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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

    Science.gov (United States)

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

    2017-01-01

    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.

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

    National Research Council Canada - National Science Library

    van Maanen A; Meijer AM; Smits MG; Oort FJ

    2017-01-01

    .... 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...

  3. 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.

  4. Oscillatority Conditions for Nonlinear Systems with Delay

    Directory of Open Access Journals (Sweden)

    Denis V. Efimov

    2007-01-01

    Full Text Available Sufficient conditions for oscillatority in the sense of Yakubovich for a class of time delay nonlinear systems are proposed. Under proposed conditions, upper and lower bounds for oscillation amplitude are given. Examples illustrating analytical results by computer simulation are presented.

  5. Delay differential equations with homogeneous integral conditions

    Directory of Open Access Journals (Sweden)

    Abdur Raheem

    2013-03-01

    Full Text Available In this article we prove the existence and uniqueness of a strong solution of a delay differential equation with homogenous integral conditions using the method of semidiscretization in time. As an application, we include an example that illustrates the main result.

  6. Delayed effects of cortisol enhance fear memory of trace conditioning.

    Science.gov (United States)

    Cornelisse, Sandra; van Ast, Vanessa A; Joëls, Marian; Kindt, Merel

    2014-02-01

    Corticosteroids induce rapid non-genomic effects followed by slower genomic effects that are thought to modulate cognitive function in opposite and complementary ways. It is presently unknown how these time-dependent effects of cortisol affect fear memory of delay and trace conditioning. This distinction is of special interest because the neural substrates underlying these types of conditioning may be differently affected by time-dependent cortisol effects. Delay conditioning is predominantly amygdala-dependent, while trace conditioning additionally requires the hippocampus. Here, we manipulated the timing of cortisol action during acquisition of delay and trace fear conditioning, by randomly assigning 63 men to one of three possible groups: (1) receiving 10mg hydrocortisone 240 min (slow cort) or (2) 60 min (rapid cort) before delay and trace acquisition, or (3) placebo at both times, in a double-blind design. The next day, we tested memory for trace and delay conditioning. Fear potentiated startle responses, skin conductance responses and unconditioned stimulus expectancy scores were measured throughout the experiment. The fear potentiated startle data show that cortisol intake 240 min before actual fear acquisition (slow cort) uniquely strengthened subsequent trace conditioned memory. No effects of cortisol delivery 60 min prior to fear acquisition were found on any measure of fear memory. Our findings emphasize that slow, presumably genomic, but not more rapid effects of corticosteroids enhance hippocampal-dependent fear memories. On a broader level, our findings underline that basic experimental research and clinically relevant pharmacological treatments employing corticosteroids should acknowledge the timing of corticosteroid administration relative to the learning phase, or therapeutic intervention.

  7. Do long delay conditioned stimuli develop inhibitory properties?

    Directory of Open Access Journals (Sweden)

    Martha eEscobar

    2015-10-01

    Full Text Available In long-delay conditioning, a long conditioned stimulus (CS is paired in its final segments with an unconditioned stimulus. With sufficient training, this procedure usually results in conditioned responding being delayed until the final segment of the CS, a pattern of responding known as inhibition of delay. However, there have been no systematic investigations of the associative structure of long delay conditioning, and whether the initial segment of a long delay CS actually becomes inhibitory is debatable. In an appetitive preparation with rat subjects, the initial segment of long delay CS A passed a retardation (Experiment 1a but not a summation (Experiment 1b test for conditioned inhibition. Furthermore, retardation was observed only if long delay conditioning and retardation training occurred in the same context (Experiment 2. Thus, the initial segment of a long delay CS appears to share more characteristics with a latent inhibitor than a conditioned inhibitor. Componential theories of conditioning appear best suited to account for these results.

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

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    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.

  9. New Stability Conditions for Linear Differential Equations with Several Delays

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    Leonid Berezansky

    2011-01-01

    Full Text Available New explicit conditions of asymptotic and exponential stability are obtained for the scalar nonautonomous linear delay differential equation x˙(t+∑k=1mak(tx(hk(t=0 with measurable delays and coefficients. These results are compared to known stability tests.

  10. GLOBAL ASYMPTOTIC STABILITY CONDITIONS OF DELAYED NEURAL NETWORKS

    Institute of Scientific and Technical Information of China (English)

    ZHOU Dong-ming; CAO Jin-de; ZHANG Li-ming

    2005-01-01

    Utilizing the Liapunov functional method and combining the inequality of matrices technique to analyze the existence of a unique equilibrium point and the global asymptotic stability for delayed cellular neural networks (DCNNs), a new sufficient criterion ensuring the global stability of DCNNs is obtained. Our criteria provide some parameters to appropriately compensate for the tradeoff between the matrix definite condition on feedback matrix and delayed feedback matrix. The criteria can easily be used to design and verify globally stable networks. Furthermore, the condition presented here is independent of the delay parameter and is less restrictive than that given in the references.

  11. Neural Circuitry and Plasticity Mechanisms Underlying Delay Eyeblink Conditioning

    Science.gov (United States)

    Freeman, John H.; Steinmetz, Adam B.

    2011-01-01

    Pavlovian eyeblink conditioning has been used extensively as a model system for examining the neural mechanisms underlying associative learning. Delay eyeblink conditioning depends on the intermediate cerebellum ipsilateral to the conditioned eye. Evidence favors a two-site plasticity model within the cerebellum with long-term depression of…

  12. 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.

  13. Delayed effects of cortisol enhance fear memory of trace conditioning

    NARCIS (Netherlands)

    Cornelisse, S.; Ast, V.A. van; Joëls, M.; Kindt, M.

    2014-01-01

    Corticosteroids induce rapid non-genomic effects followed by slower genomic effects that are thought to modulate cognitive function in opposite and complementary ways. It is presently unknown how these time-dependent effects of cortisol affect fear memory of delay and trace conditioning. This distin

  14. Delayed effects of cortisol enhance fear memory of trace conditioning

    NARCIS (Netherlands)

    Cornelisse, S.; Ast, V.A. van; Joëls, M.; Kindt, M.

    2014-01-01

    Corticosteroids induce rapid non-genomic effects followed by slower genomic effects that are thought to modulate cognitive function in opposite and complementary ways. It is presently unknown how these time-dependent effects of cortisol affect fear memory of delay and trace conditioning. This distin

  15. Treatment of bronchial ruptures by delayed surgery

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Objective:To study the causes that resulted in delayed surgery for bronchial ruptures and the results.Methods:The cases with the bronchial ruptures by the delayed surgery last decade were retrospectively reviewed.The causes and unsatisfactory results were analysed.Results:The severe complications usually occurred after the delayed surgery and the results were not as satisfactory as those by early surgery.Conclusion:The bronchial ruptures ought to be operated in the early stage after being wounded.

  16. Gompertz model with delays and treatment: mathematical analysis.

    Science.gov (United States)

    Bodnar, Marek; Piotrowska, Monika Joanna; Foryś, Urszula

    2013-06-01

    In this paper we study the delayed Gompertz model, as a typical model of tumor growth, with a term describing external interference that can reflect a treatment, e.g. chemotherapy. We mainly consider two types of delayed models, the one with the delay introduced in the per capita growth rate (we call it the single delayed model) and the other with the delay introduced in the net growth rate (the double delayed model). We focus on stability and possible stability switches with increasing delay for the positive steady state. Moreover, we study a Hopf bifurcation, including stability of arising periodic solutions for a constant treatment. The analytical results are extended by numerical simulations for a pharmacokinetic treatment function.

  17. Tropospheric Delay Analysis Based on Some Chinese Cities' Meteorologic Conditions

    Science.gov (United States)

    Liu, Q.; Chen, X. H.; Sun, J. Z.; Han, B. B.; Zhang, Q.

    2014-03-01

    With the increase of the users' precision in satellite orientation and navigation, the influence of the tropospheric delay has become increasingly vital, which needs to be corrected. The paper contrastively analyzes some main mapping functions' models of the tropospheric delay theory. It discusses the distributions of the hydrostatic/wet mapping functions of Niell Mapping Function (NMF), Vienna Mapping Function 1 (VMF1), and Global Mapping Function (GMF). And it analyzes tropospheric delay based on the meteorologic conditions in some Chinese cities. It could be concluded from the results that the hydrostatic VMF1 and GMF are in yearly periodic cosine distributions and approximately identical, whereas the hydrostatic NMF is roughly larger than the formers. The wet VMF1, which is influenced greatly by the atmosphere, displays close to cosine functions. Besides, VMF1 and GMF roughly display minimum in summer and maximum in winter, respectively. While the elevation angle is 10 degrees, the Slant Propagation Delays (SPDs) of the chosen stations are all in yearly periodic cosine distributions, and they decrease with the increase of the latitude. The SPD reaches maximum in summer and minimum in winter, and the difference is about 2 m.

  18. Patient ignorance is the main reason for treatment delay in primary rhegmatogenous retinal detachment in The Netherlands

    NARCIS (Netherlands)

    Goezinne, F.; Heij, La E.C.; Berendschot, T.; Tahzib, N.G.; Koetsier, L.S.; Hoevenaars, J.; Liem, A.T.A.; Kijlstra, A.; Webers, C.A.B.; Hendrikse, F.

    2009-01-01

    Aims Treatment delay of progressive vision-threatening conditions should be minimal. In this study, the treatment delay of patients with a rhegmatogenous retinal detachment (RRD) undergoing retinal detachment surgery was quantified, and causes for this delay were evaluated. Materials and methods Con

  19. Sharp conditions for the oscillation of delay difference equations

    Directory of Open Access Journals (Sweden)

    G. Ladas

    1989-01-01

    Full Text Available Suppose that {pn} is a nonnegative sequence of real numbers and let k be a positive integer. We prove that limn→∞inf [1k∑i=n−kn−1pi]>kk(k+1k+1 is a sufficient condition for the oscillation of all solutions of the delay difference equation An+1−An+pnAn−k=0,   n=0,1,2,…. This result is sharp in that the lower bound kk/(k+1k+1 in the condition cannot be improved. Some results on difference inequalities and the existence of positive solutions are also presented.

  20. 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.

  1. Delays in seeking treatment for symptomatic tuberculosis in Sabah, East Malaysia: factors for patient delay.

    Science.gov (United States)

    Rundi, C; Fielding, K; Godfrey-Faussett, P; Rodrigues, L C; Mangtani, P

    2011-09-01

    The state of Sabah contributes one third of the tuberculosis (TB) cases in Malaysia. To collect information on factors that affect the time period from the onset of symptoms to first contact with health care providers, whether private or government. A cross-sectional study using a pre-tested questionnaire was conducted among 296 newly registered smear-positive TB patients in 10 districts in Sabah. Univariable and multivariable analyses were used to determine which risk factors were associated with patient delay (>30 days) and 'extreme' patient delay (>90 days). The percentage of patients who sought treatment after 30 and 90 days was respectively 51.8% (95%CI 45.7-57.9) and 23.5% (95%CI 18.6-29.0). The strongest factors associated with patient delay and 'extreme' patient delay was when the first choice for treatment was a non-government health facility and in 30-39-year-olds. 'Extreme' patient delay was also weakly associated, among other factors, with comorbidity and livestock ownership. Delay and extreme delay in seeking treatment were more common when the usual first treatment choice was a non-government health facility. Continuous health education on TB aimed at raising awareness and correcting misconceptions is needed, particularly among those who use non-government facilities.

  2. Approximate Solutions of Delay Parabolic Equations with the Dirichlet Condition

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    Deniz Agirseven

    2012-01-01

    Full Text Available Finite difference and homotopy analysis methods are used for the approximate solution of the initial-boundary value problem for the delay parabolic partial differential equation with the Dirichlet condition. The convergence estimates for the solution of first and second orders of difference schemes in Hölder norms are obtained. A procedure of modified Gauss elimination method is used for the solution of these difference schemes. Homotopy analysis method is applied. Comparison of finite difference and homotopy analysis methods is given on the problem.

  3. Pediatric acute otitis media: the case for delayed antibiotic treatment.

    Science.gov (United States)

    Johnson, Nicholas C; Holger, Joel S

    2007-04-01

    Acute otitis media (AOM) is both a commonly diagnosed condition and a frequent indication for antibiotic use in children. Recent literature suggests that antibiotics are not needed in many children with AOM, as most cases resolve spontaneously without complication. However, a majority of AOM infections in children are still treated with antibiotics. The American Academy of Pediatrics and American Academy of Family Physicians released a guideline for treatment of AOM in children. We review the guideline as well as scientific evidence related to AOM treatment options. We support a set of evidence-based guidelines employing a delayed prescription option for antibiotic therapy in selected children. If used appropriately, these cost-effective guidelines will reduce the amount of antibiotics prescribed, increase parental satisfaction, and may lower rates of antibiotic resistance while producing similar rates of resolution of AOM.

  4. Delay in diagnostic workup and treatment of esophageal cancer

    NARCIS (Netherlands)

    B.A. Grotenhuis (Brechtje); P. van Hagen (Pieter); B.P.L. Wijnhoven (Bas); V.M.C.W. Spaander (Manon); H.W. Tilanus (Hugo); J.J-B. van Lanschot (Jan)

    2010-01-01

    textabstractIntroduction: Esophageal cancer should preferably be detected and treated at an early stage, but this may be prohibited by late onset of symptoms and delays in referral, diagnostic workup, and treatment. The aim of this study was to investigate the impact of these delays on outcome in pa

  5. 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...

  6. A new proposal for drug conditioning with implications for drug addiction: the Pavlovian two-step from delay to trace conditioning.

    Science.gov (United States)

    Carey, Robert J; Carrera, Marinette Pinheiro; Damianopoulos, Ernest N

    2014-12-15

    Pavlovian conditioning of drug effects is generally acknowledged to be a critical factor in the development and persistence of drug addiction. In drug conditioning the focus has essentially been on one type of Pavlovian conditioning, namely, delay conditioning in which the CS and drug UCS overlap and are temporally contiguous. Another type of Pavlovian conditioning is trace-conditioning in which the CS terminates before the onset of the UCS. While trace conditioning has been extensively studied in conditioning studies using a punctual CS and a non-drug UCS, trace conditioning has not been considered as having a role in drug conditioning. In several recent reports we have conducted experiments in which we first established a contextual drug CS using a delay conditioning protocol and subsequently used this same CS in a trace drug conditioning protocol with the same or different drug treatment and showed that the CS could be strongly modified by trace conditioning. These observations take on importance in that it has been well established that delay and trace conditioning are mediated by different CNS systems. Delay conditioning is mediated by cerebellar mechanisms, conforming to the general idea of Pavlovian conditioning as a reflexive type of learning whereas trace conditioning involves the hippocampus and frontal cortex brain structures more commonly associated with voluntary behavior. In this proposal we suggest that the emergence of potent drug associations that motivate drug-seeking behavior and addiction are initiated by delay conditioning and subsequently amplified and linked to higher brain functions by trace conditioning.

  7. Treatment delay period: the case of arsenicosis in rural Bangladesh.

    Science.gov (United States)

    Paul, Bimal Kanti; Brock, Vicki L Tinnon

    2006-12-01

    Arsenic concentrations of tubewell water that exceed acceptable limits poses a serious health problem in Bangladesh. Many Bangladeshis are now suffering from arsenic-related diseases. The objectives of this paper are to examine the extent of delay in seeking medical treatment by victims of arsenic poisoning and to identify factors contributing to this delay. Questionnaire survey successfully administered to 663 victims living in two rural areas of Bangladesh provided the major data source for this study. Analysis of survey data reveal that median delay period was 12 months, but the delay period ranged from 1 month to 18 years. Because of this extremely large range, the mean delay period was about 22 months. The study identified time of identification of symptoms of arsenicosis as the most significant determinant of treatment delay followed by treatment sought from members of mobile medical teams, perceived threat, and level of education. Based on the study findings, it is recommended that the Bangladesh government and NGOs involved in arsenic mitigation and prevention efforts should educate individuals at risk for arsenic poisoning about the benefits of seeking early treatment. This study also recommends to continue to dispatch mobile medical teams to the arsenic-impacted areas.

  8. 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.

  9. Delay Analysis and Formulation Inference of Signalized Intersection for Traffic Congestion Conditions

    Institute of Scientific and Technical Information of China (English)

    刘广萍; 丁建梅

    2004-01-01

    Vehicle delay is an important measure to evaluate the signal timings of signalized intersections.When optimization the signal control parameters, delays of vehicles from all approach directions of an intersection should be considered. Based on the analysis of the vehicle delay on an approach of intersection, directed against the typical condition of a congested intersection-over-saturated condition, the paper has analyzed and inferred the intersection delay dynamic formulation, and has established the relation between intersection delay,the signal timings, vehicle arrival rate and the queue lengths, and that provides useful information for understanding vehicle delay of signalized intersection and for establishing performance index function of signal timing optimization.

  10. 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

    2017-09-04

    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-HT2C 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.

  11. More relaxed condition for dynamics of discrete time delayed Hopfield neural networks

    Institute of Scientific and Technical Information of China (English)

    Zhang Qiang

    2008-01-01

    The dynamics of discrete time delayed Hopfield neural networks is investigated.By using a difference inequality combining with the linear matrix inequality,a sufficient condition ensuring global exponential stability of the unique equilibrium point of the networks is found.The result obtained holds not only for constant delay but also for time-varying delays.

  12. Cervical carcinoma during pregnancy : outcome of planned delay in treatment

    NARCIS (Netherlands)

    van Loon, AJ; ten Hoor, KA; Boonstra, J.

    1998-01-01

    Objective: To assess maternal mortality after delayed treatment for invasive carcinoma of the uterine cervix during pregnancy and to improve fetal outcome. Study Design: Invasive cervical cancer was diagnosed in 12 pregnant women between 1 January 1977 and 1 January 1996. The medical records were ex

  13. Coagulation syndrome: Delayed perforation after colorectal endoscopic treatments

    Institute of Scientific and Technical Information of China (English)

    Kingo; Hirasawa; Chiko; Sato; Makomo; Makazu; Hiroaki; Kaneko; Ryosuke; Kobayashi; Atsushi; Kokawa; Shin; Maeda

    2015-01-01

    Various procedure-related adverse events related to colonoscopic treatment have been reported. Previous studies on the complications of colonoscopic treatment have focused primarily on perforation or bleeding. Coagulation syndrome(CS), which is synonymous with transmural burn syndrome following endoscopic treatment, is another typical adverse event. CS is the result of electrocoagulation injury to the bowel wall that induces a transmural burn and localized peritonitis resulting in serosal inflammation. CS occurs after polypectomy, endoscopic mucosal resection(EMR), and even endoscopic submucosal dissection(ESD). The occurrence of CS after polypectomy or EMR varies according previous reports; most report an occurrence rate around 1%. However, artificial ulcers after ESD are largely theoretical, and CS following ESD was reported in about 9% of cases, which is higher than that for CS after polypectomy or EMR. Most cases of post-polypectomy syndrome(PPS) have an excellent prognosis, and they are managed conservatively with medical therapy. PPS rarely develops into delayed perforation. Delayed perforation is a severe adverse event that often requires emergency surgery. Since few studies have reported on CS and delayed perforation associated with CS, we focused on CS after colonoscopic treatments in this review. Clinicians should consider delayed perforation in CS patients.

  14. Cervical carcinoma during pregnancy : outcome of planned delay in treatment

    NARCIS (Netherlands)

    van Loon, AJ; ten Hoor, KA; Boonstra, J.

    1998-01-01

    Objective: To assess maternal mortality after delayed treatment for invasive carcinoma of the uterine cervix during pregnancy and to improve fetal outcome. Study Design: Invasive cervical cancer was diagnosed in 12 pregnant women between 1 January 1977 and 1 January 1996. The medical records were ex

  15. 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...... with focus on pre-hospital and in-hospital time delays. METHODS: We conducted a prospective cross-sectional cohort study including all patients suspected with acute limb ischemia who were admitted to the emergency department of a community hospital in a six months period. Temporal delay in the different...

  16. Effect of early or delayed treatment upon healing of mandibular fractures: a systematic literature review

    DEFF Research Database (Denmark)

    Hermund, Niels Ulrich; Hillerup, Søren; Kofod, Thomas

    2008-01-01

    The possible relation between treatment delay and healing complications in mandibular fracture treatment (excluding condylar fractures) was reviewed systematically. Twenty-two studies were identified. No randomized studies focused on the effect of immediate or delayed treatment. The main focus...

  17. Simple stability conditions of linear discrete time systems with multiple delay

    Directory of Open Access Journals (Sweden)

    Stojanović Sreten B.

    2010-01-01

    Full Text Available In this paper we have established a new Lyapunov-Krasovskii method for linear discrete time systems with multiple time delay. Based on this method, two sufficient conditions for delay-independent asymptotic stability of the linear discrete time systems with multiple delays are derived in the shape of Lyapunov inequality. Numerical examples are presented to demonstrate the applicability of the present approach.

  18. Double dissociation of amygdala and hippocampal contributions to trace and delay fear conditioning.

    Science.gov (United States)

    Raybuck, Jonathan D; Lattal, K Matthew

    2011-01-19

    A key finding in studies of the neurobiology of learning memory is that the amygdala is critically involved in Pavlovian fear conditioning. This is well established in delay-cued and contextual fear conditioning; however, surprisingly little is known of the role of the amygdala in trace conditioning. Trace fear conditioning, in which the CS and US are separated in time by a trace interval, requires the hippocampus and prefrontal cortex. It is possible that recruitment of cortical structures by trace conditioning alters the role of the amygdala compared to delay fear conditioning, where the CS and US overlap. To investigate this, we inactivated the amygdala of male C57BL/6 mice with GABA (A) agonist muscimol prior to 2-pairing trace or delay fear conditioning. Amygdala inactivation produced deficits in contextual and delay conditioning, but had no effect on trace conditioning. As controls, we demonstrate that dorsal hippocampal inactivation produced deficits in trace and contextual, but not delay fear conditioning. Further, pre- and post-training amygdala inactivation disrupted the contextual but the not cued component of trace conditioning, as did muscimol infusion prior to 1- or 4-pairing trace conditioning. These findings demonstrate that insertion of a temporal gap between the CS and US can generate amygdala-independent fear conditioning. We discuss the implications of this surprising finding for current models of the neural circuitry involved in fear conditioning.

  19. Differential acetylcholine release in the prefrontal cortex and hippocampus during pavlovian trace and delay conditioning.

    Science.gov (United States)

    Flesher, M Melissa; Butt, Allen E; Kinney-Hurd, Brandee L

    2011-09-01

    Pavlovian trace conditioning critically depends on the medial prefrontal cortex (mPFC) and hippocampus (HPC), whereas delay conditioning does not depend on these brain structures. Given that the cholinergic basal forebrain system modulates activity in both the mPFC and HPC, it was reasoned that the level of acetylcholine (ACh) release in these regions would show distinct profiles during testing in trace and delay conditioning paradigms. To test this assumption, microdialysis probes were implanted unilaterally into the mPFC and HPC of rats that were pre-trained in appetitive trace and delay conditioning paradigms using different conditional stimuli in the two tasks. On the day of microdialysis testing, dialysate samples were collected during a quiet baseline interval before trials were initiated, and again during performance in separate blocks of trace and delay conditioning trials in each animal. ACh levels were quantified using high-performance liquid chromatography and electrochemical detection techniques. Consistent with our hypothesis, results showed that ACh release in the mPFC was greater during trace conditioning than during delay conditioning. The level of ACh released during trace conditioning in the HPC was also greater than the levels observed during delay conditioning. While ACh efflux in both the mPFC and HPC selectively increased during trace conditioning, ACh levels in the mPFC during trace conditioning testing showed the greatest increases observed. These results demonstrate a dissociation in cholinergic activation of the mPFC and HPC during performance in trace but not delay appetitive conditioning, where this cholinergic activity may contribute to attentional mechanisms, adaptive response timing, or memory consolidation necessary for successful trace conditioning.

  20. Both Trace and Delay Conditioning of Evaluative Responses Depend on Contingency Awareness

    Science.gov (United States)

    Kattner, Florian; Ellermeier, Wolfgang; Tavakoli, Paniz

    2012-01-01

    Whereas previous evaluative conditioning (EC) studies produced inconsistent results concerning the role of contingency knowledge, there are classical eye-blink conditioning studies suggesting that declarative processes are involved in trace conditioning but not in delay conditioning. In two EC experiments pairing neutral sounds (conditioned…

  1. NECESSARY AND SUFFICIENT CONDITIONS FOR OSCILLATIONS OF NEUTRAL HYPERBOLIC PARTIAL DIFFERENTIAL EQUATIONS WITH DELAYS

    Institute of Scientific and Technical Information of China (English)

    Yang Jun; Wang Chunyan; Li Jing; Meng Zhijuan

    2006-01-01

    This paper is concerned with the oscillations of neutral hyperbolic partial differential equations with delays. Necessary and sufficient conditions are obtained for the oscillations of all solutions of the equations, and these results are illustrated by some examples.

  2. Hippocampal and Cerebellar Single-Unit Activity During Delay and Trace Eyeblink Conditioning in the Rat

    Science.gov (United States)

    Green, John T.; Arenos, Jeremy D.

    2007-01-01

    In delay eyeblink conditioning, the CS overlaps with the US and only a brainstem-cerebellar circuit is necessary for learning. In trace eyeblink conditioning, the CS ends before the US is delivered and several forebrain structures, including the hippocampus, are required for learning, in addition to a brainstem-cerebellar circuit. The interstimulus interval (ISI) between CS onset and US onset is perhaps the most important factor in classical conditioning, but studies comparing delay and trace conditioning have typically not matched these procedures in this crucial factor, so it is often difficult to determine whether results are due to differences between delay and trace or to differences in ISI. In the current study, we employed a 580-ms CS-US interval for both delay and trace conditioning and compared hippocampal CA1 activity and cerebellar interpositus nucleus activity in order to determine whether a unique signature of trace conditioning exists in patterns of single-unit activity in either structure. Long-Evans rats were chronically implanted in either CA1 or interpositus with microwire electrodes and underwent either delay eyeblink conditioning, or trace eyeblink conditioning with a 300-ms trace period between CS offset and US onset. On trials with a CR in delay conditioning, CA1 pyramidal cells showed increases in activation (relative to a pre-CS baseline) during the CS-US period in sessions 1-4 that was attenuated by sessions 5-6. In contrast, on trials with a CR in trace conditioning, CA1 pyramidal cells did not show increases in activation during the CS-US period until sessions 5-6. In sessions 5-6, increases in activation were present only to the CS and not during the trace period. For rats with interpositus electrodes, activation of interpositus neurons on CR trials was present in all sessions in both delay and trace conditioning. However, activation was greater in trace compared to delay conditioning in the first half of the CS-US interval (during the

  3. 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.

  4. Clinical Effects of Gemifloxacin on the Delay of Tuberculosis Treatment

    Science.gov (United States)

    Kim, Seo Yun; Yim, Jae-Joon; Park, Jong Sun; Park, Sung Soo; Heo, Eun Young; Lee, Chang-Hoon; Chung, Hee Soon

    2013-01-01

    Although gemifloxacin has low in vitro activity against Mycobacterium tuberculosis, the effect of gemifloxacin on the delay of tuberculosis (TB) treatment has not been validated in a clinical setting. The study group included patients with culture-confirmed pulmonary TB who initially received gemifloxacin for suspected community-acquired pneumonia (CAP). Two control groups contained patients treated with other fluoroquinolones or nonfluoroquinolone antibiotics. Sixteen cases were treated with gemifloxacin for suspected CAP before TB diagnosis. Sixteen and 32 patients were treated with other fluoroquinolones and nonfluoroquinolones, respectively. The median period from the initiation of antibiotics to the administration of anti-TB medication was nine days in the gemifloxacin group, which was significantly different from the other fluoroquinolones group (35 days). The median times for the nonfluoroquinolone group and the gemifloxacin group were not significantly different. There were no significant differences between the gemifloxacin and other fluoroquinolone group in terms of symptomatic and radiographic improvements. However, the frequency of radiographic improvement in the other fluoroquinolones group tended to be higher than in the gemifloxacin group. Gemifloxacin might be the preferred fluoroquinolone for treating CAP, to alleviate any concerns about delaying TB treatment. PMID:23486643

  5. 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

  6. Explicit Conditions for Stability of Nonlinear Scalar Delay Impulsive Difference Equation

    Directory of Open Access Journals (Sweden)

    Bo Zheng

    2010-01-01

    Full Text Available Sufficient conditions are obtained for the uniform stability and global attractivity of the zero solution of nonlinear scalar delay impulsive difference equation, which extend and improve the known results in the literature. An example is also worked out to verify that the global attractivity condition is a sharp condition.

  7. The Impact of Delays on Parents' Perceptions of Treatments for Problem Behavior

    Science.gov (United States)

    Call, Nathan A.; Reavis, Andrea R.; McCracken, Courtney E.; Gillespie, Scott E.; Scheithauer, Mindy C.

    2015-01-01

    Parent engagement in behavioral interventions is critical for treatments to succeed. Parental decision-making regarding treatments can be impacted by systematic biases, such as the tendency to discount the value of delayed benefits, or "delay discounting". This study examined the impact of delay discounting on parents' perceptions of…

  8. Long-term melatonin treatment delays ovarian aging.

    Science.gov (United States)

    Tamura, Hiroshi; Kawamoto, Mai; Sato, Shun; Tamura, Isao; Maekawa, Ryo; Taketani, Toshiaki; Aasada, Hiromi; Takaki, Eiichi; Nakai, Akira; Reiter, Russel J; Sugino, Norihiro

    2017-03-01

    Ovarian aging is characterized by gradual declines in oocyte quantity and quality. Melatonin is considered an anti-aging agent due to its cytoprotective actions as an antioxidant. This study examined whether long-term melatonin treatment would delay ovarian aging in mice. Female ICR mice (10 weeks old) were given melatonin-containing water (100 μg/mL; melatonin) or water only until 43 weeks of age. Their oocytes were recovered from the oviduct, and in vitro fertilization was performed. The ovaries were used for a histological analysis of the number of follicles. The mRNA expression of the aging-related sirtuin genes (SIRT1, SIRT3) and the autophagy-related gene (LC3) and the telomere length of the ovarian chromosomes were analyzed. Transcriptome changes in the ovaries were also characterized using microarray. The number of ovulated oocytes decreased with age; however, it was greater in melatonin-treated mice than that from control animals. The decreased fertilization rate and blastocyst rate during aging also were higher in the melatonin-treated mice than in the controls, as were the numbers of primordial, primary, and antral follicles. The mRNA expression of SIRT1 and LC3 and telomere length were enhanced due to melatonin treatment. Seventy-eight genes that were downregulated during aging and upregulated by melatonin were identified by a microarray analysis. Forty of these 78 genes were ribosome-related genes, and a free radical scavenging network was identified. The present results indicate that melatonin delays ovarian aging by multiple mechanisms including antioxidant action, maintaining telomeres, stimulating SIRT expression and ribosome function, and by reducing autophagy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Treatment for delayed brain injury after pituitary irradiation

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-03-01

    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.

  10. 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…

  11. 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

  12. Bridging waitlist delays with Interim Buprenorphine Treatment: Initial feasibility

    Science.gov (United States)

    Sigmon, Stacey C.; Meyer, Andrew; Hruska, Bryce; Ochalek, Taylor; Rose, Gail; Badger, Gary J.; Brooklyn, John R.; Heil, Sarah H.; Higgins, Stephen T.; Moore, Brent A.; Schwartz, Robert P.

    2015-01-01

    Despite the effectiveness of agonist maintenance for opioid dependence, individuals can remain on waitlists for months, during which they are at significant risk for morbidity and mortality. Interim dosing, consisting of daily medication without counseling, can reduce these risks. In this pilot study, we examined the initial feasibility of a novel technology-assisted interim buprenorphine treatment for waitlisted opioid-dependent adults. Following buprenorphine induction during Week 1, participants (n=10) visited the clinic at Weeks 2, 4, 6, 8, 10 and 12 to ingest their medication under staff observation, provide a urine specimen and receive their remaining doses via a computerized Med-O-Wheel Secure device. They also received daily monitoring via an Interactive Voice Response (IVR) platform, as well as random call-backs for urinalysis and medication adherence checks. The primary outcome was percent of participants negative for illicit opioids at each 2-week visit, with secondary outcomes of past-month drug use, adherence and acceptability. Participants achieved high levels of illicit opioid abstinence, with 90% abstinent at the Week 2 and 4 visits and 60% at Week 12. Significant reductions were observed in self-reported past-month illicit opioid use (p<.001), opioid withdrawal (p<.001), opioid craving (p<.001) and ASI Drug composite score (p=.008). Finally, adherence with buprenorphine administration (99%), daily IVR calls (97%) and random call-backs (82%) was high. Interim buprenorphine treatment shows promise for reducing patient and societal risks during delays to conventional treatment. A larger-scale, randomized clinical trial is underway to more rigorously examine the efficacy of this treatment approach. PMID:26256469

  13. Effects of natural gas composition on ignition delay under diesel conditions

    Science.gov (United States)

    Naber, J. D.; Siebers, D. L.; Dijulio, S. S.; Westbrook, C. K.

    1993-12-01

    Effects of variations in natural gas composition on autoignition of natural gas under direct-injection (DI) diesel engine conditions were studied experimentally in a constant-volume combustion vessel and computationally using a chemical kinetic model. Four fuel blends were investigated: pure methane, a capacity weighted mean natural gas, a high ethane content natural gas, and a natural gas with added propane typical of peak shaving conditions. Experimentally measured ignition delays were longest for pure methane and became progressively shorter as ethane and propane concentrations increased. At conditions characteristic of a DI compression ignition natural gas engine at Top Dead Center (CR = 23:1, p = 6.8 MPa, T = 1150K), measured ignition delays for the four fuels varied from 1.8 ms for the peak shaving and high ethane gases to 2.7 ms for pure methane. Numerically predicted variations in ignition delay as a function of natural gas composition agreed with these measurements.

  14. The frequency of missed test results and associated treatment delays in a highly computerized health system

    OpenAIRE

    2007-01-01

    Abstract Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results") are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA). Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary ca...

  15. Acquisition of Differential Delay Eyeblink Classical Conditioning Is Independent of Awareness

    Science.gov (United States)

    Smith, Christine N.; Clark, Robert E.; Manns, Joseph R.; Squire, Larry R.

    2009-01-01

    There has been debate about whether differential delay eyeblink conditioning can be acquired without awareness of the stimulus contingencies. In 4 experiments, the authors reexamined this question. Older participants were tested with a tone and white noise (Experiment 1) or with 2 tones (Experiment 2). In addition, younger participants were tested with 2 tones (Experiment 3) or with 2 tones plus the parameters from an earlier study that had reported a relationship between conditioning and awareness (Experiment 4). Participants who were designated aware of the stimulus contingencies and participants who were designated unaware exhibited equivalent levels of differential eyeblink conditioning. Awareness of stimulus contingencies is not required for differential delay eyeblink conditioning when simple conditioned stimuli are used. PMID:15727514

  16. Data-driven modeling of systemic delay propagation under severe meteorological conditions

    CERN Document Server

    Fleurquin, Pablo; Eguiluz, Victor M

    2013-01-01

    The upsetting consequences of weather conditions are well known to any person involved in air transportation. Still the quantification of how these disturbances affect delay propagation and the effectiveness of managers and pilots interventions to prevent possible large-scale system failures needs further attention. In this work, we employ an agent-based data-driven model developed using real flight performance registers for the entire US airport network and focus on the events occurring on October 27 2010 in the United States. A major storm complex that was later called the 2010 Superstorm took place that day. Our model correctly reproduces the evolution of the delay-spreading dynamics. By considering different intervention measures, we can even improve the model predictions getting closer to the real delay data. Our model can thus be of help to managers as a tool to assess different intervention measures in order to diminish the impact of disruptive conditions in the air transport system.

  17. 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

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

    Science.gov (United States)

    Oristaglio, J; Hyman West, S; Ghaffari, M; Lech, M S; Verma, B R; Harvey, J A; Welsh, J P; Malone, R P

    2013-09-17

    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 the 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 TD subjects with regard to the learning rate or the timing of the conditioned response. 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 the 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.

  19. Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative

    Directory of Open Access Journals (Sweden)

    Enarson Donald A

    2011-05-01

    Full Text Available Abstract Background Several FIDELIS projects (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB in Tanzania were conducted by the National Tuberculosis and Leprosy Programme (NTLP during the years 2004-2008 to strengthen diagnostic and treatment services. These projects collected information on treatment delay and some of it was available for research purposes. With this database our objective was to assess the duration and determinants of treatment delay among new smear positive pulmonary tuberculosis (TB patients in FIDELIS projects, and to compare delay according to provider visited prior to diagnosis. Methods Treatment delay among new smear positive TB patients was recorded for each patient at treatment initiation and this information was available and fairly complete in 6 out of 57 districts with FIDELIS projects enrolling patients between 2004 and 2007; other districts had discarded their forms at the time of analysis. It was analysed as a cross sectional study. Results We included 1161 cases, 10% of all patients recruited in the FIDELIS projects in Tanzania. Median delay was 12 weeks. The median duration of cough, weight loss and haemoptysis was 12, 8 and 3 weeks, respectively. Compared to Hai district Handeni had patients with longer delays and Mbozi had patients with shorter delays. Urban and rural patients reported similar delays. Patients aged 15-24 years and patients of 65 years or older had longer delays. Patients reporting contact with traditional healers before diagnosis had a median delay of 15 weeks compared to 12 weeks among those who did not. Patients with dyspnoea and with diarrhoea had longer delays. Conclusion In this patient sample in Tanzania half of the new smear positive pulmonary tuberculosis patients had a treatment delay longer than 12 weeks. Delay was similar in men and women and among urban and rural patients, but longer in the young and older age groups. Patients using traditional healers had

  20. 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

    2013-02-01

    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.

  1. Choline supplementation mitigates trace, but not delay, eyeblink conditioning deficits in rats exposed to alcohol during development.

    Science.gov (United States)

    Thomas, Jennifer D; Tran, Tuan D

    2012-03-01

    Children exposed to alcohol prenatally suffer from a range of physical, neuropathological, and behavioral alterations, referred to as fetal alcohol spectrum disorders (FASD). Both the cerebellum and hippocampus are affected by alcohol exposure during development, which may contribute to behavioral and cognitive deficits observed in children with FASD. Despite the known neuropathology associated with prenatal alcohol exposure, many pregnant women continue to drink (heavy drinkers, in particular), creating a need to identify effective treatments for their children who are adversely affected by alcohol. We previously reported that choline supplementation can mitigate alcohol's effects on cognitive development, specifically on tasks which depend on the functional integrity of the hippocampus. The present study examined whether choline supplementation could differentially mitigate alcohol's effects on trace eyeblink classical conditioning (ECC, a hippocampal-dependent task) and delay ECC (a cerebellar-dependent task). Long-Evans rats were exposed to 5.25 g/kg/day alcohol via gastric intubation from postnatal days (PD) 4-9, a period of brain development equivalent to late gestation in humans. A sham-intubated control group was included. From PD 10-30, subjects received subcutaneous injections of 100 mg/kg choline chloride or vehicle. Beginning on PD 32-34, subjects were trained on either delay or trace eyeblink conditioning. Performance of subjects exposed to alcohol was significantly impaired on both tasks, as indicated by significant reductions in percentage and amplitude of conditioned eyeblink responses, an effect that was attenuated by choline supplementation on the trace, but not delay conditioning task. Indeed, alcohol-exposed subjects treated with choline performed at control levels on the trace eyeblink conditioning task. There were no significant main or interactive effects of sex. These data indicate that choline supplementation can significantly reduce the

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

    Science.gov (United States)

    Abu-Helalah, Ahmad Munir; Alshraideh, Ahmad Hussam; 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.

  3. Lasing oscillation condition and group delay control in gain-assisted plasmon-induced transparency

    CERN Document Server

    Deng, Zi-Lan; Wang, He-Zhou; Cheng, S H; Li, Jensen

    2012-01-01

    A gain-assisted plasmonic waveguide with two detuned resonators is investigated in the plasmon-induced transparency window. Phase map is employed to study power transmittance and group delay for varying gain coefficients and frequency detunings of the two resonators. The gain coefficient for lasing oscillation condition is analytically shown to vary quadratically with the frequency detuning. In the amplification regime below the lasing threshold, the spectrum implies not only large group delay, but also high transmittance and narrow linewidth. This is in contrast to those in the loss-compensation regime and the passive case in which there always exists a trade-off between the linewidth and the peak transmittance.

  4. A Stability Condition with Delay-Dependence for a Class of Switched Large-Scale Time-Delay Systems

    Directory of Open Access Journals (Sweden)

    Chi-Jo Wang

    2013-01-01

    Full Text Available By using the time-switched method and the comparison theorem, we derived a criterion of delay-dependent stability for the switched large-scale time-delay systems. To guarantee the exponential stability for the switched large-scale time-delay systems with stability margin λ, the total activation time ratio of the switching law is determined. An example is used to illustrate the effectiveness of our result.

  5. Dorsal hippocampal lesions disrupt Pavlovian delay conditioning and conditioned-response timing.

    Science.gov (United States)

    Tam, Shu K E; Bonardi, Charlotte

    2012-04-21

    The involvement of the rat dorsal hippocampus (dhpc) in Pavlovian conditioning and timing of conditioned responding was examined in an appetitive preparation in which presentation of a relatively long, 40-s auditory conditioned stimulus (CS) was followed immediately by food delivery. Dorsal hippocampal lesions impaired Pavlovian conditioning in this task. They also produced a deficit in interval timing, replicating previous findings with short CSs. The conditioning and timing deficits observed are consistent with the findings from single-unit recording studies in other species, and suggest that the involvement of the dhpc in Pavlovian processes could be more general than is assumed by many of the current theories of hippocampal function.

  6. Dynamic stability conditions for Lotka-Volterra recurrent neural networks with delays.

    Science.gov (United States)

    Yi, Zhang; Tan, K K

    2002-07-01

    The Lotka-Volterra model of neural networks, derived from the membrane dynamics of competing neurons, have found successful applications in many "winner-take-all" types of problems. This paper studies the dynamic stability properties of general Lotka-Volterra recurrent neural networks with delays. Conditions for nondivergence of the neural networks are derived. These conditions are based on local inhibition of networks, thereby allowing these networks to possess a multistability property. Multistability is a necessary property of a network that will enable important neural computations such as those governing the decision making process. Under these nondivergence conditions, a compact set that globally attracts all the trajectories of a network can be computed explicitly. If the connection weight matrix of a network is symmetric in some sense, and the delays of the network are in L2 space, we can prove that the network will have the property of complete stability.

  7. 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

  8. 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

  9. Causes of delay in the adequate treatment of childhood illness in India.

    Science.gov (United States)

    Primhak, R; Coates, S; Hosking, G; Benakappa, D G; Benakappa, D B

    1987-12-01

    A retrospective study of children attending a government hospital in Bangalore was performed to assess the causes of delay in providing appropriate treatment. Delay had occurred in 59% of children with significant illness, and in over half the cases the primary cause of delay was inappropriate treatment or delayed referral by a doctor trained in Western-style medicine. It is concluded that there are a large number of ill children in Bangalore whose parents are seeking the help of such doctors but where management is at fault.

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

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    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

  11. Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation.

    Science.gov (United States)

    Song, Tengfei; Yan, Xu; Ye, Tianwen

    2016-06-01

    The aim of this study is to compare the clinical and radiographic results and the complication rate between early and delayed surgical treatment of acromioclavicular joint (ACJ) dislocation. Publications in the management of ACJ dislocation are identified from the PubMed database between January 1993 and December 2013 using "acromioclavicular joint" and "dislocation" as keywords. The eligibility criteria included are as follows: (1) ACJ dislocation; (2) intervention, early compared with delayed surgical treatment or the surgical treatment for acute compared with chronic ACJ dislocation; (3) human; and (4) English articles. Exclusion criteria consist of the following: (1) type I and type II ACJ dislocation, (2) no definition of the time of early and delayed surgery in studies, (3) no comparison between the clinical result of early and delayed surgery in studies, (4) laboratory studies, radiographic studies, biomechanical studies, (5) the cases including fractures or revisions in studies, and (6) systematic analyses. Eight studies comparing early and delayed surgical treatment of ACJ dislocation are included in this systematic review. According to Constant scores and shoulder subjective value, early surgery has better functional outcomes than delayed surgery in the treatment of ACJ dislocation (P < 0.05). Partial-dislocation/re-dislocation is found at 26.0 % in early and 38.1 % in delayed surgical treatment (P < 0.05). The rate of CC ossification in early surgical treatment is found as the same as the delayed. The complication rates are found at 12.5 % in early surgical treatment and 17.7 % in the delayed, which is not significantly different. Early surgical treatment may have superiority to the delayed procedure in the management of ACJ dislocation with better functional outcomes and more satisfied reduction. However, high-quality evidence studies are required to provide stronger support for this opinion in the future. IV.

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

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    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

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

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    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

  14. 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.

  15. Impact of the initial tropospheric zenith path delay on precise point positioning convergence during active conditions

    Science.gov (United States)

    Kalita, J. Z.; Rzepecka, Z.

    2017-04-01

    Tropospheric delay is one of the key factors that influence the convergence time of the precise point positioning (PPP) method. Current models do not allow for the fixing of the zenith path delay tropospheric parameter, leaving the difference between nominal and final value to the estimation process. Here, we present an analysis of several PPP result-sets using the tropospheric parameter’s nominal value adopted from models: VMF1, GPT2w, MOPS, and ZERO-WET. The last variant assumes a zero value for the initial wet part of the zenith delay. The PPP results are subtracted from a solution based on the final tropospheric product from the International GNSS Service (IGS). Several days exhibiting the most active tropospheric conditions were selected for each of the 7 stations located in the mid-latitude Central European region. During the active days, application of the VMF1 model increases the resulting height component’s quality by about 33–36% when compared to the GPT2w and MOPS. The respective improvement in VMF1 latitude and longitude components is 27% and 15%. The average relative deterioration in the result standard deviations between active and calm tropospheric conditions reaches about 20–30% of the former. We discuss the impact of the initial tropospheric parameter’s variance and bias on positioning. In addition, we compare the results with those of other studies over the impact of active tropospheric conditions on the PPP method.

  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. Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review

    Science.gov (United States)

    Ernst, E.

    1998-01-01

    BACKGROUND: Delayed onset muscle soreness (DOMS) is a frequent problem after unaccustomed exercise. No universally accepted treatment exists. Massage therapy is often recommended for this condition but uncertainty exists about its effectiveness. AIM: To determine whether post-exercise massage alleviates the symptoms of DOMS after a bout of strenuous exercise. METHOD: Various computerised literature searches were carried out and located seven controlled trials. RESULTS: Most of the trials were burdened with serious methodological flaws, and their results are far from uniform. However, most suggest that post-exercise massage may alleviate symptoms of DOMS. CONCLUSIONS: Massage therapy may be a promising treatment for DOMS. Definitive studies are warranted. 


 PMID:9773168

  18. 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.

  19. Facilitated acquisition of standard but not long delay classical eyeblink conditioning in behaviorally inhibited adolescents.

    Science.gov (United States)

    Caulfield, M D; VanMeenen, K M; Servatius, R J

    2015-02-01

    Adolescence is a key age in the development of anxiety disorders. The present study assessed the relationship between behavioral inhibition, a risk factor for anxiety typified by avoidance, and acquisition of the classically conditioned eyeblink response. 168 healthy high school students (mean age 15.7 years, 54% female) were given a battery of self-report measures including the Adult Measure of Behavioural Inhibition (AMBI). The study compared acquisition of three experimental training conditions. Two groups were given paired CS-US training: standard delay of 500-ms or long delay of 1000-ms with CS overlapping and co-terminating with a 50-ms airpuff US. A third group received unpaired training of 1000-ms CS and 50-ms airpuff US. Inhibited individuals showed greater acquisition of the conditioned eyeblink response in the 500-ms CS condition, but not in the paired 1000-ms condition. No differences in spontaneous blinks or reactivity to the stimulus were evident in the 1000-ms unpaired CS condition. Results support a relationship between associative learning and anxiety vulnerability that may be mediated by cerebellar functioning in inhibited individuals.

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

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    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.

  1. Design and analysis of clinical trials in the presence of delayed treatment effect.

    Science.gov (United States)

    Sit, Tony; Liu, Mengling; Shnaidman, Michael; Ying, Zhiliang

    2016-05-20

    In clinical trials with survival endpoint, it is common to observe an overlap between two Kaplan-Meier curves of treatment and control groups during the early stage of the trials, indicating a potential delayed treatment effect. Formulas have been derived for the asymptotic power of the log-rank test in the presence of delayed treatment effect and its accompanying sample size calculation. In this paper, we first reformulate the alternative hypothesis with the delayed treatment effect in a rescaled time domain, which can yield a simplified sample size formula for the log-rank test in this context. We further propose an intersection-union test to examine the efficacy of treatment with delayed effect and show it to be more powerful than the log-rank test. Simulation studies are conducted to demonstrate the proposed methods. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Hippocampal theta phase-contingent memory retrieval in delay and trace eyeblink conditioning.

    Science.gov (United States)

    Waselius, Tomi; Pöllänen, Eveliina; Wikgren, Jan; Penttonen, Markku; Nokia, Miriam S

    2017-09-04

    Hippocampal theta oscillations (3-12Hz) play a prominent role in learning. It has been suggested that encoding and retrieval of memories are supported by different phases of the theta cycle. Our previous study on trace eyeblink conditioning in rabbits suggests that the timing of the conditioned stimulus (CS) in relation to theta phase affects encoding but not retrieval of the memory trace. Here, we directly tested the effects of hippocampal theta phase on memory retrieval in two experiments conducted on adult female New Zealand White rabbits. In Experiment 1, animals were trained in trace eyeblink conditioning followed by extinction, and memory retrieval was tested by presenting the CS at troughs and peaks of the theta cycle during different stages of learning. In Experiment 2, animals were trained in delay conditioning either contingent on a high level of theta or at a random neural state. Conditioning was then followed by extinction conducted either at a random state, contingent on theta trough or contingent on theta peak. Our current results indicate that the phase of theta at CS onset has no effect on the performance of the behavioral learned response at any stage of classical eyeblink conditioning or extinction. In addition, theta-contingent trial presentation does not improve learning during delay eyeblink conditioning. The results are consistent with our earlier findings and suggest that the theta phase alone is not sufficient to affect learning at the behavioral level. It seems that the retrieval of recently acquired memories and consequently performing a learned response is moderated by neural mechanisms other than hippocampal theta. Copyright © 2017. Published by Elsevier B.V.

  3. An inventory model for deteriorating items under the condition of permissible delay in payments

    Directory of Open Access Journals (Sweden)

    Chang Horng-Jinh

    2002-01-01

    Full Text Available In economic order quantity (EOQ models, it is often assumed that the payment of an order is made on the receipt of items by the inventory system. However, such an assumption is not quite practical in the real world. Under most market behaviors, it can be easily found that a vendor provides a credit period for buyers to stimulate demand. In this paper, a varying rate of determination and the condition of permissible delay in payments used in conjunction with the economic order quantity model are the focus of discussion. Numerical examples are presented to illustrate the proposed models.

  4. Stability of linear multistep methods for delay differential equations in the light of Kreiss resolvent condition

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    This paper deals with the stability analysis of the linear multistep (LM) methods in the numerical solution of delay differential equations. Here we provide a qualitative stability estimates, pertiment to the classical scalar test problem of the form y'(t) = λy(t) + μy(t - τ) with τ > 0 and λ ,μ are complex, by using (vartiant to) the resolvent condition of Kreiss. We prove that for A-stable LM methods the upper bound for the norm of the n -th power of square matrix grows linearly with the order of the matrix.

  5. Stability and Bifurcation in a Delayed Reaction-Diffusion Equation with Dirichlet Boundary Condition

    Science.gov (United States)

    Guo, Shangjiang; Ma, Li

    2016-04-01

    In this paper, we study the dynamics of a diffusive equation with time delay subject to Dirichlet boundary condition in a bounded domain. The existence of spatially nonhomogeneous steady-state solution is investigated by applying Lyapunov-Schmidt reduction. The existence of Hopf bifurcation at the spatially nonhomogeneous steady-state solution is derived by analyzing the distribution of the eigenvalues. The direction of Hopf bifurcation and stability of the bifurcating periodic solution are also investigated by means of normal form theory and center manifold reduction. Moreover, we illustrate our general results by applications to the Nicholson's blowflies models with one- dimensional spatial domain.

  6. Global Stabilization of High-Order Time-Delay Nonlinear Systems under a Weaker Condition

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    Nengwei Zhang

    2014-01-01

    Full Text Available Under the weaker condition on the system growth, this paper further investigates the problem of global stabilization by state feedback for a class of high-order nonlinear systems with time-varying delays. By skillfully using the homogeneous domination approach, a continuous state feedback controller is successfully designed, which preserves the equilibrium at the origin and guarantees the global asymptotic stability of the resulting closed-loop system. A simulation example is given to demonstrate the effectiveness of the proposed design procedure.

  7. Delayed antiretroviral therapy despite integrated treatment for tuberculosis and HIV infection.

    Science.gov (United States)

    Patel, M R; Nana, M; Yotebieng, M; Tabala, M; Behets, F; Van Rie, A

    2014-06-01

    Five primary health care clinics in Kinshasa, Democratic Republic of Congo. To examine timing and predictors of delayed initiation of antiretroviral therapy (ART) during anti-tuberculosis treatment. Prospective observational cohort of adult patients receiving integrated treatment for tuberculosis (TB) and human immunodeficiency virus (HIV) who are expected to initiate ART at 1 month if CD4 count is tuberculosis treatment if subsequently CD4 count is ≤ 350 cells/mm(3) or patient has WHO Clinical Stage 4. Of 492 patients, 235 (47.8%) experienced delayed initiation of ART: 171 (72.8%) initiated ART late, after a median delay of 12 days (interquartile range [IQR] 4-27) and 64 (27.2%) never initiated ART. Contraindication to any antiretroviral drug (aOR 2.91, 95%CI 1.22-6.95), lower baseline CD4 count (aOR 1.20, 95%CI 1.08-1.33/100 cells/mm(3)), TB drug intolerance (aOR 1.93, 95%CI 1.23-3.02) and non-disclosure of HIV infection (aOR 1.50, 95%CI 1.03-2.18) predicted delayed ART initiation. Despite fully integrated treatment, half of all patients experienced delayed ART initiation. Pragmatic approaches to ensure timely ART initiation in those at risk of delayed ART initiation are needed.

  8. The frequency of missed test results and associated treatment delays in a highly computerized health system

    Science.gov (United States)

    Wahls, Terry L; Cram, Peter M

    2007-01-01

    Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results") are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA). Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary care providers in VA clinics. Methods: An anonymous on-line survey of primary care providers was conducted as part of the health systems ongoing quality improvement programs. We collected information from providers concerning their clinical effort (e.g., number of clinic sessions, number of patient visits per session), number of patients with missed abnormal test results, and the number and types of treatment delays providers encountered during the two week period prior to administration of our survey. Results: The survey was completed by 106 out of 198 providers (54 percent response rate). Respondents saw and average of 86 patients per 2 week period. Providers encountered 64 patients with missed results during the two week period leading up to the study and 52 patients with treatment delays. The most common missed results included imaging studies (29 percent), clinical laboratory (22 percent), anatomic pathology (9 percent), and other (40 percent). The most common diagnostic delays were cancer (34 percent), endocrine problems (26 percent), cardiac problems (16 percent), and others (24 percent). Conclusion: Missed results leading to clinically important treatment delays are an important and likely underappreciated source of diagnostic error. PMID:17519017

  9. The frequency of missed test results and associated treatment delays in a highly computerized health system

    Directory of Open Access Journals (Sweden)

    Wahls Terry L

    2007-05-01

    Full Text Available Abstract Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results" are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA. Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary care providers in VA clinics. Methods: An anonymous on-line survey of primary care providers was conducted as part of the health systems ongoing quality improvement programs. We collected information from providers concerning their clinical effort (e.g., number of clinic sessions, number of patient visits per session, number of patients with missed abnormal test results, and the number and types of treatment delays providers encountered during the two week period prior to administration of our survey. Results: The survey was completed by 106 out of 198 providers (54 percent response rate. Respondents saw and average of 86 patients per 2 week period. Providers encountered 64 patients with missed results during the two week period leading up to the study and 52 patients with treatment delays. The most common missed results included imaging studies (29 percent, clinical laboratory (22 percent, anatomic pathology (9 percent, and other (40 percent. The most common diagnostic delays were cancer (34 percent, endocrine problems (26 percent, cardiac problems (16 percent, and others (24 percent. Conclusion: Missed results leading to clinically important treatment delays are an important and likely underappreciated source of diagnostic error.

  10. 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

  11. Various Treatment Techniques on Signs and Symptoms of Delayed Onset Muscle Soreness

    Science.gov (United States)

    Gulick, Dawn T.; Kimura, Iris F.; Sitler, Michael; Paolone, Albert; Kelly, John D.

    1996-01-01

    Eccentric activities are an important component of physical conditioning and everyday activities. Delayed onset muscle soreness (DOMS) can result from strenuous eccentric tasks and can be a limiting factor in motor performance for several days after exercise. An efficacious method of treatment for DOMS would enhance athletic performance and hasten the return to activities of daily living. The purpose of this study was to identify a treatment method which could assist in the recovery of DOMS. In the selection of treatment methods, emphasis was directed toward treatments that could be rendered independently by an individual, therefore making the treatment valuable to an athletic trainer in team setting. DOMS was induced in 70 untrained volunteers via 15 sets of 15 eccentric contractions of the forearm extensor muscles on a Lido isokinetic dynamometer. All subjects performed a pilot exercise bout for a minimum of 9 weeks before data collection to assure that DOMS would be produced. Data were collected on 15 dependent variables: active and passive wrist flexion and extension, forearm girth, limb volume, visual analogue pain scale, muscle soreness index, isometric strength, concentric and eccentric wrist total work, concentric and eccentric angle of peak torque. Data were collected on six occasions: pre- and post-induced DOMS, 20 minutes after treatment, and 24, 48, and 72 hours after treatment. Subjects were randomly assigned to 1 of 7 groups (6 treatment and 1 control). Treatments included a nonsteroidal anti-inflammatory drug, high velocity concentric muscle contractions on an upper extremity ergometer, ice massage, 10-minute static stretching, topical Amica montana ointment, and sublingual A. montana pellets. A 7 × 6 ANOVA with repeated measures on time was performed on the delta values of each of the 15 dependent variables. Significant main effects (p < .05) were found for all of the dependent variables on time only. There were no significant differences between

  12. 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…

  13. Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries -- a review article.

    Science.gov (United States)

    Andreasen, J O; Andreasen, F M; Skeie, A; Hjørting-Hansen, E; Schwartz, O

    2002-06-01

    Based on an analysis of the literature concerning parameters influencing the prognosis of traumatic dental injuries, few studies were found to have examined possible relationships between treatment delay and pulpal and periodontal ligament healing complications. It has been commonly accepted that all injuries should be treated on an emergency basis, for the comfort of the patient and also to reduce wound healing complications. For practical and especially economic reasons, various approaches can be selected to fulfill such a demand, such as acute treatment (i.e. within a few hours), subacute (i.e. within the first 24 h), and delayed (i.e. after the first 24 h). In this survey the consequences of treatment delay on pulpal and periodontal healing have been analyzed for the various dental trauma groups. Applying such a treatment approach to the various types of injuries, the following treatment guidelines can be recommended, based on our present rather limited knowledge of the effect of treatment delay upon wound healing. Crown and crown/root fractures: Subacute or delayed approach. Root fractures: Acute or subacute approach. Alveolar fractures: Acute approach (evidence however questionable). Concussion and subluxation: Subacute approach. Extrusion and lateral luxation: Acute or subacute approach (evidence however questionable). Intrusion: Subacute approach (evidence however questionable). Avulsion: If the tooth is not replanted at the time of injury, acute approach; otherwise subacute. Primary tooth injury: Subacute approach, unless the primary tooth is displaced into the follicle of the permanent tooth or occlusal problems are present; in the latter instances, an acute approach should be chosen. These treatment guidelines are based on very limited evidence from the literature and should be revised as soon as more evidence about the effect of treatment delay becomes available.

  14. Genetic loci associated with delayed clearance of Plasmodium falciparum following artemisinin treatment in Southeast Asia

    Science.gov (United States)

    2013-01-02

    Genetic loci associated with delayed clearance of Plasmodium falciparum following artemisinin treatment in Southeast Asia Shannon Takala-Harrisona...resistant Plasmodium falcipa- rum malaria in western Cambodia could threaten prospects for malaria elimination. Identification of the genetic basis of...molecular markers Artemisinin-based combination therapies (ACTs) are the lead-ing treatment for Plasmodium falciparum malaria (1), and their use with

  15. Delayed results of treatment of paracoccidioidomycosis with amphotericin B plus sulfamides versus amphotericin B alone

    Directory of Open Access Journals (Sweden)

    Neuza Lima Dillon

    1986-08-01

    Full Text Available A delayed evaluation of two groups of patients with paracoccidioidomycosis was carried out. Both groups were treated with amphotericin B, "but one of them was submitted to maintenance treatment with sulfonamides. Statistical analysis showed that treatment is more effective when patients are maintained with sulfonamide drugs.

  16. Treatment of delayed jejunal perforation after irreducible femoral hernia repair with open abdomen management and delayed abdominal closure with skin flap approximation

    Directory of Open Access Journals (Sweden)

    Fahri Yetişir

    2015-01-01

    Conclusion: Delayed bowel perforation may develop after irreducible femoral hernia surgery. OA management with NPT and DAC with skin flap approximation are optimal treatment modalities for the hemodynamically instable patient.

  17. Global exponential stability conditions for generalized state-space systems with time-varying delays

    Energy Technology Data Exchange (ETDEWEB)

    Yu, K.-W. [Department of Marine Engineering, National Kaohsiung Marine University, Kaohsiung 811, Taiwan (China)], E-mail: kwyu@mail.nkmu.edu.tw; Lien, C.-H. [Department of Marine Engineering, National Kaohsiung Marine University, Kaohsiung 811, Taiwan (China)], E-mail: chlien.ee@msa.hinet.net

    2008-05-15

    A unified approach is proposed to deal with the exponential stability for generalized state-space systems with time-varying delays. Many systems models can be regarded as special cases of the considered systems; such as neutral time-delay systems and delayed cellular neural networks. Delay-dependent stability criteria are proposed to guarantee the global exponential stability for generalized state-space systems with two cases of uncertainties. Two numerical examples are given to show the effectiveness of our method.

  18. 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

  19. 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.

  20. Survival outcome of early versus delayed bevacizumab treatment in patients with recurrent glioblastoma.

    Science.gov (United States)

    Hamza, Mohamed A; Mandel, Jacob J; Conrad, Charles A; Gilbert, Mark R; Yung, W K Alfred; Puduvalli, Vinay K; DeGroot, John F

    2014-08-01

    Bevacizumab (BEV) is widely used for treatment of patients with recurrent glioblastoma. It is not known if there are differences in outcome between early versus delayed BEV treatment of recurrent glioblastoma. We examined the relationship between the time of starting BEV treatment and outcomes in patients with recurrent glioblastoma. In this retrospective chart review, we identified patients with recurrent glioblastoma diagnosed between 2005 and 2011 who were treated with BEV alone or BEV-containing regimens. Data was analyzed to determine overall survival (OS) from time of diagnosis and progression free survival (PFS) from time of starting BEV. A total of 298 patients were identified, 112 patients received early BEV, 133 patients received delayed BEV, and 53 patients were excluded because they either progressed within 3 months of radiation or received BEV at the time of diagnosis. There was no significant difference in PFS between patients that received early BEV and those that received delayed BEV (5.2 vs. 4.3 months, p = 0.2). Patients treated with delayed BEV had longer OS when compared to those treated with early BEV (25.9 vs. 20.8 months, p = 0.005). In patients with recurrent glioblastoma, there was no significant difference in PFS from the time of starting BEV between early and delayed BEV. Although patients treated with delayed BEV seemed to have longer OS, a conclusion regarding OS outcome requires further prospective trials. These results may indicate that delaying treatment with BEV is not detrimental for survival of patients with recurrent glioblastoma.

  1. Relational and procedural memory systems in the goldfish brain revealed by trace and delay eyeblink-like conditioning.

    Science.gov (United States)

    Gómez, A; Rodríguez-Expósito, B; Durán, E; Martín-Monzón, I; Broglio, C; Salas, C; Rodríguez, F

    2016-12-01

    The presence of multiple memory systems supported by different neural substrata has been demonstrated in animal and human studies. In mammals, two variants of eyeblink classical conditioning, differing only in the temporal relationships between the conditioned stimulus (CS) and the unconditioned stimulus (US), have been widely used to study the neural substrata of these different memory systems. Delay conditioning, in which both stimuli coincide in time, depends on a non-relational memory system supported by the cerebellum and associated brainstem circuits. In contrast, trace conditioning, in which a stimulus-free time gap separates the CS and the US, requires a declarative or relational memory system, thus depending on forebrain structures in addition to the cerebellum. The distinction between the explicit or relational and the implicit or procedural memory systems that support trace and delay classical conditioning has been extensively studied in mammals, but studies in other vertebrate groups are relatively scarce. In the present experiment we analyzed the differential involvement of the cerebellum and the telencephalon in delay and trace eyeblink-like classical conditioning in goldfish. The results show that whereas the cerebellum lesion prevented the eyeblink-like conditioning in both procedures, the telencephalon ablation impaired exclusively the acquisition of the trace conditioning. These data showing that comparable neural systems support delay and trace eyeblink conditioning in teleost fish and mammals suggest that these separate memory systems and their neural bases could be a shared ancestral brain feature of the vertebrate lineage. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. 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...

  3. Pregnancy-associated breast cancer in Taiwanese women: potential treatment delay and impact on survival.

    Science.gov (United States)

    Yang, Ya-Ling; Chan, K Arnold; Hsieh, Fon-Jou; Chang, Li-Yun; Wang, Ming-Yang

    2014-01-01

    This study investigated the clinicopathologic characteristics and survival of women diagnosed with pregnancy-associated breast cancer (PABC) in Taiwan. PABC is defined as breast cancer diagnosed during pregnancy or within 1 year after obstetric delivery. Our sample of PABC patients (N = 26) included all patients diagnosed at a major medical center in northern Taiwan from 1984 through 2009. Among these patients, 15 were diagnosed during pregnancy and 11 were diagnosed within 1 year after delivery. The comparison group included 104 patients within the same age range as the PABC patients and diagnosed with breast cancer not associated with pregnancy from 2004 through 2009 at the same hospital. Patients' initiating treatment delayed, 5-year and 10-year overall survival were delineated by stratified Kaplan-Meier estimates. Patients' characteristics were associated with initiating treatment delayed was evaluated with multivariate proportional hazards modeling. Antepartum PABC patients were younger and had longer time between diagnosis and treatment initiation than postpartum PABC patients. The predictor of treatment delayed was including birth parity, cancer stage, and pregnancy. The PABC group had larger tumors, more advanced cancer stage, and tumors with less progesterone receptor than the comparison group. The antepartum PABC patients had higher mortality than postpartum PABC and comparison groups within 5 years after diagnosis. Based on these results, we confirmed that pregnant women with breast cancer were more likely to delay treatment. Therefore, we recommend that breast cancer screening should be integrated into the prenatal and postnatal routine visits for early detection of the women's breast problems.

  4. Regulated expression of a cytokinin biosynthesis gene IPT delays leaf senescence and improves yield under rainfed and irrigated conditions in canola (Brassica napus L..

    Directory of Open Access Journals (Sweden)

    Surya Kant

    Full Text Available Delay of leaf senescence through genetic modification can potentially improve crop yield, through maintenance of photosynthetically active leaves for a longer period. Plant growth hormones such as cytokinin regulate and delay leaf senescence. Here, the structural gene (IPT encoding the cytokinin biosynthetic enzyme isopentenyltransferase was fused to a functionally active fragment of the AtMYB32 promoter and was transformed into canola plants. Expression of the AtMYB32xs::IPT gene cassette delayed the leaf senescence in transgenic plants grown under controlled environment conditions and field experiments conducted for a single season at two geographic locations. The transgenic canola plants retained higher chlorophyll levels for an extended period and produced significantly higher seed yield with similar growth and phenology compared to wild type and null control plants under rainfed and irrigated treatments. The yield increase in transgenic plants was in the range of 16% to 23% and 7% to 16% under rainfed and irrigated conditions, respectively, compared to control plants. Most of the seed quality parameters in transgenic plants were similar, and with elevated oleic acid content in all transgenic lines and higher oil content and lower glucosinolate content in one specific transgenic line as compared to control plants. The results suggest that by delaying leaf senescence using the AtMYB32xs::IPT technology, productivity in crop plants can be improved under water stress and well-watered conditions.

  5. Delay in commencing treatment for MDR TB at a specialised TB treatment centre in KwaZulu-Natal.

    Science.gov (United States)

    Narasimooloo, R; Ross, A

    2012-05-08

    Background. According to the National Department of Health (NDoH) guidelines, patients diagnosed with MDR TB must be referred to a specialised treatment centre for initiation of effective therapy. MDR TB is difficult to diagnose and the centralised referral model is beset with challenges that contribute to treatment delays, increased patient morbidity and mortality, and MDR TB nosocomial transmission. Culture and DST takes 8 weeks or longer to obtain results while line probe assays (LPAs) can give a result in hours. LPAs and the GeneXpert MTB/Rif (GX) are ground-breaking discoveries for TB diagnosis. However, they are not easily accessible or available to those needing it, so culture and sensitivity testing remains the gold standard for diagnosis. Aim. This study aimed to assess the delay in the initiation of MDR TB treatment and profiled the patients being referred to a specialised drug-resistant treatment centre in KwaZulu-Natal. Results. Of all the patients, 75% referred showed a mean delay of 12.4 weeks from the date of sputum collection for culture and drug sensitivity testing to the start of treatment. Most of the patients were symptomatic for TB and HIV-positive. Discussion. Our findings suggest that current policy on the initiation of effective treatment needs urgent revision. Staff should be appropriately trained in LPA and GX technology to reduce delays in initiating treatment for MDR TB. The NDoH's plans for rapid diagnosis and reducing the treatment burden on centralised MDR TB management facilities are in the early phases of implementation and will take years to achieve favourable and significant outcomes. Conclusion. There is a significant delay in initiating definitive management for MDR TB.

  6. 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.

    2010-01-01

    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 accordin

  7. A Comparison of Constant Time Delay Instruction with High and Low Treatment Integrity

    Science.gov (United States)

    Tekin Iftar, Elif; Kurt, Onur; Cetin, Ozlem

    2011-01-01

    Time delay (TD) procedure is an effective procedure in teaching various skills to children with developmental disabilities. Moreover, research has shown that it is used with high treatment integrity (HTI). However, there are several barriers which may prevent delivery instruction with HTI. Therefore, this study was designed to compare the…

  8. Rate, Delay and Predictors of Hepatitis C Treatment in British Columbia

    OpenAIRE

    Alan Hoi Lun Yau; Terry Lee; Alnoor Ramji; Hin Hin Ko

    2015-01-01

    BACKGROUND: The current treatment rate for chronic hepatitis C virus (HCV) infection is suboptimal despite the availability of efficacious antiviral therapy.OBJECTIVE: To determine the rate, delay and predictors of treatment in patients with chronic HCV infection.METHODS: A retrospective chart review of chronic HCV patients who were being evaluated at a tertiary hepatology centre in Vancouver, British Columbia, was performed.RESULTS: One hundred sixty-four patients with chronic HCV infection ...

  9. 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

  10. Morbid Obesity as Early Manifestation of Occult Hypothalamic-Pituitary LCH with Delay in Treatment

    Directory of Open Access Journals (Sweden)

    Jennifer Keates-Baleeiro

    2015-01-01

    Full Text Available Morbid obesity presents unique challenges in managing additional disease processes. A 16-year-old male with a history of central diabetes insipidus (DI and hypothyroidism developed destructive lesions in both his right mandible and brain, which were not discovered until the patient presented for tinnitus, 8 years after his initial diagnosis with DI. Langerhans cell histiocytosis (LCH was diagnosed on pathologic biopsy. The patient’s initial body mass index (BMI was 54.5 kg/m2 so a unique treatment approach with single agent cladribine (2-CdA was offered as traditional steroid therapy could worsen his endocrine dysfunction. The patient presented with neurodegenerative sequelae from the central LCH, possibly due to a delay in diagnosis and therapy. This case highlights difficulties in managing obese patients in an oncology setting and provides an illustrative case of how obesity may mask other comorbid conditions. Close supervision of complex obese patients with coordinated endocrinology and oncology care is vital. For the primary care practitioner, monitoring abrupt changes in BMI with serial cranial imaging may lead to a prompt diagnosis and prevention of further neurodegenerative effects. The use of 2-CdA was found to successfully bring the patient’s LCH into remission without the additional risks of steroid therapy in a morbidly obese patient.

  11. The flavonoid apigenin delays forgetting of passive avoidance conditioning in rats.

    Science.gov (United States)

    Popović, Miroljub; Caballero-Bleda, María; Benavente-García, Obdulio; Castillo, Julián

    2014-05-01

    The present experiments were performed to study the effect of the flavonoid apigenin (20 mg/kg intraperitoneally (i.p.), 1 h before acquisition), on 24 h retention performance and forgetting of a step-through passive avoidance task, in young male Wistar rats. There were no differences between saline- and apigenin-treated groups in the 24 h retention trial. Furthermore, apigenin did not prevent the amnesia induced by scopolamine (1mg/kg, i.p., 30 min before the acquisition). The saline- and apigenin-treated rats that did not step through into the dark compartment during the cut-off time (540 s) were retested weekly for up to eight weeks. In the saline treated group, the first significant decline in passive avoidance response was observed at four weeks, and complete memory loss was found five weeks after the acquisition of the passive avoidance task. At the end of the experimental period, 60% of the animals treated with apigenin still did not step through. These data suggest that 1) apigenin delays the long-term forgetting but did not modulate the 24 h retention of fear memory and 2) the obtained beneficial effect of apigenin on the passive avoidance conditioning is mediated by mechanisms that do not implicate its action on the muscarinic cholinergic system.

  12. Analysis of a Dynamic Model of Host-parasite Interaction with Delay and Treatment

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yu

    2013-01-01

    In this paper,the dynamic behaviors of a host-parasite model with intracellular delay and drug treatment is investigated.we obtain the basic reproductive ratio Ro,which determined the behaviors of the system.If Ro < 1,the infection-free equilibrium is globally asymptotic stability.If 1 < Ro < 3,the infection equilibrium is locally asymptotic stability.If Ro > 3,by choosing the delay (τ) as a bifurcation parameter,the infection equilibrium bifurcate a family of periodic solution as (τ) crosses a critical value.Furthermore,we give some examples to verify our theoretical results and discuss the sensitivity of the drug efficacy and effect of the delay.In the finally,we give a brief discussion.

  13. 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.

  14. EFFECT OF ICE BAG, DYNAMIC STRETCHING AND COMBINED TREATMENTS ON THE PREVENTION AND TREATMENT OF DELAY ONSET MUSCLE SORENESS

    OpenAIRE

    Warin Krityakiarana; Jariya Budworn; Chatchawan Khajohnanan; Nutchanad Suramas; Watcharaporn Puritasang

    2014-01-01

    Objective: To investigate the effects of ice bag, dynamic stretching, combined ice and dynamic stretching, and control (non-treated) on the prevention and treatment of delayed onset muscle soreness (DOMS) in biceps muscle. Subjects: Fifty-five participants (aged 18 to 25 years) were engaged in this study and randomly assigned into four groups (control group (non-treated) (CG), n = 13; ice bag, n = 14; dynamic stretching, n = 14; and combined treatment, n = 14). Method: Before inducing D...

  15. 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.

  16. 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...

  17. Reevaluation of the role of parallel fiber synapses in delay eyeblink conditioning in mice using Cbln1 as a tool.

    Science.gov (United States)

    Emi, Kyoichi; Kakegawa, Wataru; Miura, Eriko; Ito-Ishida, Aya; Kohda, Kazuhisa; Yuzaki, Michisuke

    2013-01-01

    The delay eyeblink conditioning (EBC) is a cerebellum-dependent type of associative motor learning. However, the exact roles played by the various cerebellar synapses, as well as the underlying molecular mechanisms, remain to be determined. It is also unclear whether long-term potentiation (LTP) or long-term depression (LTD) at parallel fiber (PF)-Purkinje cell (PC) synapses is involved in EBC. In this study, to clarify the role of PF synapses in the delay EBC, we used mice in which a gene encoding Cbln1 was disrupted (cbln1(-/-) mice), which display severe reduction of PF-PC synapses. We showed that delay EBC was impaired in cbln1(-/-) mice. Although PF-LTD was impaired, PF-LTP was normally induced in cbln1(-/-) mice. A single recombinant Cbln1 injection to the cerebellar cortex in vivo completely, though transiently, restored the morphology and function of PF-PC synapses and delay EBC in cbln1(-/-) mice. Interestingly, the cbln1(-/-) mice retained the memory for at least 30 days, after the Cbln1 injection's effect on PF synapses had abated. Furthermore, delay EBC memory could be extinguished even after the Cbln1 injection's effect were lost. These results indicate that intact PF-PC synapses and PF-LTD, not PF-LTP, are necessary to acquire delay EBC in mice. In contrast, extracerebellar structures or remaining PF-PC synapses in cbln1(-/-) mice may be sufficient for the expression, maintenance, and extinction of its memory trace.

  18. 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

  19. 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.

  20. Delay-Induced Attenuation of Latent Inhibition with a Conditioned Emotional Response Depends on CS-US Strength

    Science.gov (United States)

    De la Casa, Luis G.; Diaz, Estrella; Lubow, R.E.

    2005-01-01

    Latent Inhibition (LI) attenuation when a long delay is introduced between acquisition and test phases has been repeatedly observed using aversive conditioning procedures (e.g., Aguado, Symonds, & Hall, 1994). This effect has been used as evidence to support those theories that consider LI to be the result of a retrieval failure. We designed three…

  1. Pregnancy-associated breast cancer in Taiwanese women: potential treatment delay and impact on survival.

    Directory of Open Access Journals (Sweden)

    Ya-Ling Yang

    Full Text Available This study investigated the clinicopathologic characteristics and survival of women diagnosed with pregnancy-associated breast cancer (PABC in Taiwan. PABC is defined as breast cancer diagnosed during pregnancy or within 1 year after obstetric delivery. Our sample of PABC patients (N = 26 included all patients diagnosed at a major medical center in northern Taiwan from 1984 through 2009. Among these patients, 15 were diagnosed during pregnancy and 11 were diagnosed within 1 year after delivery. The comparison group included 104 patients within the same age range as the PABC patients and diagnosed with breast cancer not associated with pregnancy from 2004 through 2009 at the same hospital. Patients' initiating treatment delayed, 5-year and 10-year overall survival were delineated by stratified Kaplan-Meier estimates. Patients' characteristics were associated with initiating treatment delayed was evaluated with multivariate proportional hazards modeling. Antepartum PABC patients were younger and had longer time between diagnosis and treatment initiation than postpartum PABC patients. The predictor of treatment delayed was including birth parity, cancer stage, and pregnancy. The PABC group had larger tumors, more advanced cancer stage, and tumors with less progesterone receptor than the comparison group. The antepartum PABC patients had higher mortality than postpartum PABC and comparison groups within 5 years after diagnosis. Based on these results, we confirmed that pregnant women with breast cancer were more likely to delay treatment. Therefore, we recommend that breast cancer screening should be integrated into the prenatal and postnatal routine visits for early detection of the women's breast problems.

  2. Short-term subcutaneous insulin treatment delays but does not prevent diabetes in NOD mice.

    Science.gov (United States)

    Brezar, Vedran; Culina, Slobodan; Gagnerault, Marie-Claude; Mallone, Roberto

    2012-06-01

    Despite encouraging results in the NOD mouse, type 1 diabetes prevention trials using subcutaneous insulin have been unsuccessful. To explain these discrepancies, 3-week-old NOD mice were treated for 7 weeks with subcutaneous insulin at two different doses: a high dose (0.5 U/mouse) used in previous mouse studies; and a low dose (0.005 U/mouse) equivalent to that used in human trials. Effects on insulitis and diabetes were monitored along with immune and metabolic modifications. Low-dose insulin did not have any effect on disease incidence. High-dose treatment delayed but did not prevent diabetes, with reduced insulitis reappearing once insulin discontinued. This effect was not associated with significant immune changes in islet infiltrates, either in terms of cell composition or frequency and IFN-γ secretion of islet-reactive CD8(+) T cells recognizing the immunodominant epitopes insulin B(15-23) and islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP)(206-214). Delayed diabetes and insulitis were associated with lower blood glucose and endogenous C-peptide levels, which rapidly returned to normal upon treatment discontinuation. In conclusion, high- but not low-dose prophylactic insulin treatment delays diabetes onset and is associated with metabolic changes suggestive of β-cell "rest" which do not persist beyond treatment. These findings have important implications for designing insulin-based prevention trials.

  3. Novel conditions on exponential stability of a class of delayed neural networks with state-dependent switching.

    Science.gov (United States)

    Zhang, Guodong; Shen, Yi

    2015-11-01

    This paper is concerned with the global exponential stability on a class of delayed neural networks with state-dependent switching. Under the novel conditions, some sufficient criteria ensuring exponential stability of the proposed system are obtained. In particular, the obtained conditions complement and improve earlier publications on conventional neural networks with continuous or discontinuous right-hand side. Numerical simulations are also presented to illustrate the effectiveness of the obtained results.

  4. Reevaluation of the role of parallel fiber synapses in delay eyeblink conditioning in mice using Cbln1 as a tool

    OpenAIRE

    Kyoichi eEmi; Wataru eKakegawa; Eriko eMiura; Aya eIto-Ishida; Kazuhisa eKohda; Michisuke eYuzaki

    2013-01-01

    The delay eyeblink conditioning (EBC) is a cerebellum-dependent type of associative motor learning. However, the exact roles played by the various cerebellar synapses, as well as the underlying molecular mechanisms, remain to be determined. It is also unclear whether long-term potentiation (LTP) or long-term depression (LTD) at parallel fiber (PF)–Purkinje cell synapses is involved in EBC. In this study, to clarify the role of PF synapses in the delay EBC, we used mice in which a gene encodin...

  5. Cerebellar-dependent associative learning is preserved in Duchenne muscular dystrophy: a study using delay eyeblink conditioning.

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    Ulrike Schara

    Full Text Available Besides progressive muscle weakness cognitive deficits have been reported in patients with Duchenne muscular dystrophy (DMD. Cerebellar dysfunction has been proposed to explain cognitive deficits at least in part. In animal models of DMD disturbed Purkinje cell function has been shown following loss of dystrophin. Furthermore there is increasing evidence that the lateral cerebellum contributes to cognitive processing. In the present study cerebellar-dependent delay eyeblink conditioning, a form of associative learning, was used to assess cerebellar function in DMD children.Delay eyeblink conditioning was examined in eight genetically defined male patients with DMD and in ten age-matched control subjects. Acquisition, timing and extinction of conditioned eyeblink responses (CR were assessed during a single conditioning session.Both groups showed a significant increase of CRs during the course of learning (block effect p < 0.001. CR acquisition was not impaired in DMD patients (mean total CR incidence 37.4 ± 17.6% as compared to control subjects (36.2 ± 17.3%; group effect p = 0.89; group by block effect p = 0.38; ANOVA with repeated measures. In addition, CR timing and extinction was not different from controls.Delay eyeblink conditioning was preserved in the present DMD patients. Because eyeblink conditioning depends on the integrity of the intermediate cerebellum, this older part of the cerebellum may be relatively preserved in DMD. The present findings agree with animal model data showing that the newer, lateral cerebellum is primarily affected in DMD.

  6. Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia

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    Getinet Shewaseged Adenager

    2017-01-01

    Full Text Available Background. Early detection and diagnosis of tuberculosis (TB and the timely commencement of antituberculosis (anti-TB treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. Objective. To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. Findings. The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%, 233 (54.8%, and 262 (61.6% of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5 km from TB treatment health facility [AOR = 1.6, 95% CI (1.1–2.5] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70] and [AOR = 0.61 (0.39, 0.94], respectively. Conclusions. A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care.

  7. Preliminary development of flaw evaluation procedures for delayed hydride cracking initiation under hydride non-ratcheting conditions

    Energy Technology Data Exchange (ETDEWEB)

    Xu, S.; Cui, J.; Kawa, D.; Shek, G.K.; Scarth, D.A. [Kinectrics Inc., Toronto, Ontario (Canada)

    2006-07-01

    The flaw evaluation procedure for Delayed Hydride Cracking (DHC) initiation currently provided in the CSA Standard N285.8 was developed for hydride ratcheting conditions, in which flaw-tip hydrides do not completely dissolve at peak temperature. Test results have shown that hydrided regions formed under non-ratcheting conditions, in which flaw-tip hydrides completely dissolve at peak temperature, have significantly higher resistance to cracking than those formed under ratcheting conditions. This paper presents some preliminary work on the development of a procedure for the evaluation of DHC initiation for flaws under hydride non-ratcheting conditions. (author)

  8. Evaluation of delays in diagnosis and treatment of childhood malignancies in Bangladesh

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    Mamtaz Begum

    2016-01-01

    Full Text Available Introduction: Malignancy is one of the leading causes of morbidity and mortality worldwide. According to GLOBOCAN 2012, an estimated 14.1 million new cancer cases and 8.2 million cancer-related deaths occurred in 2012. It is estimated that childhood malignancies are 0.5-4.6% of total malignancies. However, from the point of view of potential year lost due to childhood malignancies, it is more important than adult. Materials and Methods: To find out the probable components for the delay in diagnosis and treatment of childhood malignancies in Bangladesh, cross-sectional observational study was done at the National Institute of Cancer Research and Hospital, Dhaka, Bangladesh, from January 2014 to June 2014. Results: A total of 171 patients were included in the study. They were divided into four age groups. The mean age was 8.422 years with standard deviation ± 5.381 years and their age ranged from 2 months to 18 years. In aggregate, about 70% of the cases had to wait for more than 90 days for the treatment. About 15% had to wait for 31-60 days. Negligible percentage of patients got treatment before 30 days. Among the three components of delay, patients delay was influenced by age of the child, economic status of the family, parental education, and awareness of the parents about malignancy. Conclusion: More than one-third of the pediatric patients had to wait three months or more for treatment to start for various reasons. By raising awareness among the stake holders this problem can be minimized. Further studies are recommended to explore the other factors which might cause delayed referral.

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

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    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.

  10. [Guidelines of treatment for peptic ulcer disease in special conditions].

    Science.gov (United States)

    Kim, Ji Hyun; Moon, Jeong Seop; Jee, Sam Ryong; Shin, Woon Geon; Park, Soo-Heon

    2009-11-01

    The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion.

  11. Interim analysis based on the weighted log-rank test for delayed treatment effects under staggered patient entry.

    Science.gov (United States)

    Yoshida, Mizuki; Matsuyama, Yutaka

    2016-01-01

    Fleming and Harrington's G(ρ,γ) class of weighted log-rank tests is appropriate for detecting delayed treatment effects such as those seen in cancer vaccines. A conditional power (CP) and an alpha spending function (ASF) approach are useful for interim analyses that are conducted with the aim of early termination due to futility and efficacy, respectively. However, calculation of the CP and the total Type I error probability are often not considered for delayed effects under the staggered patient entry. In this article, we first propose methods for calculating the CP analytically based on the weighted log-rank test. We compared the performances of the proposed methods with two other methods (i.e., usual log-rank test and optimal one) under the delayed alternatives. Our simulations demonstrated that the CP based on the weighted log-rank test was more powerful than that of the usual log-rank test and was comparable to the CP based on the optimal log-rank test. Second, we quantitatively evaluated the degree to which the Type I error probability was inflated when an ASF approach with forced independent increments assumption was applied to the weighted log-rank test. The proposed method will provide valuable tools in the decision-making stage of the interim analysis.

  12. 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

  13. Amygdala kindling disrupts trace and delay fear conditioning with parallel changes in Fos protein expression throughout the limbic brain.

    Science.gov (United States)

    Botterill, J J; Fournier, N M; Guskjolen, A J; Lussier, A L; Marks, W N; Kalynchuk, L E

    2014-04-18

    Amygdala kindling is well known to increase unconditioned fear and anxiety. However, relatively little is known about whether this form of kindling causes functional changes within the neural circuitry that mediates fear learning and the retrieval of fear memories. To address this issue, we examined the effect of short- (i.e., 30 stimulations) and long-term (i.e., 99 stimulations) amygdala kindling in rats on trace and delay fear conditioning, which are aversive learning tasks that rely predominantly on the hippocampus and amygdala, respectively. After memory retrieval, we analyzed the pattern of neural activity with Fos, the protein product of the immediate early gene c-fos. We found that kindling had no effect on acquisition of the trace fear conditioning task but it did selectively impair retrieval of this fear memory. In contrast, kindling disrupted both acquisition and retrieval of fear memory in the delay fear conditioning task. We also found that kindling-induced impairments in memory retrieval were accompanied by decreased Fos expression in several subregions of the hippocampus, parahippocampus, and amygdala. Interestingly, decreased freezing in the trace conditioning task was significantly correlated with dampened Fos expression in hippocampal and parahippocampal regions whereas decreased freezing in the delay conditioning task was significantly correlated with dampened Fos expression in hippocampal, parahippocampal, and amygdaloid circuits. Overall, these results suggest that amygdala kindling promotes functional changes in brain regions involved in specific types of fear learning and memory. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

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

    CERN Document Server

    Fernández, Alberto Alonso; Alonso, Ignacio González; Hu, Huosheng; 10.5121/ijdps.2011.2201

    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 importance of obtaining data from real-time location systems portends that a basic tool for interoperability, such as web services, can be ineffective in this scenario because of the delays added in the invocation of services. This paper is focused on introducing a web service to resolve a coordinates request without any significant delay in comparison with the sockets.

  15. Low-intensity pulsed ultrasound treatment for postoperative delayed union or nonunion of long bone fractures.

    Science.gov (United States)

    Jingushi, Seiya; Mizuno, Kosaku; Matsushita, Takashi; Itoman, Moritoshi

    2007-01-01

    Postoperative delayed union and nonunion is the most common complication in fracture treatment. Recent studies have shown an accelerating effect of low-intensity pulsed ultrasound (LIPUS) on fracture repair. However, the indications for delayed union and nonunion are not clear. To clarify the factors which influence the effects of LIPUS, the data from a previous prospective multicenter study on LIPUS treatment for postoperative delayed union and nonunion of long bone fractures were reanalyzed. Seventy-two cases of long bone fracture, including those of the femur, tibia, humerus, radius, and ulna, were analyzed. The mean time from the most recent operation to the beginning of LIPUS treatment was 11.5 (3-68) months. The relationship between the background factors and the union rate was analyzed using a logistic regression method. In addition, long bone fractures in an upper extremity or in a lower extremity were analyzed separately. The union rate was 75% in all the cases of long bone fracture. There was a significant relationship between the union rate and the period from the most recent operation to the beginning of LIPUS treatment in all cases and in those that had long bone fracture of an upper extremity. There was also a significant relationship between the union rate and the time when a radiological improvement was first observed after the beginning of the treatment in all cases and in those with fractures in a lower extremity. When LIPUS treatment was started within 6 months of the most recent operation, 89.7% of all fractures healed. When an improvement in the radiological changes at the fracture site was observed after 4 months in those cases, then the sensitivity and specificity for union were more than 90%. LIPUS treatment should be started within 6 months of the most recent operation. Because LIPUS has been shown to be effective without causing either serious invasiveness or any undue risk to the patient, it may be considered the treatment of first choice

  16. Delay in surgical treatment of patients with hilar cholangiocarcinoma: does time impact outcomes?

    Science.gov (United States)

    Ruys, Anthony T; Heuts, Simon G; Rauws, Eric A; Busch, Olivier R C; Gouma, Dirk J; Gulik, Thomas M

    2014-01-01

    Background Substantial time elapses before patients with hilar cholangiocarcinoma (HCC) receive surgical treatment because of time-consuming preoperative staging and other interventions, including biliary drainage and portal vein embolization. Prolonged times potentially lead to unresectability and the formation of metastases, yet these issues have not been investigated previously in HCC. This study aimed to evaluate the time between onset of symptoms and the provision of ultimate treatment in patients with HCC and the impact of the length of time on outcomes. Methods Delays in the treatment of consecutive patients with HCC were evaluated by contacting general practitioners (GPs) and extracting data from hospital files. Time periods were correlated with resectability, occurrence of metastasis, tumour stage and survival using logistic and Cox regression analyses. Results Treatment times in 209 consecutive HCC patients were evaluated. The median time from first GP visit until presentation at the tertiary centre was 35 days. Time until treatment was longer when initial symptoms did not include jaundice (non-specific symptoms, P < 0.001). Duration of workup and preoperative biliary drainage at the tertiary centre prior to final surgical treatment resulted in an additional median time of 74 days. No correlation was found between treatment time in weeks and resectability [odds ratio (OR) 1.010, 95% confidence interval (CI) 0.985–1.036], metastasis (OR = 0.947, 95% CI 0.897–1.000), tumour stage (OR = 1.006, 95% CI 0.981–1.031) or survival in resected patients (hazard ratio = 0.996, 95% CI 0.975–1.018). Conclusions The time that elapses between the presentation of symptoms and final treatment in patients with HCC is substantial, especially in patients with non-specific symptoms. This time, however, does not affect resectability, metastasis, tumour stage or survival, which suggests that preoperative optimization should not be omitted because of potential delays in

  17. M-matrix-based stability conditions for genetic regulatory networks with time-varying delays and noise perturbations.

    Science.gov (United States)

    Tian, Li-Ping; Shi, Zhong-Ke; Liu, Li-Zhi; Wu, Fang-Xiang

    2013-10-01

    Stability is essential for designing and controlling any dynamic systems. Recently, the stability of genetic regulatory networks has been widely studied by employing linear matrix inequality (LMI) approach, which results in checking the existence of feasible solutions to high-dimensional LMIs. In the previous study, the authors present several stability conditions for genetic regulatory networks with time-varying delays, based on M-matrix theory and using the non-smooth Lyapunov function, which results in determining whether a low-dimensional matrix is a non-singular M-matrix. However, the previous approach cannot be applied to analyse the stability of genetic regulatory networks with noise perturbations. Here, the authors design a smooth Lyapunov function quadratic in state variables and employ M-matrix theory to derive new stability conditions for genetic regulatory networks with time-varying delays. Theoretically, these conditions are less conservative than existing ones in some genetic regulatory networks. Then the results are extended to genetic regulatory networks with time-varying delays and noise perturbations. For genetic regulatory networks with n genes and n proteins, the derived conditions are to check if an n × n matrix is a non-singular M-matrix. To further present the new theories proposed in this study, three example regulatory networks are analysed.

  18. The optimal duration and delay of first aid treatment for deep partial thickness burn injuries.

    Science.gov (United States)

    Cuttle, Leila; Kempf, Margit; Liu, Pei-Yun; Kravchuk, Olena; Kimble, Roy M

    2010-08-01

    Using our porcine model of deep dermal partial thickness burn injury, various durations (10min, 20min, 30min or 1h) and delays (immediate, 10min, 1h, 3h) of 15 degrees C running water first aid were applied to burns and compared to untreated controls. The subdermal temperatures were monitored during the treatment and wounds observed weekly for 6 weeks, for re-epithelialisation, wound surface area and cosmetic appearance. At 6 weeks after the burn, tissue biopsies were taken of the scar for histological analysis. Results showed that immediate application of cold running water for 20min duration is associated with an improvement in re-epithelialisation over the first 2 weeks post-burn and decreased scar tissue at 6 weeks. First aid application of cold water for as little as 10min duration or up to 1h delay still provides benefit.

  19. A review of workers' compensation claims: the frequency of claim denial and medical treatment delay.

    Science.gov (United States)

    Kelley, C R; Amparo, J M

    2000-01-01

    A retrospective chart review of 257 patients who presented between January to March 1998, was conducted to identify the frequency of workers' compensation claim denial among patients who reported to Straub Clinic and Hospital. Results showed that 12.8% of claims were either "denied" or temporarily "denied pending investigation". Analysis of all the claims found that only 2% resulted in delayed medical care. Further analysis of the denied claims revealed the vast majority of claims (78.8%) were denied because the medical provider and the patient had incorrect workers' compensation carrier information. Other independent variables studied (size of the employer, category of employer, injury type, status of case, length of case and number of visits) did not predict either denial of the claim or treatment delay. This study suggests that the efficiency of our State's Workers' Compensation system would be greatly improved by developing a system to provide medical care providers with accurate insurance information.

  20. Recovery of cognitive dysfunction in a case of delayed encephalopathy of carbon monoxide poisoning after treatment with donepezil hydrochloride

    OpenAIRE

    Wang Pin; Zeng Tao; Chi Zhao-fu

    2009-01-01

    Delayed encephalopathy following carbon monoxide poisoning is a serious complication. Here, we report a patient with delayed encephalopathy who suffered from cognitive disorders and urinary incontinence after a temporal normal period of 15 days after acute intoxication, and his cognitive function recovered gradually following donepezil hydrochloride treatment. Now, he can undertake slight farming work.

  1. Recovery of cognitive dysfunction in a case of delayed encephalopathy of carbon monoxide poisoning after treatment with donepezil hydrochloride

    Directory of Open Access Journals (Sweden)

    Wang Pin

    2009-01-01

    Full Text Available Delayed encephalopathy following carbon monoxide poisoning is a serious complication. Here, we report a patient with delayed encephalopathy who suffered from cognitive disorders and urinary incontinence after a temporal normal period of 15 days after acute intoxication, and his cognitive function recovered gradually following donepezil hydrochloride treatment. Now, he can undertake slight farming work.

  2. Reevaluation of the role of parallel fiber synapses in delay eyeblink conditioning in mice using Cbln1 as a tool

    Directory of Open Access Journals (Sweden)

    Kyoichi eEmi

    2013-11-01

    Full Text Available The delay eyeblink conditioning (EBC is a cerebellum-dependent type of associative motor learning. However, the exact roles played by the various cerebellar synapses, as well as the underlying molecular mechanisms, remain to be determined. It is also unclear whether long-term potentiation (LTP or long-term depression (LTD at parallel fiber (PF–Purkinje cell synapses is involved in EBC. In this study, to clarify the role of PF synapses in the delay EBC, we used mice in which a gene encoding Cbln1 was disrupted (cbln1–/– mice, which display severe reduction of PF–Purkinje cell synapses. We showed that delay EBC was impaired in cbln1–/– mice. Although PF-LTD was impaired, PF-LTP was normally induced in cbln1–/– mice. A single recombinant Cbln1 injection to the cerebellar cortex in vivo completely, though transiently, restored the morphology and function of PF–Purkinje cell synapses and delay EBC in cbln1–/– mice. Interestingly, the cbln1–/– mice retained the memory for at least 30 d, after the Cbln1 injection’s effect on PF synapses had abated. Furthermore, delay EBC memory could be extinguished even after the Cbln1 injection’s effect were lost. These results indicate that intact PF–Purkinje cell synapses and PF-LTD, not PF-LTP, are necessary to acquire delay EBC in mice. In contrast, extracerebellar structures or remaining PF–Purkinje cell synapses in cbln1–/– mice may be sufficient for the expression, maintenance, and extinction of its memory trace.

  3. Treatment of distal femoral nonunion and delayed union by using a retrograde intramedullary interlocking nail

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To analyze the causes of distal femoral nonunion and delayed union and assess the outcome of the corresponding treatment, retrograde intramedullary interlocking nail (RIIN).   Methods: From June 1995 to December 1998, 15 patients (9 males and 6 females) with distal femoral nonunion and delayed union were treated with RIIN. The average age of the patients was 34.5 years (23-46 years). Bone grafting was performed in 10 patients, closed reaming was done in the other 5 patients. Correction osteotomy was performed in 2 patients, and intra-articular release of knee adhesion in 11 patients. X-ray examination and knee society clinical rating system (KSS) were used to evaluate the results.   Results: All fractures were followed up for at least 9 months with average follow-up duration of 14.5 months (9-33 months). Solid union was documented in all patients at 6.4 months on average. There were no infections or malunions in this series. Based on the final follow-up data, acceptable functional range of motion (ROM) of over 90° was achieved in most patients. The average ROM was 93.5° with significant improvement of 28° (42.7%, P<0.05) compared with the preoperative ROM. The average knee score was 96. Excellent ROM emerged in 13 patients. The knee function score was 90.5 on average.   Conclusions: The main causes of distal femoral nonunion and delayed union are improper indications and improper use of the implants. RIIN is an effective alternative for treatment of distal femoral nonunion and delayed union because it can provide a stable and reliable fixation which is beneficial for early functional exercise of knee. Bone grafting, closed reaming and intra-articular release of knee adhesion should be considered in order to enhance the bone healing and improve ROM and the knee function.

  4. Undernutrition during the brain growth period of the rat significantly delays the development of processes mediating Pavlovian trace conditioning.

    Science.gov (United States)

    Rudy, J W; Castro, C A

    1990-05-01

    Pavlovian trace conditioning procedures allow one to assess the ability of animals to associate events that are temporally separated because the conditioned stimulus terminates prior to the occurrence of the unconditioned stimulus. We report that undernutrition during Postnatal Days 2-18 significantly delays the development of trace conditioning to a visual stimulus. Previously undernourished 20-day-old rats conditioned when no temporal interval separated the termination of the CS and US onset (0-s trace interval). However, it was not until the undernourished pups were 30 days old that they conditioned when the trace interval was 10 or 30 s. In contrast, control pups only 20 days old were able to condition when a 10-s trace interval separated the CS and US events, and 25-day-old control pups conditioned when the interval was either 10 or 30 s. These results suggest that undernutrition delays the development of processes that enable the rat to sustain a representation of a visual CS during the trace interval.

  5. Successful Treatment of T Cell-Mediated Acute Rejection with Delayed CTLA4-Ig in Mice

    Directory of Open Access Journals (Sweden)

    James S. Young

    2017-09-01

    Full Text Available Clinical observations that kidney transplant recipients receiving belatacept who experienced T cell-mediated acute rejection can be successfully treated and subsequently maintained on belatacept-based immunosuppression suggest that belatacept is able to control memory T cells. We recently reported that treatment with CTLA4-Ig from day 6 posttransplantation successfully rescues allografts from acute rejection in a BALB/c to C57BL/6 heart transplant model, in part, by abolishing B cell germinal centers and reducing alloantibody titers. Here, we show that CTLA4-Ig is additionally able to inhibit established T cell responses independently of B cells. CTLA4-Ig inhibited the in vivo cytolytic activity of donor-specific CD8+ T cells, and the production of IFNγ by graft-infiltrating T cells. Delayed CTLA4-Ig treatment did not reduce the numbers of graft-infiltrating T cells nor prevented the accumulation of antigen-experienced donor-specific memory T cells in the spleen. Nevertheless, delayed CTLA4-Ig treatment successfully maintained long-term graft acceptance in the majority of recipients that had experienced a rejection crisis, and enabled the acceptance of secondary BALB/c heart grafts transplanted 30 days after the first transplantation. In summary, we conclude that delayed CTLA4-Ig treatment is able to partially halt ongoing T cell-mediated acute rejection. These findings extend the functional efficacy of CTLA4-Ig therapy to effector T cells and provide an explanation for why CTLA4-Ig-based immunosuppression in the clinic successfully maintains long-term graft survival after T cell-mediated rejection.

  6. Listening to the Patient Voice in Narcolepsy: Diagnostic Delay, Disease Burden, and Treatment Efficacy

    Science.gov (United States)

    Maski, Kiran; Steinhart, Erin; Williams, David; Scammell, Thomas; Flygare, Julie; McCleary, Kimberly; Gow, Monica

    2017-01-01

    Study Objectives: Describe common symptoms, comorbidities, functional limitations, and treatment responsiveness among patients with narcolepsy. Investigate the effect of pediatric onset of narcolepsy symptoms on time to diagnosis of narcolepsy and presence of comorbid depression. Methods: Cross-sectional survey of 1,699 people in the United States with self-reported diagnosis of narcolepsy. We utilized mixed-methods data analyses to report study findings. Results: Most participants reported receiving a diagnosis of narcolepsy more than 1 y after symptom onset. We found that the strongest predictor of this delayed diagnosis was pediatric onset of symptoms (odds ratio = 2.4, p narcolepsy symptoms. Overall, participants reported that fatigue and cognitive difficulties were their most burdensome symptoms in addition to sleepiness and cataplexy. The majority of participants reported residual daytime fatigue and/or sleepiness despite treatment. Most participants reported they could not perform at work or school as well as they would like because of narcolepsy symptoms. Conclusions: This study provides unique insight into the narcolepsy disease experience. The study quantifies the problem of diagnostic delay for narcolepsy patients in the United States and highlights that symptoms are more likely to be missed if they develop before 18 y of age. These results suggest that narcolepsy awareness efforts should be aimed at parents, pediatric health care providers, school professionals, and children/adolescents themselves. Disease burden is high because of problems with fatigue, cognition, and persistence of residual symptoms despite treatment. Citation: Maski K, Steinhart E, Williams D, Scammell T, Flygare J, McCleary K, Gow M. Listening to the patient voice in narcolepsy: diagnostic delay, disease burden and treatment efficacy. J Clin Sleep Med. 2017;13(3):419–425. PMID:27923434

  7. Factors involved in the delay of treatment initiation for cervical cancer patients: A nationwide population-based study.

    Science.gov (United States)

    Shen, Szu-Ching; Hung, Yao-Ching; Kung, Pei-Tseng; Yang, Wen-Hui; Wang, Yueh-Hsin; Tsai, Wen-Chen

    2016-08-01

    Cervical cancer ranks as the fourth leading cause of cancer death in women worldwide. In Taiwan, although the universal health insurance system has achieved 99.9% coverage and ensured easy access to medical care, some cervical cancer patients continue to delay initiation of definitive treatment after diagnosis. This study focused on cervical cancer patients who delayed treatment for at least 4 months, and examined the characteristics, related factors, and survival in these patients.Data on patients with a new confirmed diagnosis of cervical cancer by the International Federation of Gynecology and Obstetrics (FIGO) staging system between 2005 and 2010 were obtained from the National Health Insurance Research Database and the Taiwan Cancer Registry. Logistic regression analysis was performed to analyze the association of various factors with treatment delay. The Cox proportional hazards model was used to analyze the effects of various factors on mortality risk.The rate of treatment delay for cervical cancer decreased steadily from 6.46% in 2005 to 2.48% in 2010. Higher rates of treatment delay were observed among patients who were aged ≥75 years (9.91%), had severe comorbidity, had stage IV (9.50%), diagnosing hospital level at nonmedical center, or at public hospital ownership. Factors that correlated with treatment delay were age ≥75 years (odds ratio [OR] = 2.42), higher comorbidity Charlson comorbidity index (CCI) 4-6, or ≥7 (OR = 1.60, 2.00), cancer stage IV (OR = 2.60), the diagnosing hospital being a regional, district hospital, or other (OR = 3.00, 4.01, 4.60), and at public hospital ownership. Those who delayed treatment had 2.31 times the mortality risk of those who underwent timely treatment (P cervical cancer treatment in Taiwan was associated with age, comorbidity, cancer stage, diagnosing hospital level, and hospital ownership. Delaying treatment for ≥4 months substantially raised mortality risk in cervical cancer patients.

  8. Destruction of central noradrenergic neurones with DSP4 impairs the acquisition of temporal discrimination but does not affect memory for duration in a delayed conditional discrimination task.

    Science.gov (United States)

    al-Zahrani, S S; al-Ruwaitea, A S; Ho, M Y; Bradshaw, C M; Szabadi, E

    1997-03-01

    This experiment examined the effect of destroying central noradrenergic neurones using the selective neurotoxin N-(2-chloroethyl)-n-ethyl-2-bromobenzylamine (DSP4) on the acquisition of a temporal discrimination and on memory for duration, using a delayed conditional discrimination task. In phase I, rats that had received systemic treatment with DSP4 and vehicle-treated control rats were trained in a series of discrete trials to press lever A following a 2-s presentation of a light stimulus, and lever B following an 8-s presentation of the same stimulus. Following stimulus offset, a response on a panel placed midway between the two levers was required to initiate lever presentation; a single response on either lever resulted in withdrawal of both levers and, in the case of a "correct" response, reinforcer delivery. Both groups acquired accurate discrimination, achieving 90% correct choices within 50 sessions; the DSP4-treated group acquired accurate performance more slowly than the control group. In phase II, delays were interposed between stimulus offset and lever presentation in 50% of the trials. In the absence of a delay, discriminative accuracy was lower in the DSP4-treated group than in the control group. Accuracy declined as a function of post-stimulus delay in both groups; both groups showed a delay-dependent bias towards responding on lever A ("choose-short" bias). Neither of these effects differed significantly between the two groups. The concentrations of noradrenaline in the parietal cortex and hippocampus were reduced by 90% and 89% in the DSP4-treated group, compared to the levels in the control group, but the levels of dopamine, 5-hydroxytryptamine and 5-hydroxyindoleacetic acid did not differ significantly between the groups. The results confirm the deleterious effect of DSP4 on the acquisition of temporal discrimination, but do not provide evidence for a role of the noradrenergic innervation of the hippocampus and neocortex in temporal working

  9. Visual Localisation of Mobile Devices in an Indoor Environment Under Network Delay Conditions

    Directory of Open Access Journals (Sweden)

    Huosheng Hu

    2011-03-01

    Full Text Available Current progresses in home automation and service robotic environment have highlighted the need todevelop 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 anindoor environment has been investigated. The communication of the device with the location service hasbeen carried out to study the time delay that web services offer in front of the sockets. The importance ofobtaining data from real-time location systems portends that a basic tool for interoperability, such as webservices, can be ineffective in this scenario because of the delays added in the invocation of services. Thispaper is focused on introducing a web service to resolve a coordinates request without any significantdelay in comparison with the sockets.

  10. Bounded Mean-Delay Throughput and Non-Starvation Conditions in Aloha Network

    CERN Document Server

    Liew, Soung Chang; Chen, Da Rui

    2008-01-01

    This paper considers the requirements to ensure bounded mean queuing delay and non-starvation in a slotted Aloha network operating the exponential backoff protocol. It is well-known that the maximum possible throughput of a slotted Aloha system with a large number of nodes is 1/e = 0.3679. Indeed, a saturation throughput of 1/e can be achieved with an exponential backoff factor of r = e/(e-1)=1.5820. The binary backoff factor of r = 2 is assumed in the majority of prior work, and in many practical multiple-access networks such as the Ethernet and WiFi. For slotted Aloha, the saturation throughput 0.3466 for r = 2 is reasonably close to the maximum of 1/e, and one could hardly raise objection to adopting r = 2 in the system. However, this paper shows that if mean queuing delay is to be bounded, then the sustainable throughput when r = 2 is only 0.2158, a drastic 41% drop from 1/e . Fortunately, the optimal setting of r = 1.3757 under the bounded mean-delay requirement allows us to achieve sustainable throughpu...

  11. Treatment with interferon-alpha delays disease in swine infected with a highly virulent CSFV strain.

    Science.gov (United States)

    Fernandez-Sainz, I; Ramanathan, P; O'Donnell, V; Diaz-San Segundo, F; Velazquez-Salinas, L; Sturza, D F; Zhu, J; de los Santos, T; Borca, M V

    2015-09-01

    Interferon-alpha (IFNα) can effectively inhibit or abort a viral infection within the host. It has been reported that IFN induction and production is hindered during classical swine fever virus (CSFV) infection. Most of those studies have been performed in vitro, making it difficult to elucidate the actual role of IFNs during CSFV infection in swine. Here, we report the effect of IFNα treatment (delivered by a replication defective recombinant human adenovirus type 5, Ad5) in swine experimentally infected with highly virulent CSFV strain Brescia. Treatment with two different subtypes of IFNα delayed the appearance of CSF-related clinical signs and virus replication although it did not prevent lethal disease. This is the first report describing the effect of IFNα treatment during CSFV infection in swine. Published by Elsevier Inc.

  12. Plasmodium falciparum malaria: Convergent evolutionary trajectories towards delayed clearance following artemisinin treatment.

    Science.gov (United States)

    Wilairat, Prapon; Kümpornsin, Krittikorn; Chookajorn, Thanat

    2016-05-01

    Malaria is a major global health challenge with 300million new cases every year. The most effective regimen for treating Plasmodium falciparum malaria is based on artemisinin and its derivatives. The drugs are highly effective, resulting in rapid clearance of parasites even in severe P. falciparum malaria patients. During the last five years, artemisinin-resistant parasites have begun to emerge first in Cambodia and now in Thailand and Myanmar. At present, the level of artemisinin resistance is relatively low with clinical presentation of delayed artemisinin clearance (a longer time to reduce parasite load) and a small decrease in artemisinin sensitivity in cultured isolates. Nevertheless, multiple genetic loci associated with delayed parasite clearance have been reported, but they cannot account for a large portion of cases. Even the most well-studied kelch 13 propeller mutations cannot always predict the outcome of artemisinin treatment in vitro and in vivo. Here we propose that delayed clearance by artemisinin could be the result of convergent evolution, driven by multiple trajectories to overcome artemisinin-induced stress, but precluded to become full blown resistance by high fitness cost. Genetic association studies by several genome-wide approaches reveal linkage disequilibrium between multiple loci and delayed parasite clearance. Genetic manipulations at some of these loci already have resulted in loss in artemisinin sensitivity. The notion presented here is by itself consistent with existing evidence on artemisinin resistance and has the potential to be explored using available genomic data. Most important of all, molecular surveillance of artemisinin resistance based on multi-genic markers could be more informative than relying on any one particular molecular marker. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Delayed Puberty

    DEFF Research Database (Denmark)

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

    2017-01-01

    Delayed puberty can be a source of great concern and anxiety, although it usually is caused by a self-limiting variant of the normal physiological timing named constitutional delay of growth and puberty (CDGP). Delayed puberty can, however, also be the first presentation of a permanent condition ...... mineral density) and psychological (e.g., low self-esteem) and underline the importance of careful clinical assessment of the patients.......Delayed puberty can be a source of great concern and anxiety, although it usually is caused by a self-limiting variant of the normal physiological timing named constitutional delay of growth and puberty (CDGP). Delayed puberty can, however, also be the first presentation of a permanent condition...

  14. '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.

  15. Central amygdala lesions inhibit pontine nuclei acoustic reactivity and retard delay eyeblink conditioning acquisition in adult rats.

    Science.gov (United States)

    Pochiro, Joseph M; Lindquist, Derick H

    2016-06-01

    In delay eyeblink conditioning (EBC) a neutral conditioned stimulus (CS; tone) is repeatedly paired with a mildly aversive unconditioned stimulus (US; periorbital electrical shock). Over training, subjects learn to produce an anticipatory eyeblink conditioned response (CR) during the CS, prior to US onset. While cerebellar synaptic plasticity is necessary for successful EBC, the amygdala is proposed to enhance eyeblink CR acquisition. In the current study, adult Long-Evans rats received bilateral sham or neurotoxic lesions of the central nucleus of the amygdala (CEA) followed by 1 or 4 EBC sessions. Fear-evoked freezing behavior, CS-mediated enhancement of the unconditioned response (UR), and eyeblink CR acquisition were all impaired in the CEA lesion rats relative to sham controls. There were also significantly fewer c-Fos immunoreactive cells in the pontine nuclei (PN)-major relays of acoustic information to the cerebellum-following the first and fourth EBC session in lesion rats. In sham rats, freezing behavior decreased from session 1 to 4, commensurate with nucleus-specific reductions in amygdala Fos+ cell counts. Results suggest delay EBC proceeds through three stages: in stage one the amygdala rapidly excites diffuse fear responses and PN acoustic reactivity, facilitating cerebellar synaptic plasticity and the development of eyeblink CRs in stage two, leading, in stage three, to a diminution or stabilization of conditioned fear responding.

  16. Post onset, oral rapamycin treatment delays development of mitochondrial encephalopathy only at supramaximal doses.

    Science.gov (United States)

    Felici, Roberta; Buonvicino, Daniela; Muzzi, Mirko; Cavone, Leonardo; Guasti, Daniele; Lapucci, Andrea; Pratesi, Sara; De Cesaris, Francesco; Luceri, Francesca; Chiarugi, Alberto

    2017-05-01

    Mitochondrial encephalopathies are fatal, infantile neurodegenerative disorders caused by a deficit of mitochondrial functioning, for which there is urgent need to identify efficacious pharmacological treatments. Recent evidence shows that rapamycin administered both intraperitoneally or in the diet delays disease onset and enhances survival in the Ndufs4 null mouse model of mitochondrial encephalopathy. To delineate the clinical translatability of rapamycin in treatment of mitochondrial encephalopathy, we evaluated the drug's effects on disease evolution and mitochondrial parameters adopting treatment paradigms with fixed daily, oral doses starting at symptom onset in Ndufs4 knockout mice. Molecular mechanisms responsible for the pharmacodynamic effects of rapamycin were also evaluated. We found that rapamycin did not affect disease development at clinically-relevant doses (0.5 mg kg(-1)). Conversely, an oral dose previously adopted for intraperitoneal administration (8 mg kg(-1)) delayed development of neurological symptoms and increased median survival by 25%. Neurological improvement and lifespan were not further increased when the dose raised to 20 mg kg(-1). Notably, rapamycin at 8 mg kg(-1) did not affect the reduced expression of respiratory complex subunits, as well as mitochondrial number and mtDNA content. This treatment regimen however significantly ameliorated architecture of mitochondria cristae in motor cortex and cerebellum. However, reduction of mTOR activity by rapamycin was not consistently found within the brain of knockout mice. Overall, data show the ability of rapamycin to improve ultrastructure of dysfunctional mitochondria and corroborate its therapeutic potential in mitochondrial disorders. The non-clinical standard doses required, however, raise concerns about its rapid and safe clinical transferability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Delayed but Complete Response following Oral Temozolomide Treatment in Melanoma Leptomeningeal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Andreas F. Hottinger

    2011-04-01

    Full Text Available Isolated leptomeningeal recurrence of melanoma is rare, occurring in 2% of patients with central nervous system involvement secondary to melanoma. The optimal treatment of leptomeningeal carcinomatosis (LMC in melanoma has not yet been determined and remains a major challenge. We report a melanoma patient who presented with isolated LMC in the form of a new-onset weakness of the lower limbs, paresthesia of the left hand and foot, lumbago and headache. A lumbar puncture and spinal MRI confirmed LMC. The patient was treated with temozolomide 75 mg/m2/day on a 4 weeks on/2 weeks off schedule. After an initial transient clinical deterioration, the patient showed a complete radiological response as well as a dramatic improvement in quality of life. The encouraging clinical response reported here suggests that dose-intensified temozolomide might have significant activity in the treatment of leptomeningeal dissemination of melanoma and may be a valid treatment option for patients who have not been previously exposed to this agent. Moreover, this treatment regimen is extremely well tolerated and obviates the need for repeated intrathecal administrations of chemotherapeutic agents, which are often not well tolerated by patients who have significant co-morbidities due to their disease. As illustrated in this case, response to temozolomide may occur in a delayed manner, highlighting the importance of following temozolomide treatment long enough before determining that it is inefficient in a given patient.

  18. EFFECT OF ICE BAG, DYNAMIC STRETCHING AND COMBINED TREATMENTS ON THE PREVENTION AND TREATMENT OF DELAY ONSET MUSCLE SORENESS

    Directory of Open Access Journals (Sweden)

    Warin Krityakiarana

    2014-12-01

    Full Text Available Objective: To investigate the effects of ice bag, dynamic stretching, combined ice and dynamic stretching, and control (non-treated on the prevention and treatment of delayed onset muscle soreness (DOMS in biceps muscle. Subjects: Fifty-five participants (aged 18 to 25 years were engaged in this study and randomly assigned into four groups (control group (non-treated (CG, n = 13; ice bag, n = 14; dynamic stretching, n = 14; and combined treatment, n = 14. Method: Before inducing DOMS, the range of motion (ROM and maximum voluntary contraction (MVC were measured. The dynamic stretching was performed before inducing DOMS. Subjects performed biceps eccentric exercise at 110% of the predicted one-repetition maximum (1-RM, for each subject, to induce muscle soreness. Pain, ROM and MVC were assessed at 0, 24, 48, 72, and 96 hours after induction of DOMS. Results: These non-significant results for mode of treatment and time interaction showed that combined treatment, ice bag, or dynamic stretching alone is not effective at significantly reducing the symptoms of DOMS. Conclusion: These results are non-significant, the pattern of the data showed that the combined treatment may be contraindicated in the prevention of DOMS and ice bag or dynamic stretching might be the best choice of treatment. Further investigation is strongly recommended.

  19. Examining Delay Intervals in the Diagnosis and Treatment of Primary Open Angle Glaucoma in an Egyptian Population and Its Impact on Lifestyle

    Science.gov (United States)

    Abu Hussein, Nahla B.; Habib, Ahmed E.; El Sayed, Yasmine M.

    2016-01-01

    Purpose. To examine causes as well as extent of delay in diagnosis and treatment of primary open angle glaucoma patients in a sample of Egyptians. Patients and Methods. 440 patients with primary open angle glaucoma were interviewed to evaluate delay in their diagnosis and treatment. The extent and cause of delay were investigated. The total delay interval, if any, was correlated with socioeconomic and other factors. Results. The median total delay was one year, with 50% of patients having a total delay of 1 year or less, of which 25% exhibited zero total delay. 25% of patients had a delay ranging from 1 to 3 years, and 25% had a total delay ranging from 3 to 27 years. Diagnostic delay accounted for 43.03% of cases. Longer delays were met in patients with certain socioeconomic factors. Patients with a positive family history of glaucoma displayed shorter delay periods. Conclusion. Significant delay in the diagnosis and treatment of glaucoma was found. Poor socioeconomic status seems to hinder timely diagnosis and treatment of POAG. Certain socioeconomic factors seem to correlate with the extent of delay. More effort is thus needed to subsidize the cost of investigations and treatment for glaucoma patients. PMID:28116140

  20. Informative conditions for the data set in an MIMO networked control system with delays, packet dropout and transmission scheduling

    Science.gov (United States)

    Zhang, Cong; Xiong, Zhihua; Ye, Hao

    2014-07-01

    In system identification, a data set needs to be informative to guarantee that the identification criterion has a unique global minimum asymptotically and the parameter estimation is consistent. In this paper, we study the informativity of the data set in a multiple-input and multiple-output (MIMO) networked control system (NCS), which contains possible network-induced delays, packet dropout, transmission scheduling, or a combination of these factors in network transmission. Moreover, to guarantee the data set of this MIMO NCS to be informative, a group of conditions for network transmission and controller's proportional term are developed. Finally, simulation studies are given to illustrate the result.

  1. 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

    2016-01-01

    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...... is conducted without inspection errors, and the screening process and demand proceed simultaneously. The main objective is to determine the optimal inspection time and the optimal number of cycle such that the present value of the total cost is minimized. Finally, a numerical example and sensitivity analyses...

  2. 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

  3. Delayed toxicity associated with soluble anthrax toxin receptor decoy-Ig fusion protein treatment.

    Directory of Open Access Journals (Sweden)

    Diane Thomas

    Full Text Available 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.

  4. Proresolution therapy for the treatment of delayed healing of diabetic wounds.

    Science.gov (United States)

    Tang, Yunan; Zhang, Michael J; Hellmann, Jason; Kosuri, Madhavi; Bhatnagar, Aruni; Spite, Matthew

    2013-02-01

    Obesity and type 2 diabetes are emerging global epidemics associated with chronic, low-grade inflammation. A characteristic feature of type 2 diabetes is delayed wound healing, which increases the risk of recurrent infections, tissue necrosis, and limb amputation. In health, inflammation is actively resolved by endogenous mediators, such as the resolvins. D-series resolvins are generated from docosahexaenoic acid (DHA) and promote macrophage-mediated clearance of microbes and apoptotic cells. However, it is not clear how type 2 diabetes affects the resolution of inflammation. Here, we report that resolution of acute peritonitis is delayed in obese diabetic (db/db) mice. Altered resolution was associated with decreased apoptotic cell and Fc receptor-mediated macrophage clearance. Treatment with resolvin D1 (RvD1) enhanced resolution of peritonitis, decreased accumulation of apoptotic thymocytes in diabetic mice, and stimulated diabetic macrophage phagocytosis. Conversion of DHA to monohydroxydocosanoids, markers of resolvin biosynthesis, was attenuated in diabetic wounds, and local application of RvD1 accelerated wound closure and decreased accumulation of apoptotic cells and macrophages in the wounds. These findings support the notion that diabetes impairs resolution of wound healing and demonstrate that stimulating resolution with proresolving lipid mediators could be a novel approach to treating chronic, nonhealing wounds in patients with diabetes.

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

    Science.gov (United States)

    Meamarbashi, Abbas

    2017-01-01

    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. PMID:28265543

  6. 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.

  7. Causes and effects of delayed treatment of spine deformation in children and youth.

    Science.gov (United States)

    Modrzewski, Krzysztof; Skwarcz, Andrzej

    2005-02-28

    Background. Delays and negligence in the treatment of spinal deformations have both objective and subjective causes and often occur simultaneously. The aim of our study was to evaluate and analyze the pathomorphological features of spine deformation in young patients following the program suggested by Karski, especially flexion-rotations exercises. Material and methods. We analyzed 36 post-surgical patients who performed flexion-rotation exercises for varying lengths of time. In additional to information regarding the course and manner of treatment with flexion-rotation exercises obtained from anamnesis, clinical and X-ray examinations were carried out. Results. Upon analysis of the progress of treatment with flexion-rotation exercises, correction of deformityof presumed abduction contracture of the right hip, and forced positions, we observed exceptionally rapid progression of scoliosis. Conclusions. Flexion-rotation exercises do not reduce the extent of spinal deformities, and may even accelerate the process of scoliosis. Unexpectedly rapid progress of sciolosis was confirmed in 3 patients treated by this method using complete radiological examination. Prolonging flexion-rotation exercises in progressive scoliosis is harmful, since it contributes to postponing the proper surgical treatment and reduces its effectiveness by giving the changes a permanent character.

  8. Implicit Memory in Monkeys: Development of a Delay Eyeblink Conditioning System with Parallel Electromyographic and High-Speed Video Measurements.

    Directory of Open Access Journals (Sweden)

    Yasushi Kishimoto

    Full Text Available Delay eyeblink conditioning, a cerebellum-dependent learning paradigm, has been applied to various mammalian species but not yet to monkeys. We therefore developed an accurate measuring system that we believe is the first system suitable for delay eyeblink conditioning in a monkey species (Macaca mulatta. Monkey eyeblinking was simultaneously monitored by orbicularis oculi electromyographic (OO-EMG measurements and a high-speed camera-based tracking system built around a 1-kHz CMOS image sensor. A 1-kHz tone was the conditioned stimulus (CS, while an air puff (0.02 MPa was the unconditioned stimulus. EMG analysis showed that the monkeys exhibited a conditioned response (CR incidence of more than 60% of trials during the 5-day acquisition phase and an extinguished CR during the 2-day extinction phase. The camera system yielded similar results. Hence, we conclude that both methods are effective in evaluating monkey eyeblink conditioning. This system incorporating two different measuring principles enabled us to elucidate the relationship between the actual presence of eyelid closure and OO-EMG activity. An interesting finding permitted by the new system was that the monkeys frequently exhibited obvious CRs even when they produced visible facial signs of drowsiness or microsleep. Indeed, the probability of observing a CR in a given trial was not influenced by whether the monkeys closed their eyelids just before CS onset, suggesting that this memory could be expressed independently of wakefulness. This work presents a novel system for cognitive assessment in monkeys that will be useful for elucidating the neural mechanisms of implicit learning in nonhuman primates.

  9. Delay discounting and the use of mindful attention versus distraction in the treatment of drug addiction: a conceptual review.

    Science.gov (United States)

    Ashe, Melinda L; Newman, Michelle G; Wilson, Stephen J

    2015-01-01

    In recent decades, researchers have integrated measurements of delay discounting, how the subjective valuation of a reward changes as a function of time, into their study of addiction. Research has begun to explore the idea that delay discounting may serve as both a marker for the effectiveness of existing treatments for addiction and a potential target for novel intervention strategies. As this work is in its infancy, many potentially significant connections between the construct of delay discounting and the treatment of addiction have yet to be explored. Here, we present a conceptual review highlighting novel points of intersection between delay discounting and two approaches to treating addiction that have become increasingly popular in recent years: those that focus on the development of mindfulness skills and those that emphasize the use of distraction techniques. Viewing these two techniques through the lens of delay discounting is particularly intriguing because of the very different way that they address the experience of drug cravings in the present moment (nonjudgmentally attending to vs. shifting attention away from subjective cravings, respectively). We propose that these opposing strategies for dealing with cravings may interact with delay discounting in ways that have important implications for treatment effectiveness. © Society for the Experimental Analysis of Behavior.

  10. Case Report: Delayed Perforation after Definitive Treatment of Focal Intestinal Perforation with a Peritoneal Drain

    Directory of Open Access Journals (Sweden)

    Brian G. A. Dalton

    2012-01-01

    Full Text Available Focal intestinal perforation (FIP has long been described in the pediatric literature. Peritoneal drainage (PD is widely used as treatment for focal intestinal perforation. Here we report a premature infant that underwent PD on day of life 9 for a FIP. The infant recovered well from this episode and was discharged home without known sequelae. Subsequently, the same patient presented 16 months later with peritonitis. A perforation was discovered at laparotomy without evidence of surrounding necrosis. Given this finding, we believe this second episode of perforation was at the same site as the initial episode of FIP. The finding of FIP has been described without findings of surrounding necrosis. However, we believe this to be the first report of delayed perforation greater than 1 year from initial presentation after FIP treated definitively with peritoneal drain.

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

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    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.

  12. Soluble RAGE Treatment Delays Progression of Amyotrophic Lateral Sclerosis in SOD1 Mice.

    Science.gov (United States)

    Juranek, Judyta K; Daffu, Gurdip K; Geddis, Matthew S; Li, Huilin; Rosario, Rosa; Kaplan, Benjamin J; Kelly, Lauren; Schmidt, Ann Marie

    2016-01-01

    The etiology of amyotrophic lateral sclerosis (ALS), a fatal motor neuron disorder characterized by progressive muscle weakness and spasticity, remains largely unknown. Approximately 5-10% of cases are familial, and of those, 15-20% are associated with mutations in the gene encoding Cu/Zn superoxide dismutase (SOD1). Mutations of the SOD1 gene interrupt cellular homeostasis and contribute to cellular toxicity evoked by the presence of altered SOD1, along with other toxic species, such as advanced glycation end products (AGEs). AGEs trigger activation of their chief cell surface receptor, RAGE (receptor for advanced glycation end products), and induce RAGE-dependent cellular stress and inflammation in neurons, thereby affecting their function and leading to apoptosis. Here, we show for the first time that the expression of RAGE is higher in the SOD1 transgenic mouse model of ALS vs. wild-type mouse spinal cord. We tested whether pharmacological blockade of RAGE may delay the onset and progression of disease in this mouse model. Our findings reveal that treatment of SOD1 transgenic mice with soluble RAGE (sRAGE), a natural competitor of RAGE that sequesters RAGE ligands and blocks their interaction with cell surface RAGE, significantly delays the progression of ALS and prolongs life span compared to vehicle treatment. We demonstrate that in sRAGE-treated SOD1 transgenic animals at the final stage of the disease, a significantly higher number of neurons and lower number of astrocytes is detectable in the spinal cord. We conclude that RAGE antagonism may provide a novel therapeutic strategy for ALS intervention.

  13. Soluble RAGE Treatment Delays Progression of Amyotrophic Lateral Sclerosis in SOD1 Mice

    Directory of Open Access Journals (Sweden)

    Judyta K Juranek

    2016-05-01

    Full Text Available The etiology of amyotrophic lateral sclerosis (ALS, a fatal motor neuron disorder characterized by progressive muscle weakness and spasticity, remains largely unknown. Approximately 5-10% of cases are familial, and of those, 15-20% are associated with mutations in the gene encoding Cu/Zn superoxide dismutase (SOD1. Mutations of the SOD1 gene interrupt cellular homeostasis and contribute to cellular toxicity evoked by the presence of altered SOD1, along with other toxic species, such as advanced glycation end products (AGEs. AGEs trigger activation of their chief cell surface receptor, RAGE (receptor for advanced glycation end products, and induce RAGE-dependent cellular stress and inflammation in neurons, thereby affecting their function and leading to apoptosis. Here, we show for the first time that the expression of RAGE is higher in the SOD1 transgenic mouse model of ALS versus wild-type mouse spinal cord. We tested whether pharmacological blockade of RAGE may delay the onset and progression of disease in this mouse model. Our findings reveal that treatment of SOD1 transgenic mice with soluble RAGE (sRAGE, a natural competitor of RAGE that sequesters RAGE ligands and blocks their interaction with cell surface RAGE, significantly delays the progression of ALS and prolongs life span compared to vehicle treatment. We demonstrate that in sRAGE-treated SOD1 transgenic animals at the final stage of the disease, a significantly higher number of neurons and lower number of astrocytes is detectable in the spinal cord. We conclude that RAGE antagonism may provide a novel therapeutic strategy for ALS intervention.

  14. 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…

  15. Effect of acid pre-conditioning and/or delayed light irradiation on enamel bond strength of three resin-modified glass ionomers

    Directory of Open Access Journals (Sweden)

    Maryam Khoroushi

    2013-01-01

    Conclusion: Within the limitations of the present study, the effect of acid pre-conditioning, delaying irradiation and both on enamel bond strength of RMGIs was material-dependent. Further investigations are recommended.

  16. Mini-invasive treatment for delayed or non-union: the use of percutaneous autologous bone marrow injection

    Directory of Open Access Journals (Sweden)

    Trung Hau LE THUA

    2015-11-01

    Full Text Available Delayed union or nonunion of bone fracture is becoming less frequent, but still remains a challenging clinical problem. Autologous cancellous bone grafting that is the gold standard method, often involves donor site morbidities and complications. Once these fractures have been mechanically stabilized, other local factors should be investigated to promote delayed healing. The purpose of this study was to evaluate the initial outcome of the percutaneous injection of autologous bone marrow after concentration for the treatment of delayed or nonunion. Our subjects included 10 patients of delayed or nonunion fracture (3 female, 7 male with an average age of 28 years. All fractures were mechanically stabilized after accident. Delayed or nonunion affected the femur in 2 patients, the tibia in 5 patients, the humerus in 2 patients, and the ulna in 1 patient. Bone marrow aspirates were obtained from both the posterior superior iliac crest. Bone marrow aspiration concentrate was produced via density gradient centrifugation. Trocars were inserted in the delayed or nonunion gap under fluoroscopic guidance. The bone marrow aspiration concentrate was injected slowly. As results, all of 10 delayed or nonunion healed after treatment with percutaneous injection of autologous bone marrow. The mean time for new bone formation was 3.3 months, for clinical union was 5.2 months, and for radiological union was 11.8 months. The current study is encouraging in the initial outcome and percutaneous bone marrow implantation could be an effective and safe treatment for delayed or nonunion. [Biomed Res Ther 2015; 2(11.000: 389-395

  17. Resveratrol treatment delays growth plate fusion and improves bone growth in female rabbits.

    Directory of Open Access Journals (Sweden)

    Elham Karimian

    Full Text Available Trans-resveratrol (RES, naturally produced by many plants, has a structure similar to synthetic estrogen diethylstilbestrol, but any effect on bone growth has not yet been clarified. Pre-pubertal ovary-intact New Zealand white rabbits received daily oral administration of either vehicle (control or RES (200 mg/kg until growth plate fusion occurred. Bone growth and growth plate size were longitudinally monitored by X-ray imaging, while at the endpoint, bone length was assessed by a digital caliper. In addition, pubertal ovariectomized (OVX rabbits were treated with vehicle, RES or estradiol cypionate (positive control for 7 or 10 weeks and fetal rat metatarsal bones were cultured in vitro with RES (0.03 µM-50 µM and followed for up to 19 days. In ovary-intact rabbits, sixteen-week treatment with RES increased tibiae and vertebrae bone growth and subsequently improved final length. In OVX rabbits, RES delayed fusion of the distal tibia, distal femur and proximal tibia epiphyses and femur length and vertebral bone growth increased when compared with controls. Histomorphometrical analysis showed that RES-treated OVX rabbits had a wider distal femur growth plate, enlarged resting zone, increased number/size of hypertrophic chondrocytes, increased height of the hypertrophic zone, and suppressed chondrocyte expression of VEGF and laminin. In cultured fetal rat metatarsal bones, RES stimulated growth at 0.3 µM while at higher concentrations (10 μM and 50 μM growth was inhibited. We conclude that RES has the potential to improve longitudinal bone growth. The effect was associated with a delay of growth plate fusion resulting in increased final length. These effects were accompanied by a profound suppression of VEGF and laminin expression suggesting that impairment of growth plate vascularization might be an underlying mechanism.

  18. Evaluation of Early Cholecystectomy versus Delayed Cholecystectomy in the Treatment of Acute Cholecystitis

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    Miguel Sánchez-Carrasco

    2016-01-01

    Full Text Available Objective. To evaluate if early cholecystectomy (EC is the most appropriate treatment for acute cholecystitis compared to delayed cholecystectomy (DC. Patients and Methods. A retrospective cohort study of 1043 patients was carried out, with a group of 531 EC cases and a group of 512 DC patients. The following parameters were recorded: (1 postoperative hospital morbidity, (2 hospital mortality, (3 days of hospital stay, (4 readmissions, (5 admission to the Intensive Care Unit (ICU, (6 type of surgery, (7 operating time, and (8 reoperations. In addition, we estimated the direct cost savings of implementing an EC program. Results. The overall morbidity of the EC group (29.9% was significantly lower than the DC group (38.7%. EC demonstrated significantly better results than DC in days of hospital stay (8.9 versus 15.8 days, readmission percentage (6.8% versus 21.9%, and percentage of ICU admission (2.3% versus 7.8%, which can result in reducing the direct costs. The patients who benefited most from an EC were those with a Charlson index > 3. Conclusions. EC is safe in patients with acute cholecystitis and could lead to a reduction in the direct costs of treatment.

  19. Cerebral arterial gas embolism following diagnostic bronchoscopy: delayed treatment with hyperbaric oxygen.

    Science.gov (United States)

    Wherrett, Chris G; Mehran, Reza J; Beaulieu, Marc-Andre

    2002-01-01

    To describe a clinical scenario consistent with the diagnosis of cerebral arterial gas embolism (CAGE) acquired during an outpatient bronchoscopy. Our discussion explores the mechanisms and diagnosis of CAGE and the role of hyperbaric oxygen therapy. A diagnostic bronchoscopy was performed on a 70-yr-old man who had had a lobectomy for bronchogenic carcinoma three months earlier. During the direct insufflation of oxygen into the right middle lobe bronchus, the patient became unresponsive and developed subcutaneous emphysema. Immediately, an endotracheal tube and bilateral chest tubes were placed with resultant improvement in his oxygen saturation. However, he remained unresponsive with extensor and flexor responses to pain. Later, in the intensive care unit, he exhibited seizure activity requiring anticonvulsant therapy. Sedation was utilized only briefly to facilitate controlled ventilation. Investigations revealed a negative computerized tomography (CT) scan of the head, a normal cerebral spinal fluid examination, a CT chest that showed evidence of barotrauma, and an abnormal electroencephalogram. Fifty-two hours after the event, he was treated for presumed CAGE with hyperbaric oxygen using a modified United States Navy Table 6. Twelve hours later he had regained consciousness and was extubated. He underwent two more hyperbaric treatments and was discharged from hospital one week after the event, fully recovered. A patient with presumed CAGE made a complete recovery following treatment with hyperbaric oxygen therapy even though it was initiated after a significant time delay.

  20. Chitosan Treatment Delays the Induction of Senescence in Human Foreskin Fibroblast Strains.

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    Ching-Wen Tsai

    Full Text Available Fibroblasts have been extensively used as a model to study cellular senescence. The purpose of this study was to investigate whether the human foreskin fibroblast aging process could be regulated by using the biomaterial chitosan. Fibroblasts cultured on commercial tissue culture polystyrene (TCPS entered senescence after 55-60 population doublings (PDs, and were accompanied by larger cell shape, higher senescence-associated β-galactosidase (SA β-gal activity, lower proliferation capacity, and upregulation of senescence-associated molecular markers p21, p53, retinoblastoma (pRB, and p16. Before senescence was reached, PD48 cells were collected from TCPS and seeded on chitosan for three days (PD48-Cd3 to form multicellular spheroids. The protein expression of senescence-associated secretory phenotypes (SASPs and senescence-associated molecular markers of these cells in PD48-Cd3 spheroids were downregulated significantly. Following chitosan treatment, fibroblasts reseeded on TCPS showed lower SA β-gal activity, increased cellular motility, and a higher proliferation ability of 70-75 PDs. These phenotypic changes were not accompanied by colonies forming in soft agar and a continuous decrease in the senescence-associated proteins p53 and pRB which act as a barrier to tumorigenesis. These results demonstrate that chitosan treatment could delay the induction of senescence which may be useful and safe for future tissue engineering applications.

  1. 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

  2. Excess production of phage lambda delayed early proteins under conditions supporting high Escherichia coli growth rates.

    Science.gov (United States)

    Gabig, M; Obuchowski, M; Wegrzyn, A; Szalewska-Pałasz, A; Thomas, M S; Wegrzyn, G

    1998-08-01

    Bacteriophage lambda is unable to lysogenize Escherichia coli hosts harbouring the rpoA341 mutation due to a drastic reduction in transcription from CII-activated lysogenic promoters (pE, pI and paQ). In addition, the level of early transcripts involved in the lytic pathway of lambda development is also decreased in this genetic background due to impaired N-dependent antitermination. Here, it is demonstrated that despite the reduced level of early lytic pL- and pR-derived transcripts, lytic growth of bacteriophage lambda is not affected in rich media. The level of the late lytic, pR-derived transcripts also remains unaffected by the rpoA341 mutation under these conditions. However, it was found that whilst there is no significant difference in the phage burst size in rpoA+ and rpoA341 hosts growing in rich media, phage lambda is not able to produce progeny in the rpoA341 mutant growing in minimal medium, in contrast to otherwise isogenic rpoA+ bacteria. Provision of an excess of the phage replication proteins O and P in trans or overproduction of the antitermination protein N restore the ability of phage lambda to produce progeny in the rpoA341 mutant under the latter conditions. These results suggest that in rich media phage lambda produces some early proteins in excess of that needed for its effective propagation and indicate that replication proteins may be limiting factors for phage lytic growth in poor media.

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

    Science.gov (United States)

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

    2017-07-01

    The delayed treatment of zygomatic complex (ZMC) fracture presents a difficult challenge to surgeons. The aim of this study was to compare the treatment effects of delayed surgery of ZMC fractures with and without a computer-assisted navigation system (CANS). In this observer-blinded single-site randomized clinical trial, patients with unilateral ZMC fracture were included and randomized 1:1 to delayed treatment with or without CANS. The primary outcome measurement was the absolute bilateral differences of the ZMC eminence and width based on computed tomographic (CT) measurements 48 to 72 hours after surgery. One hundred three patients with unilateral ZMC fracture without immediate treatment were enrolled, and 78 were randomized to each group. Postoperative CT measurements showed that the bilateral difference in ZMC eminence was significantly less for the navigation group than for the control group (1.24 vs 2.22 mm; P control group (P = .001). Photogrammetry showed that the average difference between the postoperative CT data and the preoperative design was smaller in the navigation group (1.30 vs 2.40 mm; P = .012). Use of CANS improved ZMC symmetry in patients with unilateral ZMC fracture who had delayed treatment by allowing for more accurate implementation of the preoperative plan. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. What Are the Treatments for Spina Bifida and Related Conditions?

    Science.gov (United States)

    ... Resources and Publications What are the treatments for spina bifida & related conditions? Skip sharing on social media links Share this: Page Content Open Spina Bifida An infant with open spina bifida (myelomeningocele), in ...

  5. 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.

  6. Utilization of posaconazole oral suspension or delayed-released tablet salvage treatment for invasive fungal infection.

    Science.gov (United States)

    Kim, Jong Hun; Benefield, Russell J; Ditolla, Kali

    2016-11-01

    Posaconazole may be useful for salvage treatment (ST) for invasive fungal infections (IFIs). The aim of this study was to evaluate the efficacy of posaconazole ST with either posaconazole oral suspension (SUS) or delayed-released tablet (TAB) in patients with IFI. A retrospective review of patients who received posaconazole ST for IFI at the University of Utah Health Sciences Center between December 2007 and March 2014 was conducted. A total of 14 episodes of posaconazole ST for proven (9 episodes) and probable (5 episodes) IFI were identified in 14 patients. The median age was 54 years and the majority of patients (64.3%) had underlying haematological diseases. Posaconazole SUS and TAB were used in 11 episodes and 3 episodes respectively. The duration of posaconazole ST ranged from 28 to 370 days with a median of 65 days. Posaconazole ST with TAB achieved favourable serum posaconazole trough concentrations (median 1.4 μg mL(-1) ) compared to posaconazole SUS (median 1.0 μg mL(-1) ). The overall clinical success rate with posaconazole ST was 71.4% (10 of 14 episodes). One patient died of progression of IFI. Adverse events were noted in two patients. Posaconazole SUS or TAB may be used effectively for IFI ST.

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

    Science.gov (United States)

    Calvino-Núñez, Cristina; Domínguez-del-Toro, Eduardo

    2014-01-01

    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.

  8. Nonsteroidal Anti-Inflammatory Treatment Prevents Delayed Effects of Early Life Stress in Rats

    Science.gov (United States)

    Brenhouse, Heather C.; Andersen, Susan L.

    2017-01-01

    Background Early developmental insults can cause dysfunction within parvalbumin (PVB)-containing interneurons in the prefrontal cortex. The neuropsychiatric disorders associated with such dysfunction might involve neuroinflammatory processes. Cyclooxygenase-2 (COX-2) is a key mediator of inflammation and is therefore a potential target for preventive treatment. Here, we investigated whether the developmental trajectories of PVB expression and COX-2 induction in the prelimbic region of the prefrontal cortex are altered after maternal separation stress in male rats. Methods Male rat pups were separated from their mother and littermates for 4 hours/day between postnatal Days 2 and 20. Western blotting and immunohistochemistry were used to analyze PVB and COX-2 expression in the prefrontal cortex and hippocampus. A separate cohort of animals was treated with a COX-2 inhibitor during preadolescence and analyzed for PVB, COX-2, and working memory performance. Results We demonstrate that maternal separation causes a reduction of PVB and an increase in COX-2 expression in the prefrontal cortex in adolescence, with concurrent working memory deficits. Parvalbumin was not affected earlier in development. Prophylactic COX-2 inhibition preadolescence prevents PVB loss and improves working memory deficits induced by maternal separation. Conclusions These data are the first to show a preventive pharmacological intervention for the delayed effects of early life stress on prefrontal cortex interneurons and working memory. Our results suggest a possible mechanism for the relationship between early life stress and interneuron dysfunction in adolescence. PMID:21679927

  9. Conditioned learning in alcohol dependence: implications for cue exposure treatment.

    Science.gov (United States)

    Drummond, D C; Cooper, T; Glautier, S P

    1990-06-01

    A review of the literature pertinent to cue exposure treatment in alcohol dependence is presented. Psychological models of relapse, based on conditioning and social learning theories, are critically evaluated. In particular, attention is drawn to the potential implications for cue exposure research and treatment of an interaction between Pavlovian and operant conditioning, problems with the application of the concepts of arousal and craving and the importance of a systems model to understand physiological responses. It is concluded that no study has so far demonstrated a link between conditioned responses to alcohol-related cues and relapse, an assumption on which cue exposure treatment is based. Further, the evidence for the effectiveness of cue exposure as a treatment is lacking. Promising research directions are identified.

  10. The effect of delay between heat treatment and cold storage on alleviation of chilling injury in banana fruit.

    Science.gov (United States)

    Wang, Haibo; Zhang, Zhaoqi; Xu, Lanying; Huang, Xuemei; Pang, Xuequn

    2012-10-01

    To understand the mechanisms leading to the enhanced chilling resistance of banana by hot-water dipping (HWD, 52 °C for 3 min), we investigated the effect of a 0.5-24 h delay between HWD and cold storage on chilling resistance and the change related to the metabolism of reactive oxygen species (ROS). The HWD-treated fruit with a delay of less than 6 h exhibited markedly less chilling injury than the non-heated control fruit, while a delay more than 6 h resulted in significant loss in chilling resistance. Increased hydrogen peroxide content and rate of superoxide radical production were detected in the fruit at 0.5-1.5 h after HWD treatment, and the levels declined with a longer delay, which may be correlated with the enhanced gene expression levels of the gene coding for a ROS-generating related enzyme, NADPH oxidase (MaNOX). Enhanced activities and gene expression of an ascorbate peroxidase (MaAPX) were recorded in the fruit at 1.5-6 h after the treatment, and after 6 h the ascorbate peroxidase levels decayed to the levels as the control fruit. The higher APX gene expression was maintained in the treated fruit with a 3 h delay during the subsequent cold storage at 7 °C, correlating with the enhanced chilling resistance. The HWD-treated fruit left at ambient temperature up to 6 h prior to cold storage maintained the effect of heat treatment and transiently increased ROS content, and the ascorbate peroxidase activity that occurred 0.5-6 h after the treatment may be correlated with the elevated chilling resistance induced by HWD treatment. Copyright © 2012 Society of Chemical Industry.

  11. 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.

  12. Delay-range-dependent chaos synchronization approach under varying time-lags and delayed nonlinear coupling.

    Science.gov (United States)

    Zaheer, Muhammad Hamad; Rehan, Muhammad; Mustafa, Ghulam; Ashraf, Muhammad

    2014-11-01

    This paper proposes a novel state feedback delay-range-dependent control approach for chaos synchronization in coupled nonlinear time-delay systems. The coupling between two systems is esteemed to be nonlinear subject to time-lags. Time-varying nature of both the intrinsic and the coupling delays is incorporated to broad scope of the present study for a better-quality synchronization controller synthesis. Lyapunov-Krasovskii (LK) functional is employed to derive delay-range-dependent conditions that can be solved by means of the conventional linear matrix inequality (LMI)-tools. The resultant control approach for chaos synchronization of the master-slave time-delay systems considers non-zero lower bound of the intrinsic as well as the coupling time-delays. Further, the delay-dependent synchronization condition has been established as a special case of the proposed LK functional treatment. Furthermore, a delay-range-dependent condition, independent of the delay-rate, has been provided to address the situation when upper bound of the delay-derivative is unknown. A robust state feedback control methodology is formulated for synchronization of the time-delay chaotic networks against the L2 norm bounded perturbations by minimizing the L2 gain from the disturbance to the synchronization error. Numerical simulation results are provided for the time-delay chaotic networks to show effectiveness of the proposed delay-range-dependent chaos synchronization methodologies. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  13. Effects of Annealing Treatment Prior to Cold Rolling on Delayed Fracture Properties in Ferrite-Austenite Duplex Lightweight Steels

    Science.gov (United States)

    Sohn, Seok Su; Song, Hyejin; Kim, Jung Gi; Kwak, Jai-Hyun; Kim, Hyoung Seop; Lee, Sunghak

    2016-02-01

    Tensile properties of recently developed automotive high-strength steels containing about 10 wt pct of Mn and Al are superior to other conventional steels, but the active commercialization has been postponed because they are often subjected to cracking during formation or to the delayed fracture after formation. Here, the delayed fracture behavior of a ferrite-austenite duplex lightweight steel whose microstructure was modified by a batch annealing treatment at 1023 K (750 °C) prior to cold rolling was examined by HCl immersion tests of cup specimens, and was compared with that of an unmodified steel. After the batch annealing, band structures were almost decomposed as strong textures of {100} α-fibers and {111} γ-fibers were considerably dissolved, while ferrite grains were refined. The steel cup specimen having this modified microstructure was not cracked when immersed in an HCl solution for 18 days, whereas the specimen having unmodified microstructure underwent the delayed fracture within 1 day. This time delayed fracture was more critically affected by difference in deformation characteristics such as martensitic transformation and deformation inhomogeneity induced from concentration of residual stress or plastic strain, rather than the difference in initial microstructures. The present work gives a promise for automotive applications requiring excellent mechanical and delayed fracture properties as well as reduced specific weight.

  14. The delayed effects of DTG and MK-801 on latent inhibition in a conditioned taste-aversion paradigm.

    Science.gov (United States)

    Turgeon, S M; Auerbach, E A; Duncan-Smith, M K; George, J R; Graves, W W

    2000-07-01

    The delayed effects of phencyclidine (PCP) have been shown to disrupt latent inhibition (LI) in a conditioned taste-aversion paradigm. In an attempt to understand the mechanism of this disruption, the delayed effects of the selective sigma receptor agonist 1,3-Di(2-tolyl)guanidine (DTG) and the selective NMDA receptor antagonist MK-801 on latent inhibition were assessed in the same paradigm. Water-deprived male rats were allowed access to either water (nonpreexposed; NPE) or 5% sucrose (preexposed; PE) for 30 min on 2 consecutive days. On the third day, animals were allowed access to sucrose and subsequently injected with lithium chloride. On the forth day, animals were allowed access to both sucrose and water. LI was assessed by comparing the percent sucrose consumed in PE and NPE groups on the fourth day. DTG (1.0, 5.0, or 10.0 mg/kg), MK-801 (0.5, 1.0, or 2.0 mg/kg), or vehicle was administered IP 20 h before preexposure (days 1 and 2) and conditioning (day 3). In vehicle-treated groups, PE animals consumed a significantly higher percent sucrose on the test day than NPE animals, indicating the presence of LI. DTG (10.0 mg/kg) and MK-801 (2.0 mg/kg) decreased the percent sucrose consumed by animals in the PE group to the level observed in the NPE group, indicating disrupted LI. However, this dose of MK-801 was found to produce a decrease in percent sucrose consumed in PE animals not treated with lithium chloride, indicating that the decrease observed in the LI paradigm could be due to MK-801-induced decrease in taste preference for sucrose rather than a disruption of LI. Lower doses of MK-801 that did not produce a decrease in taste preference for sucrose did not significantly disrupt LI. None of the doses of DTG tested altered taste preference for sucrose. These data suggest a role for sigma receptors in the previously observed PCP-induced disruption of LI. Published by Elsevier Science Inc., 2000

  15. Delayed diagnosis and treatment of benign paroxysmal positional vertigo associated with current practice.

    Science.gov (United States)

    Wang, Hui; Yu, Dongzhen; Song, Ningying; Su, Kaiming; Yin, Shankai

    2014-02-01

    The purposes of this study were to demonstrate the current status of benign paroxysmal positional vertigo (BPPV) management and the advantages of repositioning maneuvers as well as to facilitate the accurate and efficient diagnosis and management of BPPV. Of 131 participants with severe dizziness/vertigo who were examined and treated, 31 (23.7%) fulfilled the diagnostic criteria for BPPV. All patients in the study had a diagnosis of BPPV confirmed by their history, typical subjective symptom reports, and characteristic positional nystagmus during the Dix-Hallpike test and/or roll test. All participants were comprehensively interviewed regarding their medical history, characteristics of the first attack of vertigo, associated symptoms, previous financial costs, and number of hospital visits. The average duration from the appearance of the first symptoms until a final diagnostic positional maneuver was >70 months. On average, patients visited hospitals more than eight times before the final diagnosis due to initial visits to inappropriate departments, including neurology, emergency, orthopaedic surgery, and Traditional Chinese Medicine, with a corresponding average financial cost of more than 5,000 RMB. The canalith repositioning procedure (CRP) was effective in 80.65% of patients after the first repositioning maneuver. Our data demonstrated that despite the significant prevalence of BPPV, delays in diagnosis and treatment frequently occur, which have both cost and quality-of-life impacts on both patients and their caregivers. The CRP is very effective for patients with BPPV. It is important for patients to pay more attention to the impact of BPPV on their lives and recognize its nature to ensure compliant follow-up in otolaryngology.

  16. Perceptions on the Effectiveness of Treatment and the Timeline of Buruli Ulcer Influence Pre-Hospital Delay Reported by Healthy Individuals

    NARCIS (Netherlands)

    Alferink, Marike; van der Werf, Tjip S.; Sopoh, Ghislain E.; Agossadou, Didier C.; Barogui, Yves T.; Assouto, Frederic; Agossadou, Chantal; Stewart, Roy E.; Stienstra, Ymkje; Ranchor, Adelita V.

    2013-01-01

    Background: Delay in seeking treatment at the hospital is a major challenge in current Buruli ulcer control; it is associated with severe sequelae and functional limitations. Choosing alternative treatment and psychological, social and practical factors appear to influence delay. Objectives were to

  17. Chronic treatment with N-acetyl-cystein delays cellular senescence in endothelial cells isolated from a subgroup of atherosclerotic patients.

    Science.gov (United States)

    Voghel, Guillaume; Thorin-Trescases, Nathalie; Farhat, Nada; Mamarbachi, Aida M; Villeneuve, Louis; Fortier, Annik; Perrault, Louis P; Carrier, Michel; Thorin, Eric

    2008-05-01

    Endothelial senescence may contribute to the pathogenesis of age-related vascular disorders. Furthermore, chronic exposure to risk factors for cardiovascular disease (CVD) accelerates the effects of chronological aging by generating stress-dependent damages, including oxidative stress, therefore promoting stress-induced premature senescence. Our objective was to determine whether a chronic treatment with an antioxidant (N-acetyl-cystein, NAC) could delay senescence of endothelial cells (EC) isolated and cultured from arterial segments of patients with severe coronary artery disease. If EC were considered as one population (n=26), chronic NAC treatment slightly shortened telomere attrition rate associated with senescence but did not significantly delay the onset of endothelial senescence. However, in a subgroup of NAC-treated EC (n=15) cellular senescence was significantly delayed, NAC decreased lipid peroxidation (HNE), activated the catalytic subunit of telomerase (hTERT) and inhibited telomere attrition. In contrast, in another subgroup of EC (n=11) characterized by initial short telomeres, no effect of NAC on HNE and high levels of DNA damages, the antioxidant was not beneficial on senescence, suggesting an irreversible stress-dependent damage. In conclusion, chronic exposure to NAC can delay senescence of diseased EC via hTERT activation and transient telomere stabilization, unless oxidative stress-associated cell damage has become irreversible.

  18. Perceptions on the effectiveness of treatment and the timeline of Buruli ulcer influence pre-hospital delay reported by healthy individuals.

    Directory of Open Access Journals (Sweden)

    Marike Alferink

    Full Text Available BACKGROUND: Delay in seeking treatment at the hospital is a major challenge in current Buruli ulcer control; it is associated with severe sequelae and functional limitations. Choosing alternative treatment and psychological, social and practical factors appear to influence delay. Objectives were to determine potential predictors for pre-hospital delay with Leventhal's commonsense model of illness representations, and to explore whether the type of available dominant treatment modality influenced individuals' perceptions about BU, and therefore, influenced pre-hospital delay. METHODOLOGY: 130 healthy individuals aged >18 years, living in BU-endemic areas in Benin without any history of BU were included in this cross-sectional study. Sixty four participants from areas where surgery was the dominant treatment and sixty six participants from areas where antibiotic treatment was the dominant treatment modality were recruited. Using a semi-structured interview we measured illness perceptions (IPQ-R, knowledge about BU, background variables and estimated pre-hospital delay. PRINCIPAL FINDINGS: The individual characteristics 'effectiveness of treatment' and 'timeline acute-chronic' showed the strongest association with pre-hospital delay. No differences were found between regions where surgery was the dominant treatment and regions where antibiotics were the dominant treatment modality. CONCLUSIONS: Individual characteristics, not anticipated treatment modality appeared predictors of pre-hospital delay.

  19. 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

    2015-01-01

    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 fro

  20. Osteoarthritis treatment using autologous conditioned serum after placebo

    NARCIS (Netherlands)

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

    2015-01-01

    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. Effect of delayed harvesting and pre-treatment methods on the antinutritional contents of trifoliate yam flour.

    Science.gov (United States)

    Abiodun, Olufunmilola Adunni; Akinoso, Rahman

    2014-03-01

    Effects of delayed harvesting and pre-treatment methods on the anti-nutritional contents of trifoliate yam flour were examined. Trifoliate yam tubers were washed, peeled, sliced and subjected to pre-treatment methods, such as soaking, pre-cooking and blanching/soaking. The phenols, phytate, oxalate, tannin and alkaloid profiles of the flours were evaluated and the values of phenols, tannin, oxalate and phytate contents were 0.02-0.32, 0.04-0.53, 0.11-4.32 and 0.20-1.05mg/100g, respectively. The predominant alkaloids in trifoliate yam flour were dioscorine and dihydrodioscorine. The white trifoliate yam flour had higher levels of anti-nutrients than the yellow trifoliate yam flour. Alkaloid contents of trifoliate yam flour increased slightly with delayed harvesting periods. Blanching/soaking method drastically reduced the anti-nutrient contents of trifoliate yam flour than other methods. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Conditioned blood reperfusion during angioplasty (CoBRA) treatment of acute myocardial infarction.

    Science.gov (United States)

    Patel, M B; Kilgore, K S; Ortolano, G A; Gryboski, C L; Qureshi, M A; Marcovitz, P; Naylor, K B; Park, J L; Wenz, B; Gikakis, N; Freedman, R J; Lucchesi, B R; O'Neill, W W

    2001-03-01

    Acute myocardial infarct (MI) results in ischemia distal to lesions which puts heart muscle at risk for reperfusion injury (RI). Neutrophils, platelets and complement are putative mediators of RI. Recent advances in filtration technology provide integrated neutrophil and platelet removal together with complement-attenuating properties in a single blood-conditioning device. The present study characterizes the properties of a blood-conditioning filter and describes its clinical effect when used in conjunction with active hemoperfusion for acute MI. The filter reduces leukocytes by 99.9998 +/- 0.0002% (pheart preparation. The deposition of membrane attack complex and the resultant functional myocardial impairments [reflected in hemodynamic and biochemical measurements, including developed pressure, coronary blood flow, lymph-derived myocardial creatine kinase (CK)] are significantly attenuated by blood conditioning. Integration of the blood-conditioning filter into an active hemoperfusion system during primary percutaneous transluminal coronary angioplasty (PTCA) for acute MI (n=8) did not delay the procedure or cause any complications. Reperfusion of occluded coronary arteries with 300 cm3 of conditioned blood led to significant improvement in echocardiographic global wall motion scores (in standard deviations) following treatment (-1.64 +/- 0.18 to -1.45 +/- 0.15, p=0.02). Initial reperfusion of totally occluded coronary arteries with conditioned blood leads to acutely improved ventricular function. Collectively, these data provide a strong indication for continued investigation of conditioned blood reperfusion in angioplasty following acute MI for the long-term effect upon recovery of salvagable myocardium.

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

    OpenAIRE

    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 per...

  4. 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

  5. Delayed Treatment with Sodium Hydrosulfide Improves Regional Blood Flow and Alleviates Cecal Ligation and Puncture (CLP)-Induced Septic Shock.

    Science.gov (United States)

    Ahmad, Akbar; Druzhyna, Nadiya; Szabo, Csaba

    2016-08-01

    Cecal ligation and puncture (CLP)-induced sepsis is a serious medical condition, caused by a severe systemic infection resulting in a systemic inflammatory response. Recent studies have suggested the therapeutic potential of donors of hydrogen sulfide (H2S), a novel endogenous gasotransmitter and biological mediator in various diseases. The aim of the present study was to assess the effect of H2S supplementation in sepsis, with special reference to its effect on the modulation of regional blood flow. We infused sodium hydrosulfide (NaHS), a compound that produces H2S in aqueous solution (1, 3, or 10 mg/kg/h, for 1 h at each dose level) in control rats or rats 24 h after CLP, and measured blood flow using fluorescent microspheres. In normal control animals, NaHS induced a characteristic redistribution of blood flow, and reduced cardiac, hepatic, and renal blood flow in a dose-dependent fashion. In contrast, in rats subjected to CLP, cardiac, hepatic, and renal blood flow was significantly reduced; infusion of NaHS (1 mg/kg/h and 3 mg/kg/h) significantly increased organ blood flow. In other words, the effect of H2S on regional blood flow is dependent on the status of the animals (i.e., a decrease in blood flow in normal controls, but an increase in blood flow in CLP). We have also evaluated the effect of delayed treatment with NaHS on organ dysfunction and the inflammatory response by treating the animals with NaHS (3 mg/kg) intraperitoneally (i.p.) at 24 h after the start of the CLP procedure; plasma levels of various cytokines and tissue indicators of inflammatory cell infiltration and oxidative stress were measured 6 h later. After 24 h of CLP, glomerular function was significantly impaired, as evidenced by markedly increased (over 4-fold over baseline) blood urea nitrogen and creatinine levels; this increase was also significantly reduced by treatment with NaHS. NaHS also attenuated the CLP-induced increases in malondialdehyde levels (an index of

  6. 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.

  7. Improved Conditions for Global Asymptotic Stability of Cohen-Grossberg Neural Networks with Time-Varying Delays

    Institute of Scientific and Technical Information of China (English)

    CHEN Jun; CUI Bao-Tong; GAO Ming

    2008-01-01

    The global asymptotic stability of delayed Cohen-Grossberg neural networks with impulses is investigated. Based on the new suitable Lyapunov functions and the Jacobsthal inequality, a set of novel sufficient criteria are derived for the global asymptotic stability of Cohen-Grossberg neural networks with time-varying delays and impulses.An illustrative example with its numerical simulations is given to demonstrate the effectiveness of the obtained results.

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

    NARCIS (Netherlands)

    van Maanen, A.; Dewald-Kaufmann, J.F.; Smits, M.G; Oort, F.J.; Meijer, A.M.

    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

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

    NARCIS (Netherlands)

    van Maanen, A.; Dewald-Kaufmann, J.F.; Smits, M.G; Oort, F.J.; Meijer, A.M.

    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 melatoni

  10. 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...controlled-temperature heating pads positioned abovd and beneath the body and a temperature probe placed in the rectum. A tracheal cannula was orally

  11. Delays in the treatment of patients with acute coronary syndrome: Focus on pre-hospital delays and non-ST-elevated myocardial infarction

    NARCIS (Netherlands)

    Mol, K. A.; Rahel, B. M.; Meeder, J. G.; van Casteren, B. C. A. M.; Doevendans, P. A.; Cramer, M. J. M.

    2016-01-01

    Delays in patients suspected of acute coronary syndrome (ACS) should be kept as short as possible to reduce complications and mortality. In this review we discuss the substantial pre-hospital delays of ST-elevated myocardial infarction (STEMI) patients as well as non-STEMI patients. The pre-hospital

  12. Human influenza A H5N1 in Indonesia: health care service-associated delays in treatment initiation.

    Science.gov (United States)

    Adisasmito, Wiku; Aisyah, Dewi Nur; Aditama, Tjandra Yoga; Kusriastuti, Rita; Trihono; Suwandono, Agus; Sampurno, Ondri Dwi; Prasenohadi; Sapada, Nurshanty A; Mamahit, M J N; Swenson, Anna; Dreyer, Nancy A; Coker, Richard

    2013-06-11

    Indonesia has had more recorded human cases of influenza A H5N1 than any other country, with one of the world's highest case fatality rates. Understanding barriers to treatment may help ensure life-saving influenza-specific treatment is provided early enough to meaningfully improve clinical outcomes. Data for this observational study of humans infected with influenza A H5N1 were obtained primarily from Ministry of Health, Provincial and District Health Office clinical records. Data included time from symptom onset to presentation for medical care, source of medical care provided, influenza virology, time to initiation of influenza-specific treatment with antiviral drugs, and survival. Data on 124 human cases of virologically confirmed avian influenza were collected between September 2005 and December 2010, representing 73% of all reported Indonesia cases. The median time from health service presentation to antiviral drug initiation was 7.0 days. Time to viral testing was highly correlated with starting antiviral treatment (p influenza H5N1 in Indonesia appear related to delays in diagnosis rather than presentation to health care settings. Either cases are not suspected of being H5N1 cases until nearly one week after presenting for medical care, or viral testing and/or antiviral treatment is not available where patients are presenting for care. Health system delays have increased since 2007.

  13. 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.

  14. Ranibizumab for the treatment of degenerative ocular conditions

    Directory of Open Access Journals (Sweden)

    Triantafylla M

    2014-06-01

    Full Text Available Magdalini Triantafylla,1 Horace F Massa,2 Doukas Dardabounis,1 Zisis Gatzioufas,2 Vassilios Kozobolis,1 Konstantinos Ioannakis,1 Irfan Perente,1,3 Georgios D Panos1,21Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece; 2Department of Ophthalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland; 3Beyoglou Eye Research and Teaching Hospital, Istanbul University, Istanbul, TurkeyAbstract: Degenerative ocular conditions, such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and myopic degeneration, have become a major public health problem and a leading cause of blindness in developed countries. Anti-vascular endothelial growth factor (VEGF drugs seem to be an effective and safe treatment for these conditions. Ranibizumab, a humanized monoclonal antibody antigen-binding fragment, which inhibits all biologically active isoforms of VEGF-A, is still the gold standard treatment for the majority of these pathological entities. In this review, we present the results of the most important clinical trials concerning the efficacy and safety of ranibizumab for the treatment of degenerative ocular conditions.Keywords: age-related macular degeneration, diabetic macular edema, retinal vein occlusion, anti-VEGF, safety, efficacy, quality of life

  15. 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…

  16. 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.

  17. Treatment of delayed rupture of the left ventricle after mitral valve replacement

    Directory of Open Access Journals (Sweden)

    Gomes Walter J.

    2002-01-01

    Full Text Available Rupture of the left ventricle following mitral valve replacement is a catastrophic complication with deadly consequences. We report here the case of a 75-year-old man who underwent elective mitral valve replacement for severe mitral regurgitation. Delayed type 1 rupture of the left ventricle developed 3 hours postoperatively in the intensive care unit. A salvaging maneuver was used, which gained time, allowing reoperation and successful intraventricular repair.

  18. Delayed endovascular treatment of descending aorta stent graft collapse in a patient treated for post- traumatic aortic rupture: a case report

    Directory of Open Access Journals (Sweden)

    Stegher Silvia

    2011-05-01

    Full Text Available Abstract Background We report a case of delayed endovascular correction of graft collapse occurred after emergent Thoracic Endovascular Aortic Repair (TEVAR for traumatic aortic isthmus rupture. Case presentation In 7th post-operative day after emergent TEVAR for traumatic aortic isthmus rupture (Gore TAG® 28-150, a partial collapse of the endoprosthesis at the descending tract occurred, with no signs of visceral ischemia. Considering patient's clinical conditions, the graft collapse wasn't treated at that time. When general conditions allowed reintervention, the patient refused any new treatment, so he was discharged. Four months later the patient complainted for severe gluteal and sural claudication, erectile disfunction and abdominal angina; endovascular correction was performed. At 18 months the graft was still patent. Discussion and Conclusion Graft collapse after TEVAR is a rare event, which should be detected and treated as soon as possible. Delayed correction of this complication can be lethal due to the risk of visceral ischemia and limbs loss.

  19. 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 (Pguinea pigs (Pguinea 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.

  20. The Mind-Tranquilizing and Menstruation-Regulating Method for Acupuncture Treatment of Delayed Menstrual Cycle——A Clinical Controlled Study

    Institute of Scientific and Technical Information of China (English)

    CAI Xue-mei; WU Jie

    2009-01-01

    To compare the therapeutic effects of the mind-tranquilizing and menstruation-regulating acupuncture method with the routine acupuncture method in treating delayed menstrual cycle. Methods: 40 patients with delayed menstrual cycle were randomly divided into a treatment group of 23 cases (treated by the mind-tranquilizing and menstruation-regulating acupuncture method),and a control group of 17 cases (treated by the routine acupuncture method for delayed menstrual cycle due to stagnation of the liver-qi). The treatment involved three menstrual cycles. The evaluations were done by scoring the symptoms before treatment and at the end of each menstrual cycle. Results: After treatment,significant differences were found between the two groups in the therapeutic effects (P<0.05). Conclusion: The therapeutic effect of the mind-tranquilizing and menstruation-regulating acupuncture method is significantly superior to that of the routine acupuncture method for delayed menstrual cycle.

  1. The role of health system factors in delaying final diagnosis and treatment of breast cancer in Mexico City, Mexico.

    Science.gov (United States)

    Bright, Kristin; Barghash, Maya; Donach, Martin; de la Barrera, Marcos Gutiérrez; Schneider, Robert J; Formenti, Silvia C

    2011-04-01

    In Mexico, breast cancer is the leading cancer-related death among women and most cases are diagnosed at advanced stages (50-60%). We hypothesized health system factors could be partly responsible for this delay and performed a prospective review of 166 new breast cases at a major public hospital in Mexico City. Our analysis confirmed the prevalence of locally advanced and metastatic disease (47% of patients). A subset analysis of 32 women with confirmed stage I-IIIC breast cancer found an average time interval of 1.8 months from symptom onset to first primary care consultation (PCC), with an additional 6.6 months from first PCC to confirmed diagnosis, and 0.6 months from diagnosis to treatment initiation. Patients underwent an average of 7.9 clinic visits before confirmed diagnosis. Findings suggest that protracted referral time from primary to specialty care accounts for the bulk of delay, with earlier stage patients experiencing longer delays. These findings reveal a critical need for further study and exploration of interventions.

  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. Effects of OEF/OIF-related physical and emotional co-morbidities on associative learning: concurrent delay and trace eyeblink classical conditioning.

    Science.gov (United States)

    McGlinchey, Regina E; Fortier, Catherine B; Venne, Jonathan R; Maksimovskiy, Arkadiy L; Milberg, William P

    2014-03-12

    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.

  4. 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

  5. Delayed antivenom treatment for a patient after envenomation by Crotalus atrox.

    Science.gov (United States)

    Rosen, P B; Leiva, J I; Ross, C P

    2000-01-01

    Bites by the Western diamondback rattlesnake (Crotalus atrox) are the most common cause of envenomation in Texas. We describe a patient who had delayed administration of antivenom after envenomation by C atrox. Because of an initial adverse response to a test dose, the patient had been unwilling to receive antivenom therapy. When compartment syndrome developed 52 hours after envenomation, however, the patient consented to antivenom therapy as an alternative to fasciotomy. We documented a decrease in compartment pressures and resolution of thrombocytopenia that was concomitant with antivenom administration.

  6. 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

  7. EFFECT OF STATIC STRETCHING AND LPG SYSTEM TECHNIQUE ON TREATMENT AND PREVENT OF DELAYED ONSET MUSCLE SORENESS

    OpenAIRE

    Vahideh Kianmarz; Afshar Jafari

    2011-01-01

    Purpose: This study was done in order to determining effect of static stretching and LPG systemtechnique on treatment and prevent of delayed onset muscle soreness.Methods: In order to thirtynon-athletic females [aged 21.8±1.15 years; fat percent 23.69±1.43 kg; BMI 21.79±1.52 kg/m2]were voluntarily selected and randomly assigned to equal three groups. The stretching groupexecuted a static stretch of hamstrings muscle for 20 min pre exercise and 12 hours postexercise. Hold each stretch 30 secon...

  8. 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

  9. 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.

  10. Electrochemical treatment of deproteinated whey wastewater and optimization of treatment conditions with response surface methodology.

    Science.gov (United States)

    Güven, Güray; Perendeci, Altunay; Tanyolaç, Abdurrahman

    2008-08-30

    Electrochemical treatment of deproteinated whey wastewater produced during cheese manufacture was studied as an alternative treatment method for the first time in literature. Through the preliminary batch runs, appropriate electrode material was determined as iron due to high removal efficiency of chemical oxygen demand (COD), and turbidity. The electrochemical treatment conditions were optimized through response surface methodology (RSM), where applied voltage was kept in the range, electrolyte concentration was minimized, waste concentration and COD removal percent were maximized at 25 degrees C. Optimum conditions at 25 degrees C were estimated through RSM as 11.29 V applied voltage, 100% waste concentration (containing 40 g/L lactose) and 19.87 g/L electrolyte concentration to achieve 29.27% COD removal. However, highest COD removal through the set of runs was found as 53.32% within 8h. These results reveal the applicability of electrochemical treatment to the deproteinated whey wastewater as an alternative advanced wastewater treatment method.

  11. 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.

  12. 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…

  13. Effects of medial septal lesions on action-outcome associations in rats under conditions of delayed reinforcement.

    Science.gov (United States)

    Numan, Robert; Ouimette, Amy S; Holloway, Katherine A; Curry, Cristi E

    2004-12-01

    In operant tasks, control rats maintain high response rates under positive contingencies, when the probability of reinforcement is greater following a response (contingent reinforcement) than during the absence of that response. However, as contingencies approach zero, response rates decrease. In this experiment, under immediate contingent reinforcement, rats with medial septal lesions reduced their response rates, just like controls, when contingencies were shifted from positive toward zero. However, the septal rats were less sensitive to this contingency shift, compared with controls, when there was a 5-s delay between lever presses and contingent reinforcements. This lesion effect appeared to be due to a failure of voluntary response memory, which impaired sensitivity to operant contingencies when there was a delay between action and outcome.

  14. Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI

    Directory of Open Access Journals (Sweden)

    Tödt Tim

    2012-02-01

    Full Text Available Abstract Background Studies on the impact of time to treatment on myocardial infarct size have yielded conflicting results. In this study of ST-Elevation Myocardial Infarction (STEMI treated with primary percutaneous coronary intervention (PCI, we set out to investigate the relationship between the time from First Medical Contact (FMC to the demonstration of an open infarct related artery (IRA and final scar size. Between February 2006 and September 2007, 89 STEMI patients treated with primary PCI were studied with contrast enhanced magnetic resonance imaging (ceMRI 4 to 8 weeks after the infarction. Spearman correlation was computed for health care delay time (defined as time from FMC to PCI and myocardial injury. Multiple linear regression was used to determine covariates independently associated with infarct size. Results An occluded artery (Thrombolysis In Myocardial Infarction, TIMI flow 0-1 at initial angiogram was seen in 56 patients (63%. The median FMC-to-patent artery was 89 minutes. There was a weak correlation between time from FMC-to-patent IRA and infarct size, r = 0.27, p = 0.01. In multiple regression analyses, LAD as the IRA, smoking and an occluded vessel at the first angiogram, but not delay time, correlated with infarct size. Conclusions In patients with STEMI treated with primary PCI we found a weak correlation between health care delay time and infarct size. Other factors like anterior infarction, a patent artery pre-PCI and effects of reperfusion injury may have had greater influence on infarct size than time-to-treatment per se.

  15. 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)

  16. The use of recombinant human bone morphogenetic protein-2 for the treatment of a delayed union following femoral neck open-wedge osteotomy

    Directory of Open Access Journals (Sweden)

    Axel W.A. Baltzer

    2012-03-01

    Full Text Available Although the clinical potential of bone morphogenetic proteins (BMPs has been known for decades, their use in humans has only been approved for a limited number of orthopaedic conditions. Promising results in animals demonstrate the utility of BMP-2 in regional bone repair without using osteoconductors. To our knowledge, no comparable human case has been described. We report the case of a 50- year-old who suffered a femoral neck fracture. After 9 months of extensive treatment, he was still not pain-free. The following open-wedge osteotomy resulted in a therapy-resistant delayed union. We therefore conducted 4 computer tomography-guided injections of recombinant human (rh BMP-2 into the bone gap. No osteoconductor was employed. Six weeks later, there was a 55-60% defect filling. Followup examination showed a complete union of the bone defect. Our case report shows that in a complicated delayed union rhBMP-2 can be successfully used to induce bone formation without any osteoconductor.

  17. Treatment effect expressed as the novel Delay of Event measure is associated with high willingness to initiate preventive treatment - A randomized survey experiment comparing effect measures.

    Science.gov (United States)

    Berglund, Erik; Westerling, Ragnar; Sundström, Johan; Lytsy, Per

    2016-12-01

    This study aimed to investigate patients' willingness to initiate a preventive treatment and compared two established effect measures to the newly developed Delay of Events (DoE) measure that expresses treatment effect as a gain in event-free time. In this cross-sectional, randomized survey experiment in the general Swedish population,1079 respondents (response rate 60.9%) were asked to consider a preventive cardiovascular treatment. Respondents were randomly allocated to one of three effect descriptions: DoE, relative risk reduction (RRR), or absolute risk reduction (ARR). Univariate and multivariate analyses were performed investigating willingness to initiate treatment, views on treatment benefit, motivation and importance to adhere and willingness to pay for treatment. Eighty-one percent were willing to take the medication when the effect was described as DoE, 83.0% when it was described as RRR and 62.8% when it was described as ARR. DoE and RRR was further associated with positive views on treatment benefit, motivation, importance to adhere and WTP. Presenting treatment effect as DoE or RRR was associated with a high willingness to initiate treatment. An approach based on the novel time-based measure DoE may be of value in clinical communication and shared decision making. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  18. 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

  19. Delayed parasite clearance after treatment with dihydroartemisinin-piperaquine in Plasmodium falciparum malaria patients in central Vietnam.

    Science.gov (United States)

    Thriemer, Kamala; Hong, Nguyen Van; Rosanas-Urgell, Anna; Phuc, Bui Quang; Ha, Do Manh; Pockele, Evi; Guetens, Pieter; Van, Nguyen Van; Duong, Tran Thanh; Amambua-Ngwa, Alfred; D'Alessandro, Umberto; Erhart, Annette

    2014-12-01

    Reduced susceptibility of Plasmodium falciparum toward artemisinin derivatives has been reported from the Thai-Cambodian and Thai-Myanmar borders. Following increasing reports from central Vietnam of delayed parasite clearance after treatment with dihydroartemisinin-piperaquine (DHA-PPQ), the current first-line treatment, we carried out a study on the efficacy of this treatment. Between September 2012 and February 2013, we conducted a 42-day in vivo and in vitro efficacy study in Quang Nam Province. Treatment was directly observed, and blood samples were collected twice daily until parasite clearance. In addition, genotyping, quantitative PCR (qPCR), and in vitro sensitivity testing of isolates was performed. The primary endpoints were parasite clearance rate and time. The secondary endpoints included PCR-corrected and uncorrected cure rates, qPCR clearance profiles, in vitro sensitivity results (for chloroquine, dihydroartemisinin, and piperaquine), and genotyping for mutations in the Kelch 13 propeller domain. Out of 672 screened patients, 95 were recruited and 89 available for primary endpoint analyses. The median parasite clearance time (PCT) was 61.7 h (interquartile range [IQR], 47.6 to 83.2 h), and the median parasite clearance rate had a slope half-life of 6.2 h (IQR, 4.4 to 7.5 h). The PCR-corrected efficacy rates were estimated at 100% at day 28 and 97.7% (95% confidence interval, 91.2% to 99.4%) at day 42. At day 3, the P. falciparum prevalence by qPCR was 2.5 times higher than that by microscopy. The 50% inhibitory concentrations (IC50s) of isolates with delayed clearance times (≥ 72 h) were significantly higher than those with normal clearance times for all three drugs. Delayed parasite clearance (PCT, ≥ 72 h) was significantly higher among day 0 samples carrying the 543 mutant allele (47.8%) than those carrying the wild-type allele (1.8%; P = 0.048). In central Vietnam, the efficacy of DHA-PPQ is still satisfactory, but the parasite clearance time

  20. Treatment with Hydrogen-Rich Saline Delays Disease Progression in a Mouse Model of Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Zhang, Yu; Li, Hang; Yang, Chen; Fan, Dan-Feng; Guo, Da-Zhi; Hu, Hui-Jun; Meng, Xiang-En; Pan, Shu-Yi

    2016-04-01

    Amyotrophic lateral sclerosis (ALS) is the most frequent adult-onset motor neuron disease, and accumulating evidence indicates that oxidative mechanisms contribute to ALS pathology, but classical antioxidants have not performed well in clinical trials. The aim of this work was to investigate the effect of treatment with hydrogen molecule on the development of disease in mutant SOD1 G93A transgenic mouse model of ALS. Treatment of mutant SOD1 G93A mice with hydrogen-rich saline (HRS, i.p.) significantly delayed disease onset and prolonged survival, and attenuated loss of motor neurons and suppressed microglial and glial activation. Treatment of mutant SOD1 G93A mice with HRS inhibited the release of mitochondrial apoptogenic factors and the subsequent activation of downstream caspase-3. Furthermore, treatment of mutant SOD1 G93A mice with HRS reduced levels of protein carbonyl and 3-nitrotyrosine, and suppressed formation of reactive oxygen species (ROS), peroxynitrite, and malondialdehyde. Treatment of mutant SOD1 G93A mice with HRS preserved mitochondrial function, marked by restored activities of Complex I and IV, reduced mitochondrial ROS formation and enhanced mitochondrial adenosine triphosphate synthesis. In conclusion, hydrogen molecule may be neuroprotective against ALS, possibly through abating oxidative and nitrosative stress and preserving mitochondrial function.

  1. Delayed Time-to-Treatment of an Antisense Morpholino Oligomer Is Effective against Lethal Marburg Virus Infection in Cynomolgus Macaques.

    Science.gov (United States)

    Warren, Travis K; Whitehouse, Chris A; Wells, Jay; Welch, Lisa; Charleston, Jay S; Heald, Alison; Nichols, Donald K; Mattix, Marc E; Palacios, Gustavo; Kugleman, Jeffrey R; Iversen, Patrick L; Bavari, Sina

    2016-02-01

    Marburg virus (MARV) is an Ebola-like virus in the family Filovirdae that causes sporadic outbreaks of severe hemorrhagic fever with a case fatality rate as high as 90%. AVI-7288, a positively charged antisense phosphorodiamidate morpholino oligomer (PMOplus) targeting the viral nucleoprotein gene, was evaluated as a potential therapeutic intervention for MARV infection following delayed treatment of 1, 24, 48, and 96 h post-infection (PI) in a nonhuman primate lethal challenge model. A total of 30 cynomolgus macaques were divided into 5 groups of 6 and infected with 1,830 plaque forming units of MARV subcutaneously. AVI-7288 was administered by bolus infusion daily for 14 days at 15 mg/kg body weight. Survival was the primary endpoint of the study. While none (0 of 6) of the saline group survived, 83-100% of infected monkeys survived when treatment was initiated 1, 24, 48, or 96 h post-infection (PI). The antisense treatment also reduced serum viremia and inflammatory cytokines in all treatment groups compared to vehicle controls. The antibody immune response to virus was preserved and tissue viral antigen was cleared in AVI-7288 treated animals. These data show that AVI-7288 protects NHPs against an otherwise lethal MARV infection when treatment is initiated up to 96 h PI.

  2. Delayed Time-to-Treatment of an Antisense Morpholino Oligomer Is Effective against Lethal Marburg Virus Infection in Cynomolgus Macaques.

    Directory of Open Access Journals (Sweden)

    Travis K Warren

    2016-02-01

    Full Text Available Marburg virus (MARV is an Ebola-like virus in the family Filovirdae that causes sporadic outbreaks of severe hemorrhagic fever with a case fatality rate as high as 90%. AVI-7288, a positively charged antisense phosphorodiamidate morpholino oligomer (PMOplus targeting the viral nucleoprotein gene, was evaluated as a potential therapeutic intervention for MARV infection following delayed treatment of 1, 24, 48, and 96 h post-infection (PI in a nonhuman primate lethal challenge model. A total of 30 cynomolgus macaques were divided into 5 groups of 6 and infected with 1,830 plaque forming units of MARV subcutaneously. AVI-7288 was administered by bolus infusion daily for 14 days at 15 mg/kg body weight. Survival was the primary endpoint of the study. While none (0 of 6 of the saline group survived, 83-100% of infected monkeys survived when treatment was initiated 1, 24, 48, or 96 h post-infection (PI. The antisense treatment also reduced serum viremia and inflammatory cytokines in all treatment groups compared to vehicle controls. The antibody immune response to virus was preserved and tissue viral antigen was cleared in AVI-7288 treated animals. These data show that AVI-7288 protects NHPs against an otherwise lethal MARV infection when treatment is initiated up to 96 h PI.

  3. 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.

  4. INFLUENCE OF REACTION CONDITIONS ON LIGNIN HYDROTHERMAL TREATMENT

    Directory of Open Access Journals (Sweden)

    Xabier eErdocia

    2014-04-01

    Full Text Available Organosolv lignin, obtained from olive tree pruning under optimised conditions, was subjected to a hydrothermal depolymerisation process catalysed by sodium hydroxide. The depolymerisation of lignin was carried out at 300 ºC using different reaction times (20, 40, 60, 70, 80, 90 and 100 min in order to study the influence of this parameter on lignin depolymerisation. The resulting products (oil and residual lignin were measured and analysed by different techniques (GC/MS, HPSEC and pyrolysis-GC/MS in order to determine their nature and composition. Coke was also formed, at a lower quantity, incompetitive repolymerisation reactions during the lignin hydrothermal treatment. The maximum oil yield and concentration of monomeric phenolic compounds was obtained after80 min of reaction time. The highest reaction time studied (100 min had the worst results with the lowest oil yield and highest coke production.

  5. Effect of sodium ascorbate and delayed treatment on the shear bond ...

    African Journals Online (AJOL)

    of bond strength of two different adhesives to bleached enamel surfaces. Objective: This ... time between the bleaching procedure and restorative treatment should be ... the application of total‑and self‑etch dental adhesive systems with nanofill ...

  6. Mitigation of Radiation Induced Pulmonary Vascular Injury by Delayed Treatment with Captopril

    Science.gov (United States)

    MOLTHEN, Robert C.; WU, Qingping; FISH, Brian L.; MOULDER, John E.; JACOBS, Elizabeth R.; MEDHORA, Meetha M.

    2013-01-01

    Background and objective A single dose of 10 Gy radiation to the thorax of rats results in decreased total lung angiotensin-converting enzyme (ACE) activity, pulmonary artery distensibility and distal vascular density while increasing pulmonary vascular resistance (PVR) at 2-months post-exposure. In this study we evaluate the potential of a renin-angiotensin system (RAS) modulator, the ACE inhibitor captopril, to mitigate this pulmonary vascular damage. Methods Rats exposed to 10 Gy thorax only irradiation and age-matched controls were studied 2-months after exposure, during the development of radiation pneumonitis. Rats were treated, either immediately or 2-weeks after radiation exposure, with 2 doses of the ACE inhibitor, captopril, dissolved in their drinking water. To determine pulmonary vascular responses, we measured pulmonary hemodynamics, lung ACE activity, pulmonary arterial distensibility, and peripheral vessel density. Results Captopril, given at a vasoactive but not a lower dose, mitigated radiation-induced pulmonary vascular injury. More importantly these beneficial effects were observed even if drug therapy was delayed for up to two weeks after exposure. Conclusions Captopril resulted in a reduction in pulmonary vascular injury that supports its use as a radiomitigator after an unexpected radiological event such as a nuclear accident. PMID:22882664

  7. Antiangiogenic treatment delays chondrocyte maturation and bone formation during limb skeletogenesis.

    Science.gov (United States)

    Yin, Melinda; Gentili, Chiara; Koyama, Eiki; Zasloff, Michael; Pacifici, Maurizio

    2002-01-01

    Hypertrophic chondrocytes have important roles in promoting invasion of cartilage by blood vessels and its replacement with bone. However, it is unclear whether blood vessels exert reciprocal positive influences on chondrocyte maturation and function. Therefore, we implanted beads containing the antiangiogenic molecule squalamine around humeral anlagen in chick embryo wing buds and monitored the effects over time. Fluorescence microscopy showed that the drug diffused from the beads and accumulated in humeral perichondrial tissues, indicating that these tissues were the predominant targets of drug action. Diaphyseal chondrocyte maturation was indeed delayed in squalamine-treated humeri, as indicated by reduced cell hypertrophy and expression of type X collagen, transferrin, and Indian hedgehog (Ihh). Although reduced in amount, Ihh maintained a striking distribution in treated and control humeri, being associated with diaphyseal chondrocytes as well as inner perichondrial layer. These decreases were accompanied by lack of cartilage invasion and tartrate-resistant acid phosphatase-positive (TRAP+) cells and a significant longitudinal growth retardation. Recovery occurred at later developmental times, when in fact expression in treated humeri of markers such as matrix metalloproteinase 9 (MMP-9) and connective tissue growth factor (CTGF) appeared to exceed that in controls. Treating primary cultures of hypertrophic chondrocytes and osteoblasts with squalamine revealed no obvious changes in cell phenotype. These data provide evidence that perichondrial tissues and blood vessels in particular influence chondrocyte maturation in a positive manner and may cooperate with hypertrophic chondrocytes in dictating the normal pace and location of the transition from cartilage to bone.

  8. 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

  9. Delay in initiation of treatment after diagnosis of pulmonary tuberculosis in primary health care setting: eight year cohort analysis from district Faridabad, Haryana, North India.

    Science.gov (United States)

    Kant, Shashi; Singh, Arvind K; Parmeshwaran, Giridara G; Haldar, Partha; Malhotra, Sumit; Kaur, Ravneet

    2017-01-01

    Delay in initiation of tuberculosis (TB) treatment may have a tremendous impact on disease transmission, development of drug resistance, poor outcome and overall survival of TB patients. The delay can occur at various levels. Delay in initiation of treatment after diagnosis is mostly due to health system failure and has immense programmatic implications. It has not been studied extensively in the Indian setting. The authors did a cohort analysis of all TB patients initiated on treatment from two primary health centres (PHCs) at Ballabgarh Health and Demographic Surveillance System between January 2007 and December 2014. Diagnosis and treatment of TB in the study area was done as per the protocol envisaged in the national program. Information related to demography, details of diagnosis and treatment of TB and outcome of treatment were extracted from the TB register. Delay in initiation of treatment after diagnosis was considered if the gap between diagnosis and treatment was greater than 7 days. Bivariate and multivariate analyses were done to find the association of various factors with delay in initiation of treatment after diagnosis. Out of 885 patients, 662 patients started treatment for pulmonary TB. Mean time interval between diagnosis and initiation of treatment was 8.95 days. Only 57.7% of pulmonary TB patients were started on treatment within 7 days of diagnosis, and an additional 24.5% were started on treatment 8-14 days after diagnosis. Patients on retreatment regimens and those residing in villages without a PHC were more likely to have delayed initiation of treatment (odds ratio (OR)=1.82 (1.3-2.7, p=0.001) and OR=1.62 (1.1-2.5, p=0.01) respectively). Delay in initiation of treatment was also associated with unfavourable treatment outcome such as default, failure or death. There is a need to have healthcare changes related to TB care to enable initiation of treatment as early as possible. Pretreatment counselling especially for retreatment patients is

  10. 1,25-dihydroxyvitamin D3 treatment delays cellular aging in human mesenchymal stem cells while maintaining their multipotent capacity.

    Directory of Open Access Journals (Sweden)

    Barbara Klotz

    Full Text Available 1,25-dihydroxyvitamin D3 (1,25D3 was reported to induce premature organismal aging in fibroblast growth factor-23 (Fgf23 and klotho deficient mice, which is of main interest as 1,25D3 supplementation of its precursor cholecalciferol is used in basic osteoporosis treatment. We wanted to know if 1,25D3 is able to modulate aging processes on a cellular level in human mesenchymal stem cells (hMSC. Effects of 100 nM 1,25D3 on hMSC were analyzed by cell proliferation and apoptosis assay, β-galactosidase staining, VDR and surface marker immunocytochemistry, RT-PCR of 1,25D3-responsive, quiescence- and replicative senescence-associated genes. 1,25D3 treatment significantly inhibited hMSC proliferation and apoptosis after 72 h and delayed the development of replicative senescence in long-term cultures according to β-galactosidase staining and P16 expression. Cell morphology changed from a fibroblast like appearance to broad and rounded shapes. Long term treatment did not induce lineage commitment in terms of osteogenic pathways but maintained their clonogenic capacity, their surface marker characteristics (expression of CD73, CD90, CD105 and their multipotency to develop towards the chondrogenic, adipogenic and osteogenic pathways. In conclusion, 1,25D3 delays replicative senescence in primary hMSC while the pro-aging effects seen in mouse models might mainly be due to elevated systemic phosphate levels, which propagate organismal aging.

  11. 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.

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

    Science.gov (United States)

    Sakamoto, Toshiro; Endo, Shogo

    2013-01-01

    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.

  13. 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.

  14. Seventy per cent hydrofluoric acid burns: delayed decontamination with hexafluorine® and treatment with calcium gluconate.

    Science.gov (United States)

    Yoshimura, Carlos Alberto; Mathieu, Laurence; Hall, Alan H; Monteiro, Mário G Kool; de Almeida, Décio Moreira

    2011-01-01

    This is a case report of decontamination and treatment of a 70% hydrofluoric acid (HF) dermal splash injury. A worker was splashed with 70% HF, sustaining approximately 10% TBSA first- to third-degree chemical skin burns of the face, trunk, and left thigh and leg. Initial decontamination involved water rinsing, removal of contaminated clothing, more water rinsing, topical application of magnesium oxide, and administration of intravenous narcotics for management of severe pain. After a delay of approximately 3 hours, active skin washing with Hexafluorine®, 5 L, was performed, followed by intravenous, intradermal perilesional, and topical inunction administration of calcium gluconate. Pain relief and a cooling sensation were quite prompt after Hexafluorine® decontamination. Surgical debridement and skin grafting of the more severe burns were required. No significant systemic toxicity developed, although this has occurred in previously reported similar concentrated HF dermal splash exposure cases, some of which resulted in fatality. While burns did develop, the patient was released from the intensive care service after 2 days and, after skin grafting, had a good outcome at 90-day follow-up. Even after a long delay, decontamination with Hexafluorine® appeared to be beneficial in this case.

  15. Effects of Zingiber cassumunar(Plai cream) in the treatment of delayed onset muscle soreness

    Institute of Scientific and Technical Information of China (English)

    Nuttaset Manimmanakorn; Apiwan Manimmanakorn; Disaphon Boobphachart; Worrawut Thuwakum; Wiroon Laupattarakasem; Michael J Hamlin

    2016-01-01

    OBJECTIVE:To evaluate the effects ofZingiber cassumunar (Plai cream) in either 7% or 14%concentration on delayed onset muscle soreness (DOMS). METHODS: Seventy-ifve untrained healthy volunteers (28 males and 47 females), performed 4 sets of 25 eccentric repetitions of the dominant quadriceps muscle on an isokinetic dynamometry machine. Participants were then randomized into 3 groups: 14% Plai cream, 7% Plai cream and placebo cream. Two grams of the cream (strips of 5-cm long) were gently rubbed into the quadriceps muscles for 5 min immediately folowing the exercise and every 8 h thereafter for 7 d in al groups. Muscle soreness, muscle strength, jump height, thigh circumference and creatine kinase were measured before and after eccentric exercise. RESULTS:Compared to the placebo cream the 14% Plai cream substantialy reduced muscle soreness over the 7 d by –82% (95% CI = –155% to –6%,P = 0.03), but had similar muscle soreness effects to 7% Plai cream (–34%, –96% to 27%,P = 0.2). Compared to the placebo cream the 7% Plai cream resulted in a smal non-signiifcant reduction in muscle soreness levels over the folowing 7 d (–40%,–116% to 36%,P = 0.3). Compared to placebo cream there was little effect of Plai cream (7% or 14%) on muscle strength, jump height, thigh circumference or creatine kinase concentration. CONCLUSION:Using 14% Plai cream over a 7-day period substantialy reduced muscle soreness symptoms compared to 7% Plai cream or a placebo cream. The authors suggest that the administration of 14% Plai cream is a useful alternative in the management of DOMS. TRIAL REGISTRATION: Thai Clinical Trial Registry TCTR20140215001.

  16. Effects of Zingiber cassumunar (Plai cream) in the treatment of delayed onset muscle soreness.

    Science.gov (United States)

    Manimmanakorn, Nuttaset; Manimmanakorn, Apiwan; Boobphachart, Disaphon; Thuwakum, Worrawut; Laupattarakasem, Wiroon; Hamlin, Michael J

    2016-03-01

    To evaluate the effects of Zingiber cassumunar (Plai cream) in either 7% or 14% concentration on delayed onset muscle soreness (DOMS). Seventy-five untrained healthy volunteers (28 males and 47 females), performed 4 sets of 25 eccentric repetitions of the dominant quadriceps muscle on an isokinetic dynamometry machine. Participants were then randomized into 3 groups: 14% Plai cream, 7% Plai cream and placebo cream. Two grams of the cream (strips of 5-cm long) were gently rubbed into the quadriceps muscles for 5 min immediately following the exercise and every 8 h thereafter for 7 d in all groups. Muscle soreness, muscle strength, jump height, thigh circumference and creatine kinase were measured before and after eccentric exercise. Compared to the placebo cream the 14% Plai cream substantially reduced muscle soreness over the 7 d by -82% (95% CI = -155% to -6%, P = 0.03), but had similar muscle soreness effects to 7% Plai cream (-34%, -96% to 27%, P = 0.2). Compared to the placebo cream the 7% Plai cream resulted in a small non-significant reduction in muscle soreness levels over the following 7 d (-40%, -116% to 36%, P = 0.3). Compared to placebo cream there was little effect of Plai cream (7% or 14%) on muscle strength, jump height, thigh circumference or creatine kinase concentration. Using 14% Plai cream over a 7-day period substantially reduced muscle soreness symptoms compared to 7% Plai cream or a placebo cream. The authors suggest that the administration of 14% Plai cream is a useful alternative in the management of DOMS. Thai Clinical Trial Registry TCTR20140215001.

  17. The mind-tranquilizing and menstruation-regulating method for acupuncture treatment of delayed menstrual cycle--a clinical controlled study.

    Science.gov (United States)

    Cai, Xue-mei; Wu, Jie

    2009-03-01

    To compare the therapeutic effects of the mind-tranquilizing and menstruation-regulating acupuncture method with the routine acupuncture method in treating delayed menstrual cycle. 40 patients with delayed menstrual cycle were randomly divided into a treatment group of 23 cases (treated by the mind-tranquilizing and menstruation-regulating acupuncture method), and a control group of 17 cases (treated by the routine acupuncture method for delayed menstrual cycle due to stagnation of the liver-qi). The treatment involved three menstrual cycles. The evaluations were done by scoring the symptoms before treatment and at the end of each menstrual cycle. After treatment, significant differences were found between the two groups in the therapeutic effects (Pmenstrual cycle.

  18. Total delay in treatment among smear positive pulmonary tuberculosis patients in five primary health centers, southern Ethiopia: a cross sectional study.

    Directory of Open Access Journals (Sweden)

    Anteneh Asefa

    Full Text Available The global burden of Tuberculosis (TB remains enormous. Delay in TB diagnosis may lead to a higher infectious pool in the community and a more advanced disease state at presentation increasing the risk of mortality. This study is conducted to determine the total delay before treatment among smear positive Pulmonary Tuberculosis (PTB patients.A health institution based cross sectional study was conducted in five primary health centers in southern Ethiopia from June to December 2012. A total of 328 smear positive PTB patients were enrolled in the study. A structured and pre-tested questionnaire was used. Median patient, diagnostic, and treatment delays were calculated to determine the total delay. Multiple logistic regression analysis was used to identify factors associated with total delay.The median patient, diagnostic, treatment and total delays measured in days were 30 (IQR 20.2, 60, 7 (IQR: 3, 14, 3 (IQR: 1, 4 and 45 (IQR: 34.5, 69.5 days respectively. Patients for whom treatment was not initiated within 45 days of onset of symptom(s (total delay constituted 49% of the study participants (59.5% among males and 39.2% among females; P<0.001. Total delay was found to be associated with: being female [AOR  = 0.34, 95% CI: 0.18-0.62], having attended tertiary level education [AOR  = 0.11, 95% CI: 0.02-0.55], perceived severity of stigma during the current TB disease course [AOR = 2. 18, 95% CI: 1.07, 4.42] and living in houses with higher family size [AOR = 0.26, 95% CI: 0.11, 0.61].Total delay in treatment of TB is still high in the study area. Patient's sex, perceived stigma, educational status and family size are significantly contributing for total delay. Therefore, a concerted effort should be taken in order to improve health seeking behavior of the community on TB and to reduce delays from seeking care after experiencing TB symptoms.

  19. Rapamycin treatment causes developmental delay, pigmentation defects, and gastrointestinal malformation on Xenopus embryogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Moriyama, Yuki [Graduate School of Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Ohata, Yoshihisa [Department of Education (Sciences), Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Mori, Shoko [Graduate School of Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Matsukawa, Shinya [Department of Education (Sciences), Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Michiue, Tatsuo [Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902 (Japan); Asashima, Makoto [Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902 (Japan); Research Center for Stem Cell Engineering, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Baien, Tsukuba, Ibaraki 305-8562 (Japan); Kuroda, Hiroki, E-mail: ehkurod@ipc.shizuoka.ac.jp [Graduate School of Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Department of Education (Sciences), Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan)

    2011-01-28

    Research highlights: {yields} Does famous anti-aging drug rapamycin work from the beginning of life? The answer is yes. {yields} This study shows that developmental speed of frog embryo was dose-dependently decreased by rapamycin treatment. {yields} In additions, morphogenetic effects such as less pigmentations and gut malformation are occurred by rapamycin. -- Abstract: Rapamycin is a drug working as an inhibitor of the TOR (target of rapamycin) signaling pathway and influences various life phenomena such as cell growth, proliferation, and life span extension in eukaryote. However, the extent to which rapamycin controls early developmental events of amphibians remains to be understood. Here we report an examination of rapamycin effects during Xenopus early development, followed by a confirmation of suppression of TOR downstream kinase S6K by rapamycin treatment. First, we found that developmental speed was declined in dose-dependent manner of rapamycin. Second, black pigment spots located at dorsal and lateral skin in tadpoles were reduced by rapamycin treatment. Moreover, in tadpole stages severe gastrointestinal malformations were observed in rapamycin-treated embryos. Taken together with these results, we conclude that treatment of the drug rapamycin causes enormous influences on early developmental period.

  20. 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.

  1. 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, A.; Meijer, A.M.; Smits, M.G.; Oort, F.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 t

  2. 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

  3. Conditional deletion of Dicer in vascular smooth muscle cells leads to the developmental delay and embryonic mortality

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Yaoqian [Department of Physiology, University of Tennessee Health Science Center, Memphis, TN 38163 (United States); Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN 38163 (United States); Balazs, Louisa [Department of Pathology, University of Tennessee Health Science Center, Memphis, TN 38163 (United States); Tigyi, Gabor [Department of Physiology, University of Tennessee Health Science Center, Memphis, TN 38163 (United States); Yue, Junming, E-mail: yue@uthsc.edu [Department of Physiology, University of Tennessee Health Science Center, Memphis, TN 38163 (United States); Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN 38163 (United States)

    2011-05-13

    Highlights: {yields} Deletion of Dicer in vascular smooth muscle cells(VSMCs) leads to embryonic mortality. {yields} Loss of Dicer in VSMCs leads to developmental delay. {yields} Loss of Dicer in VSMCs leads to hemorrhage in various organs including brain, skin and liver. {yields} Loss of Dicer in VSMCs leads to vascular wall remodeling. {yields} Loss of Dicer in VSMCs dysregulates the expression of miRNA and VSMC marker genes. -- Abstract: Dicer is a RNAase III enzyme that cleaves double stranded RNA and generates small interfering RNA (siRNA) and microRNA (miRNA). The goal of this study is to examine the role of Dicer and miRNAs in vascular smooth muscle cells (VSMCs). We deleted Dicer in VSMCs of mice, which caused a developmental delay that manifested as early as embryonic day E12.5, leading to embryonic death between E14.5 and E15.5 due to extensive hemorrhage in the liver, brain, and skin. Dicer KO embryos showed dilated blood vessels and a disarray of vascular architecture between E14.5 and E15.5. VSMC proliferation was significantly inhibited in Dicer KOs. The expression of VSMC marker genes were significantly downregulated in Dicer cKO embryos. The vascular structure of the yolk sac and embryo in Dicer KOs was lost to an extent that no blood vessels could be identified after E15.5. Expression of most miRNAs examined was compromised in VSMCs of Dicer KO. Our results indicate that Dicer is required for vascular development and regulates vascular remodeling by modulating VSMC proliferation and differentiation.

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

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Ryo [APC, (CNRS-Université Paris 7), 10 rue Alice Domon et Léonie Duquet, 75205 Paris (France); Naruko, Atsushi [Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551 (Japan); Hiramatsu, Takashi; Sasaki, Misao, E-mail: rsaito@apc.univ-paris7.fr, E-mail: naruko@th.phys.titech.ac.jp, E-mail: hiramatz@yukawa.kyoto-u.ac.jp, E-mail: misao@yukawa.kyoto-u.ac.jp [Yukawa Institute for Theoretical Physics, Kyoto University, Kyoto 606-8502 (Japan)

    2014-10-01

    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. Apomorphine Penject – Emerging Evidence and Treatment Strategies for Delayed on and off Periods in Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Olivier Rascol

    2014-07-01

    Full Text Available This educational symposium was held during the Joint Congress of European Neurology (EFNS–ENS, which took place from 31st May to 3rd June 2014 in Istanbul, Turkey, and was sponsored by Britannia Pharmaceuticals Limited. The symposium debated the problem of delayed ON and OFF periods in Parkinson’s disease that can occur even in patients optimised on oral medication. Emerging evidence for the rapid and effective resolution of such complications using apomorphine intermittent injection (penject was reviewed with particular reference to the positive results of the recent AM IMPAKT trial in patients with morning akinaesia. The discussions were illustrated with examples of ‘real life’ patient case studies to help determine which patients might be best suited for treatment with apomorphine injection.

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

    CERN Document Server

    Saito, Ryo; 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.

  7. Whole-Body Vibration and the Prevention and Treatment of Delayed-Onset Muscle Soreness

    Science.gov (United States)

    Aminian-Far, Atefeh; Hadian, Mohammad-Reza; Olyaei, Gholamreza; Talebian, Saeed; Bakhtiary, Amir Hoshang

    2011-01-01

    Abstract Context: Numerous recovery strategies have been used in an attempt to minimize the symptoms of delayed-onset muscle soreness (DOMS). Whole-body vibration (WBV) has been suggested as a viable warm-up for athletes. However, scientific evidence to support the protective effects of WBV training (WBVT) on muscle damage is lacking. Objective: To investigate the acute effect of WBVT applied before eccentric exercise in the prevention of DOMS. Design: Randomized controlled trial. Setting: University laboratory. Patients or Other Participants: A total of 32 healthy, untrained volunteers were randomly assigned to either the WBVT (n  =  15) or control (n  =  17) group. Intervention(s): Volunteers performed 6 sets of 10 maximal isokinetic (60°/s) eccentric contractions of the dominant-limb knee extensors on a dynamometer. In the WBVT group, the training was applied using a vibratory platform (35 Hz, 5 mm peak to peak) with 100° of knee flexion for 60 seconds before eccentric exercise. No vibration was applied in the control group. Main Outcome Measure(s): Muscle soreness, thigh circumference, and pressure pain threshold were recorded at baseline and at 1, 2, 3, 4, 7, and 14 days postexercise. Maximal voluntary isometric and isokinetic knee extensor strength were assessed at baseline, immediately after exercise, and at 1, 2, 7, and 14 days postexercise. Serum creatine kinase was measured at baseline and at 1, 2, and 7 days postexercise. Results: The WBVT group showed a reduction in DOMS symptoms in the form of less maximal isometric and isokinetic voluntary strength loss, lower creatine kinase levels, and less pressure pain threshold and muscle soreness (P < .05) compared with the control group. However, no effect on thigh circumference was evident (P < .05). Conclusions: Administered before eccentric exercise, WBVT may reduce DOMS via muscle function improvement. Further investigation should be undertaken to ascertain the effectiveness of WBVT in

  8. A Delay from Diagnosis to Treatment Is Associated with a Decreased Overall Survival for Patients with Endometrial Cancer.

    Science.gov (United States)

    Dolly, Darren; Mihai, Andreea; Rimel, B J; Fogg, Louis; Rotmensch, Jacob; Guirguis, Alfred; Yordan, Edgardo; Dewdney, Summer

    2016-01-01

    While Caucasian women are more likely to be diagnosed with endometrial cancer compared to African-American women, the rate of mortality is higher for African Americans. The cause of this disparity is unknown. We analyzed the time interval from diagnosis of endometrial cancer to treatment as it pertains to race and socioeconomic factors and its possible impact on survival. This was a retrospective, single institution chart review using a cancer registry database. We identified 889 patients who were diagnosed with endometrial cancer between January 2005 and June 2012. Clinicopathologic characteristics, demographics, insurance status, distance from medical center, body mass index (BMI), dates of diagnosis, and treatment were obtained from the medical records. Survival and association was determined by a one-way ANOVA test. At the time of the study, 699 patients were alive and 190 dead. The average age was noted to be 62 years (24-91 years). Stages I-IV disease accounted for 69, 6, 15, and 10%, respectively. White race accounted for 64%, African Americans 24%, and Hispanics 7% of our study population. Majority of patients were privately insured (n = 441) followed by Medicare (n = 375). The mean interval time from diagnosis to treatment was 47.5 days (0-363). A statistically significant difference was noted for this time interval with regard to both race and insurance status: white and African Americans (42.6 vs. 57.3 days, p = 0.048), privately insured and Medicare (38.4 vs. 54.1 days, p < 0.001). There was a significant association with increased risk of death with a longer delay (43.3 vs. 64.8 days, p < 0.001). No statistically significance was noted for distance from medical center or BMI. A significant increase in interval of time from diagnosis to treatment of endometrial cancer was seen in both race and insurance status. A longer interval from diagnosis to treatment was associated mortality. The causes of these delays are likely

  9. Popliteal artery injuries in an urban trauma center with a rural catchment area: do delays in definitive treatment affect amputation?

    Science.gov (United States)

    Simmons, Jon D; Gunter, Joseph W; Schmieg, Robert E; Manley, Justin D; Rushton, Fred W; Porter, John M; Mitchell, Marc E

    2011-11-01

    Extended length of time from injury to definitive vascular repair is considered to be a predictor of amputation in patients with popliteal artery injuries. In an urban trauma center with a rural catchment area, logistical issues frequently result in treatment delays, which may affect limb salvage after vascular trauma. We examined how known risk factors for amputation after popliteal trauma are affected in a more rural environment, where patients often experience delays in definitive surgical treatment. All adult patients admitted to the Level I trauma center, the University of Mississippi Medical Center, with a popliteal artery injury between January 2000 and December of 2007 were identified. Demographic information management and outcome data were collected. Body mass index, mangled extremity severity score (MESS), Guistilo open fracture score, injury severity score, and time from injury to vascular repair were examined. Fifty-one patients with popliteal artery injuries (53% blunt and 47% penetrating) were identified, all undergoing operative repair. There were nine amputations (17.6%) and one death. Patients requiring amputation had a higher MESS, 7.8 versus 5.3 (P score, Guistilo open fracture score, or time from injury to repair were not different between the two groups. Patients with a blunt mechanism of injury had a slightly higher amputation rate compared with those with penetrating trauma, 25.9 per cent versus 8.3 per cent (P = non significant). MESS, though not perfect, is the best predictor of amputation in patients with popliteal artery injuries. Morbid obesity is not a significant predictor for amputation in patients with popliteal artery injuries. Time from injury to repair of greater than 6 hours was not predictive of amputation. This study further demonstrates that a single scoring system should be used with caution when determining the need for lower extremity amputation.

  10. Postharvest response of avocado fruits of different maturity to delayed ethylene treatments.

    Science.gov (United States)

    Adato, I; Gazit, S

    1974-06-01

    The effect of 10, 100, 1000, 10,000 ppm of ethylene, applied for 3, 6, 12, and 24 hours, on the ripening rate of "Hass" avocado (Persea americana Mill.) fruits at three stages of maturity was investigated. Ethylene treatments were started either immediately after picking or 2 days later. A sharp peak of ethylene production was found to precede full softening by about 2 days and the occurrence of this peak was used to determine ripening rate. Hastening of fruit ripening was much more marked following ethylene treatment which began 2 days after harvesting than immediately after. The difference in response diminished gradually as the fruit became more mature.These results can be explained by the assumption that the factors which prevent avocado ripening on the tree, continue to exert their influence for a limited period after harvest and inhibit the ripening response in the freshly picked fruit. This inhibition decreases with advancing fruit maturity.

  11. Delay in diagnosis and treatment of patients with cases of imported malaria in Poland – one center’s experience

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    Jacek Czepiel

    2017-06-01

    Full Text Available Background . Increasingly, Polish citizens are traveling to malaria endemic regions; thus, physicians, especially primary care physicians, should be educated to recognize and treat malaria. Diagnosis and treatment of malaria encounters many difficulties in Poland. Objectives . The aim of the study was to analyze malaria chemoprophylaxis, the time from first symptoms to hospitalization and the process of diagnosis and treatment of patients with malaria. Material and methods . The medical records of patients diagnosed with malaria, hospitalized between 2012 and 2016 in the Department of Infectious Diseases of the University Hospital, Cracow, Poland, were analyzed. Results . 37 subjects with a median age of 32 years (interquartile range IQR: 28–40, mostly returning from Africa (78%, n = 29, were studied. Proper chemoprophylaxis was used in 6 cases (16%. The median length of stay in malaria endemic countries was one month. Plasmodium falciparum was the most frequent species (74%. The mean time to treatment after symptom onset was 5 days (range: 1–27 days. Conclusions . The clinical presentation of malaria in the study group was usually typical. Diagnostic delay resulted from not taking malaria into consideration during the initial differential diagnosis of fever. Few travelers use chemoprophylaxis, hence the awareness of malaria in individuals who have traveled to endemic zones should be enhanced. In a patient presenting with fever, malaria should always be considered in a differential diagnosis if there is a history of travel to a malaria-endemic zone.

  12. Delayed Treatment of Traumatized Primary Teeth with Distinct Pulp Response: Follow-Up until Permanent Successors Eruption

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    Gabriela Cristina de Oliveira

    2017-01-01

    Full Text Available Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. The pulp outcome is often unpredictable because the patient and injury which are related to variables can influence the treatment of choice and the prognosis of the case. This report presents the case of a 4-year-old boy with complicated crown fracture with pulp polyp in the primary right maxillary central incisor (51 and crown-root fracture with pulp involvement in the primary left maxillary central incisor (61, which was treated only 3 months after the tooth injuries. The treatment of choice was extraction of tooth (61 due to a periapical lesion with disruption of the dental follicle of the permanent successor and pulpotomy (MTA of the tooth (51, because the pulp presented signs of vitality. At the follow-up visits, no clinical, symptomalogical, and radiographic changes were observed until the primary tooth’s exfoliation. However, at 3-year follow-up, the permanent successors showed hypocalcification and the position of the permanent right maxillary central incisors (11 was altered. Besides the conservative and adequate delayed treatment, the sequelae on the permanent successors could not be avoided.

  13. Field triage reduces treatment delay and improves long-term clinical outcome in patients with acute ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Pedersen, Sune H; Galatius, Soren; Hansen, Peter R

    2009-01-01

    OBJECTIVES: We evaluated the independent impact of field triage on treatment delay and long-term clinical outcome in a large contemporary, consecutive population of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). BACKGROUND......: Reduction of treatment delay is crucial for patients with STEMI. METHODS: From January 2005 to July 2008, 1,437 STEMI patients were treated with pPCI at a single high-volume invasive center. We present the 1-year outcome in this observational registry study. RESULTS: A total of 616 patients were admitted...... triage had a reduced risk of reaching the combined end point of all-cause mortality or nonfatal myocardial infarction (hazard ratio: 0.67; 95% confidence interval: 0.46 to 0.97; p=0.035). CONCLUSIONS: This study shows that field triage of STEMI patients to pPCI significantly reduces treatment delay...

  14. Composite end points to assess delay of disability progression by MS treatments.

    Science.gov (United States)

    Zhang, J; Waubant, E; Cutter, G; Wolinsky, Js; Leppert, D

    2014-10-01

    The Expanded Disability Status Scale (EDSS) has low sensitivity and reliability for detecting sustained disability progression (SDP) in multiple sclerosis (MS) trials. This study evaluated composite disability end points as alternatives to EDSS alone. SDP rates were determined using 96-week data from the Olympus trial (rituximab in patients with primary progressive MS). SDP was analyzed using composite disability end points: SDP in EDSS, timed 25-foot walk test (T25FWT), or 9-hole peg test (9HPT) (composite A); SDP in T25FWT or 9HPT (composite B); SDP in EDSS and (T25FWT or 9HPT) (composite C); and SDP in any two (EDSS, T25FWT, and 9HPT) (composite D). Overall agreements between EDSS and other disability measures in defining SDP were 66%-73%. Composite A showed similar treatment effect estimate versus EDSS alone with much higher SDP rates. Composite B, C, and D all showed larger treatment effect estimate with different or similar SDP rates versus EDSS alone. Using composite A (24-week confirmation only), B, C, or D could reduce sample sizes needed for MS trials. Composite end points including multiple accepted disability measures could be superior to EDSS alone in analyzing disability progression and should be considered in future MS trials. © The Author(s) 2014.

  15. Delayed Detection of Spontaneous Bilateral Tubal Ectopic Pregnancies After Methotrexate Treatment.

    Science.gov (United States)

    Brown, Nicole E; Singer, Shereen A; Suyama, Joe

    2017-09-09

    Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube]). Diagnosis is typically made via direct visualization intraoperatively and therefore treatment is usually surgical. We present a case of spontaneous bilateral tubal ectopic pregnancies diagnosed 7 days apart via transvaginal ultrasound. The patient presented to the emergency department with pelvic pain on the contralateral side of her previously diagnosed ectopic pregnancy and vaginal spotting. Bilateral adnexal masses were visualized on ultrasound and her serum beta-human chorionic gonadotropin level had a 5.9% decline from day 4 to day 7 after methotrexate administration 7 days prior; gynecology was consulted. The patient was successfully treated with an additional dose of intramuscular methotrexate without any complications. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The implications of this case suggest that diagnosis of bilateral tubal ectopic pregnancies requires clinicians to have a high level of suspicion in any pregnant female with a suspected or known ectopic pregnancy who presents with pelvic pain regardless of prior diagnosis or treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Radiological evolution and delayed resolution of an optic nerve tuberculoma: Challenges in diagnosis and treatment

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    Ajith Sivadasan

    2013-01-01

    Full Text Available Optic nerve tuberculomas are rarely reported and their natural history, prognosis, and duration of required treatment remain unclear. A 40-year-old immunocompetent male presented with complete loss of vision in his right eye, which had evolved over 6 weeks. He had optic atrophy on examination. Initial imaging showed right optic nerve swelling and thickening suggesting an infiltrative inflammatory optic neuropathy (infectious or noninfectious. Serial imaging revealed appearance of ring enhancement with a necrotic centre. Biopsy and culture of the coexistent parietal lobe lesion revealed Mycobacterium tuberculosis. Persistent optic nerve granuloma with evidence of radiological improvement was noted at 18 months follow-up with antituberculous therapy (ATT. Visual recovery could not be achieved. The salient features in this case include the clinical presentation initially mimicking an infiltrative or compressive optic neuropathy, rapid radiological evolution into a tuberculoma, subtle paradoxical radiological worsening after initiation of ATT and persistence of granuloma on follow up scan. The challenges involved in early diagnosis and during the treatment course will be discussed.

  17. Immediate Versus Delayed Treatment with EGFR Tyrosine Kinase Inhibitors after First-line Therapy in Advanced Non-small-cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Zhi-jie Wang; Ping-ping Li; Hong Sun; Ping Yang; Jie Wang; Tong-tong An; Tony Mok; Lu Yang; Hua Bai; Jun Zhao; Jian-chun Duan; Mei-na Wu; Yu-yan Wang

    2011-01-01

    Objective: To analyze the outcomes of patients who received TKI immediately after the first-line without progression as maintenance treatment (immediate group) vs. those received delayed treatment upon disease progression as second-line therapy (delayed group). Methods: The study included 159 no-small-cell lung cancer (NSCLC) patients who received gefitinib or erlotinib as maintenance treatment in the immediate group (85 patients) or as second-line therapy in the delayed group (74patients). The primary end point was progression-free survival (PFS). EGFR mutation status was detected using denaturing high-performance liquid chromatography (DHPLC). Results: PFS was 17.3 and 16.4 months in the immediate and delayed groups, respectively (hazard ratio [HR],0.99; 95% Confidence Interval [Cl]: 0.69-1.42; P=0.947). In a subgroup analysis that included only patients with EGFR mutation, however, PFS was significantly longer in the immediate group than in the delayed group (HR, 0.48; 95% Cl:0.27-0.85; P=0.012). In patients with wild type EGFR, the risk for disease progression was comparable between the two groups (HR, 1.23; 95% Cl: 0.61-2.51; P=0.564). No significant difference was demonstrated between the immediate and delayed group in terms of the overall survival (OS) (26.1 months vs. 21.6 months, respectively;HR=0.53; 95% Cl: 0.27 to 1.06; P=0.072). There was also no difference in the incidence of adverse events between the two groups. Conclusions: EGFR TKI maintenance improves PFS in patients with EGFR mutation. Prospectively designed clinical studies that compare TKI immediate vs. delayed treatment after first-line chemotherapy upon disease progression are needed.

  18. Delayed release pancrelipase for the treatment of pancreatic exocrine insufficiency associated with cystic fibrosis

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    Susan S Baker

    2008-10-01

    Full Text Available Susan S BakerDepartment of Pediatrics, University at Buffalo, Buffalo, NY, USAAbstract: Pancreatic enzyme replacement therapy (PERT is the only treatment for malabsorption in cystic fi brosis (CF caused by pancreatic insufficiency (PI. PI occurs in approximately 85% of patients with CF. PERT overcomes some, but not all the signs and symptoms of malabsorption. Clinical parameters such as growth, abdominal pain, diarrhea and gassiness, commonly used to adjust PERT dosing, are shown not to be good indicators of their effectiveness. The FDA does not provide oversight of preparations of pancreatic enzymes consistent with the oversight it provides for all other drugs. The FDA intends to rectify this situation. Measures of the effectiveness of PERT are limited to the coefficient of fat absorption, a difficult and unpleasant exercise for patients.Keywords: pancrelipase, cystic fibrosis, malabsorption, pancreatic enzymes

  19. 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.

  20. Density matrix treatment of combined instantaneous and delayed dissipation for an electronically excited adsorbate on a solid surface

    Science.gov (United States)

    Leathers, Andrew S.; Micha, David A.; Kilin, Dmitri S.

    2009-10-01

    The interaction of an excited adsorbate with a medium undergoing electronic and vibrational transitions leads to fast dissipation due to electronic energy relaxation and slow (or delayed) dissipation from vibrational energy relaxation. A theoretical and computational treatment of these phenomena has been done in terms of a reduced density matrix satisfying a generalized Liouville-von Neumann equation, with instantaneous dissipation constructed from state-to-state transition rates, and delayed dissipation given by a memory term derived from the time-correlation function (TCF) of atomic displacements in the medium. Two representative applications are presented here, where electronic excitation may enhance vibrational relaxation of an adsorbate. They involve femtosecond excitation of (a) a CO molecule adsorbed on the Cu(001) metal surface and (b) a metal cluster on a semiconductor surface, Ag3Si(111):H, both electronically excited by visible light and undergoing electron transfer and dissipative dynamics by electronic and vibrational relaxations. Models have been parametrized in both cases from electronic structure calculations and known TCFs for the medium, which are slowly decaying in case (a) and fast decaying in case (b). This requires different numerical procedures in the solution of the integrodifferential equations for the reduced density matrix, which have been solved with an extension of the Runge-Kutta algorithm. Results for the populations of vibronic states versus time show that they oscillate due to vibrational coupling through dissipative interaction with the substrate and show quantum coherence. The total population of electronic states is, however, little affected by vibrational motions. Vibrational relaxation is important only at very long times to establish thermal equilibrium.

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

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    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.

  2. Evaluation of variables affecting crack propagation by Delayed Hydride Cracking in Zr-2.5Nb with different heat treatments

    Energy Technology Data Exchange (ETDEWEB)

    Mieza, J.I., E-mail: mieza@cnea.gov.ar [CNEA, Centro Atomico Constituyentes, Dano por Hidrogeno, Av. Gral. Paz 1499, San Martin (B1650KNA), Bs. As. (Argentina); Instituto Sabato, UNSAM-CNEA, Av. Gral. Paz 1499, San Martin (B1650KNA), Bs. As. (Argentina); Vigna, G.L.; Domizzi, G. [CNEA, Centro Atomico Constituyentes, Dano por Hidrogeno, Av. Gral. Paz 1499, San Martin (B1650KNA), Bs. As. (Argentina)

    2011-04-15

    Delayed Hydride Cracking (DHC) is a failure mechanism that may occur in zirconium alloys used in nuclear reactor core components. The knowledge of the direct effects of the variables affecting the cracking velocity could be used to minimize the risk of crack propagation. In practice, most of these variables - as for example the alloy yield stress and hydrogen diffusion coefficient - are coupled and vary during reactor operation, leading to a complex variable dependence of the cracking mechanism. In order to get an insight into the relative effect of these variables, experimental data and a theoretical approach using a generally accepted DHC model were used in this work. A series of DHC velocity measurements were made in Zr-2.5Nb tube with different heat treatments. The yield stress, the Nb concentration in {beta} phase, and hydrogen solvus of the alloy were measured for different heat treatments. Niobium concentration in {beta} phase gave an indirect indication of {beta}-phase continuity and, with a proper correlation, of the hydrogen diffusion coefficient. The obtained values were used as inputs in a theoretical calculation of cracking velocity. Good agreement between experimental data and predicted values was obtained, showing that hydrogen diffusion coefficient was the most relevant variable affecting DHC velocity cracking. Furthermore, this approach has been demonstrated to be useful in estimating DHC velocity in irradiated materials.

  3. Delayed endoluminal vacuum therapy for rectal anastomotic leaks after rectal resection in a swine model: a new treatment option.

    Science.gov (United States)

    Rosenberger, Laura H; Shada, Amber; Ritter, Lane A; Mauro, David M; Mentrikoski, Mark J; Feldman, Sanford H; Kleiner, Daniel E

    2014-04-01

    Anastomotic leaks are a dreaded surgical complication following colorectal operations. Creation of a temporary proximal diverting ileostomy is used in high-risk anastomoses, however, additional surgical risk is accumulated with its creation and reversal. Endoluminal vacuum therapy has been shown to seal anastomotic defects in the prophylactic setting in a pig model and we hypothesized it could be utilized in a delayed fashion to rescue subjects with an active anastomotic leak. Yorkshire pigs underwent rectal resection, intentional leak confirmed by fluoroscopy, and endoluminal vacuum therapy device placement to low continuous suction. Following treatment, a contrast enema and necropsy was performed for gross and histopathology. Pigs underwent 2 (or 5) days of free intraperitoneal leak prior to device placement and 5 (or 7) subsequent days of endoluminal vacuum therapy. Six of seven early-treated pigs sealed their anastomotic defect, while two of the four treated pigs in this extended group sealed the defect. Endoluminal vacuum therapy is feasible and well tolerated in a pig model, and it has been shown to seal a significant number of freely leaking anastomoses in the early period (86%). This technology warrants further study as it may provide a noninvasive means to treatment of anastomotic leaks. © 2014 Wiley Periodicals, Inc.

  4. Gender-Related Barriers and Delays in Accessing Tuberculosis Diagnostic and Treatment Services: A Systematic Review of Qualitative Studies

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    Lakshmi Krishnan

    2014-01-01

    Full Text Available Background. Tuberculosis (TB remains a significant global public health problem with known gender-related (male versus female disparities. We reviewed the qualitative evidence (written/spoken narrative for gender-related differences limiting TB service access from symptom onset to treatment initiation. Methods. Following a systematic process, we searched 12 electronic databases, included qualitative studies that assessed gender differences in accessing TB diagnostic and treatment services, abstracted data, and assessed study validity. Using a modified “inductive coding” system, we synthesized emergent themes within defined barriers and delays limiting access at the individual and provider/system levels and examined gender-related differences. Results. Among 13,448 studies, 28 studies were included. All were conducted in developing countries and assessed individual-level barriers; 11 (39% assessed provider/system-level barriers, 18 (64% surveyed persons with suspected or diagnosed TB, and 7 (25% exclusively surveyed randomly sampled community members or health care workers. Each barrier affected both genders but had gender-variable nature and impact reflecting sociodemographic themes. Women experienced financial and physical dependence, lower general literacy, and household stigma, whereas men faced work-related financial and physical barriers and community-based stigma. Conclusions. In developing countries, barriers limiting access to TB care have context-specific gender-related differences that can inform integrated interventions to optimize TB services.

  5. Effect of Diagnostic and Treatment Delay on the Risk of Tuberculosis Transmission in Shenzhen, China: An Observational Cohort Study, 1993-2010.

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    Shiming Cheng

    Full Text Available To understand better the risk of tuberculosis transmission with increasing delay in tuberculosis treatment, we undertook a retrospective cohort study in Shenzhen, China.All pulmonary tuberculosis cases in the Shenzhen tuberculosis surveillance database from 1993-2010 were included. Sputum smear positivity and presence of pulmonary cavity were used as proxies for risk of tuberculosis transmission.Among 48,441pulmonary tuberculosis cases, 70% presented with symptoms of pulmonary TB, 62% were sputum smear positive, and 21% had a pulmonary cavity on chest x-ray. 95.3% of patients self-presented for evaluation of illness after a median 58 days of delay after symptoms began. The proportion presenting sputum smear positive (p<0.001 and with a pulmonary cavity (p<0.001 increased significantly with increasing duration of delay.Delayed diagnosis and treatment of tuberculosis is associated with a significantly increased risk of pulmonary sputum smear positivity and pulmonary cavity. To decrease risk of transmission, treatment delay needs to be reduced further.

  6. Children with specific language impairment are not impaired in the acquisition and retention of Pavlovian delay and trace conditioning of the eyeblink response.

    Science.gov (United States)

    Hardiman, Mervyn J; Hsu, Hsin-jen; Bishop, Dorothy V M

    2013-12-01

    Three converging lines of evidence have suggested that cerebellar abnormality is implicated in developmental language and literacy problems. First, some brain imaging studies have linked abnormalities in cerebellar grey matter to dyslexia and specific language impairment (SLI). Second, theoretical accounts of both dyslexia and SLI have postulated impairments of procedural learning and automatisation of skills, functions that are known to be mediated by the cerebellum. Third, motor learning has been shown to be abnormal in some studies of both disorders. We assessed the integrity of face related regions of the cerebellum using Pavlovian eyeblink conditioning in 7-11year-old children with SLI. We found no relationship between oral language skills or literacy skills with either delay or trace conditioning in the children. We conclude that this elementary form of associative learning is intact in children with impaired language or literacy development. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  7. 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

  8. 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

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

    OpenAIRE

    Bahi, Amine; Dreyer, Jean-Luc

    2014-01-01

    Objective: Here, we examined the impact of chronic subordinate colony (CSC) exposure on EtOH-CPP extinction, as well as ethanol-induced reinstatement of CPP.Methods: 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 s...

  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

    2017-06-20

    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.Molecular Psychiatry advance online publication, 20 June 2017; doi:10.1038/mp.2017.84.

  11. 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.

  12. OsBBX14 delays heading date by repressing florigen gene expression under long and short-day conditions in rice.

    Science.gov (United States)

    Bai, Bo; Zhao, Jie; Li, Yaping; Zhang, Fang; Zhou, Jinjun; Chen, Fan; Xie, Xianzhi

    2016-06-01

    B-box (BBX) proteins are zinc finger proteins containing B-box domains, which have roles in Arabidopsis growth and development. However, little is known concerning rice BBXs. Herein, we identified a rice BBX protein, Oryza sativa BBX14 (OsBBX14). OsBBX14 is highly expressed in flag leaf blades. OsBBX14 expression shows a diurnal rhythm under photoperiodic conditions and subsequent continuous white light. OsBBX14 is located in the nucleus and has transcriptional activation potential. OsBBX14-overexpression (OsBBX14-OX) lines exhibited delayed heading date under long-day (LD) and short-day (SD) conditions, whereas RNAi lines of OsBBX14 lines had similar heading dates to the WT. The florigen genes, Hd3a and RFT1, were downregulated in the OsBBX14-OX lines under LD and SD conditions. Under LD conditions, Hd1 was expressed higher in the OsBBX14-OX lines than in the wild type (WT), and the rhythmic expression of circadian clock genes, OsLHY and OsPRR1, was changed in OsBBX14-OX lines. Thus, OsBBX14 acts as a floral repressor by promoting Hd1 expression under LD conditions, probably because of crosstalk with the circadian clock. Under SD conditions, Ehd1 expression was reduced in OsBBX14-OX lines, but Hd1 and circadian clock gene expressions were unaffected, indicating that OsBBX14 acts as a repressor of Ehd1. Our findings suggested that OsBBX14 regulates heading date differently under LD and SD conditions.

  13. 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.

  14. Treatment Delay for Patients With Pulmonary Tuberculosis in Poverty -stricken Areas%贫困地区肺结核病患者就诊延误分析

    Institute of Scientific and Technical Information of China (English)

    冯斌炜; 李侠采; 饶逾; 高晓凤

    2012-01-01

    Objective To understand the tendency of diagnostic delay of pulmonary tuberculosis in poverty -stricken areas. Method Fixed base and period on period growth were adopted for dynamic analysis on the data of pulmonary tuberculosis reported from two state -designated impoverished counties during 2001 -2009. Results From 2001 to 2009, the rates of tuberculosis treatment delay and dignostic delay of untreated pulmonary tuberculosis patients rose to a relatively stable level firstly and then showed a decreasing tendency. The average rates of treatment delay and dignostic delay were 86. 83% and 13. 4% respectively. Conclusion The treatment delay of pulmonary tuberculosis in poverty - stricken areas is serious, integrated measures should be taken.%目的 了解贫困地区肺结核患者就诊及诊断延误变化趋势.方法 以2001 - 2009年在西部2个国家级疾病县疾病控制中心登记的初治肺结核病患者为研究对象,采用定基比和环比增长速度进行动态分析,同期人口学资料来自南充市统计年鉴.结果 2001-2009年来,2个贫困县初治肺结核病患者就诊延误率及确诊延误率呈现出上升趋势后维持一个相对稳定的水平,然后再呈下降趋势,年均就诊延误率及确诊延误率分别为86.83%及13.4%.结论 贫困地区初治肺结核病患者存在较为严重的就诊延误现象,需采取措施.

  15. 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.

  16. The effect of various treatment conditions on natural zeolites: ion exchange, acidic, thermal and steam treatments.

    Science.gov (United States)

    Ates, Ayten; Hardacre, Christopher

    2012-04-15

    Two different natural zeolites having different phase compositions were obtained from different regions of Turkey and modified by ion-exchange (0.5M NH(4)NO(3)) and acid leaching using 1M HCl. The natural and modified samples were treated at low temperature (LT), high temperature (HT) and steam (ST) conditions and characterised by XRF, XRD, BET, FTIR, DR-UV-Vis, NH(3)-TPD and TGA. Ion-exchange with NH(4)(+) of natural zeolites results in the exchange of the Na(+) and Ca(2+) cations and the partial exchange of the Fe(3+) and Mg(2+) cations. However, steam and acidic treatments cause significant dealumination and decationisation, as well as loss of crystalline, sintering of phases and the formation of amorphous material. The presence of mordenite and quartz phases in the natural zeolites increases the stability towards acid treatment, whereas the structure of clinoptilolite-rich zeolites is mostly maintained after high temperature and steam treatments. The natural and modified zeolites treated at high temperature and in steam were found to be less stable compared with synthetic zeolites, resulting in a loss of crystallinity, a decrease in the surface area and pore volume, a decrease in the surface acidity as well as dealumination, and decationisation.

  17. Delays and loss to follow-up before treatment of drug-resistant tuberculosis following implementation of Xpert MTB/RIF in South Africa: A retrospective cohort study

    Science.gov (United States)

    Cox, Helen; Dickson-Hall, Lindy; Ndjeka, Norbert; Stevens, Wendy; Nicol, Mark

    2017-01-01

    Background South Africa has a large burden of rifampicin-resistant tuberculosis (RR-TB), with 18,734 patients diagnosed in 2014. The number of diagnosed patients has increased substantially with the introduction of the Xpert MTB/RIF test, used for tuberculosis (TB) diagnosis for all patients with presumptive TB. Routine aggregate data suggest a large treatment gap (pre-treatment loss to follow-up) between the numbers of patients with laboratory-confirmed RR-TB and those reported to have started second-line treatment. We aimed to assess the impact of Xpert MTB/RIF implementation on the delay to treatment initiation and loss to follow-up before second-line treatment for RR-TB across South Africa. Methods and findings A nationwide retrospective cohort study was conducted to assess second-line treatment initiation and treatment delay among laboratory-diagnosed RR-TB patients. Cohorts, including approximately 300 sequentially diagnosed RR-TB patients per South African province, were drawn from the years 2011 and 2013, i.e., before and after Xpert implementation. Patients with prior laboratory RR-TB diagnoses within 6 mo and currently treated patients were excluded. Treatment initiation was determined through data linkage with national and local treatment registers, medical record review, interviews with health care staff, and direct contact with patients or household members. Additional laboratory data were used to track cases. National estimates of the percentage of patients who initiated treatment and time to treatment were weighted to account for the sampling design. There were 2,508 and 2,528 eligible patients in the 2011 and 2013 cohorts, respectively; 92% were newly diagnosed with RR-TB (no prior RR-TB diagnoses). Nationally, among the 2,340 and 2,311 new RR-TB patients in the 2011 and 2013 cohorts, 55% (95% CI 53%–57%) and 63% (95% CI 61%–65%), respectively, started treatment within 6 mo of laboratory receipt of their diagnostic specimen (p South Africa that

  18. Components of treatment delay in rheumatoid arthritis differ according to autoantibody status: validation of a single-centre observation using national audit data

    Science.gov (United States)

    Lendrem, Dennis; Hargreaves, Ben; Aslam, Osman; Galloway, James B.; Isaacs, John D.

    2016-01-01

    Objective. To determine whether time to treatment following symptom onset differs between RA patients according to autoantibody status. Methods. A single-centre retrospective analysis of a UK early RA inception cohort was first undertaken to identify those components of the patient journey that differed by serological subtype. Data from a UK national audit of early inflammatory arthritis patients was accessed to replicate the key finding. Results. A total of 173 RA patients were diagnosed over a 31-month period, of whom 80 (46%) were ACPA/RF double-seropositive (ACPA+/RF+), 53 (31%) ACPA−/RF−, 17 (10%) ACPA+/RF− and 23 (13%) RF+/ACPA−. Overall, ACPA+/RF+ patients experienced significantly longer symptom duration before DMARD initiation. This was accounted for by delays in their presentation to primary care following symptom onset—a finding that was robustly confirmed in an independent dataset of 2192 UK early RA patients. In contrast, ACPA−/RF− patients were significantly more likely to experience delays in DMARD initiation after presenting to secondary care. Conclusion. Causes of treatment delays in early RA differ according to patients’ autoantibody status. More insidious symptom onset and/or distinct health-seeking behaviours among ACPA+/RF+ patients may contribute to late presentations in primary care, whereas ACPA−/RF− patients experience delayed diagnosis and treatment in secondary care. These observations inform the research agenda, potentially influencing the design of service delivery for early arthritis patients. PMID:27373893

  19. TOXIC ACTIVITY AND DELAYED EFFECTS OF FIVE BOTANICAL OILS ON THE FOLLOWING GENERATIONS OF AGROTIS IPSILON (HUFNAGEL) (INSECTA: LEPIDOPTERA: NOCTUIDAE) AFTER PARENTS TREATMENT.

    Science.gov (United States)

    Mesbah, H A; El-Sayed, N A; El-Kady, M B; Mourad, A K; Kordy, A M; Henaidy, Z M

    2014-01-01

    The present study is carried out to evaluate the toxic efficiency and delayed effects of five botanical oils on the greasy cut worm Agrotis ipsilon (Lepidoptera: Noctuidae), as a trial for the attainment of a possible use of an alternative safe and effective phytochemicals against the insect-pest. So as to minimize or prevent the repeated usage of conventional insecticides, then reduce the environmental pollution as well as the occurring hazards to man and domestic animal due to the use of the pesticides alone. Four tested concentrations (0.5, 1.0, 1.5 and 2.5% v/v) from each of camphor, red basil, menthol, rose and anise oils, were bioassayed by treating the offered castor oil bean leaves, to the 4th instar larvae along 48h, under the laboratory higrothermic conditions of 25±2 °C and 65±5% R.H. The obtained results showed that the five tested oils were found to have more or less toxic activity and drastic effects on the inspected parameters of fitness components of the treated parent generation of the insect, in particular, pupae, emerged adult moths and laid eggs/female. In this respect camphor and red basil oils were highly effective, followed by menthol oil, anise oil and the least effective one was rose oil. Moreover, the assessed unprofitable delayed effects on the going on of the biological performance within the treated insects showed the adverse effects on the fitness components of the consequent generations (fs) post (p) one treatment with each of the bioassyed oils. The prevalence of adverse effects and disturbance in the going on biological performance through the period of (p) generation; which is followed by the distinct failure of insect development in (f1) generation were recorded for each of the tested menthol oil at 0.5 and 1.5% (v/v); camphor oil at 1.5 and 2.5% and red basil oil at 2.5% (v/v). While anise and rose oils were somewhat less efficient causing the distinct failure of the following generations up to the 3rd and/or the 6th ones

  20. A combination of chondroitinase ABC, glial cell line-derived neurotrophic factor, and Nogo A antibody delayed-release microspheres for the treatment of spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Yu Zhang; Yueming Song

    2011-01-01

    The purpose of this study was to evaluate the effect of poly(lactide-co-glycolic acid) delayed-release microspheres, which were prepared using glial cell line-derived neurotrophic factor (GDNF), on the delayed-release, controllability, and protection of GDNF activity. The present study is the first to combine chondroitinase ABC, GDNF, and Nogo A antibody delayed-release microspheres for the treatment of spinal cord injury. Results show that the combined therapy of chondroitinase ABC,GDNF, and Nogo A antibody microspheres can increase the immunoreaction of neurofilament 200in the injured spinal cord, and this therapeutic effect was better than chondroitinase ABC, GDNF, or Nogo A antibody microspheres administered singularly.

  1. The Influences of Pre-testing Reviews and Delays on Differentialassociative Processing versus A Condition in which Students chose their Learning Strategy.

    Science.gov (United States)

    Hannon, Brenda

    2013-10-01

    Recent studies show that a new strategy called differential-associative processing is effective for learning related concepts. However our knowledge about differential-associative processing is still limited. Therefore the goals of the present study are to assess the duration of knowledge that is acquired from using differential-associative processing, to determine whether the efficacy of differential-associative processing changes with the addition of a 10-minute pre-testing review, and to compare differential-associate processing to two conditions in which students select their own learning strategy. The results revealed that differential-associative processing was a better strategy for learning related concepts than were either of the two comparison conditions. They also revealed that a 10-minute pre-testing review had a positive additive influence on differential-associative processing. Finally, although the knowledge acquired from using differential-associative processing declined with an increase in delay between learning and testing, this decline was equivalent to the decline observed in both comparison conditions.

  2. Delay-dependent Conditions for Absolute Stability of Lurie Control Systems with Time-varying Delay%具有时变时滞的Lurie系统绝对稳定性的时滞相关条件

    Institute of Scientific and Technical Information of China (English)

    何勇; 吴敏

    2005-01-01

    Some delay-dependent absolute stability criteria for Lurie control systems with timevarying delay are derived, in which some free-weighting matrices are used to express the relationships between the terms in the Leibniz-Newton formula. These criteria are based on linear matrix inequality(LMI) such that the upper bound of time-delay guaranteeing the absolute stability and the free-weighting matrices can be obtained through the solutions of the LMI. Moreover, the Lyapunov functional constructed by the solutions of these LMIs is adopted to guarantee the absolute stability of the systems. Finally, some examples axe provided to demonstrate the effectiveness of the proposed methods.

  3. determining treatment levels of comorbid psychiatric conditions in ...

    African Journals Online (AJOL)

    SITWALA COMPUTERS

    Key Words: Psychiatric comorbidity, detection, treatment. ABSTRACT. Background: ... anxiety disorders, occur relatively frequently in patients. 1 ... The psychiatric and cognitive disturbances .... behaviour which was found in 9.1% of the population. Table 4: .... studies suggest mortality is highest in the early years of diagnosis ...

  4. Adapting high-rate anaerobic treatment to Middle East conditions

    NARCIS (Netherlands)

    Mahmoud, N.A.; Zeeman, G.; Lier, van J.B.

    2008-01-01

    High-rate anaerobic technologies offer cost-effective solutions for sewage treatment in the Middle East and Palestine in particular. The sewage characteristics in Palestine are quite different from the values elsewhere and show solids contents of more than 1000 mg chemical oxygen demand (COD)ss/L

  5. 针对准单边Lipschitz不确定非线性时滞系统的稳定性分析%Stability Analysis for Uncertain Nonlinear Time-delay Systems with Quasi-one-sided Lipschitz Condition

    Institute of Scientific and Technical Information of China (English)

    祝乔; 胡广大

    2009-01-01

    This paper deals with the robust stability of a class of uncertain nonlinear time-delay systems. A quasi-one-sided Lipschitz condition is introduced to estimate the in-fluenee of nonlinear vector function on the stability analy-sis. Delay-independent/delay-dependent stability criteria for-mulated in the form of linear matrix inequalities are pre-sented. Furthermore, these stability criteria are available even if the system parameter is unstable, because the unneces-sary positive quasi-one-sided Lipschitz constant matrix includes much useful information of the nonlinear part. Numerical ex-amplee show the advantage of the results obtained in this paper.

  6. 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...

  7. Failure of α-MSH to delay extinction of conditioned avoidance behavior in rats with lesions in the parafascicular nuclei of the thalamus

    NARCIS (Netherlands)

    Bohus, B.; Wied, D. de

    1967-01-01

    Bilateral lesions in the thalamic parafascicular area facilitate the rate of extinction of a conditioned avoidance response without affecting avoidance learning. Treatment with long-acting α-MSH during extinction failed to affect the rate of extinction of the avoidance response. Since this peptide d

  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. Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Joung-Ho Moon, M.S.

    2016-09-01

    Full Text Available Disturbances in circadian rhythms have been suggested as a possible cause of bipolar disorder (BD. Included in this study were 31 mood episodes of 26 BD patients, and 18 controls. Circadian rhythms of BD were evaluated at admission, at 2-week intervals during hospitalization, and at discharge. All participants wore wrist actigraphs during the studies. Saliva and buccal cells were obtained at 8:00, 11:00, 15:00, 19:00, and 23:00 for two consecutive days. Collected saliva and buccal cells were used for analysis of the cortisol and gene circadian rhythm, respectively. Circadian rhythms had different phases during acute mood episodes of BD compared to recovered states. In 23 acute manic episodes, circadian phases were ~7 hour advanced (equivalent to ~17 hour delayed. Phases of 21 out of these 23 cases returned to normal by ~7 hour delay along with treatment, but two out of 23 cases returned to normal by ~17 hour advance. In three cases of mixed manic episodes, the phases were ~6–7 hour delayed. For five cases of depressive episodes, circadian rhythms phases were ~4–5 hour delayed. After treatment, circadian phases resembled those of healthy controls. Circadian misalignment due to circadian rhythm phase shifts might be a pathophysiological mechanism of BD.

  10. Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder.

    Science.gov (United States)

    Moon, Joung-Ho; Cho, Chul-Hyun; Son, Gi Hoon; Geum, Dongho; Chung, Sooyoung; Kim, Hyun; Kang, Seung-Gul; Park, Young-Min; Yoon, Ho-Kyoung; Kim, Leen; Jee, Hee-Jung; An, Hyonggin; Kripke, Daniel F; Lee, Heon-Jeong

    2016-09-01

    Disturbances in circadian rhythms have been suggested as a possible cause of bipolar disorder (BD). Included in this study were 31 mood episodes of 26 BD patients, and 18 controls. Circadian rhythms of BD were evaluated at admission, at 2-week intervals during hospitalization, and at discharge. All participants wore wrist actigraphs during the studies. Saliva and buccal cells were obtained at 8:00, 11:00, 15:00, 19:00, and 23:00 for two consecutive days. Collected saliva and buccal cells were used for analysis of the cortisol and gene circadian rhythm, respectively. Circadian rhythms had different phases during acute mood episodes of BD compared to recovered states. In 23 acute manic episodes, circadian phases were ~7hour advanced (equivalent to ~17hour delayed). Phases of 21 out of these 23 cases returned to normal by ~7hour delay along with treatment, but two out of 23 cases returned to normal by ~17hour advance. In three cases of mixed manic episodes, the phases were ~6-7hour delayed. For five cases of depressive episodes, circadian rhythms phases were ~4-5hour delayed. After treatment, circadian phases resembled those of healthy controls. Circadian misalignment due to circadian rhythm phase shifts might be a pathophysiological mechanism of BD.

  11. On the Separability of Ill-Conditioned Convolutive Mixtures of Sources with Small Time Delay%微延迟病态卷积混叠盲源分离的可分性研究

    Institute of Scientific and Technical Information of China (English)

    刘海林; 谢胜利; 章晋龙

    2003-01-01

    The paper researches separability of blind sources of convolutive mixtures on the assumption that the num-ber of sensors is less than that of sources. When time delay is small, the necessary condition of separability of the ill-conditioned convolutive mixtures is given through transforming blind sources of convolutive mixtures into that of lin-ear mixtures.

  12. 小剂量糖皮质激素治疗脑出血迟发性脑水肿临床分析%Clinical analysis of low dose glucocorticoidin treatment of delayed cerebral edema after cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    林茵

    2014-01-01

    ObjectiveTo observe the clinical efifcacy of low dose glucocorticoidin treatment of delayed cerebral edema after cerebral hemorrhage.MethodsRetrospective analysis was performed on the clinical data of 13 patients, who were of delayed cerebral edema after cerebral hemorrhage and treated with small-dosed glucocorticoid. The efficacy of glucocorticoid treatment on these patients was probed.ResultsAfter treatment, the condition of patients was improved in various degrees; the activities of daily living were signiifcantly improved. Ultimately, all the 13 patientswere discharged with better health condition while three of them were improved dramatically. ConclusionsLow dose glucocorticoid is effective in treating delayed cerebral edema after cerebral hemorrhage with no serious side effects.%目的:观察糖皮质激素对脑出血迟发性脑水肿的治疗效果。方法回顾分析13例经小剂量糖皮质激素治疗的脑出血后迟发性脑水肿患者的临床资料,探讨糖皮质激素治疗对迟发性脑水肿的效用。结果治疗后脑出血迟发性脑水肿患者病情不同程度好转,生活能力明显改善,最终13例均好转出院,其中3例症状明显改善。结论小剂量糖皮质激素对于脑出血迟发性脑水肿有明显的治疗作用,无严重不良反应。

  13. Conditions and technologies of biological wastewater treatment in Hungary.

    Science.gov (United States)

    Tardy, G M; Bakos, V; Jobbágy, A

    2012-01-01

    A survey has been carried out involving 55 Hungarian wastewater treatment plants in order to evaluate the wastewater quality, the applied technologies and the resultant problems. Characteristically the treatment temperature is very wide-ranging from less than 10 °C to higher than 26 °C. Influent quality proved to be very variable regarding both the organic matter (typical COD concentration range 600-1,200 mg l(-1)) and the nitrogen content (typical NH(4)-N concentration range 40-80 mg l(-1)). As a consequence, significant differences have been found in the carbon availability for denitrification from site to site. Forty two percent of the influents proved to lack an appropriate carbon source. As a consequence of carbon deficiency as well as technologies designed and/or operated with non-efficient denitrification, rising sludge in the secondary clarifiers typically occurs especially in summer. In case studies, application of intermittent aeration, low DO reactors, biofilters and anammox processes have been evaluated, as different biological nitrogen removal technologies. With low carbon source availability, favoring denitrification over enhanced biological phosphorus removal has led to an improved nitrogen removal.

  14. Delay-independent stabilization for teleoperation with time varying delay

    OpenAIRE

    Fujita, Hiroyuki; Namerikawa, Toru

    2009-01-01

    This paper deals with the stability for nonlinear teleoperation with time varying communication delays. The proposed method is passivity-based controllers with time varying gains which depend on the rate of change of time varying delay. In our proposed method, stability condition is independent of the magnitude of the communication delay and the damping of the system. The delay-independent stability is shown via Lyapunov stability methods. Several experimental results show the effectiveness o...

  15. 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 BACKGROUND: 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. METHODS: 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. RESULTS: 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. DISCUSSION: 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

  16. Delayed diagnosis of narcolepsy: characterization and impact.

    Science.gov (United States)

    Thorpy, Michael J; Krieger, Ana C

    2014-05-01

    Narcolepsy, a chronic neurologic condition resulting from dysregulation of the sleep-wake cycle, usually has an onset at an early age. However, a long delay until diagnosis has been consistently reported in the literature across countries and several publications have focused on characterizing this delay. Most studies report a mean delay to diagnosis of up to 15 years, with individual cases of >60 years, although a trend over time toward a shorter diagnostic delay has been suggested. While variables associated with this delay have been identified, a lack of symptom recognition resulting in misdiagnosis prior to reaching the narcolepsy diagnosis is the likely underlying reason. This lack of symptom recognition is especially relevant considering the high comorbidity burden that has been shown in patients with narcolepsy as some disorders manifest with symptoms that overlap with narcolepsy. A consequence of delayed diagnosis is delayed treatment, which affects the burden of disease. Substantial detrimental effects on health-care resource utilization, employment, and quality of life have been described after narcolepsy onset and prior to the diagnosis of narcolepsy. This review highlights the importance of closing the diagnostic gap by expanding awareness of narcolepsy and its symptoms.

  17. Flucloxacillin in the treatment of infectious conditions in children.

    Science.gov (United States)

    Price, J D; Harding, J W

    1975-01-01

    A multi-centre study was carried out in 107 children with skin and soft-tissue infections (46) or upper respiratory tract infections (61) to assess the effectivness of flucloxacillin (125 mg. q.d.s. for 5 days). Swabs were taken from the lesion sites before and after treatment for bacteriological assessment and sensitivity of the isolated organisms. The clinical success rate achieved was 93% in skin and soft-tissue infections and 94% in upper respiratory tract infections and these results correlate closely with the bacteriological findings. The main causative organism in the skin and soft-tissue infections was Staph. aureus which was resistant to benzyl penicillin and to ampicillin in all but 2 cases. All strains proved sensitive to flucloxacillin. Minimal side-effects were reported and the syrup presentation was well accepted.

  18. Effect of Transcutaneous Electrical Nerve Stimulation, Cold, and a Combination Treatment on Pain, Decreased Range of Motion, and Strength Loss Associated with Delayed Onset Muscle Soreness

    OpenAIRE

    Denegar, Craig R.; Perrin, David H.

    1992-01-01

    Athletic trainers have a variety of therapeutic agents at their disposal to treat musculoskeletal pain, but little objective evidence exists of the efficacy of the modalities they use. In this study, delayed onset muscle soreness (DOMS) served as a model for musculoskeletal injury in order to: (1) compare the changes in perceived pain, elbow extension range of motion, and strength loss in subjects experiencing DOMS in the elbow flexor muscle group following a single treatment with either tran...

  19. Dosimetry checking of treatment in stereotactic conditions by portal imager; Verification dosimetrique des traitements en conditions stereotaxiques par imageur portal

    Energy Technology Data Exchange (ETDEWEB)

    Santoro, L.; Ailleres, N.; Simeon, S.; Fenoglietto, P. [IRCM, institut de Recherche en Cancerologie, 34 - Montpellier (France)

    2009-10-15

    Objective: The irradiations in stereotactic conditions require specific tools of measurements for the dosimetry software configuration. The spatial resolution of these systems is the crucial point of this modeling and it is always difficult to make this measurement for the edge beams <1.5 cm. The checking of treatment plans is also very important because of the single dose irradiation of the target volume and if the irradiation geometry parameters are checked on the device before the patient installation, it is often difficult for temporal reasons to check and validate the dose distribution in a phantom. A fast validation process of the treatment supply is studied in our institution. Conclusion: A checking of the planned dose distribution can be realised before the patient positioning in the case of treatment in stereotactic conditions. A study realised on less than 3 cm beams is under way. (N.C.)

  20. Patient Reported Delays in Seeking Treatment for Tuberculosis among Adult and Pediatric TB Patients and TB Patients Co-Infected with HIV in Lima, Peru: A Qualitative Study.

    Science.gov (United States)

    Paz-Soldan, Valerie A; Alban, Rebecca E; Dimos Jones, Christy; Powell, Amy R; Oberhelman, Richard A

    2014-01-01

    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. The objective was to understand the complex factors that can impact TB patient health seeking behavior. 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). 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 TB symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention. 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.

  1. [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.

  2. Economic impact of delays in listing decisions by provincial drug plans after a positive Common Drug Review recommendation: the case of a smoking-cessation treatment.

    Science.gov (United States)

    Paradis, Pierre Emmanuel; Mishagina, Natalia; Carter, Valérie; Raymond, Vincent

    2012-01-01

    Although varenicline (Champix), a smoking-cessation treatment, was recommended for listing by the Common Drug Review (CDR) in 2007, only one CDR-participating drug insurance plan listed it in March 2011 (Saskatchewan). This study estimated the economic impact of delays in the public listing of varenicline in Canada. Using statistical data and peer-reviewed research, social costs and benefits of reimbursing varenicline were estimated. Flows of attempted and successful quitters were projected over a five-year period for three scenarios: immediate listing (2007), one- to four-year listing delays, and no reimbursement. Benefits of public reimbursement of varenicline would have been greatest in the first year ($271 million) and then decreased due to the erosion in smoking prevalence. The current three-year listing delay prevented a projected 17,729 current smokers from quitting, translating into a projected additional lifetime social burden of $700 million. The sizeable opportunity cost of delaying varenicline reimbursement implies broader economic issues for policy makers.

  3. 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.

  4. Delayed eruption of maxillary permanent central incisors as a consequence of mesiodens: a surgical re-treatment approach.

    Science.gov (United States)

    Moraes, Renata Simões; Farinhas, João Alfredo; Gleiser, Rogerio; Primo, Laura Guimarães

    2004-01-01

    The presence of mesiodens can cause some clinical problems. This paper reports a case of delayed eruption of permanent central incisors in a nine-year-old male as a consequence of a mesiodens and three surgical approaches prior to the eruption of incisors, which occurred after the third surgery when the crown was exposed and submitted to a gentle luxation.

  5. Effects of Immediate and Delayed Loading on the Outcomes of All-on-4 Treatment: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Hossein Najafi

    2017-01-01

    Full Text Available Objectives: The purpose of this study was to compare the outcomes of immediate and delayed rehabilitation of edentulous jaws by means of two straight and two tilted implants after one year of function.Materials and Methods: Thirty consecutive patients (16 males, 14 females were enrolled in this study. Two anterior straight and two posterior tilted implants were placed in each patient. According to the implant insertion torque and the need for bone grafting, implants were loaded immediately (at 72 hours or delayed (after four months using a fixed metal resin prosthesis. Results: One axial implant failed in the delayed group after one year of loading, resulting in cumulative implant survival rate of 99.3%. The mean marginal bone loss was 0.84mm. No significant difference was found between axial and tilted implants in the two groups (P>0.05Conclusions: Based on the results, immediate or delayed fabrication of final prosthesis on two tilted and two axial implants did not result in significant differences in survival rates or marginal bone loss.Keywords: Dental Implants; Immediate Dental Implant Loading; Prospective Studies

  6. APPLICATION OF INDIVIDUAL WASTEWATER TREATMENT PLANTS IN A DIFFICULT SOIL AND WATER CONDITIONS

    Directory of Open Access Journals (Sweden)

    Beata Karolinczak

    2014-11-01

    Full Text Available The article presents technological and economic aspects of application of individual wastewater treatment plans in difficult soil and water conditions which include impermeable soils and a high level of groundwater. Technical analysis reviews available information around possible technologies applicable to sewage treatment and its discharge. Economic analysis highlights additional outlays that are associated with a construction of the treatment plant in such difficult conditions. In summary, a cost-effectiveness analysis is carried out.

  7. 38 CFR 3.381 - Service connection of dental conditions for treatment purposes.

    Science.gov (United States)

    2010-07-01

    ... will be considered. Treatment during service, including filling or extraction of a tooth, or placement... dental conditions for treatment purposes. 3.381 Section 3.381 Pensions, Bonuses, and Veterans' Relief... treatment purposes. (a) Treatable carious teeth, replaceable missing teeth, dental or alveolar...

  8. Does empirical treatment of community-acquired pneumonia with fluoroquinolones delay tuberculosis treatment and result in fluoroquinolone resistance in Mycobacterium tuberculosis? Controversies and solutions.

    Science.gov (United States)

    Shen, Gwan-Han; Tsao, Thomas Chang-Yao; Kao, Shang-Jyh; Lee, Jen-Jyh; Chen, Yen-Hsu; Hsieh, Wei-Chung; Hsu, Gwo-Jong; Hsu, Yen-Tao; Huang, Ching-Tai; Lau, Yeu-Jun; Tsao, Shih-Ming; Hsueh, Po-Ren

    2012-03-01

    The role of fluoroquinolones (FQs) as empirical therapy for community-acquired pneumonia (CAP) remains controversial in countries with high tuberculosis (TB) endemicity owing to the possibility of delayed TB diagnosis and treatment and the emergence of FQ resistance in Mycobacterium tuberculosis. Although the rates of macrolide-resistant Streptococcus pneumoniae and amoxicillin/clavulanic acid-resistant Haemophilus influenzae have risen to alarming levels, the rates of respiratory FQ (RFQ) resistance amongst these isolates remain relatively low. It is reported that ca. 1-7% of CAP cases are re-diagnosed as pulmonary TB in Asian countries. A longer duration (≥ 7 days) of symptoms, a history of night sweats, lack of fever (> 38 °C), infection involving the upper lobe, presence of cavitary infiltrates, opacity in the lower lung without the presence of air, low total white blood cell count and the presence of lymphopenia are predictive of pulmonary TB. Amongst patients with CAP who reside in TB-endemic countries who are suspected of having TB, imaging studies as well as aggressive microbiological investigations need to be performed early on. Previous exposure to a FQ for >10 days in patients with TB is associated with the emergence of FQ-resistant M. tuberculosis isolates. However, rates of M. tuberculosis isolates with FQ resistance are significantly higher amongst multidrug-resistant M. tuberculosis isolates than amongst susceptible isolates. Consequently, in Taiwan and also in other countries with TB endemicity, a short-course (5-day) regimen of a RFQ is still recommended for empirical therapy for CAP patients if the patient is at low risk for TB. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  9. The Effects of Ice Massage, Ice Massage with Exercise, and Exercise on the Prevention and Treatment of Delayed Onset Muscle Soreness

    Science.gov (United States)

    Isabell, William Kirk; Durrant, Earlene; Myrer, William; Anderson, Shauna

    1992-01-01

    We investigated the effects of ice massage, ice massage with exercise, and exercise on the prevention and treatment of delayed onset muscle soreness (DOMS). Twenty-two subjects were randomly assigned to one of four groups. Preexercise measures were recorded for range of motion (ROM), strength, perceived soreness, and serum creatine kinase (CK) levels. Subjects performed up to 300 concentric/eccentric contractions of the elbow flexors with 90% of their 10 repetition maximum to induce muscle soreness. Dependent variables were assessed at 2, 4, 6, 24, 48, 72, 96, and 120 hours postexercise. Significant differences occurred in all variables with respect to time (ANOVA(p<.05)). However, no significant mode of treatment, or mode of treatment/assessment time interaction was present. Decreases in range of motion and flexion strength correspond with increases in perceived soreness. The nonsignificant mode of treatment/assessment time interaction suggests that the use of ice massage, ice massage with exercise, or exercise alone is not effective in significantly reducing the symptoms of delayed onset muscle soreness. In fact, though not statistically significant, the pattern of the data suggested the use of ice in the treatment of DOMS may be contraindicated. Further investigation is recommended. PMID:16558163

  10. The perspective of private practitioners regarding tuberculosis case detection and treatment delay in Amhara Region, Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Yimer Solomon A

    2011-08-01

    Full Text Available Abstract Background Engaging all health care providers in tuberculosis (TB control has been incorporated as an essential component of World Health Organization's Stop TB Strategy and the Stop TB Partnership's global plan 2006-2015. Ethiopia has a growing private health sector. The objective of the present study was to investigate the role of private practitioners (PPs in TB case detection and assess their perspectives on TB treatment delay in Amhara Region, Ethiopia. Results A cross-sectional study among 112 PPs selected from private health facilities (PHF in the region was conducted. The study was carried out between May and August 2008 and data was collected using a semi-structured questionnaire. Group differences were analyzed using one-way Anova test and a p-value of In this study, PPs saw a median of 12 TB suspects and 1.5 patients a week. The mean number of TB suspects and patients seen varied significantly among the different professions with p Conclusion PPs manage a substantial number of TB suspects and patients in Amhara Region, Ethiopia. The GHF delay observed among TB patients referred by PPs to GHF is unnecessary. Expanding PPM-DOTS in the region and improving the quality of TB care at both government and private health facilities reduces treatment delay and increases TB case detection.

  11. Delayed Endoluminal Vacuum Therapy for Rectal Anastomotic Leaks after Rectal Resection in a Swine Model: A New Treatment Option

    OpenAIRE

    Rosenberger, Laura H; Shada, Amber; Ritter, Lane A.; Mauro, David M.; Mentrikoski, Mark J.; Feldman, Sanford H.; Kleiner, Daniel E.

    2014-01-01

    Anastomotic leaks are a dreaded surgical complication following colorectal operations. Creation of a temporary proximal diverting ileostomy is used in high‐risk anastomoses, however, additional surgical risk is accumulated with its creation and reversal. Endoluminal vacuum therapy has been shown to seal anastomotic defects in the prophylactic setting in a pig model and we hypothesized it could be utilized in a delayed fashion to rescue subjects with an active anastomotic leak. Yorkshire pigs ...

  12. Pulsed electromagnetic fields for the treatment of tibial delayed unions and nonunions. A prospective clinical study and review of the literature

    Directory of Open Access Journals (Sweden)

    Assiotis Aggelos

    2012-06-01

    Full Text Available Abstract Background Pulsed electromagnetic fields (PEMF stimulation for the treatment of bone nonunion or delayed union have been in use for several years, but on a limited basis. The aim of this study was to assess the overall efficacy of the method in tibial delayed unions and nonunions and identify factors that could affect the final outcome. Methods We prospectively reviewed 44 patients (27 men with a mean age of 49.6 ± 18.4 years that received PEMF therapy due to tibial shaft delayed union or nonunion. In all cases, fracture gap was less than 1 cm and infection or soft tissue defects were absent. Results Fracture union was confirmed in 34 cases (77.3%. No relationship was found between union rate and age (p = 0.819, fracture side (left or right (p = 0.734, fracture type (simple or comminuted, open or closed (p = 0.111, smoking (p = 0.245, diabetes (p = 0.68 and initial treatment method applied (plates, nail, plaster of paris (p = 0.395. The time of treatment onset didn’t affect the incidence of fracture healing (p = 0.841. Although statistical significance was not demonstrated, longer treatment duration showed a trend of increased probability of union (p = 0.081. Conclusion PEMF stimulation is an effective non-invasive method for addressing non-infected tibial union abnormalities. Its success is not associated with specific fracture or patient related variables and it couldn’t be clearly considered a time-dependent phenomenon.

  13. Conditional loss of ErbB3 delays mammary gland hyperplasia induced by mutant PIK3CA without affecting mammary tumor latency, gene expression, or signaling.

    Science.gov (United States)

    Young, Christian D; Pfefferle, Adam D; Owens, Philip; Kuba, María G; Rexer, Brent N; Balko, Justin M; Sánchez, Violeta; Cheng, Hailing; Perou, Charles M; Zhao, Jean J; Cook, Rebecca S; Arteaga, Carlos L

    2013-07-01

    Mutations in PIK3CA, the gene encoding the p110α catalytic subunit of phosphoinositide 3-kinase (PI3K), have been shown to transform mammary epithelial cells (MEC). Studies suggest this transforming activity requires binding of mutant p110α via p85 to phosphorylated YXXM motifs in activated receptor tyrosine kinases (RTK) or adaptors. Using transgenic mice, we examined if ErbB3, a potent activator of PI3K, is required for mutant PIK3CA-mediated transformation of MECs. Conditional loss of ErbB3 in mammary epithelium resulted in a delay of PIK3CA(H1047R)-dependent mammary gland hyperplasia, but tumor latency, gene expression, and PI3K signaling were unaffected. In ErbB3-deficient tumors, mutant PI3K remained associated with several tyrosyl phosphoproteins, potentially explaining the dispensability of ErbB3 for tumorigenicity and PI3K activity. Similarly, inhibition of ErbB RTKs with lapatinib did not affect PI3K signaling in PIK3CA(H1047R)-expressing tumors. However, the p110α-specific inhibitor BYL719 in combination with lapatinib impaired mammary tumor growth and PI3K signaling more potently than BYL719 alone. Furthermore, coinhibition of p110α and ErbB3 potently suppressed proliferation and PI3K signaling in human breast cancer cells harboring PIK3CA(H1047R). These data suggest that PIK3CA(H1047R)-driven tumor growth and PI3K signaling can occur independently of ErbB RTKs. However, simultaneous blockade of p110α and ErbB RTKs results in superior inhibition of PI3K and mammary tumor growth, suggesting a rational therapeutic combination against breast cancers harboring PIK3CA activating mutations.

  14. Global distribution of polymorphisms associated with delayed Plasmodium falciparum parasite clearance following artemisinin treatment: genotyping of archive blood samples.

    Science.gov (United States)

    Murai, Kenji; Culleton, Richard; Hisaoka, Teruhiko; Endo, Hiroyoshi; Mita, Toshihiro

    2015-06-01

    The recent emergence and spread of artemisinin-resistant Plasmodium falciparum isolates is a growing concern for global malaria-control efforts. A recent genome-wide analysis study identified two SNPs at genomic positions MAL10-688956 and MAL13-1718319, which are linked to delayed clearance of parasites following artemisinin combination therapy (ACT). It is expected that continuous artemisinin pressure will affect the distribution of these SNPs. Here, we investigate the worldwide distribution of these SNPs using a large number of archived samples in order to generate baseline data from the period before the emergence of ACT resistance. The presence of SNPs in MAL10-688956 and MAL13-1718319 was assessed by nested PCR RFLP and direct DNA sequencing using 653 global P. falciparum samples obtained before the reported emergence of ACT resistance. SNPs at MAL10-688956 and MAL13-1718319 associated with delayed parasite clearance following ACT administration were observed in 8% and 3% of parasites, respectively, mostly in Cambodia and Thailand. Parasites harbouring both SNPs were found in only eight (1%) isolates, all of which were from Cambodia and Thailand. Linkage disequilibrium was detected between MAL10-688956 and MAL13-1718319, suggesting that this SNP combination may have been selected by ACT drug pressure. Neither of the SNPs associated with delayed parasite clearance were observed in samples from Africa or South America. Baseline information of the geographical difference of MAL10-688956 and MAL13-1718319 SNPs provides a solid basis for assessing whether these SNPs are selected by artemisinin-based combination therapies.

  15. Cognitive Behavioral Therapy as an Adjunct Treatment to Light Therapy for Delayed Sleep Phase Disorder in Young Adults: A Randomized Controlled Feasibility Study.

    Science.gov (United States)

    Danielsson, Katarina; Jansson-Fröjmark, Markus; Broman, Jan-Erik; Markström, Agneta

    2016-01-01

    Delayed sleep phase disorder (DSPD) is common among young people, but there is still no evidence-based treatment available. In the present study, the feasibility of cognitive behavioral therapy (CBT) was evaluated as an additive treatment to light therapy (LT) in DSPD. A randomized controlled trial with participants aged 16 to 26 years received LT for two weeks followed by either four weeks of CBT or no treatment (NT). LT advanced sleep-wake rhythm in both groups. Comparing LT+CBT with LT+NT, no significant group differences were observed in the primary endpoints. Although anxiety and depression scores were low at pretreatment, they decreased significantly more in LT+CBT compared to LT+NT. The results are discussed and some suggestions are given for further studies.

  16. 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…

  17. Biological treatment of refinery spent caustics under halo-alkaline conditions

    NARCIS (Netherlands)

    Graaff, de M.; Bijmans, M.F.M.; Abbas, B.; Euverink, G.J.W.; Muyzer, G.; Janssen, A.J.H.

    2011-01-01

    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

  18. 展宽段排队溢出状态下区段延误模型研究%Study on Section Delay Model under Widening Zone Queue Overflow Condition

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    为研究过饱和信号交叉口排队溢出状态下单周期通过展宽段车辆的区段延误模型,首先介绍了3大经典延误模型,提出了3大延误模型均未考虑展宽段长度和饱和流率的波动问题.其次,以展宽段为研究对象,在经典延误模型理论的基础上,推导出了展宽段区段延误模型.最后,从公式推导计算和VISSIM仿真两个方面对优化模型和定数理论延误模型进行了对比.结果表明:该模型能够有效地反映展宽段溢出状态下产生的区段延误,可为展宽段的科学设计提供理论基础.%In order to study the section delay model for vehicles passing widening zone in single cycle at oversaturated signalized intersection under queue overflow condition, first, we introduced 3 classical delay models, and put forward none of them considered the widening zone length and the fluctuation of saturation flow rate. Second, taking the widening zone as the research object, we derived the widening zone delay model on the basis of the classical delay model theory. Finally, we compared the optimization model and the fixed number theory based delay model by formula deriving/calculating and VISSIM simulation. The result shows that the proposed model can effectively reflect the section delay in widening zone under queue overflow condition, it can provide a theoretical basis for scientific design of widening zone.

  19. COMMENTS ON ACUPUNCTURE TREATMENT OF DISEASES ACCORDING TO SEASONAL CONDITIONS IN 《THE INTERNAL CLASSIC》

    Institute of Scientific and Technical Information of China (English)

    韩焱晶

    2000-01-01

    In the present paper, the author gives some comments on acupuncture treatment of diseases from 1 ) selecting acupoints based on seasonal conditions; 2) performing reinforcing or reducing needling manipulations in accordance with the waxing and wanning of the moon; 3 ) conducting acupuncture treatment in accordance with the time and the state of disease; and 4) performing acupuncture treatment based on the prosperity or decline of the meridian-qi, which are described in medical book The Yellow Emperor' s Internal Classic.

  20. COMMENTS ON ACUPUNCTURE TREATMENT OF DISEASES ACCORDING TO SEASONAL CONDITIONS IN 《THE INTERNAL CLASSIC》

    Institute of Scientific and Technical Information of China (English)

    HanYanjing

    2000-01-01

    In the present paper, the author gives some comments on acupuncture treatment of diseases from 1) selecting acupoints based on seasonal conditions; 2) performing reinforcing or reducing needling manipulations in accordance with the waxing and wanning of the moon; 3) conducting acupuncture treatment in accordance with the time and the state of disease; and 4 ) performing acupuncture treatment based on the prosperity or decline of the meridian-qi, which are described in medical book The Yellow Emperor' s Internal Classic.

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

    Science.gov (United States)

    2015-10-01

    physically healthy and without mental health conditions  Sleep regulated 1 week prior to entering lab  Restricted from caffeine /alcohol 48 hours prior to...Award Number: W81XWH-11-2-0001 TITLE: “Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD...Annual 3. DATES COVERED (From - To) 1 OCT 2014- 30 SEP 2015 4. TITLE AND SUBTITLE Role of Sleep Deprivation in Fear Conditioning and Extinction

  2. 'No delays achiever'.

    Science.gov (United States)

    2007-05-01

    The latest version of the NHS Institute for Innovation and Improvement's 'no delays achiever', a web based tool created to help NHS organisations achieve the 18-week target for GP referrals to first treatment, is available at www.nodelaysachiever.nhs.uk.

  3. The effect of steroids for the treatment of delayed urological involvement arising from radiation therapy; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Shinichi; Tasaki, Yoshihisa; Fukunaga, Yoshikazu (Oita National Hospital (Japan))

    1992-07-01

    A 55-year-old woman visited our hospital with the chief complaint of high fever. She had received whole pelvic radiation therapy following radical hysterectomy 22 years earlier. Excretory urography revealed bilateral severe hydrone phrosis. Urological examinations were carried out. Urethral stricture and marked small bladder were found. This case was diagnosed as delayed urological involvement arising from radiation therapy complicated with neurogenic bladder. Prednisolone at a total dose of 1,060 mg was administered over 51 days under indwelling catheters to the urethra and to both ureters. The function of the urinary bladder has been maintained at an improved level over a period of 2 months following the removal of the ureteral and urethral catheters. (author).

  4. The delayed-release combination of doxylamine and pyridoxine (Diclegis®/Diclectin ®) for the treatment of nausea and vomiting of pregnancy.

    Science.gov (United States)

    Madjunkova, Svetlana; Maltepe, Caroline; Koren, Gideon

    2014-06-01

    Nausea and vomiting of pregnancy (NVP) affects up to 85 % of all pregnancies. Effective treatment can greatly improve a woman's quality of life, reduce the risk for maternal and fetal complications, and reduce healthcare costs. Unfortunately, many women receive either no pharmacological treatment or are recommended therapies for which fetal safety and efficacy have not been established. First-line treatment of NVP, as recommended by several leading healthcare and professional organizations, is the combination of doxylamine and pyridoxine. This combination, formulated as a 10 mg/10 mg delayed-release tablet, was approved by the US Food and Drug Administration (FDA) for the treatment of NVP in April 2013 under the brand name Diclegis(®), and has been on the Canadian market since 1979, currently under the brand name Diclectin(®). The efficacy of Diclegis(®)/Diclectin(®) has been demonstrated in several clinical trials, and, more importantly, studies on more than 200,000 women exposed to doxylamine and pyridoxine in the first trimester of pregnancy have demonstrated no increased fetal risk for congenital malformations and other adverse pregnancy outcomes. The present review aims to present the scientific evidence on the effectiveness and fetal safety of Diclegis(®)/Diclectin(®) for the treatment of NVP to justify its use as first-line treatment for NVP.

  5. 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.

  6. 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…

  7. 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.

  8. Delayed childbearing.

    Science.gov (United States)

    Francis, H H

    1985-06-01

    In many Western nations, including England and Wales, Sweden, and the US, there is a current trend towards delayed childbearing because of women's pursuit of a career, later marriage, a longer interval between marriage and the 1st birth, and the increasing number of divorcees having children in a 2nd marriage. Wives of men in social classes I and II in England and Wales are, on average, having their 1st child at 27.9 years, 1.6 years later than in 1973, and in social classes IV and V, 1.0 years later than in 1973, at a mean age of 23.7 years. Consequently, the total period fertility rate for British women aged 30-34 years, 35-39 years, and 40 and over increased by 4%, 2%, and 4%, respectively, between 1982-83, in contrast to reductions of 2% and 3%, respectively, in the 15-19 year and 20-24 year age groups, with the 25-29-year-olds remaining static. The average maternal mortality for all parties in England and Wales during 1976-78 was 106/million for adolescents, 70.4/million for 20-24 year-olds, and 1162/million for those aged 40 years and older. The specific obstetric and allied conditions which increase with age are the hypertensive diseases of pregnancy, hemorrhage, pulmonary embolism, abortion, cardiac disease, caesarean section, ruptured uterus, and amniotic fluid embolism. The Swedish Medical Birth Registry of all live births and perinatal deaths since 1973 has shown that the risk of late fetal death is significantly greater in women aged 30-39 years than in those of the same parity and gravidity aged 20-24 years. The risk of giving birth to low birth weight babies preterm and at term and of premature labor are similarly increased. The early neonatal death rate also was increased for primigravidas and nulliparas in the 30-39 year age group but not in parous women. This is, in part, due to the rise in incidence of fetal abnormalities with advancing maternal age because of chromosomal and nonchromosomal anomalies. These also appear to be the cause of the

  9. Small delay approximation of stochastic delay differential equations

    Science.gov (United States)

    Guillouzic, Steve; L'heureux, Ivan; Longtin, André

    1999-04-01

    Delay differential equations evolve in an infinite-dimensional phase space. In this paper, we consider the effect of external fluctuations (noise) on delay differential equations involving one variable, thus leading to univariate stochastic delay differential equations (SDDE's). For small delays, a univariate nondelayed stochastic differential equation approximating such a SDDE is presented. Another approximation, complementary to the first, is also obtained using an average of the SDDE's drift term over the delayed dynamical variable, which defines a conditional average drift. This second approximation is characterized by the fact that the diffusion term is identical to that of the original SDDE. For small delays, our approach yields a steady-state probability density and a conditional average drift which are in close agreement with numerical simulations of the original SDDE. We illustrate this scheme with the delayed linear Langevin equation and a stochastic version of the delayed logistic equation. The technique can be used with any type of noise, and is easily generalized to multiple delays.

  10. Higher Order Inference On A Treatment Effect Under Low Regularity Conditions.

    Science.gov (United States)

    Li, Lingling; Tchetgen, Eric Tchetgen; van der Vaart, Aad; Robins, James M

    2011-07-01

    We describe a novel approach to nonparametric point and interval estimation of a treatment effect in the presence of many continuous confounders. We show the problem can be reduced to that of point and interval estimation of the expected conditional covariance between treatment and response given the confounders. Our estimators are higher order U-statistics. The approach applies equally to the regular case where the expected conditional covariance is root-n estimable and to the irregular case where slower non-parametric rates prevail.

  11. 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.

  12. conditions

    Directory of Open Access Journals (Sweden)

    M. Venkatesulu

    1996-01-01

    Full Text Available Solutions of initial value problems associated with a pair of ordinary differential systems (L1,L2 defined on two adjacent intervals I1 and I2 and satisfying certain interface-spatial conditions at the common end (interface point are studied.

  13. Depression treatment in individuals with cancer: a comparative analysis with cardio-metabolic conditions

    Directory of Open Access Journals (Sweden)

    Pallavi B. Rane

    2013-01-01

    Full Text Available A clear picture of the current state of nationwide depression treatment practices in individuals with cancer and depression does not exist in the United States (US. Therefore, the primary objective of this study was to examine rates of any depression treatment among individuals with cancer and depression in the US. To better understand the relationship between any treatment for depression and presence of cancer, we used a comparison group of individuals with cardio-metabolic conditions owing to the similar challenges faced in management of depression in individuals with these conditions. We used a retrospective cross-sectional design and data from multiple years of the Medical Expenditure Panel Survey, a nationally representative household-survey on healthcare utilization and expenditures. Study sample consisted of adults aged 21 or older with self-reported depression and cancer (n=528 or self-reported depression and diabetes, heart disease or hypertension (n=1643. Depression treatment comprised of any use of antidepres- sants and/or any use of mental health counseling services. Treatment rates for depression were 78.0% and 81.7% among individuals with cancer and cardio-metabolic conditions respectively. After controlling for socio-demographic, access-to-care, number of physician-visits, health-status, and lifestyle risk-factors related variables; individuals with cancer were less likely to report any treatment for depression (Adjusted Odds Ratio=0.67; 95% Confidence Interval=0.49, 0.92 compared to individuals with cardio-metabolic conditions (P≤0.01. Our findings highlight the possibility that competing demands may crowd out treatment for depression and that cancer diagnosis may be a barrier to depression treatment.

  14. Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: personal experience and review

    OpenAIRE

    Levy LL; Emer JJ

    2012-01-01

    Lauren L Levy, Jason J EmerDepartment of Dermatology, Mount Sinai School of Medicine, New York, NY, USABackground: 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 lite...

  15. Delay-Dependent Observers for Uncertain Nonlinear Time-Delay Systems

    Directory of Open Access Journals (Sweden)

    Dongmei Yan

    2013-05-01

    Full Text Available This paper is concerned with the observer design problem for a class of discrete-time uncertain nonlinear systems with time-varying delay. The nonlinearities are assumed to satisfy global Lipschitz conditions which appear in both the state and measurement equations. The uncertainties are assumed to be time-varying but norm-bounded. Two Luenberger-like observers are proposed. One is delay observer and the other is delay-free observer. The delay observer which has an internal time delay is applicable when the time delay is known. The delay-free observer which does not use delayed information is especially applicable when the time delay is not known explicitly. Delay-dependent conditions for the existences of these two observers are derived based on Lyapunpv functional approach. Based on these conditions, the observer gains are obtained using the cone complementarity linearization algorithm. Finally, a numerical example is given to illustrate the effectiveness of the proposed method.

  16. 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

  17. [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

  18. Delayed GM-CSF treatment stimulates axonal regeneration and functional recovery in paraplegic rats via an increased BDNF expression by endogenous macrophages.

    Science.gov (United States)

    Bouhy, Delphine; Malgrange, Brigitte; Multon, Sylvie; Poirrier, Anne-Lise; Scholtes, Félix; Schoenen, Jean; Franzen, Rachelle

    2006-06-01

    Macrophages (monocytes/microglia) could play a critical role in central nervous system repair. We have previously found a synchronism between the regression of spontaneous axonal regeneration and the deactivation of macrophages 3-4 wk after a compression-injury of rat spinal cord. To explore whether reactivation of endogenous macrophages might be beneficial for spinal cord repair, we have studied the effects of granulocyte-macrophage colony stimulating factor (GM-CSF) in the same paraplegia model and in cell cultures. There was a significant, though transient, improvement of locomotor recovery after a single delayed intraperitoneal injection of 2 microg GM-CSF, which also increased significantly the expression of Cr3 and brain-derived neurotrophic factor (BDNF) by macrophages at the lesion site. At longer survival delays, axonal regeneration was significantly enhanced in GM-CSF-treated rats. In vitro, BV2 microglial cells expressed higher levels of BDNF in the presence of GM-CSF and neurons cocultured with microglial cells activated by GM-CSF generated more neurites, an effect blocked by a BDNF antibody. These experiments suggest that GM-CSF could be an interesting treatment option for spinal cord injury and that its beneficial effects might be mediated by BDNF.

  19. Delayed onset muscle soreness: is massage effective?

    Science.gov (United States)

    Nelson, Nicole

    2013-10-01

    Despite the widespread occurrence of delayed onset muscle soreness (DOMS), there is little consensus as to the exact cause or which treatments may be most effective at alleviating symptoms. Greater understanding of DOMS can give sports medicine and fitness professionals an opportunity to help prevent or speed recovery of this performance limiting condition. This article will review the DOMS literature, including the potential role of psychosocial factors and explore studies which involve massage therapy as a treatment modality. Articles from PubMed, MEDLINE, Google Scholar, and references from articles are included in this review. Search words and phrases included delayed onset muscle soreness, repeated bout effect, massage effectiveness, exercise induced muscle damage, and eccentric exercise.

  20. Effect of Transcutaneous Electrical Nerve Stimulation, Cold, and a Combination Treatment on Pain, Decreased Range of Motion, and Strength Loss Associated with Delayed Onset Muscle Soreness

    Science.gov (United States)

    Denegar, Craig R.; Perrin, David H.

    1992-01-01

    Athletic trainers have a variety of therapeutic agents at their disposal to treat musculoskeletal pain, but little objective evidence exists of the efficacy of the modalities they use. In this study, delayed onset muscle soreness (DOMS) served as a model for musculoskeletal injury in order to: (1) compare the changes in perceived pain, elbow extension range of motion, and strength loss in subjects experiencing DOMS in the elbow flexor muscle group following a single treatment with either transcutaneous electrical nerve stimulation (TENS), cold, a combination of TENS and cold, sham TENS, or 20 minutes of rest; (2) compare the effects of combining static stretching with these treatments; and (3) determine if decreased pain is accompanied by a restoration of strength. DOMS was induced in the non-dominant elbow flexor muscle group in 40 females (age = 22.0 ± 4.3 yr) with repeated eccentric contractions. Forty-eight hours following exercise, all subjects presented with pain, decreased elbow extension range of motion, and decreased strength consistent with DOMS. Subjects were randomly assigned to 20-minute treatments followed by static stretching. Cold, TENS, and the combined treatment resulted in significant decreases in perceived pain. Treatments with cold resulted in a significant increase in elbow extension range of motion. Static stretching also significantly reduced perceived pain. Only small, nonsignificant changes in muscle strength were observed following treatment or stretching, regardless of the treatment group. These results suggest that the muscle weakness associated with DOMS is not the result of inhibition caused by pain. The results suggest that these modalities are effective in treating the pain and muscle spasm associated with DOMS, and that decreased pain may not be an accurate indicator of the recovery of muscle strength. PMID:16558162

  1. IMPACT OF DELAYED PREHOSPITAL DIAGNOSIS ON THE RESULTS OF TREATMENT IN PATIENTS WITH GERMINOGENIC TESTICULAR TUMORS IN SAINT PETERSBURG

    Directory of Open Access Journals (Sweden)

    A. K. Nosov

    2014-07-01

    Full Text Available Over the past quarter-century germ cell tumors are one of the few cancers for which highly effective treatment is found. However there is a lack of awareness of young men and general practitioners about germ cell tumors which is often cause of late medical aid appealability and potential diagnostic errors. Reducing the time between patient's medical aid appealability and final diagnosis may contribute to the diagnostics of germ cell tumors in the early stages, reducing the amount of treatment and improving survival rates.

  2. Identifying the microbial communities and operational conditions for optimized wastewater treatment in microbial fuel cells.

    Science.gov (United States)

    Ishii, Shun'ichi; Suzuki, Shino; Norden-Krichmar, Trina M; Wu, Angela; Yamanaka, Yuko; Nealson, Kenneth H; Bretschger, Orianna

    2013-12-01

    Microbial fuel cells (MFCs) are devices that exploit microorganisms as "biocatalysts" to recover energy from organic matter in the form of electricity. MFCs have been explored as possible energy neutral wastewater treatment systems; however, fundamental knowledge is still required about how MFC-associated microbial communities are affected by different operational conditions and can be optimized for accelerated wastewater treatment rates. In this study, we explored how electricity-generating microbial biofilms were established at MFC anodes and responded to three different operational conditions during wastewater treatment: 1) MFC operation using a 750 Ω external resistor (0.3 mA current production); 2) set-potential (SP) operation with the anode electrode potentiostatically controlled to +100 mV vs SHE (4.0 mA current production); and 3) open circuit (OC) operation (zero current generation). For all reactors, primary clarifier effluent collected from a municipal wastewater plant was used as the sole carbon and microbial source. Batch operation demonstrated nearly complete organic matter consumption after a residence time of 8-12 days for the MFC condition, 4-6 days for the SP condition, and 15-20 days for the OC condition. These results indicate that higher current generation accelerates organic matter degradation during MFC wastewater treatment. The microbial community analysis was conducted for the three reactors using 16S rRNA gene sequencing. Although the inoculated wastewater was dominated by members of Epsilonproteobacteria, Gammaproteobacteria, and Bacteroidetes species, the electricity-generating biofilms in MFC and SP reactors were dominated by Deltaproteobacteria and Bacteroidetes. Within Deltaproteobacteria, phylotypes classified to family Desulfobulbaceae and Geobacteraceae increased significantly under the SP condition with higher current generation; however those phylotypes were not found in the OC reactor. These analyses suggest that species

  3. 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.

  4. Fear less : Individual differences in fear conditioning and their relation to treatment outcome in anxiety disorders

    NARCIS (Netherlands)

    Duits, P.

    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 anxiet

  5. 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

  6. Critical appraisal of clinical prediction rules that aim to optimize treatment selection for musculoskeletal conditions

    NARCIS (Netherlands)

    T.R. Stanton (Tasha); M.J. Hancock (Mark J.); C. Maher (Chris); B.W. Koes (Bart)

    2010-01-01

    textabstractBackground. Clinical prediction rules (CPRs) for treatment selection in musculoskeletal conditions have become increasingly popular. Purpose. The purposes of this review are: (1) to critically appraise studies evaluating CPRs and (2) to consider the clinical utility and stage of developm

  7. 42 CFR 32.111 - Conditions and extent of treatment; charges.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conditions and extent of treatment; charges. 32.111 Section 32.111 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS MEDICAL CARE FOR PERSONS WITH HANSEN'S DISEASE AND OTHER PERSONS IN EMERGENCIES...

  8. Delayed treatment of 6-Bromoindirubin-3'-oxime stimulates neurogenesis and functional recovery after focal ischemic stroke in mice.

    Science.gov (United States)

    Wang, Li-Li; Li, Jimei; Gu, Xiaohuan; Wei, Ling; Yu, Shan Ping

    2017-04-01

    Glycogen synthase kinase 3β (GSK3β) was originally identified as a regulator for glycogen metabolism and is now an important therapeutic target for a variety of brain disorders including neurodegenerative diseases due to it's pivotal role in cellular metabolism, proliferation and differentiation. In the development of stroke therapies focusing on tissue repair and functional recovery, promoting neurogenesis is a main approach in regenerative medicine. In the present investigation, we explored the effects of a GSK3β specific inhibitor, 6-Bromoindirubin-3'-oxime (BIO), on regenerative activities of neuroblasts in the subventricular zone (SVZ) and functional recovery after focal cerebral ischemia. Adult C57/BL mice were subjected to occlusion of distal branches of middle cerebral artery (MCA) supplying the sensorimotor barrel cortex. Three days later, BIO (8.5μg/kg, i.p.) was administered every 2days until sacrificed at 14 or 21days after stroke. The BIO treatment significantly increased generation of neuroblasts labeled with BrdU and BrdU/doublecortin (DCX) in the SVZ. Comparing to vehicle controls, increased number of neuroblasts migrated to the peri-infarct region where they differentiate into mature neurons. Along with the elevated BDNF expression at the peri-infarct area, the number of newly formed neurons was significantly increased. BIO treatment significantly enhanced sensorimotor functional recovery after the focal ischemia. It is suggested that the GSK3 signaling may be a potential therapeutic target for regenerative treatment after ischemic stroke.

  9. Condition of hearing sense and tinnitus before and after the treatment of otosclerosis

    Directory of Open Access Journals (Sweden)

    Terzić Negra

    2010-01-01

    Full Text Available Introduction. Otosclerosis is an osteodystrophy disease of the bony labyrinth of the ear which leads to stapes fixation and to bradyecoia of a conductive type. The microsurgical treatment by the use of a stapes prosthesis provides hearing improvement and a reduction or disappearing of tinnitus. The aim of our study was to determine the hearing condition and tinnitus before and after the treatment of otosclerosis. Material and methods. A hundred patients with otosclerosis, aged 20 to 70, were surgically treated at the Otorhinolaryngology Clinic and the Functional Diagnostics, Military Medical Academy, Belgrade. After the treatment, the audiometric examinations were performed in order to assess the hearing condition and tinnitus was assessed by a questionnaire. The subjective assessment of tinnitus was ranged as present, reduced or absent. Results. Before the treatment, hearing impairment was present in all the patients, while tinnitus was found in 91% of them. One year following the surgical treatment hearing improvement was found in 96% of the patients, and tinnitus cessation in 89% of them. Conclusion. The surgical treatment can result in hearing improvement and cessation or reduction of tinnitus.

  10. The High Risk of Infection With Delayed Treatment of Open Seymour Fractures: Salter-Harris I/II or Juxta-epiphyseal Fractures of the Distal Phalanx With Associated Nailbed Laceration.

    Science.gov (United States)

    Reyes, Bryan A; Ho, Christine A

    2017-06-01

    To describe treatment methods and complication rates of all open Seymour fractures (Salter-Harris I/II or juxta-epiphyseal fractures of the distal phalanx of the hand with associated nailbed laceration) treated at or referred to a pediatric level 1 trauma center over a 10-year time period. We hypothesized that delayed treatment of Seymour fractures results in higher infectious complication rates. We identified all patients treated for open Seymour fractures at the orthopaedic hand clinic at our level 1 pediatric trauma center between August 2002 and December 2012. All charts were reviewed retrospectively. Patients were divided into groups based on timing and completeness of treatment. "Appropriate" treatment was defined as irrigation and debridement, fracture reduction, and antibiotic administration. "Partial" treatment was defined as any type of incomplete treatment; "Acute" treatment was defined as management within 24 hours of the injury; and "Delayed" as having received treatment after 24 hours from the time of injury. Statistical comparisons were performed using the Fisher exact test. A total of 34 patients treated for 35 Seymour fractures met the inclusion criteria. In total, 31% (11/35) received acute, appropriate treatment, 37% (13/35) received acute, partial treatment, and 31% (11/35) received delayed treatment. There were 7 infectious complications: 2 superficial and 5 osteomyelitis. No infections occurred in the acutely, appropriately treated group (infection rate 0%, 0/11), 2 occurred in the acutely, partially treated group (15%, 2/13), and 5 occurred in the delayed treatment group (45%, 5/11). The timing and quality of treatment of open Seymour fractures significantly influences infection rates. This study highlights the importance of timely and appropriate treatment of this seemingly innocuous fracture. Level III-retrospective study, therapeutic.

  11. 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

  12. Chronic medical conditions among jail detainees in residential psychiatric treatment: a latent class analysis.

    Science.gov (United States)

    Swartz, James A

    2011-08-01

    Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma and diabetes, and of infectious diseases such as tuberculosis compared with general population rates. This study explored the pattern of chronic medical conditions in a sample of adult detainees in psychiatric treatment in a large urban jail to develop a clinical profile encompassing the full range of medical conditions. A total of 431 male and female detainees were sampled with certainty from admissions to a residential psychiatric treatment program (overall recruitment rate = 67%). Interviews used the World Mental Health version of the Composite International Diagnostic Interview to assess psychiatric and substance use disorders per DSM-IV criteria and chronic medical conditions. Latent class analysis was conducted using 17 medical conditions as class indicators, yielding a 3-class model composed of: a latent class with a high to intermediate probability of multiple medical conditions (HMC; 12.5% of the sample); an intermediate class with a lower probability of having a smaller number of medical conditions (MMC; 43.2%); and a class with a low probability of any medical condition (44.3%). Those in the HMC class were more likely to report respiratory problems, severe headaches, musculoskeletal pain, hypertension, and arthritis, have greater functional impairment, and have a higher number of co-occurring psychiatric disorders. Being older (50+ years) and female were associated with higher odds of being in the HMC or MMC classes. The policy implications for providing medical care to incarcerates with complex mixtures of medical conditions and psychiatric disorders are considered.

  13. Integration of advanced oxidation processes at mild conditions in wet scrubbers for odourous sulphur compounds treatment.

    Science.gov (United States)

    Vega, Esther; Martin, Maria J; Gonzalez-Olmos, Rafael

    2014-08-01

    The effectiveness of different advanced oxidation processes on the treatment of a multicomponent aqueous solution containing ethyl mercaptan, dimethyl sulphide and dimethyl disulphide (0.5 mg L(-1) of each sulphur compound) was investigated with the objective to assess which one is the most suitable treatment to be coupled in wet scrubbers used in odour treatment facilities. UV/H2O2, Fenton, photo-Fenton and ozone treatments were tested at mild conditions and the oxidation efficiency obtained was compared. The oxidation tests were carried out in magnetically stirred cylindrical quartz reactors using the same molar concentration of oxidants (hydrogen peroxide or ozone). The results show that ozone and photo-Fenton are the most efficient treatments, achieving up to 95% of sulphur compounds oxidation and a mineralisation degree around 70% in 10 min. Furthermore, the total costs of the treatments taking into account the capital and operational costs were also estimated for a comparative purpose. The economic analysis revealed that the Fenton treatment is the most economical option to be integrated in a wet scrubber to remove volatile organic sulphur compounds, as long as there are no space constraints to install the required reactor volume. In the case of reactor volume limitation or retrofitting complexities, the ozone and photo-Fenton treatments should be considered as viable alternatives.

  14. 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.

  15. Optimization of antitumor treatment conditions for transcutaneous CO2 application: An in vivo study.

    Science.gov (United States)

    Ueha, Takeshi; Kawamoto, Teruya; Onishi, Yasuo; Harada, Risa; Minoda, Masaya; Toda, Mitsunori; Hara, Hitomi; Fukase, Naomasa; Kurosaka, Masahiro; Kuroda, Ryosuke; Akisue, Toshihiro; Sakai, Yoshitada

    2017-06-01

    Carbon dioxide (CO2) therapy can be applied to treat a variety of disorders. We previously found that transcutaneous application of CO2 with a hydrogel decreased the tumor volume of several types of tumors and induced apoptosis via the mitochondrial pathway. However, only one condition of treatment intensity has been tested. For widespread application in clinical antitumor therapy, the conditions must be optimized. In the present study, we investigated the relationship between the duration, frequency, and treatment interval of transcutaneous CO2 application and antitumor effects in murine xenograft models. Murine xenograft models of three types of human tumors (breast cancer, osteosarcoma, and malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma) were used to assess the antitumor effects of transcutaneous CO2 application of varying durations, frequencies, and treatment intervals. In all human tumor xenografts, apoptosis was significantly induced by CO2 treatment for ≥10 min, and a significant decrease in tumor volume was observed with CO2 treatments of >5 min. The effect on tumor volume was not dependent on the frequency of CO2 application, i.e., twice or five times per week. However, treatment using 3- and 4-day intervals was more effective at decreasing tumor volume than treatment using 2- and 5-day intervals. The optimal conditions of transcutaneous CO2 application to obtain the best antitumor effect in various tumors were as follows: greater than 10 min per application, twice per week, with 3- and 4-day intervals, and application to the site of the tumor. The results suggest that this novel transcutaneous CO2 application might be useful to treat primary tumors, while mitigating some side effects, and therefore could be safe for clinical trials.

  16. Preparation and Evaluations of Mangiferin-Loaded PLGA Scaffolds for Alveolar Bone Repair Treatment Under the Diabetic Condition.

    Science.gov (United States)

    Li, Hao; Liao, Hongbing; Bao, Chongyun; Xiao, Yu; Wang, Qi

    2017-02-01

    The aim of the present study was to prepare and evaluate a sustained-release mangiferin scaffold for improving alveolar bone defect repair in diabetes. Mangiferin-loaded poly(D,L-lactide-co-glycolide) (PLGA) scaffolds were prepared using a freeze-drying technique with ice particles as the porogen material. The produced scaffolds were examined using a scanning electron microscope (SEM). Drug content and drug release were detected using a spectrophotometer. Degradation behaviors were monitored as a measure of weight loss and examined using SEM. Then, the scaffolds were incubated with rat bone marrow stromal cells under the diabetic condition in vitro, and cell viability was assessed using an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Afterward, the scaffolds were implanted into alveolar bone defects of diabetic rats, and bone repair was examined using hematoxylin and eosin staining. The fabricated scaffolds showed porous structures, with average pore size range from 111.35 to 169.45 μm. A higher PLGA concentration led to decreased average pore size. A lower PLGA concentration or a higher mangiferin concentration resulted in increased drug content. The prepared scaffolds released mangiferin in a sustained manner with relatively low initial burst during 10 weeks. Their degradation ratios gradually increased as degradation proceeded. The mangiferin-loaded scaffolds attenuated cell viability decrease under the diabetic condition in vitro. Moreover, they increased histological scorings of bone regeneration and improved delayed alveolar bone defect healing in diabetic rats. These results suggest that the produced mangiferin-loaded scaffolds may provide a potential approach in the treatment of impaired alveolar bone healing in diabetes.

  17. Traumatic Brain Injury Related to Motor Vehicle Accidents in Guinea: Impact of Treatment Delay, Access to Healthcare, and Patient's Financial Capacity on Length of Hospital Stay and In-hospital Mortality

    Science.gov (United States)

    Béavogui, Kézély; Koïvogui, Akoï; Loua, Tokpagnan Oscar; Baldé, Ramata; Diallo, Boubacar; Diallo, Aminata Rougui; Béavogui, Zézé; Goumou, Koué; Guilavogui, Vamala; Sylla, N’famara; Chughtai, Morad; Qureshi, Adnan I.; Diallo, Aissatou Taran; Camara, Naby Daouda

    2015-01-01

    Background Traumatic brain injury related to road traffic accidents poses a major challenge in resource-poor settings within Guinea. Objective To analyze the impact of treatment delay, access to healthcare, and patient's financial capacity on duration of hospital stay and in-hospital mortality. Methodology Data from patients with traumatic brain injury secondary to motor vehicle accident admitted to a reference hospital (public or private) in Guinea during 2009 were analyzed. The association between various factors (treatment delay, access to healthcare, and patient's financial capacity) and prolonged hospital stay (>21 days) and in-hospital mortality were analyzed using two multivariate logistic regression models. Results The mean (±standard deviation) duration of hospital stay was 8.0 (±8.1) days. The risk of prolonged hospital stay increased by 60% when the time interval between accident and hospital arrival was greater than 12 hours compared with those in whom the time interval was less than 6 hours (adjusted odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.0–2.6, p = 0.03). Compared with patients with low-financial capacity, patients with medium-financial capacity (adjusted OR = 0.6, 95% CI = 0.4–0.8, p = 0.001) and those with high capacity (adjusted OR = 0.6, 95% CI = 0.4–0.9, p = 0.02) were less likely to have a prolonged hospital stay. The risk of in-hospital mortality was 2.6 times higher in patients with time interval between accident and hospital arrival greater than 12 hours compared with those in whom the time interval was less than 6 hours (adjusted OR = 2.6, 95% CI = 1.1–6.2 p = 0.03). In-hospital mortality was not related to patient’s financial capacity. Conclusion Prolonged hospital stay and higher in-hospital mortality was associated with longer time interval between accident and hospital arrival. This delay is attributed to inadequate condition of intercity roads and lack of emergency medical services. PMID:26576213

  18. Effect of ultrasound treatment conditions on Saccharomyces cerevisiae by response surface methodology.

    Science.gov (United States)

    Liu, Junyan; Li, Lin; Zhou, Lizhen; Li, Bing; Xu, Zhenbo

    2017-09-15

    This study aimed to investigate the effect of different ultrasound treatment conditions on the inactivation of Saccharomyces cerevisiae with the application of response surface methodology (RSM). Ultrasound treatment were applied on different concentrations of S. cerevisiae cells with different pH, temperature, ultrasound power, irradiating time, and pulse duty ratio. Cell viability was determined by plate counting method. Response surface methodology was used to analysis the correlation among various factors. Limited with low ultrasound power, lower pH value slightly improved the ultrasound treatment efficiency. Also, higher nonlethal temperature and ultrasound power, longer irradiation time, and lower pulse duty ratio facilitated the inactivation of S. cerevisiae. Cell concentration has no effect on ultrasound efficiency. Ultrasound power played the most important role in the ultrasound irradiation process according to RSM analyses. Information derived from this study may aid in the control of the sublethal injury of S. cerevisiae during ultrasound treatment in food industry. Copyright © 2017. Published by Elsevier Ltd.

  19. Evaluation of enzyme treatment conditions on extraction of anthocyanins from Prunus nepalensis L.

    Science.gov (United States)

    Swer, Tanya L; Chauhan, Komal; Paul, Prodyut K; Mukhim, C

    2016-11-01

    The study was designed to investigate the effect of enzyme assisted extraction of anthocyanins from Sohiong fruit (Prunus nepalensis) under varied time, temperature and treatment conditions. Highest anthocyanins yield was obtained by coupling enzymatic treatment along with solvent extraction simultaneously. Additionally, effect of enzyme type, enzyme concentration, reaction time and temperature were evaluated subsequently in following experiments. Cellulase treatment (10% E/S) for 180min at 4°C exhibited highest yield of 984.40±3.84mg C3G/100gdm which accounts to 14.61% higher yield when compared to conventional method (858.84±6.88mg C3G/100gdm). The study provides an economical alternative for commercial extraction of anthocyanins from Sohiong fruit which can be used as a colourant for various food and other products and owing to its antioxidizing properties can be effective for the prevention and treatment of diseases.

  20. Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations.

    Science.gov (United States)

    Galárraga, Omar; Genberg, Becky L; Martin, Rosemarie A; Barton Laws, M; Wilson, Ira B

    2013-09-01

    We present selected theoretical issues regarding conditional economic incentives (CEI) for HIV treatment adherence. High HIV treatment adherence is essential not only to improve individual health for persons living with HIV, but also to reduce transmission. The incentives literature spans several decades and various disciplines, thus we selectively point out useful concepts from economics, psychology and HIV clinical practice to elucidate the complex interaction between socio-economic issues, psychological perspectives and optimal treatment adherence. Appropriately-implemented CEI can help patients improve their adherence to HIV treatment in the short-term, while the incentives are in place. However, more research is needed to uncover mechanisms that can increase habit formation or maintenance effects in the longer-term. We suggest some potentially fruitful avenues for future research in this area, including the use of concepts from self-determination theory. This general framework may have implications for related research among disadvantaged communities with high rates of HIV/AIDS infection.

  1. Effects of delayed transfer and treatment with oestrogen on the transport of microspheres by the rat oviduct.

    Science.gov (United States)

    Moore, G D; Croxatto, H B

    1988-07-01

    Starch or dextran blue microspheres were transferred microsurgically to the infundibulum of the oviduct on Days 1, 2, or 3 of pregnancy of control and oestradiol-treated rats. The animals were killed a few hours to several days after transfer to assess the number and distribution of ova and microspheres in the tract. After transfer on Day 1 of pregnancy, microspheres and eggs crossed the ampullary-isthmic junction (AIJ) 18 h after ovulation. After transfer on Day 2 of pregnancy, more than 50% of microspheres were retained in the ampulla, indicating that the AIJ changes again 34 h after ovulation. Treatment with oestradiol did not advance the passage of eggs or microspheres across the AIJ but caused accelerated transport through the isthmus as soon as the eggs or microspheres reached this segment. Dextran blue microspheres were seen to move back and forth in the isthmus of control anaesthetized rats at a frequency of 5-6 times/min. Between 7 and 20 h after treatment with oestradiol the frequency of these movements was significantly augmented, indicating that increased frequency of contractions of the smooth muscle of the isthmus precedes and accompanies accelerated transport of ova through this segment.

  2. Pharmacological aversion treatment of alcohol dependence. I. Production and prediction of conditioned alcohol aversion.

    Science.gov (United States)

    Howard, M O

    2001-08-01

    Eighty-two hospitalized alcoholics receiving pharmacological aversion therapy (PAT) over a 10-day treatment interval completed cognitive, behavioral, and psychophysiological measures evaluating conditioned aversion to alcohol. Pre-post assessments provided convergent support for the efficacy of PAT vis-à-vis production of conditioned aversion to alcohol. Positive alcohol-related outcome expectancies were significantly reduced, whereas confidence that drinking could be avoided in various high-risk situations for consumption was increased following PAT. Behavioral and cardiac rate assessments revealed significant changes following PAT that were specific to alcoholic beverages and potentially reflective of conditioned alcohol aversion. Patients with more extensive pretreatment experiences with alcohol-associated nausea and greater involvement in antisocial conduct appeared to be less susceptible to the PAT conditioning protocol.

  3. Musculoskeletal Conditions of the Foot and Ankle: Assessments and Treatment Options

    Science.gov (United States)

    Rao, Smita; Riskowski, Jody; Hannan, Marian T.

    2012-01-01

    Musculoskeletal conditions of the foot and ankle are an important public health challenge due to their increasing incidence combined with their substantial negative impact on patients’ quality of life. Non-pharmacological treatments serve as the first line of treatment and are frequently used for patients with musculoskeletal conditions of the foot and ankle. This review provides a summary of the assessments and non-invasive treatment options based upon available evidence. Recent studies show that individuals with foot and ankle pain have multiple co-existing impairments in alignment, motion, load distribution and muscle performance that may be evident in static and/or dynamic tasks. Additionally, both clinical and epidemiological studies support the inter-dependence between the foot and proximal joints. For instance, aberrant foot structure has been linked to foot osteoarthritis (OA), as well as OA and pain at the knee and hip. Most recently, advances in motion capture technology and plantar load distribution measurement offer opportunities for precise dynamic assessments of the foot and ankle. In individuals with musculoskeletal conditions of the foot and ankle, the chief objectives of treatment are to afford pain relief, restore mechanics (alignment, motion and/or load distribution) and return the patient to their desired level of activity participation. Given that most patients present with multiple impairments, combinational therapies that target foot-specific as well as global impairments have shown promising results. In particular, in individuals with rheumatoid arthritis and other rheumatic diseases, comprehensive rehabilitation strategies including early detection, foot-based interventions (such as orthoses) and wellness-based approaches for physical activity and self-management have been successful. While significant improvements have been made in the last decade to the assessment and treatment of foot and ankle conditions, few randomized clinical

  4. Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: personal experience and review

    Directory of Open Access Journals (Sweden)

    Levy LL

    2012-11-01

    Full Text Available Lauren L Levy, Jason J EmerDepartment of Dermatology, Mount Sinai School of Medicine, New York, NY, USABackground: 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.Methods: A search of the Medline and Scopus databases was performed to identify articles documenting the emotional benefit of cosmetic camouflage.Results: 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.Conclusion: 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.Keywords: facial skin conditions, psychological health, emotional benefits, cosmetic camouflage, makeup

  5. 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.

  6. Delayed traumatic diaphragmatic hernia

    Science.gov (United States)

    Lu, Jing; Wang, Bo; Che, Xiangming; Li, Xuqi; Qiu, Guanglin; He, Shicai; Fan, Lin

    2016-01-01

    Abstract Background: Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. Methods: Clinical data of patients who received treatment for delayed traumatic diaphragmatic hernias in registers of the First Affiliated Hospital of Xi’an Jiaotong University from 1998 to 2014 were analyzed retrospectively. Results: Six patients were included in this study. Left hemidiaphragm was affected in all of them. Most of the patients had a history of traffic accident and 1 a stab-penetrating injury. The interval from injury to developing symptoms ranged from 2 to 11 years (median 5 years). The hernial contents included the stomach, omentum, small intestine, and colon. Diaphragmatic injury was missed in all of them during the initial managements. All patients received operations once the diagnosis of delayed TDH was confirmed, and no postoperative mortality was detected. Conclusions: Delayed TDHs are not common, but can lead to serious consequences once occurred. Early detection of diaphragmatic injuries is crucial. Surgeons should maintain a high suspicion for injuries of the diaphragm in cases with abdominal or lower chest traumas, especially in the initial surgical explorations. We emphasize the need for radiographical follow-up to detect diaphragmatic injuries at an earlier stage. PMID:27512848

  7. 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.

  8. 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.

  9. Delays to the diagnosis of cervical dystonia.

    Science.gov (United States)

    Bertram, Kelly L; Williams, David R

    2016-03-01

    The diagnosis of cervical dystonia (CD) is based on physical examination and is therefore reliant on clinician experience. Due to variability of presenting symptoms it may be misdiagnosed, thus delaying the provision of effective treatment. We sought to determine the average time taken to make a diagnosis of CD in our clinical cohort and explore contributing factors to diagnostic delay. Forty-nine patients with a diagnosis of CD attending a movement disorder specialist for treatment completed a questionnaire regarding symptoms and clinical interactions at onset and diagnosis. The mean time from symptom onset to diagnosis was 6.8 years (range 0-53 years). More than 50% of patients sought physical therapies initially, prior to consulting their general practitioner. Only 40% of patients sought medical advice within the first 6 months of symptom onset and only 10% were given an initial diagnosis of CD. The first referral from the general practitioner was to a specialist other than a neurologist in 31% of patients. Patients were seen by a mean of three doctors (range one to nine) before being given the correct diagnosis of CD. Delay to diagnosis of CD may in part be due to lack of awareness of the condition amongst health care professionals. Improved diagnostic skill appears likely to have had a substantial impact on the delivery of appropriate treatment in this population.

  10. Effect of the heat treatment conditions on the synthesis of Sr-hexaferrite

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Garcia, R., E-mail: rmartinez@fi.uba.ar [Laboratorio de Solidos Amorfos - INTECIN, Facultad de Ingenieria, Universidad de Buenos Aires, Av. Paseo Colon 850, C1063ACV, Buenos Aires (Argentina); Bilovol, V.; Socolovsky, L.M. [Laboratorio de Solidos Amorfos - INTECIN, Facultad de Ingenieria, Universidad de Buenos Aires, Av. Paseo Colon 850, C1063ACV, Buenos Aires (Argentina)

    2012-08-15

    The effect of heat treatment conditions under oxygen atmosphere on the SrFe{sub 12}O{sub 19} synthesis is analyzed. Effect of partial evacuation of decomposition gases of the organometallic precursor on the phase composition of different samples is studied. An accurate structural analysis of samples obtained between 250 Degree-Sign C and 600 Degree-Sign C is reported. From the structural analysis several secondary phases are identified. The amount of secondary phases can be manipulated through the control of the heat treatment conditions, and therefore, this constitutes a methodology to manipulate the composition and the magnetic properties of the obtained nanopowders. The quantitative determination of phases is performed by structural refinement of X-ray powder patterns, using Rietveld analysis. Magnetic study is done by magnetization vs. applied magnetic field at room temperature.

  11. Transplantation of human neural precursor cells in Matrigel scaffolding improves outcome from focal cerebral ischemia after delayed postischemic treatment in rats.

    Science.gov (United States)

    Jin, Kunlin; Mao, Xiaoou; Xie, Lin; Galvan, Veronica; Lai, Bin; Wang, Yaoming; Gorostiza, Olivia; Wang, Xiaomei; Greenberg, David A

    2010-03-01

    Transplantation of neural cells is a potential approach for stroke treatment, but disruption of tissue architecture may limit transplant efficacy. One strategy for enhancing the ability of transplants to restore brain structure and function is to administer cells together with biomaterial scaffolding. We electrocoagulated the distal middle cerebral artery in adult rats and, 3 weeks later, injected one of the following into the infarct cavity: artificial cerebrospinal fluid, Matrigel scaffolding, human embryonic stem cell-derived neuronal precursor cells, scaffolding plus cells, or cells cultured in and administered together with scaffolding. Five weeks after transplantation, the latter two groups showed approximately 50% and approximately 60% reductions, respectively, in infarct cavity volume. Rats given cells cultured in and administered together with scaffolding also showed (1) survival and neuronal differentiation of transplanted cells shown by immunostaining for neuronal marker proteins and cleaved caspase-3, and by patch-clamp recording, 8 weeks after transplantation and (2) improved outcome on tests of sensorimotor and cognitive functions, 4 to 9 weeks after transplantation. These results indicate that transplantation of human neural cells together with biomaterial scaffolding has the potential to improve the outcome from stroke, even when treatment is delayed for several weeks after the ischemic event.

  12. Asynchronous Bounded Expected Delay Networks

    CERN Document Server

    Bakhshi, Rena; Fokkink, Wan; Pang, Jun

    2010-01-01

    The commonly used asynchronous bounded delay (ABD) network models assume a fixed bound on message delay. We propose a probabilistic network model, called asynchronous bounded expected delay (ABE) model. Instead of a strict bound, the ABE model requires only a bound on the expected message delay. While the conditions of ABD networks restrict the set of possible executions, in ABE networks all asynchronous executions are possible, but executions with extremely long delays are less probable. In contrast to ABD networks, ABE networks cannot be synchronised efficiently. At the example of an election algorithm, we show that the minimal assumptions of ABE networks are sufficient for the development of efficient algorithms. For anonymous, unidirectional ABE rings of known size N we devise a probabilistic leader election algorithm having average message and time complexity O(N).

  13. 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.

  14. 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...... 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...... 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....

  15. Functional Muscular Condition Dynamics at Osteoarthrosis Conservative Treatment of Major Joints of Lower Extremities

    Directory of Open Access Journals (Sweden)

    М.S. Sayfutdinov

    2009-06-01

    Full Text Available The method of global electromyography has been used for the evaluation of 231 patients aged from 16 to 74 (43,7±0,8 with bilateral osteoarthrosis of major joints of lower extremities I-III degrees before the course of conservative treatment, immediately after the end of conservative treatment and in three months. Conservative treatment of patients with osteoarthrosis of major joints of lower extremities has been shown to cause restructuring of EMG patterns of maximal voluntary muscle contraction in lower extremities accompanied by decreased asymmetry of activity levels in muscle pairs and less observations of pathologically changed EMG that results in improved functional condition of the locomotor system.

  16. Surface Cleaning or Activation?Control of Surface Condition Prior to Thermo-Chemical Heat Treatment

    Institute of Scientific and Technical Information of China (English)

    Brigitte Haase; Juan Dong; Jens Heinlein

    2004-01-01

    Actual heat treatment processes must face increasing specifications with reference to process quality, safety and results in terms of reproducibility and repeatability. They can be met only if the parts' surface condition is controlled during manufacturing and, especially, prior to the treatment. An electrochemical method for the detection of a steel part's surface condition is presented, together with results, consequences, and mechanisms concerning surface pre-treatment before the thermochemical process. A steel surface's activity or passivity can be detected electrochemically, independently from the chemical background. The selected method was the recording of potential vs. time curves at small constant currents, using a miniaturized electrochemical cell, a (nearly) non-destructive electrolyte and a potentio-galvanostatic setup. The method enables to distinguish types of surface contamination which do not interfere with the thermochemical process, from passive layers which do and must be removed. Whereas some types of passive layers can be removed using conventional cleaning processes and agents, others are so stable that their effects can only be overcome by applying an additional activation pre-treatment, e.g. oxynitriding.

  17. Low strength wastewater treatment under low temperature conditions by a novel sulfur redox action process.

    Science.gov (United States)

    Yamaguchi, T; Bungo, Y; Takahashi, M; Sumino, H; Nagano, A; Araki, N; Imai, T; Yamazaki, S; Harada, H

    2006-01-01

    The objective of this research is to make a novel wastewater treatment process activated by a sulfur-redox cycle action of microbes in low temperature conditions. This action is carried out by sulfate-reducing bacteria (SRB) and sulfur-oxidizing bacteria (SOB). The process was comprised of a UASB reactor as pre-treatment and an aerobic downflow hanging sponge (DHS) reactor as post-treatment. As the results of reactor operation, the whole process achieved that over 90% of CODcr removal efficiency, less than 30 mgCODcr/L (less than 15 mgBOD/L) of final effluent, at 12 h of HRT and at 8 degrees C of UASB reactor temperature. Acetobacterium sp. was detected as the predominant species by PCR-DGGE method targeting 16SrDNA with band excision and sequence analysis. In the UASB reactor, various species of sulfate-reducing bacterium, Desulfobulbus sp., Desulfovibrio sp., and Desulfomicrobium sp., were found by cloning analysis. In the DHS reactor, Tetracoccus sp. presented as dominant. The proposed sulfur-redox action process was considered as an applicable process for low strength wastewater treatment in low temperature conditions.

  18. Investigating reinforcer magnitude and reinforcer delay: a contingency management analog study.

    Science.gov (United States)

    Packer, Robert R; Howell, Donelle N; McPherson, Sterling; Roll, John M

    2012-08-01

    The influence of reinforcer magnitude and reinforcer delay on smoking abstinence was studied using an analog model of contingency management. Participants (N = 103, 74% men) visited our laboratory 3 times daily for 5 days and received money for providing a breath sample that indicated smoking abstinence (carbon monoxide level ≤6 parts per million). Using a factorial design, we assigned participants randomly to 1 of 4 groups that could earn a total of either $207.50 (high-magnitude condition) or $70.00 (low-magnitude condition), and received earnings either at each visit (no-delay condition) or in a single lump sum 1 week following the study (delay condition). High-magnitude reinforcement, regardless of delay, was associated with higher rates of abstinence than was low-magnitude reinforcement. High magnitude of reinforcement provided immediately but in incremental amounts was associated with longer intervals to relapse during treatment in comparison with high-magnitude reinforcement provided in a single lump sum after a delay. Low rates of responding in the low-magnitude conditions made interpretation of the impact of delay in those conditions difficult. These findings further demonstrate that high magnitude of reinforcement results in better outcomes than does low magnitude of reinforcement, and that a delay to reinforcement can be detrimental-even when a high magnitude of reinforcement is provided.

  19. Radiation treatment of painful degenerative skeletal conditions; Schmerzbestrahlung bei degenerativ bedingten Skeletterkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, U. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie; Micke, O. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie; Willich, N. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie

    1996-10-01

    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) [Deutsch] Ziel dieser Untersuchung war es, die eigenen Erfahrungen mit der Schmerzbestrahlung degenerativer Skeletterkrankungen darzustellen und vor allem die Langzeitergebnisse zu untersuchen. Im Zeitraum von 1985 bis 1991 wurden 157 Patienten mit schmerzhaften degenerativen Gelenkerkrankungen retrospektiv untersucht. Der Therapieerfolg wurde mittels Fragebogenaktion ermittelt. Insgesamt waren 94 Frageboegen auswertbar. Die Schmerzanamnese betrug in 45% der Faelle ueber 1 Jahr. Bei 74% der Patienten war eine erfolglose medikamentoese oder orthopaedische Vorbehandlung erfolgt. Sofort nach Beendigung der Radiotherapie gaben insgesamt 38% der Patienten eine Schmerzfreiheit oder wesentliche Besserung der Beschwerden an, zum Zeitpunkt der Fragebogenaktion 76% der Patienten. Die Schmerzbestrahlung degenerativer Skeletterkrankungen erzielte in unserem Patientengut in

  20. Treatment for Multiple Acute Cardiopulmonary Conditions Among Older Patients Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure

    Science.gov (United States)

    Dharmarajan, Kumar; Strait, Kelly M.; Tinetti, Mary E.; Lagu, Tara; Lindenauer, Peter K.; Lynn, Joanne; Krukas, Michelle R.; Ernst, Frank R.; Li, Shu-Xia; Krumholz, Harlan M.

    2016-01-01

    Objectives To determine how often hospitalized older patients principally diagnosed with pneumonia, chronic obstructive pulmonary disease (COPD), or heart failure (HF) are concurrently treated for two or more of these acute cardiopulmonary conditions. Design Retrospective cohort study. Setting 368 US hospitals in the Premier research database Participants Patients ≥65 years-old principally hospitalized with pneumonia, COPD, or HF in 2009 or 2010. Measurements Proportion of diagnosed episodes of pneumonia, COPD, or HF concurrently treated for two or more of these acute cardiopulmonary conditions during the first two hospital days. Results Among 91,709 diagnosed pneumonia hospitalizations, 32% received treatment for two or more acute cardiopulmonary conditions (18% received treatment for HF, 18% received treatment for COPD, and 4% received treatment for both HF and COPD). Among 41,052 diagnosed COPD hospitalizations, 19% received treatment for two or more acute cardiopulmonary conditions (all of which involved additional HF treatment). Among 118,061 diagnosed HF hospitalizations, 38% received treatment for two or more acute cardiopulmonary conditions (34% received treatment for pneumonia, 9% received treatment for COPD, and 5% received treatment for both pneumonia and COPD). Conclusion Hospitalized older patients diagnosed with pneumonia, COPD, or HF are frequently treated for two or more acute cardiopulmonary conditions, suggesting that clinical syndromes often fall between traditional diagnostic categories. Research is needed to evaluate the risks and benefits of real-world treatment for the many older patients whose presentations elicit diagnostic uncertainty or concern for coexisting acute conditions. PMID:27448329

  1. 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%.

  2. Delayed Puberty

    Science.gov (United States)

    ... problems such as Turner syndrome in girls or Klinefelter syndrome in boys • Some cancer treatments that affect sex ... Menopause/upload/polycystic- ovary-syndrome-bilingual-071509.pdf ——Klinefelter Syndrome: www.hormone.org/Resources/ upload/FS_MH_Klinefelter_ ...

  3. Selection of heat treatment condition of the Mg-Al-Zn alloys

    Directory of Open Access Journals (Sweden)

    L.A. Dobrzański

    2009-02-01

    Full Text Available Purpose: Main aim of this paper are results of the optimization of heat treatment conditions, which are temperature and heating time during solution heat treatment or ageing as well the cooling rate after solution treatment for MCMgAl12Zn1, MCMgAl9Zn1, MCMgAl6Zn1, MCMgAl3Zn1 cast magnesium alloys.Design/methodology/approach: The following results concern mechanical properties especially hardness.Findings: The different heat treatment kinds employed contributed to the improvement of mechanical properties of the alloy.Research limitations/implications: According to the alloys characteristic, the applied cooling rate and alloy additions seems to be a good compromise for mechanical properties, nevertheless further tests should be carried out in order to examine different cooling rates and parameters of solution treatment process and aging process.Practical implications: Generally magnesium alloys are applied in motor industry and machine building, but they find application in a helicopter production, planes, disc scanners, a mobile telephony, computers, bicycle elements, household and office equipment, radio engineering and an air - navigation, in chemical, power, textile and nuclear industrial, etc.Originality/value: Contemporary materials should possess high mechanical properties, physical and chemical, as well as technological ones, to ensure long and reliable use. The above mentioned requirements and expectations regarding the contemporary materials are met by the non-ferrous metals alloys used nowadays, including the magnesium alloys.

  4. Demoras en el diagnóstico y tratamiento de mujeres con cáncer de mama en Bogotá, Colombia Delay for diagnosis and treatment of breast cancer in Bogotá, Colombia

    Directory of Open Access Journals (Sweden)

    Marion Piñeros

    2011-12-01

    Full Text Available OBJETIVO: Establecer la demora en la atención de cáncer de mama. MATERIAL Y MÉTODOS: En 1 106 mujeres que recibían tratamiento por cáncer de mama en Bogotá, se establecieron tasas de incidencia de diagnóstico y de tratamiento a partir de la primera consulta. Se compararon con las variables de interés y se elaboró un modelo de peligro de Cox. RESULTADOS: Las medianas de tiempo desde la primera consulta hasta el diagnóstico y hasta el tratamiento fueron de 91 días (IC95%:82-97 días y de 137 días (IC95%:127-147 días respectivamente. El diagnóstico y el tratamiento fueron más rápidos en mujeres con mayor nivel educativo, afiliadas al régimen especial de salud, en el estrato socioeconómico más alto y cuando consultaron por tamización. CONCLUSION: Las demoras en la atención son excesivas. Hay una clara inequidad y se requieren intervenciones para brindar mayor oportunidad, particularmente para el diagnóstico.OBJECTIVE: Establish provider delay for breast cancer and related factors. MATERIAL AND METHODS: 1 106 women with breast cancer were approached in health care institutions of Bogota, Colombia. According to the history of first consultation, we established diagnostic and treatment incidence rates, which were compared for different variables. A Cox hazard model was established. RESULTS: Median time from first consultation to diagnosis and start of treatment were 91 days (CI95%:82-97 days and 137 days (CI95%:127-147 days respectively. Diagnosis and treatment were faster in women with higher educational level, affiliated to the "special" social security, with better socioeconomic conditions and in screening-detected breast cancers. CONCLUSION: Provider delay is excessive. There are clear inequities in access to services and a need of reducing the waiting times for women with a suspicion of breast cancer.

  5. Acute withdrawal from repeated cocaine treatment enhances latent inhibition of a conditioned fear response.

    Science.gov (United States)

    Murphy, C A; Heidbreder, C; Feldon, J

    2001-02-01

    Psychostimulant-induced locomotor sensitization and disrupted latent inhibition (LI) of a classically conditioned association are two paradigms that have been widely studied as animal behavioural models of psychosis. In this study we assessed the effects of withdrawal from the repeated intermittent administration of cocaine on LI of a conditioned fear response. Animals which were either preexposed (PE) to a tone conditioned stimulus (CS) or naive to the tone (i.e. non-preexposed: NPE) subsequently experienced 10 pairings of the tone CS with footshock. Afterwards, both groups received five daily injections of cocaine (20 mg/kg, i.p.) or saline. After 3 days of withdrawal from drug treatment, animals were tested for conditioned freezing to the context of the footshock chamber, and 1 day later, for conditioned freezing to the tone CS. Cocaine-sensitized animals exhibited markedly enhanced LI compared to saline-treated animals, due to the fact that NPE-cocaine animals spent more time freezing during the tone CS than NPE-saline animals, whereas PE-cocaine animals showed a tendency toward reduced freezing compared to the saline groups. While these results suggest the presence of increased anxiety in cocaine-withdrawn NPE animals, the absence of this effect in cocaine-withdrawn PE rats indicates that cocaine withdrawal also influences the retrieval of previously learned information.

  6. 延迟间隔和提取条件对短时错误记忆的影响%The Research on the Influence of Delay Interval and Retrival Condition on Short-Term False Memory

    Institute of Scientific and Technical Information of China (English)

    陈红; 郭春彦; 杨海波

    2015-01-01

    This research explored the influnce of retrival condition and delay interval on short-term false memory with short-term DRM paradigm on a forced choice test. The results suggested short-term false memory were basically from the lost of store details access at retrival stage. That means delay interval could improve false memory without effective retrival. But on effective retrical condition, increased access of true memory trace could greatly reduce fasle memory and the effect of delay was not significant. The results of this experiment will enrich the theory of false memory.%采用短时DRM迫选任务,探讨提取条件和延迟间隔对短时错误记忆的影响,以进一步考察短时错误记忆的产生机制。结果发现,短时错误记忆的产生主要源于提取时对存贮细节通达的缺失。在无有效提取线索的条件下,延迟间隔能够增加错误记忆率;而有效提取线索存在时,真实记忆痕迹的可通达性增加能够极大避免错误记忆的产生,延迟间隔的作用则不显著。该实验的结果是对错误记忆理论解释的一种补充。

  7. Shelf life extension and antioxidant activity of 'Hayward' kiwi fruit as a result of prestorage conditioning and 1-methylcyclopropene treatment.

    Science.gov (United States)

    Park, Yong Seo; Im, Myeng He; Gorinstein, Shela

    2015-05-01

    Kiwi fruits (Actinidia deliciosa C.F. Liang et A.R. Ferguson) were treated by prestorage conditioning (20 °C for 2 days), 1-methylcyclopropene (1-MCP, 1 ppm for 16 h) and conditioning plus 1-MCP. After the treatment the fruits were immediately stored at 0 °C during 24 weeks. Flesh firmness gradually decreased with storage time and the rate of its loss was lower in 1-MCP and conditioning plus 1-MCP treatments than those of control or conditioning. However, SSC, acidity and pH did not change among treatments. Starch content decreased during the storage time regardless of treatments. Oppositely the amount of reducing sugars increased at the same duration of the treatments. Rate and incidence of fruit decay was the lowest in fruit treated with conditioning plus 1-MCP treatment. Fruit decay mainly caused pathogen Botrytis cinerea and its rate significantly decreased with conditioning plus 1-MCP treatment. Ethylene and respiration abruptly increased after 8 weeks of storage, but their contents were lower in 1-MCP and conditioning plus 1-MCP. Total soluble phenolics, flavonoids, and total antioxidant capacities were much higher than in other treatments. Kiwi fruits treated with conditioning plus 1-MCP extended the shelf life by reducing the rate of fruit decay and softening during the storage. The bioactive compounds and total antioxidant status of fruits increased during the treatment.

  8. Effects of extinction treatments on the reduction of conditioned responding and conditioned hyperarousal in a rabbit model of posttraumatic stress disorder (PTSD).

    Science.gov (United States)

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

    2015-10-01

    We have previously characterized a model of posttraumatic stress disorder (PTSD), based on classical conditioning of the rabbit nictitating membrane response (NMR), that focuses on 2 key PTSD-like features: conditioned responses to trauma-associated cues and hyperarousal. In addition to the development of conditioned NMRs (CRs) to a tone conditioned stimulus (CS) associated with a periorbital shock unconditioned stimulus (US), we have observed that rabbits also exhibit a conditioning-specific reflex modification (CRM) of the NMR that manifests as an exaggerated and more complex reflexive NMR to presentations of the US by itself, particularly to intensities that elicited little response prior to conditioning. Previous work has demonstrated that unpaired presentations of the CS and US are successful at extinguishing CRs and CRM simultaneously, even when a significantly weakened version of the US is utilized. In the current study, additional extinction treatments were tested, including continued pairings of the CS with a weakened US and exposure to the training context alone, and these treatments were contrasted with the effects of unpaired extinction with a weakened US and remaining in home cages with no further treatment. Results showed that continued pairings only slightly decreased CRs and CRM, while context exposure had no effect on CRs and marginal effects on reducing CRM. Unpaired extinction was still the most effective treatment for reducing both. Findings are discussed in terms of applications to cognitive-behavioral therapies for treatment of PTSD, such as incorporating mild, innately stressful stimuli into virtual reality therapy.

  9. The Treatment of Pulmonary Diseases and Respiratory-Related Conditions with Inhaled (Nebulized or Aerosolized Glutathione

    Directory of Open Access Journals (Sweden)

    Jonathan Prousky

    2008-01-01

    Full Text Available Reduced glutathione or simply glutathione (γ-glutamylcysteinylglycine; GSH is found in the cytosol of most cells of the body. GSH in the epithelial lining fluid (ELF of the lower respiratory tract is thought to be the first line of defense against oxidative stress. Inhalation (nebulized or aerosolized is the only known method that increases GSH's levels in the ELF. A review of the literature was conducted to examine the clinical effectiveness of inhaled GSH as a treatment for various pulmonary diseases and respiratory-related conditions. This report also discusses clinical and theoretical indications for GSH inhalation, potential concerns with this treatment, its presumed mechanisms of action, optimal doses to be administered and other important details. Reasons for inhaled GSH's effectiveness include its role as a potent antioxidant, and possibly improved oxygenation and host defenses. Theoretical uses of this treatment include Farmer's lung, pre- and postexercise, multiple chemical sensitivity disorder and cigarette smoking. GSH inhalation should not be used as a treatment for primary lung cancer. Testing for sulfites in the urine is recommended prior to GSH inhalation. Minor side effects such as transient coughing and an unpleasant odor are common with this treatment. Major side effects such as bronchoconstriction have only occurred among asthma patients presumed to be sulfite-sensitive. The potential applications of inhaled GSH are numerous when one considers just how many pulmonary diseases and respiratory-related conditions are affected by deficient antioxidant status or an over production of oxidants, poor oxygenation and/or impaired host defenses. More studies are clearly warranted.

  10. 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...

  11. 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.

  12. 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.

  13. 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.

  14. Optimal Control with Time Delays via the Penalty Method

    Directory of Open Access Journals (Sweden)

    Mohammed Benharrat

    2014-01-01

    Full Text Available We prove necessary optimality conditions of Euler-Lagrange type for a problem of the calculus of variations with time delays, where the delay in the unknown function is different from the delay in its derivative. Then, a more general optimal control problem with time delays is considered. Main result gives a convergence theorem, allowing us to obtain a solution to the delayed optimal control problem by considering a sequence of delayed problems of the calculus of variations.

  15. 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

  16. Assessment of the acute effects of glucocorticoid treatment on coronary microembolization using cine, first-pass perfusion, and delayed enhancement MRI.

    Science.gov (United States)

    Jin, Hang; Yun, Hong; Ma, Jian-ying; Chen, Zhang-wei; Chang, Shu-fu; Ge, Mei-ying; Zeng, Meng-su

    2016-04-01

    To assess the acute effects of methylprednisone treatment (MPT) on coronary microembolization (CME) by cardiac cine, first-pass perfusion, and delayed gadolinium enhancement magnetic resonance imaging (DE-MRI) in an experimental swine model. Microembolization was established by intracoronary infusion of microspheres into the left anterior artery. Swine received placebo (n = 12) or methylprednisolone (n = 10, 30 mg/kg) intravenously 30 minutes before microembolization. Perfusion and DE-MRI was performed 6 hours after microembolization. Cine MR images of pre-/post-CME were obtained using 1.5T scanner. Cine MRI demonstrated relative amelioration of the post-CME myocardial contractile dysfunction in the glucocorticoid-treated group compared to the placebo group (P < 0.001). Post-CME target myocardial perfusion parameters decreased in both groups after microembolization. The extent of these decreases were the same for the embolized-to-control area ratio of maximum upslope (P = 0.245; 95% confidence interval of the difference [CID], -0.041/0.148) and time to peak ratio (P = 0.122; 95% CID, -0.201/0.026); however, the maximum signal intensity was higher in the glucocorticoid-treated group (P = 0.012; 95% CID, 0.023/0.156). DE-MRI revealed patchy hyperenhancement in all placebo pigs (n = 12/12) after microembolization, but no hyperenhanced regions in the glucocorticoid-pretreated pigs (n = 0/10). Standard, readily available, cardiac MRI techniques are useful in demonstrating post-CME myocardial dysfunction and the acute effects of glucocorticoid treatment on CME. Glucocorticoid pretreatment improves myocardial contractile dysfunction, prevents hyperenhancement, and partially ameliorates the decline of myocardial perfusion in the embolized area. © 2015 Wiley Periodicals, Inc.

  17. Effects of repeated quetiapine treatment on conditioned avoidance responding in rats.

    Science.gov (United States)

    Gao, Jun; Feng, Min; Swalve, Natashia; Davis, Collin; Sui, Nan; Li, Ming

    2015-12-15

    The present study characterized the behavioral mechanisms of avoidance-disruptive effect of quetiapine in the conditioned avoidance response test under two behavioral testing (2 warning signals vs. 1 warning signal) and two drug administration conditions (subcutaneous vs. intravenous). In Experiments 1 and 2, well-trained adult male Sprague-Dawley rats were tested under the subcutaneous (s.c.) quetiapine treatment (5.0, 15.0, 25.0, 50.0mg/kg) for 7 days in a novel procedure consisting of two conditioned stimuli (CS) (white noise serving as CS1 and pure tone as CS2). Only the highest dose (50.0mg/kg) produced a persistent suppression of the avoidance response without impairing the escape response. The magnitude of suppression of the CS1 avoidance was similar to that of CS2 avoidance. No significant group difference was found in the quetiapine (15.0mg/kg, s.c.) challenge test, indicating a lack of a long-term quetiapine effect. In Experiment 3, well-trained rats were tested under the intravenous (i.v.) quetiapine treatment (3.0, 9.0, 15.0mg/kg) for 5 days and challenged with quetiapine (6.0mg/kg, i.v. followed by 9.0mg/kg, s.c.). Only the white noise was used as the CS. Similar to what was being observed in Experiments 1 and 2, intravenously administered quetiapine dose-dependently suppressed avoidance responding during the drug test days, but did not alter drug sensitivity in the challenge days. Thus, quetiapine does not appear to show a preferential inhibition of the avoidance response to a less salient stimulus; and prior quetiapine treatment (s.c. and i.v.) does not cause a sensitization or tolerance to quetiapine.

  18. 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.

  19. Pulse treatment with the proteasome inhibitor bortezomib inhibits osteoclast resorptive activity in clinically relevant conditions

    DEFF Research Database (Denmark)

    Boissy, P; Levin Andersen, Thomas; Lund, T

    2008-01-01

    Myeloma bone disease is due to bone degradation by osteoclasts, and absence of repair by bone forming osteoblasts. Recent observations suggest that the anti-myeloma drug bortezomib, a proteasome inhibitor, stimulates bone formation and may inhibit bone resorption. Here, we tested bortezomib...... on cultured osteoclasts in conditions mimicking the pulse treatment used in the clinic, thereby avoiding continuous proteasome inhibition and unselective toxicity. A 3h pulse with 25nM bortezomib followed by a 3-day culture in its absence markedly inhibited osteoclast activity as evaluated through bone...... resorption, TRAcP release, and RANKL-induced NF-kappaB translocation into nuclei, an event dependent on proteasomes and critical for osteoclast function. The effect on TRAcP was maximal during the first 24h post-pulse, and then tended to subside. Importantly, applying this pulse treatment to cultured myeloma...

  20. The range of time delay and the global stability of the equilibrium for an IVGTT model☆

    Science.gov (United States)

    Li, Jiaxu; Wang, Minghu; De Gaetano, Andrea; Palumbo, Pasquale; Panunzi, Simona

    2011-01-01

    Diabetes mellitus has become a prevalent disease in the world. Diagnostic protocol for the onset of diabetes mellitus is the initial step in the treatments. The intravenous glucose tolerance test (IVGTT) has been considered as the most accurate method to determine the insulin sensitivity and glucose effectiveness. It is well known that there exists a time delay in insulin secretion stimulated by the elevated glucose concentration level. However, the range of the length of the delay in the existing IVGTT models are not fully discussed and thus in many cases the time delay may be assigned to a value out of its reasonable range. In addition, several attempts had been made to determine when the unique equilibrium point is globally asymptotically stable. However, all these conditions are delay-independent. In this paper, we discuss the range of the time delay and provide easy-to-check delay-dependent conditions for the global asymptotic stability of the equilibrium point for a recent IVGTT model through Liapunov function approach. Estimates of the upper bound of the delay for global stability are given in corollaries. In addition, the numerical simulation in this paper is fully incorporated with functional initial conditions, which is natural and more appropriate in delay differential equation system. PMID:22123436

  1. Delay Independent Criterion for Multiple Time-delay Systems

    Science.gov (United States)

    Chang, C. J.; Liu, K. F. R.; Yeh, K.; Chen, C. W.; Chung, P. Y.

    Based on the fuzzy Lyapunov method, this work addresses the stability conditions for nonlinear systems with multiple time delays to ensure the stability of building structure control systems. The delay independent conditions are derived via the traditional Lyapunov and fuzzy Lyapunov methods for multiple time-delay systems as approximated by the Tagagi-Sugeno (T-S) fuzzy model. The fuzzy Lyapunov function is defined as a fuzzy blending of quadratic Lyapunov functions. A parallel distributed compensation (PDC) scheme is utilized to construct a global fuzzy logic control (FLC) by blending all linear local state feedback controllers in the controller design procedure. Furthermore, the H infinity performance and robustness of the design for modeling errors also need to be considered in the stability conditions.

  2. Resveratrol in prevention and treatment of common clinical conditions of aging.

    Science.gov (United States)

    Markus, M Andrea; Morris, Brian J

    2008-01-01

    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.

  3. Exome sequencing results in successful riboflavin treatment of a rapidly progressive neurological condition

    Science.gov (United States)

    Petrovski, Slavé; Shashi, Vandana; Petrou, Steven; Schoch, Kelly; McSweeney, Keisha Melodi; Dhindsa, Ryan S.; Krueger, Brian; Crimian, Rebecca; Case, Laura E.; Khalid, Roha; El-Dairi, Maysantoine A.; Jiang, Yong-Hui; Mikati, Mohamad A.; Goldstein, David B.

    2015-01-01

    Genetically targeted therapies for rare Mendelian conditions are improving patient outcomes. Here, we present the case of a 20-mo-old female suffering from a rapidly progressing neurological disorder. Although diagnosed initially with a possible autoimmune condition, analysis of the child's exome resulted in a diagnosis of Brown–Vialetto–Van Laere syndrome 2 (BVVLS2). This new diagnosis led to a change in the therapy plan from steroids and precautionary chemotherapy to high-dose riboflavin. Improvements were reported quickly, including in motor strength after 1 mo. In this case, the correct diagnosis and appropriate treatment would have been unlikely in the absence of exome sequencing and careful interpretation. This experience adds to a growing list of examples that emphasize the importance of early genome-wide diagnostics. PMID:27148561

  4. Pharmacologic doses of nicotinamide in the treatment of inflammatory skin conditions: a review.

    Science.gov (United States)

    Niren, Neil M

    2006-01-01

    Various skin disorders with an inflammatory component often have been treated with steroids and/or oral antibiotics. However, long-term use of these agents has drawbacks: steroids may induce numerous serious side effects such as hypertension, immunosuppression, and osteoporosis, and overuse of oral antibiotics may contribute to the development of bacterial resistance, as well as to a host of nuisance side effects such as diarrhea, yeast infections, and photosensitivity. As a result, alternative oral treatments, such as nicotinamide, have been investigated. During the past 50 years, many clinical reports have identified nicotinamide as a beneficial agent in the treatment of a variety of inflammatory skin disorders; what's more, its exceptional safety profile at pharmacologic doses makes it a potentially ideal long-term oral therapy for patients with inflammatory skin diseases. A recent large study evaluating nicotinamide for the treatment of acne or rosacea has confirmed the potential benefits of oral nicotinamide as an alternative approach to managing inflammatory lesions associated with acne vulgaris and acne rosacea. This article reviews the substantial number of reports published over the past 50 years that document the clinical utility and safety of oral and topical formulations of nicotinamide for the treatment of a variety of inflammatory skin conditions.

  5. HOT AIR TREATMENT, IN NATURAL CONVECTION CONDITIONS, FOR EGG SURFACE DECONTAMINATION

    Directory of Open Access Journals (Sweden)

    Chiara Cevoli

    2012-06-01

    Full Text Available In order to improve the animal welfare, the Council Directive 1999/74/EC (defining minimum standards for the welfare of laying hens will ban conventional cage systems from 2012, in favor of enriched cages or floor systems. As a consequence an increased risk of bacterial contamination of eggshells is expected. This has lead toward the development of efficient techniques to reduce eggshell contamination by bacterial pathogens, and thus to prevent any potential or additional food safety risk for Human health. The objectives of this research were to develop and validate a numerical model useful to study the physics of treatment with hot air, in natural convection conditions, and then to assess the impact of the treatment on egg quality and Salmonella Enteritidis inactivation on the shell. As regards the decontamination effectiveness, a reduction in microbial load up to 2.6 log10 after 200 minutes was observed. A linear correlation between the time of treatment and the microbial decimal reduction (R2 0.92 was also observed. This suggests the opportunity of further study with longer treatment. Moreover the results about weak action on quality parameters suggest the practical feasibility of a transportation system for eggs, from production to sorting plant, in heated container.

  6. Biotransformation of nonylphenol ethoxylates during sewage treatment under anaerobic and aerobic conditions

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Biotransformation of nonylphenol ethoxylates (NPEOs) during continuous anaerobic sewage treatment was compared with the aerobic treatment of sewage spiked with 23 μmol/L technical NPEOs over a period of 90 d. Immediate degradation of NPEOs was observed under both anaerobic and aerobic conditions, indicating that the enzymes and bacteria required for NPEO degradation existed abundantly in both aerobic and anaerobic sludge. Both treatments achieved high removal (>92%) of the spiked NPEO9 mixture.Liquid chromatography-mass spectrometry (LC-MS) analysis showed that short-chain NPEOs (NPEO1-NPEO3) accumulated in anaerobic (2.01-2.56 μmol/L) and aerobic (1.62-2.03 μmol/L) effluents, with nonylphenol (NP) (0.24-0.31 μmol/L) as another group of metabolites in the anaerobic effluent, and nonylphenoxy carboxylates (NPECs) (2.79-3.30 μmol/L) in the aerobic effluent. Significant accumulation of NP in the anaerobic sludge and NPEO1-3 in the sludge of two reactors was observed. These results indicated that it was difficult to control these harmful metabolites in the conventional treatment processes. Denaturing gradient gel electrophoresis profiles of sludge samples support the speculation that the NPEO degradation bacteria might be the dominant indigenous species.

  7. An Exploration of Responses to Drug Conditioned Stimuli during Treatment for Substance Dependence

    Directory of Open Access Journals (Sweden)

    Benjamin Goddard

    2013-01-01

    Full Text Available Although it is well established that drug conditioned stimuli produce a variety of conditioned responses, it is not known whether such stimuli can also reinforce an arbitrary operant response and thus serve as conditioned reinforcers. Volunteers (n=39 recruited from a residential treatment center for substance dependence were tested on a task in which presses on computer keys activated images of drugs/drug paraphernalia on a progressive ratio schedule of reinforcement. They also completed a personalized craving questionnaire and a personalized Implicit Association Test. A significant bias in responding was found for images of preferred drugs/route of drug administration. Craving, however, was low and the images generated negative evaluative reactions. Two additional studies were performed to ascertain the generalizability of the effects to a different population of drug-using individuals (i.e., students who drink and to incentive stimuli of a different nature (i.e., sexual. The additional studies partially replicated and extended the central findings of the main study. Therefore, although these data should be considered preliminary in light of small group sizes, it is concluded that cue specificity and availability of the unconditioned stimuli (drugs and sex plays a role in modulating responding maintained by conditioned reinforcers.

  8. 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

  9. 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

    more frequently atypical symptoms and increased prehospital delay caused by prolonged physician and transportation delay. Physician delay among women and men were 69 and 16 min, respectively. Patients with prior myocardial infarction had reduced prehospital delay, which was caused by shorter decision...... 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....

  10. Controllability of delay systems with restrained controls

    Science.gov (United States)

    Chukwu, E. N.

    1979-01-01

    Using a geometric growth condition, both the function space and Euclidean controllability of a nonlinear delay system which has a compact and convex control set are characterized. This extends analogous results for ordinary differential systems, and it yields conditions under which perturbed nonlinear delay controllable systems are controllable.

  11. 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.

  12. 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.

  13. Hydrophobicity and carbonation treatment of earthen monuments in humid weather condition

    Institute of Scientific and Technical Information of China (English)

    LI Min; ZHANG HuYuan

    2012-01-01

    Water stability of soil is crucial to the durability of earthen monuments,especially those located in the humid weather condition.This paper discusses the selection reason of materials (tung oil and quicklime) for earthen monument treatment,and then validates the applicability of these materials with tests of soil-water characteristic curve (SWCC),aggregate stability test (AST) and scanning electron microscope (SEM).The soil tested was sampled from Da Bao'en temple in Nanjing,Jiangsu province,China.The test results indicate that the carbonation reaction of quicklime offers a favorable environment for the formation of tung oil film.Meanwhile,the regulatory function of tung oil restricts the crystallinity of calcium carbonate (CaCO3) and forms fine crystals.Soil treated with both of tung oil and quicklime has good water repellency and aggregate stability without obvious changing in aesthetic appearance.Hydrophobicity and carbonation treatment can be applied prospectively in the conservation of earthen monument located in humid weather condition.

  14. B-cell reconstitution for SCID: should a conditioning regimen be used in SCID treatment?

    Science.gov (United States)

    Haddad, Elie; Leroy, Sandrine; Buckley, Rebecca H

    2013-04-01

    Bone marrow transplantation has resulted in life-saving sustained T-cell reconstitution in many infants with severe combined immunodeficiency (SCID), but correction of B-cell function has been more problematic. At the annual meeting of the Primary Immunodeficiency Treatment Consortium held in Boston, Massachusetts, on April 27, 2012, a debate was held regarding the use of pretransplantation conditioning versus no pretransplantation conditioning in an effort to address this problem. Reviews of the literature were made by both debaters, and there was agreement that there was a higher rate of B-cell chimerism and a lower number of patients who required ongoing immunoglobulin replacement therapy in centers that used pretransplantation conditioning. However, there were still patients who required immunoglobulin replacement in those centers, and therefore pretransplantation conditioning did not guarantee development of B-cell function. Dr Rebecca H. Buckley presented data on B-cell function according to the molecular defect of the patient, and showed that patients with IL-7 receptor α, ADA, and CD3 chain gene mutations can have normal B-cell function after transplantation with only host B cells. Dr Elie Haddad presented a statistical analysis of B-cell function in published reports and showed that only a conditioning regimen that contained busulfan was significantly associated with better B-cell function after transplantation. The question is whether the risk of immediate and long-term toxicity with use of busulfan is justified, particularly in patients with SCID with DNA repair defects and in very young newborns with SCID who will be detected by using newborn screening.

  15. Constructed treatment wetland: a study of eight plant species under saline conditions.

    Science.gov (United States)

    Klomjek, Pantip; Nitisoravut, Suwanchai

    2005-02-01

    A series of investigations was conducted to evaluate the feasibility of using constructed treatment wetlands to remove pollutants from saline wastewater. Eight emergent plants; cattail, sedge, water grass, Asia crabgrass, salt meadow cordgrass, kallar grass, vetiver grass and Amazon, were planted in experimental plots and fed with municipal wastewater that was spiked with sodium chloride (NaCl) to simulate a saline concentration of approximately 14-16 mScm-1. All macrophytes were found tolerant under the tested conditions except Amazon and vetiver grass. Nutrient assimilation of salt tolerant species was in the range of 0.006-0.061 and 0.0002-0.0024 gm-2d-1 for nitrogen and phosphorus, respectively. Treatment performances of planted units were found to be 72.4-78.9% for BOD5, 43.2-56.0% for SS, 67.4-76.5% for NH3-N and 28.9-44.9% for TP. The most satisfactory plant growth and nitrogen assimilation were found for cattail (Typha angustifolia) though the plant growth was limited, whereas Asia crabgrass (Digitaria bicornis) was superior for BOD5 removal. Both were evaluated again in a continuous flow constructed wetland system receiving saline feed processing wastewater. A high removal rate regularly occurred in long-term operating conditions. The reduction in BOD5, SS, NH3-N and TP was in the range of 44.4-67.9%, 41.4-70.4%, 18.0-65.3% and 12.2-40.5%, respectively. Asia crabgrass often provided higher removal especially for BOD5 and SS removal. Nutrient enriched wastewater promoted flourishing growth of algae and plankton in the surface flow system, which tended to reduce treatment performance.

  16. Primary Care Clinicians’ Experiences with Treatment Decision-Making for Older Persons with Multiple Conditions

    Science.gov (United States)

    Fried, Terri R.; Tinetti, Mary E.; Iannone, Lynne

    2010-01-01

    Background Clinicians are caring for an increasing number of older patients with multiple diseases, in the face of uncertainty concerning the benefits and harms associated with guideline-directed interventions. Understanding how primary care clinicians approach treatment decision-making for these patients is critical to the design of improving the decision-making process. Methods Focus groups were conducted with study with forty primary care clinicians (physicians, nurse-practitioners, physician assistants) in academic, community, and VA-affiliated primary care practices. Participants were given open-ended questions about their approach to treatment decision-making for older persons with multiple medical conditions. Responses were organized into themes using qualitative content analysis. Results Participants were concerned about their patients’ ability to adhere to complex regimens deriving from guideline-directed care. There was variability in beliefs regarding and approaches to balancing the benefits and harms of guideline-directed care. There was also variability in how they involved patients in the process of decision making, with clinicians describing conflicts between their own and their patients’ goals. Participants listed a number of barriers to making good treatment decisions, including lack of outcome data, the role of specialists, patient and family expectations, and insufficient time and reimbursement. Conclusions The experiences of practicing clinicians suggest that they struggle with the uncertainties of applying disease-specific guidelines to their older patients with multiple conditions. To improve decision making, they need more data, alternative guidelines, approaches to reconciling their own and their patients’ priorities, the support of their subspecialist colleagues, and an altered reimbursement system. PMID:20837819

  17. High shear treatment of concentrates and drying conditions influence the solubility of milk protein concentrate powders.

    Science.gov (United States)

    Augustin, Mary Ann; Sanguansri, Peerasak; Williams, Roderick; Andrews, Helen

    2012-11-01

    The solubility of milk protein concentrate (MPC) powders was influenced by the method used for preparing the concentrate, drying conditions, and the type of dryer used. Increasing total solids of the ultrafiltered concentrates (23% total solids, TS) by diafiltration to 25% TS or evaporation to 31% TS decreased the solubility of MPC powders (80-83% protein, w/w dry basis), with ultrafiltration followed by evaporation to higher total solids having the greater detrimental effect on solubility. High shear treatment (homogenisation at 350/100 bar, microfluidisation at 800 bar or ultrasonication at 24 kHz, 600 watts) of ultrafiltered and diafiltered milk protein concentrates prior to spray drying increased the nitrogen solubility of MPC powders (82% protein, w/w dry basis). Of the treatments applied, microfluidisation was the most effective for increasing nitrogen solubility of MPC powders after manufacture and during storage. Manufacture of MPC powders (91% protein, w/w dry basis) prepared on two different pilot-scale dryers (single stage or two stage) from milk protein concentrates (20% TS) resulted in powders with different nitrogen solubility and an altered response to the effects of microfluidisation. Microfluidisation (400, 800 and 1200 bar) of the concentrate prior to drying resulted in increased long term solubility of MPC powders that were prepared on a single stage dryer but not those produced on a two stage spray dryer. This work demonstrates that microfluidisation can be used as a physical intervention for improving MPC powder solubility. Interactions between the method of preparation and treatment of concentrate prior to drying, the drying conditions and dryer type all influence MPC solubility characteristics.

  18. Diagnosis and Treatment of Delayed Hemothorax after Closed Rib Fractures%闭合性肋骨骨折迟发性血胸的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    向敏峰; 袁天柱; 陈卫民; 廖文勇; 蒋清柏; 吴先球

    2013-01-01

    Objective To explore the causes, diagnosis, treatment and prevention measures of delayed hemothorax after closed rib fractures. Methods The clinical data of 142 patients with delayed hemothorax from January 2001 to December 2011 was retrospectively analyzed. Results All 142 patients were with no hemothorax when admission by chest X-ray or CT examination, but with signs of pleural effusion on 2 -29 days after the admission. 12 patients underwent the thoracocentesis,130 patients received closed, chest drainage. The volume of bloody pleural effusion was more than 500 ml in all cases. The cases underwent the thoracot-omy. 139 cases were cured and 3 cases were died. Conclusion Closed rib fractures can easily lead to a delayed hemothorax. The regularly check with chest X-ray or CT should early diagnosed the delayed hemothorax. Thoracic drainage with big diameter tube can quickly drain off the pleural effusion;recover the recruitment maneuver,so as to stop bleeding. For the patients with bloody pleural effusion or without recruitment maneuver,the thoracotomy should be performed timely. To raise the awareness of this disease, closely observation of the condition of patients, regularly chest X-ray or CT examination can improve the diagnosis of this disease.%目的 探讨闭合性肋骨骨折迟发性血胸的发生原因、诊治方法及防范措施.方法 回顾性分析2000年1月-2011年12月收治的142例闭合性肋骨骨折迟发性血胸患者的临床资料.结果 142例患者入院时胸片或胸部CT检查无血胸,入院后2~29d复查均发现有胸腔积液征象,12例行胸腔穿刺,130例行胸腔闭式引流术,均穿刺或引流出血性胸水>500 ml,剖胸手术10例.治愈139例,死亡3例.结论 闭合性肋骨骨折易并发迟发性血胸,伤后应定期行胸片或CT检查,确诊后早期进行胸腔闭式引流是治疗迟发性血胸最简单有效的措施,选择大口径引流管能快速通畅地排尽胸腔内积血,使肺脏迅速复张,

  19. Effects of combined nicotine and fluoxetine treatment on adult hippocampal neurogenesis and conditioned place preference.

    Science.gov (United States)

    Faillace, M P; Zwiller, J; Bernabeu, R O

    2015-08-06

    Adult neurogenesis occurs in mammals within the dentate gyrus, a hippocampal subarea. It is known to be induced by antidepressant treatment and reduced in response to nicotine administration. We checked here whether the antidepressant fluoxetine would inverse the decrease in hippocampal neurogenesis caused by nicotine. It is shown that repeated, but not a single injection of rats with fluoxetine was able to abolish the decrease in adult dentate cell proliferation produced by nicotine treatment. We measured the expression of several biochemical parameters known to be associated with neurogenesis in the dentate gyrus. Both drugs increased the expression of p75 neurotrophin receptor, which promotes proliferation and early maturation of dentate gyrus cells. Using the conditioned place preference (CPP) paradigm, we also gave both drugs in a context in which their rewarding properties could be measured. Fluoxetine produced a significant but less robust CPP than nicotine. A single injection of fluoxetine was found to reduce nicotine-induced CPP. Moreover, the rewarding properties of nicotine were completely abolished in response to repeated fluoxetine injections. Expression of nicotine-induced CPP was accompanied by an increase of phospho-CREB (cyclic AMP-responsive element-binding protein) and HDAC2 (histone deacetylase 2) expression in the nucleus accumbens. The data suggest that fluoxetine reward, as opposed to nicotine reward, depends on dentate gyrus neurogenesis. Since fluoxetine was able to disrupt the association between nicotine and the environment, this antidepressant may be tested as a treatment for nicotine addiction using cue exposure therapy.

  20. Comparing oxalic acid and sucrocide treatments for Varroa destructor (Acari: Varroidae) control under desert conditions.

    Science.gov (United States)

    Sammataro, D; Finley, J; Underwood, R

    2008-08-01

    The effectiveness of oxalic acid (OA) and Sucrocide (S) (AVA Chemical Ventures, L.L.C., Portsmouth, NH) in reducing populations of the varroa mite Varroa destructor Anderson & Trueman (Acari: Varroidae) in honey bee, Apis mellifera L. (Hymenoptera: Apidae) colonies was measured under the desert conditions of Arizona, USA. OA and S were applied three times 7 d apart. A 3.2% solution of OA was applied in sugar syrup via a large volume syringe, trickling 5 ml per space between frames in the colony. S was applied at a concentration of 0.625% (mixed with water), according to the label directions, using a compressed air Chapin sprayer at 20 psi to apply 59 ml per frame space. Varroa mites, collected on a sticky board before, during, and after the treatments, were counted to assess the effectiveness of the treatments. This study showed that a desert climate zone did not confer any positive or negative results on the acaricidal properties of OA. Even with brood present in colonies, significant varroa mite mortality occurred in the OA colonies. In contrast, we found that Sucrocide was not effective as a mite control technique. Despite its ability to increase mite mortality in the short-term, varroa mite populations measured posttreatment were not affected any more by Sucrocide than by no treatment at all.

  1. Temperature and Time Requirements for Controlling Bed Bugs (Cimex lectularius under Commercial Heat Treatment Conditions

    Directory of Open Access Journals (Sweden)

    Stephen A. Kells

    2011-08-01

    Full Text Available Developing effective alternative approaches for disinfesting bed bugs from residential spaces requires a balance between obtaining complete insect mortality, while minimizing costs and energy consumption. One method of disinfestation is the application of lethal high temperatures directly to rooms and contents within a structure (termed whole-room heat treatments. However, temperature and time parameters for efficacy in whole-room heat treatments are unknown given the slower rate of temperature increase and the probable variability of end-point temperatures within a treated room. The objective of these experiments was to explore requirements to produce maximum mortality from heat exposure using conditions that are more characteristic of whole-room heat treatments. Bed bugs were exposed in an acute lethal temperature (LTemp trial, or time trials at sub-acute lethal temperatures (LTime. The lethal temperature (LTemp99 for adults was 48.3 °C, while LTemp99 for eggs was 54.8 °C. Adult bed bugs exposed to 45 °C had a LTime99 of 94.8 min, while eggs survived 7 h at 45 °C and only 71.5 min at 48 °C. We discuss differences in exposure methodologies, potential reasons why bed bugs can withstand higher temperatures and future directions for research.

  2. Temperature and Time Requirements for Controlling Bed Bugs (Cimex lectularius) under Commercial Heat Treatment Conditions.

    Science.gov (United States)

    Kells, Stephen A; Goblirsch, Michael J

    2011-08-29

    Developing effective alternative approaches for disinfesting bed bugs from residential spaces requires a balance between obtaining complete insect mortality, while minimizing costs and energy consumption. One method of disinfestation is the application of lethal high temperatures directly to rooms and contents within a structure (termed whole-room heat treatments). However, temperature and time parameters for efficacy in whole-room heat treatments are unknown given the slower rate of temperature increase and the probable variability of end-point temperatures within a treated room. The objective of these experiments was to explore requirements to produce maximum mortality from heat exposure using conditions that are more characteristic of whole-room heat treatments. Bed bugs were exposed in an acute lethal temperature (LTemp) trial, or time trials at sub-acute lethal temperatures (LTime). The lethal temperature (LTemp99) for adults was 48.3 °C, while LTemp99 for eggs was 54.8 °C. Adult bed bugs exposed to 45 °C had a LTime99 of 94.8 min, while eggs survived 7 h at 45 °C and only 71.5 min at 48 °C. We discuss differences in exposure methodologies, potential reasons why bed bugs can withstand higher temperatures and future directions for research.

  3. Effect of Alkali Treatment of Wheat Straw on Adsorption of Cu(II under Acidic Condition

    Directory of Open Access Journals (Sweden)

    Yiping Guo

    2016-01-01

    Full Text Available The convenient and feasible pretreatment method of alkali treatment is very common in the degradation process of wheat straw. However, its utilization in the pretreatment of wheat straw as alternative adsorbents for aqueous heavy metals remediation is rarely reported. The present study investigated the removal efficiency of Cu(II ions using wheat straw with alkali pretreatment. The condition of alkali treatment on wheat straw was optimized with the adsorption capacity of Cu(II as indicator using single-factor experiments. The influences of wheat straw dosages, pH values, contact time, and temperatures on adsorption performance for both untreated wheat straw (UWS and alkali-treated wheat straw (AWS were investigated. Results showed that the relatively large removal rate of Cu(II could be obtained, and chemical behavior occurred during the adsorption process. Characteristic analysis found that the major function of alkali treatment to wheat straw was to introduce the hydroxy group, which resulted in the increase of -C-O- group. Although the adsorption capacity is not as high as the one of ligands supported adsorbents, the method is easy to operate and has a wide range of application; at the same time, it could realize both purposes of treating heavy metal pollution and solid wastes.

  4. The Condition of Silica Sand Grains Surface Subjected to Reclamation Treatment

    Directory of Open Access Journals (Sweden)

    Łucarz, M.

    2006-01-01

    Full Text Available The results of investigations are concerned on evaluation of new silica sand grains surface condition after mechanical reclamation treatment as well as on the conditions of reclaimed sand grains surface subjected to thermal and thermo-mechanical reclamation processes. The purpose of research was to answer the question how the applied methods have influenced the surface condition of reclaimed sand grains which was tested by means of bending strength determination of sand samples prepared with resin binder and reclaimed sand. The immediate aim of the research was to explain the mechanism of impurities cleaning on the sand grains surface after thermal reclamation, when the sand is used several times in preparation of a foundry mixture, and to determine what effect these impurities may have on the technological properties of the ready sand mixture. The task of the additionally applied mechanical reclamation was to remove the accumulated inorganic compounds from the sand grains surface and confirm if further improvement of the reclaim quality is possible.

  5. High methylmercury production under ferruginous conditions in sediments impacted by sewage treatment plant discharges.

    Science.gov (United States)

    Bravo, Andrea G; Bouchet, Sylvain; Guédron, Stéphane; Amouroux, David; Dominik, Janusz; Zopfi, Jakob

    2015-09-01

    Sewage treatment plants (STPs) are important point sources of mercury (Hg) to the environment. STPs are also significant sources of iron when hydrated ferric oxide (HFO) is used as a dephosphatation agent during water purification. In this study, we combined geochemical and microbiological characterization with Hg speciation and sediment amendments to evaluate the impact of STP's effluents on monomethylmercury (MMHg) production. The highest in-situ Hg methylation was found close to the discharge pipe in subsurface sediments enriched with Hg, organic matter, and iron. There, ferruginous conditions were prevailing with high concentrations of dissolved Fe(2+) and virtually no free sulfide in the porewater. Sediment incubations demonstrated that the high MMHg production close to the discharge was controlled by low demethylation yields. Inhibition of dissimilatory sulfate reduction with molybdate led to increased iron reduction rates and Hg-methylation, suggesting that sulfate-reducing bacteria (SRB) may not have been the main Hg methylators under these conditions. However, Hg methylation in sediments amended with amorphous Fe(III)-oxides was only slightly higher than control conditions. Thus, in addition to iron-reducing bacteria, other non-SRB most likely contributed to Hg methylation. Overall, this study highlights that sediments impacted by STP discharges can become local hot-spots for Hg methylation due to the combined inputs of i) Hg, ii) organic matter, which fuels bacterial activities and iii) iron, which keeps porewater sulfide concentration low and hence Hg bioavailable.

  6. Periodontal conditions and treatment in urban and rural population of West Bengal, India

    Institute of Scientific and Technical Information of China (English)

    Mehta R; Kundu D; Chakrabarty S; Bharati P

    2010-01-01

    Objective:To search adequate epidemiological data on periodontal conditions for the planning of oral health programs in Indian population, and to determine the prevalence of periodontal diseases, in regards to age and gender of urban and rural population in West Bengal, India. Methods: 22 542 subjects aged 15 years onwards, representative of rural and urban areas of West Bengal were examined for their periodontal conditions using the community periodontal index (CPI).Results: Supra and/or sub gingival calculus dominated as the most frequent score (score 2) among males (76.51%) and females (76.58%), which was least affected in young age group and higher in rural population. Severity of highest score were significant (P<0.001) according to their gender, age group and habitation and had independent effects (P<0.001) on it. Mean number of sextants affected by scores 1, 2, 3, & 4 were more in the rural areas. Assessed treatment needed was predominantly type II (Scaling and improved oral hygiene).Conclusions:The severe periodontal condition (Score 2, 3 and 4) is observed among rural males in older age group more than its urban counterparts of West Bengal, India.

  7. Early outcomes and the virologic impact of delayed treatment switching on second-line therapy in an antiretroviral roll-out program in South Africa

    Science.gov (United States)

    Levison, Julie H.; Orrell, Catherine; Losina, Elena; Lu, Zhigang; Freedberg, Kenneth A.; Wood, Robin

    2011-01-01

    Background More patients in resource-limited settings are starting 2nd-line ART following 1st-line ART failure. We aimed to describe predictors of lack of virologic suppression in HIV-infected patients on 2nd-line ART in a roll-out program in South Africa. Methods Retrospective analysis was performed on an adult HIV treatment cohort who started 2nd-line ART (lopinavir/ritonavir, didanosine, and zidovudine) after virologic failure of 1st-line ART (2 consecutive HIV RNA >1000 copies/ml). Predictors of week-24 lack of suppression (HIV RNA > 400 copies/ml) on 2nd-line ART were determined by bivariate analysis where missing equals failure. A multivariable model adjusted for gender, age, and time to ART switch. We tested these findings in sensitivity analyses defining lack of suppression at week-24 as HIV RNA > 1000 and > 5000 copies/ml. Results Of 6,339 patients on ART, 202 started 2nd-line ART. At week-24 an estimated 41% (95% CI 34–47%) did not achieve virologic suppression. Female sex (adjusted OR=2.25; 95% CI, 1.03–4.88) and time to ART switch, (adjusted OR=1.07; 95% CI, 1.01–1.14 for each additional month) increased the risk of lack of virologic suppression. Age, CD4 count, and HIV RNA at 2nd-line ART initiation did not predict this outcome. In multivariate models, these findings were insensitive to the definition of lack of virologic suppression. Conclusions A substantial number of HIV-infected patients do not achieve virologic suppression by week-24 of 2nd-line ART. Women and patients with delayed start of 2nd-line ART after 1st-line ART failure were at an increased risk of lack of virologic suppression. PMID:21900717

  8. Treatment of the Delayed Monteggia's Fracture in Children%儿童陈旧性孟氏骨折的手术治疗及随诊结果

    Institute of Scientific and Technical Information of China (English)

    史颖奇; 朱振华; 王承武

    1994-01-01

    Twenty-five cases of delayed Monteggia' s fracture were treated surgically.Different surgical procedures were adopted according to the course and clinical menifestations of the injury.The patients were followed up for 52 months in average and the satisfactory results were achieved in 73%.The authors believe that surgical treatment of old Monteggia's fracture should be done as early as possible.Because,in early stage,the annular ligment can be repaired anatomically and it would be better than a reconstruction of the annular ligment hy a fascia graft.Forthurmore,the less secondary changes in the upper radioulnar joint may not prevent the radial head from reduction.In order to avoid radioulnar fusion after operation,nontraumatic surgical technique should be emphasized.A partial osteotomy with osteoclasia is done at the site of angulation of the ulna to correct the angular deformity of the ulna.And this will make the radial head reduced stable.%手术治疗陈旧性孟氏骨折26例,优良率为73%.陈旧性孟氏骨折应尽早进行桡骨头切开复位,主张在尺骨成角部位行骨膜外不全截骨,矫正尺骨成角畸形,使桡骨头复位稳定.认为术后尺桡骨融合问题与原始畸形严重及术中软组织损伤范围大有关,强调手术一定要严洛无创操作,避免损伤过多的组织.

  9. Patient delay in patients with ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, Christel Ga; Laut, Kristina G; Jensen, Lisette O

    2016-01-01

    BACKGROUND AND AIMS: To improve treatment success of ST-elevation myocardial infarction, a minimal delay from symptom onset to reperfusion therapy is crucial. The patient's response to initial symptoms (patient delay) substantially affects the delay. We investigated time patterns of patient delay...

  10. Delay-dependent robust passivity control for uncertain time-delay systems

    Institute of Scientific and Technical Information of China (English)

    Li Guifang; Li Huiying; Yang Chengwu

    2007-01-01

    The robust passivity control problem is addressed for a class of uncertain delayed systems with timevarying delay. The parameter uncertainties are norm-bounded. First, the delay-dependent stability sufficient condition is obtained for the nominal system, and then, based-on the former, the delay-dependent robust passivity criteria is provided and the corresponding controller is designed in terms of linear matrix inequalities. Finally, a numerical example is given to demonstrate the validity of the proposed approach.

  11. Variation in diffusion of gases through PDMS due to plasma surface treatment and storage conditions.

    Science.gov (United States)

    Markov, Dmitry A; Lillie, Elizabeth M; Garbett, Shawn P; McCawley, Lisa J

    2014-02-01

    Polydimethylsiloxane (PDMS) is a commonly used polymer in the fabrication of microfluidic devices due to such features as transparency, gas permeability, and ease of patterning with soft lithography. The surface characteristics of PDMS can also be easily changed with oxygen or low pressure air plasma converting it from a hydrophobic to a hydrophilic state. As part of such a transformation, surface methyl groups are removed and replaced with hydroxyl groups making the exposed surface to resemble silica, a gas impermeable substance. We have utilized Platinum(II)-tetrakis(pentaflourophenyl)porphyrin immobilized within a thin (~1.5 um thick) polystyrene matrix as an oxygen sensor, Stern-Volmer relationship, and Fick's Law of simple diffusion to measure the effects of PDMS composition, treatment, and storage on oxygen diffusion through PDMS. Results indicate that freshly oxidized PDMS showed a significantly smaller diffusion coefficient, indicating that the SiO2 layer formed on the PDMS surface created an impeding barrier. This barrier disappeared after a 3-day storage in air, but remained significant for up to 3 weeks if PDMS was maintained in contact with water. Additionally, higher density PDMS formulation (5:1 ratio) showed similar diffusion characteristics as normal (10:1 ratio) formulation, but showed 60 % smaller diffusion coefficient after plasma treatment that never recovered to pre-treatment levels even after a 3-week storage in air. Understanding how plasma surface treatments contribute to oxygen diffusion will be useful in exploiting the gas permeability of PDMS to establish defined normoxic and hypoxic oxygen conditions within microfluidic bioreactor systems.

  12. Conditioning of sludge produced through chemical treatment of radioactive liquid waste - Operating experiences

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, D. Anji, E-mail: anji@igcar.gov.i [Centralised Waste Management Facility, Nuclear Recycle Group, BARC Facilities, Kalpakkam 603 102, Tamil Nadu (India); Khandelwal, S.K.; Muthiah, R.; Shanmugamani, A.G.; Paul, Biplob; Rao, S.V.S.; Sinha, P.K. [Centralised Waste Management Facility, Nuclear Recycle Group, BARC Facilities, Kalpakkam 603 102, Tamil Nadu (India)

    2010-07-15

    At Centralised Waste Management Facility (CWMF) 160 m{sup 3} of radioactive chemical sludge, generated from treatment of several batches of category-II and category-III radioactive liquid wastes by chemical precipitation method was stored in clariflocculator (CF) for downstream processing. The sludge needed conditioning before disposal. The analysis of the sludge samples collected at different radial locations and depths from the CF showed suspended solid content of 2.37-13.07% and radioactive content of gross {beta}-{gamma} 5000-27,000 Bq/g and {alpha} 100-600 Bq/g. After comparing different options available for conditioning of the sludge based on their technological and economical aspects, it was decided to dewater it using centrifuge before fixing in cement matrix with additives. Process Control Laboratory of CWMF studied the process in detail to optimize the relevant parameters for fixation of the concentrate obtained from centrifuge. Based on these results, conditioning of the stored sludge was undertaken. The process consisted of diluting the sludge with low active effluents/water for homogenisation and facilitating the transfer of sludge, dewatering of the slurry utilising decanter centrifuge, fixation of dewatered concentrate in Ordinary Portland Cement (OPC) with vermiculite as an additive using in-drum mixing method, providing sufficient time for hardening of fixed mass, transportation and safe disposal into Near Surface Disposal Facility (NSDF). Total 150 m{sup 3} of conditioned waste was produced (750 numbers of drums containing cement fixed concentrate). The paper includes the results of the studies conducted on cement fixed concentrate blocks for finding out their compressive strength and leaching characteristics. It also describes the experiences gained from the above operations.

  13. 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

  14. Influence of prior growth conditions, pressure treatment parameters, and recovery conditions on the inactivation and recovery of Listeria monocytogenes, Escherichia coli, and Salmonella Typhimurium in turkey meat.

    Science.gov (United States)

    Juck, Greg; Neetoo, Hudaa; Beswick, Ethan; Chen, Haiqiang

    2012-02-01

    The relatively high prevalence of Listeria monocytogenes, Escherichia coli O157:H7, and Salmonella enterica serovar Typhimurium in various food products is of great concern to the food industry. The objective of this study was to determine the pressure-inactivation of the pathogens in a representative food model as affected by prior growth temperature, physiological age of the culture, pressure level and treatment temperature. The effect of post-treatment conditions (incubation temperature and gas atmosphere) on the bacterial recovery was also determined. The pathogens being studied were inoculated into sterile turkey breast meat to a final level of ca. 3 logCFU/g and then grown to two stages, the early stage (representative of exponential phase) and late stage (representative of stationary phase), at 15, 25, 35, and 40 °C. Turkey meat samples were pressure-treated at 400 and 600 MPa for 2 min at initial sample temperatures of 4, 20 and 40 °C. Following treatment, bacterial counts in the samples were determined aerobically or anaerobically at incubation temperatures of 15, 25, 35, and 40 °C. Pressure inactivation of the bacterial pathogens increased as a function of the pressure levels and treatment temperatures. Generally speaking, early stage cells were more resistant than late stage cells (Ppressure treatment and recovery conditions of the bacteria after pressure treatment when considering the adequacy of pressure treatments to enhance the microbiological safety of foods. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Estrus induction and fertility response following different treatment protocols in Murrah buffaloes under field conditions

    Science.gov (United States)

    Kumar, L.; Phogat, J. B.; Pandey, A. K.; Phulia, S. K.; Kumar, S.; Dalal, J.

    2016-01-01

    Aim: The aim of this study was to evaluate the efficacy of three different treatment protocols for estrus induction and conception rate in postpartum anestrus buffaloes during breeding season under field conditions. Materials and Methods: The 47 postpartum anestrus buffaloes of the 2nd to 6th parity were divided into three groups. Group 1 (n=16): Buffaloes received cosynch treatment, that is, buserelin acetate 10 µg on day 0 and 9, cloprostenol 500 µg on day 7 followed by fixed-time artificial insemination (FTAI) at the time of second buserelin acetate and 24 h later. Group 2 (n=15): Buffaloes received norgestomet ear implant subcutaneously for 9 days, estradiol benzoate 2 mg on the day of implant insertion (day 0), pregnant mare serum gonadotropin (PMSG) 400 IU and cloprostenol 500 µg on day 9 followed by AI at 48 and 72 h after implant removal. Group 3 (Cosynch-plus, n=16): Buffaloes received Cosynch protocol as per Group 1 except an additional injection of PMSG 400 IU (i.m.) was given 3 days before the start of protocol and FTAI done at the same time of Group 1. Pregnancy diagnosis was performed after 45 days of AI. Results: The estrus induction response following the treatment was 81.3%, 100%, and 93.7% in Group 1, 2, and 3, respectively. The buffaloes of Group 1, 2, and 3 expressed intense (38.4%, 60% and 46.6%, respectively) and moderate estrus (46.1%, 26.6%, and 40%, respectively). The conception rates in Group 1, 2, and 3, at FTAI and overall including subsequent estrus were 37.5% and 62.5%, 53.3%, and 66.6%, 56.3%, and 75%, respectively. Conclusion: All the three treatment protocols can be effectively used for induction of estrus with acceptable conception rate in postpartum anestrus buffaloes during breeding season under field conditions. However, Cosynch-plus (similar to Cosynch protocol except addition of PMSG, 400 IU 3 days before the start of first buserelin acetate administration) protocol results comparatively better pregnancy rate.

  16. Combined action of MK-801 and ceftriaxone impairs the acquisition and reinstatement of morphine-induced conditioned place preference,and delays morphine extinction in rats

    Institute of Scientific and Technical Information of China (English)

    Yaodong Fan; Haichen Niu; Joshua D.Rizak; Ling Li; Guimei Wang; Liqi Xu; He Ren; Hao Lei; Hualin Yu

    2012-01-01

    Objective It is well established that glutamate and its receptors,particularly the N-methyl-D-aspartate receptor (NMDAR),play a significant role in addiction and that the inhibition of glutamatergic hyperfunction reduces addictive behaviors in experimental animals.Specifically,NMDAR antagonists such as MK-801,and an inducer of the expression of glutamate transporter subtype-1 (GLT-1) (cefiriaxone) are known to inhibit addictive behavior.The purpose of this study was to determine whether the combined action of a low dose of MK-801 and a low dose of ceftriaxone provides better inhibition of the acquisition,extinction,and reinstatement of morphine-induced conditioned place preference (CPP) than either compound alone.Methods A morphine-paired CPP experiment was used to study the effects of low doses of MK-801,ceftriaxone and a combination of both on reward-related memory (acquisition,extinction,and reinstatement of morphine preference) in rats.Results A low dose of neither MK-801 (0.05 mg/kg,i.p.) nor ceftriaxone (25 mg/kg,i.p.) alone effectively impaired CPP behaviors.However,when applied in combination,they reduced the acquisition of morphine-induced CPP and completely prevented morphine reinstatement.Their combination also notably impaired the extinction of morphine-induced CPP.Conclusion The combined action of a low dose of an NMDAR antagonist (MK-801)and GLT-1 activation by ceftriaxone effectively changed different phases of CPP behavior.

  17. 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.

  18. Subclinical effects and fenbendazole treatment of turkey ascaridiasis under simulated field conditions.

    Science.gov (United States)

    Yazwinski, T A; Tucker, C; Stelzleni, A; Johnson, Z; Robins, J; Downum, K; Fincher, M; Matlock, J; Chapman, H D

    2002-01-01

    Under simulated natural conditions of bird production and parasite challenge, the effects of ascaridiasis and the effectiveness of fenbendazole treatment (6-day regimes in the feed at 16 ppm) were documented. Birds were artificially challenged with ascarid larvae on a daily basis from day 35 to 112, with bird grow out ending on day 119. Experimental groups, on a per pen basis, were infected control, treated with fenbendazole at days 63-69, treated with fenbendazole at days 63-69 and days 91-97, and uninfected control. In the same order as above, and on an experimental group mean bird basis, final weights were 13.34, 13.47, 13.59, and 13.78 kg, average daily gains from day 7 to day 119 were 117.8, 118.9, 120.1, and 121.8 g, and units gained per unit of feed consumed from day 7 to day 119 were 0.337, 0.341, 0.347, and 0.362. Infected control bird mean Ascaridia dissimilis burdens, with all stages combined, ranged from 351.1 on day 63 to 117.2 on day 91, levels seen commonly with naturally infected commercial turkeys. Trial data dearly indicated that moderate A. dissimilis burdens negatively impacted animal performance (average daily gains and feed efficiencies) and that these parasite burdens are effectively removed by fenbendazole treatment.

  19. Optimization of Electrochemical Treatment Process Conditions for Distillery Effluent Using Response Surface Methodology.

    Science.gov (United States)

    Arulmathi, P; Elangovan, G; Begum, A Farjana

    2015-01-01

    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/cm(2), electrolysis time of 103.27 min, and electrolyte (NaCl) concentration of 1.67 g/L, respectively.

  20. Experimental Investigation of the Mechanical Behavior in Unloading Conditions of Sandstone After High-Temperature Treatment

    Science.gov (United States)

    Ding, Qi-Le; Ju, Feng; Mao, Xian-Biao; Ma, Dan; Yu, Bang-Yong; Song, Shuai-Bing

    2016-07-01

    A detailed understanding of damage evolution in rock after high-temperature treatment in unloading conditions is extremely important in underground engineering applications, such as the disposal of highly radioactive nuclear waste, underground coal gasification, and post-disaster reconstruction. We have studied the effects of temperature (200, 400, 600 and 800 °C) and confining pressure (20, 30 and 40 MPa) on the mechanical properties of sandstone. Scanning electron microscopy studies revealed that at temperatures exceeding 400 °C, new cracks formed, and original cracks extended substantially. When the confining pressure was 20 MPa, a temperature increase from 400 to 800 °C resulted in a 75.2% increase in peak strain, a decrease in Young's modulus and peak strength of 62.5 and 35.8 %, respectively, and transition of the failure mechanism from brittleness to ductility. In the triaxial compression tests, the specimen deformed in a more obvious ductile failure manner at higher confining pressure, whereas in the unloading confining pressure experiments, brittle failure was more obvious when the initial confining pressure was higher. We focused on the effects of temperature and initial confining pressure on peak effective loading stress and peak ductile deformation during unloading. At temperatures of >400 °C, the peak ductile deformation increased rapidly with increases in the high temperature treatment or initial confining pressure. The peak effective loading stress decreased sharply with increased temperature but barely changed when the initial confining pressure was varied.

  1. Contaminant removal in septage treatment with vertical flow constructed wetlands operated under batch flow conditions.

    Science.gov (United States)

    Jong, Valerie Siaw Wee; Tang, Fu Ee

    2016-01-01

    Individual septic tanks are the most common means of on-site sanitation in Malaysia, but they result in a significant volume of septage. A two-staged vertical flow constructed wetlands (VFCWs) system for the treatment of septage was constructed and studied in Sarawak, Malaysia. Raw septage was treated in the first stage wetlands, and the resulting percolate was fed onto the second stage wetlands for further treatment. Here, the effects of a batch loading regime on the contaminant removal efficiency at the second stage wetlands, which included palm kernel shell within their filter substrate, are presented. The batch loading regime with pond:rest (P:R) period of 1:1, 2:2 and 3:3 (day:day) was studied. The improvement of the effluent redox condition was evident with P:R = 3:3, resulting in excellent organic matters (chemical oxygen demand and biochemical oxygen demand) and nitrogen reduction. The bed operated with P:R = 1:1 experienced constant clogging, with a water layer observed on the bed surface. For the P:R = 3:3 regime, the dissolved oxygen profile was not found to decay drastically after 24 hours of ponding, suggesting that the biodegradation mainly occurred during the first day. The study results indicate that a suitable application regime with an adequate rest period is important in VFCWs to ensure efficient operation.

  2. Optimization of the preparation conditions of ceramic products using drinking water treatment sludges.

    Science.gov (United States)

    Zamora, R M Ramirez; Ayala, F Espesel; Garcia, L Chavez; Moreno, A Duran; Schouwenaars, R

    2008-11-01

    The aim of this work is to optimize, via Response Surface Methodology, the values of the main process parameters for the production of ceramic products using sludges obtained from drinking water treatment in order to valorise them. In the first experimental stage, sludges were collected from a drinking water treatment plant for characterization. In the second stage, trials were carried out to elaborate thin cross-section specimens and fired bricks following an orthogonal central composite design of experiments with three factors (sludge composition, grain size and firing temperature) and five levels. The optimization parameters (Y(1)=shrinking by firing (%), Y(2)=water absorption (%), Y(3)=density (g/cm(3)) and Y(4)=compressive strength (kg/cm(2))) were determined according to standardized analytical methods. Two distinct physicochemical processes were active during firing at different conditions in the experimental design, preventing the determination of a full response surface, which would allow direct optimization of production parameters. Nevertheless, the temperature range for the production of classical red brick was closely delimitated by the results; above this temperature, a lightweight ceramic with surprisingly high strength was produced, opening possibilities for the valorisation of a product with considerably higher added value than what was originally envisioned.

  3. 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

  4. Implications of delayed bone marrow aspirations at the end of treatment induction for risk stratification and outcome in children with acute lymphoblastic leukaemia.

    Science.gov (United States)

    Zuna, Jan; Moericke, Anja; Arens, Mari; Koehler, Rolf; Panzer-Grümayer, Renate; Bartram, Claus R; Fischer, Susanna; Fronkova, Eva; Zaliova, Marketa; Schrauder, André; Stanulla, Martin; Zimmermann, Martin; Trka, Jan; Stary, Jan; Attarbaschi, Andishe; Mann, Georg; Schrappe, Martin; Cario, Gunnar

    2016-06-01

    Minimal residual disease (MRD) at the end of induction therapy is important for risk stratification of acute lymphoblastic leukaemia (ALL), but bone marrow (BM) aspiration is often postponed or must be repeated to fulfil qualitative and quantitative criteria for morphological assessment of haematological remission and/or MRD analysis. The impact of BM aspiration delay on measured MRD levels and resulting risk stratification is currently unknown. We analysed paired MRD data of 289 paediatric ALL patients requiring a repeat BM aspiration. MRD levels differed in 108 patients (37%) with a decrease in the majority (85/108). This would have resulted in different risk group allocation in 64 of 289 patients (23%) when applying the ALL-Berlin-Frankfurt-Münster 2000 criteria. MRD change was associated with the duration of delay; 40% of patients with delay ≥7 days had a shift to lower MRD levels compared to only 18% after a shorter delay. Patients MRD-positive at the original but MRD-negative at the repeat BM aspiration (n = 50) had a worse 5-year event-free survival than those already negative at first aspiration (n = 115) (86 ± 5% vs. 94 ± 2%; P = 0·024). We conclude that BM aspirations should be pursued as scheduled in the protocol because delayed MRD sampling at end of induction may result in false-low MRD load and distort MRD-based risk assessment.

  5. Water Vapor Adsorption on Biomass Based Carbons under Post-Combustion CO2 Capture Conditions: Effect of Post-Treatment

    Science.gov (United States)

    Querejeta, Nausika; Plaza, Marta G.; Rubiera, Fernando; Pevida, Covadonga

    2016-01-01

    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. PMID:28773488

  6. 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.

  7. 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

  8. Treatment of hydrocarbon contamination under flow through conditions by using magnetite catalyzed chemical oxidation.

    Science.gov (United States)

    Usman, M; Faure, P; Lorgeoux, C; Ruby, C; Hanna, K

    2013-01-01

    Soil pollution by hydrocarbons (aromatic and aliphatic hydrocarbons) is a major environmental issue. Various treatments have been used to remove them from contaminated soils. In our previous studies, the ability of magnetite has been successfully explored to catalyze chemical oxidation for hydrocarbon remediation in batch slurry system. In the present laboratory study, column experiments were performed to evaluate the efficiency of magnetite catalyzed Fenton-like (FL) and activated persulfate (AP) oxidation for hydrocarbon degradation. Flow-through column experiments are intended to provide a better representation of field conditions. Organic extracts isolated from three different soils (an oil-contaminated soil from petrochemical industrial site and two soils polluted by polycyclic aromatic hydrocarbon (PAH) originating from coking plant sites) were spiked on sand. After solvent evaporation, spiked sand was packed in column and was subjected to oxidation using magnetite as catalyst. Oxidant solution was injected at a flow rate of 0.1 mL min(-1) under water-saturated conditions. Organic analyses were performed by GC-mass spectrometry, GC-flame ionization detector, and micro-Fourier transform infrared spectroscopy. Significant abatement of both types of hydrocarbons (60-70 %) was achieved after chemical oxidation (FL and AP) of organic extracts. No significant by-products were formed during oxidation experiment, underscoring the complete degradation of hydrocarbons. No selective degradation was observed for FL with almost similar efficiency towards all hydrocarbons. However, AP showed less reactivity towards higher molecular weight PAHs and aromatic oxygenated compounds. Results of this study demonstrated that magnetite-catalyzed chemical oxidation can effectively degrade both aromatic and aliphatic hydrocarbons (enhanced available contaminants) under flow-through conditions.

  9. Research progress of autophagy for delay aging and treatment of Alzheimer’s disease%自噬延缓衰老及治疗阿尔茨海默病的研究进展

    Institute of Scientific and Technical Information of China (English)

    陈发菊; 吴芹; 石京山

    2015-01-01

    OBJECTIVE To introduce the research progress for the treatment of Alzheimer’s disease and delay aging by autophagy as the strategy. METHODS A lot of reading literature in recent years were reviewed. RESULTS AND CONCLUSION Autophagy delay aging, enhance cognitive function, which providing ideas for the future research of new autophagy used in the treatment of AD and aging.%目的:介绍以自噬(autophagy)为策略治疗阿尔茨海默病(Alzheimer’s disease,AD)和延缓衰老的研究进展。方法:大量阅读近年来相关文献进行综述。结果和结论:自噬延缓衰老、改善AD的认知功能,为续延缓衰老和AD的治疗提供思路。

  10. Measuring information-transfer delays.

    Directory of Open Access Journals (Sweden)

    Michael Wibral

    Full Text Available In complex networks such as gene networks, traffic systems or brain circuits it is important to understand how long it takes for the different parts of the network to effectively influence one another. In the brain, for example, axonal delays between brain areas can amount to several tens of milliseconds, adding an intrinsic component to any timing-based processing of information. Inferring neural interaction delays is thus needed to interpret the information transfer revealed by any analysis of directed interactions across brain structures. However, a robust estimation of interaction delays from neural activity faces several challenges if modeling assumptions on interaction mechanisms are wrong or cannot be made. Here, we propose a robust estimator for neuronal interaction delays rooted in an information-theoretic framework, which allows a model-free exploration of interactions. In particular, we extend transfer entropy to account for delayed source-target interactions, while crucially retaining the conditioning on the embedded target state at the immediately previous time step. We prove that this particular extension is indeed guaranteed to identify interaction delays between two coupled systems and is the only relevant option in keeping with Wiener's principle of causality. We demonstrate the performance of our approach in detecting interaction delays on finite data by numerical simulations of stochastic and deterministic processes, as well as on local field potential recordings. We also show the ability of the extended transfer entropy to detect the presence of multiple delays, as well as feedback loops. While evaluated on neuroscience data, we expect the estimator to be useful in other fields dealing with network dynamics.

  11. 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

  12. Treatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure.

    Science.gov (United States)

    Dharmarajan, Kumar; Strait, Kelly M; Tinetti, Mary E; Lagu, Tara; Lindenauer, Peter K; Lynn, Joanne; Krukas, Michelle R; Ernst, Frank R; Li, Shu-Xia; Krumholz, Harlan M

    2016-08-01

    To determine how often hospitalized older adults principally diagnosed with pneumonia, chronic obstructive pulmonary disease (COPD), or heart failure (HF) are concurrently treated for two or more of these acute cardiopulmonary conditions. Retrospective cohort study. 368 U.S. hospitals in the Premier research database. Individuals aged 65 and older principally hospitalized with pneumonia, COPD, or HF in 2009 or 2010. Proportion of diagnosed episodes of pneumonia, COPD, or HF concurrently treated for two or more of these acute cardiopulmonary conditions during the first 2 hospital days. Of 91,709 diagnosed pneumonia hospitalizations, 32% received treatment for two or more acute cardiopulmonary conditions (18% for HF, 18% for COPD, 4% for both). Of 41,052 diagnosed COPD hospitalizations, 19% received treatment for two or more acute cardiopulmonary conditions (all of which involved additional HF treatment). Of 118,061 diagnosed HF hospitalizations, 38% received treatment for two or more acute cardiopulmonary conditions (34% for pneumonia, 9% for COPD, 5% for both). Hospitalized older adults diagnosed with pneumonia, COPD, or HF are frequently treated for two or more acute cardiopulmonary conditions, suggesting that clinical syndromes often fall between traditional diagnostic categories. Research is needed to evaluate the risks and benefits of real-world treatment for the many older adults whose presentations elicit diagnostic uncertainty or concern about coexisting acute conditions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  13. 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

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    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.

  14. A-B Status of Behavior Therapy Technicians as Related to Success of Mowrer's Conditioning Treatment for Enuresis

    Science.gov (United States)

    James, Leonard E.; Foreman, Milton E.

    1973-01-01

    This investigation was designed to evaluate the relationship of therapy technician A-B status and the outcomes of a specific behavior treatment; namely, Mowrer's conditioning paradigm for the treatment of enuresis. Results support the hypothesis that B-status technicians would be associated with higher successful outcomes than A-status…

  15. Conversion of linear time-invariant time-delay feedback systems into delay-differential equations with commensurate delays

    Science.gov (United States)

    Yamazaki, Tatsuya; Hagiwara, Tomomichi

    2014-08-01

    A new stability analysis method of time-delay systems (TDSs) called the monodromy operator approach has been studied under the assumption that a TDS is represented as a time-delay feedback system consisting of a finite-dimensional linear time-invariant (LTI) system and a pure delay. For applying this approach to TDSs described by delay-differential equations (DDEs), the problem of converting DDEs into representation as time-delay feedback systems has been studied. With regard to such a problem, it was shown that, under discontinuous initial functions, it is natural to define the solutions of DDEs in two different ways, and the above conversion problem was solved for each of these two definitions. More precisely, the solution of a DDE was represented as either the state of the finite-dimensional part of a time-delay feedback system or a part of the output of another time-delay feedback system, depending on which definition of the DDE solution one is talking about. Motivated by the importance in establishing a thorough relationship between time-delay feedback systems and DDEs, this paper discusses the opposite problem of converting time-delay feedback systems into representation as DDEs, including the discussions about the conversion of the initial conditions. We show that the state of (the finite-dimensional part of) a time-delay feedback system can be represented as the solution of a DDE in the sense of one of the two definitions, while its 'essential' output can be represented as that of another DDE in the sense of the other type of definition. Rigorously speaking, however, it is also shown that the latter representation is possible regardless of the initial conditions, while some initial condition could prevent the conversion into the former representation. This study hence establishes that the representation of TDSs as time-delay feedback systems possesses higher ability than that with DDEs, as description methods for LTI TDSs with commensurate delays.

  16. 工程项目延期总部管理费用索赔核算问题研究%Problem and Countermeasure of the Claim for Home Office Overhead Under the Condition of Engineering Project Delay

    Institute of Scientific and Technical Information of China (English)

    牛彦秀; 巩彦忠; 张天熹

    2015-01-01

    The Eichleay formula and Hudson formula are the methods which are used for calculating the amount of claim for home office overhead in the case of owner-caused delay. However,those two formulas are not perfect. To overcome their limitations,this paper provides an accounting model of activity-based costing,divide into direct and indirect home office overhead to refine engineering project accounting. This model establishes activity center,allocating resource cost according to resource drivers and allocating activity cost according to activity drivers. At last,a simplified case is given to explain the procedure. The accounting results can provide timely,reasonable and accurate evidences for the claim for home office overhead under the condition of engineering project delay.%核算工程项目因业主原因延期,企业索赔期间分摊总部管理费用采用的方法主要有Eichleay公式法和Hudson公式法,然而这两种方法都存在各自的局限性,为克服其缺陷,提出作业成本核算模式,区分直接和间接总部管理费用,细化工程项目核算,建立作业中心,按资源动因分配资源成本,按作业动因分配作业成本,以合理确定索赔额,并以案例形式演示核算程序。作业成本核算模式的核算结果可以为工程项目延期索赔总部管理费用提供及时、合理而准确的证据。

  17. National Utilization Patterns of Steroid Injection and Operative Intervention for Treatment of Common Hand Conditions

    Science.gov (United States)

    Sears, Erika D.; Swiatek, Peter R.; Chung, Kevin C

    2015-01-01

    Purpose To conduct a population-level analysis of practice trends and probability of surgery based on the number of steroid injections for common hand conditions. Methods Patients at least 18 years old receiving injection or surgery for carpal tunnel syndrome (CTS), trigger finger (TF), or De Quervain tenovaginitis (DQ) were identified for inclusion using the 2009–2013 Truven MarketScan databases. The number of injections performed was counted, and time between injection and operation was calculated for patients receiving both treatments. A multivariable logistic regression model was created to evaluate the odds of undergoing surgery based on the number of injections performed, controlling for patient age, sex, comorbidities, and insurance type. Results The study sample included 251,030 patients who underwent steroid injection or operative release for CTS (n=129,917), TF (n=102,778), and DQ (n=18,335). The majority of CTS patients were managed with immediate surgery (71%), whereas most patients with TF and DQ were managed initially with injection (74% and 84%, respectively). Among patients receiving both an injection and an operation, a single injection was the most common practice prior to surgery (69%, 58%, and 67% of patients with CTS, TF, and DQ, respectively). Multiple injections for DQ and TF were associated with relatively low predicted probability of surgery (17% and 26%, respectively, after 2 injections). However, the predicted probability of surgery after two injections was higher in patients with CTS (44%). Conclusions Given the associated probability of surgery after multiple injections for the three hand conditions examined, the practice of repeat injections should be critically examined to determine whether underuse or overuse is present and whether efficiency and resource utilization can be improved upon. Level of Evidence Level II (retrospective prognostic study) PMID:26774548

  18. 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