respectively. However, the removal of the organic compounds was mainly carried out by Fenton-based Fe 3+ coagulation rather than Fenton oxidation. Fenton process proved to be much more efficient than previously performed ozone-based oxidation processes.

  9. Hydrothermal Testing of K Basin Sludge and N Reactor Fuel at Sludge Treatment Project Operating Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, Calvin H.; Schmidt, Andrew J.; Thornton, Brenda M.

    2007-03-30

    The Sludge Treatment Project (STP), managed for the U. S. DOE by Fluor Hanford (FH), was created to design and operate a process to eliminate uranium metal from K Basin sludge prior to packaging for Waste Isolation Pilot Plant (WIPP). The STP process uses high temperature liquid water to accelerate the reaction, produce uranium dioxide from the uranium metal, and safely discharge the hydrogen. Under nominal process conditions, the sludge will be heated in pressurized water at 185°C for as long as 72 hours to assure the complete reaction (corrosion) of up to 0.25-inch diameter uranium metal pieces. Under contract to FH, the Pacific Northwest National Laboratory (PNNL) conducted bench-scale testing of the STP hydrothermal process in November and December 2006. Five tests (~50 ml each) were conducted in sealed, un-agitated reaction vessels under the hydrothermal conditions (e.g., 7 to 72 h at 185°C) of the STP corrosion process using radioactive sludge samples collected from the K East Basin and particles/coupons of N Reactor fuel also taken from the K Basins. The tests were designed to evaluate and understand the chemical changes that may be occurring and the effects that any changes would have on sludge rheological properties. The tests were not designed to evaluate engineering aspects of the process. The hydrothermal treatment affected the chemical and physical properties of the sludge. In each test, significant uranium compound phase changes were identified, resulting from dehydration and chemical reduction reactions. Physical properties of the sludge were significantly altered from their initial, as-settled sludge values, including, shear strength, settled density, weight percent water, and gas retention.

  10. A simple model of carcinogenic mutations with time delay and diffusion.

    Science.gov (United States)

    Piotrowska, Monika Joanna; Foryś, Urszula; Bodnar, Marek; Poleszczuk, Jan

    2013-06-01

    In the paper we consider a system of delay differential equations (DDEs) of Lotka-Volterra type with diffusion reflecting mutations from normal to malignant cells. The model essentially follows the idea of Ahangar and Lin (2003) where mutations in three different environmental conditions, namely favorable, competitive and unfavorable, were considered. We focus on the unfavorable conditions that can result from a given treatment, e.g. chemotherapy. Included delay stands for the interactions between benign and other cells. We compare the dynamics of ODEs system, the system with delay and the system with delay and diffusion. We mainly focus on the dynamics when a positive steady state exists. The system which is globally stable in the case without the delay and diffusion is destabilized by increasing delay, and therefore the underlying kinetic dynamics becomes oscillatory due to a Hopf bifurcation for appropriate values of the delay. This suggests the occurrence of spatially non-homogeneous periodic solutions for the system with the delay and diffusion.

  11. Optimization of Electrochemical Treatment Process Conditions for Distillery Effluent Using Response Surface Methodology

    Directory of Open Access Journals (Sweden)

    P. Arulmathi

    2015-01-01

    Full Text Available Distillery industry is recognized as one of the most polluting industries in India with a large amount of annual effluent production. In this present study, the optimization of electrochemical treatment process variables was reported to treat the color and COD of distillery spent wash using Ti/Pt as an anode in a batch mode. Process variables such as pH, current density, electrolysis time, and electrolyte dose were selected as operation variables and chemical oxygen demand (COD and color removal efficiency were considered as response variable for optimization using response surface methodology. Indirect electrochemical-oxidation process variables were optimized using Box-Behnken response surface design (BBD. The results showed that electrochemical treatment process effectively removed the COD (89.5% and color (95.1% of the distillery industry spent wash under the optimum conditions: pH of 4.12, current density of 25.02 mA/cm2, electrolysis time of 103.27 min, and electrolyte (NaCl concentration of 1.67 g/L, respectively.

  12. Effects of heat treatments of coal on coke destruction under blast furnace conditions

    Energy Technology Data Exchange (ETDEWEB)

    Shkoller, M.B.; Dinel' t, V.M.; Korchuganova, G.S.; Petrov, V.B.

    1983-09-01

    This paper discusses results of investigations on effects of chemical reactions in a blast furnace on coke disintegration and destruction. The investigations were carried out by the VUKhIN Institute branch in Kuznetsk. Effects of silicates and carbonates of sodium, potassium and zinc on mechanical coke properties were investigated under laboratory conditions. Coke samples were placed in a reactor and were treated by vapors of metal compounds. Coke produced from a coal mixture with conventional moisture content and from preheated coal mixture was used. Coal properties are given in a table. Design of laboratory equipment used for tests is shown in 2 schemes. Heat treatments influenced coke porosity and its structural strength. Proportion of large pores accessible to sodium and potassium in coke from preheated coal was 4.5 times lower than in coke from a conventional mixture. Adsorption of sodium and potassium on coke from preheated charge was lower (from 0.22% to 0.24%) than on coke from a conventional mixture (from 2.5% to 2.9%). Adsorption of alkali metals on coke reduced its structural strength and increased coke oxidation rate by carbon dioxide. Use of heat treatments of coal for coking reduced adsorption of alkali metals on coke in a blast furnace, increased coke structural strength and reduced coke oxidation rate by carbon dioxide. (16 refs.) (In Russian)

  13. Biological treatment of refinery spent caustics under halo-alkaline conditions.

    Science.gov (United States)

    de Graaff, Marco; Bijmans, Martijn F M; Abbas, Ben; Euverink, Gert-J W; Muyzer, Gerard; Janssen, Albert J H

    2011-08-01

    The present research demonstrates the biological treatment of refinery sulfidic spent caustics in a continuously fed system under halo-alkaline conditions (i.e. pH 9.5; Na(+)= 0.8M). Experiments were performed in identical gas-lift bioreactors operated under aerobic conditions (80-90% saturation) at 35°C. Sulfide loading rates up to 27 mmol L(-1)day(-1) were successfully applied at a HRT of 3.5 days. Sulfide was completely converted into sulfate by the haloalkaliphilic sulfide-oxidizing bacteria belonging to the genus Thioalkalivibrio. Influent benzene concentrations ranged from 100 to 600 μM. At steady state, benzene was removed by 93% due to high stripping efficiencies and biodegradation. Microbial community analysis revealed the presence of haloalkaliphilic heterotrophic bacteria belonging to the genera Marinobacter, Halomonas and Idiomarina which might have been involved in the observed benzene removal. The work shows the potential of halo-alkaliphilic bacteria in mitigating environmental problems caused by alkaline waste. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Resveratrol in prevention and treatment of common clinical conditions of aging

    Directory of Open Access Journals (Sweden)

    M Andrea Markus

    2008-06-01

    Full Text Available M Andrea Markus, Brian J MorrisSchool of Medical Sciences and Bosch Institute, The University of Sydney, Sydney, NSW, AustraliaAbstract: Resveratrol is a potent member of the class of natural, plant-derived chemicals known as polyphenols. These help explain in part why a diet high in fruit and vegetables confers health benefits and are associated with reduced risk of common complex conditions such as cardiovascular disease, cancer, diabetes, and Alzheimer’s disease. We present the latest molecular findings that account for the beneficial actions of resveratrol. The intracellular pathways activated are crucial for anti-oxidant defence, regulation of the cell cycle, mitochondrial energy production, vascular tone, oncogene suppression, and many other phenomena which if unchecked lead to morbidity and mortality from onset and progression of these various diseases. While a healthy diet and lifestyle is strongly recommended in prevention of such conditions, the future bodes well for the use of resveratrol and analogues of higher potency than the natural form for treatment of diseases that afflict humans, particularly as they age.Keywords: resveratrol, longevity, SIRT, wine, aging, cancer

  15. Thermodynamic analysis of the conditions of deoxidation and secondary treatment of low-silicon steel grade

    Directory of Open Access Journals (Sweden)

    Євген Анатолійович Чичкарьов

    2015-10-01

    Full Text Available This article is concerned with analysis and production testing of technological solutions aimed at reducing the consumption of aluminium for steel deoxidation and reducing level of metal contamination by oxide non-metal inclusions, as well as preventing silicon reduction during out-of-furnace treatment. The conditions of low-silicon steel deoxidation and out-of-furnace treatment have been analysed. It has been found that the scope of oxygen activity variation in the converter before tapping increases while the mass fraction of carbon in the metal decreases. For the converter meltings with a mass fraction of carbon over the range 0,05-0,07 % [C] before tapping the real range of variation was 150-300 ppm. The effect of meltings carburizing on aluminium consumption and the degree of aluminium assimilation have been analysed. It has been shown that in fact the same specific consumption of ferromanganese and comparable changes within the metal oxidation change range before tapping (400-1100 ppm the addition of the carburizer decreases the consumption of aluminium by 0,15 kg/t (in amounts of pure aluminium. The variation interval of assimilation degree of aluminium, consumed for binding the dissolved oxygen in metal and for dissolution in metal has been found. It has been shown that in the melting of low-silicon steel with out- of-furnace treatment but without the use of furnace-ladle unit the rational limit of variation of mass fraction of magnesium oxide variation in the ladle slag is equal to- 6-8 % by weight

  16. Water Vapor Adsorption on Biomass Based Carbons under Post-Combustion CO2 Capture Conditions: Effect of Post-Treatment

    Directory of Open Access Journals (Sweden)

    Nausika Querejeta

    2016-05-01

    Full Text Available The effect of post-treatment upon the H2O adsorption performance of biomass-based carbons was studied under post-combustion CO2 capture conditions. Oxygen surface functionalities were partially replaced through heat treatment, acid washing, and wet impregnation with amines. The surface chemistry of the final carbon is strongly affected by the type of post-treatment: acid treatment introduces a greater amount of oxygen whereas it is substantially reduced after thermal treatment. The porous texture of the carbons is also influenced by post-treatment: the wider pore volume is somewhat reduced, while narrow microporosity remains unaltered only after acid treatment. Despite heat treatment leading to a reduction in the number of oxygen surface groups, water vapor adsorption was enhanced in the higher pressure range. On the other hand acid treatment and wet impregnation with amines reduce the total water vapor uptake thus being more suitable for post-combustion CO2 capture applications.

  17. Patient reported delays in seeking treatment for Tuberculosis (TB among adult and pediatric TB patients and TB patients co-infected with HIV in Lima, Peru: a qualitative study

    Directory of Open Access Journals (Sweden)

    Valerie A Paz-Soldan

    2014-12-01

    Full Text Available Abstract: Tuberculosis (TB remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness. Objectives: The objective was to understand the complex factors that can impact TB patient health seeking behavior. Methods: In-depth interviews were conducted with adult and parents of pediatric patients receiving TB treatment (n=43, within that group a sub-group was also co-infected with HIV (n=11. Results: Almost all of the study participants recognized delays in seeking either their child’s or their own diagnosis of their TB symptoms. The principal reasons for treatment-seeking delays were lack of knowledge and confusion of tuberculosis symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention.Conclusions: Health promotion activities that target patient delays have the potential to improve individual patient outcomes and mitigate the spread of TB at a community level.

  18. Factors that lessen the burden of treatment in complex patients with chronic conditions: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ridgeway JL

    2014-03-01

    Full Text Available Jennifer L Ridgeway,1,2 Jason S Egginton,1,2 Kristina Tiedje,3 Mark Linzer,4,5 Deborah Boehm,4 Sara Poplau,6 Djenane Ramalho de Oliveira,7 Laura Odell,8 Victor M Montori,2,9 David T Eton1,2 1The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 2Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 3Department of Anthropology, Université Lumière Lyon 2, Lyon, France; 4Division of General Internal Medicine, Hennepin County Medical Center, 5University of Minnesota Medical School, 6Minneapolis Medical Research Foundation, Minneapolis, MN, USA; 7Department of Social Pharmacy, Universidade Federal de Minas Gerais, Brazil; 8Pharmacy Services, 9Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA Purpose: Patients with multiple chronic conditions (multimorbidity often require ongoing treatment and complex self-care. This workload and its impact on patient functioning and well-being are, together, known as treatment burden. This study reports on factors that patients with multimorbidity draw on to lessen perceptions of treatment burden. Patients and methods: Interviews (n=50 and focus groups (n=4 groups, five to eight participants per group were conducted with patients receiving care in a large academic medical center or an urban safety-net hospital. Interview data were analyzed using qualitative framework analysis methods, and themes and subthemes were used to identify factors that mitigate burden. Focus groups were held to confirm these findings and clarify any new issues. This study was part of a larger program to develop a patient-reported measure of treatment burden. Results: Five major themes emerged from the interview data. These included: 1 problem-focused strategies, like routinizing self-care, enlisting support of others, planning for the future, and using technology; 2 emotion-focused coping strategies, like

  19. Effect of EI-treatment in relation to physiological and biochemical traits in rice: delay in germination and its recovery with provision of glucose

    International Nuclear Information System (INIS)

    Inoue, M.; Hasegawa, H.; Hori, S.

    1975-01-01

    Rice seeds treated with 0.2 to 1.2 v/v % of ethyleneimine (EI) demonstrated increasingly delayed germination concomitant with increasing dose. At the time of germination, the release of storage products was slightly inhibited at lower doses and completely reduced at higher doses. With increasing time after germination the development of shoot length, content of reducing sugar and free amino acid, and synthesis of nucleic acid and protein in treated seeds, showed the same response pattern as the control, although at reduced levels in the treated seeds. Consequently, it is interpreted that the delay of germination is due to physiological dormancy, i.e. impaired release of dormancy which would normally yield active forms of enzymes. When treated seeds were cultured in [ 14 C]-glucose medium, the specific activity of [ 14 C]-glucose was higher in late-germinating seeds than in early-germinating seeds. Furthermore, the provision of glucose prevented the delay of germination, resulting in about a 10% increase in germination rate (survival rate), and yet had no effect on subsequent growth. Finally, it is concluded that the damage resulting in delayed germination and reduction of survival differs from the damage leading to inhibition of subsequent growth in that the former can be compensated for by provision of glucose while the latter cannot. (author)

  20. Early versus delayed endocrine treatment of pN1-3 M0 prostate cancer without local treatment of the primary tumor: results of European Organisation for the Research and Treatment of Cancer 30846--a phase III study

    NARCIS (Netherlands)

    Schröder, Fritz H.; Kurth, Karl Heinz; Fosså, Sophie D.; Hoekstra, Wytze; Karthaus, Peter P. M.; Debois, Muriel; Collette, Laurence

    2004-01-01

    The timing of endocrine treatment for prostate cancer remains controversial. The issue is addressed in protocol 30846 of the European Organisation for Research and Treatment of Cancer for patients with lymph node positive cancer without local treatment of the primary tumor. A total of 302 patients

  1. Molasses wastewater treatment and lipid production at low temperature conditions by a microalgal mutant Scenedesmus sp. Z-4

    OpenAIRE

    Ma, Chao; Wen, Hanquan; Xing, Defeng; Pei, Xuanyuan; Zhu, Jiani; Ren, Nanqi; Liu, Bingfeng

    2017-01-01

    Background Simultaneous wastewater treatment and lipid production by oleaginous microalgae show great potential to alleviate energy shortage and environmental pollution, because they exhibit tremendous advantages over traditional activated sludge. Currently, most research on wastewater treatment by microalgal are carried out at optimized temperature conditions (25?35??C), but no information about simultaneous wastewater treatment and lipid production by microalgae at low temperatures has been...

  2. Chaos synchronization in time-delayed systems with parameter mismatches and variable delay times

    International Nuclear Information System (INIS)

    Shahverdiev, E.M.; Nuriev, R.A.; Hashimov, R.H.; Shore, K.A.

    2004-06-01

    We investigate synchronization between two undirectionally linearly coupled chaotic nonidentical time-delayed systems and show that parameter mismatches are of crucial importance to achieve synchronization. We establish that independent of the relation between the delay time in the coupled systems and the coupling delay time, only retarded synchronization with the coupling delay time is obtained. We show that with parameter mismatch or without it neither complete nor anticipating synchronization occurs. We derive existence and stability conditions for the retarded synchronization manifold. We demonstrate our approach using examples of the Ikeda and Mackey Glass models. Also for the first time we investigate chaos synchronization in time-delayed systems with variable delay time and find both existence and sufficient stability conditions for the retarded synchronization manifold with the coupling-delay lag time. (author)

  3. [Outcome-quality of treatment for headache on primary care conditions].

    Science.gov (United States)

    Lang, E; Eisele, R; Jankowsky, H; Kastner, S; Bickel, A; Martus, P; Neundörfer, B

    2000-12-01

    Little is known about the outcome-quality of treatment for headache on primary care conditions in Germany. All physicians (2100) of middle franconia, a bavarian greater district with 1,6 Mio. inhabitants, involved in outpatient management were asked to include consecutively patients in the study which suffer from migraine (at least 2 attacks/month) and/or tension type headache (at least 8 days/month) of at least 4 weeks duration. Before and after a 6 months interval patients documented the following outcome data in a questionnaire: pain intensity during the last attack (numeric rating scale), pain dependent disability (Brief Pain Inventory, German version), health related quality of life (SF-36, German version) and depressivity (Allgemeine Depressionsskala). The pain chronification state (Mainz Pain Staging System) has been assessed by the physician. Therapy was not standardized and included the natural spectrum of medicamental and non-medicamental therapy of headache. Agreement of therapy with recommendations of the "Arzneimittelkommission der Deutschen Aerzteschaft" has been assessed. 24 physicians participated in the study. Pre-post-data of 80 patients (46+/-14 y) could be analysed. Initially 67% were classified in pain chronification state I, 27% in state II and 6% in state III. Medicamental therapy agreed with recommendations in approximately 50% of patients, non-medicamental therapy has been used rarely. The pain intensity, pain dependent disability, depression and quality of life improved significantly. 45% and 55% of patients improved in at least 2 of 6 outcome-parameters by 30% of baseline value or by half standard deviation of the corresponding pre-post-differences, respectively. The latter outcome-measure reflects a medium effect size. On primary care conditions about 50% of patients suffering from migraine and/or tension type headache (predominantly low chronification stae) perceive a therapy effect that corresponds to a medium effect size.

  4. UAVs and Control Delays

    National Research Council Canada - National Science Library

    de Vries, S. C

    2005-01-01

    .... Delays of about 250-300 ms often lead to unacceptable airplane handling qualities. Techniques such as filtering and predictive displays may extend the range of acceptable delays up to about 400 ms...

  5. Delayed puberty in boys

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007695.htm Delayed puberty in boys To use the sharing features on this page, please enable JavaScript. Delayed puberty in boys is when puberty does not begin ...

  6. Condition-specific Quality of Life Assessment at Each Stage of Class III Surgical Orthodontic Treatment -A Prospective Study.

    Science.gov (United States)

    Tachiki, Chie; Nishii, Yasushi; Takaki, Takashi; Sueishi, Kenji

    2018-01-01

    Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (ppre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (ppre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre

  7. Effect of Diabetes Condition on Topical Treatment of Binahong Leaf Fraction in Wound Healing Process

    Directory of Open Access Journals (Sweden)

    Kintoko Kintoko

    2017-08-01

    Full Text Available Diabetes mellitus (DM is a metabolic disease which is becoming the first number of health problem in Indonesia, based on the results of the Basic Health Research of Ministry of Health in 2013. One of the diabetes complications affected by high levels of blood glucose is diabetic ulcers wich 85% the number of cases was overed by amputation as the result of improper handling. Herbal treatments could be an alternative treatment of diabetic ulcers, one of them is binahong plant. The results of previous studies have shown the ability of ethanolic extract of binahong leaf in accelerating wound healing in diabetic rats. This study would be a continued study to test five kinds of binahong leaf fractions (FDB with gradual solvent polarity in accelerating wound healing in diabetic ulcer. Wound healing parameters observed were percentage of wound healing from the wound diameter contraction. The test begins with ethanolic extract of binahong leaf fractionation to produce fractions of hexane (FHDB, chloroform (FKDB, ethyl acetate (FEADB, and ethanol (FEDB. Water fraction (FADB was obtained from ethanolic leaf extract residues of binahong leaf extraction. Each fraction activity was tested topically twice daily on dorsal of test animals that created wounds using a punch biopsy 5 mm diameters. Grouping of test animals were divided into 13 groups with normal control group (non diabetes, negative control (diabetes + topical application of biocream®, positive control (diabetes + topical application of madecassol, and 10 diabetes groups with topical application of 5 kinds of binahong leaf fractions with each fractions consist of a concentrations of 5% and 10% with biocream® as a vehicle. Diabetic parameters measured include blood glucose levels (KGD and weight lost percentage (PB% in day 1 and 10 during a 10-day treatment. The results showed the influence of KGD in the condition of diabetes on wound healing rats diabetic ulcers which topically treated with

  8. Beta delayed particle emission in light nuclei

    International Nuclear Information System (INIS)

    Riisager, K.; Gabelmann, H.

    1991-01-01

    A short discussion of theoretical treatments of beta delayed particle emission is followed by a presentation of data on the newly found beta delayed deuteron decay of 6 He. This decay cannot be described properly with existing theories. (author) 8 refs.; 3 figs

  9. Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale

    Directory of Open Access Journals (Sweden)

    Suchismita Paul

    2016-01-01

    Full Text Available Background. Skin diseases associated with Human Immunodeficiency Virus (HIV infection are associated with significant morbidity and mortality. In resource-limited settings, nondermatologists and lay health care providers on the front line of HIV care provide much of the treatment for these conditions. Objective. To evaluate guidelines for treatment of HIV-related skin conditions and assess their accessibility, comprehensiveness, and quality of evidence employed. Methods. A review was undertaken of all national and society guidelines which included treatment information on the ten highest burden HIV-related skin conditions. The search strategy included gray and peer-reviewed literature. Results. Of 430 potential guidelines, 86 met inclusion criteria, and only 2 were written specifically to address HIV-related skin diseases as a whole. Treatment information for HIV-related skin conditions was embedded within guidelines written for other purposes, primarily HIV/AIDs treatment guidelines (49%. Development of guidelines relied either partially or completely on expert opinion (62%. Only 16% of guidelines used gradation of evidence quality and these were primarily from high-income countries (p=0.001. Limitations. Due to the nature of gray literature, not all guidelines may have been identified. Conclusion. This review highlights the need for evidence-based summary guidelines that address treatment for HIV-related skin conditions in an accessible format.

  10. Finalizing a measurement framework for the burden of treatment in complex patients with chronic conditions

    Directory of Open Access Journals (Sweden)

    Eton DT

    2015-03-01

    % were coping with multiple chronic conditions. A preliminary conceptual framework using data from the first 32 interviews was evaluated and was modified using narrative data from 18 additional interviews with a racially and socioeconomically diverse sample of patients. The final framework features three overarching themes with associated subthemes. These themes included: 1 work patients must do to care for their health (eg, taking medications, keeping medical appointments, monitoring health; 2 challenges/stressors that exacerbate perceived burden (eg, financial, interpersonal, provider obstacles; and 3 impacts of burden (eg, role limitations, mental exhaustion. All themes and subthemes were subsequently confirmed in focus groups. Conclusion: The final conceptual framework can be used as a foundation for building a patient self-report measure to systematically study treatment burden for research and analytical purposes, as well as to promote meaningful clinic-based dialogue between patients and providers about the challenges inherent in maintaining complex self-management of health. Keywords: treatment burden, conceptual framework, adherence, questionnaire, self-management, multi-morbidity

  11. Conditional Order-m Efficiency of Wastewater Treatment Plants: The Role of Environmental Factors

    Directory of Open Access Journals (Sweden)

    Ramón Fuentes

    2015-10-01

    Full Text Available The growing economic and environmental importance of managing water resources at a global level also entails greater efforts and interest in improving the functioning and efficiency of the increasingly more numerous wastewater treatment plants (WWTPs. In this context, this study analyzes the efficiency of a uniform sample of plants of this type located in the region of Valencia (Spain. The type of efficiency measure used for this (conditional order-m efficiency allows continuous and discrete contextual variables to be directly involved in the analysis and enables the assessment of their statistical significance and effect (positive or negative. The main findings of the study showed that the quality of the influent water and also the size and age of the plants had a significant influence on their efficiency levels. In particular, as regards the effect of such variables, the findings pointed to the existence of an inverse relationship between the quality of the influent water and the efficiency of the WWTPs. Also, a lower annual volume of treated water and more modern installations showed a positive influence. Additionally, the average efficiency levels observed turned out to be higher than those reported in previous studies.

  12. Treatment and final conditioning of solid radioactive wastes; Traitement et conditionnement definitif des dechets radioactifs solides

    Energy Technology Data Exchange (ETDEWEB)

    Cerre, J [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

    1960-07-01

    The storage of solid radioactive wastes on a site is so cumbersome and dangerous that we have developed a method of treatment and conditioning by means of which the volume of waste is considerably reduced and very long-lasting shielding can be provided. This paper describes the techniques adopted at Saclay, where the wastes are sheared, compressed and enveloped in concrete of variable thickness. The main part of the report is devoted to a description of the corresponding remote handling installation. (author) [French] L'encombrement et le danger que presentent sur un site le stockage de dechets radioactifs solides nous ont amenes a etudier un mode de traitement et de conditionnement permettant une sensible reduction du volume des dechets et une protection de tres longue duree. La presente communication expose les techniques adoptees a Saclay ou les dechets sont cisailles, comprimes et enrobes dans du beton d'epaisseur variable. La description de l'installation telecommandee correspondante fait l'objet principal de cette communication. (auteur)

  13. Influence of Thermal Treatment Conditions on the Properties of Dental Silicate Cements

    Directory of Open Access Journals (Sweden)

    Georgeta Voicu

    2016-02-01

    Full Text Available In this study the sol-gel process was used to synthesize a precursor mixture for the preparation of silicate cement, also called mineral trioxide aggregate (MTA cement. This mixture was thermally treated under two different conditions (1400 °C/2 h and 1450 °C/3 h followed by rapid cooling in air. The resulted material (clinker was ground for one hour in a laboratory planetary mill (v = 150 rot/min, in order to obtain the MTA cements. The setting time and mechanical properties, in vitro induction of apatite formation by soaking in simulated body fluid (SBF and cytocompatibility of the MTA cements were assessed in this study. The hardening processes, nature of the reaction products and the microstructural characteristics were also investigated. The anhydrous and hydrated cements were characterized by different techniques e.g., X-ray diffraction (XRD, scanning electron microscopy (SEM, infrared spectroscopy (FT-IR and thermal analysis (DTA-DTG-TG. The setting time of the MTA cement obtained by thermal treatment at 1400 °C/2 h (MTA1 was 55 min and 15 min for the MTA cement obtained at 1450 °C/3 h (MTA2. The compressive strength values were 18.5 MPa (MTA1 and 22.9 MPa (MTA2. Both MTA cements showed good bioactivity (assessed by an in vitro test, good cytocompatibility and stimulatory effect on the proliferation of cells.

  14. Optimization of wet lay-up conditions for steam generators hydrazine chemical treatment

    International Nuclear Information System (INIS)

    Long, A.; Organista, M.; Brun, C.; Combrade, P.

    2002-01-01

    Since a long time, hydrazine is used as a chemical agent to prevent corrosion of unalloyed steels. This is a conventional treatment widely used by nuclear power plant operators. But its application in SG lay-up at French nuclear power plants has, however, lead to some drawbacks. Effluent releases: Due to regulation relative to release of hydrazine and alkaline chemical compounds, some plant operators limit the concentrations of reagents to levels that could lead to insufficient protection of materials. Safety hazards associated with SG nitrogen blanketing: Prohibiting use of nitrogen blankets for SG wet lay-up due to associated safety hazards could likewise jeopardize corrosion protection at normally specified hydrazine levels. As the exact limits of hydrazine action against corrosion during SG lay-up are not well known, it is sometimes difficult to evaluate the risk associated to low dosage of N 2 H 4 . In order to answer to these problems, Framatome ANP (France) decided to carry out a test program aimed to determine the limit conditions for use of hydrazine in a wet lay-up environment. (authors)

  15. Delayed Orgasm and Anorgasmia

    OpenAIRE

    Jenkins, Lawrence C.; Mulhall, John P.

    2015-01-01

    Delayed orgasm/anorgasmia defined as the persistent or recurrent difficulty, delay in, or absence of attaining orgasm after sufficient sexual stimulation, which causes personal distress. Delayed orgasm and anorgasmia are associated with significant sexual dissatisfaction. A focused medical history can shed light on the potential etiologies; which include: medications, penile sensation loss, endocrinopathies, penile hyperstimulation and psychological etiologies, amongst others. Unfortunately, ...

  16. Self-regulation strategies may enhance the acute effect of exercise on smoking delay.

    Science.gov (United States)

    Hatzigeorgiadis, Antonis; Pappa, Vassiliki; Tsiami, Anastasia; Tzatzaki, Theodora; Georgakouli, Kalliopi; Zourbanos, Nikos; Goudas, Marios; Chatzisarantis, Nikos; Theodorakis, Yannis

    2016-06-01

    The present study examined the acute effect of a moderate intensity aerobic exercise session combined with self-regulation on smoking delay in physically inactive smokers. Participants were 11 adults (5 males and 6 females) that completed three experimental conditions: control, exercise, and exercise using self-regulation strategies (SR). Following the experimental treatment smoking for the two exercise conditions delayed significantly more than for the control condition; in addition exercise SR delayed smoking marginally more that the plain exercise condition. Findings supported previous research that acute exercise reduces cravings to smoke, and suggests that the use of self-regulation strategies may strengthen exercise for smoking cessation interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. ALMOST PERIODIC SOLUTIONS TO SOME NONLINEAR DELAY DIFFERENTIAL EQUATION

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The existence of an almost periodic solutions to a nonlinear delay diffierential equation is considered in this paper. A set of sufficient conditions for the existence and uniqueness of almost periodic solutions to some delay diffierential equations is obtained.

  18. Stability of Neutral Fractional Neural Networks with Delay

    Institute of Scientific and Technical Information of China (English)

    LI Yan; JIANG Wei; HU Bei-bei

    2016-01-01

    This paper studies stability of neutral fractional neural networks with delay. By introducing the definition of norm and using the uniform stability, the sufficient condition for uniform stability of neutral fractional neural networks with delay is obtained.

  19. Alteration of MX-80 by hydrothermal treatment under high salt content conditions

    Energy Technology Data Exchange (ETDEWEB)

    Pusch, R. [Geodevelopment AB, Lund (Sweden); Kasbohm, J. [Greifswald Univ. (Germany). Geological Dep.

    2002-02-01

    If brammalit, i.e. sodium illite, is formed from smectite in Na-rich salt water at high temperature such conversion can also take place in the buffer clay that surrounds the canisters in a KBS-3 repository. The present study comprised two laboratory test series with MX-80 clay, one with compacted clay powder with a dry density of 1200 to 1300 kg/m{sup 3} and saturation with 10% and 20% NaCl solutions followed by heating to 110 deg C under closed conditions for 30 days. In the second series air-dry compacted clay powder in a cell was heated at 110 deg C for the same period of time and connected to vessels with 10% and 20% NaCl solutions. The first series represents the conditions in the buffer clay after saturation with Na-rich salt water while the second one corresponds to the conditions in the course of saturation with such water. All laboratory tests were made after short-term percolation with distilled water for making sure that the hydro-thermally treated samples were fully fluid-saturated. The results from the physical testing showed that the hydraulic conductivity and swelling pressure of the hydrothermally treated clay samples were on the same order of magnitude as for untreated clay. Comparison with illitic clays shows that the latter are at least a hundred times more permeable than the hydrothermally treated salt clays in the present study, which hence indicates that conversion to illite was insignificant. This is obvious also from the fact that while illitic clays have very low swelling pressures the hydrothermally treated clays exhibited swelling pressures on the same order of magnitude as untreated MX-80. XRD analysis showed a clear difference in mineral constitution between the two test series. Thus, while no significant change from the typical mineralogy of untreated MX-80 was found for hydrothermal treatment of clay saturated with 10 and 20% NaCl solution, except for some very slight neoformation of illite-smectite mixed layers or irreversible

  20. Delays in the management of retroperitoneal sarcomas

    DEFF Research Database (Denmark)

    Seinen, Jojanneke; Almquist, Martin; Styring, Emelie

    2010-01-01

    Retroperitoneal sarcomas are rare and treatment should optimally be centralized. Despite successful centralization with 90% of the patients referred prior to surgery, delays occur, which led us to assess lead times in a population-based series. Method. Patients diagnosed with retroperitoneal...... sarcoma in the southern Sweden health care region 2003-2009 were eligible for the study. Data on referrals and diagnostic investigations were collected from clinical files from primary health care, local hospitals, and from the sarcoma centre. Lead times were divided into patient delays and health care...... delays caused by primary health care, local hospitals, or procedures at the sarcoma centre. Results. Complete data were available from 33 patients and demonstrated a median patient delay of 23¿days (0-17¿months) and median health care delay of 94¿days (1-40¿months) with delays of median 15¿days...

  1. Taxonomy of the burden of treatment: a multi-country web-based qualitative study of patients with chronic conditions.

    Science.gov (United States)

    Tran, Viet-Thi; Barnes, Caroline; Montori, Victor M; Falissard, Bruno; Ravaud, Philippe

    2015-05-14

    Management strategies for patients with chronic conditions are becoming increasingly complex, which may result in a burden of treatment for patients. To develop a Minimally Disruptive Medicine designed to reduce the burden of treatment, clinicians need to understand which healthcare tasks and aggravating factors may be responsible for this burden. The objective of the present study was to describe and classify the components of the burden of treatment for patients with chronic conditions from the patient's perspective. We performed a multi-country qualitative study using an online survey and a purposive sampling strategy to select English-, French-, and Spanish-speaking participants with different chronic conditions. Participants were recruited by physicians, patients' associations, advertisement on social media, and 'snowballing'. The answers were analyzed by i) manual content analysis with a grounded theory approach, coded by two researchers, and ii) automatic textual analysis by Reinert's method. Between 2013 and 2014, 1,053 participants from 34 different countries completed the online survey using 408,625 words. Results from both analyses were synthesized in a taxonomy of the burden of treatment, which described i) the tasks imposed on patients by their diseases and by their healthcare system (e.g., medication management, lifestyle changes, follow-up, etc.); ii) the structural (e.g., access to healthcare resources, coordination between care providers), personal, situational, and financial factors that aggravated the burden of treatment; and iii) patient-reported consequences of the burden (e.g., poor adherence to treatments, financial burden, impact on professional, family, and social life, etc.). Our findings may not be applicable to patients with chronic conditions who differ from those who responded to our survey. Our taxonomy of the burden of treatment, provided by patients with chronic conditions from different countries and settings, supports the

  2. Living with, managing and minimising treatment burden in long term conditions: a systematic review of qualitative research.

    Science.gov (United States)

    Demain, Sara; Gonçalves, Ana-Carolina; Areia, Carlos; Oliveira, Rúben; Marcos, Ana Jorge; Marques, Alda; Parmar, Ranj; Hunt, Katherine

    2015-01-01

    'Treatment burden', defined as both the workload and impact of treatment regimens on function and well-being, has been associated with poor adherence and unfavourable outcomes. Previous research focused on treatment workload but our understanding of treatment impact is limited. This research aimed to systematically review qualitative research to identify: 1) what are the treatment generated disruptions experienced by patients across all chronic conditions and treatments? 2) what strategies do patients employ to minimise these treatment generated disruptions? The search strategy centred on: treatment burden and qualitative methods. Medline, CINAHL, Embase, and PsychINFO were searched electronically from inception to Dec 2013. No language limitations were set. Teams of two reviewers independently conducted paper screening, data extraction, and data analysis. Data were analysed using framework synthesis informed by Cumulative Complexity Model. Eleven papers reporting data from 294 patients, across a range of conditions, age groups and nationalities were included. Treatment burdens were experienced as a series of disruptions: biographical disruptions involved loss of freedom and independence, restriction of meaningful activities, negative emotions and stigma; relational disruptions included strained family and social relationships and feeling isolated; and, biological disruptions involved physical side-effects. Patients employed "adaptive treatment work" and "rationalised non-adherence" to minimise treatment disruptions. Rationalised non-adherence was sanctioned by health professionals at end of life; at other times it was a "secret-act" which generated feelings of guilt and impacted on family and clinical relationships. Treatments generate negative emotions and physical side effects, strain relationships and affect identity. Patients minimise these disruptions through additional adaptive work and/or by non-adherence. This affects physical outcomes and care

  3. Living with, managing and minimising treatment burden in long term conditions: a systematic review of qualitative research.

    Directory of Open Access Journals (Sweden)

    Sara Demain

    Full Text Available 'Treatment burden', defined as both the workload and impact of treatment regimens on function and well-being, has been associated with poor adherence and unfavourable outcomes. Previous research focused on treatment workload but our understanding of treatment impact is limited. This research aimed to systematically review qualitative research to identify: 1 what are the treatment generated disruptions experienced by patients across all chronic conditions and treatments? 2 what strategies do patients employ to minimise these treatment generated disruptions?The search strategy centred on: treatment burden and qualitative methods. Medline, CINAHL, Embase, and PsychINFO were searched electronically from inception to Dec 2013. No language limitations were set. Teams of two reviewers independently conducted paper screening, data extraction, and data analysis. Data were analysed using framework synthesis informed by Cumulative Complexity Model. Eleven papers reporting data from 294 patients, across a range of conditions, age groups and nationalities were included. Treatment burdens were experienced as a series of disruptions: biographical disruptions involved loss of freedom and independence, restriction of meaningful activities, negative emotions and stigma; relational disruptions included strained family and social relationships and feeling isolated; and, biological disruptions involved physical side-effects. Patients employed "adaptive treatment work" and "rationalised non-adherence" to minimise treatment disruptions. Rationalised non-adherence was sanctioned by health professionals at end of life; at other times it was a "secret-act" which generated feelings of guilt and impacted on family and clinical relationships.Treatments generate negative emotions and physical side effects, strain relationships and affect identity. Patients minimise these disruptions through additional adaptive work and/or by non-adherence. This affects physical outcomes and

  4. Profitless delays for extinction in nonautonomous Lotka-Volterra system

    Science.gov (United States)

    Liu, Shengqiang; Chen, Lansun

    2001-12-01

    We study the delayed periodic n-species Lotka-Voterra systems where the growth rate of each species is not always positive. The sufficient conditions for the extinction that are independent of the delays are obtained. Some known results are improved and generalized. Our results suggest that under some conditions, the introduction and the variance of the time delays can be both harmless and profitless. Discussion about the effect of time delays on the extinction of the system is also advanced.

  5. Exploring the Limits and Utility of Operant Conditioning in the Treatment of Drug Addiction

    Science.gov (United States)

    Silverman, Kenneth

    2004-01-01

    This article describes a research program to develop an operant treatment for cocaine addiction in low-income, treatment-resistant methadone patients. The treatment's central feature is an abstinence reinforcement contingency in which patients earn monetary reinforcement for providing cocaine-free urine samples. Success and failure of this…

  6. Treatment of Ligament Constructs with Exercise-conditioned Serum: A Translational Tissue Engineering Model.

    Science.gov (United States)

    Lee-Barthel, Ann; Baar, Keith; West, Daniel W D

    2017-06-11

    In vitro experiments are essential to understand biological mechanisms; however, the gap between monolayer tissue culture and human physiology is large, and translation of findings is often poor. Thus, there is ample opportunity for alternative experimental approaches. Here we present an approach in which human cells are isolated from human anterior cruciate ligament tissue remnants, expanded in culture, and used to form engineered ligaments. Exercise alters the biochemical milieu in the blood such that the function of many tissues, organs and bodily processes are improved. In this experiment, ligament construct culture media was supplemented with experimental human serum that has been 'conditioned' by exercise. Thus the intervention is more biologically relevant since an experimental tissue is exposed to the full endogenous biochemical milieu, including binding proteins and adjunct compounds that may be altered in tandem with the activity of an unknown agent of interest. After treatment, engineered ligaments can be analyzed for mechanical function, collagen content, morphology, and cellular biochemistry. Overall, there are four major advantages versus traditional monolayer culture and animal models, of the physiological model of ligament tissue that is presented here. First, ligament constructs are three-dimensional, allowing for mechanical properties (i.e., function) such as ultimate tensile stress, maximal tensile load, and modulus, to be quantified. Second, the enthesis, the interface between boney and sinew elements, can be examined in detail and within functional context. Third, preparing media with post-exercise serum allows for the effects of the exercise-induced biochemical milieu, which is responsible for the wide range of health benefits of exercise, to be investigated in an unbiased manner. Finally, this experimental model advances scientific research in a humane and ethical manner by replacing the use of animals, a core mandate of the National

  7. Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions

    Directory of Open Access Journals (Sweden)

    Ethan L Matz

    2018-01-01

    Full Text Available Purpose: Autologous platelet rich plasma (PRP is used increasingly in a variety of settings. PRP injections have been used for decades to improve angiogenesis and wound healing. They have also been offered commercially in urology with little to no data on safety or efficacy. PRP could theoretically improve multiple urologic conditions, such as erectile dysfunction (ED, Peyronie's disease (PD, and stress urinary incontinence (SUI. A concern with PRP, however, is early washout, a situation potentially avoided by conversion to platelet rich fibrin matrix (PRFM. Before clinical trials can be performed, safety analysis is desirable. We reviewed an initial series of patients receiving PRFM for urologic pathology to assess safety and feasibility. Materials and Methods: Data were reviewed for patients treated with PRFM at our center from November 2012 to July 2017. Patients were observed immediately post-injection and at follow-up for complications and tolerability. Where applicable, International Index of Erectile Function (IIEF-5 scores were reviewed before and after injections for ED and/or PD. Pad use data was collected pre/post injection for SUI. Results: Seventeen patients were identified, with a mean receipt of 2.1 injections per patient. Post-procedural minor adverse events were seen in 3 men, consisting of mild pain at injection site and mild penile bruising. No patients experienced complications at follow-up. No decline was observed in men completing pre/post IIEF-5 evaluations. Conclusions: PRFM appears to be a safe and feasible treatment modality in patients with urologic disease. Further placebo-controlled trials are warranted.

  8. Lead particle size and its association with firing conditions and range maintenance: implications for treatment.

    Science.gov (United States)

    Dermatas, Dimitris; Chrysochoou, Maria

    2007-08-01

    Six firing range soils were analyzed, representing different environments, firing conditions, and maintenance practices. The particle size distribution and lead (Pb) concentration in each soil fraction were determined for samples obtained from the backstop berms. The main factors that were found to influence Pb fragment size were the type of soil used to construct the berms and the type of weapon fired. The firing of high velocity weapons, i.e., rifles, onto highly angular soils induced significant fragmentation of the bullets and/or pulverization of the soil itself. This resulted in the accumulation of Pb in the finer soil fractions and the spread of Pb contamination beyond the vicinity of the backstop berm. Conversely, the use of clay as backstop and the use of low velocity pistols proved to be favorable for soil clean-up and range maintenance, since Pb was mainly present as large metallic fragments that can be recovered by a simple screening process. Other factors that played important roles in Pb particle size distribution were soil chemistry, firing distance, and maintenance practices, such as the use of water spray for dust suppression and deflectors prior to impact. Overall, coarse Pb particles provide much easier and more cost-effective maintenance, soil clean-up, and remediation via physical separation. Fine Pb particles release Pb more easily, pose an airborne Pb hazard, and require the application of stabilization/solidification treatment methods. Thus, to ensure sustainable firing range operations by means of cost-effective design, maintenance, and clean-up, especially when high velocity weapons are used, the above mentioned factors should be carefully considered.

  9. Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD

    Science.gov (United States)

    2014-10-01

    and thus PTSD, is fear condition - ing. Fear conditioning is a Pavlovian response whereby a neutral stimulus is paired with an aversive stimulus until...for drug use, sleep disorders, and psychiatric and medical conditions via structured interview and laboratory tests. Inclu- sion criteria included the...Annual 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for

  10. Controllability of nonlinear delay oscillating systems

    Directory of Open Access Journals (Sweden)

    Chengbin Liang

    2017-05-01

    Full Text Available In this paper, we study the controllability of a system governed by second order delay differential equations. We introduce a delay Gramian matrix involving the delayed matrix sine, which is used to establish sufficient and necessary conditions of controllability for the linear problem. In addition, we also construct a specific control function for controllability. For the nonlinear problem, we construct a control function and transfer the controllability problem to a fixed point problem for a suitable operator. We give a sufficient condition to guarantee the nonlinear delay system is controllable. Two examples are given to illustrate our theoretical results by calculating a specific control function and inverse of a delay Gramian matrix.

  11. Effect of thermal treatment conditions on properties of vanadium molybdenum oxide catalyst in acrolein oxidation reaction to acrylic acid

    International Nuclear Information System (INIS)

    Gorshkova, T.P.; Tarasova, D.V.; Olen'kova, I.P.; Andrushkevich, T.V.; Nikoro, T.A.

    1984-01-01

    The effect of thermal treatment conditions (temperature and gas medium) on properties of vanadium molybdenum oxide catalyst in acrolein oxidation reaction to acrylic acid is investigated. It is shown that active and selective catalysts are formed in the course of thermal decomposition of the drying product of ammonium metavanadate and paramolybdate under the conditions ensuring the vanadium ion reduction up to tetravalent state with conservation of molybdenum oxidation degree equal to 6. It is possible to realize it either by treatment of the catalyst calcinated in the air flow at 300 deg by the reaction mixture at the activation stage or by gas-reducer flow treatment at 280 deg. Thermal treatment in the reducing medium of the oxidized catalyst does not lead to complete regeneration of its properties

  12. The impact of place of enrollment and delay to reperfusion on 90-day post-infarction mortality in the ASSENT-4 PCI trial: assessment of the safety and efficacy of a new treatment strategy with percutaneous coronary intervention.

    Science.gov (United States)

    Ross, Allan M; Huber, Kurt; Zeymer, Uwe; Armstrong, Paul W; Granger, Christopher B; Goldstein, Patrick; Bogaerts, Kris; Van de Werf, Frans

    2009-10-01

    We have performed a retrospective analysis of the data stratified by time to treatment and by enrollment site: percutaneous coronary intervention hospitals (PCIH), nonpercutaneous coronary intervention hospitals (NoPCIH), or in a pre-hospital setting (PreH). The ASSENT-4 PCI (Assessment of the Safety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention) trial intended to test the hypothesis that in ST-segment elevation myocardial infarction (STEMI) patients an upfront fibrinolytic bolus before PCI ("facilitated PCI") compared with primary PCI would benefit STEMI patients facing a long pre-PCI delay. Seven hundred forty-nine patients (45%) presented directly to PCIH, 578 (34%) presented to NoPCIH, and 334 (20%) were randomized and initially treated in the PreH setting. Patients in the PreH-facilitated group had the shortest delays (pain-to-fibrinolytic treatment 125 min) and the lowest 90-day mortality (3.1%). Among patients randomized to primary PCI, the shortest time from pain to first balloon was similarly in the PreH group (223 min). They had the lowest mortality of the primary PCI patient groups (4.1%). The highest mortality (8.4%) was in patients presenting to a PCIH and assigned to the facilitated strategy. Their pain-to-lysis time was 174 min and pain-to-PCI time 266 min (or 92 min after lysis). Few patients fit the target population, long delays to PCI for whom facilitated PCI was designed. Patients treated early after pain onset in the PreH setting do well after a facilitated approach. Despite limitations of post hoc subgroup analysis, these observations suggest caution in extrapolating the results of the ASSENT-4 trial to the "real world" where many patients might have potentially short pain-to-fibrinolysis time but are facing a long transport time to primary PCI.

  13. Effect on treatment delay of prehospital teletransmission of 12-lead electrocardiogram to a cardiologist for immediate triage and direct referral of patients with ST-segment elevation acute myocardial infarction to primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Sejersten, M.; Sillesen, M.; Hansen, Peter Riis

    2008-01-01

    the hospital. The primary study purpose was to determine whether delays could be decreased in an urban area by transmitting a prehospital 12-lead ECG directly to the attending cardiologist's mobile telephone for rapid triage and transport to a primary percutaneous coronary intervention (PCI) center, bypassing......, including 2 deaths (1%) caused by treatment-resistant arrhythmia. In conclusion, transmission of a prehospital 12-lead ECG directly to the attending cardiologist's mobile telephone decreased door-to-PCI time by >1 hour when patients were transported directly to PCI centers, bypassing local hospitals...

  14. Full scale treatment of phenolic coke coking waste water under unsteady conditions

    Energy Technology Data Exchange (ETDEWEB)

    Suschka, Jan [Institute for Ecology of Industrial Areas, Katowice (Poland); Morel, Jacek; Mierzwinski, Stanislaw; Januszek, Ryszard [Coke Plant Przyjazn, Dabrowa Gornicza (Poland)

    1993-12-31

    Phenolic waste water from the largest coke coking plant in Poland is treated at a full technical scale. From the very beginning it became evident that very high qualitative variations in short and long periods were to be expected. For this purpose, the biological treatment plant based on activated sludge is protected through preliminary physical-chemical treatment and the results are secured by a final chemical stage of treatment. Nevertheless, improvements in the performance of the treatment plant have been found necessary to introduce. In this work, the experience gained over the last five years is described and developed improvements were presented. 3 refs., 9 figs., 1 tab.

  15. Full scale treatment of phenolic coke coking waste water under unsteady conditions

    Energy Technology Data Exchange (ETDEWEB)

    Suschka, Jan [Institute for Ecology of Industrial Areas, Katowice (Poland); Morel, Jacek; Mierzwinski, Stanislaw; Januszek, Ryszard [Coke Plant Przyjazn, Dabrowa Gornicza (Poland)

    1994-12-31

    Phenolic waste water from the largest coke coking plant in Poland is treated at a full technical scale. From the very beginning it became evident that very high qualitative variations in short and long periods were to be expected. For this purpose, the biological treatment plant based on activated sludge is protected through preliminary physical-chemical treatment and the results are secured by a final chemical stage of treatment. Nevertheless, improvements in the performance of the treatment plant have been found necessary to introduce. In this work, the experience gained over the last five years is described and developed improvements were presented. 3 refs., 9 figs., 1 tab.

  16. Economic evaluation of therapeutic sequences in the treatment of patients with chronic lymphocytic leukemia and coexisting conditions

    Directory of Open Access Journals (Sweden)

    Antonio Cuneo

    2017-10-01

    Full Text Available Economic evaluation of therapeutic sequences in the treatment of patients with chronic lymphocytic leukemia and coexisting conditionsIntroductionChronic lymphocytic leukemia (CLL is a chronic lymphoproliferative syndrome and it is the most common hematological malignancy in Western countries. It has a tendency to develop subsequent relapses, so affected patients are likely to undergo more than one line of treatment.MethodsRather than evaluating the cost-effectiveness of individual therapeutic agents, it becomes therefore recommendable for decision-makers to identify an optimal sequencing of such agents. A four-year cost-consequence analysis was conducted, comparing three alternative strategies for the first-line treatment of patients with previously untreated CLL and coexisting conditions: i obinutuzumab with chlorambucil (Obi-Clb, ii rituximab with chlorambucil (Rtx-Clb, and iii ofatumumab with chlorambucil (Ofa-Clb. Only drug costs were considered in the analysis.ResultsIn two trials, median time to next treatment (TTNT was longer in Obi-Clb (51.1 months as compared to Rtx-Clb (38.2 months or to Ofa-Clb (39.8 months. Therefore, during a 48-month time horizon, patients treated with Obi-Clb would maintain on average the first line treatment; on the contrary, patients treated with Rtx-Clb or with Ofa-Clb would receive on average a second line treatment consisting in the majority of cases of ibrutinib monotherapy, or rituximab with idelalisib or rituximab with bendamustine. The sequence using Obi-Clb regimen in first line showed the lower mean cost of treatment: €22,958 over the 48-month time horizon. Sensitivity analyses on a couple of scenarios provided similar conclusions in terms of overall costs.ConclusionObi-Clb as first-line treatment appears a recommendable strategy in terms of drug costs in the treatment of patients with previously untreated CLL and coexisting conditions.

  17. Effect of operating conditions in soil aquifer treatment on the removals of pharmaceuticals and personal care products

    Energy Technology Data Exchange (ETDEWEB)

    He, Kai, E-mail: hekai@urban.env.kyoto-u.ac.jp; Echigo, Shinya; Itoh, Sadahiko

    2016-09-15

    Soil aquifer treatment (SAT) is an alternative advanced treatment for wastewater reclamation, and it has the potential to control micropollutants including pharmaceuticals and personal care products (PPCPs). However, the relationship of operating conditions in SAT and removals of micropollutants was not clear. In this study, the effects of operating conditions on the removals of PPCPs were evaluated by using lab-scale columns and plant pilot-scale reactors under different operating conditions. Firstly, weathered granite soil (WGS), standard sand (SAND) and Toyoura standard sand (TS) have different soil characteristics such as total organic carbon (TOC) and cation exchange capacity (CEC). In the columns with these packing materials, the removals of carboxylic analgesics and antilipidemics were effective regardless packing materials. The removals of antibiotics were more effective in WGS than in TS and SAND, indicating high TOC and CEC enhance the sorption in SAT. Secondly, with the extension of hydraulic retention time (HRT), the removals of sulfamethoxazole, acetaminophen, crotamiton, and antipyrine were improved in WGS columns, and adaptable biodegradation for moderately removable PPCPs was formed. Thirdly, the removal efficiencies of sulfamethoxazole and crotamiton were higher in the WGS column under vadose condition than in the WGS column under saturated condition, because of aerobic condition in WGS column under vadose condition. Though long HRT and vadose condition had positive influence on the removals of several PPCPs such as sulfamethoxazole, WGS column with an HRT of 7 days under saturated condition removed most PPCPs. - Highlights: • Soil organic matter and cation exchange capacity enhanced the removals of antibiotics in SAT. • A hydraulic retention time (HRT) of 7 days was sufficient for the removals of most PPCPs. • The removals of most selected PPCPs were similar under vadose and saturated conditions. • Vadose condition contributed to the

  18. Teriparatide Induced Delayed Persistent Hypercalcemia

    Directory of Open Access Journals (Sweden)

    Nirosshan Thiruchelvam

    2014-01-01

    Full Text Available Teriparatide, a recombinant PTH, is an anabolic treatment for osteoporosis that increases bone density. Transient hypercalcemia is a reported side effect of teriparatide that is seen few hours following administration of teriparatide and resolves usually within 16 hours of drug administration. Persistent hypercalcemia, although not observed in clinical trials, is rarely reported. The current case describes a rare complication of teriparatide induced delayed persistent hypercalcemia.

  19. RETARDAMENTO DA MATURAÇÃO DE MAÇÃS 'FUJI' PELO TRATAMENTO COM 1-MCP E MANEJO DA TEMPERATURA DELAYING 'FUJI' APPLE RIPENING BY 1-MCP TREATMENT AND MANAGEMENT OF STORAGE TEMPERATURE

    Directory of Open Access Journals (Sweden)

    LUIZ CARLOS ARGENTA

    2001-08-01

    Full Text Available Maçãs cv. Fuji foram tratadas com 42 mimol·m-3 de 1-metilciclopropeno (1-MCP por 24 h a 20°C, um dia após a colheita, e então armazenadas a 0; 10 ou 20ºC por 70 dias. Tratamento com 1-MCP efetivamente retardou a maturação de maçãs 'Fuji'. 1-MCP reduziu a taxa respiratória dos frutos mantidos a 10 e 20ºC e inibiu a produção de etileno dos frutos mantidos nas três temperaturas de armazenagem. Frutos tratados com 1-MCP e armazenados a 20ºC exibiram taxas respiratórias similares ou inferiores àquelas de frutos-controle armazenados a 10ºC. Quando armazenados a 10 ou 20ºC, frutos tratados com 1-MCP preservaram mais a firmeza da polpa e a acidez titulável e exibiram menor amarelecimento da epiderme que frutos-controle. Entretanto, não houve benefícios significativos do tratamento 1-MCP sobre a conservação da qualidade dos frutos armazenados a 0ºC no período de 70 dias após a colheita. Os resultados indicam que o tratamento com 1-MCP pode ser uma estratégia para o aumento da conservação de maçãs cv. Fuji durante o transporte e a distribuição sob 10 ou 20ºC. O prolongamento da armazenagem a 20ºC por período superior a 40 dias pode ser limitado pelo murchamento dos frutos e desenvolvimento de podridões.'Fuji' apples were treated with 42 mumol·m-3 of 1-methylcyclopropene (1-MCP for 24 h at 20°C then stored at 0, 10 or 20 ºC for 70 days. MCP treatment reduced respiration on fruit held at 10 and 20 ºC and inhibited ethylene production regardless of storage temperature. Treated fruits held at 20ºC presented respiration rate similar to those of untreated fruits held at 10ºC. For fruit held at 10 or 20ºC, MCP treatment inhibited softening, loss of acidity and color changes on fruit surface. However, there was no considerable benefit of 1-MCP treatment on maintenance of fruit quality during short-term (70 days and storage at 0ºC. Results indicated that 1-MCP is an effective mean to delay ripening and to retain

  20. Theoretical analysis of municipal solid waste treatment by leachate recirculation under anaerobic and aerobic conditions

    NARCIS (Netherlands)

    van Turnhout, A.G.; Brandstätter, Christian; Kleerebezem, R.; Fellner, Johann; Heimovaara, T.J.

    2018-01-01

    Long-term emissions of Municipal Solid Waste (MSW) landfills are a burden for future generations because of the required long-term aftercare. To shorten aftercare, treatment methods have to be developed that reduce long-term emissions. A treatment method that reduces emissions at a lysimeter

  1. Association of Knowledge and Cultural Perceptions of Malaysian Women with Delay in Diagnosis and Treatment of Breast Cancer: a Systematic Review.

    Science.gov (United States)

    Khan, Tahir Mehmood; Leong, Jamie Pik Yan; Ming, Long Chiau; Khan, Amer Hayat

    2015-01-01

    Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of

  2. Proposal of conditioning of the not-in-use sealed sources which are stored in the Radioactive Wastes Treatment Facility

    International Nuclear Information System (INIS)

    Jova, L.; Garcia, N.; Benitez, J.C.; Salgado, M.; Hernandez, A.

    1996-01-01

    There is a considerable number of sealed sources which are no longer in use at the radioactive wastes treatment facility. In the present work a methodology is proposed for the final conditioning of these sources, based on their immobilization in a cement matrix. This cementation is accomplished within a 200-liter tank

  3. Robust and predictive fuzzy key performance indicators for condition-based treatment of squats in railway infrastructures

    NARCIS (Netherlands)

    Jamshidi, A.; Nunez Vicencio, Alfredo; Dollevoet, R.P.B.J.; Li, Z.

    2017-01-01

    This paper presents a condition-based treatment methodology for a type of rail surface defect called squat. The proposed methodology is based on a set of robust and predictive fuzzy key performance indicators. A fuzzy Takagi-Sugeno interval model is used to predict squat evolution for different

  4. Two-step upflow anaerobic sludge bed system for sewage treatment under subtropical conditions with posttreatment in waste stabilization ponds

    NARCIS (Netherlands)

    Seghezzo, L.; Trupiano, A.P.; Liberal, V.; Todd, P.G.; Figueroa, M.E.; Gutierrez, M.A.; Silva Wilches, Da A.C.; Iribarnegaray, M.; Guerra, R.G.; Arena, A.; Cuevas, C.M.; Zeeman, G.; Lettinga, G.

    2003-01-01

    A pilot-scale sewage treatment system consisting of two upflow anaerobic sludge bed (UASB) reactors followed by five waste stabilization ponds (WSPs) in series was studied under subtropical conditions. The first UASB reactor started up in only 1 mo (stable operation, high chemical oxygen demand

  5. Delayed radiation necrosis in the optochiasmatic region

    International Nuclear Information System (INIS)

    Andoh, Takashi; Yokoyama, Kazutoshi; Kumagai, Morio

    1984-01-01

    Two cases with delayed radiation necrosis of the chiasmatic region following irradiation of the hypophysis for treatment of Cushing's disease were presented. Case 1 was a 36-year-old female who had reduction of visual acuity and bitemporal hemianopsia 2 years after 60 Co-irradiation therapy (total 8000 rads) for Cushing's disease. CT scans showed low density in the pituitary fossa and irregular contrast-enhanced suprasellar mass, and metrizamide CT cisternography revealed the pituitary fossa filled with contrast medium. From those findings, secondary empty sella syndrome was suspicious. Case 2 was a 35-year-old male who had progressive visual disturbance 3 years after 60 Co-irradiation therapy (total 9050 rads) for Cushing's disease. The right visual acuity was 0.05 and the left one was 0.1. Examination of visual field showed left homonymous hemianopsia. CT scans showed the contrast enhanced suprasellar mass extending to the right anterior thalamic region, and metrizamide CT cisternography detected secondary empty sella as same as that of Case 1. Authors reviewed and analyzed literatures of delayed radiation necrosis. The incidence of this condition was 4% to 9% and onset of the symptoms occured approximately 2 years after irradiation to hypophysis. Administration of steroid hormone and surgical treatment for the radiation necrosis involving the chiasmatic region were almost ineffective and also the prognosis of radionecrotic lesions involving the hypothalamus was very poor. Therefore, radiotherapy for hypophyseal region must be carried out by means of a rotation or arching technique in order to avoid this condition and further total dosage and its fractionation in radiation therapy should not exceed 6000 rads and 200 rads a day. (J.P.N.)

  6. Oral conditions, periodontal status and periodontal treatment need of chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Modupeoluwa Omotunde Soroye

    2016-01-01

    Conclusion: Majority of the CKD patients reviewed had poor periodontal status with code 2 TN. We, therefore, recommend nonsurgical periodontal treatment for all CKD patients to improve their oral health and forestall the systemic effects of periodontal pathology.

  7. Bioequivalence of two lansoprazole delayed release capsules 30 mg in healthy male volunteers under fasting, fed and fasting-applesauce conditions: a partial replicate crossover study design to estimate the pharmacokinetics of highly variable drugs.

    Science.gov (United States)

    Thota, S; Khan, S M; Tippabhotla, S K; Battula, R; Gadiko, C; Vobalaboina, V

    2013-11-01

    An open-label, 2-treatment, 3-sequence, 3-period, single-dose, partial replicate crossover studies under fasting (n=48), fed (n=60) and fasting-applesauce (n=48) (sprinkled on one table spoonful of applesauce) modalities were conducted in healthy adult male volunteers to evaluate bioequivalence between 2 formulations of lansoprazole delayed release capsules 30 mg. In all the 3 studies, as per randomization, either test or reference formulations were administered in a crossover manner with a required washout period of at least 7 days. Blood samples were collected adequately (0-24 h) to determine lansoprazole plasma concentrations using a validated LC-MS/MS analytical method. To characterize the pharmacokinetic parameters (Cmax, AUC0-t, AUC0-∞, Tmax, Kel and T1/2) of lansoprazole, non-compartmental analysis and ANOVA was applied on ln-transformed values. The bioequivalence was tested based on within-subject variability of the reference formulation. In fasting and fed studies (within-subject variability>30%) bioequivalence was evaluated with scaled average bioequivalence, hence for the pharmacokinetic parameters Cmax, AUC0-t and AUC0-∞, the 95% upper confidence bound for (μT-μR)2-θσ2 WR was ≤0, and the point estimates (test-to-reference ratio) were within the regulatory acceptance limit 80.00-125.00%. In fasting-applesauce study (within-subject variability<30%) bioequivalence was evaluated with average bioequivalence, the 90% CI of ln-transformed data of Cmax, AUC0-t and AUC0-∞ were within the regulatory acceptance limit 80.00-125.00%. Based on these aforesaid statistical inferences, it was concluded that the test formulation is bioequivalent to reference formulation. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Operant Conditioning Principles in the Treatment of Learning and Behavior Problems with Delinquent Boys

    Science.gov (United States)

    Bednar, Richard L.; And Others

    1970-01-01

    This study on operant conditioning showed that both groups showed significant improvement in reading skills from pretest to posttest, but that the reinforced group showed significantly more improvement than the nonreinforced group. (Author)

  9. Development of methods for treatment and conditioning of biological radioactive waste in the Czech Republic

    Energy Technology Data Exchange (ETDEWEB)

    Holub, J [NYCOM, Prague (Czech Republic)

    1997-02-01

    Incineration of biological radioactive waste was performed in a facility manufactured in the Czech Republic for combustion of burnable, radioactive and non-radioactive residues. The equipment has shown an adequate capability for combustion of biological waste. Basic technical parameters of the incinerator SP-603 can guarantee combustion of majority of wastes from different radionuclide users in the country. To ensure proper further handling with the resulting ash, three conditioning options were studied, the bituminization process, incorporation into cement, and embedding of ash into a mixture of bituminous and cementitious materials. Mechanical properties of the conditioned ash were in good compliance with those published elsewhere. Bituminized ash exhibits lowest leachibility, followed by the ash conditioned by means of the mixed process. Potential abnormal operation conditions were evaluated and their consequences assessed. The evaluation encompassed sensitivity analysis of the consequences potentially affecting the operating staff, nearby population and the environment. Cost estimate was carried out using a national approach for the calculation. From the results it can be seen that there are no large differences between the conditioning and disposal of wastes resulting from different conditioning processes. (author). 16 refs, 4 figs, 15 tabs.

  10. Development of methods for treatment and conditioning of biological radioactive waste in the Czech Republic

    International Nuclear Information System (INIS)

    Holub, J.

    1997-01-01

    Incineration of biological radioactive waste was performed in a facility manufactured in the Czech Republic for combustion of burnable, radioactive and non-radioactive residues. The equipment has shown an adequate capability for combustion of biological waste. Basic technical parameters of the incinerator SP-603 can guarantee combustion of majority of wastes from different radionuclide users in the country. To ensure proper further handling with the resulting ash, three conditioning options were studied, the bituminization process, incorporation into cement, and embedding of ash into a mixture of bituminous and cementitious materials. Mechanical properties of the conditioned ash were in good compliance with those published elsewhere. Bituminized ash exhibits lowest leachibility, followed by the ash conditioned by means of the mixed process. Potential abnormal operation conditions were evaluated and their consequences assessed. The evaluation encompassed sensitivity analysis of the consequences potentially affecting the operating staff, nearby population and the environment. Cost estimate was carried out using a national approach for the calculation. From the results it can be seen that there are no large differences between the conditioning and disposal of wastes resulting from different conditioning processes. (author). 16 refs, 4 figs, 15 tabs

  11. Euclidean null controllability of nonlinear infinite delay systems with ...

    African Journals Online (AJOL)

    Sufficient conditions for the Euclidean null controllability of non-linear delay systems with time varying multiple delays in the control and implicit derivative are derived. If the uncontrolled system is uniformly asymptotically stable and if the control system is controllable, then the non-linear infinite delay system is Euclidean null ...

  12. Lag synchronization of chaotic systems with time-delayed linear

    Indian Academy of Sciences (India)

    In this paper, the lag synchronization of chaotic systems with time-delayed linear terms via impulsive control is investigated. Based on the stability theory of impulsive delayed differential equations, some sufficient conditions are obtained guaranteeing the synchronized behaviours between two delayed chaotic systems.

  13. American Dream Delayed

    DEFF Research Database (Denmark)

    Khorunzhina, Natalia; Miller, Robert A.

    This paper investigates the delay in homeownership and a subsequent reduction in homeownership rate observed over the past decades. We focus on the delay in giving birth to children and increased labor market participation as contributing factors to homeownership dynamics for prime-age female hou...

  14. Prehospital delay in acute coronary syndrome--an analysis of the components of delay

    DEFF Research Database (Denmark)

    Ottesen, Michael Mundt; Dixen, Ulrik; Torp-Pedersen, Christian

    2004-01-01

    BACKGROUND: Prompt hospital admission is essential when treating acute coronary syndrome. Delay prior to admission is unnecessarily long. Therefore, a thorough scrutiny of the influence of characteristics, circumstantial and subjective variables on elements of prehospital delay among patients...... admitted with acute coronary syndrome is warranted. METHODS: A structured interview was conducted on 250 consecutive patients admitted alive with acute coronary syndrome. RESULTS: Median prehospital, decision, physician and transportation delays were 107, 74, 25 and 22 min, respectively. Women (n=77) had...... of acute coronary syndrome among women, and thereby contributes to unnecessary long delay to treatment. The patient's prior experience and interpretation has a significant influence on behaviour....

  15. Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: results from the German prospective, multicentre FITT-STEMI trial.

    Science.gov (United States)

    Scholz, Karl Heinrich; Maier, Sebastian K G; Maier, Lars S; Lengenfelder, Björn; Jacobshagen, Claudius; Jung, Jens; Fleischmann, Claus; Werner, Gerald S; Olbrich, Hans G; Ott, Rainer; Mudra, Harald; Seidl, Karlheinz; Schulze, P Christian; Weiss, Christian; Haimerl, Josef; Friede, Tim; Meyer, Thomas

    2018-04-01

    The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n = 12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI). Patients were stratified by cardiogenic shock (CS) and out-of-hospital cardiac arrest (OHCA). For patients treated within 60 to 180 min from the first medical contact, we found a nearly linear relationship between contact-to-balloon times and mortality in all four STEMI groups. In CS patients with no OHCA, every 10-min treatment delay resulted in 3.31 additional deaths in 100 PCI-treated patients. This treatment delay-related increase in mortality was significantly higher as compared to the two groups of OHCA patients with shock (2.09) and without shock (1.34), as well as to haemodynamically stable patients (0.34, P < 0.0001). In patients with CS, the time elapsing from the first medical contact to primary PCI is a strong predictor of an adverse outcome. This patient group benefitted most from immediate PCI treatment, hence special efforts to shorten contact-to-balloon time should be applied in particular to these high-risk STEMI patients. NCT00794001.

  16. Effect of atmospheric pressure plasma treatment condition on adhesion of ramie fibers to polypropylene for composite

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ying [College of Material and Textile Engineering, Jiaxing University, Jiaxing 314033 (China); Center for Plasma-Aided Manufacturing, Madison, WI 53706 (United States); School of Human Ecology, University of Wisconsin-Madison, Madison, WI 53706 (United States); Manolache, Sorin [Center for Plasma-Aided Manufacturing, Madison, WI 53706 (United States); US Forest Products Laboratory, Madison, WI 53726 (United States); Qiu, Yiping, E-mail: ypqiu@dhu.edu.cn [College of Textiles, Donghua University, Shanghai 201620 (China); Sarmadi, Majid, E-mail: majidsar@wisc.edu [Center for Plasma-Aided Manufacturing, Madison, WI 53706 (United States); School of Human Ecology, University of Wisconsin-Madison, Madison, WI 53706 (United States); Materials Science Program, University of Wisconsin-Madison, Madison, WI 53706 (United States)

    2016-02-28

    Graphical abstract: - Highlights: • The continuous ethanol flow technique can successfully modify ramie fiber surface with an increase in IFSS value up to 50%. • Response surface methodology was applied to design the plasma treatment parameters for ramie fiber modification. • The ethanol flow rate was the most influential treatment parameter in plasma modification process. - Abstract: In order to improve the interfacial adhesion between hydrophilic ramie fibers and hydrophobic polypropylene (PP) matrices, ramie fibers are modified by atmospheric pressure dielectric barrier discharge (DBD) plasma with our continuous ethanol flow technique in helium environment. A central composite design of experiments with different plasma processing parameter combinations (treatment current, treatment time and ethanol flow rate) is applied to find the most influential parameter and to obtain the best modification effect. Field emission scanning electron microscope (SEM) shows the roughened surfaces of ramie fibers from the treated groups due to plasma etching effect. Dynamic contact angle analysis (DCAA) demonstrates that the wettability of the treated fibers drastically decreases. Microbond pullout test shows that the interfacial shear strength (IFSS) between treated ramie fibers and PP matrices increases significantly. Residual gas analysis (RGA) confirms the creation of ethyl groups during plasma treatment. This study shows that our continuous ethanol flow technique is effective in the plasma modification process, during which the ethanol flow rate is the most influential parameter but all parameters have simultaneous influence on plasma modification effect of ramie fibers.

  17. Global synchronization criteria with channel time-delay for chaotic time-delay system

    International Nuclear Information System (INIS)

    Sun Jitao

    2004-01-01

    Based on the Lyapunov stabilization theory, matrix measure, and linear matrix inequality (LMIs), this paper studies the chaos synchronization of time-delay system using the unidirectional linear error feedback coupling with time-delay. Some generic conditions of chaos synchronization with time-delay in the transmission channel is established. The chaotic Chua's circuit is used for illustration, where the coupling parameters are determined according to the criteria under which the global chaos synchronization of the time-delay coupled systems is achieved

  18. Pinus Pinaster surface treatment realized in spatial and temporal afterglow DBD conditions

    Science.gov (United States)

    Lecoq, E.; Clément, F.; Panousis, E.; Loiseau, J.-F.; Held, B.; Castetbon, A.; Guimon, C.

    2008-04-01

    This experimental work deals with the exposition of Pinus Pinaster wood samples to a DBD afterglow. Electrical parameters like duty cycle and injected energy in the gas are being varied and the modifications induced by the afterglow on the wood are analysed by several macroscopic and microscopic ways like wettability, XPS analyses and also soaking tests of treated wood in a commercial fungicide solution. Soaking tests show that plasma treatment could enhance the absorption of fungicide into the wood. The wettability results point out that the plasma treatment can inflict on the wood different surface properties, making it hydrophilic or hydrophobic, when varying electrical parameters. XPS analyses reveal several chemical modifications like an increase of the O/C ratio and the presence of carboxyl groups on the surface after plasma treatments.

  19. Effect of design and operational conditions on the performance of subsurface flow treatment wetlands: Emerging organic contaminants as indicators.

    Science.gov (United States)

    Kahl, Stefanie; Nivala, Jaime; van Afferden, Manfred; Müller, Roland A; Reemtsma, Thorsten

    2017-11-15

    Six pilot-scale subsurface flow treatment wetlands loaded with primary treated municipal wastewater were monitored over one year for classical wastewater parameters and a set of emerging organic compounds (EOCs) serving as process indicators for biodegradation: caffeine, ibuprofen, naproxen, benzotriazole, diclofenac, acesulfame, and carbamazepine. The wetland technologies investigated included conventional horizontal flow, unsaturated vertical flow (single and two-stage), horizontal flow with aeration, vertical flow with aeration, and reciprocating. Treatment efficiency for classical wastewater parameters and EOCs generally increased with increasing design complexity and dissolved oxygen concentrations. The two aerated wetlands and the two-stage vertical flow system showed the highest EOC removal, and the best performance in warm season and most robust performance in the cold season. These three systems performed better than the adjacent conventional WWTP with respect to EOC removal. Acesulfame was observed to be removed (>90%) by intensified wetland systems and with use of a tertiary treatment sand filter during the warm season. Elevated temperature and high oxygen content (aerobic conditions) proved beneficial for EOC removal. For EOCs of moderate to low biodegradability, the co-occurrence of aerobic conditions and low content of readily available carbon appears essential for efficient removal. Such conditions occurred in the aerated systems and with use of a tertiary treatment sand filter. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Assessing effects of aerobic and anaerobic conditions on phosphorus sorption and retention capacity of water treatment residuals.

    Science.gov (United States)

    Oliver, Ian W; Grant, Cameron D; Murray, Robert S

    2011-03-01

    Water treatment residuals (WTRs) are the by-products of drinking water clarification processes, whereby chemical flocculants such as alum or ferric chloride are added to raw water to remove suspended clay particles, organic matter and other materials and impurities. Previous studies have identified a strong phosphorus (P) fixing capacity of WTRs which has led to experimentation with their use as P-sorbing materials for controlling P discharges from agricultural and forestry land. However, the P-fixing capacity of WTRs and its capacity to retain sorbed P under anaerobic conditions have yet to be fully demonstrated, which is an issue that must be addressed for WTR field applications. This study therefore examined the capacity of WTRs to retain sorbed P and sorb further additional P from aqueous solution under both aerobic and anaerobic conditions. An innovative, low cost apparatus was constructed and successfully used to rapidly establish anoxic conditions in anaerobic treatments. The results showed that even in treatments with initial solution P concentrations set at 100 mg l(-1), soluble reactive P concentrations rapidly fell to negligible levels (due to sorption by WTRs), while total P (i.e. dissolved + particulate and colloidal P) was less than 3 mg l(-1). This equated to an added P retention rate of >98% regardless of anaerobic or aerobic status, indicating that WTRs are able to sorb and retain P in both aerobic and anaerobic conditions. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Idiopathic burning mouth syndrome: a common treatment-refractory somatoform condition responsive to ECT.

    Science.gov (United States)

    McGirr, Alexander; Davis, Lindsay; Vila-Rodriguez, Fidel

    2014-04-30

    Somatic symptom disorders are common causes of disability and suffering, and can pose significant management challenges. Idiopathic burning mouth syndrome is a challenging somatic symptom disorder with relatively high prevalence, particularly among post-menopausal women. Here, we present the case of a woman with severe treatment refractory idiopathic burning mouth syndrome and comorbid major depressive disorder, who was successfully treated with bitemporal electroconvulsive therapy. This case highlights the potential effectiveness of electroconvulsive therapy in idiopathic burning mouth syndrome when other treatment options have been exhausted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Practical Fluid Therapy and Treatment Modalities for Field Conditions for Horses and Foals with Gastrointestinal Problems.

    Science.gov (United States)

    Fielding, C Langdon

    2018-04-01

    With advances in technology and owner education, field management in equine veterinary medicine continues to evolve. Equine gastrointestinal disease is one of the most common types of emergencies evaluated by equine practitioners, and many of these patients can be effectively managed in the field. Although the equine veterinarian must make numerous decisions, fluid therapy, pain management, and antimicrobial use are 3 of the major choices that must be addressed when initiating field treatment of equine gastrointestinal disease. This article addresses the practical use of these 3 treatment categories that are essential to field practice. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Explicit treatment for Dirichlet, Neumann and Cauchy boundary conditions in POD-based reduction of groundwater models

    Science.gov (United States)

    Gosses, Moritz; Nowak, Wolfgang; Wöhling, Thomas

    2018-05-01

    In recent years, proper orthogonal decomposition (POD) has become a popular model reduction method in the field of groundwater modeling. It is used to mitigate the problem of long run times that are often associated with physically-based modeling of natural systems, especially for parameter estimation and uncertainty analysis. POD-based techniques reproduce groundwater head fields sufficiently accurate for a variety of applications. However, no study has investigated how POD techniques affect the accuracy of different boundary conditions found in groundwater models. We show that the current treatment of boundary conditions in POD causes inaccuracies for these boundaries in the reduced models. We provide an improved method that splits the POD projection space into a subspace orthogonal to the boundary conditions and a separate subspace that enforces the boundary conditions. To test the method for Dirichlet, Neumann and Cauchy boundary conditions, four simple transient 1D-groundwater models, as well as a more complex 3D model, are set up and reduced both by standard POD and POD with the new extension. We show that, in contrast to standard POD, the new method satisfies both Dirichlet and Neumann boundary conditions. It can also be applied to Cauchy boundaries, where the flux error of standard POD is reduced by its head-independent contribution. The extension essentially shifts the focus of the projection towards the boundary conditions. Therefore, we see a slight trade-off between errors at model boundaries and overall accuracy of the reduced model. The proposed POD extension is recommended where exact treatment of boundary conditions is required.

  4. Combined supra-transorbital keyhole approach for treatment of delayed intraorbital encephalocele: A minimally invasive approach for an unusual complication of decompressive craniectomy

    Science.gov (United States)

    di Somma, Lucia; Iacoangeli, Maurizio; Nasi, Davide; Balercia, Paolo; Lupi, Ettore; Girotto, Riccardo; Polonara, Gabriele; Scerrati, Massimo

    2016-01-01

    Background: Intraorbital encephalocele is a rare entity characterized by the herniation of cerebral tissue inside the orbital cavity through a defect of the orbital roof. In patients who have experienced head trauma, intraorbital encephalocele is usually secondary to orbital roof fracture. Case Description: We describe here a case of a patient who presented an intraorbital encephalocele 2 years after severe traumatic brain injury, treated by decompressive craniectomy and subsequent autologous cranioplasty, without any evidence of orbital roof fracture. The encephalocele removal and the subsequent orbital roof reconstruction were performed by using a modification of the supraorbital keyhole approach, in which we combine an orbital osteotomy with a supraorbital minicraniotomy to facilitate view and access to both the anterior cranial fossa and orbital compartment and to preserve the already osseointegrated autologous cranioplasty. Conclusions: The peculiarities of this case are the orbital encephalocele without an orbital roof traumatic fracture, and the combined minimally invasive approach used to fix both the encephalocele and the orbital roof defect. Delayed intraorbital encephalocele is probably a complication related to an unintentional opening of the orbit during decompressive craniectomy through which the brain herniated following the restoration of physiological intracranial pressure gradients after the bone flap repositioning. The reconstruction of the orbital roof was performed by using a combined supra-transorbital minimally invasive approach aiming at achieving adequate surgical exposure while preserving the autologous cranioplasty, already osteointegrated. To the best of our knowledge, this approach has not been previously used to address intraorbital encephalocele. PMID:26862452

  5. One-stage treatment of delayed 'jersey finger' by Z-step lengthening of the flexor digitorum profundus tendon at the wrist.

    Science.gov (United States)

    Sawaya, Elias T; Choughri, Hussein; Pelissier, Philippe

    2012-02-01

    The authors report the case of a 19-year-old female with delayed presentation of a type II 'jersey finger' of the fourth dominant digit. A surgical approach was performed, revealing a retracted flexor digitorum profundus tendon within a still patent sheath. The resulting loss of tendon length overruled any possibility of direct reinsertion of the tendon. A lengthening "Z-step" tendinoplasty was then performed on the tendon at the wrist, thus enabling reinsertion at the base of the distal phalanx. The patient then underwent conventional splinting and physiotherapy. Total Active Motion was measured at 220° with a 6-month follow-up. Even though there is no clear consensus concerning management of such cases, different techniques have been described, such as one- or two-stage grafting, or tenotomy at the musculotendinous junction. Lengthening tendinoplasties have been applied by certain authors but only to the flexor pollicis longus tendon. To our knowledge, this is the only reported case of lengthening Z-step applied to a long digit for the repair of type II 'jersey finger' lesions. The satisfactory functional and cosmetic outcome encourages us to consider this one-stage technique in other select cases, in order to gather more formal evidence. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. 38 CFR 3.381 - Service connection of dental conditions for treatment purposes.

    Science.gov (United States)

    2010-07-01

    ... treatment purposes. (a) Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease will be considered service-connected solely for the purpose of establishing... will consider each defective or missing tooth and each disease of the teeth and periodontal tissues...

  7. Biological treatment of sulfidic spent caustics under haloalkaline conditions using soda lake bacteria

    NARCIS (Netherlands)

    Graaff, de C.M.

    2012-01-01

    In this thesis, the development of a newbiotechnological process for the treatment of undiluted sulfidic spent caustics (SSC’s) using soda lake bacteria is described. SSC’s are waste solutions that are formed in the oil and gas industry due to the caustic (NaOH) scrubbing of hydrocarbon streams

  8. Maprotiline treatment differentially influences cardiac β-adrenoreceptors expression under normal and stress conditions

    Directory of Open Access Journals (Sweden)

    Natasa Spasojevic

    2012-12-01

    Full Text Available Alterations in cardiac function were observed in antidepressants treated patients and published in several clinical reports. These detected changes could be either a consequence of the treatment or of depression itself, which has already been proved to be a risk factor in heart diseases. In order to determine a possible influence of chronic treatment with norepinephrinergic reuptake inhibitor, maprotiline, on the heart, we investigated gene expression of cardiac β-adrenoceptors both in controls and in animals with signs of depression. The rats were divided into two groups, unstressed controls and those exposed to chronic unpredictable mild stress (CUMS. The groups were further divided into two subgroups, one receiving daily intraperitoneal injections of vehicle (sterile water and another one maprotiline (10 mg/kg for four weeks. Tissue samples were collected after the last application. Gene expression of cardiac β1- and β2-adrenoceptor was determined using Real-time RT-PCR analysis. Our results show that in control animals expression of both adrenoreceptors was decreased in the right atria after 4 weeks of maprotiline application. Contrary, the same treatment led to a significant increase in expression of cardiac β1-adrenoceptor in the stressed rats, with no change in the characteristics of β2-adrenoceptor. Our findings might reflect the that molecular mechanisms are underlying factors involved in the development of cardiovascular diseases linked with antidepressant treatment.

  9. Performance of crossbred calves raised on different dietary treatments under smallholder dairy farm conditions

    DEFF Research Database (Denmark)

    Lyimo, H L N; Laswai, G H; Mtenga, L A

    2010-01-01

    and was formulated using locally available feed resources. Twenty-seven (27) male calves, with birth weight 32 ± 1.5 kg were randomly allocated to three treatments, whereby Treatment 1 (DC) calves were fed the developed concentrate, Treatment 2 (FC) calves were fed a common home made dairy cow concentrate (CP 130 g......An on-farm study was carried out in Tanzania to assess the performance of crossbred (Frisian/Ayrshire x Tanzania Shorthorn Zebu) dairy calves fed on a concentrate, previously developed and tested on-station. The developed concentrate contained 189 g