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Sample records for early invasive strategy

  1. Early Invasive Versus Selective Strategy for Non-ST-Segment Elevation Acute Coronary Syndrome: The ICTUS Trial

    NARCIS (Netherlands)

    Hoedemaker, N.P.G.; Damman, P.; Woudstra, P.; Hirsch, A.; Windhausen, F.; Tijssen, J.G.; Winter, R.J. de; Verheugt, F.W.A.; et al.,

    2017-01-01

    BACKGROUND: The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and an elevated cardiac troponin T. No long-term

  2. Early Invasive Versus Selective Strategy for Non-ST-Segment Elevation Acute Coronary Syndrome: The ICTUS Trial

    NARCIS (Netherlands)

    Hoedemaker, Niels P. G.; Damman, Peter; Woudstra, Pier; Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G. P.; de Winter, Robbert J.; Peters, R. J. G.; Dunselman, P. H. J. M.; Verheugt, F. W. A.; Janus, C. L.; Umans, V.; Bendermacher, P. E. F.; Michels, H. R.; Sadé e, A.; Hertzberger, D.; de Miliano, P. A. R. M.; Liem, A. H.; Tjon Joe Gin, R.; van der Linde, M.; Lok, D.; Hoedemaker, G.; Pieterse, M.; van den Merkhof, L.; Danië ls, M.; van Hessen, M.; Hermans, W.; Schotborgh, C. E.; de Zwaan, C.; Bredero, A.; de Jaegere, P.; Janssen, M.; Louwerenburg, J.; Veerhoek, M.; Schalij, M.; de Porto, A.; Zijlstra, F.; Winter, J.; de Feyter, P.; Robles de Medina, R.; Withagen, P.; Sedney, M.; Thijssen, H.; van Rees, C.; van den Bergh, P.; de Cock, C.; van 't Hof, A.; Suttorp, M. J.; Windhausen, F.; Cornel, J. H.

    2017-01-01

    The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and an elevated cardiac troponin T. No long-term benefit of an

  3. Cost-effectiveness of early versus selectively invasive strategy in patients with acute coronary syndromes without ST-segment elevation

    NARCIS (Netherlands)

    Dijksman, L. M.; Hirsch, A.; Windhausen, F.; Asselman, F. F.; Tijssen, J. G. P.; Dijkgraaf, M. G. W.; de Winter, R. J.

    2009-01-01

    AIMS: The ICTUS trial compared an early invasive versus a selectively invasive strategy in high risk patients with a non-ST-segment elevation acute coronary syndrome and an elevated cardiac troponin T. Alongside the ICTUS trial a cost-effectiveness analysis from a provider perspective was performed.

  4. [Early invasive strategy in diabetic patients with non-ST-segment elevation acute coronary syndromes].

    Science.gov (United States)

    Baeza Román, Anna; Latour Pérez, Jaime; de Miguel Balsa, Eva; Pino Izquierdo, Karel; Coves Orts, Francisco Javier; García Ochando, Luis; de la Torre Fernández, Maria José

    2014-05-20

    In the management of non-ST-segment elevation acute coronary syndromes (NSTE-ACS), several studies have shown a reduction in mortality with the use of an invasive strategy in high-risk patients, including diabetic patients. Paradoxically, other studies have shown an under-utilization of this invasive strategy in these patients. The aim of this study is to determine the characteristics of patients managed conservatively and identify determinants of the use of invasive or conservative strategy. Retrospective cohort study conducted in diabetic patients with NSTE-ACS included in the ARIAM-SEMICYUC registry (n=531) in 2010 and 2011. We performed crude and adjusted unconditional logistic regression. We analyzed 531 diabetic patients, 264 (49.7%) of which received invasive strategy. Patients managed conservatively were a subgroup characterized by older age and cardiovascular comorbidity, increased risk of bleeding and the absence of high-risk electrocardiogram (ECG). In diabetic patients with NSTE-ACS, independent predictors associated with conservative strategy were low-risk ECG, initial Killip class>1, high risk of bleeding and pretreatment with clopidogrel. The fear of bleeding complications or advanced coronary lesions could be the cause of the underutilization of an invasive strategy in diabetic patients with NSTE-ACS. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  5. Long-term outcome after an early invasive versus selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome and elevated cardiac troponin T (the ICTUS trial): a follow-up study.

    NARCIS (Netherlands)

    Hirsch, A.; Windhausen, F.; Tijssen, J.G.P.; Verheugt, F.W.A.; Cornel, J.H.; Winter, R.J. de

    2007-01-01

    BACKGROUND: The ICTUS trial was a study that compared an early invasive with a selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS). The study reported no difference between the strategies for frequency of death, myocardial infarction, or

  6. Long-term outcome after an early invasive versus selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome and elevated cardiac troponin T (the ICTUS trial): a follow-up study

    NARCIS (Netherlands)

    Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G. P.; Verheugt, Freek W. A.; Hein Cornel, Jan; de Winter, Robbert J.

    2007-01-01

    BACKGROUND: The ICTUS trial was a study that compared an early invasive with a selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS). The study reported no difference between the strategies for frequency of death, myocardial infarction, or

  7. [Predictors of the use of the early invasive strategy in women with non-ST-elevation acute coronary syndrome].

    Science.gov (United States)

    de Miguel-Balsa, E; Baeza-Román, A; Pino-Izquierdo, K; Latour-Pérez, J; Coves-Orts, F J; Alcoverro-Pedrola, J M; Pavía-Pesquera, M C; Felices-Abad, F; Calvo-Embuena, R

    2014-11-01

    To identify determinants associated to an early invasive strategy in women with acute coronary syndromes without ST elevation (NSTE-ACS). A retrospective cohort study was made. Crude and adjusted analysis of the performance of the early invasive strategy using logistic regression. Coronary Units enrolled in 2010 - 2011 in the ARIAM-SEMICYUC registry. A total of 440 women with NSTE-ACS were studied. Sixteen patients were excluded due to insufficient data, together with 58 patients subjected to elective coronary angiography (> 72 h). Demographic parameters, coronary risk factors, previous medication, comorbidity. Clinical, laboratory, hemodynamic and electrocardiographic data of the episode. Women treated conservatively were of older age, had oral anticoagulation, diabetes, previous coronary lesions, and heart failure (p 80 years (OR 0.48, 95% CI 0.27 to 0.82, p=0.009), known coronary lesions (OR 0.47, 95% CI 0.26-0.84, p=0.011), and heart rate (OR 0.98, 95% CI 0.97-0.99, p=0.003) were independently associated to conservative treatment. Smoking (OR 2.50, 95% CI 1.20 to 5.19, p=0.013) and high-risk electrocardiogram (OR 2.96, 95% CI 1.72 to 4.97, p 80 years and increased heart rate were independent factors associated to conservative treatment. Copyright © 2012 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  8. [Prehospital thrombolysis: A national perspective. Pharmaco-invasive strategy for early reperfusion of STEMI in Mexico].

    Science.gov (United States)

    Arriaga-Nava, Roberto; Valencia-Sánchez, Jesús-Salvador; Rosas-Peralta, Martin; Garrido-Garduño, Martin; Calderón-Abbo, Moisés

    2015-01-01

    To review the existing evidence on the role of prehospital thrombolysis in patients with ST-segment elevation acute myocardial infarction (STEMI) as part of a strategy of cutting edge to reduce the time of coronary reperfusion and as a consequence improves both the survival and function. We used the technique of exploration-reduction-evaluation-analysis and synthesis of related studies, with an overview of current recommendations, data from controlled clinical trials and from the national and international registries about the different strategies for STEMI reperfusion. In total, we examined 186 references on prehospital thrombolysis, 130 references in times door-treatment, 139 references in STEMI management and national and international registries as well as 135 references on rescue and primary percutaneous coronary intervention for STEMI. Finally the 48 references that were more relevant and informative were retained. The «time» factor is crucial in the success of early reperfusion in STEMI especially if thrombolysis is applied correctly during the prehospital time. The primary percutaneous coronary intervention is contingent upon its feasibility before 120 min from the onset of symptoms. In our midst to internationally, thrombolysis continues to be a strategy with great impact on their expectations of life and function of patients. Telecommunication systems should be incorporate in real time to the priority needs of catastrophic diseases such as STEMI where life is depending on time. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  9. RNA-seq analysis of early enteromyxosis in turbot (Scophthalmus maximus): new insights into parasite invasion and immune evasion strategies.

    Science.gov (United States)

    Ronza, Paolo; Robledo, Diego; Bermúdez, Roberto; Losada, Ana Paula; Pardo, Belén G; Sitjà-Bobadilla, Ariadna; Quiroga, María Isabel; Martínez, Paulino

    2016-07-01

    Enteromyxum scophthalmi, an intestinal myxozoan parasite, is the causative agent of a threatening disease for turbot (Scophthalmus maximus, L.) aquaculture. The colonisation of the digestive tract by this parasite leads to a cachectic syndrome associated with high morbidity and mortality rates. This myxosporidiosis has a long pre-patent period and the first detectable clinical and histopathological changes are subtle. The pathogenic mechanisms acting in the early stages of infection are still far from being fully understood. Further information on the host-parasite interaction is needed to assist in finding efficient preventive and therapeutic measures. Here, a RNA-seq-based transcriptome analysis of head kidney, spleen and pyloric caeca from experimentally-infected and control turbot was performed. Only infected fish with early signs of infection, determined by histopathology and immunohistochemical detection of E. scophthalmi, were selected. The RNA-seq analysis revealed, as expected, less intense transcriptomic changes than those previously found during later stages of the disease. Several genes involved in IFN-related pathways were up-regulated in the three organs, suggesting that the IFN-mediated immune response plays a main role in this phase of the disease. Interestingly, an opposite expression pattern had been found in a previous study on severely infected turbot. In addition, possible strategies for immune system evasion were suggested by the down-regulation of different genes encoding complement components and acute phase proteins. At the site of infection (pyloric caeca), modulation of genes related to different structural proteins was detected and the expression profile indicated the inhibition of cell proliferation and differentiation. These transcriptomic changes provide indications regarding the mechanisms of parasite attachment to and invasion of the host. The current results contribute to a better knowledge of the events that characterise the early

  10. Early versus delayed invasive strategy for intermediate- and high-risk acute coronary syndromes managed without P2Y12 receptor inhibitor pretreatment: Design and rationale of the EARLY randomized trial.

    Science.gov (United States)

    Lemesle, Gilles; Laine, Marc; Pankert, Mathieu; Puymirat, Etienne; Cuisset, Thomas; Boueri, Ziad; Maillard, Luc; Armero, Sébastien; Cayla, Guillaume; Bali, Laurent; Motreff, Pascal; Peyre, Jean-Pascal; Paganelli, Franck; Kerbaul, François; Roch, Antoine; Michelet, Pierre; Baumstarck, Karine; Bonello, Laurent

    2018-01-01

    According to recent literature, pretreatment with a P2Y 12 ADP receptor antagonist before coronary angiography appears no longer suitable in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) due to an unfavorable risk-benefit ratio. Optimal delay of the invasive strategy in this specific context is unknown. We hypothesize that without P2Y 12 ADP receptor antagonist pretreatment, a very early invasive strategy may be beneficial. The EARLY trial (Early or Delayed Revascularization for Intermediate- and High-Risk Non-ST-Segment Elevation Acute Coronary Syndromes?) is a prospective, multicenter, randomized, controlled, open-label, 2-parallel-group study that plans to enroll 740 patients. Patients are eligible if the diagnosis of intermediate- or high-risk NSTE-ACS is made and an invasive strategy intended. Patients are randomized in a 1:1 ratio. In the control group, a delayed strategy is adopted, with the coronary angiography taking place between 12 and 72 hours after randomization. In the experimental group, a very early invasive strategy is performed within 2 hours. A loading dose of a P2Y 12 ADP receptor antagonist is given at the time of intervention in both groups. Recruitment began in September 2016 (n = 558 patients as of October 2017). The primary endpoint is the composite of cardiovascular death and recurrent ischemic events at 1 month. The EARLY trial aims to demonstrate the superiority of a very early invasive strategy compared with a delayed strategy in intermediate- and high-risk NSTE-ACS patients managed without P2Y 12 ADP receptor antagonist pretreatment. © 2018 Wiley Periodicals, Inc.

  11. Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis

    NARCIS (Netherlands)

    O'Donoghue, Michelle; Boden, William E.; Braunwald, Eugene; Cannon, Christopher P.; Clayton, Tim C.; de Winter, Robbert J.; Fox, Keith A. A.; Lagerqvist, Bo; McCullough, Peter A.; Murphy, Sabina A.; Spacek, Rudolf; Swahn, Eva; Wallentin, Lars; Windhausen, Fons; Sabatine, Marc S.

    2008-01-01

    CONTEXT: Although an invasive strategy is frequently used in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), data from some trials suggest that this strategy may not benefit women. OBJECTIVE: To conduct a meta-analysis of randomized trials to compare the effects of an

  12. Invasive species information networks: Collaboration at multiple scales for prevention, early detection, and rapid response to invasive alien species

    Science.gov (United States)

    Simpson, Annie; Jarnevich, Catherine S.; Madsen, John; Westbrooks, Randy G.; Fournier, Christine; Mehrhoff, Les; Browne, Michael; Graham, Jim; Sellers, Elizabeth A.

    2009-01-01

    Accurate analysis of present distributions and effective modeling of future distributions of invasive alien species (IAS) are both highly dependent on the availability and accessibility of occurrence data and natural history information about the species. Invasive alien species monitoring and detection networks (such as the Invasive Plant Atlas of New England and the Invasive Plant Atlas of the MidSouth) generate occurrence data at local and regional levels within the United States, which are shared through the US National Institute of Invasive Species Science. The Inter-American Biodiversity Information Network's Invasives Information Network (I3N), facilitates cooperation on sharing invasive species occurrence data throughout the Western Hemisphere. The I3N and other national and regional networks expose their data globally via the Global Invasive Species Information Network (GISIN). International and interdisciplinary cooperation on data sharing strengthens cooperation on strategies and responses to invasions. However, limitations to effective collaboration among invasive species networks leading to successful early detection and rapid response to invasive species include: lack of interoperability; data accessibility; funding; and technical expertise. This paper proposes various solutions to these obstacles at different geographic levels and briefly describes success stories from the invasive species information networks mentioned above. Using biological informatics to facilitate global information sharing is especially critical in invasive species science, as research has shown that one of the best indicators of the invasiveness of a species is whether it has been invasive elsewhere. Data must also be shared across disciplines because natural history information (e.g. diet, predators, habitat requirements, etc.) about a species in its native range is vital for effective prevention, detection, and rapid response to an invasion. Finally, it has been our

  13. Invasive strategy and frailty in very elderly patients with acute coronary syndromes.

    Science.gov (United States)

    Llaó, Isaac; Ariza-Solé, Albert; Sanchis, Juan; Alegre, Oriol; López-Palop, Ramon; Formiga, Francesc; Marín, Francisco; Vidán, María T; Martínez-Sellés, Manuel; Sionis, Alessandro; Vives-Borrás, Miguel; Gómez-Hospital, Joan Antoni; Gómez-Lara, Josep; Roura, Gerard; Díez-Villanueva, Pablo; Núñez-Gil, Iván; Maristany, Jaume; Asmarats, Lluis; Bueno, Héctor; Abu-Assi, Emad; Cequier, Àngel

    2018-04-03

    Current guidelines recommend an early invasive strategy in patients with non-ST segment elevation acute coronary syndromes (NSTEACS). The role of an invasive strategy in frail elderly patients remains controversial. The LONGEVO-SCA registry included unselected NSTEACS patients aged ≥80 years. A geriatric assessment was performed during hospitalization, including frailty. We evaluated the impact of an invasive strategy during the admission on the incidence of cardiac death, reinfarction or new revascularisation at 6-months. From 531 patients included, 145 (27.3%) were frail. Mean age was 84.3 years. Most patients underwent an invasive strategy (407/531, 76.6%). Patients undergoing an invasive strategy were younger and had lower proportion of frailty (23.3% vs 40.3%, pstrategy-frailty was significant (p=0.032) Conclusions: An invasive strategy was independently associated with better outcomes in very elderly patients with NSTEACS. This association was different according to frailty status.

  14. Early detection of invasive plants: principles and practices

    Science.gov (United States)

    Welch, Bradley A.; Geissler, Paul H.; Latham, Penelope

    2014-01-01

    Invasive plants infest an estimated 2.6 million acres of the 83 million acres managed by the National Park Service (NPS) in the United States. The consequences of these invasions present a significant challenge for the NPS to manage the agency’s natural resources “unimpaired for the enjoyment of future generations.” More NPS lands are infested daily despite diligent efforts to curtail the problem. Impacts from invasive species have been realized in most parks, resulting in an expressed need to control existing infestations and restore affected ecosystems. There is a growing urgency in the NPS and other resource management organizations to be proactive. The NPS I&M Program, in collaboration with the U.S. Geological Survey (USGS) Status and Trends Program, compiled this document to provide guidance and insight to parks and other natural areas engaged in developing early-detection monitoring protocols for invasive plants. While several rapid response frameworks exist, there is no consistent or comprehensive guidance informing the active detection of nonnative plants early in the invasion process. Early-detection was selected as a primary focus for invasive-species monitoring because, along with rapid response, it is a key strategy for successful management of invasive species. Eradication efforts are most successful on small infestations (that is less than 1 hectare) and become less successful as infestation size increases, to the point that eradication is unlikely for large (that is greater than 1,000 hectares) populations of invasive plants. This document provides guidance for natural resource managers wishing to detect invasive plants early through an active, directed monitoring program. It has a Quick-Start Guide to direct readers to specific chapters and text relevant to their needs. Decision trees and flow charts assist the reader in deciding what methods to choose and when to use them. This document is written in a modular format to accommodate use of

  15. Evaluation of an early step-down strategy from intravenous anidulafungin to oral azole therapy for the treatment of candidemia and other forms of invasive candidiasis: results from an open-label trial.

    Science.gov (United States)

    Vazquez, Jose; Reboli, Annette C; Pappas, Peter G; Patterson, Thomas F; Reinhardt, John; Chin-Hong, Peter; Tobin, Ellis; Kett, Daniel H; Biswas, Pinaki; Swanson, Robert

    2014-02-21

    Hospitalized patients are at increased risk for candidemia and invasive candidiasis (C/IC). Improved therapeutic regimens with enhanced clinical and pharmacoeconomic outcomes utilizing existing antifungal agents are still needed. An open-label, non-comparative study evaluated an intravenous (i.v.) to oral step-down strategy. Patients with C/IC were treated with i.v. anidulafungin and after 5 days of i.v. therapy had the option to step-down to oral azole therapy (fluconazole or voriconazole) if they met prespecified criteria. The primary endpoint was the global response rate (clinical + microbiological) at end of treatment (EOT) in the modified intent-to-treat (MITT) population (at least one dose of anidulafungin plus positive Candida within 96 hours of study entry). Secondary endpoints included efficacy at other time points and in predefined patient subpopulations. Patients who stepped down early (≤ 7 days' anidulafungin) were identified as the "early switch" subpopulation. In total, 282 patients were enrolled, of whom 250 were included in the MITT population. The MITT global response rate at EOT was 83.7% (95% confidence interval, 78.7-88.8). Global response rates at all time points were generally similar in the early switch subpopulation compared with the MITT population. Global response rates were also similar across multiple Candida species, including C. albicans, C. glabrata, and C. parapsilosis. The most common treatment-related adverse events were nausea and vomiting (four patients each). A short course of i.v. anidulafungin, followed by early step-down to oral azole therapy, is an effective and well-tolerated approach for the treatment of C/IC. ClinicalTrials.gov: NCT00496197.

  16. Underuse of an invasive strategy for patients with diabetes with acute coronary syndrome

    DEFF Research Database (Denmark)

    Gustafsson, Ida; Hvelplund, Anders; Hansen, Kim Wadt

    2015-01-01

    BACKGROUND: Guidelines recommend an early invasive strategy for patients with diabetes with acute coronary syndromes (ACS). We investigated if patients with diabetes with ACS are offered coronary angiography (CAG) and revascularisation to the same extent as patients without diabetes. METHODS AND ...

  17. Invasive strategy for treatment of myocardial infarction.

    Science.gov (United States)

    Höfling, B; von Pölnitz, A

    1990-01-01

    The classical approach to the treatment of acute myocardial infarction (MI) has been one of stabilization and complication management. In an effort to optimize treatment, the initiation of the cardiac care unit and the use of antiarrhythmic therapy have succeeded in lowering the mortality rate substantially. More modern concepts are aimed at limiting infarct size and preserving myocardial function. These aims can be achieved medically using intravenous (i.v.) thrombolysis or invasively either with intracoronary (i.c.) thrombolysis, percutaneous transluminal coronary angioplasty (PTCA), or bypass surgery. Although i.c. thrombolysis is more effective than the i.v. route, the necessity for acute coronary catheterization makes it incompatible and difficult for routine use, and thus is usually reserved for cases in which i.v. lysis has failed. Intravenous thrombolysis is becoming the standard approach to MI, and the remaining questions are those of which drug and dosage are optimal and how to approach the patient after thrombolysis. In this regard, we favor a symptom-guided approach, as shown by the TIMI-IIA and European cooperative studies. In patients with ongoing ischemia postlysis, heart catheterization is indicated and a decision regarding PTCA or surgery is then made, depending on anatomy. In patients remaining stable after acute lysis, a predischarge stress may help in selecting patients requiring catheterization. As an alternative invasive approach to acute MI, PTCA may be the quickest and most effective method to recanalize a vessel, but, again, logistical problems make it incompatible in the acute setting. The same is true for bypass surgery, and although extensive improvements have been made in intraoperative myocardial preservation so that a 2% mortality is achievable, it is reserved for patients with extensive ischemia and anatomy unsuitable for PTCA (extensive multivessel or left main disease).

  18. Controlled invasive mechanical ventilation strategies in obese patients undergoing surgery.

    Science.gov (United States)

    Maia, Lígia de Albuquerque; Silva, Pedro Leme; Pelosi, Paolo; Rocco, Patricia Rieken Macedo

    2017-06-01

    The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes. Expert commentary: Before determining the ideal intraoperative ventilation strategy, it is important to analyze the pathophysiology and comorbidities of each obese patient. Protective ventilation with low tidal volume, driving pressure, energy, and mechanical power should be employed during surgery; however, further studies are required to clarify the most effective ventilation strategies, such as the optimal positive end-expiratory pressure and whether recruitment maneuvers minimize lung injury. In this context, an ongoing trial of intraoperative ventilation in obese patients (PROBESE) should help determine the mechanical ventilation strategy that best improves clinical outcome in patients with body mass index≥35kg/m 2 .

  19. Efficacy and Safety of a Pharmaco-Invasive Strategy With Half-Dose Alteplase Versus Primary Angioplasty in ST-Segment-Elevation Myocardial Infarction: EARLY-MYO Trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction).

    Science.gov (United States)

    Pu, Jun; Ding, Song; Ge, Heng; Han, Yaling; Guo, Jinchen; Lin, Rong; Su, Xi; Zhang, Heng; Chen, Lianglong; He, Ben

    2017-10-17

    Timely primary percutaneous coronary intervention (PPCI) cannot be offered to all patients with ST-segment-elevation myocardial infarction (STEMI). Pharmaco-invasive (PhI) strategy has been proposed as a valuable alternative for eligible patients with STEMI. We conducted a randomized study to compare the efficacy and safety of a PhI strategy with half-dose fibrinolytic regimen versus PPCI in patients with STEMI. The EARLY-MYO trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction) was an investigator-initiated, prospective, multicenter, randomized, noninferiority trial comparing a PhI strategy with half-dose alteplase versus PPCI in patients with STEMI 18 to 75 years of age presenting ≤6 hours after symptom onset but with an expected PCI-related delay. The primary end point of the study was complete epicardial and myocardial reperfusion after PCI, defined as thrombolysis in myocardial infarction flow grade 3, thrombolysis in myocardial infarction myocardial perfusion grade 3, and ST-segment resolution ≥70%. We also measured infarct size and left ventricular ejection fraction with cardiac magnetic resonance and recorded 30-day clinical and safety outcomes. A total of 344 patients from 7 centers were randomized to PhI (n=171) or PPCI (n=173). PhI was noninferior (and even superior) to PPCI for the primary end point (34.2% versus 22.8%, P noninferiority <0.05, P superiority =0.022), with no significant differences in the frequency of the individual components of the combined end point: thrombolysis in myocardial infarction flow 3 (91.3% versus 89.2%, P =0.580), thrombolysis in myocardial infarction myocardial perfusion grade 3 (65.8% versus 62.9%, P =0.730), and ST-segment resolution ≥70% (50.9% versus 45.5%, P =0.377). Infarct size (23.3%±11.3% versus 25.8%±13.7%, P =0.101) and left ventricular ejection fraction (52.2%±11.0% versus 51.4%±12.0%, P =0.562) were similar in both

  20. Minimally invasive transcanal myringotomy for pediatric early stage congenital cholesteatoma.

    Science.gov (United States)

    Jang, Chul Ho; Jung, Eun Kyung; Sung, Chung Man; Kim, Seung Beom; Kim, Young Yoon; Seong, Jong Yuap; Kang, Sung Hoon; Cho, Yong Beom

    2016-11-01

    Recently, minimally invasive transcanal myringotomy (MITM), which is a useful surgical technique for early stage congenital cholesteatoma (CC) in children, was introduced. The purpose of this study is to evaluate the short-term surgical results of MITM in pediatric early stage CC. We retrospectively reviewed the charts of 24 patients who underwent MITM between January 2013 and October 2015. The patients' ages ranged from 1 to 16 years (mean, 2.6 years). There were 17 male and 7 female patients. The right side (n = 13) was affected twice as often as the left side (n = 11). The most common site was the anterosuperior quadrant (15 cases). The diameter of the CC on axial computed tomography images ranged from 2.8 to 5.7 mm (mean, 3.9 mm). CCs were graded according to Potsic's system: 18 cases were classified as stage I, 3 case as stage II, and 3 cases as stage III. AllCCs except 1 were closed type. In21 patients, the tympanic membrane closed naturally without recurrence. Three patients showed small persistent dry perforation. Natural closure occurred in these patients, who were treated with paper patches. MITM is a simple, effective technique for removing an early stage CC from the middle ear, and it can minimize operative time, length of hospitalization, and postoperative morbidity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Conservative versus invasive stable ischemic heart disease management strategies: what do we plan to learn from the ISCHEMIA trial?

    Science.gov (United States)

    Cheng-Torres, Kathleen A; Desai, Karan P; Sidhu, Mandeep S; Maron, David J; Boden, William E

    2016-01-01

    Over the past decade, landmark randomized clinical trials comparing initial management strategies in stable ischemic heart disease (SIHD) have demonstrated no significant reduction in 'hard' end points (all-cause mortality, cardiac death or myocardial infarction) with one strategy versus another. The main advantage derived from early revascularization is improved short-term quality of life. Nonetheless, questions remain regarding how best to manage SIHD patients, such as whether a high-risk subgroup can be identified that may experience a survival or myocardial infarction benefit from early revascularization, and if not, when should diagnostic catheterization and revascularization be performed. The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial is designed to address these questions by randomizing SIHD patients with at least moderate ischemia to an initial conservative strategy of optimal medical therapy or an initial invasive strategy of optimal medical therapy plus cardiac catheterization and revascularization.

  2. Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials.

    Science.gov (United States)

    Jobs, Alexander; Mehta, Shamir R; Montalescot, Gilles; Vicaut, Eric; Van't Hof, Arnoud W J; Badings, Erik A; Neumann, Franz-Josef; Kastrati, Adnan; Sciahbasi, Alessandro; Reuter, Paul-Georges; Lapostolle, Frédéric; Milosevic, Aleksandra; Stankovic, Goran; Milasinovic, Dejan; Vonthein, Reinhard; Desch, Steffen; Thiele, Holger

    2017-08-19

    A routine invasive strategy is recommended for patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). However, optimal timing of invasive strategy is less clearly defined. Individual clinical trials were underpowered to detect a mortality benefit; we therefore did a meta-analysis to assess the effect of timing on mortality. We identified randomised controlled trials comparing an early versus a delayed invasive strategy in patients presenting with NSTE-ACS by searching MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. We included trials that reported all-cause mortality at least 30 days after in-hospital randomisation and for which the trial investigators agreed to collaborate (ie, providing individual patient data or standardised tabulated data). We pooled hazard ratios (HRs) using random-effects models. This meta-analysis is registered at PROSPERO (CRD42015018988). We included eight trials (n=5324 patients) with a median follow-up of 180 days (IQR 180-360). Overall, there was no significant mortality reduction in the early invasive group compared with the delayed invasive group HR 0·81, 95% CI 0·64-1·03; p=0·0879). In pre-specified analyses of high-risk patients, we found lower mortality with an early invasive strategy in patients with elevated cardiac biomarkers at baseline (HR 0·761, 95% CI 0·581-0·996), diabetes (0·67, 0·45-0·99), a GRACE risk score more than 140 (0·70, 0·52-0·95), and aged 75 years older (0·65, 0·46-0·93), although tests for interaction were inconclusive. An early invasive strategy does not reduce mortality compared with a delayed invasive strategy in all patients with NSTE-ACS. However, an early invasive strategy might reduce mortality in high-risk patients. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 10-Year Mortality Outcome of a Routine Invasive Strategy Versus a Selective Invasive Strategy in Non-ST-Segment Elevation Acute Coronary Syndrome: The British Heart Foundation RITA-3 Randomized Trial.

    Science.gov (United States)

    Henderson, Robert A; Jarvis, Christopher; Clayton, Tim; Pocock, Stuart J; Fox, Keith A A

    2015-08-04

    The RITA-3 (Third Randomised Intervention Treatment of Angina) trial compared outcomes of a routine early invasive strategy (coronary arteriography and myocardial revascularization, as clinically indicated) to those of a selective invasive strategy (coronary arteriography for recurrent ischemia only) in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). At a median of 5 years' follow-up, the routine invasive strategy was associated with a 24% reduction in the odds of all-cause mortality. This study reports 10-year follow-up outcomes of the randomized cohort to determine the impact of a routine invasive strategy on longer-term mortality. We randomized 1,810 patients with NSTEACS to receive routine invasive or selective invasive strategies. All randomized patients had annual follow-up visits up to 5 years, and mortality was documented thereafter using data from the Office of National Statistics. Over 10 years, there were no differences in mortality between the 2 groups (all-cause deaths in 225 [25.1%] vs. 232 patients [25.4%]: p = 0.94; and cardiovascular deaths in 135 [15.1%] vs. 147 patients [16.1%]: p = 0.65 in the routine invasive and selective invasive groups, respectively). Multivariate analysis identified several independent predictors of 10-year mortality: age, previous myocardial infarction, heart failure, smoking status, diabetes, heart rate, and ST-segment depression. A modified post-discharge Global Registry of Acute Coronary Events (GRACE) score was used to calculate an individual risk score for each patient and to form low-risk, medium-risk, and high-risk groups. Risk of death within 10 years varied markedly from 14.4 % in the low-risk group to 56.2% in the high-risk group. This mortality trend did not depend on the assigned treatment strategy. The advantage of reduced mortality of routine early invasive strategy seen at 5 years was attenuated during later follow-up, with no evidence of a difference in outcome at 10 years

  4. Surgical outcomes of early congenital cholesteatoma: minimally invasive transcanal approach.

    Science.gov (United States)

    Lee, Sang H; Jang, Jeong H; Lee, Dongjun; Lee, Hye-Ryung; Lee, Kyu-Yup

    2014-03-01

    To introduce a simple and alternative surgical technique, minimally invasive transcanal myringotomy (MITM), for early stage congenital cholesteatoma in children and to evaluate the feasibility and results of MITM for management of early stage congenital cholesteatoma with respect to its effectiveness and safety. Retrospective review. Between August 2008 and September 2012, a total of 36 patients with congenital cholesteatoma met the inclusion criteria and were analyzed. Patient medical records, including demographic characteristics, intraoperative findings, and follow-up records, were reviewed. Subjects consisted of 23 males (64%) and 13 females (36%), and the age at operation ranged from 12 months to 6 years (mean age = 3 years and 6 months). The number of congenital cholesteatoma was as follows: 26 patients at stage I and 10 patients at stage II. The follow-up duration was between 12 and 56 months, with an average of 30 months. There were no postoperative complications such as tympanic membrane perforation, dizziness, or secondary middle ear infection. Among 36 patients who had undergone the MITM approach for the treatment of congenital cholesteatoma, five (13.8%) showed recurrence and underwent a second-look operation. On the basis of our data, the MITM approach is a useful surgical technique for early stage congenital cholesteatoma in children. It has many advantages, in that there is no external wound and it is a simple surgical technique that involves easy postoperative care, a short operation time and hospitalization period, avoidance of serious complications, and easy repeatability for recurrence. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Optimal detection and control strategies for invasive species management

    Science.gov (United States)

    Shefali V. Mehta; Robert G. Haight; Frances R. Homans; Stephen Polasky; Robert C. Venette

    2007-01-01

    The increasing economic and environmental losses caused by non-native invasive species amplify the value of identifying and implementing optimal management options to prevent, detect, and control invasive species. Previous literature has focused largely on preventing introductions of invasive species and post-detection control activities; few have addressed the role of...

  6. Carcinoma of the cervix. Value of dynamic magnetic resonance imaging in assessing early stromal invasion

    International Nuclear Information System (INIS)

    Kojima, Yumi; Aoki, Yoichi; Kase, Hiroaki; Kodama, Shoji; Tanaka, Kenichi

    1998-01-01

    The purpose of this study was to assess the accuracy of contrast-enhanced magnetic resonance imaging (dynamic MR imaging) in the evaluation of preinvasive and early invasive cancer of the cervix. Twenty-nine women with untreated squamous cell carcinoma of the cervix with either no stromal invasion or early stromal invasion underwent pretreatment MR imaging and dynamic MR imaging within 4 weeks of surgical evaluation. The images were evaluated for tumor detection and compared with results of histologic examination of the surgical specimens. The lesions in 17 cases with histologically proven stromal invasion of 4 mm or greater were detected with dynamic MR imaging, whereas lesions in only 8 of these cases were detected with T2 imaging. In 9 cases with stromal invasion between 4.0 mm and 5.0 mm, lesions were represented as early phase focal enhancement on dynamic MR images, but not detected on T2-weighted images. In the 12 cases with less than 4 mm stromal invasion, no lesions were visualized on either T2-weighted images or dynamic MR images, except in 1 case of glandular involvement without stromal invasion that appeared as enhancement on early-phase dynamic MR imaging. Dynamic MR imaging detected more lesions of early stromal invasion in pretreatment imaging for cervical cancer than nonenhanced MR imaging. (author)

  7. Early invasive versus non-invasive treatment in patients with non-ST-elevation acute coronary syndrome (FRISC-II): 15 year follow-up of a prospective, randomised, multicentre study.

    Science.gov (United States)

    Wallentin, Lars; Lindhagen, Lars; Ärnström, Elisabet; Husted, Steen; Janzon, Magnus; Johnsen, Søren Paaske; Kontny, Frederic; Kempf, Tibor; Levin, Lars-Åke; Lindahl, Bertil; Stridsberg, Mats; Ståhle, Elisabeth; Venge, Per; Wollert, Kai C; Swahn, Eva; Lagerqvist, Bo

    2016-10-15

    The FRISC-II trial was the first randomised trial to show a reduction in death or myocardial infarction with an early invasive versus a non-invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome. Here we provide a remaining lifetime perspective on the effects on all cardiovascular events during 15 years' follow-up. The FRISC-II prospective, randomised, multicentre trial was done at 58 Scandinavian centres in Sweden, Denmark, and Norway. Between June 17, 1996, and Aug 28, 1998, we randomly assigned (1:1) 2457 patients with non-ST-elevation acute coronary syndrome to an early invasive treatment strategy, aiming for revascularisation within 7 days, or a non-invasive strategy, with invasive procedures at recurrent symptoms or severe exercise-induced ischaemia. Plasma for biomarker analyses was obtained at randomisation. For long-term outcomes, we linked data with national health-care registers. The primary endpoint was a composite of death or myocardial infarction. Outcomes were compared as the average postponement of the next event, including recurrent events, calculated as the area between mean cumulative count-of-events curves. Analyses were done by intention to treat. At a minimum of 15 years' follow-up on Dec 31, 2014, data for survival status and death were available for 2421 (99%) of the initially recruited 2457 patients, and for other events after 2 years for 2182 (89%) patients. During follow-up, the invasive strategy postponed death or next myocardial infarction by a mean of 549 days (95% CI 204-888; p=0·0020) compared with the non-invasive strategy. This effect was larger in non-smokers (mean gain 809 days, 95% CI 402-1175; p interaction =0·0182), patients with elevated troponin T (778 days, 357-1165; p interaction =0·0241), and patients with high concentrations of growth differentiation factor-15 (1356 days, 507-1650; p interaction =0·0210). The difference was mainly driven by postponement of new myocardial infarction

  8. UWB based low-cost and non-invasive practical breast cancer early detection

    Science.gov (United States)

    Vijayasarveswari, V.; Khatun, S.; Fakir, M. M.; Jusoh, M.; Ali, S.

    2017-03-01

    Breast cancer is one of the main causes of women death worldwide. Breast tumor is an early stage of cancer that locates in cells of a human breast. As there is no remedy, early detection is crucial. Towards this, Ultra-Wideband (UWB) is a prominent candidate. It is a wireless communication technology which can achieve high bandwidth with low power utilization. UWB is suitable to be used for short range communication systems including breast cancer detection since it is secure, non-invasive and human health friendly. This paper presents the low-cost and non-invasive early breast cancer detection strategy using UWB sensor (or antenna). Emphasis is given here to detect breast tumor in 2D and 3D environments. The developed system consisted of hardware and software. Hardware included UWB transceiver and a pair of home-made directional sensor/antenna. The software included feed-forward back propagation Neural Network (NN) module to detect the tumor existence, size and location along with soft interface between software and hardware. Forward scattering technique was used by placing two sensors diagonally opposite sides of a breast phantom. UWB pulses were transmitted from one side of phantom and received from other side, controlled by the software interface in PC environment. Collected received signals were then fed into the NN module for training, testing and validation. The system exhibited detection efficiency on tumor existence, location (x, y, z), and size were approximately 100%, (78.17%, 70.66%, 92.46%), 85.86% respectively. The proposed UWB based early breast cancer detection system could be more practical with low-cost, user friendly and non-harmful features. This project may help users to monitor their breast health regularly at their home.

  9. Diverging associations of an intended early invasive strategy compared with actual revascularization, and outcome in patients with non-ST-segment elevation acute coronary syndrome: the problem of treatment selection bias.

    NARCIS (Netherlands)

    Hirsch, A.; Windhausen, F.; Tijssen, J.G.P.; Oude Ophuis, A.J.M.; Giessen, W.J. van der; Zee, P.M. van der; Cornel, J.H.; Verheugt, F.W.A.; Winter, R.J. de

    2009-01-01

    AIMS: In several observational studies, revascularization is associated with substantial reduction in mortality in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS). This has strengthened the belief that routine early angiography would lead to a reduction in mortality. We

  10. Reconstruction of the early invasion history of the quagga mussel (Dreissena rostriformis bugensis) in Western Europe

    OpenAIRE

    Heiler, Katharina; Vaate, Abraham bij de; Ekschmitt, Klemens; Oheimb, Parm von; Albrecht, Christian; Wilke, Thomas

    2013-01-01

    The recent introduction of the quagga mussel into Western European freshwaters marked the beginning of one of the most successful biological invasions during the past years in this region. However, the spatial and temporal origin of the first invasive population(s) in Western Europe as well as subsequent spreading routes still remain under discussion. In this study, we therefore aim at reconstructing the early invasion history of the quagga mussel in Western Europe based on an age-corrected t...

  11. Early outcome of minimally invasive mitral valve surgery

    Directory of Open Access Journals (Sweden)

    Shawky Fareed

    2016-08-01

    Conclusion: Right anterolateral mini-thoracotomy minimally invasive technique provides excellent exposure of the mitral valve, even with a small atrium and offers a better cosmetic lateral scar which is less prone to keloid formation. In addition, minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. It should be used as an initial approach for mitral valve surgery. Furthermore, it was believed that less spreading of the incision, no interference with the diaphragm and less tissue dissection might improve outcomes, particularly respiratory function.

  12. [Strategy for minimally invasive cochlear implantation and residual hearing preservation].

    Science.gov (United States)

    Huang, Y Y; Chen, J Y; Shen, M; Yang, J

    2018-01-07

    In the past few decades, considerable development was achieved in the cochlear implantation following the emergence of innovative electrode array and advances in minimally invasive surgery. Minimally invasive technique led to a better preservation of residual low-frequency hearing. The loss of residual hearing was caused by complicated factors. According to previous studies, a slower and stable speed of electrode insertion and the use of perioperative steroids were demonstrated to have a positive impact on hearing preservation. The selection of electrode array or its insertion approaches didn't show any distinctive benefits in hearing preservation.

  13. Reproduction in crabs: strategies, invasiveness and environmental influences thereon

    NARCIS (Netherlands)

    Brink, van den A.M.

    2013-01-01

    This thesis provides insights into the interconnectedness of crab reproductive biology, the selective forces leading to their development, the possible links to invasiveness and the influences of environmental factors thereon. The empirical data collected and presented in this thesis can be used

  14. N-terminal pro-brain natriuretic peptide in relation to inflammation, myocardial necrosis, and the effect of an invasive strategy in unstable coronary artery disease.

    Science.gov (United States)

    Jernberg, Tomas; Lindahl, Bertil; Siegbahn, Agneta; Andren, Bertil; Frostfeldt, Gunnar; Lagerqvist, Bo; Stridsberg, Mats; Venge, Per; Wallentin, Lars

    2003-12-03

    We sought to examine whether measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP), in addition to cardiac troponin T (cTnT) and interleukin-6 (IL-6), improve the ability to identify high-risk patients who benefit from an early invasive strategy. Biochemical indicators of cardiac performance (e.g., NT-proBNP), inflammation (e.g., IL-6), and myocardial damage (e.g., cTnT) predict mortality in unstable coronary artery disease (UCAD) (i.e., unstable angina or non-ST-segment elevation myocardial infarction [MI]). In these patients, an early invasive treatment strategy improves the outcome. Levels of NT-proBNP, cTnT, and IL-6 were measured in 2,019 patients with UCAD randomized to an invasive or non-invasive strategy in the FRagmin and fast revascularization during InStability in Coronary artery disease (FRISC-II) trial. Patients were followed up for two years to determine death and MI. Patients in the third NT-proBNP tertile had a 4.1-fold (95% confidence interval [CI] 2.4 to 7.2) and 3.5-fold (95% CI 1.8 to 6.8) increased mortality in the non-invasive and invasive groups, respectively. An increased NT-proBNP level was independently associated with mortality. In patients with increased levels of both NT-proBNP and IL-6, an early invasive strategy reduced mortality by 7.3% (risk ratio 0.46, 95% CI 0.21 to 1.00). In patients with lower NT-proBNP or IL-6 levels, the mortality was not reduced. Only elevated cTnT was independently associated with future MI and a reduction of MI by means of an invasive strategy. N-terminal proBNP is independently associated with mortality. The combination of NT-proBNP and IL-6 seems to be a useful tool in the identification of patients with a definite survival benefit from an early invasive strategy. Only cTnT is independently associated with future MI and a reduction of MI by an invasive strategy.

  15. Early embryonic demise: no evidence of abnormal spiral artery transformation or trophoblast invasion.

    Science.gov (United States)

    Ball, E; Robson, S C; Ayis, S; Lyall, F; Bulmer, J N

    2006-03-01

    Invasion by extravillous trophoblast of uterine decidua and myometrium and the associated spiral artery 'transformation' are essential for the development of normal pregnancy. Small pilot studies of placental bed and basal plate tissues from miscarriages have suggested that impaired interstitial and endovascular trophoblast invasion may play a role in the pathogenesis of miscarriage. The hypothesis that early miscarriage is associated with reduced extravillous trophoblast invasion and spiral artery transformation was tested in a large series of placental bed biopsies containing decidua and myometrium and at least one spiral artery from early, karyotyped embryonic miscarriages (invasion and individual features of spiral artery transformation were assessed histologically in spiral arteries of miscarriages (n = 176) and controls (n = 246) and analysed statistically using a logistic regression model. Trophoblast invasion of uterine tissues and spiral artery transformation did not differ between euploid and aneuploid early miscarriage and also did not differ significantly from normal pregnancy. These findings suggest that failed trophoblast invasion and spiral artery transformation do not have a pivotal role in the pathogenesis of early miscarriage.

  16. Analysis of the Trojan Y-Chromosome eradication strategy for an invasive species.

    Science.gov (United States)

    Wang, Xueying; Walton, Jay R; Parshad, Rana D; Storey, Katie; Boggess, May

    2014-06-01

    The Trojan Y-Chromosome (TYC) strategy, an autocidal genetic biocontrol method, has been proposed to eliminate invasive alien species. In this work, we analyze the dynamical system model of the TYC strategy, with the aim of studying the viability of the TYC eradication and control strategy of an invasive species. In particular, because the constant introduction of sex-reversed trojan females for all time is not possible in practice, there arises the question: What happens if this injection is stopped after some time? Can the invasive species recover? To answer that question, we perform a rigorous bifurcation analysis and study the basin of attraction of the recovery state and the extinction state in both the full model and a certain reduced model. In particular, we find a theoretical condition for the eradication strategy to work. Additionally, the consideration of an Allee effect and the possibility of a Turing instability are also studied in this work. Our results show that: (1) with the inclusion of an Allee effect, the number of the invasive females is not required to be very low when the introduction of the sex-reversed trojan females is stopped, and the remaining Trojan Y-Chromosome population is sufficient to induce extinction of the invasive females; (2) incorporating diffusive spatial spread does not produce a Turing instability, which would have suggested that the TYC eradication strategy might be only partially effective, leaving a patchy distribution of the invasive species.

  17. Analysis of the Trojan Y-Chromosome eradication strategy for an invasive species

    KAUST Repository

    Wang, Xueying

    2013-05-24

    The Trojan Y-Chromosome (TYC) strategy, an autocidal genetic biocontrol method, has been proposed to eliminate invasive alien species. In this work, we analyze the dynamical system model of the TYC strategy, with the aim of studying the viability of the TYC eradication and control strategy of an invasive species. In particular, because the constant introduction of sex-reversed trojan females for all time is not possible in practice, there arises the question: What happens if this injection is stopped after some time? Can the invasive species recover? To answer that question, we perform a rigorous bifurcation analysis and study the basin of attraction of the recovery state and the extinction state in both the full model and a certain reduced model. In particular, we find a theoretical condition for the eradication strategy to work. Additionally, the consideration of an Allee effect and the possibility of a Turing instability are also studied in this work. Our results show that: (1) with the inclusion of an Allee effect, the number of the invasive females is not required to be very low when the introduction of the sex-reversed trojan females is stopped, and the remaining Trojan Y-Chromosome population is sufficient to induce extinction of the invasive females; (2) incorporating diffusive spatial spread does not produce a Turing instability, which would have suggested that the TYC eradication strategy might be only partially effective, leaving a patchy distribution of the invasive species. © 2013 Springer-Verlag Berlin Heidelberg.

  18. Invasive plant species: Inventory, mapping, and monitoring - A national strategy

    Science.gov (United States)

    Ludke, J. Larry; D'Erchia, Frank; Coffelt, Jan; Hanson, Leanne

    2002-01-01

    America is under siege by invasive species of plants and animals, and by diseases. The current environmental, economic, and health-related costs of invasive species could exceed $138 billion per year-more than all other natural disasters combined. Notorious examples include West Nile virus, Dutch elm disease, chestnut blight, and purple loose- strife in the Northeast; kudzu, Brazilian peppertree, water hyacinth, nutria, and fire ants in the Southeast; zebra mussels, leafy spurge, and Asian long-horn beetles in the Midwest; salt cedar, Russian olive, and Africanized bees in the Southwest; yellow star thistle, European wild oats, oak wilt disease, Asian clams, and white pine blister rust in California; cheatgrass, various knapweeds, and thistles in the Great Basin; whirling disease of salmonids in the Northwest; hundreds of invasive species from microbes to mammals in Hawaii; and the brown tree snake in Guam. Thousands of species from other countries are introduced intentionally or accidentally into the United States each year. Based on past experience, 10-15 percent can be expected to establish free-living populations and about 1 percent can be expected to cause significant impacts to ecosystems, native species, economic productivity, and (or) human health.

  19. Use of and inhospital outcomes after early clopidogrel therapy in patients not undergoing an early invasive strategy for treatment of non-ST-segment elevation myocardial infarction: results from Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association guidelines (CRUSADE).

    Science.gov (United States)

    Alexander, Deepu; Ou, Fang-Shu; Roe, Matthew T; Pollack, Charles V; Ohman, E Magnus; Cannon, Christopher P; Gibler, W Brian; Fintel, Dan J; Peterson, Eric D; Brown, David L

    2008-09-01

    Although current guidelines recommend early initiation of clopidogrel in patients with non-ST-segment elevation myocardial infarction (NSTEMI), the degree to which it has been adopted in clinical practice remains unclear. We sought to determine patterns of early (vs 9.5%, P = .90). Until recently, up to 50% of NSTEMI patients in contemporary practice in the United States not undergoing PCI within 24 hours of arrival in the United States are not treated according to guideline recommendations. Among a high-risk NSTEMI population not undergoing PCI within 24 hours of arrival, the nonrandomized short-term use of clopidogrel is associated with a lower risk of inhospital mortality without an increased risk of major bleeding.

  20. Using life strategies to explore the vulnerability of ecosystem services to invasion by alien plants

    NARCIS (Netherlands)

    Vicente, J.; Pinro, A.; Araujo, M.; Lomba, A.; Randin, C.; Guisan, A.; Honrado, J.; Verburg, P.H.

    2013-01-01

    Invasive plants can have different effects on ecosystem functioning and on the provision of ecosystem services, with the direction and magnitude of such effects depending on the service and ecosystem being considered, but also on the life strategies of the invaders. Strategies can influence

  1. Histone deacetylase inhibition as an alternative strategy against invasive aspergillosis

    Directory of Open Access Journals (Sweden)

    Frederic eLamoth

    2015-02-01

    Full Text Available Invasive aspergillosis (IA is a life-threatening infection due to Aspergillus fumigatus and other Aspergillus spp. Drugs targeting the fungal cell membrane (triazoles, amphotericin B or cell wall (echinocandins are currently the sole therapeutic options against IA. Their limited efficacy and the emergence of resistance warrant the identification of new antifungal targets. Histone deacetylases (HDACs are enzymes responsible of the deacetylation of lysine residues of core histones, thus controlling chromatin remodeling and transcriptional activation. HDACs also control the acetylation and activation status of multiple non-histone proteins, including the heat shock protein 90 (Hsp90, an essential molecular chaperone for fungal virulence and antifungal resistance. This review provides an overview of the different HDACs in Aspergillus spp. as well as their respective contribution to total HDAC activity, fungal growth, stress responses, and virulence. The potential of HDAC inhibitors, currently under development for cancer therapy, as novel alternative antifungal agents against IA is discussed.

  2. Spatio-temporal patterns of tree establishment are indicative of biotic interactions during early invasion of a montane meadow

    Science.gov (United States)

    J.M. Rice; C.B. Halpern; J.A. Antos; J.A. Jones

    2012-01-01

    Tree invasions of grasslands are occurring globally, with profound consequences for ecosystem structure and function. We explore the spatio-temporal dynamics of tree invasion of a montane meadow in the Cascade Mountains of Oregon, where meadow loss is a conservation concern. We examine the early stages of invasion, where extrinsic and intrinsic processes can be clearly...

  3. Patient Preferences for Minimally Invasive and Open Locoregional Treatment for Early-Stage Breast Cancer

    NARCIS (Netherlands)

    Knuttel, Floor; van den Bosch, Maurice A A J; Young-Afat, Danny A.; Emaus, Marleen J.; van den Bongard, Desirée H J G; Witkamp, Arjen J.; Verkooijen, Helena M.

    Background: Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients' preferences with regard to these new treatments have not been investigated. Objectives: To assess preferences of patients with breast cancer

  4. Early invasion of brain parenchyma by African trypanosomes.

    Directory of Open Access Journals (Sweden)

    Ute Frevert

    Full Text Available Human African trypanosomiasis or sleeping sickness is a vector-borne parasitic disease that has a major impact on human health and welfare in sub-Saharan countries. Based mostly on data from animal models, it is currently thought that trypanosome entry into the brain occurs by initial infection of the choroid plexus and the circumventricular organs followed days to weeks later by entry into the brain parenchyma. However, Trypanosoma brucei bloodstream forms rapidly cross human brain microvascular endothelial cells in vitro and appear to be able to enter the murine brain without inflicting cerebral injury. Using a murine model and intravital brain imaging, we show that bloodstream forms of T. b. brucei and T. b. rhodesiense enter the brain parenchyma within hours, before a significant level of microvascular inflammation is detectable. Extravascular bloodstream forms were viable as indicated by motility and cell division, and remained detectable for at least 3 days post infection suggesting the potential for parasite survival in the brain parenchyma. Vascular inflammation, as reflected by leukocyte recruitment and emigration from cortical microvessels, became apparent only with increasing parasitemia at later stages of the infection, but was not associated with neurological signs. Extravascular trypanosomes were predominantly associated with postcapillary venules suggesting that early brain infection occurs by parasite passage across the neuroimmunological blood brain barrier. Thus, trypanosomes can invade the murine brain parenchyma during the early stages of the disease before meningoencephalitis is fully established. Whether individual trypanosomes can act alone or require the interaction from a quorum of parasites remains to be shown. The significance of these findings for disease development is now testable.

  5. Analysis of the Trojan Y-Chromosome eradication strategy for an invasive species

    KAUST Repository

    Wang, Xueying; Walton, Jay R.; Parshad, Rana; Storey, Katie; Boggess, May M.

    2013-01-01

    of the TYC eradication and control strategy of an invasive species. In particular, because the constant introduction of sex-reversed trojan females for all time is not possible in practice, there arises the question: What happens if this injection is stopped

  6. Minimally invasive and surgical management strategies tailored to the severity of acute diverticulitis.

    LENUS (Irish Health Repository)

    McDermott, F D

    2014-01-01

    The severity of acute diverticulitis ranges from mild, simple inflammation to pericolic abscesses, or perforation with faeculent peritonitis. Treatment of diverticulitis has evolved towards more conservative and minimally invasive strategies. The aim of this review is to highlight recent concepts and advances in management.

  7. Bullying Prevention Strategies in Early Childhood Education

    Science.gov (United States)

    Saracho, Olivia N.

    2017-01-01

    Bullying is a serious problem that affects the young children's well being. Early childhood educators find it difficult to manage bullying in the classroom. Preschool is the first environment outside of the home setting where children encounter difficulties when they socially interact with their peers. Based on the principles of protecting and…

  8. Effective and less invasive diagnostic strategy for gastrointestinal GVHD

    Science.gov (United States)

    Endo, Katsuya; Fujishima, Fumiyoshi; Kuroha, Masatake; Moroi, Rintaro; Onodera, Motoyuki; Naito, Takeo; Kanazawa, Yoshitake; Kimura, Tomoya; Shiga, Hisashi; Kakuta, Yoichi; Kinouchi, Yoshitaka; Shimosegawa, Tooru

    2018-01-01

    %, and 88.9 %, respectively. Conclusion  Orange peel appearance, spotty redness, small mucosal sloughing, and diffuse mucosal defect are the characteristic colonoscopic findings useful for diagnosis of gastrointestinal GVHD. These findings are frequently observed in the rectosigmoid portion. The histological detection rates for crypt cell apoptosis from these findings are high. Identifying the four characteristic findings on rectosigmoidoscopy and taking biopsies from these areas could be essential for the diagnostic strategy for gastrointestinal GVHD. PMID:29507868

  9. Macropinosomes are Key Players in Early Shigella Invasion and Vacuolar Escape in Epithelial Cells.

    Directory of Open Access Journals (Sweden)

    Allon Weiner

    2016-05-01

    Full Text Available Intracellular pathogens include all viruses, many bacteria and parasites capable of invading and surviving within host cells. Key to survival is the subversion of host cell pathways by the pathogen for the purpose of propagation and evading the immune system. The intracellular bacterium Shigella flexneri, the causative agent of bacillary dysentery, invades host cells in a vacuole that is subsequently ruptured to allow growth of the pathogen within the host cytoplasm. S. flexneri invasion has been classically described as a macropinocytosis-like process, however the underlying details and the role of macropinosomes in the intracellular bacterial lifestyle have remained elusive. We applied dynamic imaging and advanced large volume correlative light electron microscopy (CLEM to study the highly transient events of S. flexneri's early invasion into host epithelial cells and elucidate some of its fundamental features. First, we demonstrate a clear distinction between two compartments formed during the first step of invasion: the bacterial containing vacuole and surrounding macropinosomes, often considered identical. Next, we report a functional link between macropinosomes and the process of vacuolar rupture, demonstrating that rupture timing is dependent on the availability of macropinosomes as well as the activity of the small GTPase Rab11 recruited directly to macropinosomes. We go on to reveal that the bacterial containing vacuole and macropinosomes come into direct contact at the onset of vacuolar rupture. Finally, we demonstrate that S. flexneri does not subvert pre-existing host endocytic vesicles during the invasion steps leading to vacuolar rupture, and propose that macropinosomes are the major compartment involved in these events. These results provide the basis for a new model of the early steps of S. flexneri epithelial cell invasion, establishing a different view of the enigmatic process of cytoplasmic access by invasive bacterial

  10. Economic Comparison of an Empirical Versus Diagnostic-Driven Strategy for Treating Invasive Fungal Disease in Immunocompromised Patients.

    Science.gov (United States)

    Barnes, Rosemary; Earnshaw, Stephanie; Herbrecht, Raoul; Morrissey, Orla; Slavin, Monica; Bow, Eric; McDade, Cheryl; Charbonneau, Claudie; Weinstein, David; Kantecki, Michal; Schlamm, Haran; Maertens, Johan

    2015-06-01

    Patients with persistent or recurrent neutropenic fevers at risk of invasive fungal disease (IFD) are treated empirically with antifungal therapy (AFT). Early treatment using a diagnostic-driven (DD) strategy may reduce clinical and economic burdens. We compared costs and outcomes of both strategies from a UK perspective. An empirical strategy with conventional amphotericin B deoxycholate (C-AmB), liposomal amphotericin B (L-AmB), or caspofungin was compared with a DD strategy (initiated based on positive ELISA results for galactomannan antigen) and/or positive results for Aspergillus species on polymerase chain reaction assay) using C-AmB, voriconazole, or L-AmB in a decision-analytic model. Rates of IFD incidence, overall mortality, and IFD-related mortality in adults expected to be neutropenic for ≥10 days were obtained. The empirical strategy was assumed to identify 30% of IFD and targeted AFT to improve survival by a hazard ratio of 0.589. AFT-specific adverse events were obtained from a summary of product characteristics. Resource use was obtained, and costs were estimated by using standard UK costing sources. All costs are presented in 2012 British pounds sterling. Total costs were 32% lower for the DD strategy (£1561.29) versus the empirical strategy (£2301.93) due to a reduced incidence of adverse events and decreased use of AFT. Administration of AFT was reduced by 41% (DD strategy, 74 of 1000; empirical strategy, 125 of 1000), with similar survival rates. This study suggests that a DD strategy is likely to be cost-saving versus empirical treatment for immunocompromised patients with persistent or recurrent neutropenic fevers. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Early-onset invasive aspergillosis and other fungal infections in patients treated with ibrutinib.

    Science.gov (United States)

    Ghez, David; Calleja, Anne; Protin, Caroline; Baron, Marine; Ledoux, Marie-Pierre; Damaj, Gandhi; Dupont, Mathieu; Dreyfus, Brigitte; Ferrant, Emmanuelle; Herbaux, Charles; Laribi, Kamel; Le Calloch, Ronan; Malphettes, Marion; Paul, Franciane; Souchet, Laetitia; Truchan-Graczyk, Malgorzata; Delavigne, Karen; Dartigeas, Caroline; Ysebaert, Loïc

    2018-04-26

    Ibrutinib has revolutionized the management of chronic lymphocytic leukemia and is now being increasingly used. Although considered to be less immunosuppressive than conventional immunochemotherapy, the observation of a few cases of invasive fungal infections in patients treated with ibrutinib prompted us to conduct a retrospective survey. We identified 33 cases of invasive fungal infections in patients receiving ibrutinib alone or in combination. Invasive aspergillosis (IA) was overrepresented (27/33) and was associated with cerebral localizations in 40% of the cases. Remarkably, most cases of invasive fungal infections occurred with a median of 3 months after starting ibrutinib. In 18/33 cases, other conditions that could have contributed to decreased antifungal responses, such as corticosteroids, neutropenia, or combined immunochemotherapy, were present. These observations indicate that ibrutinib may be associated with early-onset invasive fungal infections, in particular IA with frequent cerebral involvement, and that patients on ibrutinib should be closely monitored in particular when other risk factors of fungal infections are present. © 2018 by The American Society of Hematology.

  12. Strategies for preventing invasive plant outbreaks after prescribed fire in ponderosa pine forest

    Science.gov (United States)

    Symstad, Amy J.; Newton, Wesley E.; Swanson, Daniel J.

    2014-01-01

    Land managers use prescribed fire to return a vital process to fire-adapted ecosystems, restore forest structure from a state altered by long-term fire suppression, and reduce wildfire intensity. However, fire often produces favorable conditions for invasive plant species, particularly if it is intense enough to reveal bare mineral soil and open previously closed canopies. Understanding the environmental or fire characteristics that explain post-fire invasive plant abundance would aid managers in efficiently finding and quickly responding to fire-caused infestations. To that end, we used an information-theoretic model-selection approach to assess the relative importance of abiotic environmental characteristics (topoedaphic position, distance from roads), pre-and post-fire biotic environmental characteristics (forest structure, understory vegetation, fuel load), and prescribed fire severity (measured in four different ways) in explaining invasive plant cover in ponderosa pine forest in South Dakota’s Black Hills. Environmental characteristics (distance from roads and post-fire forest structure) alone provided the most explanation of variation (26%) in post-fire cover of Verbascum thapsus (common mullein), but a combination of surface fire severity and environmental characteristics (pre-fire forest structure and distance from roads) explained 36–39% of the variation in post-fire cover of Cirsium arvense (Canada thistle) and all invasives together. For four species and all invasives together, their pre-fire cover explained more variation (26–82%) in post-fire cover than environmental and fire characteristics did, suggesting one strategy for reducing post-fire invasive outbreaks may be to find and control invasives before the fire. Finding them may be difficult, however, since pre-fire environmental characteristics explained only 20% of variation in pre-fire total invasive cover, and less for individual species. Thus, moderating fire intensity or targeting areas

  13. Evaluating impacts of fire management strategies on native and invasive plants using an individual-based model

    Science.gov (United States)

    Gangur, Alexander N.; Fill, Jennifer M.; Northfield, Tobin D.; van de Wiel, Marco

    2017-04-01

    The capacity for species to coexist and potentially exclude one another can broadly be attributed to drivers that influence fitness differences (such as competitive ability) and niche differences (such as environmental change). These drivers, and thus the determinants of coexistence they influence, can interact and fluctuate both spatially and temporally. Understanding the spatiotemporal variation in niche and fitness differences in systems prone to fluctuating drivers, such as fire, can help to inform the management of invasive species. In the Cape floristic region of South Africa, invasive Pinus pinaster seedlings are strong competitors in the post-burn environment of the fire-driven Fynbos vegetation. In this, system native Protea spp. are especially vulnerable to unseasonal burns, but seasonal prescribed (Summer) burns are thought to present a high safety risk. Together, these issues have limited the appeal of prescribed burn management as an alternative to costly manual eradication of P. pinaster. Using a spatially-explicit field-of-neighbourhood individual-based model, we represent the drivers of spatiotemporal variation in niche differences (driven by fire regimes) and fitness differences (driven by competitive ability). In doing so, we evaluate optimal fire management strategies to a) control invasive P. pinaster in the Cape floristic region of South Africa, while b) minimizing deleterious effects of management on native Protea spp. The scarcity of appropriate data for model calibration has been problematic for models in invasion biology, but we use recent advances in Approximate Bayesian Computing techniques to overcome this limitation. We present early conclusions on the viability of prescribed burn management to control P. pinaster in South Africa.

  14. Early invasive pulmonary aspergillosis with fatal outcome in a patient with acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Gaspar, M.; Poczova, M.; Sladekova, M.; Drgona, L.

    2015-01-01

    Purpose: The main objective of this publication is to highlight the complexity of the issue of care for patients with hemato-oncological disease, with a focus on infectious complication - invasive pulmonary aspergillosis. Case: We present a case report of a 49-year-old patient treated for acute lymphoblastic leukemia. In the early post-transplant period, in spite of combined antimicrobial treatment, an onset of fever and dyspnoea occurred. Because of the clinical condition of our immunosuppressed patient, as well as radiological finding of suspected inflammatory changes in the lung, antibiotic and antifungal therapy was changed. Respiratory symptoms progressed and the state extorted artificial ventilation. Realized bronchoscopy showed structural changes in bronchial mucosa. The results of laboratory analyses of bronchoalveolar lavage testified to fungal infection - pulmonary aspergillosis, with the cultures of Aspergillus flavus. Despite intensive complex treatment, the patient's condition led to multiple organ failure and on the Day D +27 after transplantation physicians stated exitus letalis. Autopsy confirmed invasive pulmonary aspergillosis. Conclusion: Acute leukemia and its treatment is an increased risk of systemic fungal infections in those patients - especially invasive aspergillosis. The fatality rate for invasive aspergillosis in this risk group represents on average 50 %. With this in mind, it is necessary for life-saving to diagnose the infection in time and treat it appropriately. (author)

  15. DESI-Detection of early-season invasives (software-installation manual and user's guide version 1.0)

    Science.gov (United States)

    Kokaly, Raymond F.

    2011-01-01

    This report describes a software system for detecting early-season invasive plant species, such as cheatgrass. The report includes instructions for installing the software and serves as a user's guide in processing Landsat satellite remote sensing data to map the distributions of cheatgrass and other early-season invasive plants. The software was developed for application to the semi-arid regions of southern Utah; however, the detection parameters can be altered by the user for application to other areas.

  16. Fruit fate, seed germination and growth of an invasive vine - an experimental test of 'sit and wait' strategy

    Science.gov (United States)

    Cathryn H. Greenberg; Lindsay M. Smith; Douglas J. Levey

    2001-01-01

    Oriental bittersweet (Celastrus orbiculutus Thunb.) is a non-indigenous, invasive woody vine in North America that proliferates in disturbed open sites. Unlike most invasive species, C. orbiculatus exhibits a `sit and wait' strategy by establishing and persisting indefinitely in undisturbed, closed canopy forest and...

  17. Optimal surveillance strategy for invasive species management when surveys stop after detection.

    Science.gov (United States)

    Guillera-Arroita, Gurutzeta; Hauser, Cindy E; McCarthy, Michael A

    2014-05-01

    Invasive species are a cause for concern in natural and economic systems and require both monitoring and management. There is a trade-off between the amount of resources spent on surveying for the species and conducting early management of occupied sites, and the resources that are ultimately spent in delayed management at sites where the species was present but undetected. Previous work addressed this optimal resource allocation problem assuming that surveys continue despite detection until the initially planned survey effort is consumed. However, a more realistic scenario is often that surveys stop after detection (i.e., follow a "removal" sampling design) and then management begins. Such an approach will indicate a different optimal survey design and can be expected to be more efficient. We analyze this case and compare the expected efficiency of invasive species management programs under both survey methods. We also evaluate the impact of mis-specifying the type of sampling approach during the program design phase. We derive analytical expressions that optimize resource allocation between monitoring and management in surveillance programs when surveys stop after detection. We do this under a scenario of unconstrained resources and scenarios where survey budget is constrained. The efficiency of surveillance programs is greater if a "removal survey" design is used, with larger gains obtained when savings from early detection are high, occupancy is high, and survey costs are not much lower than early management costs at a site. Designing a surveillance program disregarding that surveys stop after detection can result in an efficiency loss. Our results help guide the design of future surveillance programs for invasive species. Addressing program design within a decision-theoretic framework can lead to a better use of available resources. We show how species prevalence, its detectability, and the benefits derived from early detection can be considered.

  18. Invasion strategies in clonal aquatic plants: Are phenotypic differences caused by phenotypic plasticity or local adaptation?

    DEFF Research Database (Denmark)

    Riis, Tenna; Lambertini, Carla; Olesen, Birgit

    2010-01-01

    conditions and plant morphological characteristics. Conclusions: The results indicate that at the current stage of spread into New Zealand, the primary adaptive strategy of these three invasive macrophytes is phenotypic plasticity. However, while limited, the possibility that genetic diversity between......Background and Aims: The successful spread of invasive plants in new environments is often linked to multiple introductions and a diverse gene pool that facilitates local adaptation to variable environmental conditions. For clonal plants, however, phenotypic plasticity may be equally important....... Methods: Field populations with a large phenotypic variety were sampled in a range of lakes and streams with different chemical and physical properties. The phenotypic plasticity of the species before and after cultivation was studied in a common garden growth experiment, and the genetic diversity...

  19. 5-Year Clinical Outcomes in the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) Trial A Randomized Comparison of an Early Invasive Versus Selective Invasive Management in Patients With Non-ST-Elevation Acute Coronary Syndrome

    NARCIS (Netherlands)

    Damman, Peter; Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G. P.; de Winter, Robbert J.

    2010-01-01

    OBJECTIVES: We present the 5-year clinical outcomes according to treatment strategy with additional risk stratification of the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial. BACKGROUND: Long-term outcomes may be relevant to decide treatment strategy for patients

  20. Invasion strategies in clonal aquatic plants: are phenotypic differences caused by phenotypic plasticity or local adaptation?

    Science.gov (United States)

    Riis, Tenna; Lambertini, Carla; Olesen, Birgit; Clayton, John S.; Brix, Hans; Sorrell, Brian K.

    2010-01-01

    Background and Aims The successful spread of invasive plants in new environments is often linked to multiple introductions and a diverse gene pool that facilitates local adaptation to variable environmental conditions. For clonal plants, however, phenotypic plasticity may be equally important. Here the primary adaptive strategy in three non-native, clonally reproducing macrophytes (Egeria densa, Elodea canadensis and Lagarosiphon major) in New Zealand freshwaters were examined and an attempt was made to link observed differences in plant morphology to local variation in habitat conditions. Methods Field populations with a large phenotypic variety were sampled in a range of lakes and streams with different chemical and physical properties. The phenotypic plasticity of the species before and after cultivation was studied in a common garden growth experiment, and the genetic diversity of these same populations was also quantified. Key Results For all three species, greater variation in plant characteristics was found before they were grown in standardized conditions. Moreover, field populations displayed remarkably little genetic variation and there was little interaction between habitat conditions and plant morphological characteristics. Conclusions The results indicate that at the current stage of spread into New Zealand, the primary adaptive strategy of these three invasive macrophytes is phenotypic plasticity. However, while limited, the possibility that genetic diversity between populations may facilitate ecotypic differentiation in the future cannot be excluded. These results thus indicate that invasive clonal aquatic plants adapt to new introduced areas by phenotypic plasticity. Inorganic carbon, nitrogen and phosphorous were important in controlling plant size of E. canadensis and L. major, but no other relationships between plant characteristics and habitat conditions were apparent. This implies that within-species differences in plant size can be explained

  1. Early benefits of minimally invasive transforaminal lumbar interbody fusion in comparison with the traditional open procedure

    Directory of Open Access Journals (Sweden)

    Gregor Rečnik

    2015-06-01

    Full Text Available AbstractBackgroundLumbar interbody fusion is a standard operative procedure in orthopedic spine surgery. Morphological and functional changes in the multifidus muscle after an open procedure have led to the development of a minimally invasive technique, after which no such muscle changes were observed. MethodsSixty-four patients, with clinical and radiological criteria for one-level transforaminal lumbar interbody fusion were enrolled in our prospective randomized study between December 2011 and March 2014. They were randomized into two groups: open approach (33 patients vs. minimally invasive approach (31 patients; one patient was excluded from each group due to postoperative complications. Independent samples T-test was used to compare average values of increase in creatin kinase (CK, which is an enzymatic marker of muscle injury, average surgical time, loss of blood during and after surgery, back pain according to the Visual Analogue Scale (VAS and day of discharge from the hospital. ResultsStatistically important (P< 0.001 lower blood loss (188 ml vs. 527 ml total, less CK increase (15 ukat/L vs. 29 ukat/L, lower VAS score after surgery (7.3 vs. 8.7 and earlier discharge from the hospital (3.5 days vs. 5.2 days were observed in the minimally invasive transforaminal lumbar interbody fusion group. No significant difference in average surgical time was recorded. Conclusions Our results suggest, that minimally invasive transforaminal lumbar interbody fusion causes is associated with less muscle damage, lower blood loss, less post surgical pain and faster early rehabilitation, which is in accordance with previous studies.

  2. Management strategy evaluation of pheromone-baited trapping techniques to improve management of invasive sea lamprey

    Science.gov (United States)

    Dawson, Heather; Jones, Michael L.; Irwin, Brian J.; Johnson, Nicholas; Wagner, Michael C.; Szymanski, Melissa

    2016-01-01

    We applied a management strategy evaluation (MSE) model to examine the potential cost-effectiveness of using pheromone-baited trapping along with conventional lampricide treatment to manage invasive sea lamprey. Four pheromone-baited trapping strategies were modeled: (1) stream activation wherein pheromone was applied to existing traps to achieve 10−12 mol/L in-stream concentration, (2) stream activation plus two additional traps downstream with pheromone applied at 2.5 mg/hr (reverse-intercept approach), (3) trap activation wherein pheromone was applied at 10 mg/hr to existing traps, and (4) trap activation and reverse-intercept approach. Each new strategy was applied, with remaining funds applied to conventional lampricide control. Simulating deployment of these hybrid strategies on fourteen Lake Michigan streams resulted in increases of 17 and 11% (strategies 1 and 2) and decreases of 4 and 7% (strategies 3 and 4) of the lakewide mean abundance of adult sea lamprey relative to status quo. MSE revealed performance targets for trap efficacy to guide additional research because results indicate that combining lampricides and high efficacy trapping technologies can reduce sea lamprey abundance on average without increasing control costs.

  3. Preinfarct Health Status and the Use of Early Invasive Versus Ischemia-Guided Management in Non-ST-Elevation Acute Coronary Syndrome.

    Science.gov (United States)

    Qintar, Mohammed; Smolderen, Kim G; Chan, Paul S; Gosch, Kensey L; Jones, Philip G; Buchanan, Donna M; Girotra, Saket; Spertus, John A

    2017-10-01

    Early invasive management improves outcomes in non-ST-elevation myocardial infarction (NSTEMI). The association between preinfarct health status and the selecting patients for early invasive management is unknown. The Prospective Registry Evaluating outcomes after Myocardial Infarctions: Events and Recovery and Translational Research Investigating Underlying disparities in acute Myocardial infarction Patients' Health status are consecutive US multicenter registries, in which the associations between preinfarct angina frequency and quality of life (both assessed by the Seattle Angina Questionnaire on admission) and the Global Registry of Acute Coronary Events (GRACE) risk score and referral to early invasive management (coronary angiography within 48 hours) were evaluated using Poisson regression, after adjusting for site, demographics, and clinical and psychosocial variables. Of 3,768 patients with NSTEMI, 2,182 (57.9%) patients were referred for early invasive treatment. Patients with excellent, good, or very good baseline angina-specific quality of life, respectively, were more likely to receive early angiography, even after adjustment, as compared with patients reporting poor baseline quality of life because of angina (62.1.0%, 60.9%, 59.6%, vs 51.2%; adjusted relative risk [RR] = 1.09, 95% confidence interval [CI] 1.04 to 1.16; RR = 1.13, 95% CI 1.01 to 1.27; RR 1.14, 95% CI 0.99 to 1.31, respectively). Finally, patients with a GRACE score in the highest risk decile (199.5 to management. Further work is needed to understand the role of preinfarct health status and in-hospital treatment strategy. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Stochastic models for the Trojan Y-Chromosome eradication strategy of an invasive species.

    Science.gov (United States)

    Wang, Xueying; Walton, Jay R; Parshad, Rana D

    2016-01-01

    The Trojan Y-Chromosome (TYC) strategy, an autocidal genetic biocontrol method, has been proposed to eliminate invasive alien species. In this work, we develop a Markov jump process model for this strategy, and we verify that there is a positive probability for wild-type females going extinct within a finite time. Moreover, when sex-reversed Trojan females are introduced at a constant population size, we formulate a stochastic differential equation (SDE) model as an approximation to the proposed Markov jump process model. Using the SDE model, we investigate the probability distribution and expectation of the extinction time of wild-type females by solving Kolmogorov equations associated with these statistics. The results indicate how the probability distribution and expectation of the extinction time are shaped by the initial conditions and the model parameters.

  5. SECONDARY WASTE MANAGEMENT STRATEGY FOR EARLY LOW ACTIVITY WASTE TREATMENT

    Energy Technology Data Exchange (ETDEWEB)

    TW, CRAWFORD

    2008-07-17

    This study evaluates parameters relevant to River Protection Project secondary waste streams generated during Early Low Activity Waste operations and recommends a strategy for secondary waste management that considers groundwater impact, cost, and programmatic risk. The recommended strategy for managing River Protection Project secondary waste is focused on improvements in the Effiuent Treatment Facility. Baseline plans to build a Solidification Treatment Unit adjacent to Effluent Treatment Facility should be enhanced to improve solid waste performance and mitigate corrosion of tanks and piping supporting the Effiuent Treatment Facility evaporator. This approach provides a life-cycle benefit to solid waste performance and reduction of groundwater contaminants.

  6. Trojan Horse Strategy for Non-invasive Interference of Clock Gene in the Oyster Crassostrea gigas.

    Science.gov (United States)

    Payton, Laura; Perrigault, Mickael; Bourdineaud, Jean-Paul; Marcel, Anjara; Massabuau, Jean-Charles; Tran, Damien

    2017-08-01

    RNA interference is a powerful method to inhibit specific gene expression. Recently, silencing target genes by feeding has been successfully carried out in nematodes, insects, and small aquatic organisms. A non-invasive feeding-based RNA interference is reported here for the first time in a mollusk bivalve, the pacific oyster Crassostrea gigas. In this Trojan horse strategy, the unicellular alga Heterocapsa triquetra is the food supply used as a vector to feed oysters with Escherichia coli strain HT115 engineered to express the double-stranded RNA targeting gene. To test the efficacy of the method, the Clock gene, a central gene of the circadian clock, was targeted for knockout. Results demonstrated specific and systemic efficiency of the Trojan horse strategy in reducing Clock mRNA abundance. Consequences of Clock disruption were observed in Clock-related genes (Bmal, Tim1, Per, Cry1, Cry2, Rev.-erb, and Ror) and triploid oysters were more sensitive than diploid to the interference. This non-invasive approach shows an involvement of the circadian clock in oyster bioaccumulation of toxins produced by the harmful alga Alexandrium minutum.

  7. Mammographic findings predicting an extensive intraductal component in early stage invasive breast cancer : analysis on microcalcification

    International Nuclear Information System (INIS)

    Kim, Jeong Ah; Kim, Mi Hye; Lee, Mi Kyung; Oh, Ki Keun; Kim, Eun Kyung

    2000-01-01

    To analyze the mammographic findings of extensive intraductal component (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in an invasive carcinoma. The mammographic and pathologic findings in 71 patients aged 34-79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were retrospectively analysed. The mammographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalcification only. The shape and distribution of a calcification were classified according to the BI-RADS lexicon, and its extent was classified as either more or less than 3 cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were re-examined by means of slide mappings. Twenty-eight of 71 patients (39%) showed ECI positivity. The mammographic findings of EIC-positive invasive cancer (n=3D28) were mass with microcalcification (n=3D14), microcalcification only (n=3D7) and mass only (n=3D7). The mammographic finding which predicted EIC positivity was mass with microcalcification (PPV:0.67, NPV:0.33, p=3D0.02). A mammographic of mass only (n=3D39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, P less than 0.01). A comparison of cases with or without calcification showed that those with microcalcifications (n=3D32) showed a significantly high PPV of 0.66 (NPV:0.34, p less than 0.01) while those without calcification (n=3D39) showed a significantly high NPV of 0.82 (PPV:0.18, p less than 0.01). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Whenever microcalcification with or without mass is seen on mammographs obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS lexicon. (author)

  8. Invasive strategies and outcomes for non-ST-segment elevation acute coronary syndromes: a twelve-year experience from SWEDEHEART

    NARCIS (Netherlands)

    Damman, Peter; Jernberg, Tomas; Lindahl, Bertil; de Winter, Robbert J.; Jeppsson, Anders; Johanson, Per; Held, Claes; James, Stefan K.

    2016-01-01

    Despite recommendations in recent guidelines for a routine invasive strategy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS), long-term data on the implementation of treatment strategies in clinical practice are not available. Our aim was to provide long-term data on the

  9. Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: a randomized controlled trial.

    Science.gov (United States)

    Rouzé, Anahita; Loridant, Séverine; Poissy, Julien; Dervaux, Benoit; Sendid, Boualem; Cornu, Marjorie; Nseir, Saad

    2017-11-01

    The aim of this study was to determine the impact of a biomarker-based strategy on early discontinuation of empirical antifungal treatment. Prospective randomized controlled single-center unblinded study, performed in a mixed ICU. A total of 110 patients were randomly assigned to a strategy in which empirical antifungal treatment duration was determined by (1,3)-β-D-glucan, mannan, and anti-mannan serum assays, performed on day 0 and day 4; or to a routine care strategy, based on international guidelines, which recommend 14 days of treatment. In the biomarker group, early stop recommendation was determined using an algorithm based on the results of biomarkers. The primary outcome was the percentage of survivors discontinuing empirical antifungal treatment early, defined as a discontinuation strictly before day 7. A total of 109 patients were analyzed (one patient withdraw consent). Empirical antifungal treatment was discontinued early in 29 out of 54 patients in the biomarker strategy group, compared with one patient out of 55 in the routine strategy group [54% vs 2%, p strategy compared with routine strategy [median (IQR) 6 (4-13) vs 13 (12-14) days, p strategy increased the percentage of early discontinuation of empirical antifungal treatment among critically ill patients with suspected invasive Candida infection. These results confirm previous findings suggesting that early discontinuation of empirical antifungal treatment had no negative impact on outcome. However, further studies are needed to confirm the safety of this strategy. This trial was registered at ClinicalTrials.gov, NCT02154178.

  10. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tamara Alexandrov

    2014-01-01

    consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%, femur fracture (2%, greater trochanteric fracture (12%, postoperative periprosthetic intertrochanteric fracture (2%, femoral nerve palsy (5%, hematoma (2%, and postoperative iliopsoas avulsion (2%. Radiographic analysis revealed average cup anteversion of 19.6°±6.6, average cup abduction angle of 48.4°±7, stem varus of 0.9°±2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.

  11. Early diagnosis of incipient caries based on non-invasive lasers

    Science.gov (United States)

    Velescu, A.; Todea, C.; Vitez, B.

    2016-03-01

    AIM: The aim of this study is to detect incipient caries and enamel demineralization using laser fluorescence.This serves only as an auxilary aid to identify and to monitor the development of these lesions. MATERIALS AND METHODS: 6 patients were involved in this study, three females and three male. Each patient underwent a professional cleaning, visual examination of the oral cavity, and then direct inspection using DiagnoCam and DIAGNOdent. After data recording each patient was submitted to retro-alveolar X-ray on teeth that were detected with enamel lesions. All data was collected and analyzed statistically. RESULTS: Of 36 areas considered in clinically healthy, 24 carious surfaces were found using laser fluorescence, a totally non-invasive method for detecting incipient carious lesions compared with the radiographic examination. CONCLUSIONS: This method has good applicability for patients because it improves treatment plan by early detection of caries and involves less fear for anxious patients and children.

  12. Non-invasive method for screening and early detection of breast tumors using thermal field analysis

    Directory of Open Access Journals (Sweden)

    O. Drosu

    2009-10-01

    Full Text Available The paper refers to general presentation of international and European evaluation regarding breast cancer incidence and mortality as well as recommendations for prevention, screening, detection and treatment.The past years international research development in biomedical engineering has put a particular emphasis on the thermography use in breast pathology diagnosis and its main advantages, such as: an early diagnose of the breast cancer, in that stage when the mammography or ultrasounds can not easily detect the changes of the tissue; a totally non-invasive interaction with human body; very low costs and possibilities for the women to do a self thermographic test.We also present some important results of our research within the field of breast tumor detection using the numerical analysis of the thermal inverse problem.

  13. DPEP1, expressed in the early stages of colon carcinogenesis, affects cancer cell invasiveness.

    Science.gov (United States)

    Toiyama, Yuji; Inoue, Yasuhiro; Yasuda, Hiromi; Saigusa, Susumu; Yokoe, Takeshi; Okugawa, Yoshinaga; Tanaka, Koji; Miki, Chikao; Kusunoki, Masato

    2011-02-01

    We investigated changes in the gene expression profile in colon cancer in order to identify gene markers that may be useful in the management of this disease. The Cancer Genome Anatomy Project was used to detect differences in gene expression between normal and cancer tissue. The overexpression of dipeptidase-1 (DPEP1) in cancer tissue was confirmed in a sample of 76 patients by real-time PCR. To identify the function of DPEP1, RNA interference (RNAi) was used to inactivate this gene in the colon cancer cell line. Immunohistochemical analysis was performed to characterize the pattern of DPEP1 expression in colon cancer. DPEP1 expression in cancer was significantly higher than that in normal tissue. However, DPEP1 expression decreased with pathological differentiation, lymph-node and distant metastasis. Patients with tumors with decreased DPEP1 expression showed a poorer prognosis, and this was also true of patients with tumors who are treated with curative intent. RNAi-mediated DPEP1 reduction in the colon cancer cell line did not result in cell proliferation or apoptosis, but was associated with an increased invasive ability. DPEP1 protein was observed on the apical side of the cancer cells, and is expressed in the early stages of carcinogenesis, even in adenomas of both sporadic colorectal cancer and familial adenomatous polyposis patients. DPEP1 expression in normal colonic mucosa is very low, but it is highly expressed in colorectal adenoma and cancer specimens and is negatively correlated with parameters of pathological aggressiveness and poor prognosis. DPEP1 is expressed in the early stages of colon carcinogenesis and affects cancer cell invasiveness.

  14. Proliferation of endogenous retroviruses in the early stages of a host germ line invasion.

    Science.gov (United States)

    Ishida, Yasuko; Zhao, Kai; Greenwood, Alex D; Roca, Alfred L

    2015-01-01

    Endogenous retroviruses (ERVs) comprise 8% of the human genome and are common in all vertebrate genomes. The only retrovirus known to be currently transitioning from exogenous to endogenous form is the koala retrovirus (KoRV), making koalas (Phascolarctos cinereus) ideal for examining the early stages of retroviral endogenization. To distinguish endogenous from exogenous KoRV proviruses, we isolated koala genomic regions flanking KoRV integration sites. In three wild southern Australian koalas, there were fewer KoRV loci than in three captive Queensland koalas, consistent with reports that southern Australian koalas carry fewer KoRVs. Of 39 distinct KoRV proviral loci examined in a sire-dam-progeny triad, all proved to be vertically transmitted and endogenous; none was exogenous. Of the 39 endogenous KoRVs (enKoRVs), only one was present in the genomes of both the sire and the dam, suggesting that, at this early stage in the retroviral invasion of a host germ line, very large numbers of ERVs have proliferated at very low frequencies in the koala population. Sequence divergence between the 5'- and 3'-long terminal repeats (LTRs) of a provirus can be used as a molecular clock. Within each of ten enKoRVs, the 5'-LTR sequence was identical to the 3'-LTR sequence, suggesting a maximum age for enKoRV invasion of the koala germ line of approximately 22,200-49,900 years ago, although a much younger age is possible. Across the ten proviruses, seven LTR haplotypes were detected, indicating that at least seven different retroviral sequences had entered the koala germ line. © The Author 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Proliferation of Endogenous Retroviruses in the Early Stages of a Host Germ Line Invasion

    Science.gov (United States)

    Ishida, Yasuko; Zhao, Kai; Greenwood, Alex D.; Roca, Alfred L.

    2015-01-01

    Endogenous retroviruses (ERVs) comprise 8% of the human genome and are common in all vertebrate genomes. The only retrovirus known to be currently transitioning from exogenous to endogenous form is the koala retrovirus (KoRV), making koalas (Phascolarctos cinereus) ideal for examining the early stages of retroviral endogenization. To distinguish endogenous from exogenous KoRV proviruses, we isolated koala genomic regions flanking KoRV integration sites. In three wild southern Australian koalas, there were fewer KoRV loci than in three captive Queensland koalas, consistent with reports that southern Australian koalas carry fewer KoRVs. Of 39 distinct KoRV proviral loci examined in a sire–dam–progeny triad, all proved to be vertically transmitted and endogenous; none was exogenous. Of the 39 endogenous KoRVs (enKoRVs), only one was present in the genomes of both the sire and the dam, suggesting that, at this early stage in the retroviral invasion of a host germ line, very large numbers of ERVs have proliferated at very low frequencies in the koala population. Sequence divergence between the 5′- and 3′-long terminal repeats (LTRs) of a provirus can be used as a molecular clock. Within each of ten enKoRVs, the 5′-LTR sequence was identical to the 3′-LTR sequence, suggesting a maximum age for enKoRV invasion of the koala germ line of approximately 22,200–49,900 years ago, although a much younger age is possible. Across the ten proviruses, seven LTR haplotypes were detected, indicating that at least seven different retroviral sequences had entered the koala germ line. PMID:25261407

  16. Invasive Candidiasis in Various Patient Populations: Incorporating Non-Culture Diagnostic Tests into Rational Management Strategies

    Science.gov (United States)

    Clancy, Cornelius J.; Shields, Ryan K.; Nguyen, M. Hong

    2016-01-01

    Mortality rates due to invasive candidiasis remain unacceptably high, in part because the poor sensitivity and slow turn-around time of cultures delay the initiation of antifungal treatment. β-d-glucan (Fungitell) and polymerase chain reaction (PCR)-based (T2Candida) assays are FDA-approved adjuncts to cultures for diagnosing invasive candidiasis, but their clinical roles are unclear. We propose a Bayesian framework for interpreting non-culture test results and developing rational patient management strategies, which considers test performance and types of invasive candidiasis that are most common in various patient populations. β-d-glucan sensitivity/specificity for candidemia and intra-abdominal candidiasis is ~80%/80% and ~60%/75%, respectively. In settings with 1%–10% likelihood of candidemia, anticipated β-d-glucan positive and negative predictive values are ~4%–31% and ≥97%, respectively. Corresponding values in settings with 3%–30% likelihood of intra-abdominal candidiasis are ~7%–51% and ~78%–98%. β-d-glucan is predicted to be useful in guiding antifungal treatment for wide ranges of populations at-risk for candidemia (incidence ~5%–40%) or intra-abdominal candidiasis (~7%–20%). Validated PCR-based assays should broaden windows to include populations at lower-risk for candidemia (incidence ≥~2%) and higher-risk for intra-abdominal candidiasis (up to ~40%). In the management of individual patients, non-culture tests may also have value outside of these windows. The proposals we put forth are not definitive treatment guidelines, but rather represent starting points for clinical trial design and debate by the infectious diseases community. The principles presented here will be applicable to other assays as they enter the clinic, and to existing assays as more data become available from different populations. PMID:29376927

  17. Invasive Candidiasis in Various Patient Populations: Incorporating Non-Culture Diagnostic Tests into Rational Management Strategies

    Directory of Open Access Journals (Sweden)

    Cornelius J. Clancy

    2016-02-01

    Full Text Available Mortality rates due to invasive candidiasis remain unacceptably high, in part because the poor sensitivity and slow turn-around time of cultures delay the initiation of antifungal treatment. β-d-glucan (Fungitell and polymerase chain reaction (PCR-based (T2Candida assays are FDA-approved adjuncts to cultures for diagnosing invasive candidiasis, but their clinical roles are unclear. We propose a Bayesian framework for interpreting non-culture test results and developing rational patient management strategies, which considers test performance and types of invasive candidiasis that are most common in various patient populations. β-d-glucan sensitivity/specificity for candidemia and intra-abdominal candidiasis is ~80%/80% and ~60%/75%, respectively. In settings with 1%–10% likelihood of candidemia, anticipated β-d-glucan positive and negative predictive values are ~4%–31% and ≥97%, respectively. Corresponding values in settings with 3%–30% likelihood of intra-abdominal candidiasis are ~7%–51% and ~78%–98%. β-d-glucan is predicted to be useful in guiding antifungal treatment for wide ranges of populations at-risk for candidemia (incidence ~5%–40% or intra-abdominal candidiasis (~7%–20%. Validated PCR-based assays should broaden windows to include populations at lower-risk for candidemia (incidence ≥~2% and higher-risk for intra-abdominal candidiasis (up to ~40%. In the management of individual patients, non-culture tests may also have value outside of these windows. The proposals we put forth are not definitive treatment guidelines, but rather represent starting points for clinical trial design and debate by the infectious diseases community. The principles presented here will be applicable to other assays as they enter the clinic, and to existing assays as more data become available from different populations.

  18. Update on Pharmaceutical and Minimally Invasive Management Strategies for Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Rokhsara Rafii

    2011-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a debilitating pulmonary disorder with systemic effects, and it is the fourth leading cause of death in the United States. COPD patients not only develop respiratory limitations, but can also demonstrate systemic wasting, features of depression, and can succumb to social isolation. Smoking cessation is crucial, and pharmacotherapy with bronchodilators is helpful in symptom management. Inhaled corticosteroids may be beneficial in some patients. In addition, pulmonary rehabilitation and palliative care are important components under the right clinical circumstance. This review highlights current guidelines and management strategies for COPD and emphasizes novel pharmacotherapy and minimally invasive (nonsurgical lung-volume reduction interventions that may prove to be of significant benefit in the future.

  19. Reproductive biology and early establishment of Pinus elliottii var. elliottii in Brazilian sandy coastal plain vegetation: implications for biological invasion

    Directory of Open Access Journals (Sweden)

    Fernando Campanhã Bechara

    2013-04-01

    Full Text Available Pinus is the most invasive woody taxon, exceeded only by herbaceous plants. This study reports the reproductive biology and early establishment of Pinus elliottii Engelm. var. elliottii, describing its invasive properties in a protected natural area of the Brazilian coastal sandy plains. We evaluated the seed germination and rain, longevity of seed viability and the initial dynamics of the seedlings of Pinus elliottii var elliottii through field and laboratory experiments. We recorded a continuous seed rain of about 204.0 viable seeds m- 2 per year, with a 90 % germination rate. The seeds exhibited a low longevity of viability in the soil and a dense, permanent seedling bank that may explain the high levels of pine invasion. The environmental impact caused by the pine's biological invasion suggests the recommendation for its immediate eradication, together with a restoration plan to restitute the native biodiversity gradually.

  20. Performance of serum biomarkers for the early detection of invasive aspergillosis in febrile, neutropenic patients: a multi-state model.

    Directory of Open Access Journals (Sweden)

    Michaël Schwarzinger

    Full Text Available The performance of serum biomarkers for the early detection of invasive aspergillosis expectedly depends on the timing of test results relative to the empirical administration of antifungal therapy during neutropenia, although a dynamic evaluation framework is lacking.We developed a multi-state model describing simultaneously the likelihood of empirical antifungal therapy and the risk of invasive aspergillosis during neutropenia. We evaluated whether the first positive test result with a biomarker is an independent predictor of invasive aspergillosis when both diagnostic information used to treat and risk factors of developing invasive aspergillosis are taken into account over time. We applied the multi-state model to a homogeneous cohort of 185 high-risk patients with acute myeloid leukemia. Patients were prospectively screened for galactomannan antigenemia twice a week for immediate treatment decision; 2,214 serum samples were collected on the same days and blindly assessed for (1->3- β-D-glucan antigenemia and a quantitative PCR assay targeting a mitochondrial locus.The usual evaluation framework of biomarker performance was unable to distinguish clinical benefits of β-glucan or PCR assays. The multi-state model evidenced that the risk of invasive aspergillosis is a complex time function of neutropenia duration and risk management. The quantitative PCR assay accelerated the early detection of invasive aspergillosis (P = .010, independently of other diagnostic information used to treat, while β-glucan assay did not (P = .53.The performance of serum biomarkers for the early detection of invasive aspergillosis is better apprehended by the evaluation of time-varying predictors in a multi-state model. Our results provide strong rationale for prospective studies testing a preemptive antifungal therapy, guided by clinical, radiological, and bi-weekly blood screening with galactomannan antigenemia and a standardized quantitative PCR assay.

  1. Early clinical assessment for harsh child discipline strategies.

    Science.gov (United States)

    Gaffney, Kathleen F; Barndt-Maglio, Bonnie; Myers, Sue; Kollar, Shelley J

    2002-01-01

    To examine the relationships among four maternal variables: 1) prenatal report of discipline expectant mothers received when they were children, 2) prenatal intentions for disciplining one's own child, 3) report of intended child discipline strategies when infant is 8 months old, and 4) observed maternal role sufficiency behaviors. Replication and extension study; 3-wave prospective longitudinal design. The procedure consisted of prenatal clinic interviews in which women (N = 185) reported how their mothers handled specific child behaviors and how they intended to handle the same behaviors with their children. During a home visit when their babies were 8 months old, the mothers (n = 126) were again asked how they intended to handle these behaviors, and observations were made of maternal role sufficiency behaviors. Correlation and regression analyses were performed with data generated from an adaptation of the Ways of Handling Irritating Behavior scale, the NCAST Teaching Scale, and the HOME scale. A significant relationship was found between mothers' prenatal reports of discipline received as a child and prenatal reports of intentions for disciplining their own children. For mothers of infants, reported intentions for future child discipline strategies were predicted by their prenatal reports. Mothers with clinically at-risk scores on the NCAST Teaching Scale and HOME scale reported more intended harsh child discipline strategies than those not at-risk. Assessment for harsh, nonnurturing child discipline strategies during prenatal and well-baby health maintenance checks may assist in uncovering "red flags" for early intervention to reduce the risk of later child abuse and neglect.

  2. Early and late outcomes of 1000 minimally invasive aortic valve operations.

    Science.gov (United States)

    Tabata, Minoru; Umakanthan, Ramanan; Cohn, Lawrence H; Bolman, Ralph Morton; Shekar, Prem S; Chen, Frederick Y; Couper, Gregory S; Aranki, Sary F

    2008-04-01

    Minimal access cardiac valve surgery is increasingly utilized. We report our 11-year experience with minimally invasive aortic valve surgery. From 07/96 to 12/06, 1005 patients underwent minimally invasive aortic valve surgery. Early and late outcomes were analyzed. Median patient age was 68 years (range: 24-95), 179 patients (18%) were 80 years or older, 130 patients (13%) had reoperative aortic valve surgery, 86 (8.4%) had aortic root replacement, 62 (6.1%) had concomitant ascending aortic replacement, and 26 (2.6%) had percutaneous coronary intervention on the day of surgery (hybrid procedure). Operative mortality was 1.9% (19/1005). The incidences of deep sternal wound infection, pneumonia and reoperation for bleeding were 0.5% (5/1005), 1.3% (13/1005) and 2.4% (25/1005), respectively. Median length of stay was 6 days and 733 patients (72%) were discharged home. Actuarial survival was 91% at 5 years and 88% at 10 years. In the subgroup of the elderly (> or =80 years), operative mortality was 1.7% (3/179), median length of stay was 8 days and 66 patients (37%) were discharged home. Actuarial survival at 5 years was 84%. There was a significant decreasing trend in cardiopulmonary bypass time, the incidence of bleeding, and operative mortality over time. Minimal access approaches in aortic valve surgery are safe and feasible with excellent outcomes. Aortic root replacement, ascending aortic replacement, and reoperative surgery can be performed with these approaches. These procedures are particularly well-tolerated in the elderly.

  3. Multidisciplinary strategies in the management of early chronic kidney disease.

    Science.gov (United States)

    Martínez-Ramírez, Héctor R; Cortés-Sanabria, Laura; Rojas-Campos, Enrique; Hernández-Herrera, Aurora; Cueto-Manzano, Alfonso M

    2013-11-01

    Chronic kidney disease (CKD) is a worldwide epidemic especially in developing countries, with clear deficiencies in identification and treatment. Better care of CKD requires more than only economic resources, utilization of health research in policy-making and health systems changes that produce better outcomes. A multidisciplinary approach may facilitate and improve management of patients from early CKD in the primary health-care setting. This approach is a strategy for improving comprehensive care, initiating and maintaining healthy behaviors, promoting teamwork, eliminating barriers to achieve goals and improving the processes of care. A multidisciplinary intervention may include educational processes guided by health professional, use of self-help groups and the development of a CKD management plan. The complex and fragmented care management of patients with CKD, associated with poor outcome, enhances the importance of implementing a multidisciplinary approach in the management of this disease from the early stages. Multidisciplinary strategies should focus on the needs of patients (to increase their empowerment) and should be adapted to the resources and health systems prevailing in each country; its systematic implementation can help to improve patient care and slow the progression of CKD. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.

  4. Korean nuclear reactor strategy for the early 21st century

    International Nuclear Information System (INIS)

    Lee, Byong Whi; Shin, Young Kyun

    1991-01-01

    The system analysis for Korean nuclear power reactor option is made on the basis of reliability, cost minimization, finite uranium resource availability and nuclear engineering manpower supply constraints. The reference reactor scenarios are developed considering the future electricity demand, nuclear share, current nuclear power plant standardization program and manufacturing capacity. The levelized power generation cost, uranium requirement and nuclear engineering professionals demand are estimated for each reference reactor scenarios and nuclear fuel cycle options from the year 1990 up to the year 2030. Based on the outcomes of the analysis, uranium resource utilization, reliability and nuclear engineering manpower requirements are sensitive to the nuclear reactor strategy and associated fuel cycle whereas the system cost is not. APWR, CANDU: FBR strategy is to be the best option for Korea. However, APWR, CANDU: Passive Safe Reactor (PSR) vFBR strategy should be also considered as a contingency for growing national concerns on nuclear safety and public acceptance deterioration in the future. FBR development and establishment of related fuel cycle should be started as soon as possible considering the uranium shortage anticipated between 2007 and 2032. It should be noted that the increasing use of nuclear energy to minimize the greenhouse effects in the early 21st century would accelerate the uranium resource depletion. The study also concludes that the current level of nuclear engineering professionals employment is not sufficient until 2010 for the establishment of nuclear infrastructure. (Author)

  5. Non-invasive assessment determine the swallowing and respiration dysfunction in early Parkinson's disease.

    Science.gov (United States)

    Wang, Chin-Man; Shieh, Wann-Yun; Weng, Yi-Hsin; Hsu, Yi-Hsuan; Wu, Yih-Ru

    2017-09-01

    Dysphagia is common among patients with Parkinson's disease. Swallowing and its coordination with respiration is extremely important to achieve safety swallowing. Different tools have been used to assess this coordination, however the results have been inconsistent. We aimed to investigate this coordination in patients with Parkinson's disease using a non-invasive method. Signals of submental muscle activity, thyroid cartilage excursion, and nasal airflow during swallowing were recorded simultaneously. Five different water boluses were swallowed three times, and the data were recorded and analyzed. Thirty-seven controls and 42 patients with early-stage Parkinson's disease were included. The rates of non-expiratory/expiratory pre- and post-swallowing respiratory phase patterns were higher in the patients than in the controls (P Parkinson's disease, and safety compensation mechanisms were used more than efficiency during swallowing. The results of this study may serve as a baseline for further research into new treatment regimens and to improve the management of swallowing in patients with Parkinson's disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Early stages of bipolar disorder: characterization and strategies for early intervention

    Directory of Open Access Journals (Sweden)

    Adiel C. Rios

    2015-12-01

    Full Text Available Objective: To characterize the early stages of bipolar disorder (BD, defined as the clinical prodrome/subsyndromal stage and first-episode phase, and strategies for their respective treatment. Methods: A selective literature search of the PubMed, Embase, PsycINFO, and ISI databases from inception until March 2014 was performed. Included in this review were articles that a characterized prodromal and first-episode stages of BD or b detailed efficacy and safety/tolerability of interventions in patients considered prodromal for BD or those with only one episode of mania/hypomania. Results: As research has only recently focused on characterization of the early phase of BD, there is little evidence for the effectiveness of any treatment option in the early phase of BD. Case management; individual, group, and family therapy; supportive therapy; and group psychoeducation programs have been proposed. Most evidence-based treatment guidelines for BD do not address treatment specifically in the context of the early stages of illness. Evidence for pharmacotherapy is usually presented in relation to illness polarity (i.e., manic/mixed or depressed or treatment phase. Conclusions: Although early recognition and treatment are critical to preventing unfavorable outcomes, there is currently little evidence for interventions in these stages of BD.

  7. Minimally invasive or interventional repair of atrial septal defects in children: experience in 171 cases and comparison with conventional strategies.

    Science.gov (United States)

    Formigari, R; Di Donato, R M; Mazzera, E; Carotti, A; Rinelli, G; Parisi, F; Pasquini, L; Ballerini, L

    2001-05-01

    The goal of this study was to evaluate percutaneous interventional and minimally invasive surgical closure of secundum atrial septal defect (ASD) in children. Concern has surrounded abandoning conventional midline sternotomy in favor of the less invasive approaches pursuing a better cosmetic result and a more rational resource utilization. A retrospective analysis was performed on the patients treated from June 1996 to December 1998. One hundred seventy-one children (median age 5.8 years, median weight 22.1 kg) underwent 52 device implants, 72 minimally invasive surgical operations and 50 conventional sternotomy operations. There were no deaths and no residual left to right shunt in any of the groups. The overall complication rate causing delayed discharge was 12.6% for minimally invasive surgery, 12.0% for midline sternotomy and 3.8% for transcatheter device closure (p appeal of the percutaneous and minimally invasive approaches must be weighed against their greater exposure to technical pitfalls. Adequate training is needed if a strategy of surgical or percutaneous minimally invasive closure of ASD in children is planned in place of conventional surgery.

  8. A Non-Invasive Strategy for Neonatal Alloimmune Thrombocytopenia Diagnosis: Newborn Platelet Genotyping with Buccal Swabs

    Directory of Open Access Journals (Sweden)

    Gérald Bertrand

    2016-07-01

    Full Text Available Neonatal alloimmune thrombocytopenia results from the maternal immune response against fetal-specific antigens inherited from the father. The diagnosis is ascertained only when the maternal alloantibody and the offending antigen present in the newborn are identified. Up until now most laboratories perform DNA extraction for neonatal genotyping from newborn blood samplings. In order to avoid such an invasive procedure, two protocols of DNA extraction from buccal swabs were developed: a manual protocol using the QIAamp mini blood kit (Qiagen, and an automated procedure with the MagNA Pure Compact instrument (Roche. Both EDTA-blood and buccal swabs from thrombocytopenic newborns were genotyped manually (14 samples, automatically (15 samples or both manually and automatically (two samples. Human Platelet Antigen (HPA genotyping was performed using the BeadChip assay (BioArray, Immucor. Concordant genotypings were obtained for all samples except for one swab with the manual method. The automated DNA extraction from newborn buccal swabs with the MagNA Pure Compact instrument was chosen as the first-line strategy, with a significant gain of time in processing buccal swabs.

  9. Plasticity in early immune evasion strategies of a bacterial pathogen.

    Science.gov (United States)

    Bernard, Quentin; Smith, Alexis A; Yang, Xiuli; Koci, Juraj; Foor, Shelby D; Cramer, Sarah D; Zhuang, Xuran; Dwyer, Jennifer E; Lin, Yi-Pin; Mongodin, Emmanuel F; Marques, Adriana; Leong, John M; Anguita, Juan; Pal, Utpal

    2018-04-17

    Borrelia burgdorferi is one of the few extracellular pathogens capable of establishing persistent infection in mammals. The mechanisms that sustain long-term survival of this bacterium are largely unknown. Here we report a unique innate immune evasion strategy of B. burgdorferi , orchestrated by a surface protein annotated as BBA57, through its modulation of multiple spirochete virulent determinants. BBA57 function is critical for early infection but largely redundant for later stages of spirochetal persistence, either in mammals or in ticks. The protein influences host IFN responses as well as suppresses multiple host microbicidal activities involving serum complement, neutrophils, and antimicrobial peptides. We also discovered a remarkable plasticity in BBA57-mediated spirochete immune evasion strategy because its loss, although resulting in near clearance of pathogens at the inoculum site, triggers nonheritable adaptive changes that exclude detectable nucleotide alterations in the genome but incorporate transcriptional reprograming events. Understanding the malleability in spirochetal immune evasion mechanisms that ensures their host persistence is critical for the development of novel therapeutic and preventive approaches to combat long-term infections like Lyme borreliosis.

  10. Early-Onset Invasive Candidiasis in Extremely Low Birth Weight Infants: Perinatal Acquisition Predicts Poor Outcome.

    Science.gov (United States)

    Barton, Michelle; Shen, Alex; O'Brien, Karel; Robinson, Joan L; Davies, H Dele; Simpson, Kim; Asztalos, Elizabeth; Langley, Joanne; Le Saux, Nicole; Sauve, Reginald; Synnes, Anne; Tan, Ben; de Repentigny, Louis; Rubin, Earl; Hui, Chuck; Kovacs, Lajos; Yau, Yvonne C W; Richardson, Susan E

    2017-04-01

    Neonatal invasive candidiasis (IC) presenting in the first week of life is less common and less well described than later-onset IC. Risk factors, clinical features, and disease outcomes have not been studied in early-onset disease (EOD, ≤7 days) or compared to late-onset disease (LOD, >7 days). All extremely low birth weight (ELBW, candidiasis enrolled from 2001 to 2003 were included in this study. Factors associated with occurrence and outcome of EOD in ELBW infants were determined. Forty-five ELBW infants and their 84 matched controls were included. Fourteen (31%) ELBW infants had EOD. Birth weight <750 g, gestation <25 weeks, chorioamnionitis, and vaginal delivery were all strongly associated with EOD. Infection with Candida albicans, disseminated disease, pneumonia, and cardiovascular disease were significantly more common in EOD than in LOD. The EOD case fatality rate (71%) was higher than in LOD (32%) or controls (15%) (P = .0001). The rate of neurodevelopmental impairment and mortality combined was similar in EOD (86%) and LOD (72%), but higher than in controls (32%; P = .007). ELBW infants with EOD have a very poor prognosis compared to those with LOD. The role of perinatal transmission in EOD is supported by its association with chorioamnionitis, vaginal delivery, and pneumonia. Dissemination and cardiovascular involvement are common, and affected infants often die. Empiric treatment should be considered for ELBW infants delivered vaginally who have pneumonia and whose mothers have chorioamnionitis or an intrauterine foreign body. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  11. Invasion strategies in round goby (Neogobius melanostomus: Is bigger really better?

    Directory of Open Access Journals (Sweden)

    Joerg Brandner

    Full Text Available Few studies have systematically investigated mid- or long-term temporal changes of biological characteristics in invasive alien species considering the different phases of an invasion. We studied the invasion performance of one of the most invasive species worldwide, the round goby Neogobius melanostomus, from total absence over first occurrence until establishment from 2010 to 2015 in the upper Danube River. After an upstream movement of the invasion front of about 30 river km within four years, the pattern that round goby pioneering populations significantly differ from longer established ones has been confirmed: Pioneering populations at the invasion front comprised more females than males, and adult specimens with a larger body size compared to those at longer inhabited areas. On the population-level, the proportion of juveniles increased with time since invasion. The results of this study provide support for the previously postulated ´bigger is better´ and ´individual trait utility´ hypotheses explaining invasion success in round goby. Pioneering invaders with their greater exploratory behavior, highly adaptive phenotypic plasticity and increased competitive ability seem to act as prime emperors of new habitats, strongly following and benefiting from man-made river-bank structures.

  12. New Approaches for Early Detection of Breast Tumor Invasion or Progression

    National Research Council Canada - National Science Library

    Man, Yan-Gao

    2003-01-01

    To assess interactions between epithelial (EP) and myoepithelial (ME) cells in association with breast tumor progression and invasion, a double immunostaining technique with antibodies to smooth muscle actin (SMA...

  13. Minimal invasive surgery for patients with urolithiasis with early postoperative rehabilitation in Truskavets

    Directory of Open Access Journals (Sweden)

    I. Derkach

    2017-07-01

    Full Text Available Introduction. Undoubtedly, technological progress, the "conquest" of civilization leads to a deterioration of the environmental situation. It affects the human body, causing a violation of homeostasis, due to disorders in it. The purpose of the work. In view of the above, the task was to study the peculiarities of the process of the use of minimally invasive techniques in patients with urolithiasis treated in the period from 2012 to 2017 in the urological department of the Truskavets City Hospital and in the private office of lithotripsy Ya.V. Feciak in the complex with the use of medical water "Naftusya" during treatment and in the early postoperative period as a means of metaphysics of recurrent stone formation and quicker rehabilitation of patients. Materials and methods of research. The treatment of 1757 patients with urolithiasis in the urological department of Truskavets city hospital and the private office of lithotripsy Ya.V. Fetsiak for the period of 2012 - 2017. The study included 681 patients with kidney stones, 1045 patients - with ureteric stones and 31 patients with urinary bladder specimens. 357 contact nephrolithotripsy, 491 contact ureterolithotripsy (CULT, 27 contact cystolithotripsy and 2074 extracorporeal shock-wave lithotripsy (ESWL sessions were performed for these patients. Men were 946 (54%, women 811 (46%. The age of the patients ranged from 18 to 84 years. The size of the concretions localized in the ureter ranged from 0.6 cm to 3.4 cm and, as a rule, was 0.9-1.2 cm. The maximum size of the kidney stone was 9.5 cm, and the average size varied within 1 , 4-27cm. ESWL was performed on the Dornier Compact S machine. In the 882 patients, 2074 procedures were carried out for the ESWL, which was 2.35 procedures per patient. In the planned period, 71% of patients, 29% in urgent (at the height of the renal colic or within the next 30 hours were treated. Results In the contingent of patients treated with ESWL, medical water

  14. Incidental serous tubal intraepithelial carcinoma and early invasive serous carcinoma in the nonprophylactic setting: analysis of a case series.

    Science.gov (United States)

    Morrison, Jane C; Blanco, Luis Z; Vang, Russell; Ronnett, Brigitte M

    2015-04-01

    ovaries as an incidental (clinically occult) microscopic lesion in the absence of widespread pelvic carcinoma provides further evidence that STIC is the earliest form of pelvic high-grade serous carcinoma and that the fallopian tube is the site of origin. This study demonstrates the potential for complete examination of the fallopian tubes and ovaries to identify STICs and early invasive serous carcinomas that might be more amenable to the earliest intervention and potential cure.

  15. A less invasive approach to screening for early onset neonatal GBS.

    LENUS (Irish Health Repository)

    Glackin, S

    2015-03-01

    Recent recommendations for the management of an asymptomatic term infant with one septic risk factor for Group B Streptococcal (GBS) invasive disease have advised a clinical approach. Following a previous audit in our unit which showed that high numbers of asymptomatic infants were receiving antibiotics, a new protocol was introduced which emphasised the importance of clinical examination. This study assessed the safety and efficacy of this new protocol through chart review of 1855 eligible infants. We found a statistically significant decrease (P < 0.0001) from 444 (19%) to 121 (6.5%) in the total number of term infants who underwent septic evaluations and received antibiotics. 241 asymptomatic infants with one septic risk factor were managed conservatively. No eligible infants had GBS invasive disease during the three month study period. The new protocol is a safe and effective tool for evaluating infants at risk of GBS invasive disease.

  16. B Subunit of Human Chorionic Gonadotropin Promotes Tumor Invasion and Predicts Poor Prognosis of Early-Stage Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Jiali Li

    2018-01-01

    Full Text Available Background/Aims: It is well established that many non-trophoblastic tumors secrete HCG (human chorionic gonadotropin and that such secretion is correlated with the poor prognosis of tumor patients. This study aims to analyze the correlation between β-HCG expression and outcome of colorectal cancer (CRC and understand its role in CRC pathology Methods: We detected the mRNA and protein expression of β-HCG in human CRC tissues with RT-qPCR and immunohistochemistry, and we compared the clinical-pathological characteristics, prognosis and progression between the β-HCG positive and negative groups. We also generated CRC cell lines with β-HCG over-expression as well as β-HCG stable knockout, and evaluated cell function and mechanism in vitro and in vivo. Results: Fifty out of 136 CRC patients (37% expressed β-HCG at the invasive front. Clinical-pathological data showed that β-HCG was positively correlated with Dukes staging (P=0.031 and lymph node metastasis (P=0.012. Survival analysis suggested that the patients with high expression of β-HCG had poorer prognosis than those with low β-HCG expression (P=0.0289. β-HCG expression level was also positively correlated with tumor invasion in early-stage CRC patient tissues (P=0.0227. Additionally β-HCG promoted the migration and invasion of CRC in vitro and in vivo but had no effect on the proliferation of tumor cells. Conclusion: Our study demonstrated that β-HCG was ectopically expressed in the CRC patients and its high expression correlated with poor prognosis of early-stage CRC. Additionally it worked as an oncogene that promotes the migration and invasion of CRC by epithelial-mesenchymal transition (EMT.

  17. Early diagnosis of fungal infections in lung transplant recipients, colonization versus invasive disease?

    Science.gov (United States)

    Herrera, Sabina; Husain, Shahid

    2018-05-21

    The diagnosis of invasive aspergillosis remains challenging in solid organ transplants in general, and in lung transplant recipients, in particular, because of colonization. Lung transplant recipients may be over treated with antifungal drugs because of the lack of appropriate diagnostic tools. A review of the new developments of diagnostic tools and whether this help distinguishing colonization from invasive disease is presented. Efforts are being made to develop new tools that will allow us to identify which patients will develop IPA, and those who will be able to control the disease.

  18. Peers Influence Mathematics Strategy Use in Early Elementary School

    Science.gov (United States)

    Carr, Martha; Barned, Nicole; Otumfuor, Beryl

    2016-01-01

    This study examined the impact of performance goals on arithmetic strategy use, and how same-sex peer groups contributed to the selection of strategies used by first-graders. It was hypothesized that gender differences in strategy use are a function of performance goals and the influence of same-sex peers. Using a sample of 75 first grade…

  19. Ecological and Economic Impacts and Invasion Management Strategies for the European Green Crab (2008)

    Science.gov (United States)

    The goals of this case study were to estimate the European green crab’s current and historical impacts on ecosystem services on the East Coast of the United States and to estimate the European green crab’s current and potential future impacts from invasion

  20. Seedling traits, plasticity and local differentiation as strategies of invasive species of Impatiens in central Europe

    Czech Academy of Sciences Publication Activity Database

    Skálová, Hana; Havlíčková, Vendula; Pyšek, Petr

    2012-01-01

    Roč. 110, č. 7 (2012), s. 1429-1438 ISSN 0305-7364 R&D Projects: GA ČR GA206/07/0668; GA MŠk LC06073 Institutional research plan: CEZ:AV0Z60050516 Keywords : plant invasions * plasticity * local differentiation Subject RIV: EF - Botanics Impact factor: 3.449, year: 2012

  1. Teaching Preschoolers to Count: Effective Strategies for Achieving Early Mathematics Milestones

    Science.gov (United States)

    Jacobi-Vessels, Jill L.; Brown, E. Todd; Molfese, Victoria J.; Do, Ahn

    2016-01-01

    Attention to early childhood mathematics instructional strategies has sharpened due to the relatively poor mathematics performance of U.S. students in comparison to students from other countries and research evidence that early mathematics skills impact later achievement. Early Childhood counting skills form the foundation for subsequent…

  2. ERP services effort estimation strategies based on early requirements

    NARCIS (Netherlands)

    Erasmus, I.P.; Daneva, Maia; Kalenborg, Axel; Trapp, Marcus

    2015-01-01

    ERP clients and vendors necessarily estimate their project interventions at a very early stage, before the full requirements to an ERP solution are known and often before a contract is finalized between a vendor/ consulting company and a client. ERP project estimation at the stage of early

  3. Early predictors of success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

    Science.gov (United States)

    Bhattacharyya, D; Prasad, Bnbm; Tampi, P S; Ramprasad, R

    2011-10-01

    Non-invasive positive pressure ventilation (NIPPV) has emerged as a significant advancement in the management of acute hypercapnic respiratory failure. Patients with hypercapnic respiratory failure requiring ventilation therapy (respiratory rate [RR] of > 30 breaths per minutes, PaCO2 > 55 mmHg and arterial pH success group and these parameters continued to improve even after four and 24 hours of NIPPV treatment. Out of 24 (24%) patients who failed to respond, 13 (54%) needed endotracheal intubation within one hour. The failure group had higher baseline HR than the success group. Improvement in HR, RR, pH, and PCO2 one hour after putting the patient on NIPPV predicts success of non-invasive positive pressure ventilation in hypercapnic respiratory failure.

  4. COPEPOD REPRODUCTIVE STRATEGIES: LIFE-HISTORY THEORY, PHYLOGENETIC PATTERN AND INVASION OF INLAND WATERS. (R824771)

    Science.gov (United States)

    AbstractLife-history theory predicts that different reproductive strategies should evolve in environments that differ in resource availability, mortality, seasonality, and in spatial or temporal variation. Within a population, the predicted optimal strategy is driven ...

  5. Early bird catches the worm: germination as a critical step in plant invasion

    Czech Academy of Sciences Publication Activity Database

    Gioria, Margherita; Pyšek, Petr

    2017-01-01

    Roč. 19, č. 4 (2017), s. 1055-1080 ISSN 1387-3547 R&D Projects: GA ČR GB14-36079G Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : lpant invasions * germination * traits Subject RIV: EH - Ecology, Behaviour OBOR OECD: Biodiversity conservation Impact factor: 2.473, year: 2016

  6. Gene expression analysis of early stage endometrial cancersreveals unique transcripts associated with grade and histologybut not depth of invasion

    Directory of Open Access Journals (Sweden)

    John eRisinger

    2013-06-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in the United States but it remains poorly understood at the molecular level. This investigation was conducted to specifically assess whether gene expression changes underlie the clinical and pathologic factors traditionally used for determining treatment regimens in women with stage I endometrial cancer. These include the effect of tumor grade, depth of myometrial invasion and histotype. We utilized oligonucleotide microarrays to assess the transcript expression profile in epithelial glandular cells laser microdissected from 79 endometrioid and 12 serous stage I endometrial cancers with a heterogeneous distribution of grade and depth of myometrial invasion, along with 12 normal post-menopausal endometrial samples. Unsupervised multidimensional scaling analyses revealed that serous and endometrioid stage I cancers have similar transcript expression patterns when compared to normal controls where 900 transcripts were identified to be differentially expressed by at least 4-fold (univariate t-test, p <0.001 between the cancers and normal endometrium. This analysis also identified transcript expression differences between serous and endometrioid cancers and tumor grade, but no apparent differences were identified as a function of depth of myometrial invasion. Four genes were validated by quantitative PCR on an independent set of cancer and normal endometrium samples. These findings indicate that unique gene expression profiles are associated with histologic type and grade, but not myometrial invasion among early stage endometrial cancers. These data provide a comprehensive perspective on the molecular alterations associated with stage I endometrial cancer, particularly those subtypes that have the worst prognosis.

  7. Interagency partnering for weed prevention--progress on development of a National Early Detection and Rapid Response System for Invasive Plants in the United States

    Science.gov (United States)

    Westbrooks, R.; Westbrooks, R.

    2011-01-01

    Over the past 50 years, experience has shown that interagency groups provide an effective forum for addressing various invasive species issues and challenges on multiple land units. However, more importantly, they can also provide a coordinated framework for early detection, reporting, identification and vouchering, rapid assessment, and rapid response to new and emerging invasive plants in the United States. Interagency collaboration maximizes the use of available expertise, resources, and authority for promoting early detection and rapid response (EDRR) as the preferred management option for addressing new and emerging invasive plants. Currently, an interagency effort is underway to develop a National EDRR System for Invasive Plants in the United States. The proposed system will include structural and informational elements. Structural elements of the system include a network of interagency partner groups to facilitate early detection and rapid response to new invasive plants, including the Federal Interagency Committee for the Management of Noxious and Exotic Weeds (FICMNEW), State Invasive Species Councils, State Early Detection and Rapid Response Coordinating Committees, State Volunteer Detection and Reporting Networks, Invasive Plant Task Forces, and Cooperative Weed Management Areas. Informational elements and products being developed include Regional Invasive Plant Atlases, and EDRR Guidelines for EDRR Volunteer Network Training, Rapid Assessment and Rapid Response, and Criteria for Selection of EDRR Species. System science and technical support elements which are provided by cooperating state and federal scientists, include EDRR guidelines, training curriculum for EDRR volunteers and agency field personnel, plant identification and vouchering, rapid assessments, as well as predictive modeling and ecological range studies for invasive plant species.

  8. Early Outcomes of Minimally Invasive Anterior Longitudinal Ligament Release for Correction of Sagittal Imbalance in Patients with Adult Spinal Deformity

    Directory of Open Access Journals (Sweden)

    Armen R. Deukmedjian

    2012-01-01

    Full Text Available The object of this study was to evaluate a novel surgical technique in the treatment of adult degenerative scoliosis and present our early experience with the minimally invasive lateral approach for anterior longitudinal ligament release to provide lumbar lordosis and examine its impact on sagittal balance. Methods. All patients with adult spinal deformity (ASD treated with the minimally invasive lateral retroperitoneal transpsoas interbody fusion (MIS LIF for release of the anterior longitudinal ligament were examined. Patient demographics, clinical data, spinopelvic parameters, and outcome measures were recorded. Results. Seven patients underwent release of the anterior longitudinal ligament (ALR to improve sagittal imbalance. All cases were split into anterior and posterior stages, with mean estimated blood loss of 125 cc and 530 cc, respectively. Average hospital stay was 8.3 days, and mean follow-up time was 9.1 months. Comparing pre- and postoperative 36′′ standing X-rays, the authors discovered a mean increase in global lumbar lordosis of 24 degrees, increase in segmental lumbar lordosis of 17 degrees per level of ALL released, decrease in pelvic tilt of 7 degrees, and decrease in sagittal vertical axis of 4.9 cm. At the last followup, there was a mean improvement in VAS and ODI scores of 26.2% and 18.3%. Conclusions. In the authors’ early experience, release of the anterior longitudinal ligament using the minimally invasive lateral retroperitoneal transpsoas approach may be a feasible alternative in correcting sagittal deformity.

  9. Assessing the geographic origin of the invasive grey squirrel using DNA sequencing: Implications for management strategies

    Directory of Open Access Journals (Sweden)

    Claire D. Stevenson-Holt

    2015-01-01

    Full Text Available The invasive grey squirrel Sciurus carolinensis has become a major pest species causing negative effects to forestry and biodiversity. This study aims to assess the origin of grey squirrel within Cumbria using phylogeographic analysis to aid in management and control. The work reported analysed mitochondrial DNA sequences in the D-Loop gene of 73 grey squirrel individuals from multiple locations in the UK. The results indicate that individuals in north Cumbria are derived from individuals from Scotland and North East England. Other individuals in north Cumbria share a unique haplotype with south Cumbria and Lancashire suggesting a southerly origin and movement around or over the Cumbrian Mountain range which is thought of as a barrier to movements. The assessment of invasive species geographical origin and the identification of potential wildlife transit corridors through natural barriers are becoming more important as species shift range in response to environmental and ecological changes. With the grey squirrel population expansion also occurring in Italy, the European red squirrel may become threatened across its entire range. It is crucial to understand the population origins of the invasive grey squirrel and landscape usage to successfully manage the incursion routes and control the population.

  10. Invasive Management Strategies and Antithrombotic Treatments in Patients With Non-ST-Segment-Elevation Acute Coronary Syndrome in China: Findings From the Improving CCC Project (Care for Cardiovascular Disease in China).

    Science.gov (United States)

    Yang, Qing; Wang, Ying; Liu, Jing; Liu, Jun; Hao, Yongchen; Smith, Sidney C; Huo, Yong; Fonarow, Gregg C; Ma, Changsheng; Ge, Junbo; Taubert, Kathryn A; Morgan, Louise; Guo, Yang; Wang, Wei; Zhou, Yujie; Zhao, Dong

    2017-06-01

    Early invasive strategies and antithrombotic treatments are key treatments of non-ST-segment-elevation acute coronary syndrome (NSTE-ACS). Few studies have examined the use of these strategies in patients with NSTE-ACS in China. This study aimed to assess the applications of invasive strategies and antithrombotic treatments in patients with NSTE-ACS and compare their outcomes. A nationwide registry study, Improving CCC (Care for Cardiovascular Disease in China) ACS project, was launched in 2014 as a collaborative study of the American Heart Association and Chinese Society of Cardiology (CSC), with 142 participating hospitals reporting details of clinical management and outcomes of patients with NSTE-ACS. The use of invasive strategies and antithrombotic treatments was examined based on updated guidelines. Major adverse cardiovascular events were analyzed. A total of 9953 patients with NSTE-ACS were enrolled. Angiography was performed in 63.1% of these patients, and 58.2% underwent percutaneous coronary intervention (PCI). However, 40.6% of patients did not undergo early risk assessment, and very-high-risk patients had the lowest proportion of PCI (41.7%). PCI was performed within recommended times in 11.1% of very-high-risk patients and 26.3% of high risk patients. Those who underwent PCI within 2 hours had higher mortality in high-risk and very-high-risk patients who received PCI. Early dual antiplatelet treatment was given in 88.3% of patients. There are notable differences between guideline recommendations and the clinical management of patients with NSTE-ACS in China. The reasons for very-high-risk NSTE-ACS patients not undergoing PCI, and the optimal timing of PCI, require further clarification. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02306616. © 2017 American Heart Association, Inc.

  11. Outcomes in women with invasive ductal or invasive lobular early stage breast cancer treated with anastrozole or exemestane in CCTG (NCIC CTG) MA.27.

    Science.gov (United States)

    Strasser-Weippl, K; Sudan, G; Ramjeesingh, R; Shepherd, L E; O'Shaughnessy, J; Parulekar, W R; Liedke, P E R; Chen, B E; Goss, P E

    2018-02-01

    Histological subtype, (invasive ductal breast cancer (IDBC)/invasive lobular breast cancer (ILBC)), might be a marker for differential response to endocrine therapy in breast cancer. Clinical trial MA.27 compared 5 years of adjuvant anastrozole or exemestane in postmenopausal patients with hormone receptor positive early breast cancer. We evaluated IDBC versus ILBC (based on original pathology reports) as predictor for event-free survival (EFS) and overall survival (OS). A total of 5709 patients (5021 with IDBC and 688 with ILBC) were included (1876 were excluded because of missing or other histological subtype). Median follow-up was 4.1 years. Overall, histological subtype did not influence OS or EFS (HR (hazard ratio) 1.14, 95% confidence interval (CI) [0.79-1.63], P = 0.49 and HR 1.04, 95% CI [0.77-1.41], P = 0.81, respectively). There was no significant difference in OS between treatment with exemestane versus treatment with anastrozole in the IDBC group (HR = 0.92, 95% CI [0.73-1.16], P = 0.46). In the ILBC group, a marginally significant difference in favour of treatment with anastrozole was seen (HR = 1.79, 95% CI [0.98-3.27], P = 0.055). In multivariable analysis a prognostic effect of the interaction between treatment and histological subtype on OS (but not on EFS) was noted, suggesting a better outcome for patients with ILBC on anastrozole (HR 2.1, 95% CI [0.99-4.29], P = 0.05). After stepwise selection in the multivariable model, a marginally significant prognostic effect for the interaction variable (treatment with histological subtype) on OS (but not on EFS) was noted (Ratio of HR 2.1, 95% CI [1.00-4.31], P = 0.05). Our data suggest an interaction effect between treatment and histology (P = 0.05) on OS. Here, patients with ILBC cancers had a better OS when treated with anastrozole versus exemestane, whereas no difference was noted for patients with IDBC. NCT00066573. Crown Copyright © 2017. Published by Elsevier Ltd. All rights

  12. Human consumption as an invasive species management strategy. A preliminary assessment of the marketing potential of invasive Asian carp in the US.

    Science.gov (United States)

    Varble, Sarah; Secchi, Silvia

    2013-06-01

    Over the past 20 years, Asian carp have invaded rivers and lakes in the Midwest and southern United States, with large negative impacts, such as encroachment on the habitat of native fish and mass die-off. They also respond to boat motors by jumping out of the water, which can cause harm to boaters and fishermen. Policymakers in the Great Lakes region between the US and Canada are worried about possible expansion of the Asian carp to their region and its effects on their fishing industry. A potential solution to the problem is to harvest Asian carp for human consumption. This study analyzes the results of the first national survey on the attitudes of US fish consumers towards Asian carp. We find that this is a potentially promising strategy. Most respondents would be willing to try a free sample of Asian carp and would be willing to pay for it. Because of the negative connotation attached to carp in general, this figure is encouraging. Creating demand for Asian carp could be a market based, cost-effective solution for a problem (invasive species) that is typically dealt with through command and control policies, if it is coupled with appropriate policies and safeguards to ensure the fish is eventually eradicated and not cultivated for profit after removal from US rivers and lakes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. WE-EF-210-07: Development of a Minimally Invasive Photo Acoustic Imaging System for Early Prostate Cancer Detection

    Energy Technology Data Exchange (ETDEWEB)

    Sano, M; Yousefi, S; Xing, L [Stanford University School of Medicine, Stanford, CA (United States)

    2015-06-15

    Purpose: The objective of this work is to design, implement and characterize a catheter-based ultrasound/photoacoustic imaging probe for early-diagnosis of prostate cancer and to aid in image-guided radiation therapy. Methods: The need to image across 6–10cm of tissue to image the whole prostate gland limits the resolution achievable with a transrectal ultrasound approach. In contrast, the urethra bisects the prostate gland, providing a minimally invasive pathway for deploying a high resolution ultrasound transducer. Utilizing a high-frequency (20MHz) ultrasound/photoacoustic probe, high-resolution structural and molecular imaging of the prostate tissue is possible. A custom 3D printed probe containing a high-frequency single-element ultrasound transducer is utilized. The diameter of the probe is designed to fit inside a Foley catheter and the probe is rotated around the central axis to achieve a circular B-scan. A custom ultrasound amplifier and receiver was set up to trigger the ultrasound pulse transmission and record the reflected signal. The reconstructed images were compared to images generated by traditional 5 MHz ultrasound transducers. Results: The preliminary results using the high-frequency ultrasound probe show that it is possible to resolve finely detailed information in a prostate tissue phantom that was not achievable with previous low-frequency ultrasound systems. Preliminary ultrasound imaging was performed on tissue mimicking phantom and sensitivity and signal-to-noise ratio of the catheter was measured. Conclusion: In order to achieve non-invasive, high-resolution, structural and molecular imaging for early-diagnosis and image-guided radiation therapy of the prostate tissue, a transurethral catheter was designed. Structural/molecular imaging using ultrasound/photoacoustic of the prostate tissue will allow for localization of hyper vascularized areas for early-stage prostate cancer diagnosis.

  14. The sword-shield strategy of the early 1960s

    International Nuclear Information System (INIS)

    Steinhoff, J.

    1994-01-01

    The sword and shield strategy of the post WWII German Federal Republic is discussed. The effort to rebuild the German air force following WWII is outlined. This effort was initiated in 1956 with material furnished by the US through the Nash Plan. The debate surrounding the validity of the sword-shield concept is described

  15. Incorporating Early Learning Strategies in the School Improvement Grants (SIG) Program

    Science.gov (United States)

    Connors-Tadros, Lori; Dunn, Lenay; Martella, Jana; McCauley, Carlas

    2015-01-01

    The Center on Enhancing Early Learning Outcomes (CEELO) and the Center on School Turnaround (CST) collaborated to develop case studies of three selected schools receiving SIG funds that have, with the support of their districts, promoted the use of early childhood programming (PK-3) as a key strategy in their schools' turnaround models. The goal…

  16. Early use of non invasive ventilation in patients with amyotrophic lateral sclerosis: what benefits?

    Science.gov (United States)

    Terzano, C; Romani, S

    2015-11-01

    The aim of this study was to analyze the efficacy of an early start of NIV in ALS patients, evaluating respiratory and ventilatory parameters. Functional respiratory parameters and arterial blood gas analysis were evaluated in forty-six patients. All patients were informed about the benefits and possible adverse effects of therapeutic support with NIV and divided in two groups based on the compliance to early start therapy with NIV (Group A) or not (Group B). Among 46 ALS patients consecutively visited in our Unit, we included 20 patients in the Group A and 16 in the Group B. We have emphasized the importance of the early use of NIV stressing the difference between two groups analyzed, particularly in terms of pulmonary function tests and arterial blood gas analysis. Significant correlation was observed between Vital Capacity (VC), Forced Expiratory volume in one second (FEV1), and maximal inspiratory pressures (PImax). Our study highlights the importance of noninvasive mechanical ventilation as a treatment for ALS patients and also shows the early start of NIV as an important approach in order to postpone the functional decline and the decrease of respiratory muscle strength.

  17. Activation of PPAR{gamma} by Human Cytomegalovirus for de novo Replication Impairs Migration and Invasiveness of Cytotrophoblast from Early Placenta

    DEFF Research Database (Denmark)

    Rauwel, Benjamin; Mariamé, Bernard; Martin, Hélène

    2010-01-01

    , as assessed by using well-established in vitro models of invasive trophoblast i.e. primary cultures of EVCT isolated from first trimester placentas and the EVCT-derived cell line HIPEC. Our data provide new clues to explain how early infection during pregnancy could impair implantation, placentation...... and chromatin immunoprecipitation assays. Due to the key role of PPARgamma in placentation and its specific trophoblast expression within the human placenta, we then provided evidence that by activating PPARgamma human cytomegalovirus dramatically impaired early human trophoblast migration and invasiveness...

  18. Social Strategies during University Studies Predict Early Career Work Burnout and Engagement: 18-Year Longitudinal Study

    Science.gov (United States)

    Salmela-Aro, Katariina; Tolvanen, Asko; Nurmi, Jari-Erik

    2011-01-01

    This longitudinal study spanning 18 years examined the role of social strategies in early career adaptation. The aim was to find out whether individuals' social strategies measured during their university studies had an impact on work burnout and work engagement measured 10-18 years later. A sample of 292 university students completed the SAQ…

  19. Factors Associated with South Korean Early Childhood Educators' Observed Behavior Support Strategies

    Science.gov (United States)

    Kim, Yeon Ha; Stormont, Melissa

    2012-01-01

    This study was an exploratory study of 34 South Korean early childhood educators' strategies for addressing behavior problems in natural settings. Factors related to teachers' strategy implementation were also explored. Four specific teacher behaviors were observed: precorrection, behavioral-specific praise, redirection, and reprimand/punishment.…

  20. Spawning strategies and transport of early stages of the two Cape ...

    African Journals Online (AJOL)

    Seasonal and short-term variability of environmental parameters influence the spawning strategies of fish species. In this study, the spawning strategies and the transport of early stages of the two Cape hake species off South Africa were investigated. Distribution of eggs and larvae of Merluccius paradoxus and M. capensis ...

  1. The effects of invasive pests and pathogens on strategies for forest diversification.

    Science.gov (United States)

    Macpherson, Morag F; Kleczkowski, Adam; Healey, John R; Quine, Christopher P; Hanley, Nick

    2017-04-24

    Diversification of the tree species composition of production forests is a frequently advocated strategy to increase resilience to pests and pathogens; however, there is a lack of a general framework to analyse the impact of economic and biological conditions on the optimal planting strategy in the presence of tree disease. To meet this need we use a novel bioeconomic model to quantitatively assess the effect of tree disease on the optimal planting proportion of two tree species. We find that diversifying the species composition can reduce the economic loss from disease even when the benefit from the resistant species is small. However, this key result is sensitive to a pathogen's characteristics (probability of arrival, time of arrival, rate of spread of infection) and the losses (damage of the disease to the susceptible species and reduced benefit of planting the resistant species). This study provides an exemplar framework which can be used to help understand the effect of a pathogen on forest management strategies.

  2. Towards non-invasive diagnostic techniques for early detection of acute renal transplant rejection: A review

    Directory of Open Access Journals (Sweden)

    Elizabeth Hollis

    2017-03-01

    Full Text Available The kidney is a very important complicated filtering organ of the body. When the kidney reaches stage 5 chronic kidney disease, end stage renal failure, the preeminent therapy is renal transplantation. Although it is the best form of treatment, lack of kidney donors is still challenging. Therefore, all efforts should be employed to prolong the survival rate of the transplanted kidney. However, graft dysfunction (e.g., acute rejection is one of the serious barriers to long term kidney transplant survival. Currently, graft dysfunction’s gold standard of diagnosis is renal biopsy. Although renal biopsy is helpful, it is not preferred due to its invasive nature, high morbidity rates, and expensiveness. Therefore, noninvasive imaging techniques have become the subject of extensive research and interest, giving a strong promise to replace, or at least to decrease, biopsy usage in diagnosing graft dysfunction. This survey will discuss not only the current diagnosis and treatment of graft dysfunction but also the state-of-the-art imaging techniques in detecting acute renal transplant rejection.

  3. Early detection strategies for untreated first-episode psychosis

    DEFF Research Database (Denmark)

    Johannessen, Jan Olav; McGlashan, T H; Larsen, Tor Ketil

    2001-01-01

    -year inclusion period (1997-2000) are described. It includes targeted information towards the general public, health professionals and schools, and ED teams to recruit appropriate patients into treatment as soon as possible. This plus easy access to psychiatric services via ED teams systematically changed......Some studies in first-episode schizophrenia correlate shorter duration of untreated psychosis (DUP) with better prognosis, suggesting that timing of treatment may be important. A three-site prospective clinical trial in Norway and Denmark is underway to investigate the effect of the timing......-episode cases. The study ultimately will compare early detected with usual detected patients. This paper describes the study's major independent intervention variable, i.e. a comprehensive education and detection system to change DUP in first onset psychosis. System variables and first results from the four...

  4. Rehabilitation Strategies for the Athletic Individual with Early Knee Osteoarthritis.

    Science.gov (United States)

    Jayabalan, Prakash; Ihm, Joseph

    2016-01-01

    Knee osteoarthritis (OA) is a major cause of disability in the United States. The condition has most commonly been associated with elderly sedentary individuals; however, it also can affect those who participate in regular athletic activities. The diagnosis and management of these individuals can be challenging because of both their higher level of physical activity and their overall athletic goals. Treatment requires an appropriate exercise regimen, rehabilitation program, and education of both the athlete and the coach. The focus of our article is to provide an up-to-date overview of the evaluation and management of the athletic individual who presents with symptomatic early knee OA, in particular, the nonsurgical rehabilitation treatment options available to the practitioner and the evidence to support these recommendations.

  5. Health Literacy: Cancer Prevention Strategies for Early Adults.

    Science.gov (United States)

    Simmons, Robert A; Cosgrove, Susan C; Romney, Martha C; Plumb, James D; Brawer, Rickie O; Gonzalez, Evelyn T; Fleisher, Linda G; Moore, Bradley S

    2017-09-01

    Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon and improve their patient education using plain language easy-to-understand written materials and teach-back, and also designed plain language written materials including visuals to provide more culturally and linguistically appropriate health education and enhance web-based information. Several sustainable health system policy changes occurred over time. At the community level, organizational assessments and peer leader training on health literacy have occurred to reduce communication barriers between consumers and providers. Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Long-term prognosis of chronic kidney disease in non-ST elevation acute coronary syndrome treated with invasive strategy.

    Science.gov (United States)

    Roldán Torres, Ildefonso; Salvador Mercader, Inmaculada; Cabadés Rumbeu, Claudia; Díez Gil, José Luis; Ferrando Cervelló, José; Monteagudo Viana, Marta; Fernández Galera, Rubén; Mora Llabata, Vicente

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular outcomes after non-ST elevation acute coronary syndrome (NSTEACS). However, the information available on this specific population, is scarce. We evaluate the impact of CKD on long-term prognosis in patients with NSTEACS managed with invasive strategy. We conduct a prospective registry of patients with NSTEACS and coronary angiography. CKD was defined as a glomerular filtration rate < 60ml/min/1,73m 2 . The composite primary end-point was cardiac death and non fatal cardiovascular readmission. We estimated the cumulative probability and hazard rate (HR) of combined primary end-point at 3-years according to the presence or absence of CKD. We included 248 p with mean age of 66.9 years, 25% women. CKD was present at baseline in 67 patients (27%). Patients with CKD were older (74.9 vs. 63.9 years; P<.0001) with more prevalence of hypertension (89.6 vs. 66.3%; P<.0001), diabetes (53.7 vs. 35.9%; P=.011), history of heart failure (13.4 vs. 3.9%; P=.006) and anemia (47.8 vs. 16%; P<.0001). No differences in the extent of coronary artery disease. CKD was associated with higher cumulative probability (49.3 vs. 28.2%; log-rank P=.001) and HR of the primary combined end-point (HR: 1.94; CI95%: 1.12-3.27; P=.012). CKD was an independent predictor of adverse cardiovascular outcomes at 3-years (HR: 1.66; CI95%: 1.05-2.61; P=.03). In NSTEACS patients treated with invasive strategie CKD is associated independently with an increased risk of adverse cardiovascular outcomes at 3years. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Non-Invasive Brain Stimulation: A New Strategy in Mild Cognitive Impairment?

    Science.gov (United States)

    Birba, Agustina; Ibáñez, Agustín; Sedeño, Lucas; Ferrari, Jesica; García, Adolfo M.; Zimerman, Máximo

    2017-01-01

    Non-invasive brain stimulation (NIBS) techniques can significantly modulate cognitive functions in healthy subjects and patients with neuropsychiatric disorders. Recently, they have been applied in patients with mild cognitive impairment (MCI) and subjective cognitive impairment (SCI) to prevent or delay the development of Alzheimer’s disease (AD). Here we review this emerging empirical corpus and discuss therapeutic effects of NIBS on several target functions (e.g., memory for face-name associations and non-verbal recognition, attention, psychomotor speed, everyday memory). Available studies have yielded mixed results, possibly due to differences among their tasks, designs, and samples, let alone the latter’s small sizes. Thus, the impact of NIBS on cognitive performance in MCI and SCI remains to be determined. To foster progress in this direction, we outline methodological approaches that could improve the efficacy and specificity of NIBS in both conditions. Furthermore, we discuss the need for multicenter studies, accurate diagnosis, and longitudinal approaches combining NIBS with specific training regimes. These tenets could cement biomedical developments supporting new treatments for MCI and preventive therapies for AD. PMID:28243198

  8. An early deployment strategy for carbon capture, utilisation, and storage

    Energy Technology Data Exchange (ETDEWEB)

    Carter, L.D.

    2012-11-01

    This report describes the current use of CO2 for EOR, and discusses potential expansion of EOR using CO2 from power plants. Analysis of potential EOR development in the USA, where most current CO2-based EOR production takes place, indicates that relatively low cost, traditional sources of CO2 for EOR (CO2 domes and CO2 from natural gas processing plants) are insufficient to exploit the full potential of EOR. To achieve that full potential will require use of CO2 from combustion and gasification systems, such as fossil fuel power plants, where capture of CO2 is more costly. The cost of current CCUS systems, even with the revenue stream for sale of the CO2 for EOR, is too high to result in broad deployment of the technology in the near term. In the longer term, research and development may be sufficient to reduce CO2 capture costs to a point where CCUS would be broadly deployed. This report describes a case study of conditions in the USA to explore a financial incentive to promote early deployment of CCUS, providing a range of immediate benefits to society, greater likelihood of reducing the long-term cost of CCUS, and greater likelihood of broad deployment of CCUS and CCS in the long term. Additionally, it may be possible to craft such an incentive in a manner that its cost is more than offset by taxes flowing from increased domestic oil production. An example of such an incentive is included in this report.

  9. Detection of lymphovascular invasion in early breast cancer by D2-40 (podoplanin): a clinically useful predictor for axillary lymph node metastases.

    NARCIS (Netherlands)

    Braun, M.; Flucke, U.E.; Debald, M.; Walgenbach-Bruenagel, G.; Walgenbach, K.J.; Holler, T.; Polcher, M.; Wolfgarten, M.; Sauerwald, A.; Keyver-Paik, M.; Kuhr, M.; Buttner, R.; Kuhn, W.

    2008-01-01

    PURPOSE: The aim of this study was to investigate the use of D2-40 for the detection of lymphovascular invasion (LVI) in node positive and negative early breast cancer. LVI is associated with axillary lymph node metastases (ALNM) and a long-term prognostic factor. A precise identification of LVI

  10. Increased detection of lymphatic vessel invasion by D2-40 (podoplanin) in early breast cancer: possible influence on patient selection for accelerated partial breast irradiation.

    NARCIS (Netherlands)

    Debald, M.; Polcher, M.; Flucke, U.E.; Walgenbach-Brunagel, G.; Walgenbach, K.J.; Holler, T.; Wolfgarten, M.; Rudlowski, C.; Buttner, R.; Schild, H.; Kuhn, W.; Braun, M.

    2010-01-01

    PURPOSE: Several international trials are currently investigating accelerated partial breast irradiation (APBI) for patients with early-stage breast cancer. According to existing guidelines, patients with lymphatic vessel invasion (LVI) do not qualify for APBI. D2-40 (podoplanin) significantly

  11. Photochemical internalisation, a minimally invasive strategy for light-controlled endosomal escape of cancer stem cell-targeting therapeutics.

    Science.gov (United States)

    Selbo, Pål Kristian; Bostad, Monica; Olsen, Cathrine Elisabeth; Edwards, Victoria Tudor; Høgset, Anders; Weyergang, Anette; Berg, Kristian

    2015-08-01

    Despite progress in radio-, chemo- and photodynamic-therapy (PDT) of cancer, treatment resistance still remains a major problem for patients with aggressive tumours. Cancer stem cells (CSCs) or tumour-initiating cells are intrinsically and notoriously resistant to conventional cancer therapies and are proposed to be responsible for the recurrence of tumours after therapy. According to the CSC hypothesis, it is imperative to develop novel anticancer agents or therapeutic strategies that take into account the biology and role of CSCs. The present review outlines our recent study on photochemical internalisation (PCI) using the clinically relevant photosensitiser TPCS2a/Amphinex® as a rational, non-invasive strategy for the light-controlled endosomal escape of CSC-targeting drugs. PCI is an intracellular drug delivery method based on light-induced ROS-generation and a subsequent membrane-disruption of endocytic vesicles, leading to cytosolic release of the entrapped drugs of interest. In different proof-of-concept studies we have demonstrated that PCI of CSC-directed immunotoxins targeting CD133, CD44, CSPG4 and EpCAM is a highly specific and effective strategy for killing cancer cells and CSCs. CSCs overexpressing CD133 are PDT-resistant; however, this is circumvented by PCI of CD133-targeting immunotoxins. In view of the fact that TPCS2a is not a substrate of the efflux pumps ABCG2 and P-glycoprotein (ABCB1), the PCI-method is a promising anti-CSC therapeutic strategy. Due to a laser-controlled exposure, PCI of CSC-targeting drugs will be confined exclusively to the tumour tissue, suggesting that this drug delivery method has the potential to spare distant normal stem cells.

  12. Corneal Deformation Response and Ocular Geometry: A Non-invasive Diagnostic Strategy in Marfan Syndrome

    Science.gov (United States)

    Beene, Lauren C.; Traboulsi, Elias I.; Seven, Ibrahim; Ford, Matthew R.; Roy, Abhijit Sinha; Butler, Robert S.; Dupps, William J.

    2015-01-01

    Purpose To evaluate corneal air-puff deformation responses and ocular geometry as predictors of Marfan syndrome. Design Prospective observational clinical study Methods Sixteen investigator-derived, 4 standard Ocular Response Analyzer (ORA), and geometric variables from corneal tomography and optical biometry using Oculus Pentacam and IOL Master were assessed for discriminative value in Marfan syndrome, measuring right eyes of 24 control and 13 Marfan syndrome subjects. Area under the receiver operating characteristic (AUROC) curve was assessed in univariate and multivariate analyses Results Six investigator-derived ORA variables successfully discriminated Marfan syndrome. The best lone disease predictor was Concavity Min (Marfan syndrome 47.5 ± 20, control 69 ± 14, p = 0.003; AUROC = 0.80). Corneal hysteresis and corneal resistance factor were decreased (Marfan syndrome CH 9.45 ± 1.62, control CH 11.24 ± 1.21, p = 0.01; Marfan syndrome CRF 9.77 ± 1.65, control CRF 11.03 ± 1.72, p = 0.01) and corneas were flatter in Marfan syndrome (Marfan syndrome Kmean 41.25 ± 2.09 D, control Kmean 42.70 ± 1.81 D, p = 0.046). No significant differences were observed in central corneal thickness, axial eye length, or intraocular pressure. A multivariate regression model incorporating corneal curvature and hysteresis loop area (HLA) provided the best predictive value for Marfan syndrome (AUROC = 0.85). Conclusions This study describes novel biodynamic features of corneal deformation responses in Marfan syndrome, including increased deformation, decreased bending resistance, and decreased energy dissipation capacity. A predictive model incorporating HLA and corneal curvature shows greatest potential for non-invasive clinical diagnosis of Marfan syndrome. PMID:26432567

  13. Invasion strategy and abiotic activity triggers for non-native gobiids of the River Rhine.

    Directory of Open Access Journals (Sweden)

    Jan Baer

    Full Text Available The 24 hour activity patterns of three non-native gobiids (round goby Neogobius melanostomus, Western tubenose goby Proterorhinus semilunaris and bighead goby Ponticola kessleri were assessed over 46 consecutive months between 2011 and 2014 from their occurrence in the cooling water intake of a nuclear power plant on the River Rhine, Germany. In total, 117717 gobiids were identified and classified. The occurrence of all three species varied strongly between sampling years, and species-specific activity triggers were identified. The activity of juveniles of all three gobiids species was positively temperature dependent while adult tubenose goby activity appeared to be negatively temperature dependent. Increasing fluvial discharge in the adjoining main river stimulated the activity of juvenile round goby but inhibited activity of adult tubenose goby. Except for adult bighead goby, activity was also structured by time of day, but with no uniform mean. Meteorological factors such as precipitation, air pressure and duration of sunshine hours had little or no influence on gobiid activity. On selected rare occasions, mainly at night, all three species exhibited pulsed swarming behaviour, with thousands of individuals recorded in the intake water. Round goby swarms exhibited both the highest intensity and the largest swarming individuals, suggesting a potential competitive advantage over tubenose and bighead goby. Electric fishing surveys in natural river stretches corroborated this observation. Negative effects on the native fish fauna were apparent only for the bullhead, Cottus gobio. The activity triggers identified offer a unique insight into the invasion mechanisms of these ecosystem-changing non-native gobiids.

  14. Non-invasive toluene sensor for early diagnosis of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Saxena, Rahul; Srivastava, Sudha, E-mail: sudha.srivastava@jiit.ac.in [Department of Biotechnology, Jaypee Institute of Information Technology, A-10, Sector-62, Noida-201307,Uttar Pradesh (India)

    2016-04-13

    Here we present, quantification of volatile organic compounds in human breath for early detection of lung cancer to increase survival probability. Graphene oxide nanosheets synthesized by modified Hummer’s method were employed as a sensing element to detect the presence of toluene in the sample. Optical and morphological characterization of synthesized nanomaterial was performed by UV-Visible spectroscopy and scanning electron microscopy (SEM) respectively. Spectroscopic assay shows a linearly decreasing intensity of GO absorption peak with increasing toluene concentration with a linear range from 0-200 pM. While impedimetric sensor developed on a graphene oxide nanosheetsmodified screen printed electrodes displayed a decreasing electron transfer resistance increasing toluene with much larger linear range of 0-1000 pM. Reported techniques are advantageous as these are simple, sensitive and cost effective, which can easily be extended for primary screening of other VOCs.

  15. Minimally Invasive Surgical Staging in Early-stage Ovarian Carcinoma: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Bogani, Giorgio; Borghi, Chiara; Leone Roberti Maggiore, Umberto; Ditto, Antonino; Signorelli, Mauro; Martinelli, Fabio; Chiappa, Valentina; Lopez, Carlos; Sabatucci, Ilaria; Scaffa, Cono; Indini, Alice; Ferrero, Simone; Lorusso, Domenica; Raspagliesi, Francesco

    Few studies investigated the efficacy and safety of minimally invasive surgery for the treatment of early-stage epithelial ovarian cancer (eEOC). In this context, we aimed to review the current evidence comparing laparoscopy and the laparotomic approach for staging procedures in eEOC. This systematic review was registered in the International Prospective Register of Systematic Reviews. Overall, 3065 patients were included: 1450 undergoing laparoscopy and 1615 undergoing laparotomic staging. Patients undergoing laparoscopy experienced a longer (but not statistically significant) operative time (weighted mean difference [WMD] = 28.3 minutes; 95% confidence interval [CI], -2.59 to 59.2), a lower estimated blood loss (WMD = -156.5 mL; 95% CI, -216.4 to -96.5), a shorter length of hospital stay (WMD = -3.7 days; 95% CI, -5.2 to -2.1), and a lower postoperative complication rate (odds ratio [OR] = 0.48; 95% CI, 0.29-0.81) than patients undergoing laparotomy. The upstaging (OR = 0.81; 95% CI, 0.55-1.20) and cyst rupture (OR = 1.32; 95% CI, 0.52-3.38) rates were similar between groups. Laparoscopic staging is associated with a shorter time to chemotherapy than laparotomic procedures (WMD = -5.16 days; 95% CI, -8.68 to -1.64). Survival outcomes were not influenced by the route of surgery. Pooled data suggested that the minimally invasive surgical approach is equivalent to laparotomy for the treatment of eEOC and may be superior in terms of perioperative outcomes. However, because of the low level of evidence of the included studies, further randomized trials are warranted. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

  16. Earthquake Early Warning: New Strategies for Seismic Hardware

    Science.gov (United States)

    Allardice, S.; Hill, P.

    2017-12-01

    Implementing Earthquake Early Warning System (EEWS) triggering algorithms into seismic networks has been a hot topic of discussion for some years now. With digitizer technology now available, such as the Güralp Minimus, with on average 40-60ms delay time (latency) from earthquake origin to issuing an alert the next step is to provide network operators with a simple interface for on board parameter calculations from a seismic station. A voting mechanism is implemented on board which mitigates the risk of false positives being communicated. Each Minimus can be configured to with a `score' from various sources i.e. Z channel on seismometer, N/S E/W channels on accelerometer and MEMS inside Minimus. If the score exceeds the set threshold then an alert is sent to the `Master Minimus'. The Master Minimus within the network will also be configured as to when the alert should be issued i.e. at least 3 stations must have triggered. Industry standard algorithms focus around the calculation of Peak Ground Acceleration (PGA), Peak Ground Velocity (PGV), Peak Ground Displacement (PGD) and C. Calculating these single station parameters on-board in order to stream only the results could help network operators with possible issues, such as restricted bandwidth. Developments on the Minimus allow these parameters to be calculated and distributed through Common Alert Protocol (CAP). CAP is the XML based data format used for exchanging and describing public warnings and emergencies. Whenever the trigger conditions are met the Minimus can send a signed UDP packet to the configured CAP receiver which can then send the alert via SMS, e-mail or CAP forwarding. Increasing network redundancy is also a consideration when developing these features, therefore the forwarding CAP message can be sent to multiple destinations. This allows for a hierarchical approach by which the single station (or network) parameters can be streamed to another Minimus, or data centre, or both, so that there is no

  17. Serogroup C Neisseria meningitidis invasive infection: analysis of the possible vaccination strategies for a mass campaign.

    Science.gov (United States)

    Chiappini, Elena; Venturini, Elisabetta; Bonsignori, Francesca; Galli, Luisa; de Martino, Maurizio

    2010-11-01

    The serogroup C meningococcal conjugate vaccine is available since 1999. In the absence of randomized controlled trials that support a specific schedule, each country has adopted different vaccination programmes. Hereby, we analyse positive and negative aspects of the different vaccination strategies. While waiting for the introduction of other antimeningococcal vaccines, covering also for the Group B meningococci, further studies on effectiveness of an optimal schedule to be adopted in European countries are needed. © 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.

  18. Intervention radiology for venous thrombosis: early thrombus removal using invasive methods.

    Science.gov (United States)

    Casanegra, Ana I; McBane, Robert D; Bjarnason, Haraldur

    2017-04-01

    The post thrombotic syndrome is one of the most dreaded complications of proximal deep vein thrombosis. This syndrome leads to pain and suffering with leg swelling, recalcitrant ulceration and venous claudication which greatly impairs mobility and quality of life. The prevalence can be high in patients with iliofemoral venous involvement particularly in the setting of a proximal venous stenosis, such as occurs in May Thurner syndrome. Anticoagulation alone does not reduce the likelihood of this outcome. Compression therapy may be effective but garment discomfort limits its implementation. Pharmacomechanical thrombectomy, which combines catheter-directed thrombolysis with mechanical thrombus dissolution, provides an attractive treatment strategy for such patients. The rationale and delivery of pharmacomechanical thrombectomy, including patient selection and adjunctive antithrombotic therapy, will be reviewed in addition to tips and tricks for managing difficult patient scenarios. © 2017 John Wiley & Sons Ltd.

  19. An assessment of the effectiveness of a large, national-scale invasive alien plant control strategy in South Africa

    CSIR Research Space (South Africa)

    Van Wilgen, BW

    2012-04-01

    Full Text Available extent of invasive species control operations, assessments of the effectiveness of biological control, and smaller-scale studies. The 19 most important invasive taxa, mainly trees, in terrestrial biomes were identified. The effectiveness of control...

  20. Risk of early surgery for Crohn's disease: implications for early treatment strategies.

    Science.gov (United States)

    Sands, Bruce E; Arsenault, Joanne E; Rosen, Michael J; Alsahli, Mazen; Bailen, Laurence; Banks, Peter; Bensen, Steven; Bousvaros, Athos; Cave, David; Cooley, Jeffrey S; Cooper, Herbert L; Edwards, Susan T; Farrell, Richard J; Griffin, Michael J; Hay, David W; John, Alex; Lidofsky, Sheldon; Olans, Lori B; Peppercorn, Mark A; Rothstein, Richard I; Roy, Michael A; Saletta, Michael J; Shah, Samir A; Warner, Andrew S; Wolf, Jacqueline L; Vecchio, James; Winter, Harland S; Zawacki, John K

    2003-12-01

    In this study we aimed to define the rate of early surgery for Crohn's disease and to identify risk factors associated with early surgery as a basis for subsequent studies of early intervention in Crohn's disease. We assembled a retrospective cohort of patients with Crohn's disease diagnosed between 1991 and 1997 and followed for at least 3 yr, who were identified in 16 community and referral-based practices in New England. Chart review was performed for each patient. Details of baseline demographic and disease features were recorded. Surgical history including date of surgery, indication, and procedure were also noted. Risk factors for early surgery (defined as major surgery for Crohn's disease within 3 yr of diagnosis, exclusive of major surgery at time of diagnosis) were identified by univariate analysis. Multiple logistic regression was used to identify independent risk factors. Of 345 eligible patients, 69 (20.1%) required surgery within 3 yr of diagnosis, excluding the 14 patients (4.1%) who had major surgery at the time of diagnosis. Overall, the interval between diagnosis and surgery was short; one half of all patients who required surgery underwent operation within 6 months of diagnosis. Risk factors identified by univariate analysis as significantly associated with early surgery included the following: smoking; disease of small bowel without colonic involvement; nausea and vomiting or abdominal pain on presentation; neutrophil count; and steroid use in the first 6 months. Disease localized to the colon only, blood in the stool, use of 5-aminosalicylate, and lymphocyte count were inversely associated with risk of early surgery. Logistic regression confirmed independent associations with smoking as a positive risk factor and involvement of colon without small bowel as a negative risk factor for early surgery. The rate of surgery is high in the first 3 yr after diagnosis of Crohn's disease, particularly in the first 6 months. These results suggest that

  1. Estimating suitable environments for invasive plant species across large landscapes: A remote sensing strategy using Landsat 7 ETM+

    Science.gov (United States)

    The key to reducing ecological and economic damage caused by invasive plant species is to locate and eradicate new invasions before they threaten native biodiversity and ecological processes. We used Landsat Enhanced Thematic Mapper Plus imagery to estimate suitable environments for four invasive pl...

  2. In-situ non-invasive device for early detection of fouling in aquatic systems

    KAUST Repository

    Fortunato, Luca

    2017-01-05

    An in-situ, non-destructive sensor device, system and method are provided to detect or assess fouling at a very early stage of development. They can be used to detect or assess fouling on a surface of an aquatic system. They can be used to obtain a depth profile of the fouling. Data concerning the depth profile can be extracted and used to assess the fouling on the surface, in one or more aspects, the method can include providing an optical tomography spectrometer; optically positioning the optical tomography spectrometer in association with a surface of an area to be assessed for fouling in an aqueous system; irradiating the surface; acquiring, from irradiating the surface, a plurality of signals as a function of a distance from the surface at different times; extracting data from the signals as a function of the distance to obtain a depth profile of the surface at the different times; and determining a change in the depth profile between the different times to assess fouling on the surface.

  3. Aspects of the application of complementary brachytherapy for early invasive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Homma, L.A.H. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares; Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas]. E-mail: luciahomma@terra.com.br; Campos, T.P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares]. E-mail: campos@nuclear.ufmg.br; Silva, S.Z.C. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas; Lima, C.F. [ECOGRAF, Belo Horizonte, MG (Brazil). Nucleo de Diagnostico

    2007-07-01

    Initial studies of brachytherapy with the 'Mammosite Radiation Therapy System', a device consisted by a catheter centered inside a inflate balloon, to perform breast brachytherapy was revised. A high activity source was applied into the balloon, exposing to the tumor bed to a high absorbed dose, while the surrounding areas receives one reduced by to a factor 1/r{sup 2}, during a short interval of time. The high acute dose provides a booster to conventional radiation therapy, resulting in a better local control. The acceptable esthetic impact achieved and an easier device setting stimulated the present dosimetric study. The brachytherapy with Ir{sup 192} was simulated through the development of a computerized digital voxels phantom, which represented the breast anatomy. The Monte Carlo Code (MCNP {sup TM}, 1977) was used to evaluate the radiation of the tumor bed and health tissues. Results from simulations shows, as example, an amount of radiation absorbed by the tumor bed of 11.30 Gy up to 5 mm around the balloon surface. Radiation selectivity is also shown, in which tumour bed absorbed more radiation than the surrounding tissues, whose maximum values were: skin (6.73 Gy), muscle (7.69 Gy), and lung (3.02 Gy), for a fifteen-minute exposure of a Ir-152 source. The simulation results are presented. Reliability of this radiotherapy technique as a postoperative booster in early breast cancer is presented and confirmed in this work. (author)

  4. Aspects of the application of complementary brachytherapy for early invasive breast cancer

    International Nuclear Information System (INIS)

    Homma, L.A.H.; Universidade Federal de Minas Gerais; Campos, T.P.R.; Silva, S.Z.C.; Lima, C.F.

    2007-01-01

    Initial studies of brachytherapy with the 'Mammosite Radiation Therapy System', a device consisted by a catheter centered inside a inflate balloon, to perform breast brachytherapy was revised. A high activity source was applied into the balloon, exposing to the tumor bed to a high absorbed dose, while the surrounding areas receives one reduced by to a factor 1/r 2 , during a short interval of time. The high acute dose provides a booster to conventional radiation therapy, resulting in a better local control. The acceptable esthetic impact achieved and an easier device setting stimulated the present dosimetric study. The brachytherapy with Ir 192 was simulated through the development of a computerized digital voxels phantom, which represented the breast anatomy. The Monte Carlo Code (MCNP TM , 1977) was used to evaluate the radiation of the tumor bed and health tissues. Results from simulations shows, as example, an amount of radiation absorbed by the tumor bed of 11.30 Gy up to 5 mm around the balloon surface. Radiation selectivity is also shown, in which tumour bed absorbed more radiation than the surrounding tissues, whose maximum values were: skin (6.73 Gy), muscle (7.69 Gy), and lung (3.02 Gy), for a fifteen-minute exposure of a Ir-152 source. The simulation results are presented. Reliability of this radiotherapy technique as a postoperative booster in early breast cancer is presented and confirmed in this work. (author)

  5. Prunus necrotic ringspot virus Early Invasion and Its Effects on Apricot Pollen Grain Performance.

    Science.gov (United States)

    Amari, Khalid; Burgos, Lorenzo; Pallas, Vicente; Sanchez-Pina, María Amelia

    2007-08-01

    ABSTRACT The route of infection and the pattern of distribution of Prunus necrotic ringspot virus (PNRSV) in apricot pollen were studied. PNRSV was detected both within and on the surface of infected pollen grains. The virus invaded pollen during its early developmental stages, being detected in pollen mother cells. It was distributed uniformly within the cytoplasm of uni- and bicellular pollen grains and infected the generative cell. In mature pollen grains, characterized by their triangular shape, the virus was located mainly at the apertures, suggesting that PNRSV distribution follows the same pattern as the cellular components required for pollen tube germination and cell wall tube synthesis. PNRSV also was localized inside pollen tubes, especially in the growth zone. In vitro experiments demonstrated that infection with PNRSV decreases the germination percentage of pollen grains by more than half and delays the growth of pollen tubes by approximately 24 h. However, although PNRSV infection affected apricot pollen grain performance during germination, the presence of the virus did not completely prevent fertilization, because the infected apricot pollen tubes, once germinated, were able to reach the apricot embryo sacs, which, in the climatic conditions of southeastern Spain, mature later than in other climates. Thus, infected pollen still could play an important role in the vertical transmission of PNRSV in apricot.

  6. Testicular neoplasia in undescended testes of cryptorchid boys-does surgical strategy have an impact on the risk of invasive testicular neoplasia?

    DEFF Research Database (Denmark)

    Cortes, Dina; Thorup, Jørgen Mogens; Petersen, Bodil Laub

    2004-01-01

    We investigated whether or not surgical strategy has an impact on the risk of invasive testicular neoplasia in cases of cryptorchidism. We made a database study of the incidence of testicular neoplasia at surgery for cryptorchidism in childhood, and evaluated if such abnormalities were found......, p placed...

  7. Early Childhood Educators' Meta-Cognitive Knowledge of Problem-Solving Strategies and Quality of Childcare Curriculum Implementation

    Science.gov (United States)

    Kim, Yeon Ha

    2016-01-01

    This study aims to explore the impact of early childhood educators' meta-cognitive knowledge on the quality of their childcare curriculum implementation, and to gain insights regarding successful problem-solving strategies associated with early education and care. Early childhood educators' implementation of general problem-solving strategies in…

  8. Non-invasive identification of protein biomarkers for early pregnancy diagnosis in the cheetah (Acinonyx jubatus.

    Directory of Open Access Journals (Sweden)

    Diana C Koester

    Full Text Available Approximately 80% of cheetahs living in typical zoological collections never reproduce. In more than 60% of breedings, the female is confirmed to ovulate, but parturition fails to occur. It is unknown if these non-pregnant intervals of elevated progesterone (deemed luteal phases are conception failures or a pregnancy terminating in embryonic/fetal loss. There have been recent advances in metabolic profiling and proteome analyses in many species with mass spectrometry used to identify 'biomarkers' and mechanisms indicative of specific physiological states (including pregnancy. Here, we hypothesized that protein expression in voided cheetah feces varied depending on pregnancy status. We: 1 identified the expansive protein profile present in fecal material of females; and 2 isolated proteins that may be candidates playing a role in early pregnancy establishment and diagnosis. Five hundred and seventy unique proteins were discovered among samples from pregnant (n = 8, non-pregnant, luteal phase (n = 5, and non-ovulatory control (n = 5 cheetahs. Four protein candidates were isolated that were significantly up-regulated and two were down-regulated in samples from pregnant compared to non-pregnant or control counterparts. One up-regulated candidate, immunoglobulin J chain (IGJ; an important component of the secretory immune system was detected using a commercially available antibody via immunoblotting. Findings revealed that increased IGJ abundance could be used to detect pregnancy successfully in >80% of 23 assessed females within 4 weeks after mating. The discovery of a novel fecal pregnancy marker improves the ability to determine reproductive, especially gestational, status in cheetahs managed in an ex situ insurance and source population.

  9. Non-invasive identification of protein biomarkers for early pregnancy diagnosis in the cheetah (Acinonyx jubatus).

    Science.gov (United States)

    Koester, Diana C; Wildt, David E; Maly, Morgan; Comizzoli, Pierre; Crosier, Adrienne E

    2017-01-01

    Approximately 80% of cheetahs living in typical zoological collections never reproduce. In more than 60% of breedings, the female is confirmed to ovulate, but parturition fails to occur. It is unknown if these non-pregnant intervals of elevated progesterone (deemed luteal phases) are conception failures or a pregnancy terminating in embryonic/fetal loss. There have been recent advances in metabolic profiling and proteome analyses in many species with mass spectrometry used to identify 'biomarkers' and mechanisms indicative of specific physiological states (including pregnancy). Here, we hypothesized that protein expression in voided cheetah feces varied depending on pregnancy status. We: 1) identified the expansive protein profile present in fecal material of females; and 2) isolated proteins that may be candidates playing a role in early pregnancy establishment and diagnosis. Five hundred and seventy unique proteins were discovered among samples from pregnant (n = 8), non-pregnant, luteal phase (n = 5), and non-ovulatory control (n = 5) cheetahs. Four protein candidates were isolated that were significantly up-regulated and two were down-regulated in samples from pregnant compared to non-pregnant or control counterparts. One up-regulated candidate, immunoglobulin J chain (IGJ; an important component of the secretory immune system) was detected using a commercially available antibody via immunoblotting. Findings revealed that increased IGJ abundance could be used to detect pregnancy successfully in >80% of 23 assessed females within 4 weeks after mating. The discovery of a novel fecal pregnancy marker improves the ability to determine reproductive, especially gestational, status in cheetahs managed in an ex situ insurance and source population.

  10. [Early onset pneumonia after successful resuscitation : Incidence after mild invasive hypothermia therapy].

    Science.gov (United States)

    Erath, J W; Hodrius, J; Bushoven, P; Fichtlscherer, S; Zeiher, A M; Seeger, F H; Honold, J

    2017-09-01

    Targeted temperature management (TTM) represents an effective therapy to improve neurologic outcome in patients who survive an out-of-hospital cardiac arrest (OHCA). First publications about this therapy reported a higher incidence of infections in patients who underwent TTM induced by external cooling devices. Whether intravascular cooling devices are also associated with an increased infection rate has not been investigated so far. In a single center retrospective study, the incidence of early onset pneumonia (EOP) in OHCA patients with or without intravascular TTM at 33 °C target temperature for 24 h who survived at least 24 h after admission was analyzed. A total of 68 OHCA survivors (mean age 65 ± 15 years) were included in this analysis. The most common causes of OHCA were myocardial infarction (35 %), primary ventricular fibrillation (24 %), asystole (15 %), and pulmonary embolism (7 %). Of those, 32 patients (48 %) received TTM. The overall incidence of EOP was 38 %. Incidence of EOP did not differ significantly between groups, was more frequent in the group without TTM (42 % vs. 34 %, p = 0.57) and had no impact on mortality (hazard ratio = 1.02; 95 % confidence interval 0.25-4.16; p = 0.97). Intravascular TTM at 33 °C with a cooling catheter is not associated with more infective complications in OHCA patients. This finding underscores the safety of TTM.

  11. The need for non- or minimally-invasive biomonitoring strategies and the development of pharmacokinetic/pharmacodynamic models for quantification

    Energy Technology Data Exchange (ETDEWEB)

    Timchalk, Charles; Weber, Thomas J.; Smith, Jordan N.

    2017-06-01

    Advancements in Exposure Science involving the development and deployment of biomarkers of exposure and biological response are anticipated to significantly (and positively) influence health outcomes associated with occupational, environmental and clinical exposure to chemicals/drugs. To achieve this vision, innovative strategies are needed to develop multiplex sensor platforms capable of quantifying individual and mixed exposures (i.e. systemic dose) by measuring biomarkers of dose and biological response in readily obtainable (non-invasive) biofluids. Secondly, the use of saliva (alternative to blood) for biomonitoring coupled with the ability to rapidly analyze multiple samples in real-time offers an innovative opportunity to revolutionize biomonitoring assessments. In this regard, the timing and number of samples taken for biomonitoring will not be limited as is currently the case. In addition, real-time analysis will facilitate identification of work practices or conditions that are contributing to increased exposures and will make possible a more rapid and successful intervention strategy. The initial development and application of computational models for evaluation of saliva/blood analyte concentration at anticipated exposure levels represents an important opportunity to establish the limits of quantification and robustness of multiplex sensor systems by exploiting a unique computational modeling framework. The use of these pharmacokinetic models will also enable prediction of an exposure dose based on the saliva/blood measurement. This novel strategy will result in a more accurate prediction of exposures and, once validated, can be employed to assess dosimetry to a broad range of chemicals in support of biomonitoring and epidemiology studies.

  12. Challenges and perspective of drug repurposing strategies in early phase clinical trials.

    Science.gov (United States)

    Kato, Shumei; Moulder, Stacy L; Ueno, Naoto T; Wheler, Jennifer J; Meric-Bernstam, Funda; Kurzrock, Razelle; Janku, Filip

    2015-01-01

    Despite significant investments in the development of new agents only 5% of cancer drugs entering Phase I clinical trials are ultimately approved for routine clinical cancer care. Drug repurposing strategies using novel combinations of previously tested anticancer agents could reduce the cost and improve treatment outcomes. At MD Anderson Cancer Center, early phase clinical trials with drug repurposing strategies demonstrated promising outcomes in patients with both rare and common treatment refractory advanced cancers. Despite clinical efficacy advancing drug repurposing strategies in the clinical trial trajectory beyond early phase studies has been challenging mainly due to lack of funding and interest from the pharmaceutical industry. In this review, we delineate our experience and challenges with drug repurposing strategies.

  13. The Role of Early Maladaptive Schemas and Coping Strategies in Substance Dependency

    Directory of Open Access Journals (Sweden)

    Bikem Haciomeroglu

    2014-12-01

    Discussion: Current study showed that the substance dependents had more maladaptive unhealthy core beliefs and ineffective coping strategies than a non-clinical control group. These findings support the importance of early maladaptive schemas which might be the underlying factor for the dependency problem, and might prevent the person to deal with the problem with more active and problem focused coping strategies. [JCBPR 2014; 3(3.000: 162-170

  14. Invasion of Eukaryotic Cells by Legionella Pneumophila: A Common Strategy for all Hosts?

    Directory of Open Access Journals (Sweden)

    Paul S Hoffman

    1997-01-01

    Full Text Available Legionella pneumophila is an environmental micro-organism capable of producing an acute lobar pneumonia, commonly referred to as Legionnaires’ disease, in susceptible humans. Legionellae are ubiquitous in aquatic environments, where they survive in biofilms or intracellularly in various protozoans. Susceptible humans become infected by breathing aerosols laden with the bacteria. The target cell for human infection is the alveolar macrophage, in which the bacteria abrogate phagolysosomal fusion. The remarkable ability of L pneumophila to infect a wide range of eukaryotic cells suggests a common strategy that exploits very fundamental cellular processes. The bacteria enter host cells via coiling phagocytosis and quickly subvert organelle trafficking events, leading to formation of a replicative phagosome in which the bacteria multiply. Vegetative growth continues for 8 to 10 h, after which the bacteria develop into a short, highly motile form called the ‘mature form’. The mature form exhibits a thickening of the cell wall, stains red with the Gimenez stain, and is between 10 and 100 times more infectious than agar-grown bacteria. Following host cell lysis, the released bacteria infect other host cells, in which the mature form differentiates into a Gimenez-negative vegetative form, and the cycle begins anew. Virulence of L pneumophila is considered to be multifactorial, and there is growing evidence for both stage specific and sequential gene expression. Thus, L pneumophila may be a good model system for dissecting events associated with the host-parasite interactions.

  15. Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Chul; Kim, Jai Keun; Lee, Jei Hee [Ajou University School of Medicine, Department of Radiology, Suwon, Gyeonggi-do (Korea, Republic of); Kim, Myeong-Jin [Yonsei University Health system, Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Kim, Young Bae [Ajou University School of Medicine, Department of Pathology, Suwon (Korea, Republic of); Shin, Sung Jae [Ajou University School of Medicine, Department of Gastroenterology, Suwon (Korea, Republic of)

    2016-02-15

    To evaluate the feasibility of mesorectal vascular invasion (MVI) in predicting early distant metastasis developed within 1 year of diagnosis of T3 rectal cancer using magnetic resonance imaging (MRI) Sixty-five patients with T3 rectal cancer (early metastasis, n = 28; non-metastasis, n = 37) were enrolled in this study. Early distant metastases developed in 28 patients (liver, n = 15; lung, n = 9; both, n = 4). Logistic regression was used to determine the independent predictors for early distant metastasis. In univariate analysis, tumour location, carcinoembryonic antigen (CEA), lymphovascular invasion (LVI), MRI-detected MVI, and mesorectal fat infiltration (MFI) (odds ratio [OR], 4.533, 9.583, 5.539, 27.046, and 5.539, respectively) were associated with early distant metastasis. Multivariate analysis demonstrated that MVI (OR, 29.949; P < 0.002) and LVI (OR, 6.684; P = 0.033) were independent factors for early distant metastasis. Specificity and positive predictive value (PPV) of MVI (94.59 %, and 89.47 %, respectively) were significantly higher than those of LVI (64.86 %, and 61.76 %), but sensitivity and negative predictive value were not significantly different between MVI (60.71 %, and 76.09 %) and LVI (75.00 %, and 77.42 %). While sensitivity of MRI-detected MVI was equal to that of CEA in predicting early distant metastasis from T3 rectal cancer, specificity and PPV may be improved by assessing MVI. (orig.)

  16. Timing of angiography with a routine invasive strategy and long-term outcomes in non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) Trials.

    Science.gov (United States)

    Damman, Peter; van Geloven, Nan; Wallentin, Lars; Lagerqvist, Bo; Fox, Keith A A; Clayton, Tim; Pocock, Stuart J; Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G P; de Winter, Robbert J

    2012-02-01

    This study sought to investigate long-term outcomes after early or delayed angiography in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS) undergoing a routine invasive management. The optimal timing of angiography in patients with nSTE-ACS is currently a topic for debate. Long-term follow-up after early (within 2 days) angiography versus delayed (within 3 to 5 days) angiography was investigated in the FRISC-II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) (FIR) nSTE-ACS patient-pooled database. The main outcome was cardiovascular death or myocardial infarction up to 5-year follow-up. Hazard ratios (HR) were calculated with Cox regression models. Adjustments were made for the FIR risk score, study, and the propensity of receiving early angiography using inverse probability weighting. Of 2,721 patients originally randomized to the routine invasive arm, consisting of routine angiography and subsequent revascularization if suitable, 975 underwent early angiography and 1,141 delayed angiography. No difference was observed in 5-year cardiovascular death or myocardial infarction in unadjusted (HR: 1.06, 95% confidence interval [CI]: 0.79 to 1.42, p=0.61) and adjusted (HR: 0.93, 95% CI: 0.75 to 1.16, p=0.54) Cox regression models. In the FIR database of patients presenting with nSTE-ACS, the timing of angiography was not related to long-term cardiovascular mortality or myocardial infarction. (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes [ICTUS]; ISRCTN82153174. Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction [the Third Randomised Intervention Treatment of Angina Trials (RITA-3)]; ISRCTN

  17. Performance: A Strategy for Professional Development in Early Childhood Teacher Preparation

    Science.gov (United States)

    Maude, Susan P.; Brotherson, Mary Jane; Summers, Jean Ann; Erwin, Elizabeth J.; Palmer, Susan; Peck, Nancy F.; Zheng, Yu Zhu; Kruse, Aryn; Haines, Shana J.; Weigel, Cindy J.

    2011-01-01

    The purpose of this article is to propose performance as a creative instructional strategy to convey complex competencies related to understanding and working effectively with families in early childhood education. Performance derives from performance ethnography, which is a qualitative research methodology. Its application to professional…

  18. Early Adolescent Health Risk Behaviors, Conflict Resolution Strategies, and School Climate

    Science.gov (United States)

    LaRusso, Maria; Selman, Robert

    2011-01-01

    Drawing upon an ethnically and socio-economically diverse sample of 323 7th grade students from twelve urban schools within one school district, this mixed method study examined early adolescents' self-reported health risk behaviors as related to their conflict resolution strategies and their school's conflict resolution climate. Survey data…

  19. Effective Early Childhood Care and Education: Successful Approaches and Didactic Strategies for Fostering Child Development

    Science.gov (United States)

    Burger, Kaspar

    2015-01-01

    This research article attempts to determine strategies that can be used to support children's cognitive and social-emotional development in early childhood care and education programs. By synthesizing empirical evidence about pedagogical techniques that promote children's competencies, the article aims to identify those characteristics of programs…

  20. A Strategy for Embedding Functional Motor and Early Numeracy Skill Instruction into Physical Education Activities

    Science.gov (United States)

    Whinnery, Stacie B.; Whinnery, Keith W.; Eddins, Daisy

    2016-01-01

    This article addresses the challenges educators face when attempting to find a balance between both functional and academic skill instruction for students with severe, multiple disabilities including motor impairments. The authors describe a strategy that employs embedded instruction of early numeracy and functional motor skills during physical…

  1. Early Child Care Teachers' Socialization Goals and Preferred Behavioral Strategies: A Cross-Cultural Comparison

    Science.gov (United States)

    Gernhardt, Ariane; Lamm, Bettina; Keller, Heidi; Döge, Paula

    2014-01-01

    This study investigated early child care teachers' culturally shaped socialization goals and preferred behavioral strategies. The participants were 183 female teachers and trainees, 93 from Osnabrück, Germany, representing an urban Western context, which can be characterized by a primary cultural orientation toward psychological autonomy and a…

  2. Links between belowground and aboveground resource-related traits reveal species growth strategies that promote invasive advantages.

    Science.gov (United States)

    Smith, Maria S; Fridley, Jason D; Goebel, Marc; Bauerle, Taryn L

    2014-01-01

    Belowground processes are rarely considered in comparison studies of native verses invasive species. We examined relationships between belowground fine root production and lifespan, leaf phenology, and seasonal nitrogen dynamics of Lonicera japonica (non-native) versus L. sempervirens (native) and Frangula alnus (non-native) versus Rhamnus alnifolia (native), over time. First and second order fine roots were monitored from 2010 to 2012 using minirhizotron technology and rhizotron windows. 15N uptake of fine roots was measured across spring and fall seasons. Significant differences in fine root production across seasons were seen between Lonicera species, but not between Frangula and Rhamnus, with both groups having notable asynchrony in regards to the timing of leaf production. Root order and the number of root neighbors at the time of root death were the strongest predictors of root lifespan of both species pairs. Seasonal 15N uptake was higher in spring than in the fall, which did not support the need for higher root activity to correspond with extended leaf phenology. We found higher spring 15N uptake in non-native L. japonica compared to native L. sempervirens, although there was no difference in 15N uptake between Frangula and Rhamnus species. Our findings indicate the potential for fast-growing non-native Lonicera japonica and Frangula alnus to outcompete native counterparts through differences in biomass allocation, root turnover, and nitrogen uptake, however evidence that this is a general strategy of invader dominance is limited.

  3. Links between belowground and aboveground resource-related traits reveal species growth strategies that promote invasive advantages.

    Directory of Open Access Journals (Sweden)

    Maria S Smith

    Full Text Available Belowground processes are rarely considered in comparison studies of native verses invasive species. We examined relationships between belowground fine root production and lifespan, leaf phenology, and seasonal nitrogen dynamics of Lonicera japonica (non-native versus L. sempervirens (native and Frangula alnus (non-native versus Rhamnus alnifolia (native, over time. First and second order fine roots were monitored from 2010 to 2012 using minirhizotron technology and rhizotron windows. 15N uptake of fine roots was measured across spring and fall seasons. Significant differences in fine root production across seasons were seen between Lonicera species, but not between Frangula and Rhamnus, with both groups having notable asynchrony in regards to the timing of leaf production. Root order and the number of root neighbors at the time of root death were the strongest predictors of root lifespan of both species pairs. Seasonal 15N uptake was higher in spring than in the fall, which did not support the need for higher root activity to correspond with extended leaf phenology. We found higher spring 15N uptake in non-native L. japonica compared to native L. sempervirens, although there was no difference in 15N uptake between Frangula and Rhamnus species. Our findings indicate the potential for fast-growing non-native Lonicera japonica and Frangula alnus to outcompete native counterparts through differences in biomass allocation, root turnover, and nitrogen uptake, however evidence that this is a general strategy of invader dominance is limited.

  4. The Role Of Early Maladaptive Schemas And Coping Strategies In Substance Dependence

    Directory of Open Access Journals (Sweden)

    Bikem HACIÖMEROĞLU

    2014-11-01

    Full Text Available Objective: The aim of this study was to evaluate the early maladaptive schemas and coping strategies of substance dependents. We hypothesized that substance dependents would have more maladaptive schemas and would use less adaptive coping strategies than healthy controls. Methods: Thirty-two patients diagnosed with substance dependence and 31 control subjects without any psychiatric disorders were evaluated via Young Schema Questionnaire-SF, COPE, and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I. Results: The substance dependents scored significantly higher than the control group in nine out of fourteen early maladaptive schemas. In terms of coping strategies, the substance dependents scored significantly lower than the control group in positive reinterpretation and growth, seeking social support for instrumental reasons, active coping, and seeking social support for emotional reasons, and significantly higher in behavioral disengagement and alcohol-drug disengagement subscales. Moreover, alcohol-drug disengagement type of coping style was significantly predicted by schemas of emotional deprivation, emotional inhibition, enmeshment/dependence, entitlement/ insufficient self-control, abandonment/instability, punitiveness, defectiveness/shame, vulnerability to harm or illness, and unrelenting standards/hypercriticalness. Discussion: Current study showed that the substance dependents had more maladaptive unhealthy core beliefs and ineffective coping strategies than a non-clinical control group. These findings support the importance of early maladaptive schemas which might be the underlying factor for the dependence problem, and might prevent the person to deal with the problem with more active and problem focused coping strategies.

  5. Early post-operative pulmonary function tests after mitral valve replacement: Minimally invasive versus conventional approach. Which is better?

    Directory of Open Access Journals (Sweden)

    Magdy Gomaa

    2016-12-01

    Conclusion: Minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. There was a highly significant difference denoting better post operative pulmonary function of the minimally invasive approach.

  6. Seasonal dynamics of early life stages of invasive and native ctenophores give clues to invasion and bloom potential in the Baltic Sea

    DEFF Research Database (Denmark)

    Jaspers, Cornelia; Haraldsson, Matilda; Lombard, Fabien

    2013-01-01

    and distribution of larvae and eggs of these two species. We show that their occurrence is significantly but inversely related to salinity. Mertensia ovum was present year round throughout the brackish Baltic Sea but also occurred in high-saline areas during cold seasons. Larvae of M. leidyi occurred throughout......Recently, both the invasive ctenophore Mnemiopsis leidyi and the arctic Mertensia ovum were discovered in the Baltic Sea but their range expansion remains unclear due to misidentification of their larval stages. Supported by molecular species verification we describe seasonal abundance...

  7. An approach to the development of a national strategy for controlling invasive alien plant species: The case of Parthenium hysterophorus in South Africa

    Directory of Open Access Journals (Sweden)

    Colette Terblanche

    2016-06-01

    Full Text Available Invasive alien species require co-ordinated strategic management if negative impacts are to be effectively avoided. Here we describe a strategy for the management of Parthenium hysterophorus L. (Asteraceae in South Africa. P. hysterophorus is an annual herb native to tropical America, which has become invasive in over 30 countries. The strategy sets goals for (1 the prevention of spread to new areas; (2 local eradication of isolated populations; (3 containment in areas where eradication is not possible; and (4 actions to protect assets where containment is no longer an option. We developed both a national strategy to set policy and to monitor progress towards goals at a national level and an implementation plan to set goals and timeframes for their achievement at local levels. It is not clear, at this stage, whether or not the goals of the strategy are achievable because implementation will face many challenges arising from ecological features of the target plant, social and cultural practices that will influence management, inadequate levels of funding and multiple political considerations. Our strategy proposes regular assessment using high-level indicators, a practice that is widely recognised as essential but seldom implemented at a national scale. Because the outcomes are uncertain, it is vital that regular monitoring of outcomes should be instituted from the start, so that both appropriate adjustments can be made to the strategy and lessons for the implementation of similar strategies elsewhere can be derived.

  8. Early Engagement of Stakeholders with Individual-Based Modeling Can Inform Research for Improving Invasive Species Management: The Round Goby as a Case Study

    Directory of Open Access Journals (Sweden)

    Emma Samson

    2017-11-01

    Full Text Available Individual-based models (IBMs incorporating realistic representations of key range-front processes such as dispersal can be used as tools to investigate the dynamics of invasive species. Managers can apply insights from these models to take effective action to prevent further spread and prioritize measures preventing establishment of invasive species. We highlight here how early-stage IBMs (constructed under constraints of time and data availability can also play an important role in defining key research priorities for providing key information on the biology of an invasive species in order that subsequent models can provide robust insight into potential management interventions. The round goby, Neogobius melanostomus, is currently spreading through the Baltic Sea, with major negative effects being reported in the wake of its invasion. Together with stakeholders, we parameterize an IBM to investigate the goby's potential spread pattern throughout the Gulf of Gdansk and the Baltic Sea. Model parameters were assigned by integrating information obtained through stakeholder interaction, from scientific literature, or estimated using an inverse modeling approach when not available. IBMs can provide valuable direction to research on invasive species even when there is limited data and/or time available to parameterize/fit them to the degree to which we might aspire in an ideal world. Co-development of models with stakeholders can be used to recognize important invasion patterns, in addition to identifying and estimating unknown environmental parameters, thereby guiding the direction of future research. Well-parameterized and validated models are not required in the earlier stages of the modeling cycle where their main utility is as a tool for thought.

  9. The strategy of therapy of the axilla in early cancer. Surgery or radiotherapy

    International Nuclear Information System (INIS)

    Izuo, Masaru

    1998-01-01

    The therapy of the axillary lymph node in early breast cancer was assessed perspectively. Recently, axillary irradiation was carried out and compared with surgery. Radiotherapy was not evaluated more successful. To carry out in accordance with the present guide line, so called ''modern technique'' or ''modern dosage schedule'', radiotherapy of the axilla is effective as well as surgery. We have many agreements that the rate of incidence of complication associated with irradiation was decreased in accordance with ''modern technique''. It is reasonable to radiate additionally after the selection by the ''node sampling'' in the sense of decreasing unnecessary irradiation. But it is not sufficient in their reliability, it is hard to expect this method getting more popular than now. We cannot find any difference in the effect of the treatment itself between present dissection and radiotherapy. However we have many agreements that axillary dissection may give the information about n-stage, and the contribution to the suitable selection to the prognosis factor and adjuvant chemotherapy was not so less even in early cancer. Some early cancers (non-invasive carcinoma or micro carcinoma) will not need the axillary therapy. It is one of the options ''to combine mastectomy under local anesthesia and radiotherapy'' in close cooperation with the skilled radiologist. (K.H.) 120 refs

  10. Attachment Styles To The Father and Coping Strategies Among Early Adolescents In Banda Aceh City

    OpenAIRE

    Fatmawati, Fatmawati; Muhammad Alwi Zainuddin, Nuzsep Almigo Bin

    2014-01-01

    This present study sought to investigate the relationship between attachment styles to the father and coping strategies among early adolescents. The population that has been studied was the seventh grade students ofin one of junior high school in Banda Aceh city that meet the established criteria, specifically at least 12 years old and still have father. The sampling technique applied was universal sampling because the number of eligible population was only 81 students. Total of samples taken...

  11. Supra-annular valve strategy for an early degenerated transcatheter balloon-expandable heart valve.

    Science.gov (United States)

    Kamioka, Norihiko; Caughron, Hope; Corrigan, Frank; Block, Peter; Babaliaros, Vasilis

    2018-01-23

    Currently, there are no recommendations regarding the selection of valve type for a transcatheter heart valve (THV)-in-THV procedure. A supra-annular valve design may be superior in that it results in a larger effective orifice area and may have a lower chance of valve thrombosis after THV-in-THV. In this report, we describe the use of a supra-annular valve strategy for an early degenerated THV. © 2018 Wiley Periodicals, Inc.

  12. Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

    Science.gov (United States)

    Comin, Arianna; Stegeman, Arjan; Marangon, Stefano; Klinkenberg, Don

    2012-01-01

    In recent years, the early detection of low pathogenicity avian influenza (LPAI) viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms) was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h)). The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h) reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control). Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier), whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus introduction

  13. Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

    Directory of Open Access Journals (Sweden)

    Arianna Comin

    Full Text Available In recent years, the early detection of low pathogenicity avian influenza (LPAI viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h. The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control. Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier, whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus

  14. Src Family Kinases Mediate Betel Quid-Induced Oral Cancer Cell Motility and Could Be a Biomarker for Early Invasion in Oral Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Jeff Yi-Fu Chen

    2008-12-01

    Full Text Available Betel quid (BQ-chewing oral cancer is a prevalent disease in many countries of Southeast Asia. Yet, the precise disease mechanism remains largely unknown. Here, we show that BQ extract-induced cell motility in three oral cancer cells (Ca9-22, SAS, and SCC9 presumably involves the Src family kinases (SFKs. Besides, BQ extract can markedly induce cell migration of wild type mouse embryonic fibroblasts (MEFs but not MEFs lacking three SFK members, namely, Src, Yes, and Fyn, indicating the requirement of SFKs for BQ-induced cell motility. Betel quid extract can also elevate cellular SFK activities because phosphorylation of tyrosine 416 at the catalytic domain is increased, which in turn promotes phosphorylation of an in vitro substrate, enolase. Furthermore, we identified that areca nut, a major component of BQ, is the key factor accounting for BQ-induced cell migration and invasion through SFKs-mediated signaling pathways. Immunohistochemistry revealed that, particularly in BQ-chewing cases, the activity of SFKs was significantly higher in tumor-adjacent mucosa than that in solid tumor areas (P < .01. These results suggest a possible role of SFKs in tumor-host interface and thus in early tumor invasion in vivo. Consistent with this is the observation that activation of SFKs is colocalized with invasive tumor fronts in oral squamous cell carcinoma. Together, we conclude that SFKs may represent a potential biomarker of invasion and therapeutic target in BQ-induced oral cancer.

  15. Estimating suitable environments for invasive plant species across large landscapes: a remote sensing strategy using Landsat 7 ETM+

    Science.gov (United States)

    Young, Kendal E.; Abbott, Laurie B.; Caldwell, Colleen A.; Schrader, T. Scott

    2013-01-01

    The key to reducing ecological and economic damage caused by invasive plant species is to locate and eradicate new invasions before they threaten native biodiversity and ecological processes. We used Landsat Enhanced Thematic Mapper Plus imagery to estimate suitable environments for four invasive plants in Big Bend National Park, southwest Texas, using a presence-only modeling approach. Giant reed (Arundo donax), Lehmann lovegrass (Eragrostis lehmanniana), horehound (Marrubium vulgare) and buffelgrass (Pennisteum ciliare) were selected for remote sensing spatial analyses. Multiple dates/seasons of imagery were used to account for habitat conditions within the study area and to capture phenological differences among targeted species and the surrounding landscape. Individual species models had high (0.91 to 0.99) discriminative ability to differentiate invasive plant suitable environments from random background locations. Average test area under the receiver operating characteristic curve (AUC) ranged from 0.91 to 0.99, indicating that plant predictive models exhibited high discriminative ability to differentiate suitable environments for invasive plant species from random locations. Omission rates ranged from <1.0 to 18%. We demonstrated that useful models estimating suitable environments for invasive plants may be created with <50 occurrence locations and that reliable modeling using presence-only datasets can be powerful tools for land managers.

  16. ST-segment deviation on the admission electrocardiogram, treatment strategy, and outcome in non-ST-elevation acute coronary syndromes - A substudy of the Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) Trial

    NARCIS (Netherlands)

    Windhausen, Fons; Hirsch, Alexander; Tijssen, Jan G. P.; Cornel, Jan Hein; Verheugt, Freek W. A.; Klees, Margriet I.; de Winter, Robbert J.

    2007-01-01

    Background: We assessed the prognostic significance of the presence of cumulative (Sigma) ST-segment deviation on the admission electrocardiogram (ECG) in patients with non-ST-elevation acute coronary syndrome and an elevated troponin T randomized to a selective invasive (SI) or an early invasive

  17. Early responses of resistant and susceptible potato roots during invasion by the potato cyst nematode Globodera rostochiensis.

    Science.gov (United States)

    Sheridan, Jacqueline P; Miller, Anthony J; Perry, Roland N

    2004-03-01

    Signals from roots of resistant (cv. Maris Piper) and susceptible (cv. Désirée) potato cultivars during invasion by second stage juveniles (J2s) of the potato cyst nematode, Globodera rostochiensis, were investigated. Novel experimental chambers enabled the recording of electrophysiological responses from roots during nematode invasion. The root cell membrane potentials were maintained throughout the 3 d required to assess invasion and feeding site development. The steady-state resting membrane potentials of Désirée were more negative than those of Maris Piper on day 1, but the reverse on day 3. After 5 d there was no difference between the two cultivars. Intracellular microelectrodes detected marked spike activity in roots after the application of J2s and there were distinct and reproducible differences between the two cultivars, with the response from Désirée being much greater than that from Maris Piper. The responses to mechanical stimulation of roots by blunt micropipettes and sharp electrodes were consistent and similar in both cultivars to the responses in Maris Piper obtained after nematode invasion, but could not account for the marked response found in Désirée. Exogenous application of exoenzymes, used to mimic nematode chemical secretions, resulted in a distinct depolarization pattern that, although similar in both cultivars, was different from patterns obtained during nematode invasion or mechanical stimulation. The pH of homogenates prepared from roots of both cultivars was measured and a Ca2+ channel blocker was used to assess the role of Ca2+ in nematode invasion. The results indicated a role for Ca2+ in the signalling events that occur during nematode invasion.

  18. Postoperative Outcomes of Minimally Invasive Gastrectomy Versus Open Gastrectomy During the Early Introduction of Minimally Invasive Gastrectomy in the Netherlands: A Population-based Cohort Study.

    Science.gov (United States)

    Brenkman, Hylke J F; Gisbertz, Suzanne S; Slaman, Annelijn E; Goense, Lucas; Ruurda, Jelle P; van Berge Henegouwen, Mark I; van Hillegersberg, Richard

    2017-11-01

    To compare postoperative outcomes of minimally invasive gastrectomy (MIG) to open gastrectomy (OG) for cancer during the introduction of MIG in the Netherlands. Between 2011 and 2015, the use of MIG increased from 4% to 53% in the Netherlands. This population-based cohort study included all patients with curable gastric adenocarcinoma that underwent gastrectomy between 2011 and 2015, registered in the Dutch Upper GI Cancer Audit. Patients with missing preoperative data, and patients in whom no lymphadenectomy or reconstruction was performed were excluded. Propensity score matching was applied to create comparable groups between patients receiving MIG or OG, using year of surgery and other potential confounders. Morbidity, mortality, and hospital stay were evaluated. Of the 1697 eligible patients, 813 were discarded after propensity score matching; 442 and 442 patients who underwent MIG and OG, respectively, remained. Conversions occurred in 10% of the patients during MIG. Although the overall postoperative morbidity (37% vs 40%, P = 0.489) and mortality rates (6% vs 4%, P = 0.214) were comparable between the 2 groups, patients who underwent MIG experienced less wound complications (2% vs 5%, P = 0.006). Anastomotic leakage occurred in 8% of the patients after MIG, and in 7% after OG (P = 0.525). The median hospital stay declined over the years for both procedures (11 to 8 days, P Netherlands, with overall morbidity and mortality comparable with OG, less wound complications and shorter hospitalization.

  19. Early-Life Stress Triggers Juvenile Zebra Finches to Switch Social Learning Strategies.

    Science.gov (United States)

    Farine, Damien R; Spencer, Karen A; Boogert, Neeltje J

    2015-08-17

    Stress during early life can cause disease and cognitive impairment in humans and non-humans alike. However, stress and other environmental factors can also program developmental pathways. We investigate whether differential exposure to developmental stress can drive divergent social learning strategies between siblings. In many species, juveniles acquire essential foraging skills by copying others: they can copy peers (horizontal social learning), learn from their parents (vertical social learning), or learn from other adults (oblique social learning). However, whether juveniles' learning strategies are condition dependent largely remains a mystery. We found that juvenile zebra finches living in flocks socially learned novel foraging skills exclusively from adults. By experimentally manipulating developmental stress, we further show that social learning targets are phenotypically plastic. While control juveniles learned foraging skills from their parents, their siblings, exposed as nestlings to experimentally elevated stress hormone levels, learned exclusively from unrelated adults. Thus, early-life conditions triggered individuals to switch strategies from vertical to oblique social learning. This switch could arise from stress-induced differences in developmental rate, cognitive and physical state, or the use of stress as an environmental cue. Acquisition of alternative social learning strategies may impact juveniles' fit to their environment and ultimately change their developmental trajectories. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Impact of Bug-in-Ear Professional Development on Early Childhood Co-Teachers' Use of Communication Strategies

    Science.gov (United States)

    Ottley, Jennifer R.; Grygas Coogle, Christan; Rahn, Naomi L.; Spear, Caitlin F.

    2017-01-01

    The goal of this study was to build the capacity of early childhood teachers to implement evidence-based strategies. We investigated the efficacy of professional development with bug-in-ear peer coaching in improving teachers' use of communication strategies, the teachers' maintenance of strategies post intervention, and the social validity of the…

  1. [Curriculum analysis and comparison between strategies or programs for early child development in Mexico].

    Science.gov (United States)

    Vargas-López, Guillermo; Guadarrama-Orozco, Jessica Haydee; Rizzoli-Córdoba, Antonio; Narcizo-Cenobio, Francisco Javier; Medrano-Loera, Gerónimo; Villagrán, Daniel Aceves; O'Shea Cuevas, Gabriel; Muñoz Hernández, Onofre

    Most of the strategies or programs that support early child development in Mexico are independent efforts that vary in scale, services offered and means of providing them. For the evaluation of the quality of these programs, an important aspect is the curriculum content. The aim of this study was to analyze and compare the curriculum content of the different strategies or programs focused on the promotion and intervention of early child development, which are offered by the Federal Government in Health and Education sectors in Mexico. We conducted a review of the curriculum content of the strategies and programs. The qualitative phase consisted of a comparative analysis where 75 indicators proposed by the Inter-American Development Bank were identified. The quantitative phase consisted of a descriptive analysis of the indicators. Finally, the analyses were compared to establish the performance of each one. Six strategies or programs were identified. In the analysis of the presence of indicators, the Oportunidades de Aprendizaje (Learning Opportunities, LO) strategy showed a larger number of indicators. In the amplitude analysis, both PEI-CONAFE and LO were the best balanced. Finally, in-depth analysis of the indicators LO and Skills for life were the best balanced while PEI-CONAFE was the best balanced in the social-emotional area, CeNSIA program for language and LO for cognitive development area. LO strategy showed the closest level of contents established by the Inter-American Development Bank. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  2. Improving outcomes in patients with melanoma: strategies to ensure an early diagnosis

    Directory of Open Access Journals (Sweden)

    Voss RK

    2015-11-01

    Full Text Available Rachel K Voss,1 Tessa N Woods,1 Kate D Cromwell,1 Kelly C Nelson,2 Janice N Cormier1 1Department of Surgical Oncology, 2Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Patients with thin, low-risk melanomas have an excellent long-term prognosis and higher quality of life than those who are diagnosed at later stages. From an economic standpoint, treatment of early stage melanoma consumes a fraction of the health care resources needed to treat advanced disease. Consequently, early diagnosis of melanoma is in the best interest of patients, payers, and health care systems. This review describes strategies to ensure that patients receive an early diagnosis through interventions ranging from better utilization of primary care clinics, to in vivo diagnostic technologies, to new “apps” available in the market. Strategies for screening those at high risk due to age, male sex, skin type, nevi, genetic mutations, or family history are discussed. Despite progress in identifying those at high risk for melanoma, there remains a lack of general consensus worldwide for best screening practices. Strategies to ensure early diagnosis of recurrent disease in those with a prior melanoma diagnosis are also reviewed. Variations in recurrence surveillance practices by type of provider and country are featured, with evidence demonstrating that various imaging studies, including ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging, provide only minimal gains in life expectancy, even for those with more advanced (stage III disease. Because the majority of melanomas are attributable to ultraviolet radiation in the form of sunlight, primary prevention strategies, including sunscreen use and behavioral interventions, are reviewed. Recent international government regulation of tanning beds is described, as well as issues surrounding the continued use artificial ultraviolet

  3. Acer negundo invasion along a successional gradient: early direct facilitation by native pioneers and late indirect facilitation by conspecifics.

    Science.gov (United States)

    Saccone, Patrick; Pagès, Jean-Philippe; Girel, Jacky; Brun, Jean-Jacques; Michalet, Richard

    2010-08-01

    *Here, we analysed the role of direct and indirect plant interactions in the invasion process of Acer negundo along a natural successional gradient in the Middle Rhone floodplain (France). We addressed two questions: What are the responses of the invasive Acer seedlings to native communities' effects along the successional gradient? What are the effects of the invasive Acer adult trees on the native communities? *In the three communities (Salix, Acer and Fraxinus stands) we transplanted juveniles of the invasive and juveniles of the natives within the forest and in experimental gaps, and with and without the herb layer. We also quantified changes in understory functional composition, light, nitrogen and moisture among treatments. *Acer seedlings were directly facilitated for survival in the Salix and Acer communities and indirectly facilitated for growth by adult Acer through the reduction of the abundance of highly competitive herbaceous competitors. *We conclude that direct facilitation by the tree canopy of the native pioneer Salix is very likely the main biotic process that induced colonization of the invasive Acer in the floodplain and that indirect facilitation by adult conspecifics contributed to population establishment.

  4. Effects of age on long-term outcomes after a routine invasive or selective invasive strategy in patients presenting with non-ST segment elevation acute coronary syndromes: a collaborative analysis of individual data from the FRISC II - ICTUS - RITA-3 (FIR) trials

    NARCIS (Netherlands)

    Damman, Peter; Clayton, Tim; Wallentin, Lars; Lagerqvist, Bo; Fox, Keith A. A.; Hirsch, Alexander; Windhausen, Fons; Swahn, Eva; Pocock, Stuart J.; Tijssen, Jan G. P.; de Winter, Robbert J.

    2012-01-01

    Objective To perform a patient-pooled analysis of a routine invasive versus a selective invasive strategy in elderly patients with non-ST segment elevation acute coronary syndrome. Methods A meta-analysis was performed of patient-pooled data from the FRISC IIeICTUSeRITA-3 (FIR) studies. (Un)adjusted

  5. Proteomic analysis of human skin treated with larval schistosome peptidases reveals distinct invasion strategies among species of blood flukes.

    Directory of Open Access Journals (Sweden)

    Jessica Ingram

    2011-09-01

    Full Text Available Skin invasion is the initial step in infection of the human host by schistosome blood flukes. Schistosome larvae have the remarkable ability to overcome the physical and biochemical barriers present in skin in the absence of any mechanical trauma. While a serine peptidase with activity against insoluble elastin appears to be essential for this process in one species of schistosomes, Schistosoma mansoni, it is unknown whether other schistosome species use the same peptidase to facilitate entry into their hosts.Recent genome sequencing projects, together with a number of biochemical studies, identified alternative peptidases that Schistosoma japonicum or Trichobilharzia regenti could use to facilitate migration through skin. In this study, we used comparative proteomic analysis of human skin treated with purified cercarial elastase, the known invasive peptidase of S. mansoni, or S. mansoni cathespin B2, a close homolog of the putative invasive peptidase of S. japonicum, to identify substrates of either peptidase. Select skin proteins were then confirmed as substrates by in vitro digestion assays.This study demonstrates that an S. mansoni ortholog of the candidate invasive peptidase of S. japonicum and T. regenti, cathepsin B2, is capable of efficiently cleaving many of the same host skin substrates as the invasive serine peptidase of S. mansoni, cercarial elastase. At the same time, identification of unique substrates and the broader species specificity of cathepsin B2 suggest that the cercarial elastase gene family amplified as an adaptation of schistosomes to human hosts.

  6. Strategy to control the invasive alien tree Miconia calvescens in Pacific islands: Eradication, containment or something else?

    Science.gov (United States)

    Meyer, Jean-Yves; Loope, Lloyd; Goarant, Anne-Claire; Veitch, C.R.; Clout, M.N.; Towns, D. R.

    2011-01-01

    Miconia calvescens (Melastomataceae) is a notorious plant invader in the tropical islands of French Polynesia, Hawaii and New Caledonia. A small tree native to Central and South America, it was first introduced as an ornamental in private botanic gardens in Tahiti (1937), Honolulu (1961), and Nouméa (1970s) where it escaped, became naturalised, and formed dense monospecific stands. More than 80,000 ha are currently invaded in French Polynesia, 10,000 ha in the Hawaiian Islands and 140 ha in New Caledonia. Control programmes have been under way in the Hawaiian Islands (Oahu, Maui, Hawaii, Kauai) and French Polynesia (Raiatea, Tahaa, Nuku Hiva, Fatu Hiva) since the early 1990s, and in New Caledonia (Province Sud) since 2006. Despite more than 15 years of intensive control efforts and millions of plants destroyed, eradication has not been achieved in any of these islands, mainly because the species has multiple features that thwart its elimination (e.g., prolific seed production, active dispersal by alien and native frugivorous birds, large and persistent soil seed bank, shade-tolerance), combined with the difficulty of detecting and destroying plants on rough terrain and steep slopes, insufficient control frequency, and limited financial and human resources. Miconia’s life cycle requires at least four years growth from seedling to fruiting. Consequently, prevention of fruit production may be an effective management strategy for small populations. This “juvenilization” process may allow the eradication of small populations when carefully conducted over a quarter century. 

  7. Low effective organizational strategies in visual memory performance of unmedicated alcoholics during early abstinence.

    Science.gov (United States)

    Daig, Isolde; Mahlberg, Richard; Schroeder, Franziska; Gudlowski, Yehonala; Wrase, Jana; Wertenauer, Florian; Bschor, Tom; Esser, Guenter; Heinz, Andreas; Kienast, Thorsten

    2010-12-14

    Alcohol-dependent patients in early abstinence show an impairment of cognitive functions which can be seen in poor implementation of newly learned skills for avoiding relapse. Executive dysfunction may persist during abstinence in alcohol-dependent persons, thus mitigating long-term abstinence. This study assessed visual memory function and choice of organizational strategies in alcoholics, as these are major factors necessary to implement ongoing behavior changes which are required for maintaining abstinence. We investigated 25 severely alcohol-dependent male patients between days 7 to 10 of abstinence, immediately after clinical withdrawal symptoms have ceased, compared to 15 healthy age, sex, and education matched controls. Pharmacological therapy had been terminated at least four half-lifes before inclusion into the study. Visual perceptual learning and organizational strategies were assessed with the Rey-Osterrieth Complex Figure Test (R-OCF). There were no group differences in copying or recalling the figure, but time differences occurred. Alcoholics and healthy controls performed worse in recalling than in copying. But, alcoholics used less effective organizational strategies. There was a deficit in choice of organizational strategy in newly abstinent and unmedicated alcohol-dependent patients. Due to the imperfect organizational strategies, alcoholics might need auxiliary therapeutic care to strengthen their cognitive ability.

  8. Chronic Disease Management Strategies of Early Childhood Caries: Support from the Medical and Dental Literature.

    Science.gov (United States)

    Edelstein, Burton L; Ng, Man Wai

    2015-01-01

    An Institute of Medicine report places chronic disease management (CDM) as an intervention on a treatment spectrum between prevention and acute care. CDM commonly focuses on conditions in which patient self-care efforts are significant. Framing early childhood caries (ECC) as such a chronic condition invites dentistry to reconsider its approach to caries management and shift gears from a strictly surgical approach to one that also incorporates a medical approach. This paper's purpose was to explore the definition of and concepts inherent in CDM. An explanatory model is introduced to describe the multiple factors that influence ECC-CDM strategies. Reviewed literature suggests that early evidence from ECC-CDM interventions, along with results of pediatric asthma and diabetes CDM, supports CDM of ECC as a valid approach that is independent of both prevention and repair. Early results of ECC-CDM endeavors have demonstrated a reduction in rates of new cavitation, dental pain, and referral to the operating room compared to baseline rates. ECC-CDM strategies hold strong promise to curtail caries activity while complementing dental repair when needed, thereby reducing disease progression and cavity recurrence. Institutionalizing ECC-CDM will both require and benefit from evolving health care delivery and financing systems that reward positive health outcomes.

  9. Early repositioning through compound set enrichment analysis: a knowledge-recycling strategy.

    Science.gov (United States)

    Temesi, Gergely; Bolgár, Bence; Arany, Adám; Szalai, Csaba; Antal, Péter; Mátyus, Péter

    2014-04-01

    Despite famous serendipitous drug repositioning success stories, systematic projects have not yet delivered the expected results. However, repositioning technologies are gaining ground in different phases of routine drug development, together with new adaptive strategies. We demonstrate the power of the compound information pool, the ever-growing heterogeneous information repertoire of approved drugs and candidates as an invaluable catalyzer in this transition. Systematic, computational utilization of this information pool for candidates in early phases is an open research problem; we propose a novel application of the enrichment analysis statistical framework for fusion of this information pool, specifically for the prediction of indications. Pharmaceutical consequences are formulated for a systematic and continuous knowledge recycling strategy, utilizing this information pool throughout the drug-discovery pipeline.

  10. Stabilizing ER Ca2+ channel function as an early preventative strategy for Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Shreaya Chakroborty

    Full Text Available Alzheimer's disease (AD is a devastating neurodegenerative condition with no known cure. While current therapies target late-stage amyloid formation and cholinergic tone, to date, these strategies have proven ineffective at preventing disease progression. The reasons for this may be varied, and could reflect late intervention, or, that earlier pathogenic mechanisms have been overlooked and permitted to accelerate the disease process. One such example would include synaptic pathology, the disease component strongly associated with cognitive impairment. Dysregulated Ca(2+ homeostasis may be one of the critical factors driving synaptic dysfunction. One of the earliest pathophysiological indicators in mutant presenilin (PS AD mice is increased intracellular Ca(2+ signaling, predominantly through the ER-localized inositol triphosphate (IP(3 and ryanodine receptors (RyR. In particular, the RyR-mediated Ca(2+ upregulation within synaptic compartments is associated with altered synaptic homeostasis and network depression at early (presymptomatic AD stages. Here, we offer an alternative approach to AD therapeutics by stabilizing early pathogenic mechanisms associated with synaptic abnormalities. We targeted the RyR as a means to prevent disease progression, and sub-chronically treated AD mouse models (4-weeks with a novel formulation of the RyR inhibitor, dantrolene. Using 2-photon Ca(2+ imaging and patch clamp recordings, we demonstrate that dantrolene treatment fully normalizes ER Ca(2+ signaling within somatic and dendritic compartments in early and later-stage AD mice in hippocampal slices. Additionally, the elevated RyR2 levels in AD mice are restored to control levels with dantrolene treatment, as are synaptic transmission and synaptic plasticity. Aβ deposition within the cortex and hippocampus is also reduced in dantrolene-treated AD mice. In this study, we highlight the pivotal role of Ca(2+ aberrations in AD, and propose a novel strategy to

  11. Effects of age on long-term outcomes after a routine invasive or selective invasive strategy in patients presenting with non-ST segment elevation acute coronary syndromes: a collaborative analysis of individual data from the FRISC II - ICTUS - RITA-3 (FIR) trials.

    Science.gov (United States)

    Damman, Peter; Clayton, Tim; Wallentin, Lars; Lagerqvist, Bo; Fox, Keith A A; Hirsch, Alexander; Windhausen, Fons; Swahn, Eva; Pocock, Stuart J; Tijssen, Jan G P; de Winter, Robbert J

    2012-02-01

    To perform a patient-pooled analysis of a routine invasive versus a selective invasive strategy in elderly patients with non-ST segment elevation acute coronary syndrome. A meta-analysis was performed of patient-pooled data from the FRISC II-ICTUS-RITA-3 (FIR) studies. (Un)adjusted HRs were calculated by Cox regression, with adjustments for variables associated with age and outcomes. The main outcome was 5-year cardiovascular death or myocardial infarction (MI) following routine invasive versus selective invasive management. Regarding the 5-year composite of cardiovascular death or MI, the routine invasive strategy was associated with a lower hazard in patients aged 65-74 years (HR 0.72, 95% CI 0.58 to 0.90) and those aged ≥75 years (HR 0.71, 95% CI 0.55 to 0.91), but not in those aged RITA-3).

  12. Health Resources and Strategies among Employed Women in Norway during Pregnancy and Early Motherhood

    Science.gov (United States)

    Alstveit, Marit; Karlsen, Bjørg

    2015-01-01

    The number of women in paid employment is increasing. However, when becoming a mother for the first time, many seem unprepared for the challenge of balancing motherhood and work as well as for the impact on their health. The aim of this study was to investigate the health resources and strategies of employed women in Norway during pregnancy and early motherhood by means of salutogenic theory. A hypothetical-deductive interpretive approach based on Antonovsky's salutogenic theory was applied in a secondary analysis. A total of six themes were identified; three were classified as health resources when experiencing tension and three as health strategies. Salutogenic theory seems to be a useful framework for illuminating the health resources and strategies adopted by employed women who become mothers. The identified health resources when experiencing tension and the health strategies applied may have implications for maternity care professionals and employers in promoting the health of such women and supporting them to combine work and family life. PMID:25945258

  13. Pre-operative Screening and Manual Drilling Strategies to Reduce the Risk of Thermal Injury During Minimally Invasive Cochlear Implantation Surgery.

    Science.gov (United States)

    Dillon, Neal P; Fichera, Loris; Kesler, Kyle; Zuniga, M Geraldine; Mitchell, Jason E; Webster, Robert J; Labadie, Robert F

    2017-09-01

    This article presents the development and experimental validation of a methodology to reduce the risk of thermal injury to the facial nerve during minimally invasive cochlear implantation surgery. The first step in this methodology is a pre-operative screening process, in which medical imaging is used to identify those patients that present a significant risk of developing high temperatures at the facial nerve during the drilling phase of the procedure. Such a risk is calculated based on the density of the bone along the drilling path and the thermal conductance between the drilling path and the nerve, and provides a criterion to exclude high-risk patients from receiving the minimally invasive procedure. The second component of the methodology is a drilling strategy for manually-guided drilling near the facial nerve. The strategy utilizes interval drilling and mechanical constraints to enable better control over the procedure and the resulting generation of heat. The approach is tested in fresh cadaver temporal bones using a thermal camera to monitor temperature near the facial nerve. Results indicate that pre-operative screening may successfully exclude high-risk patients and that the proposed drilling strategy enables safe drilling for low-to-moderate risk patients.

  14. Prevention, early detection and containment of invasive, nonnative plants in the Hawaiian Islands: current efforts and needs

    Science.gov (United States)

    Christoph Kueffer,; Loope, Lloyd

    2009-01-01

    Introduction: Invasive, non-native plants (or environmental weeds) have long been recognized as a major threat to the native biodiversity of oceanic islands (Cronk & Fuller, 1995; Denslow, 2003). Globally, several hundred non-native plant species have been reported to have major impacts on natural areas on oceanic islands (Kueffer et al., 2009). In Hawaii, at least some 50 non-native plant species reach dominance in natural areas (Kueffer et al., 2009) and many of them are known to impact ecosystem processes or biodiversity. One example is the invasive Australian tree fern (Cyathea cooperi), which has been shown to be very efficient at utilizing soil nitrogen and can grow six times as rapidly in height, maintain four times more fronds, and produce significantly more fertile fronds per month than the native Hawaiian endemic tree ferns, Cibotium spp. (Durand & Goldstein, 2001a, b). Additionally, while native tree ferns provide an ideal substrate for epiphytic growth of many understory ferns and flowering plants, the Australian tree fern has the effect of impoverishing the understory and failing to support an abundance of native epiphytes (Medeiros & Loope, 1993). Other notorious examples of invasive plant species problematic for biodiversity and ecosystem processes in Hawaii include miconia (Miconia calvescens), strawberry guava (Psidium cattleianum), albizia (Falcataria moluccana), firetree (Morella faya), clidemia (Clidemia hirta), kahili ginger (Hedychium gardnerianum), and fountain grass (Pennisetum setaceum), to name just a few. Fireweed (Senecio madagascariensis) is a recent example of a seriously problematic invasive species for Hawaii’s agriculture and is damaging certain high-elevations native ecosystems as well.

  15. Mechanisms for dominance in an early successional old field by the invasive non-native Lespedeza cuneata (Dum. Cours.) G. Don

    Science.gov (United States)

    Brandon, A.L.; Gibson, D.J.; Middleton, B.A.

    2004-01-01

    Researchers studying invasive plants often concentrate their efforts on predictive models thought to allow invasive plants to dominate native landscapes. However, if an invasive is already well established then experimental research is necessary to provide the information necessary to effectively manage the species. Prescribing appropriate management strategies without prior experimental research may not only be ineffective but also may squander limited resources or have the unintended consequence of furthering spread. Lespedeza cuneata (Dum. Cours.) G. Don. is a well-established invasive plant of old fields and tall-grass prairie in the US. Managers suspect this species shades-out native plants and this is proposed as its primary mechanism for dominance. Using field experiments we tested probable factors allowing the speices to establish itself and once established, interfere in old field plant communities. We also examined the effects of two common anthropogenic disturbances (mowing and nutrients) on L. cuneata growth and establishment. When L. cuneata was treated (clipping, herbicide and stem pull-back) there was a significant increase in species richness and native speices cover. Stem density and canopy cover of L. cuneata increased significantly with mowing frequency but decreased with nutrient input. We suggest that mowing benefits L. cuneata while also hindering woody competition. Results also indicate L. cuneata is less prevalent on nutrient enriched soils than on unamended soil. Lespedeza cuneata appears to suppress native plants by shading them out and it can subsequently take over grassland communities. Since it has a varying response to human induced disturbances and may actually benefit from mowing, land managers should be cautious when utilizing this as a management tool.

  16. Increased Detection of Lymphatic Vessel Invasion by D2-40 (Podoplanin) in Early Breast Cancer: Possible Influence on Patient Selection for Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Debald, Manuel; Poelcher, Martin; Flucke, Uta; Walgenbach-Bruenagel, Gisela

    2010-01-01

    Purpose: Several international trials are currently investigating accelerated partial breast irradiation (APBI) for patients with early-stage breast cancer. According to existing guidelines, patients with lymphatic vessel invasion (LVI) do not qualify for APBI. D2-40 (podoplanin) significantly increases the frequency of LVI detection compared with conventional hematoxylin and eosin (HE) staining in early-stage breast cancer. Our purpose was to retrospectively assess the hypothetical change in management from APBI to whole breast radiotherapy with the application of D2-40. Patients and Methods: Immunostaining with D2-40 was performed on 254 invasive breast tumors of 247 patients. The following criteria were used to determine the eligibility for APBI: invasive ductal adenocarcinoma of ≤3 cm, negative axillary node status (N0), and unifocal disease. Of the 247 patients, 74 with available information concerning LVI, as detected by D2-40 immunostaining and routine HE staining, formed our study population. Results: Using D2-40, our results demonstrated a significantly greater detection rate (p = .031) of LVI compared with routine HE staining. LVI was correctly identified by D2-40 (D2-40-positive LVI) in 10 (13.5%) of 74 tumors. On routine HE staining, 4 tumors (5.4%) were classified as HE-positive LVI. Doublestaining of these specimens with D2-40 unmasked false-positive LVI status in 2 (50%) of the 4 tumors. According to the current recommendations for APBI, immunostaining with D2-40 would have changed the clinical management from APBI to whole breast radiotherapy in 8 (10.8%) of 74 patients and from whole breast radiotherapy to APBI in 2 patients (2.7%). Conclusion: These data support the implementation of D2-40 immunostaining in the routine workup to determine a patient's eligibility for APBI.

  17. Korean Early Childhood Educators' Perceptions of Importance and Implementation of Strategies to Address Young Children's Social-Emotional Competence

    Science.gov (United States)

    Heo, Kay H.; Cheatham, Gregory A.; Hemmeter, Mary Louise; Noh, Jina

    2014-01-01

    In South Korea, there has been a rapid increase in challenging behaviors and other social-emotional difficulties at the early childhood level. Korean early childhood educators' perspectives and strategies to address young children's social-emotional competencies and challenging behaviors were investigated. Overall, results suggest that many Korean…

  18. Early Admission Call-Up: A Strategy and Marketing Perk for Attracting Better Students to a College in Lebanon

    Science.gov (United States)

    Naimy, Viviane; Nasser, Ramzi

    2009-01-01

    The purpose of this study was to determine whether an early call-up strategy helps in attracting better students to a private university in Lebanon. Early admission call-up was administered to the top 25 percentile-ranked students of main feeder schools at a private university in Lebanon. Admission data was accrued for students who applied for…

  19. Early change in coping strategies in responsive treatments for borderline personality disorder: A mediation analysis.

    Science.gov (United States)

    Kramer, Ueli; Keller, Sabine; Caspar, Franz; de Roten, Yves; Despland, Jean-Nicolas; Kolly, Stéphane

    2017-05-01

    Difficulty in emotion regulation is a hallmark feature of patients with borderline personality disorder (BPD). Therefore, change in the frequency of certain patients' coping strategies-aiming at emotion regulation-are among the most promising mechanisms of change in treatments for BPD. In parallel, it was highlighted that therapist responsiveness significantly contributed to outcome across treatment approaches (Stiles, 2009). Based on a randomized controlled trial (Kramer et al., 2014), the present process-outcome mediation analysis aims at examining the patient's early change in frequency of coping strategies-in particular the decrease in behavioral forms of coping-as potential mechanism of change in responsive treatments for BPD. A total of 57 patients with BPD were included in the present analysis, out of whom 27 were randomly assigned to a 10-session psychiatric treatment and 30 to a 10-session psychiatric treatment augmented with the responsive intervention of the motive-oriented therapeutic relationship (Caspar, 2007). The 1st, 5th, and 9th session of each therapy were transcribed and analyzed using the Coping Action Pattern Rating Scale (Perry et al., 2005; 171 sessions analyzed in total), a validated observer-rated method for assessing coping strategies in the therapy process. Psychological distress was assessed using the OQ-45 at intake, after Session 5, and after Session 10. The results confirmed a responsiveness effect associated with the motive-oriented therapeutic relationship and showed a significant decrease in frequency of behavioral forms of coping, F(1, 54) = 3.09, p = .05, d = .56, which was not different between the 2 conditions. In addition, we demonstrated that the early decrease in behavioral forms of coping between Sessions 1 and 5 partially mediated the link between the group assignment and the change in psychological distress between Sessions 5 and 10. These results shed light on the centrality of therapist responsiveness in treatments for

  20. Lipid raft disarrangement as a result of neuropathological progresses: a novel strategy for early diagnosis?

    Science.gov (United States)

    Marin, R; Rojo, J A; Fabelo, N; Fernandez, C E; Diaz, M

    2013-08-15

    Lipid rafts are the preferential site of numerous membrane signaling proteins which are involved in neuronal functioning and survival. These proteins are organized in multiprotein complexes, or signalosomes, in close contact with lipid classes particularly represented in lipid rafts (i.e. cholesterol, sphingolipids and saturated fatty acids), which may contribute to physiological responses leading to neuroprotection. Increasing evidence indicates that alteration of lipid composition in raft structures as a consequence of neuropathologies, such as Alzheimer's disease (AD) and Parkinson's disease (PD), causes a dramatic increase in lipid raft order. These phenomena may correlate with perturbation of signalosome activities, likely contributing to neurodegenerative progression. Interestingly, significant disruption of stable raft microenvironments has been already observed in the first stages of either AD or PD, suggesting that these alterations may represent early events in the neuropathological development. In this regard, the search for biochemical markers, such as specific metabolic products altered in the brain at the first steps of the disease, presently represents an important challenge for early diagnostic strategies. Alterations of these biomarkers may be reflected in either plasma or cerebrospinal fluid, thus representing a potential strategy to predict an accurate diagnosis. We propose that pathologically-linked lipid raft markers may be interesting candidates to be explored at this level, although it has not been studied so far to what extent alteration of different signalosome components may be reflected in peripheral fluids. In this mini-review, we will discuss on relevant aspects of lipid rafts that contribute to the modulation of neuropathological events related to AD and PD. An interesting hypothesis is that anomalies on raft biomarkers measured at peripheral fluids might mirror the lipid raft pathology observed in early stages of AD and PD. Copyright

  1. Semantic and syntactic reading comprehension strategies used by deaf children with early and late cochlear implantation.

    Science.gov (United States)

    Gallego, Carlos; Martín-Aragoneses, M Teresa; López-Higes, Ramón; Pisón, Guzmán

    2016-01-01

    Deaf students have traditionally exhibited reading comprehension difficulties. In recent years, these comprehension problems have been partially offset through cochlear implantation (CI), and the subsequent improvement in spoken language skills. However, the use of cochlear implants has not managed to fully bridge the gap in language and reading between normally hearing (NH) and deaf children, as its efficacy depends on variables such as the age at implant. This study compared the reading comprehension of sentences in 19 children who received a cochlear implant before 24 months of age (early-CI) and 19 who received it after 24 months (late-CI) with a control group of 19 NH children. The task involved completing sentences in which the last word had been omitted. To complete each sentence children had to choose a word from among several alternatives that included one syntactic and two semantic foils in addition to the target word. The results showed that deaf children with late-CI performed this task significantly worse than NH children, while those with early-CI exhibited no significant differences with NH children, except under more demanding processing conditions (long sentences with infrequent target words). Further, the error analysis revealed a preference of deaf students with early-CI for selecting the syntactic foil over a semantic one, which suggests that they draw upon syntactic cues during sentence processing in the same way as NH children do. In contrast, deaf children with late-CI do not appear to use a syntactic strategy, but neither a semantic strategy based on the use of key words, as the literature suggests. Rather, the numerous errors of both kinds that the late-CI group made seem to indicate an inconsistent and erratic response when faced with a lack of comprehension. These findings are discussed in relation to differences in receptive vocabulary and short-term memory and their implications for sentence reading comprehension. Copyright © 2015

  2. A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking.

    Science.gov (United States)

    Storr, Carla L; Ialongo, Nicholas S; Kellam, Sheppard G; Anthony, James C

    2002-03-01

    In this article, we examine the impact of two universal, grade 1 preventive interventions on the onset of tobacco smoking as assessed in early adolescence. The classroom-centered (CC) intervention was designed to reduce the risk for tobacco smoking by enhancing teachers' behavior management skills in first grade and, thereby, reducing child attention problems and aggressive and shy behavior-known risk behaviors for later substance use. The family-school partnership (FSP) intervention targeted these early risk behaviors via improvements in parent-teacher communication and parents' child behavior management strategies. A cohort of 678 urban, predominately African-American, public school students were randomly assigned to one of three Grade 1 classrooms at entrance to primary school (age 6). One classroom featured the CC intervention, a second the FSP intervention, and the third served as a control classroom. Six years later, 81% of the students completed audio computer-assisted self-interviews. Relative to controls, a modest attenuation in the risk of smoking initiation was found for students who had been assigned to either the CC or FSP intervention classrooms (26% versus 33%) (adjusted relative risk for CC/control contrast=0.57, 95% confidence interval (CI), 0.34-0.96; adjusted relative risk for FSP/control contrast=0.69, 95% CI, 0.50-0.97). Results lend support to targeting the early antecedent risk behaviors for tobacco smoking.

  3. Why so many flowers? A preliminary assessment of mixed pollination strategy enhancing sexual reproduction of the invasive Acacia longifolia in Portugal

    Directory of Open Access Journals (Sweden)

    M. Giovanetti

    2018-03-01

    Full Text Available Acacia longifolia, a native legume from Australia, has been introduced in many European countries and elsewhere, thus becoming one of the most important global invasive species. In Europe, its flowering occurs in a period unsuitable for insect activity: nonetheless it is considered entomophilous. Floral traits of this species are puzzling: brightly coloured and scented as liked by insects, but with abundant staminate small-sized flowers and relatively small pollen grains, as it is common in anemophilous species. Invasion processes are especially favoured when reshaping local ecological networks, thus the interest in understanding pollination syndromes associated with invasive plant species that may facilitate invasiveness. Moreover, a striking difference exists between its massive flowering and relatively poor seed set. We introduced a novel approach: first, we consider the possibility that a part of the pollination success is carried on by wind and, second, we weighted the ethological perspective of the main pollinator. During the flowering season of A. longifolia (February–April 2016, we carried on exclusion experiments to detect the relative contribution of insects and wind. While the exclusion experiments corroborated the need for pollen vectors, we actually recorded a low abundance of insects. The honeybee, known pollinator of acacias, was relatively rare and not always productive in terms of successful visits. While wind contributed to seed set, focal observations confirmed that honeybees transfer pollen when visiting both the inflorescences to collect pollen and the extrafloral nectaries to collect nectar. The mixed pollination strategy of A. longifolia may then be the basis of its success in invading Portugal's windy coasts.

  4. Preliminary Study of Late Pleistocene to Early Holocene Plant Food Strategies in China

    Science.gov (United States)

    Hayashi Tang, M.; Liu, X.; Fritz, G.; Zhao, Z.

    2017-12-01

    In recent decades, studies on the domestication and early cultivation of seed crops have contributed significantly to how we understand human-plant interactions, and their impact on human social organisation and the environment. It is becoming clear, however, that plants have been critical to the human diet for much longer and in more diverse ways than previously assumed. This paper is a preliminary attempt at identifying and addressing early prehistoric plant food strategies in China. In particular, very little is known about the use of vegetatively propagated plants, despite their significant representation in modern crops. Many ingredients of Chinese medicine are also roots and tubers (or vegetative storage organs, VSOs). Unlike seed crops, however, we lack a systematic criterion for examining diagnostic characters of different VSO taxa in the archaeological record. To address this issue, we characterized commonly consumed and historically significant VSOs in China, by studying experimentally charred modern samples under the optical microscope and scanning electron microscope. We then compared the characteristics of these modern VSO samples against plant remains from Late Pleistocene to early Holocene archaeological sites in China, such as Zengpiyan (Guangxi), Zhaoguodong (Guizhou), and Jiahu (Henan) sites. We found that different taxa of VSOs can be differentiated by using multiple lines of evidence, including: shape and size of various cells, texture and arrangement of cell walls, as well as anatomical arrangements of organs, especially the vascular bundles. Though identification can be difficult when fragile cell structures have collapsed or deteriorated, more robust features are often preserved for diagnosis. Our results suggest that the potential for studying the role of vegetatively propagated plants in early human-environmental interactions is overlooked, and can be expanded significantly with further investment in their systematic identification.

  5. Invasive bladder cancer: treatment strategies using transurethral surgery, chemotherapy and radiation therapy with selection for bladder conservation

    International Nuclear Information System (INIS)

    Shipley, William U.; Zietman, Anthony L.; Kaufman, Donald S.; Althausen, Alex F.; Heney, Niall M.

    1997-01-01

    Purpose: Combined modality therapy has become the standard oncologic approach to achieve organ preservation in many malignancies. Methods and Materials: Although radical cystectomy has been considered as standard treatment for invasive bladder carcinoma in the United States, good results have been recently reported from several centers using multimodality treatment, particularly in patients with clinical T2 and T3a disease who do not have a ureter obstructed by tumor. Results: The components of the combined treatment are usually transurethral resection of the bladder tumor (TURBT) followed by concurrent chemotherapy and radiation therapy. Following an induction course of therapy a histologic response is evaluated by cystoscopy and rebiopsy. Clinical 'complete responders' (tumor site rebiopsy negative and urine cytology with no tumor cells present) continue with a consolidation course of concurrent chemotherapy and radiation. Those patients not achieving a clinical complete response are recommended to have an immediate cystectomy. Individually the local monotherapies of radiation, TURBT, or multidrug chemotherapy each achieve a local control rate of the primary tumor of from 20 to 40%. When these are combined, clinical complete response rates of from 65 to 80% can be achieved. Seventy-five to 85% of the clinical complete responders will remain with bladders free of recurrence of an invasive tumor. Conclusions: Bladder conservation trials using combined modality treatment approaches with selection for organ conservation by response of the tumor to initial treatment report overall 5-year survival rates of approximately 50%, and a 40-45% 5-year survival rate with the bladder intact. These modern multimodality bladder conservation approaches offer survival rates similar to radical cystectomy for patients of similar clinical stage and age. Bladder-conserving therapy should be offered to patients with invasive bladder carcinoma as a realistic alternative to radical

  6. On Different Tracks? Gender, Professional Strategies, and Early Career Wage Gaps

    Directory of Open Access Journals (Sweden)

    Anne Grönlund

    2017-06-01

    Full Text Available A longstanding notion in labor market theory is that women accommodate family responsibilities in their occupational and job choices. Utilizing a survey of newly graduated highly educated men and women in five occupations in Sweden (n≈2400, the article explores whether men and women differ in their professional strategies and if such differences produce early career wage gaps. Findings based on OLS regressions show that women express dual commitment to work and family; compared with men, they value ‘family-friendly’ work-conditions higher but do not value wages and career lower. Parenthood is not related to lower levels of career focus, but neutralizes occupational differences in family focus for women. Despite the select sample, women have lower wages than men, but the wage gap is not explained by different prioritization of family/career. The findings suggest that assumptions about gendered skill investments must be empirically scrutinized and theories further developed.

  7. Metabolites from invasive pests inhibit mitochondrial complex II: A potential strategy for the treatment of human ovarian carcinoma?

    Energy Technology Data Exchange (ETDEWEB)

    Ferramosca, Alessandra, E-mail: alessandra.ferramosca@unisalento.it [Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Lecce (Italy); Conte, Annalea; Guerra, Flora; Felline, Serena [Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Lecce (Italy); Rimoli, Maria Grazia [Dipartimento di Farmacia, Università di Napoli Federico II, Napoli (Italy); Mollo, Ernesto [Istituto di Chimica Biomolecolare, Consiglio Nazionale delle Ricerche, Pozzuoli (Italy); Zara, Vincenzo [Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Lecce (Italy); Terlizzi, Antonio [Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Lecce (Italy); Stazione Zoologica Anton Dohrn, Napoli (Italy)

    2016-05-13

    The red pigment caulerpin, a secondary metabolite from the marine invasive green algae Caulerpa cylindracea can be accumulated and transferred along the trophic chain, with detrimental consequences on biodiversity and ecosystem functioning. Despite increasing research efforts to understand how caulerpin modifies fish physiology, little is known on the effects of algal metabolites on mammalian cells. Here we report for the first time the mitochondrial targeting activity of both caulerpin, and its closely related derivative caulerpinic acid, by using as experimental model rat liver mitochondria, a system in which bioenergetics mechanisms are not altered. Mitochondrial function was tested by polarographic and spectrophotometric methods. Both compounds were found to selectively inhibit respiratory complex II activity, while complexes I, III, and IV remained functional. These results led us to hypothesize that both algal metabolites could be used as antitumor agents in cell lines with defects in mitochondrial complex I. Ovarian cancer cisplatin-resistant cells are a good example of cell lines with a defective complex I function on which these molecules seem to have a toxic effect on proliferation. This provided novel insight toward the potential use of metabolites from invasive Caulerpa species for the treatment of human ovarian carcinoma cisplatin-resistant cells. -- Highlights: •Novel insight toward the potential use of the algal metabolites for the treatment of human diseases. •Caulerpin and caulerpinic acid inhibit respiratory complex II activity. •Both algal metabolites could be used as antitumor agents in ovarian cancer cisplatin-resistant cells.

  8. Metabolites from invasive pests inhibit mitochondrial complex II: A potential strategy for the treatment of human ovarian carcinoma?

    International Nuclear Information System (INIS)

    Ferramosca, Alessandra; Conte, Annalea; Guerra, Flora; Felline, Serena; Rimoli, Maria Grazia; Mollo, Ernesto; Zara, Vincenzo; Terlizzi, Antonio

    2016-01-01

    The red pigment caulerpin, a secondary metabolite from the marine invasive green algae Caulerpa cylindracea can be accumulated and transferred along the trophic chain, with detrimental consequences on biodiversity and ecosystem functioning. Despite increasing research efforts to understand how caulerpin modifies fish physiology, little is known on the effects of algal metabolites on mammalian cells. Here we report for the first time the mitochondrial targeting activity of both caulerpin, and its closely related derivative caulerpinic acid, by using as experimental model rat liver mitochondria, a system in which bioenergetics mechanisms are not altered. Mitochondrial function was tested by polarographic and spectrophotometric methods. Both compounds were found to selectively inhibit respiratory complex II activity, while complexes I, III, and IV remained functional. These results led us to hypothesize that both algal metabolites could be used as antitumor agents in cell lines with defects in mitochondrial complex I. Ovarian cancer cisplatin-resistant cells are a good example of cell lines with a defective complex I function on which these molecules seem to have a toxic effect on proliferation. This provided novel insight toward the potential use of metabolites from invasive Caulerpa species for the treatment of human ovarian carcinoma cisplatin-resistant cells. -- Highlights: •Novel insight toward the potential use of the algal metabolites for the treatment of human diseases. •Caulerpin and caulerpinic acid inhibit respiratory complex II activity. •Both algal metabolites could be used as antitumor agents in ovarian cancer cisplatin-resistant cells.

  9. Global threats from invasive alien species in the twenty-first century and national response capacities

    Science.gov (United States)

    Early, Regan; Bradley, Bethany A.; Dukes, Jeffrey S.; Lawler, Joshua J.; Olden, Julian D.; Blumenthal, Dana M.; Gonzalez, Patrick; Grosholz, Edwin D.; Ibañez, Ines; Miller, Luke P.; Sorte, Cascade J. B.; Tatem, Andrew J.

    2016-01-01

    Invasive alien species (IAS) threaten human livelihoods and biodiversity globally. Increasing globalization facilitates IAS arrival, and environmental changes, including climate change, facilitate IAS establishment. Here we provide the first global, spatial analysis of the terrestrial threat from IAS in light of twenty-first century globalization and environmental change, and evaluate national capacities to prevent and manage species invasions. We find that one-sixth of the global land surface is highly vulnerable to invasion, including substantial areas in developing economies and biodiversity hotspots. The dominant invasion vectors differ between high-income countries (imports, particularly of plants and pets) and low-income countries (air travel). Uniting data on the causes of introduction and establishment can improve early-warning and eradication schemes. Most countries have limited capacity to act against invasions. In particular, we reveal a clear need for proactive invasion strategies in areas with high poverty levels, high biodiversity and low historical levels of invasion. PMID:27549569

  10. Elevated S100A9 expression in tumor stroma functions as an early recurrence marker for early-stage oral cancer patients through increased tumor cell invasion, angiogenesis, macrophage recruitment and interleukin-6 production.

    Science.gov (United States)

    Fang, Wei-Yu; Chen, Yi-Wen; Hsiao, Jenn-Ren; Liu, Chiang-Shin; Kuo, Yi-Zih; Wang, Yi-Ching; Chang, Kung-Chao; Tsai, Sen-Tien; Chang, Mei-Zhu; Lin, Siao-Han; Wu, Li-Wha

    2015-09-29

    S100A9 is a calcium-binding protein with two EF-hands and frequently deregulated in several cancer types, however, with no clear role in oral cancer. In this report, the expression of S100A9 in cancer and adjacent tissues from 79 early-stage oral cancer patients was detected by immunohistochemical staining. Although S100A9 protein was present in both tumor and stromal cells, only the early-stage oral cancer patients with high stromal expression had reduced recurrence-free survival. High stromal S100A9 expression was also significantly associated with non-well differentiation and recurrence. In addition to increasing cell migration and invasion, ectopic S100A9 expression in tumor cells promoted xenograft tumorigenesis as well as the dominant expression of myeloid cell markers and pro-inflammatory IL-6. The expression of S100A9 in one stromal component, monocytes, stimulated the aggressiveness of co-cultured oral cancer cells. We also detected the elevation of serum S100A9 levels in early-stage oral cancer patients of a separate cohort of 73 oral cancer patients. The release of S100A9 protein into extracellular milieu enhanced tumor cell invasion, transendothelial monocyte migration and angiogenic activity. S100A9-mediated release of IL-6 requires the crosstalk of tumor cells with monocytes through the activation of NF-κB and STAT-3. Early-stage oral cancer patients with both high S100A9 expression and high CD68+ immune infiltrates in stroma had shortest recurrence-free survival, suggesting the use of both S100A9 and CD68 as poor prognostic markers for oral cancer. Together, both intracellular and extracellular S100A9 exerts a tumor-promoting action through the activation of oral cancer cells and their associated stroma in oral carcinogenesis.

  11. Association between partial-volume corrected SUVmax and Oncotype DX recurrence score in early-stage, ER-positive/HER2-negative invasive breast cancer.

    Science.gov (United States)

    Lee, Su Hyun; Ha, Seunggyun; An, Hyun Joon; Lee, Jae Sung; Han, Wonshik; Im, Seock-Ah; Ryu, Han Suk; Kim, Won Hwa; Chang, Jung Min; Cho, Nariya; Moon, Woo Kyung; Cheon, Gi Jeong

    2016-08-01

    Oncotype DX, a 21-gene expression assay, provides a recurrence score (RS) which predicts prognosis and the benefit from adjuvant chemotherapy in patients with early-stage, estrogen receptor-positive (ER-positive), and human epidermal growth factor receptor 2-negative (HER2-negative) invasive breast cancer. However, Oncotype DX tests are expensive and not readily available in all institutions. The purpose of this study was to investigate whether metabolic parameters on (18)F-FDG PET/CT are associated with the Oncotype DX RS and whether (18)F-FDG PET/CT can be used to predict the Oncotype DX RS. The study group comprised 38 women with stage I/II, ER-positive/HER2-negative invasive breast cancer who underwent pretreatment (18)F-FDG PET/CT and Oncotype DX testing. On PET/CT, maximum (SUVmax) and average standardized uptake values, metabolic tumor volume, and total lesion glycolysis were measured. Partial volume-corrected SUVmax (PVC-SUVmax) determined using the recovery coefficient method was also evaluated. Oncotype DX RS (0 - 100) was categorized as low (negative breast cancer.

  12. Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

    Directory of Open Access Journals (Sweden)

    Pan Lianjun

    2012-09-01

    Full Text Available Abstract Background Recent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China. Methods Simple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son. Results Data derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1–5 with “1” being “reluctantly agree” and “5” being “very strongly agree”. The major reason for EIMC was for health (44.8%, followed by doctor’s advice (31.2%. The major reason not to agree to EIMC was concern about pain (50.5%, followed by the risk of the procedure (23.5%. Conclusion The willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

  13. Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy

    Directory of Open Access Journals (Sweden)

    Konstantinos Blouhos

    2013-01-01

    Full Text Available When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula.

  14. The impact of lymph vascular space invasion on recurrence and survival in patients with early stage endometrial cancer.

    Science.gov (United States)

    Loizzi, V; Cormio, G; Lorusso, M; Latorre, D; Falagario, M; Demitri, P; Scardigno, D; Selvaggi, L E

    2014-05-01

    The aim of this study was to determine impact of lymph vascular space involvement (LVSI) on recurrence and survival in early stage of endometrial cancer. From 1991 through 2010, all endometrial cancer patients at University Hospital of Bari, Italy were identified. The Log-rank test and Kaplan-Meyer methods were used for time-to-event analysis to evaluate the effects of on lymph vascular space involvement recurrence rate and survival time. Of the 560 endometrial cancer patients, 525 underwent primary surgery. Of those, 399 had early stage disease. Three hundred and forty women were not found to have LVSI, whereas 59 were found to have lymph vascular space involvement. Forty-nine (12%) patients developed a recurrence and 20 of them showed lymph vascular space involvement. The statistical analysis demonstrated that LVSI was strongly associated with a poor survival (P < 0.0001). Lymph vascular space involvement is associated with a high risk of recurrence and poor overall survival in early stage of endometrial cancer; therefore, the clinical decision to decide whether or not a patient with early stage endometrial cancer should receive adjuvant therapy should be included the evaluation of lymph vascular space involvement. © 2013 John Wiley & Sons Ltd.

  15. Laser Raman detection of platelet as a non-invasive approach for early and differential diagnosis of Alzheimer's disease

    International Nuclear Information System (INIS)

    Chen, P; Wang, X H; Cheng, Y; Peng, J; Shen, A G; Hu, J M; Tian, Q; Shang, X L; Liu, Z C; Yao, X Q; Wang, J Z; Baek, S J; Park, A

    2011-01-01

    Early and differential diagnosis of Alzheimer's disease (AD) is a problem that puzzled many doctors. Reliable markers in easy-assembling samples are of considerable clinical diagnostic value. In this work, laser Raman spectroscopy (LRS) was developed a new method that potentially allows early and differential diagnosis of AD from the platelet sample. Raman spectra of platelets isolated from different ages of AD transgenic mice and non-transgenic controls were collected and analyzed. Multilayer perceptron networks (MLP) classification method was used to classify spectra and establish the diagnostic models. For differential diagnosis, spectra of platelets isolated from AD, Parkinson's disease (PD) and vascular dementia (VD) mice were also discriminated. Two notable spectral differences at 740 and 1654 cm -1 were revealed in the mean spectrum of platelets isolated from AD transgenic mice and the controls. MLP displayed a powerful ability in the classifying of early, advanced AD and the control group, and in differential diagnosis of PD and advanced AD, as well as VD and advanced AD. The results suggest that platelet detecting by LRS coupled with MLP analysis appears to be an easy and accurate method for early and differential diagnosis of AD. This technique could be rapidly promoted from laboratory to the hospital

  16. Early Detection of Myocardial Bioenergetic Deficits: A 9.4 Tesla Complete Non Invasive 31P MR Spectroscopy Study in Mice with Muscular Dystrophy.

    Directory of Open Access Journals (Sweden)

    Weina Cui

    Full Text Available Duchenne muscular dystrophy (DMD is the most common fatal form of muscular dystrophy characterized by striated muscle wasting and dysfunction. Patients with DMD have a very high incidence of heart failure, which is increasingly the cause of death in DMD patients. We hypothesize that in the in vivo system, the dystrophic cardiac muscle displays bioenergetic deficits prior to any functional or structural deficits. To address this we developed a complete non invasive 31P magnetic resonance spectroscopy (31P MRS approach to measure myocardial bioenergetics in the heart in vivo.Six control and nine mdx mice at 5 months of age were used for the study. A standard 3D -Image Selected In vivo Spectroscopy (3D-ISIS sequence was used to provide complete gradient controlled three-dimensional localization for heart 31P MRS. These studies demonstrated dystrophic hearts have a significant reduction in PCr/ATP ratio compare to normal (1.59±0.13 vs 2.37±0.25, p<0.05.Our present study provides the direct evidence of significant cardiac bioenergetic deficits in the in vivo dystrophic mouse. These data suggest that energetic defects precede the development of significant hemodynamic or structural changes. The methods provide a clinically relevant approach to use myocardial energetics as an early marker of disease in the dystrophic heart. The new method in detecting the in vivo bioenergetics abnormality as an early non-invasive marker of emerging dystrophic cardiomyopathy is critical in management of patients with DMD, and optimized therapies aimed at slowing or reversing the cardiomyopathy.

  17. Suppression of microRNA-31 increases sensitivity to 5-FU at an early stage, and affects cell migration and invasion in HCT-116 colon cancer cells

    Directory of Open Access Journals (Sweden)

    Sun Xiao-Feng

    2010-11-01

    Full Text Available Abstract Background MicroRNAs (miRNAs are endogenously expressed noncoding RNAs with important biological and pathological functions. Although several studies have shown that microRNA-31 (miR-31 is obviously up-regulated in colorectal cancer (CRC, there is no study on the functional roles of miR-31 in CRC. Methods Anti-miR™ miRNA 31 inhibitor (anti-miR-31 is a sequence-specific and chemically modified oligonucleotide to specifically target and knockdown miR-31 molecule. The effect of anti-miR-31 transfection was investigated by real-time PCR. HCT-116p53+/+ and HCT-116p53-/-colon cancer cells were treated by anti-miR-31 with or without 5-fluorouracil (5-FU, cell proliferation was determined by MTT assay; apoptosis was detected by DAPI staining; cell cycle was evaluated by flow cytometry; colony formation, migration and invasion assays were performed to investigate the effect of suppression of miR-31 on the cell lines. Results Real-time PCR results showed that anti-miR-31 was efficiently introduced into the cells and reduced miR-31 levels to 44.1% in HCT-116p53+/+ and 67.8% in HCT-116p53-/-cell line (p = 0.042 and 0.046. MTT results showed that anti-miR-31 alone had no effect on the proliferation of HCT-116p53+/+ or HCT-116p53-/-. However, when combined with 5-FU, anti-miR-31 inhibited the proliferation of the two cell lines as early as 24 h after exposure to 5-FU (p = 0.038 and 0.044. Suppression of miR-31 caused a reduction of the migratory cells by nearly 50% compared with the negative control in both HCT-116p53+/+ and HCT-116p53-/-(p = 0.040 and 0.001. The invasive ability of the cells were increased by 8-fold in HCT-116p53+/+ and 2-fold in HCT-116p53-/- (p = 0.045 and 0.009. Suppression of miR-31 had no effect on cell cycle and colony formation (p > 0.05. Conclusions Suppression of miR-31 increases sensitivity to 5-FU at an early stage, and affects cell migration and invasion in HCT-116 colon cancer cells.

  18. Surgical data and early postoperative outcomes after minimally invasive lumbar interbody fusion: results of a prospective, multicenter, observational data-monitored study.

    Directory of Open Access Journals (Sweden)

    Paulo Pereira

    Full Text Available Minimally invasive lumbar interbody fusion (MILIF offers potential for reduced operative morbidity and earlier recovery compared with open procedures for patients with degenerative lumbar disorders (DLD. Firm conclusions about advantages of MILIF over open procedures cannot be made because of limited number of large studies of MILIF in a real-world setting. Clinical effectiveness of MILIF in a large, unselected real-world patient population was assessed in this Prospective, monitored, international, multicenter, observational study.To observe and document short-term recovery after minimally invasive interbody fusion for DLD.In a predefined 4-week analysis from this study, experienced surgeons (≥ 30 MILIF surgeries pre-study treated patients with DLD by one- or two-level MILIF. The primary study objective was to document patients' short-term post-interventional recovery (primary objective including back/leg pain (visual analog scale [VAS], disability (Oswestry Disability Index [ODI], health status (EQ-5D and Patient satisfaction.At 4 weeks, 249 of 252 patients were remaining in the study; the majority received one-level MILIF (83% and TLIF was the preferred approach (94.8%. For one-level (and two-level procedures, surgery duration was 128 (182 min, fluoroscopy time 115 (154 sec, and blood-loss 164 (233 mL. Time to first ambulation was 1.3 days and time to study-defined surgery recovery was 3.2 days. Patients reported significantly (P < 0.0001 reduced back pain (VAS: 2.9 vs 6.2, leg pain (VAS: 2.5 vs 5.9, and disability (ODI: 34.5% vs 45.5%, and a significantly (P < 0.0001 improved health status (EQ-5D index: 0.61 vs 0.34; EQ VAS: 65.4 vs 52.9 4 weeks postoperatively. One adverse event was classified as related to the minimally invasive surgical approach. No deep site infections or deaths were reported.For experienced surgeons, MILIF for DLD demonstrated early benefits (short time to first ambulation, early recovery, high patient satisfaction

  19. Early invasion population structure of quagga mussel and associated benthic invertebrate community composition on soft sediment in a large reservoir

    Science.gov (United States)

    Wittmann, Marion E.; Chandra, Sudeep; Caires, Andrea; Denton, Marianne; Rosen, Michael R.; Wong, Wai Hing; Teitjen, Todd; Turner, Kent; Roefer, Peggy; Holdren, G. Chris

    2010-01-01

    In 2007 an invasive dreissenid mussel species, Dreissena bugensis (quagga mussel), was discovered in Lake Mead reservoir (AZ–NV). Within 2 years, adult populations have spread throughout the lake and are not only colonizing hard substrates, but also establishing in soft sediments at depths ranging from 1 to >100 m. Dreissena bugensis size class and population density distribution differs between basins; cluster analysis revealed 5 adult cohorts within Boulder Basin and Overton Arm but low densities and low cohort survival in the Las Vegas Basin. Regression analysis suggests depth and temperature are not primary controllers of D. bugensis density in Lake Mead, indicating other factors such as sediment type, food availability or other resource competition may be important. Monthly veliger tows showed at least 2 major spawning events per year, with continuous presence of veligers in the water column. Adult mussels have been found in spawn or post-spawn condition in soft sediments in shallow to deep waters (>80 m) indicating the potential for reproduction at multiple depths. Comparisons to a 1986 benthic survey suggest there have been shifts in nondreissenid macroinvertebrate composition; however, it is unclear if this is due to D. bugensis presence. Current distribution of nondreissenid macroinvertebrates is heterogeneous in all 3 basins, and their biodiversity decreased when D. bugensis density was 2500/m2 or greater.

  20. Non-invasive detection of the early phase of kidney injury by photoacoustic/computed tomography imaging

    Science.gov (United States)

    Pan, Wanma; Peng, Wen; Ning, Fengling; Zhang, Yu; Zhang, Yunfei; Wang, Yinhang; Xie, Weiyi; Zhang, Jing; Xin, Hong; Li, Cong; Zhang, Xuemei

    2018-06-01

    The early diagnosis of kidney diseases, which can remarkably impair the quality of life and are costly, has encountered great difficulties. Therefore, the development of methods for early diagnosis has great clinical significance. In this study, we used an emerging technique of photoacoustic (PA) imaging, which has relatively high spatial resolution and good imaging depth. Two kinds of PA gold nanoparticle (GNP)-based bioprobes were developed based on their superior photo detectability, size controllability and biocompatibility. The kidney injury mouse model was developed by unilateral ureteral obstruction for 96 h and the release of obstruction model). Giving 3.5 and 5.5 nm bioprobes by tail vein injection, we found that the 5.5 nm probe could be detected in the bladder in the model group, but not in the control group. These results were confirmed by computed tomography imaging. Furthermore, the model group did not show changes in the blood biochemical indices (BUN and Scr) and histologic examination. The 5.5 nm GNPs were found to be the critical point for early diagnosis of kidney injury. This new method was faster and more sensitive and accurate for the detection of renal injury, compared with conventional methods, and can be used for the development of a PA GNP-based bioprobe for diagnosing renal injury.

  1. Early-Life Stressors, Personality Development, and Fast Life Strategies: An Evolutionary Perspective on Malevolent Personality Features

    OpenAIRE

    Árpád Csathó; Béla Birkás

    2018-01-01

    Life history theory posits that behavioral adaptation to various environmental (ecological and/or social) conditions encountered during childhood is regulated by a wide variety of different traits resulting in various behavioral strategies. Unpredictable and harsh conditions tend to produce fast life history strategies, characterized by early maturation, a higher number of sexual partners to whom one is less attached, and less parenting of offspring. Unpredictability and harshness not only af...

  2. A Less Invasive Strategy for Ruptured Cerebral Aneurysms with Intracerebral Hematomas: Endovascular Coil Embolization Followed by Stereotactic Aspiration of Hematomas Using Urokinase

    Science.gov (United States)

    Kim, Sang Heum; Kong, Min Ho

    2017-01-01

    Objective Aneurysm clipping and simultaneous hematoma evacuation through open craniotomy is traditionally recommended for ruptured cerebral aneurysms accompanied by intracerebral or intrasylvian hemorrhages. We report our experience of adapting a less invasive treatment strategy in poor-grade patients with intracerebral or intrasylvian hemorrhages associated with ruptured cerebral aneurysms, where the associated ruptured cerebral aneurysms were managed by endovascular coil embolization, followed by stereotactic aspiration of hematomas (SRH) using urokinase. Materials and Methods We retrospectively analyzed 112 patients with ruptured cerebral aneurysms. There were accompanying intracerebral or intrasylvian hemorrhages in 36 patients (32.1%). The most common site for these ruptured aneurysms was the middle cerebral artery (MCA) (n = 15; 41.6%). Endovascular coil embolization followed by SRH using urokinase was performed in 9 patients (25%). Results In these 9 patients, the most common site of aneurysms was the MCA (n = 3; 33.4%); the hematoma volume ranged from 19.24 to 61.68 mL. Four patients who were World Federation of Neurological Surgeons (WFNS) grade-IV on admission, achieved favorable outcomes (Glasgow Outcome Score [GOS] 4 or 5) at 6-months postoperatively. In the five patients who were WFNS grade-V on admission, one achieved a favorable outcome, whereas 4 achieved GOS scores of 2 or 3, 6-months postoperatively. There was no mortality. Conclusion If immediate hematoma evacuation is not mandated by clinical or radiological signs of brain herniation, a less invasive strategy, such as endovascular coil embolization followed by SRH using urokinase, may be a good alternative in poor-grade patients with intracerebral or intrasylvian hemorrhages associated with ruptured cerebral aneurysms. PMID:29152466

  3. Impact of an early respiratory care programme with non-invasive ventilation adaptation in patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Vitacca, M; Montini, A; Lunetta, C; Banfi, P; Bertella, E; De Mattia, E; Lizio, A; Volpato, E; Lax, A; Morini, R; Paneroni, M

    2018-03-01

    Forced vital capacity (FVC) NIV) in amyotrophic lateral sclerosis (ALS). It was hypothesized that a very early start of NIV could lengthen the free interval before death compared to later-start NIV; as a secondary outcome, the survival rate of patients on NIV without tracheotomy was also evaluated. This retrospective study was conducted on 194 ALS patients, divided into a later group (LG) with FVC NIV prescription (n = 129) and a very early group (VEG) with FVC ≥80% at NIV prescription (n = 65). Clinical and respiratory functional data and time free to death between groups over a 3-year follow-up were compared. At 36 months from diagnosis, mortality was 35% for the VEG versus 52.7% for the LG (P = 0.022). Kaplan-Meier survival curves adjusted for tracheotomy showed a lower probability of death (P = 0.001) for the VEG as a whole (P = 0.001) and for the non-bulbar (NB) subgroup (P = 0.007). Very early NIV was protective of survival for all patients [hazard ratio (HR) 0.45; 95% confidence interval (CI) 0.28-0.74; P = 0.001] and for the NB subgroup (HR 0.43; 95% CI 0.23-0.79; P = 0.007), whilst a tracheotomy was protective for all patients (HR 0.27; 95% CI 0.15-0.50; P = 0.000) and both NB (HR 0.26; 95% CI 0.12-0.56; P = 0.001) and bulbar subgroups (HR 0.29; 95% CI 0.11-0.77; P = 0.013). Survival in VEG patients on NIV without tracheotomy was three times that for the LG (43.1% vs. 14.7%). Very early NIV prescription prolongs the free time from diagnosis to death in NB ALS patients whilst tracheotomy reduces the mortality risk in all patients. © 2017 EAN.

  4. 18F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response

    International Nuclear Information System (INIS)

    Martinez, V.; Grenier, G.; Fior, R.; Boue, F.; Castilla-Lievre, M.A.; Guillet-Caruba, C.; Desarnaud, S.

    2012-01-01

    To evaluate the potential of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for early therapeutic intervention in patients with probable or confirmed tuberculosis (TB). Twenty-one consecutive human immunodeficiency virus negative patients were prospectively included. All patients underwent 18 F-FDG PET/CT before and after 1 month of anti-tuberculosis treatment. The maximum standardised uptake value (SUV max ) of the most 18 F-FDG avid lesions was recorded. The median age of patients was 36 years (range 18-84); 33.3% were male, 80.9% were born in endemic countries, and 23.8% had a past history of TB. TB was confirmed on culture in 8, on histology in 9 and on the basis of clinical symptoms in 4 patients. 18 F-FDG PET/CT detected active pulmonary TB (n = 1), extrapulmonary (n = 10) or both (n = 10). The second 18 F-FDG PET/CT showed reduced radiotracer uptake intensity in 19 of 21 patients, with a median percentage decrease of SUV max of 31% (range 2-84). Two patients showed no improvement. TB was ruled out in one patient during follow-up; the final diagnosis was a non-Hodgkin's lymphoma. The other patient was smear-positive for 3 months. 18 F-FDG PET/CT allows an easy evaluation of early therapeutic response in patients with TB, particularly extra-pulmonary TB. (authors)

  5. [Invasive pulmonary aspergillosis].

    Science.gov (United States)

    Blanchard, E; Gabriel, F; Jeanne-Leroyer, C; Servant, V; Dumas, P-Y

    2018-02-01

    Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in a wide range of patients. Early recognition and diagnosis have become a major focus in improving the management and outcomes of this life-threatening disease. IPA typically occurs during a period of severe and prolonged neutropenia. However, solid organ transplant recipients, patients under immunosuppressive therapy or hospitalized in intensive care units are also at risk. The diagnosis is suspected in the presence of a combination of clinical, biological and CT scan evidence. The microbiological diagnostic strategy should be adapted to the patient's profile. Conventional methods with culture and species identification remain the standard but early diagnosis has been improved by the use of biomarkers such as galactomannan antigen in serum or in bronchoalveolar lavage. The epidemiology of IPA should change with the increased use of antifungal prophylactic regimens and the arrival of targeted therapies. Other microbiological tools, such as PCR and other biomarkers, are currently being assessed. IPA must be considered in a wide range of patients. Its prognosis remains poor despite progress in the microbiological diagnosis and therapeutic management. Copyright © 2018 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  6. Incorporating Early Learning Strategies in the School Improvement Grants (SIG) Program: How Three Schools Integrated Early Childhood Strategies into School Turnaround Efforts to Improve Instruction for All Students

    Science.gov (United States)

    Connors-Tadros, Lori; Dunn, Lenay; Martella, Jana; McCauley, Carlas

    2015-01-01

    A significant body of research shows that achievement gaps evident in persistently low-performing schools, in many instances, manifest prior to children entering kindergarten. High-quality early learning programs have proven to demonstrate positive effects on closing academic gaps both for individual children and in the aggregate for the school.…

  7. Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography.

    Science.gov (United States)

    Kadziela, Jacek; Michalowska, Ilona; Pregowski, Jerzy; Janaszek-Sitkowska, Hanna; Lech, Katarzyna; Kabat, Marek; Staruch, Adam; Januszewicz, Andrzej; Witkowski, Adam

    2016-01-01

    Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA) versus conventional angiography. Forty patients (41 renal arteries), aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D) and lesion length (CTA_LL) were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D) and lesion length (ANGIO_LL) as well as proposed stent dimensions were obtained by visual estimation. The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001). Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001). The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS), with significant correlation of these variables (r = 0.66, p < 0.0001). The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005) and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001). Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure.

  8. The use of questions as problem-solving strategies during early childhood.

    Science.gov (United States)

    Legare, Cristine H; Mills, Candice M; Souza, André L; Plummer, Leigh E; Yasskin, Rebecca

    2013-01-01

    This study examined the strategic use of questions to solve problems across early childhood. Participants (N=54, 4-, 5-, and 6-year-olds) engaged in two tasks: a novel problem-solving question task that required asking questions to an informant to determine which card in an array was located in a box and a cognitive flexibility task that required classifying stimuli by multiple dimensions. The results from the question task indicated that there were age differences in the types of questions asked, with 6-year-olds asking more constraint-seeking questions than 4- and 5-year-olds. The number of constraint-seeking questions asked was the only significant predictor of accuracy. Performance on the cognitive flexibility task correlated with both constraint-seeking strategy use and accuracy in the question task. In sum, our results provide evidence that the capacity to use questions to generate relevant information develops before the capacity to apply this information successfully and consistently to solve complex problems. We propose that the process of using questions as strategic tools is an ideal context for examining how children come to gain active and intentional control over problem solving. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Organ-specific defence strategies of pepper (Capsicum annuum L.) during early phase of water deficit.

    Science.gov (United States)

    Sziderics, Astrid Heide; Oufir, Mouhssin; Trognitz, Friederike; Kopecky, Dieter; Matusíková, Ildikó; Hausman, Jean-Francois; Wilhelm, Eva

    2010-03-01

    Drought is one of the major factors that limits crop production and reduces yield. To understand the early response of plants under nearly natural conditions, pepper plants (Capsicum annuum L.) were grown in a greenhouse and stressed by withholding water for 1 week. Plants adapted to the decreasing water content of the soil by adjustment of their osmotic potential in root tissue. As a consequence of drought, strong accumulation of raffinose, glucose, galactinol and proline was detected in the roots. In contrast, in leaves the levels of fructose, sucrose and also galactinol increased. Due to the water deficit cadaverine, putrescine, spermidine and spermine accumulated in leaves, whereas the concentration of polyamines was reduced in roots. To study the molecular basis of these responses, a combined approach of suppression subtractive hybridisation and microarray technique was performed on the same material. A total of 109 unique ESTs were detected as responsive to drought, while additional 286 ESTs were selected from the bulk of rare transcripts on the array. The metabolic profiles of stressed pepper plants are discussed with respect to the transcriptomic changes detected, while attention is given to the differences between defence strategies of roots and leaves.

  10. Profiling of volatile organic compounds in exhaled breath as a strategy to find early predictive signatures of asthma in children.

    Directory of Open Access Journals (Sweden)

    Agnieszka Smolinska

    Full Text Available Wheezing is one of the most common respiratory symptoms in preschool children under six years old. Currently, no tests are available that predict at early stage who will develop asthma and who will be a transient wheezer. Diagnostic tests of asthma are reliable in adults but the same tests are difficult to use in children, because they are invasive and require active cooperation of the patient. A non-invasive alternative is needed for children. Volatile Organic Compounds (VOCs excreted in breath could yield such non-invasive and patient-friendly diagnostic. The aim of this study was to identify VOCs in the breath of preschool children (inclusion at age 2-4 years that indicate preclinical asthma. For that purpose we analyzed the total array of exhaled VOCs with Gas Chromatography time of flight Mass Spectrometry of 252 children between 2 and 6 years of age. Breath samples were collected at multiple time points of each child. Each breath-o-gram contained between 300 and 500 VOCs; in total 3256 different compounds were identified across all samples. Using two multivariate methods, Random Forests and dissimilarity Partial Least Squares Discriminant Analysis, we were able to select a set of 17 VOCs which discriminated preschool asthmatic children from transient wheezing children. The correct prediction rate was equal to 80% in an independent test set. These VOCs are related to oxidative stress caused by inflammation in the lungs and consequently lipid peroxidation. In conclusion, we showed that VOCs in the exhaled breath predict the subsequent development of asthma which might guide early treatment.

  11. An Overview of Research Strategies and Findings (1971-1975) of the Kamehameha Early Education Program. Technical Report #66.

    Science.gov (United States)

    Gallimore, Ronald; Tharp, Roland G.

    This report reviews the major lines of investigation of the Kamehameha Early Education Program (KEEP) for the period 1971-75. A brief introductory section describes the selection of initial research strategies, identification of problems, issues in research design (such as internal versus external validity) and problems pertaining to the process…

  12. Supporting Early Childhood Educators' Use of Embedded Communication Strategies by Providing Feedback via Bug-in-Ear Technology

    Science.gov (United States)

    Riggie, Jennifer

    2013-01-01

    The purpose of this study was to examine the relationship between coaching provided with bug-in-ear technology, the frequency of the early childhood educators' use of targeted communication strategies and children's expressive communication. Four multiple-baseline single-case design experiments were completed to evaluate these relationships.…

  13. Adherence to a treat-to-target strategy in early rheumatoid arthritis : results of the DREAM remission induction cohort

    NARCIS (Netherlands)

    Vermeer, Marloes; Kuper, Hillechiena H.; Moens, Hein J. Bernelot; Hoekstra, Monique; Posthumus, Marcel D.; van Riel, Piet L. C. M.; van de Laar, Mart A. F. J.

    2012-01-01

    Introduction: Clinical trials have demonstrated that treatment-to-target (T2T) is effective in achieving remission in early rheumatoid arthritis (RA). However, the concept of T2T has not been fully implemented yet and the question is whether a T2T strategy is feasible in daily clinical practice. The

  14. Resisting Pressure from Peers to Engage in Sexual Behavior: What Communication Strategies Do Early Adolescent Latino Girls Use?

    Science.gov (United States)

    Norris, Anne E.; Pettigrew, Jonathan; Miller-Day, Michelle; Hecht, Michael L.; Hutchison, Janet; Campoe, Kristi

    2015-01-01

    A content analysis of early adolescent X-bar = 12.02 years) Latino girls' (n = 44) responses to open-ended questions embedded in an electronic survey was conducted to explore strategies girls may use to resist peer pressure with respect to sexual behavior. Analysis yielded 341 codable response units, 74% of which were consistent with the REAL…

  15. Increasing Early Childhood Educators' Use of Communication-Facilitating and Language-Modelling Strategies: Brief Speech and Language Therapy Training

    Science.gov (United States)

    McDonald, David; Proctor, Penny; Gill, Wendy; Heaven, Sue; Marr, Jane; Young, Jane

    2015-01-01

    Intensive Speech and Language Therapy (SLT) training courses for Early Childhood Educators (ECEs) can have a positive effect on their use of interaction strategies that support children's communication skills. The impact of brief SLT training courses is not yet clearly understood. The aims of these two studies were to assess the impact of a brief…

  16. Discovering and annotating fish early life-stage (FELS) adverse outcome pathways: Putting the research strategy into practice

    Science.gov (United States)

    In May 2012, a HESI-sponsored expert workshop yielded a proposed research strategy for systematically discovering, characterizing, and annotating fish early life-stage (FELS) adverse outcome pathways (AOPs) as well as prioritizing AOP development in light of current restrictions ...

  17. Two-layer optical model of skin for early, non-invasive detection of wound development on the diabetic foot

    Science.gov (United States)

    Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

    2010-02-01

    Foot ulceration is a debilitating comorbidity of diabetes that may result in loss of mobility and amputation. Optical detection of cutaneous tissue changes due to inflammation and necrosis at the preulcer site could constitute a preventative strategy. A commercial hyperspectral oximetry system was used to measure tissue oxygenation on the feet of diabetic patients. A previously developed predictive index was used to differentiate preulcer tissue from surrounding healthy tissue with a sensitivity of 92% and specificity of 80%. To improve prediction accuracy, an optical skin model was developed treating skin as a two-layer medium and explicitly accounting for (i) melanin content and thickness of the epidermis, (ii) blood content and hemoglobin saturation of the dermis, and (iii) tissue scattering in both layers. Using this forward model, an iterative inverse method was used to determine the skin properties from hyperspectral images of preulcerative areas. The use of this information in lowering the false positive rate was discussed.

  18. Early diagnosis of asthma in young children by using non-invasive biomarkers of airway inflammation and early lung function measurements: study protocol of a case-control study

    Science.gov (United States)

    van de Kant, Kim DG; Klaassen, Ester MM; Jöbsis, Quirijn; Nijhuis, Annedien J; van Schayck, Onno CP; Dompeling, Edward

    2009-01-01

    Background Asthma is the most common chronic disease in childhood, characterized by chronic airway inflammation. There are problems with the diagnosis of asthma in young children since the majority of the children with recurrent asthma-like symptoms is symptom free at 6 years, and does not have asthma. With the conventional diagnostic tools it is not possible to differentiate between preschool children with transient symptoms and children with asthma. The analysis of biomarkers of airway inflammation in exhaled breath is a non-invasive and promising technique to diagnose asthma and monitor inflammation in young children. Moreover, relatively new lung function tests (airway resistance using the interrupter technique) have become available for young children. The primary objective of the ADEM study (Asthma DEtection and Monitoring study), is to develop a non-invasive instrument for an early asthma diagnosis in young children, using exhaled inflammatory markers and early lung function measurements. In addition, aetiological factors, including gene polymorphisms and gene expression profiles, in relation to the development of asthma are studied. Methods/design A prospective case-control study is started in 200 children with recurrent respiratory symptoms and 50 control subjects without respiratory symptoms. At 6 years, a definite diagnosis of asthma is made (primary outcome measure) on basis of lung function assessments and current respiratory symptoms ('golden standard'). From inclusion until the definite asthma diagnosis, repeated measurements of lung function tests and inflammatory markers in exhaled breath (condensate), blood and faeces are performed. The study is registered and ethically approved. Discussion This article describes the study protocol of the ADEM study. The new diagnostic techniques applied in this study could make an early diagnosis of asthma possible. An early and reliable asthma diagnosis at 2–3 years will have consequences for the management of

  19. Invasive Candidiasis

    Science.gov (United States)

    ... Waterborne, and Environmental Diseases Mycotic Diseases Branch Invasive Candidiasis Recommend on Facebook Tweet Share Compartir Global Emergence ... antifungal drugs. Learn more about C. auris Invasive candidiasis is an infection caused by a yeast (a ...

  20. Diverse Early Life-History Strategies in Migratory Amazonian Catfish: Implications for Conservation and Management.

    Directory of Open Access Journals (Sweden)

    Jens C Hegg

    Full Text Available Animal migrations provide important ecological functions and can allow for increased biodiversity through habitat and niche diversification. However, aquatic migrations in general, and those of the world's largest fish in particular, are imperiled worldwide and are often poorly understood. Several species of large Amazonian catfish carry out some of the longest freshwater fish migrations in the world, travelling from the Amazon River estuary to the Andes foothills. These species are important apex predators in the main stem rivers of the Amazon Basin and make up the region's largest fishery. They are also the only species to utilize the entire Amazon Basin to complete their life cycle. Studies indicate both that the fisheries may be declining due to overfishing, and that the proposed and completed dams in their upstream range threaten spawning migrations. Despite this, surprisingly little is known about the details of these species' migrations, or their life history. Otolith microchemistry has been an effective method for quantifying and reconstructing fish migrations worldwide across multiple spatial scales and may provide a powerful tool to understand the movements of Amazonian migratory catfish. Our objective was to describe the migratory behaviors of the three most populous and commercially important migratory catfish species, Dourada (Brachyplatystoma rousseauxii, Piramutaba (Brachyplatystoma vaillantii, and Piraíba (Brachyplatystoma filamentosum. We collected fish from the mouth of the Amazon River and the Central Amazon and used strontium isotope signatures ((87Sr/(86Sr recorded in their otoliths to determine the location of early rearing and subsequent. Fish location was determined through discriminant function classification, using water chemistry data from the literature as a training set. Where water chemistry data was unavailable, we successfully in predicted (87Sr/(86Sr isotope values using a regression-based approach that related

  1. Diverse Early Life-History Strategies in Migratory Amazonian Catfish: Implications for Conservation and Management.

    Science.gov (United States)

    Hegg, Jens C; Giarrizzo, Tommaso; Kennedy, Brian P

    2015-01-01

    Animal migrations provide important ecological functions and can allow for increased biodiversity through habitat and niche diversification. However, aquatic migrations in general, and those of the world's largest fish in particular, are imperiled worldwide and are often poorly understood. Several species of large Amazonian catfish carry out some of the longest freshwater fish migrations in the world, travelling from the Amazon River estuary to the Andes foothills. These species are important apex predators in the main stem rivers of the Amazon Basin and make up the region's largest fishery. They are also the only species to utilize the entire Amazon Basin to complete their life cycle. Studies indicate both that the fisheries may be declining due to overfishing, and that the proposed and completed dams in their upstream range threaten spawning migrations. Despite this, surprisingly little is known about the details of these species' migrations, or their life history. Otolith microchemistry has been an effective method for quantifying and reconstructing fish migrations worldwide across multiple spatial scales and may provide a powerful tool to understand the movements of Amazonian migratory catfish. Our objective was to describe the migratory behaviors of the three most populous and commercially important migratory catfish species, Dourada (Brachyplatystoma rousseauxii), Piramutaba (Brachyplatystoma vaillantii), and Piraíba (Brachyplatystoma filamentosum). We collected fish from the mouth of the Amazon River and the Central Amazon and used strontium isotope signatures ((87)Sr/(86)Sr) recorded in their otoliths to determine the location of early rearing and subsequent. Fish location was determined through discriminant function classification, using water chemistry data from the literature as a training set. Where water chemistry data was unavailable, we successfully in predicted (87)Sr/(86)Sr isotope values using a regression-based approach that related the geology

  2. Timing of Angiography With a Routine Invasive Strategy and Long-Term Outcomes in Non-ST-Segment Elevation Acute Coronary Syndrome A Collaborative Analysis of Individual Patient Data From the FRISC II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) Trials

    NARCIS (Netherlands)

    Damman, Peter; van Geloven, Nan; Wallentin, Lars; Lagerqvist, Bo; Fox, Keith A. A.; Clayton, Tim; Pocock, Stuart J.; Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G. P.; de Winter, Robbert J.

    2012-01-01

    Objectives This study sought to investigate long-term outcomes after early or delayed angiography in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS) undergoing a routine invasive management. Background The optimal timing of angiography in patients with nSTE-ACS is currently

  3. Assessment of early-stage optic nerve invasion in retinoblastoma using high-resolution 1.5 Tesla MRI with surface coils: a multicentre, prospective accuracy study with histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, Herve J. [Institut Curie, Department of Radiology, Paris (France); Institut CURIE, Imaging Department, Paris (France); Graaf, Pim de; Rodjan, Firazia; Jong, Marcus C. de; Castelijns, Jonas A. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Galluzzi, Paolo [Neuroimaging and Neurointerventional Unit (NINT) Azienda Ospedaliera e Universitaria Senese, Siena (Italy); Cosker, Kristel; Savignoni, Alexia [Institut Curie, Department of Biostatistics, Paris (France); Maeder, Philippe [Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Department of Radiology, Lausanne (Switzerland); Goericke, Sophia [University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Aerts, Isabelle [Institut Curie, Department of Pediatric Oncology, Paris (France); Desjardins, Laurence [Institut Curie, Department of Ophthalmology, Paris (France); Moll, Annette C. [VU University Medical Center, Department of Ophthalmology, Amsterdam (Netherlands); Hadjistilianou, Theodora [Azienda Ospedaliera Universitaria Senese, Department of Ophthalmology, Siena (Italy); Toti, Paolo [University of Siena, Department of Medical Biotechnologies, Pathology Unit, Siena (Italy); Valk, Paul van der [VU University Medical Center, Department of Pathology, Amsterdam (Netherlands); Sastre-Garau, Xavier [Institut Curie, Department of Biopathology, Paris (France); Collaboration: European Retinoblastoma Imaging Collaboration (ERIC)

    2015-05-01

    To assess the accuracy of high-resolution (HR) magnetic resonance imaging (MRI) in diagnosing early-stage optic nerve (ON) invasion in a retinoblastoma cohort. This IRB-approved, prospective multicenter study included 95 patients (55 boys, 40 girls; mean age, 29 months). 1.5-T MRI was performed using surface coils before enucleation, including spin-echo unenhanced and contrast-enhanced (CE) T1-weighted sequences (slice thickness, 2 mm; pixel size <0.3 x 0.3 mm{sup 2}). Images were read by five neuroradiologists blinded to histopathologic findings. ROC curves were constructed with AUC assessment using a bootstrap method. Histopathology identified 41 eyes without ON invasion and 25 with prelaminar, 18 with intralaminar and 12 with postlaminar invasion. All but one were postoperatively classified as stage I by the International Retinoblastoma Staging System. The accuracy of CE-T1 sequences in identifying ON invasion was limited (AUC = 0.64; 95 % CI, 0.55 - 0.72) and not confirmed for postlaminar invasion diagnosis (AUC = 0.64; 95 % CI, 0.47 - 0.82); high specificities (range, 0.64 - 1) and negative predictive values (range, 0.81 - 0.97) were confirmed. HR-MRI with surface coils is recommended to appropriately select retinoblastoma patients eligible for primary enucleation without the risk of IRSS stage II but cannot substitute for pathology in differentiating the first degrees of ON invasion. (orig.)

  4. Comparative RNA-seq analysis of early-infected peach leaves by the invasive phytopathogen Xanthomonas arboricola pv. pruni.

    Directory of Open Access Journals (Sweden)

    Didier Socquet-Juglard

    Full Text Available Xanthomonas arboricola pv. pruni is a quarantine bacterial pathogen that threatens peach production by causing necrotic spots on leaves and fruits, thus with the potential of severely reducing yields. The current understanding of the host plant defense responses to the pathogen is very limited. Using whole transcriptome sequencing, differential gene expression was analyzed at two time points, 2 h and 12 h post inoculation (hpi, by comparing the inoculated samples to their respective controls. On the total of 19,781 known peach genes that were expressed in all time points and conditions, 34 and 263 were differentially expressed at 2 and 12 hpi, respectively. Of those, 82% and 40% were up-regulated, respectively; and 18% and 60% were down-regulated, respectively. The functional annotation based on gene ontology (GO analysis highlighted that genes involved in metabolic process and response to stress were particularly represented at 2 hpi whereas at 12 hpi cellular and metabolic processes were the categories with the highest number of genes differentially expressed. Of particular interest among the differentially expressed genes identified were several pathogen-associated molecular pattern (PAMP receptors, disease resistance genes including several RPM1-like and pathogenesis related thaumatin encoding genes. Other genes involved in photosynthesis, in cell wall reorganization, in hormone signaling pathways or encoding cytochrome were also differentially expressed. In addition, novel transcripts were identified, providing another basis for further characterization of plant defense-related genes. Overall, this study gives a first insight of the peach defense mechanisms during the very early stages of infection with a bacterial disease in the case of a compatible interaction.

  5. Effect of Interval to Definitive Breast Surgery on Clinical Presentation and Survival in Early-Stage Invasive Breast Cancer

    International Nuclear Information System (INIS)

    Vujovic, Olga; Yu, Edward; Cherian, Anil; Perera, Francisco; Dar, A. Rashid; Stitt, Larry; Hammond, A.

    2009-01-01

    Purpose: To examine the effect of clinical presentation and interval to breast surgery on local recurrence and survival in early-stage breast cancer. Methods and Materials: The data from 397 patients with Stage T1-T2N0 breast carcinoma treated with conservative surgery and breast radiotherapy between 1985 and 1992 were reviewed at the London Regional Cancer Program. The clinical presentation consisted of a mammogram finding or a palpable lump. The intervals from clinical presentation to definitive breast surgery used for analysis were 0-4, >4-12, and >12 weeks. The Kaplan-Meier estimates of the time to local recurrence, disease-free survival, and cause-specific survival were determined for the three groups. Cox regression analysis was used to evaluate the effect of clinical presentation and interval to definitive surgery on survival. Results: The median follow-up was 11.2 years. No statistically significant difference was found in local recurrence as a function of the interval to definitive surgery (p = .424). A significant difference was noted in disease-free survival (p = .040) and cause-specific survival (p = .006) with an interval of >12 weeks to definitive breast surgery. However, the interval to definitive surgery was dependent on the presentation for cause-specific survival, with a substantial effect for patients with a mammographic presentation and a negligible effect for patients with a lump presentation (interaction p = .041). Conclusion: The results of this study suggest that an interval of >12 weeks to breast surgery might be associated with decreased survival for patients with a mammographic presentation, but it appeared to have no effect on survival for patients presenting with a palpable breast lump.

  6. Management strategies, early results, benefits, and risk factors of laparoscopic repair of perforated peptic ulcer.

    Science.gov (United States)

    Lunevicius, Raimundas; Morkevicius, Matas

    2005-10-01

    The primary goal of this study was to describe epidemiology and management strategies of the perforated duodenal ulcer, as well as the most common methods of laparoscopic perforated duodenal ulcer repair. The secondary goal was to demonstrate the value of prospective and retrospective studies regarding the early results of surgery and the risk factors. The tertiary goal was to emphasize the benefits of this operation, and the fourth goal was to clarify the possible risk factors associated with laparoscopic repair of the duodenal ulcer. The Medline/Pubmed database was used. Review was done after evaluation of 96 retrieved full-text articles. Thirteen prospective and twelve retrospective studies were selected, grouped, and summarized. The spectrum of the retrospective studies' results are as follows: median overall morbidity rate 10.5 %, median conversion rate 7%, median hospital stay 7 days, and median postoperative mortality rate 0%. The following is the spectrum of results of the prospective studies: median overall morbidity rate was slightly less (6%); the median conversion rate was higher (15%); the median hospital stay was shorter (5 days) and the postoperative mortality was higher (3%). The risk factors identified were the same. Shock, delayed presentation (> 24 hours), confounding medical condition, age > 70 years, poor laparoscopic expertise, ASA III-IV, and Boey score should be considered preoperative laparoscopic repair risk factors. Each of these factors independently should qualify as a criterion for open repair due to higher intraoperative risks as well as postoperative morbidity. Inadequate ulcer localization, large perforation size (defined by some as > 6 mm diameter, and by others as > 10 mm), and ulcers with friable edges are also considered as conversion risk factors.

  7. Towards the Adriatic meteotsunami early warning system: modelling strategy and validation

    Science.gov (United States)

    Denamiel, Clea; Šepić, Jadranka; Vilibić, Ivica

    2017-04-01

    Destructive meteotsunamis are known to occur along the eastern Adriatic coastal areas and islands (Vilibić and Šepić, 2009). The temporal lag between the offshore generation of meteotsunamis due to specific atmospheric conditions and the arrival of a dangerous nearshore propagating wave at known locations is of the order of tens of minutes to a couple of hours. In order to reduce the coastal risk for the coastal communities, an early warning system must rely on the ability to detect these extreme storms offshore with in-situ measurements and to predict the hydrodynamic response nearshore via numerical models within this short time lag. However, the numerical modelling of meteotsunamis requires both temporal and spatial high-resolution atmospheric and ocean models which are highly demanding concerning time and computer resources. Furthermore, both a multi-model approach and an ensemble modelling strategy should be used to better forecast the distribution of the nearshore impact of meteotsunamis. The modelling strategy used in this study thus rely on the development of an operational atmosphere-ocean model of the Adriatic Sea at 1km spatial resolution based on the state-of-the-art fully coupled COAWST model (Warner et al., 2010). The model allows for generation of meteotsunamis offshore, while various high-resolution (up to 5m) nearshore hydrodynamic models (such as ADCIRC - Luettich and Westerink, 1991; SELFE - Zhang et al., 2008 and GeoClaw - LeVeque, 2012) are setup to properly reproduce meteotsunami dynamics of the entire Croatian coastal areas, which are characterized by a great number of islands, channels and bays. The implementation and validation of each component of this modelling system is first undertaken for the well documented meteotsunami event (Šepić et al., 2016), which was recorded along the Croatian Adriatic coast on the 25th and the 26th of June 2014. The validation of the modelling strategy as well as the model results is presented and

  8. The Role Of Multidetector Computed Tomography In The Early Diagnosis Of Invasive Pulmonary Aspergıllosis In Patients With Febrile Neutropenia Undergoing Hematopoietic Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Nazan Çiledağ

    2012-03-01

    Full Text Available OBJECTIVE: To evaluate the vessel involvement and the role of multidedector computed tomograpy (MDCT in the early diagnosis of invasive pulmonary aspergillosis (IPA at MDCT in autologous bone morrow transplantation patients with febrile neutropenia and antibiotic-resistant fever of unknown origin with clinically suspected IPA. METHODS: 74 pulmonary MDCT examinations of 37 consecutive hematopoietic stem cell transplantation patients with febrile neutropenia with clinically suspected IPA were retrospectively evaluated. RESULTS: The diagnosis of IPA was made according to according to the Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Consensus Group criteria and 0, 14, 11 patients were diagnosed as proven, probable, possible IPA, respectively. Among 25 cases accepted as probable and possible IPA, all patients had pulmonary MDCT findings consistent with IPA. Remaining 12 patients were accepted as having fever of unknown origin (FUO and in these 12, MDCT showed patent vessel. In patients with probable/possible IPA, 72 focal pulmonary lesions were detected. In 41 of 72 (57%, vascular occlusion was detected. The CT halo sign was present in 25 of 41 (61% lesions. A clinical improvement, resolution of fever was observed following antifungal therapy in 19 (76% of 25 patients with probable/possible IPA. Six (25% patients diagnosed as IPA died during follow-up. Transplant related mortality at day 100 in patients with IPA and FUO were found to be 24% and 0%, respectively. CONCLUSION: In conclusion, MDCT has a potential role in early diagnosis of IPA by detection of vessel occlusion.

  9. Prognostic impact of proliferation for resected early stage 'pure' invasive lobular breast cancer: Cut-off analysis of Ki67 according to histology and clinical validation.

    Science.gov (United States)

    Carbognin, Luisa; Sperduti, Isabella; Fabi, Alessandra; Dieci, Maria Vittoria; Kadrija, Dzenete; Griguolo, Gaia; Pilotto, Sara; Guarneri, Valentina; Zampiva, Ilaria; Brunelli, Matteo; Orvieto, Enrico; Nortilli, Rolando; Fiorio, Elena; Parolin, Veronica; Manfrin, Erminia; Caliò, Anna; Nisticò, Cecilia; Pellini, Francesca; Scarpa, Aldo; Pollini, Giovanni Paolo; Conte, Pierfranco; Tortora, Giampaolo; Bria, Emilio

    2017-10-01

    The intent of this analysis was to investigate and validate the prognostic potential of Ki67 in a multi-center series of patients affected by early stage 'pure' invasive lobular carcinoma (ILC). Clinical-pathological data of patients affected by ILC were correlated with overall survival and disease-free survival (OS/DFS); data from a parallel invasive ductal carcinoma (IDC) patients' cohort were gathered as well. The maximally selected Log-Rank statistics analysis was applied to Ki67 continuous variable to estimate the appropriate cut-off. The Subpopulation Treatment Effect Pattern Plot (STEPP) analysis was performed as well. Data from overall 1097 (457/222 ILC: training/validation set; 418 IDC) patients were gathered. The identified optimal Ki67 cut-offs were 4% and 14% for DFS in ILC and IDC cohort, respectively. In ILC patients, the Ki67 cut-off was an independent OS predictor. Ten-years OS and DFS were 89.9% and 77.2% (p = 0.007) and 79.4% and 69.2% (p = 0.03) for patients with Ki67 ≤ 4% and >4%, respectively. In IDC patients, 10-years OS was 93.8% and 71.7%, p = 0.02, DFS was 84.0% and 52.6%, p = 0.0003, for patients with Ki67 ≤ 14% and >14%, respectively. In the validation set, the optimal Ki67 OS cut-off was 5%. The STEPP analysis showed that in the presence of low Ki67 values, IDC patients have a better DFS than ILC patients, while with the increase of values the prognosis tends to overlap. Despite the retrospective design of the study, the prognostic relevance of Ki67 (as well as its optimal cut-off) seems to significantly differ according to breast cancer histology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. "APOPTOSIS COLOR." SCREENING STRATEGY FOR DIAGNOSIS EARLY STAGES OF PRIMARY OPEN-ANGLE GLAUCOMA

    Directory of Open Access Journals (Sweden)

    M. A. Kovalevskaya

    2017-01-01

    Full Text Available Purpose: to develop a screening strategy for the early diagnosis of primary open-angle glaucoma.Patients and Methods: 1 group — 250 patients with suspected glaucoma (42–75 years, 2 — 250 with the 1st stage primary open-angle glaucoma (42–61, 3 — 3,000 healthy persons (35 to 50. Surveys: visometry, tonometry iCare, biomicroscopy, gonioscopy, pachymeria, ophthalmoscopy with a high dioptric lens of 60 D, standard automated perimetry of the SITA-Standard and SITA-SWAP program, assessing the color sensitivity according to the Famsworth-Munsell 100 HueTes method.Results: 1 group — SITA-SWAP: MD -2,55±0,7 dB, PSD 2,46±1,15 dB. Mansell test: TES = 58.6±18.7 (p<0.05, average level of color recognition; mild deficiency of color vision — 41–100 TES; by the RGB system: colors of the first order; tone in RGB (0–239: blue — 160; HCV: blue — 240; range of wavelengths: blue — 440–485 nm; frequency: blue — 620–680 THz. 2 group — on SITA-SWAP: MD — 5,13±1,3 dB, PSD 2,58±0,9 dB. Mansell test: TES = 86,9±21,8; average level of color recognition; mild deficiency of color vision; single deviations in the system of blue (azure, blue, blue; color I order (blue, III order (blue, azure; tone in RGB — (0–239: blue (azure, blue — 140, blue — 160; HCV — blue (azure, blue — 210, blue — 240; range of wavelengths: 450–500 nm (blue — 485–500, blue — 440–485; frequencies: 600–680 THz (blue — 600–620, blue — 620–680. Control group — SITA-SWAP within the norm, Mansell test: TES = 40,1±17,3 (p<0.05, medium level of color recognition, lack of color vision absent / mild, single deviations.Conclusion: in patients with glaucoma suspicion, the score of errors was higher than in the control group with Munsell test. In patients with glaucoma, the number of errors is greater than in patients with suspected glaucoma, and 2.2 times higher than in the control group.

  11. Evaluation of a pilot police-led suicide early alert surveillance strategy in the UK.

    Science.gov (United States)

    McGeechan, Grant James; Richardson, Catherine; Weir, Kevin; Wilson, Lynn; O'Neill, Gillian; Newbury-Birch, Dorothy

    2017-07-19

    Those bereaved by suicide are at increased risk of psychological harm, which can be reduced with the provision of timely support. This paper outlines an evaluation of a pilot police-led suicide strategy, in comparison to a coroner-led suicide strategy looking at the number, and length of time it takes for deaths to be recorded for each strategy. Additionally, the police-led strategy offers timely contact from support services for bereaved individuals. We examined what impact this offer of support had on the capacity of support services. A mixed methods evaluation compared how long it took for suspected suicides to be recorded using both strategies. The number of referrals received by support services during the pilot strategy were compared with those from previous years. A feedback focus group, and interviews, were held with key stakeholders. The coroner strategy was more consistent at identifying suspected suicides; however, reports were filed quicker by the police. Bereaved individuals were willing to share contact details with police officers and consent for referral to support services which lead to increased referrals. The focus group and interviews revealed that the pilot police strategy needs better integration into routine police practice. This strategy has the potential to deliver a real benefit to those bereaved by suicide; however, there are still aspects which could be improved. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Primary School Students' Strategies in Early Algebra Problem Solving Supported by an Online Game

    Science.gov (United States)

    van den Heuvel-Panhuizen, Marja; Kolovou, Angeliki; Robitzsch, Alexander

    2013-01-01

    In this study we investigated the role of a dynamic online game on students' early algebra problem solving. In total 253 students from grades 4, 5, and 6 (10-12 years old) used the game at home to solve a sequence of early algebra problems consisting of contextual problems addressing covarying quantities. Special software monitored the…

  13. Primary school students’ strategies in early algebra problem solving supported by an online game

    NARCIS (Netherlands)

    van den Heuvel-Panhuizen, M.H.A.M; Kolovou, A.; Robitzsch, A.

    2013-01-01

    In this study we investigated the role of a dynamic online game on students’ early algebra problem solving. In total 253 students from grades 4, 5, and 6 (10–12 years old) used the game at home to solve a sequence of early algebra problems consisting of contextual problems addressing covarying

  14. Analyzing the social factors that influence willingness to pay for invasive alien species management under two different strategies: eradication and prevention.

    Science.gov (United States)

    García-Llorente, Marina; Martín-López, Berta; Nunes, Paulo A L D; González, José A; Alcorlo, Paloma; Montes, Carlos

    2011-09-01

    Biological invasions occur worldwide, and have been the object of ecological and socio-economic research for decades. However, the manner in which different stakeholder groups identify the problems associated with invasive species and confront invasive species management under different policies remains poorly understood. In this study, we conducted an econometric analysis of the social factors influencing willingness to pay for invasive alien species management under two different regimes: eradication and prevention in the Doñana Natural Protected Area (SW Spain). Controlling for the participation of local residents, tourists and conservationists, email and face-to-face questionnaires were conducted. Results indicated that respondents were more willing to pay for eradication than prevention; and public support for invasive alien species management was influenced by an individual's knowledge and perception of invasive alien species, active interest in nature, and socio-demographic attributes. We concluded that invasive alien species management research should confront the challenges to engage stakeholders and accept any tradeoffs necessary to modify different conservation policies to ensure effective management is implemented. Finally, our willingness to pay estimates suggest the Department of Environment of Andalusian Government has suitable social support to meet the budgetary expenditures required for invasive alien species plans and adequate resources to justify an increase in the invasive alien species management budget.

  15. Terrestrial animals as invasive species and as species at risk from invasions

    Science.gov (United States)

    Deborah M. Finch; Dean Pearson; Joseph Wunderle; Wayne Arendt

    2010-01-01

    Including terrestrial animal species in the invasive species strategy plan is an important step in invasive species management. Invasions by nonindigenous species threaten nearly 50 percent of imperiled native species in the United States and are the Nation's second leading cause of species endangerment. Invasion and conversion of native habitats by exotic species...

  16. Sentinel lymph node dissection only versus complete axillary lymph node dissection in early invasive breast cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Glechner, Anna; Wöckel, Achim; Gartlehner, Gerald; Thaler, Kylie; Strobelberger, Michaela; Griebler, Ursula; Kreienberg, Rolf

    2013-03-01

    The Z0011-study, a landmark randomised controlled trial (RCT) challenged the benefits of complete axillary lymph node dissection (ALND) compared with sentinel lymph node dissection only (SLND) in breast cancer patients with positive sentinel nodes. The study, however, has been criticised for lack of power and low applicability. The aim of this review was to systematically assess the evidence on the comparative benefits and harms of ALND versus SLND for sentinel node positive breast cancer patients. We systematically searched PubMed, Embase, the Cochrane Library, and reference lists of pertinent review articles from January 2006 to August 2011. We dually reviewed the literature and rated the risk of bias of each study. For effectiveness, we included RCTs and observational studies of at least 1 year follow-up. In addition, we considered studies conducted in sentinel node-negative women to assess the risk of harms. If data were sufficient, we conducted random effects meta-analysis of outcomes of interest. Meta-analysis of three studies with 50,120 patients indicated similar 5-year survival and regional recurrence rates between patients treated with ALND or SLND, although prognostic tumour characteristics varied among the 3 study-populations. Results from 6 studies on more than 11,500 patients reported a higher risk for harms for ALND than SLND. Long-term evidence on pertinent health outcomes is missing. The available evidence indicates that for some women with early invasive breast cancer SLND appears to be a justifiable alternative to ALND. Surgeons need to discuss advantages and disadvantages of both approaches with their patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Potential therapeutic strategies for non - muscle invasive bladder cancer based on association of intravesical immunotherapy with p - mapa and systemic administration of cisplatin and doxorubicin.

    Science.gov (United States)

    Dias, Queila Cristina; Nunes, Iseu da Silva; Garcia, Patrick Vianna; Favaro, Wagner Jose

    2016-01-01

    The present study describes the histopathological and molecular effects of P-MAPA (Protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride) intravesical immunotherapy combined with systemic doxorubicin or cisplatin for treatment of non-muscle invasive bladder cancer (NMIBC) in an appropriate animal model. Our results showed an undifferentiated tumor, characterizing a tumor invading mucosa or submucosa of the bladder wall (pT1) and papillary carcinoma in situ (pTa) in the Cancer group. The histopathological changes were similar between the combined treatment with intravesical P-MAPA plus systemic Cisplatin and P-MAPA immunotherapy alone, showing decrease of urothelial neoplastic lesions progression and histopathological recovery in 80% of the animals. The animals treated systemically with cisplatin or doxorubicin singly, showed 100% of malignant lesions in the urinary bladder. Furthemore, the combined treatment with P-MAPA and Doxorubicin showed no decrease of urothelial neoplastic lesions progression and histopathological recovery. Furthermore, Akt, PI3K, NF-kB and VEGF protein levels were significantly lower in intravesical P-MAPA plus systemic cisplatin and in intravesical P-MAPA alone treatments than other groups. In contrast, PTEN protein levels were significantly higher in intravesical P-MAPA plus systemic cisplatin and in intravesical P-MAPA alone treatments. Thus, it could be concluded that combination of intravesical P-MAPA immunotherapy and systemic cisplatin in the NMIBC animal model was effective, well tolerated and showed no apparent signs of antagonism between the drugs. In addition, intravesical P-MAPA immunotherapy may be considered as a valuable option for treatment of BCG unresponsive patients that unmet the criteria for early cystectomy. Copyright® by the International Brazilian Journal of Urology.

  18. Creating a Community Classroom: Strategies to Promote Inclusion and Reduce Bullying in Early Childhood

    Directory of Open Access Journals (Sweden)

    Julie C. Parker

    2014-10-01

    Full Text Available Research suggests that young children with disabilities often fall victim to bullying because of a lack of social competence and social skills necessary for consistent engagement with peers. This article focuses on a comprehensive approach to classroom management and offers important strategies for a multi-level positive behavioral support plan. The positive behavioral support plan is embedded in the daily curriculum and includes strategies that enhance cooperative learning and socialization experiences, increases academic readiness, and supports academic success.

  19. Economics of Harmful Invasive Species: A Review

    Directory of Open Access Journals (Sweden)

    George Marbuah

    2014-07-01

    Full Text Available The purpose of this study is to review theoretical and empirical findings in economics with respect to the challenging question of how to manage invasive species. The review revealed a relatively large body of literature on the assessment of damage costs of invasive species; single species and groups of species at different geographical scales. However, the estimated damage costs show large variation, from less than 1 million USD to costs corresponding to 12% of gross domestic product, depending on the methods employed, geographical scale, and scope with respect to inclusion of different species. Decisions regarding optimal management strategies, when to act in the invasion chain and which policy to choose, have received much less attention in earlier years, but have been subject to increasing research during the last decade. More difficult, but also more relevant policy issues have been raised, which concern the targeting in time and space of strategies under conditions of uncertainty. In particular, the weighting of costs and benefits from early detection and mitigation against the uncertain avoidance of damage with later control, when the precision in targeting species is typically greater is identified as a key challenge. The role of improved monitoring for detecting species and their spread and damage has been emphasized, but questions remain on how to achieve this in practice. This is in contrast to the relatively large body of literature on policies for mitigating dispersal by trade, which is regarded as one of the most important vectors for the spread of invasive species. On the other hand, the literature on how to mitigate established species, by control or adaptation, is much more scant. Studies evaluating causes for success or failure of policies against invasive in practice are in principal non-existing.

  20. Early-Life Stressors, Personality Development, and Fast Life Strategies: An Evolutionary Perspective on Malevolent Personality Features

    Directory of Open Access Journals (Sweden)

    Árpád Csathó

    2018-03-01

    Full Text Available Life history theory posits that behavioral adaptation to various environmental (ecological and/or social conditions encountered during childhood is regulated by a wide variety of different traits resulting in various behavioral strategies. Unpredictable and harsh conditions tend to produce fast life history strategies, characterized by early maturation, a higher number of sexual partners to whom one is less attached, and less parenting of offspring. Unpredictability and harshness not only affects dispositional social and emotional functioning, but may also promote the development of personality traits linked to higher rates of instability in social relationships or more self-interested behavior. Similarly, detrimental childhood experiences, such as poor parental care or high parent-child conflict, affect personality development and may create a more distrustful, malicious interpersonal style. The aim of this brief review is to survey and summarize findings on the impact of negative early-life experiences on the development of personality and fast life history strategies. By demonstrating that there are parallels in adaptations to adversity in these two domains, we hope to lend weight to current and future attempts to provide a comprehensive insight of personality traits and functions at the ultimate and proximate levels.

  1. Early-Life Stressors, Personality Development, and Fast Life Strategies: An Evolutionary Perspective on Malevolent Personality Features.

    Science.gov (United States)

    Csathó, Árpád; Birkás, Béla

    2018-01-01

    Life history theory posits that behavioral adaptation to various environmental (ecological and/or social) conditions encountered during childhood is regulated by a wide variety of different traits resulting in various behavioral strategies. Unpredictable and harsh conditions tend to produce fast life history strategies, characterized by early maturation, a higher number of sexual partners to whom one is less attached, and less parenting of offspring. Unpredictability and harshness not only affects dispositional social and emotional functioning, but may also promote the development of personality traits linked to higher rates of instability in social relationships or more self-interested behavior. Similarly, detrimental childhood experiences, such as poor parental care or high parent-child conflict, affect personality development and may create a more distrustful, malicious interpersonal style. The aim of this brief review is to survey and summarize findings on the impact of negative early-life experiences on the development of personality and fast life history strategies. By demonstrating that there are parallels in adaptations to adversity in these two domains, we hope to lend weight to current and future attempts to provide a comprehensive insight of personality traits and functions at the ultimate and proximate levels.

  2. Evaluation of continuing education of family health strategy teams for the early identification of suspected cases of cancer in children.

    Science.gov (United States)

    Costa, Ana Maria Aranha Magalhaes; Magluta, Cynthia; Gomes Junior, Saint Clair

    2017-09-07

    This study evaluated the influence of continuing education of family health strategy teams by the Ronald McDonald Institute program on the early diagnosis of cancer in children and adolescents. The study applied Habicht's model to evaluate the adequacy and plausibility of continuing education by using as outcome the number of children with suspected cancer who were referred to the hospital of references in the 1 year before and 1 year after intervention and the number of patients referred by intervention group and control group family health strategy teams. Medical records from each hospital of reference were used to collect information of suspect cases of cancer. Descriptive analyses were performed using frequencies and mean values. Chi-square tests were used to assess statistically significant differences between the groups and periods by using p-values family health strategy teams that underwent the intervention referred 3.6 times more number of children to hospital of references than did the control group. Only the intervention group showed an increase in the number of confirmed cases. This evaluation of a continuing education program for early identification of pediatric cancer showed that the program was adequate in achieving the established goals and that the results could be attributed to the program.

  3. The presence of proliferative breast disease with atypia does not significantly influence outcome in early-stage invasive breast cancer treated with conservative surgery and radiation

    International Nuclear Information System (INIS)

    Fowble, B.; Hanlon, A.L.; Patchefsky, A.; Freedman, G.; Hoffman, J.P.; Sigurdson, E.R.; Goldstein, L.J.

    1998-01-01

    Purpose: To evaluate the influence of the benign background breast-tissue change of atypical hyperplasia (AH) on outcome in patients with early-stage invasive breast cancer treated with conservative surgery and radiation. Materials and Methods: Four hundred and sixty women with Stage I--II breast cancer treated with conservative surgery and radiation from 1982-1994 had pathologic assessment of their background adjacent benign breast tissue. The median follow-up was 5.6 years (range 0.1-15). The median age was 55 years (range 24-88). Of these, 23% had positive axillary nodes; 25% received adjuvant chemotherapy (CMF or CAF) with (9%) or without (17%) tamoxifen. Of the total, 24% received adjuvant tamoxifen alone. The patients were divided into 2 groups: 131 patients with atypical hyperplasia (ductal, 99 patients; lobular, 20 pts; and type not specified, 12 pts), and 329 patients with no proliferative changes or proliferative changes without atypia. Result: A statistically significant difference was observed between the 2 groups for method of detection, primary tumor size, presence of lobular carcinoma in situ (LCIS), pathologic nodal status, region(s) treated with radiation, and type of adjuvant therapy. Patients with atypical hyperplasia (AH) had smaller primary tumors (T1 80% vs. 70%) more often detected solely by mammography (51% vs. 36%) with negative axillary nodes (87% vs. 73%) and radiation treatment to the breast only (93% vs. 78%). LCIS was observed in 9% of the patients with AH and 3% of those without AH. Patients with AH more often received tamoxifen alone (32% vs. 21%), rather than chemotherapy (15% vs. 29%). There were no statistically significant differences between the 2 groups for race, age, menopausal status, family history, histology, histologic subtype DCIS when present, the presence or absence of an extensive intraductal component, final margin status, estrogen or progesterone receptor status, use of re-excision, or total radiation dose to the

  4. Reducing Early Childhood Tooth Decay: Strategies for State Medicaid and CHIP Dental Program Managers

    OpenAIRE

    Colin Reusch; Meg Booth; Leslie Foster

    2015-01-01

    Young children who are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) can be at risk for developing early childhood caries (ECC). ECC is a chronic bacterial infection that causes severe tooth decay and can begin to develop before baby teeth erupt.

  5. Caregiver Coaching Strategies for Early Intervention Providers: Moving toward Operational Definitions

    Science.gov (United States)

    Friedman, Mollie; Woods, Juliann; Salisbury, Christine

    2012-01-01

    Early intervention (EI) providers increasingly coach and collaborate with caregivers to strengthen and support caregiver-child interactions. The EI providers learning to coach other adults benefit from knowing what, exactly, they should do to support caregivers. This article serves two purposes. First, it proposes an operationally defined,…

  6. Anthracycline-induced cardiotoxicity, a pathophysiology based approach for early detection and protective strategies

    NARCIS (Netherlands)

    Broeyer, Frederik Jan Ferdinand

    2012-01-01

    In this thesis the development of a pathophysiology-based method for the early evaluation of anthracycline-induced cardiotoxicity was described. We evaluated a comprehensive array of biomarkers, representing several aspects of anthracycline-induced cardiotoxicity, including cardiac injury and

  7. Early life stress shapes female reproductive strategy through eggshell pigmentation in Japanese quail

    Czech Academy of Sciences Publication Activity Database

    Duval, C.; Zimmer, C.; Mikšík, Ivan; Cassey, P.; Spencer, K.A.

    2014-01-01

    Roč. 208, Nov 1 (2014), s. 146-153 ISSN 0016-6480 Institutional support: RVO:67985823 Keywords : breeding conditions * early-life stress * eggshell pigmentation * Japanese quail Subject RIV: ED - Physiology Impact factor: 2.470, year: 2014

  8. Launching Early College Districtwide: Pharr-San Juan-Alamo's "College for All" Strategy

    Science.gov (United States)

    Le, Cecilia

    2012-01-01

    Across the nation, early college schools are creating a path to college success for young people underrepresented in higher education. For a decade, these innovative public schools blending high school and college have proven that, with the right support, all high school students can tackle college work. Now, a Texas school district near the…

  9. Invasive Aspergillosis in Hematological Patients.

    Science.gov (United States)

    Kimura, Shun-Ichi

    2016-01-01

    Invasive aspergillosis (IA) is still one of the leading causes of morbidity and mortality in hematological patients, although its outcome has been improving. Prolonged and profound neutropenia in patients receiving intensive chemotherapy for acute leukemia and stem cell transplantation is a major risk factor for IA. Allogeneic stem cell transplant recipients with graft-versus-host disease and corticosteroid use are also at high risk. Management in a protective environment with high efficiency particular air (HEPA) filter is generally recommended to prevent aspergillosis in patients with prolonged and profound neutropenia. Antifungal prophylaxis against Aspergillus species should be considered in patients with past history of aspergillosis or colonization of Aspergillus species, at facilities with high incidence of IA and those without a protective environment. Early diagnosis and prompt antifungal treatment is important to improve outcome. Imaging studies such as computed tomography and biomarkers such as galactomannan antigen and β-D-glucan are useful for early diagnosis. Empirical antifungal treatment based on persistent or recurrent fever during neutropenia despite broad-spectrum antibiotic therapy is generally recommended in high-risk patients. Alternatively, a preemptive treatment strategy has recently been proposed in the context of progress in the early diagnosis of IA based on the results of imaging studies and biomarkers. Voriconazole is recommended for initial therapy for IA. Liposomal amphotericin B is considered as alternative initial therapy. Combination antifungal therapy of echinocandin with voriconazole or liposomal amphotericin B could be a choice for refractory cases.

  10. Comparative Effectiveness of 5 Treatment Strategies for Early-Stage Non-Small Cell Lung Cancer in the Elderly

    Energy Technology Data Exchange (ETDEWEB)

    Shirvani, Shervin M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jiang, Jing [Department of Biostatistics and Applied Mathematics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y.; Welsh, James W.; Gomez, Daniel R. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swisher, Stephen [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-12-01

    Purpose: The incidence of early-stage non-small cell lung cancer (NSCLC) among older adults is expected to increase because of demographic trends and computed tomography-based screening; yet, optimal treatment in the elderly remains controversial. Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare cohort spanning 2001-2007, we compared survival outcomes associated with 5 strategies used in contemporary practice: lobectomy, sublobar resection, conventional radiation therapy, stereotactic ablative radiation therapy (SABR), and observation. Methods and Materials: Treatment strategy and covariates were determined in 10,923 patients aged {>=}66 years with stage IA-IB NSCLC. Cox regression, adjusted for patient and tumor factors, compared overall and disease-specific survival for the 5 strategies. In a second exploratory analysis, propensity-score matching was used for comparison of SABR with other options. Results: The median age was 75 years, and 29% had moderate to severe comorbidities. Treatment distribution was lobectomy (59%), sublobar resection (11.7%), conventional radiation (14.8%), observation (12.6%), and SABR (1.1%). In Cox regression analysis with a median follow-up time of 3.2 years, SABR was associated with the lowest risk of death within 6 months of diagnosis (hazard ratio [HR] 0.48; 95% confidence interval [CI] 0.38-0.63; referent is lobectomy). After 6 months, lobectomy was associated with the best overall and disease-specific survival. In the propensity-score matched analysis, survival after SABR was similar to that after lobectomy (HR 0.71; 95% CI 0.45-1.12; referent is SABR). Conventional radiation and observation were associated with poor outcomes in all analyses. Conclusions: In this population-based experience, lobectomy was associated with the best long-term outcomes in fit elderly patients with early-stage NSCLC. Exploratory analysis of SABR early adopters suggests efficacy comparable with that of surgery in select populations

  11. Parents and Preschool Workers' Perceptions of Competence, Collaboration, and Strategies for Addressing Bullying in Early Childhood

    Science.gov (United States)

    Cameron, David Lansing; Kovac, Velibor Bobo

    2017-01-01

    The purpose of this study was to explore and compare parents' (n = 141) and preschool workers' (n = 81) perceptions of bullying with respect to preschool workers' competence, collaboration with parents, and strategies for dealing with bullying. Whereas most participants held positive views about their collaboration, preschool workers tended to be…

  12. Early Reading Strategies in Irish and English: Evidence from Error Types

    Science.gov (United States)

    Parsons, Christine E.; Lyddy, Fiona

    2009-01-01

    For the majority of people in Ireland, Irish is a second language acquired primarily through the schooling system. This study examined the reading strategies children used in response to English and Irish words (presented in isolation), through an analysis of their oral reading errors. Children in their 4th year of schooling attending…

  13. The Advertising Strategies of Early E-cigarette Brand Leaders in the United States.

    Science.gov (United States)

    Haardörfer, Regine; Cahn, Zachary; Lewis, Michael; Kothari, Shreya; Sarmah, Raina; Getachew, Betelihem; Berg, Carla J

    2017-04-01

    We examined differential advertising strategies used by 4 major United States e-cigarette companies with differential affiliations with the traditional tobacco industry (ie, Njoy - independent, Blu - acquired, Vuse and MarkTen - launched by cigarette companies) over time. We conducted a mixed-methods study regarding e-cigarette adspend, adspend per media channel (eg, TV, print), and advertising messaging strategies among these 4 top e-cigarette brands from January 2013 through December 2015. E-cigarette adspend increased from $59 million in 2013 to $91 million in 2014, followed by a sharp decline to $37 million in 2015. These companies showed distinct spending trajectories overall and across media channels, with Njoy and Vuse spending a higher proportion of their dollars on TV and Blu and MarkTen spending more on print. Marketing messages were also different by company. Key themes included switching from cigarettes (particularly by Njoy and Blu), circumventing smoke-free policies (particularly by Blu), and technological advancement (particularly by Vuse and MarkTen). These e-cigarette brands have shifted their adspend, use of media channels, and advertising messaging strategies over time. Some differing strategies may reflect the different affiliations of each brand to the traditional cigarette industry.

  14. Interventions with Men Who Are Violent to Their Partners: Strategies for Early Engagement

    Science.gov (United States)

    Adams, Peter J.

    2012-01-01

    Practitioners who view intimate partner violence as a set of strategies aimed at maintaining positions of power and privilege often face an engagement dilemma when men at their first contact talk of themselves as disempowered by circumstances such as separation, loss of access to children, legal problems, substance abuse issues, and their own…

  15. Invasive tightly coupled processor arrays

    CERN Document Server

    LARI, VAHID

    2016-01-01

    This book introduces new massively parallel computer (MPSoC) architectures called invasive tightly coupled processor arrays. It proposes strategies, architecture designs, and programming interfaces for invasive TCPAs that allow invading and subsequently executing loop programs with strict requirements or guarantees of non-functional execution qualities such as performance, power consumption, and reliability. For the first time, such a configurable processor array architecture consisting of locally interconnected VLIW processing elements can be claimed by programs, either in full or in part, using the principle of invasive computing. Invasive TCPAs provide unprecedented energy efficiency for the parallel execution of nested loop programs by avoiding any global memory access such as GPUs and may even support loops with complex dependencies such as loop-carried dependencies that are not amenable to parallel execution on GPUs. For this purpose, the book proposes different invasion strategies for claiming a desire...

  16. A National Early Intervention System as a Strategy to Promote Inclusion and Academic Achievement in Portugal

    Directory of Open Access Journals (Sweden)

    Vitor Franco

    2017-07-01

    Full Text Available Early intervention with children at risk or facing developmental problems is a practice defined by three fundamental characteristics: being family-centered, being based on the community and on the child’s life context, and being conducted by a team with transdisciplinary practice. In this paper we wish to present how the SNIPI-National System of Early Intervention, implemented in Portugal over the past 15 years, contributes to promote maximum development and the full inclusion of children up to 6 years of age and works to prevent school failure. The SNIPI covers the entire territory and intends to respond to the needs of children with developmental disorders or those in at risk situations. This community-based early intervention model is linked to the health, education and social care systems, involving the three responsible Ministries. In the present community case study, we present the implementation of this program in the Alentejo region, involving 31 local teams and almost 2500 children. Through the regional structure’s reports and the responses of parents and professionals in impact studies, we demonstrate how the system is established and how it tackles school failure and improves the educational inclusion of these children. The impact of this Early Intervention model has been significant not only on children’s developmental outcomes, but also for the health, education and social care professionals who work in a transdisciplinary perspective, as well as for the families who became more skilled at evaluating the children’s needs and the support provided. This approach to implementing a family-centered Early Intervention program can contribute to full inclusion. It facilitates the transition to schooling based on a non-discriminatory approach and educational achievement by aiding development and an adapted contextualization in pre-school education. This program system introduces significant innovation within the framework of existing

  17. A National Early Intervention System as a Strategy to Promote Inclusion and Academic Achievement in Portugal.

    Science.gov (United States)

    Franco, Vitor; Melo, Madalena; Santos, Graça; Apolónio, Ana; Amaral, Leonor

    2017-01-01

    Early intervention with children at risk or facing developmental problems is a practice defined by three fundamental characteristics: being family-centered, being based on the community and on the child's life context, and being conducted by a team with transdisciplinary practice. In this paper we wish to present how the SNIPI-National System of Early Intervention, implemented in Portugal over the past 15 years, contributes to promote maximum development and the full inclusion of children up to 6 years of age and works to prevent school failure. The SNIPI covers the entire territory and intends to respond to the needs of children with developmental disorders or those in at risk situations. This community-based early intervention model is linked to the health, education and social care systems, involving the three responsible Ministries. In the present community case study, we present the implementation of this program in the Alentejo region, involving 31 local teams and almost 2500 children. Through the regional structure's reports and the responses of parents and professionals in impact studies, we demonstrate how the system is established and how it tackles school failure and improves the educational inclusion of these children. The impact of this Early Intervention model has been significant not only on children's developmental outcomes, but also for the health, education and social care professionals who work in a transdisciplinary perspective, as well as for the families who became more skilled at evaluating the children's needs and the support provided. This approach to implementing a family-centered Early Intervention program can contribute to full inclusion. It facilitates the transition to schooling based on a non-discriminatory approach and educational achievement by aiding development and an adapted contextualization in pre-school education. This program system introduces significant innovation within the framework of existing educational policies that

  18. [Operative treatment strategies for multiple trauma patients : early total care versus damage control].

    Science.gov (United States)

    Klüter, T; Lippross, S; Oestern, S; Weuster, M; Seekamp, A

    2013-09-01

    The treatment of multiple trauma patients is a great challenge for an interdisciplinary team. After preclinical care and subsequent treatment in the emergency room the order of the interventions is prioritized depending of the individual risk stratification. For planning the surgery management it is essential to distinguish between absolutely essential operations to prevent life-threatening situations for the patient and interventions with shiftable indications, depending on the general condition of the patient. All interventions need to be done without causing significant secondary damage to prohibit hyperinflammation and systemic inflammatory response syndrome. The challenge consists in determination of the appropriate treatment at the right point in time. In general the early primary intervention, early total care, is differentiated from the damage control concept.

  19. Strategies for Early Outbreak Detection of Malaria in the Amhara Region of Ethiopia

    Science.gov (United States)

    Nekorchuk, D.; Gebrehiwot, T.; Mihretie, A.; Awoke, W.; Wimberly, M. C.

    2017-12-01

    Traditional epidemiological approaches to early detection of disease outbreaks are based on relatively straightforward thresholds (e.g. 75th percentile, standard deviations) estimated from historical case data. For diseases with strong seasonality, these can be modified to create separate thresholds for each seasonal time step. However, for disease processes that are non-stationary, more sophisticated techniques are needed to more accurately estimate outbreak threshold values. Early detection for geohealth-related diseases that also have environmental drivers, such as vector-borne diseases, may also benefit from the integration of time-lagged environmental data and disease ecology models into the threshold calculations. The Epidemic Prognosis Incorporating Disease and Environmental Monitoring for Integrated Assessment (EPIDEMIA) project has been integrating malaria case surveillance with remotely-sensed environmental data for early detection, warning, and forecasting of malaria epidemics in the Amhara region of Ethiopia, and has five years of weekly time series data from 47 woredas (districts). Efforts to reduce the burden of malaria in Ethiopia has been met with some notable success in the past two decades with major reduction in cases and deaths. However, malaria remains a significant public health threat as 60% of the population live in malarious areas, and due to the seasonal and unstable transmission patterns with cyclic outbreaks, protective immunity is generally low which could cause high morbidity and mortality during the epidemics. This study compared several approaches for defining outbreak thresholds and for identifying a potential outbreak based on deviations from these thresholds. We found that model-based approaches that accounted for climate-driven seasonality in malaria transmission were most effective, and that incorporating a trend component improved outbreak detection in areas with active malaria elimination efforts. An advantage of these early

  20. Early Empowerment Strategies Boost Self-Efficacy to Improve Cardiovascular Health Behaviors

    OpenAIRE

    Kashani, Mariam; Eliasson, Arn H; Walizer, Elaine M; Fuller, Clarie E; Engler, Renata J; Villines, Todd C; Vernalis, Marina N

    2016-01-01

    Background: Self-efficacy, defined as confidence in the ability to carry out behavior to achieve a desired goal, is considered to be a prerequisite for behavior change. Self-efficacy correlates with cardiovascular health although optimal timing to incorporate self-efficacy strategies is not well established. We sought to study the effect of an empowerment approach implemented in the introductory phase of a multicomponent lifestyle intervention on cardiovascular health outcomes. Design: Prospe...

  1. Light-controlled endosomal escape of the novel CD133-targeting immunotoxin AC133-saporin by photochemical internalization - A minimally invasive cancer stem cell-targeting strategy.

    Science.gov (United States)

    Bostad, Monica; Olsen, Cathrine Elisabeth; Peng, Qian; Berg, Kristian; Høgset, Anders; Selbo, Pål Kristian

    2015-05-28

    The cancer stem cell (CSC) marker CD133 is an attractive target to improve antitumor therapy. We have used photochemical internalization (PCI) for the endosomal escape of the novel CD133-targeting immunotoxin AC133-saporin (PCIAC133-saporin). PCI employs an endocytic vesicle-localizing photosensitizer, which generates reactive oxygen species upon light-activation causing a rupture of the vesicle membranes and endosomal escape of entrapped drugs. Here we show that AC133-saporin co-localizes with the PCI-photosensitizer TPCS2a, which upon light exposure induces cytosolic release of AC133-saporin. PCI of picomolar levels of AC133-saporin in colorectal adenocarcinoma WiDr cells blocked cell proliferation and induced 100% inhibition of cell viability and colony forming ability at the highest light doses, whereas no cytotoxicity was obtained in the absence of light. Efficient PCI-based CD133-targeting was in addition demonstrated in the stem-cell-like, triple negative breast cancer cell line MDA-MB-231 and in the aggressive malignant melanoma cell line FEMX-1, whereas no enhanced targeting was obtained in the CD133-negative breast cancer cell line MCF-7. PCIAC133-saporin induced mainly necrosis and a minimal apoptotic response based on assessing cleavage of caspase-3 and PARP, and the TUNEL assay. PCIAC133-saporin resulted in S phase arrest and reduced LC3-II conversion compared to control treatments. Notably, co-treatment with Bafilomycin A1 and PCIAC133-saporin blocked LC3-II conversion, indicating a termination of the autophagic flux in WiDr cells. For the first time, we demonstrate laser-controlled targeting of CD133 in vivo. After only one systemic injection of AC133-saporin and TPCS2a, a strong anti-tumor response was observed after PCIAC133-saporin. The present PCI-based endosomal escape technology represents a minimally invasive strategy for spatio-temporal, light-controlled targeting of CD133+ cells in localized primary tumors or metastasis. Copyright © 2015

  2. Safety and feasibility of minimally invasive gastrectomy during the early introduction in the Netherlands: short-term oncological outcomes comparable to open gastrectomy.

    Science.gov (United States)

    Brenkman, H J F; Ruurda, J P; Verhoeven, R H A; van Hillegersberg, R

    2017-09-01

    Minimally invasive techniques for gastric cancer surgery have recently been introduced in the Netherlands, based on a proctoring program. The aim of this population-based cohort study was to evaluate the short-term oncological outcomes of minimally invasive gastrectomy (MIG) during its introduction in the Netherlands. The Netherlands Cancer Registry identified all patients with gastric adenocarcinoma who underwent gastrectomy with curative intent between 2010 and 2014. Multivariable analysis was performed to compare MIG and open gastrectomy (OG) on lymph node yield (≥15), R0 resection rate, and 1-year overall survival. The pooled learning curve per center of MIG was evaluated by groups of five subsequent procedures. Between 2010 and 2014, a total of 277 (14%) patients underwent MIG and 1633 (86%) patients underwent OG. During this period, the use of MIG and neoadjuvant chemotherapy increased from 4% to 39% (p introduction of minimally invasive gastrectomy in Western countries is feasible and can be performed safely.

  3. India's NCD strategy in the SDG era: are there early signs of a paradigm shift?

    Science.gov (United States)

    Mondal, Shinjini; Van Belle, Sara

    2018-04-25

    The Sustainable Development Goals (SDGs) are seen in most corners as the embodiment of a more inclusive and holistic development approach, key to addressing the numerous and urgent challenges the world faces. In the health realm, a true SDG approach will require a five-fold paradigm shift according to Buse and Hawkes. This article explores whether early traces of this paradigm shift can already be witnessed in the Indian context, focusing on Non-Communicable Diseases (NCDs) more in particular. By now, NCDs make up a large health burden in India, both individually and on the health system. Inspired by an SDG vision, tackling NCDs will require a comprehensive approach rooted in preventive, curative and rehabilitative services. In India, some early momentum in this respect can already be witnessed, certainly in addressing the first two challenges identified by Buse and Hawkes, leadership and intersectoral coherence, and a shift from treatment to prevention. A central plan addressing health through an inter-sectoral approach has shaped the trajectory so far, moving away from silos to engagement with sectors beyond health. New guidelines addressing comprehensive primary healthcare propose a community outreach and preventive approach for NCDs. At a broader level, NCD prevention is also closely linked to tackling the so called "commercial determinants of health" and will require among others strong (central and state level) regulation, teaming up with global advocacy networks and capitalizing on global frameworks, where they exist. Strong political leadership will be indispensable for this, and is according to Buse and Hawkes closely linked to seeing health as a right and the government as accountable when it comes to providing for the right to health through its policies and actions. National stewardship will thus be key, via a more adaptive network governance structure with the central level coordinating with the state level to ensure implementation, while also engaging

  4. The Care of Corporal Punishment: Conceptions of Early Childhood Discipline Strategies among Parents and Grandparents in a Poor and Urban Area in Tanzania

    Science.gov (United States)

    Frankenberg, Sofia Johnson; Holmqvist, Rolf; Rubenson, Birgitta

    2010-01-01

    This study investigates conceptions of early childhood discipline strategies discussed in focus groups with parents and grandparents in a poor urban area in Tanzania. A grounded theory analysis suggested a model that included four discipline strategies related to corporal punishment: to beat with care, to treat like an egg, as if beating a snake…

  5. Identification of water use strategies at early growth stages in durum wheat from shoot phenotyping and physiological measurements.

    Directory of Open Access Journals (Sweden)

    ALIREZA NAKHFOROOSH

    2016-08-01

    Full Text Available Modern imaging technology provides new approaches to plant phenotyping for traits relevant to crop yield and resource efficiency. Our objective was to investigate water use strategies at early growth stages in durum wheat genetic resources using shoot imaging at the ScreenHouse phenotyping facility combined with physiological measurements. 12 durum landraces from different pedoclimatic backgrounds were compared to three modern check cultivars in a greenhouse pot experiment under well watered (75 % plant available water, PAW and drought (25 % PAW conditions. Transpiration rate was analyzed for the underlying main morphological (leaf area duration and physiological (stomata conductance factors. Combining both morphological and physiological regulation of transpiration, four distinct water use types were identified. Most landraces had high transpiration rates either due to extensive leaf area (area types or both large leaf areas together with high stomata conductance (spender types. All modern cultivars were distinguished by high stomata conductance with comparatively compact canopies (conductance types. Only few landraces were water saver types with both small canopy and low stomata conductance. During early growth, genotypes with large leaf area had high dry-matter accumulation under both well watered and drought conditions compared to genotypes with compact stature. However, high stomata conductance was the basis to achieve high dry matter per unit leaf area, indicating high assimilation capacity as a key for productivity in modern cultivars. We conclude that the identified water use strategies based on early growth shoot phenotyping combined with stomata conductance provide an appropriate framework for targeted selection of distinct pre-breeding material adapted to different types of water limited environments.

  6. Identification of Water Use Strategies at Early Growth Stages in Durum Wheat from Shoot Phenotyping and Physiological Measurements

    Science.gov (United States)

    Nakhforoosh, Alireza; Bodewein, Thomas; Fiorani, Fabio; Bodner, Gernot

    2016-01-01

    Modern imaging technology provides new approaches to plant phenotyping for traits relevant to crop yield and resource efficiency. Our objective was to investigate water use strategies at early growth stages in durum wheat genetic resources using shoot imaging at the ScreenHouse phenotyping facility combined with physiological measurements. Twelve durum landraces from different pedoclimatic backgrounds were compared to three modern check cultivars in a greenhouse pot experiment under well-watered (75% plant available water, PAW) and drought (25% PAW) conditions. Transpiration rate was analyzed for the underlying main morphological (leaf area duration) and physiological (stomata conductance) factors. Combining both morphological and physiological regulation of transpiration, four distinct water use types were identified. Most landraces had high transpiration rates either due to extensive leaf area (area types) or both large leaf areas together with high stomata conductance (spender types). All modern cultivars were distinguished by high stomata conductance with comparatively compact canopies (conductance types). Only few landraces were water saver types with both small canopy and low stomata conductance. During early growth, genotypes with large leaf area had high dry-matter accumulation under both well-watered and drought conditions compared to genotypes with compact stature. However, high stomata conductance was the basis to achieve high dry matter per unit leaf area, indicating high assimilation capacity as a key for productivity in modern cultivars. We conclude that the identified water use strategies based on early growth shoot phenotyping combined with stomata conductance provide an appropriate framework for targeted selection of distinct pre-breeding material adapted to different types of water limited environments. PMID:27547208

  7. Improving Outcomes and Resource Use in Multiple Sclerosis: What are the Benefits Associated With an Early Treatment Strategy With Fingolimod?

    Directory of Open Access Journals (Sweden)

    João Carrasco

    2016-07-01

    Full Text Available Objective: This analysis aims to estimate the cost-effectiveness of early treatment versus delayed treatment with fingolimod 0.5 mg/day in patients with relapsing-remitting multiple sclerosis. Study Type: Economic evaluation of health technologies Local: Portugal Population: Multiple sclerosis patients (MS receiving treatment with fingolimod or interferon beta followed by fingolimod Methodology: A Microsoft Excel-based model was developed to estimate costs and health outcomes associated to two treatment strategies in MS: 1 early treatment with fingolimod -patients received treatment with 0.5 mg/day oral fingolimod continuously for 54 months; and 2 delayed treatment with fingolimod - patients received 12 months treatment with interferon beta-1a (IFN-β1a followed by an additional 42 months of treatment with fingolimod (total of 54 months. The model estimates the total number of relapses associated with the different treatment strategies, the total treatment costs and the cost per relapse avoided. Effectiveness data was derived from the annualized relapse rate of TRANSFORMS and its extension phase. Health care resource use and local clinical practice was estimated based in local experts’ opinion. The study adopted the hospital perspective and only direct medical costs were included. The analysis considered a time horizon of 54 months, and costs and outcomes were discounted at a yearly rate of 5%. Final results are presented as incremental cost-effectiveness ratio. One-way sensitivity analysis was conducted on key inputs to assess their impact on final incremental cost-effectiveness ratio. Results: For a hypothetical cohort of 100 patient’s early treatment with fingolimod was more effective in avoiding relapses when compared to delayed treatment, less 44 relapses (64.10 relapses versus 103.35 for 100 patients after 54 months. Early treatment was associated with incremental costs (€562,165 for 100 patients after 54 months. The incremental cost

  8. Simple technologies and diverse food strategies of the Late Pleistocene and Early Holocene at Huaca Prieta, Coastal Peru.

    Science.gov (United States)

    Dillehay, Tom D; Goodbred, Steve; Pino, Mario; Vásquez Sánchez, Víctor F; Tham, Teresa Rosales; Adovasio, James; Collins, Michael B; Netherly, Patricia J; Hastorf, Christine A; Chiou, Katherine L; Piperno, Dolores; Rey, Isabel; Velchoff, Nancy

    2017-05-01

    Simple pebble tools, ephemeral cultural features, and the remains of maritime and terrestrial foods are present in undisturbed Late Pleistocene and Early Holocene deposits underneath a large human-made mound at Huaca Prieta and nearby sites on the Pacific coast of northern Peru. Radiocarbon ages indicate an intermittent human presence dated between ~15,000 and 8000 calendar years ago before the mound was built. The absence of fishhooks, harpoons, and bifacial stone tools suggests that technologies of gathering, trapping, clubbing, and exchange were used primarily to procure food resources along the shoreline and in estuarine wetlands and distant mountains. The stone artifacts are minimally worked unifacial stone tools characteristic of several areas of South America. Remains of avocado, bean, and possibly cultivated squash and chile pepper are also present, suggesting human transport and consumption. Our new findings emphasize an early coastal lifeway of diverse food procurement strategies that suggest detailed observation of resource availability in multiple environments and a knowledgeable economic organization, although technologies were simple and campsites were seemingly ephemeral and discontinuous. These findings raise questions about the pace of early human movement along some areas of the Pacific coast and the level of knowledge and technology required to exploit maritime and inland resources.

  9. Climate change mitigation strategies in fast-growing countries: The benefits of early action

    International Nuclear Information System (INIS)

    Bosetti, Valentina; Carraro, Carlo; Tavoni, Massimo

    2009-01-01

    This paper builds on the assumption that OECD countries are (or will soon be) taking actions to reduce their greenhouse gas emissions. These actions, however, will not be sufficient to control global warming, unless developing countries also get involved in the cooperative effort to reduce GHG emissions. The paper investigates the best short-term strategies that emerging economies can adopt in reacting to OECD countries' mitigation effort, given the common long-term goal to prevent excessive warming without hampering economic growth. Results indicate that developing countries would incur substantial economic losses by following a myopic strategy that disregards climate in the short-run, and that their optimal investment behaviour is to anticipate the implementation of a climate policy by roughly 10 years. Investing in innovation ahead of time is also found to be advantageous. The degree of policy anticipation is shown to be important in determining the financial transfers of an international carbon market meant to provide incentives for the participation of developing countries. This is especially relevant for China, whose recent and foreseeable trends of investments in innovation are consistent with the adoption of domestic emission reduction obligations in 2030.

  10. [Invasive nosocomial pulmonary aspergillosis].

    Science.gov (United States)

    Germaud, P; Haloun, A

    2001-04-01

    Immunodepressed patients, particularly those with neutropenia or bone marrow or organ grafts, are at risk of developing nosocomial invasive pulmonary aspergilosis. The favoring factors, early diagnostic criteria and curative treatment protocols are well known. Prognosis remains however quite severe with a death rate above 50%. Preventive measures are required for the treatment of these high-risk patients and epidemiology surveillance is needed in case of aspergillosis acquired in the hospital.

  11. Early engagement of stakeholders with individual-based modelling can inform research for improving invasive species management: the round goby as a case study

    DEFF Research Database (Denmark)

    Samson, Emma; Hirsch, Philipp E.; Palmer, Stephen C.

    2017-01-01

    Individual-based models (IBMs) incorporating realistic representations of key range-front processes such as dispersal can be used as tools to investigate the dynamics of invasive species. Managers can apply insights from these models to take effective action to prevent further spread and prioriti...

  12. Risk of lymph node metastasis associated with deeper invasion by early adenocarcinoma of the esophagus and cardia: study based on endoscopic resection specimens

    NARCIS (Netherlands)

    Alvarez Herrero, L.; Pouw, R. E.; van Vilsteren, F. G.; ten Kate, F. J.; Visser, M.; van Berge Henegouwen, M. I.; Weusten, B. L.; Bergman, J. J.

    2010-01-01

    Background: Most risk estimations for lymph node metastasis in adenocarcinoma of the esophagus and cardia (AEC) with invasion into the muscularis mucosae (m3) or submucosa are based on surgical series. This study aimed to correlate the lymph node metastasis rate with m3 and submucosal infiltration

  13. Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

    DEFF Research Database (Denmark)

    Hauerberg, L; Høgdall, C; Loft, A

    2015-01-01

    OBJECTIVE: To present and evaluate an unselected national single center strategy with fertility preserving trachelectomy in cervical cancer. In 2003 nationwide single-center referral of women for trachelectomies was agreed upon between all Danish departments performing cervical cancer surgery...... a total of 77 pregnancies. Of the 72 women 40 were referred to fertility treatment. First and second trimester miscarriage rates were 21.6% and 2.7%, respectively. A total of 53 children were born of which 41 were delivered after gestational week 34. CONCLUSION: This unselected national single center...... of 120 unselected consecutive VRTs were assessed. To obtain complete follow-up about fertility treatment, pregnancy and obstetric outcome the women filled out an electronic questionnaire. Median follow-up: 55.7 months. RESULTS: 85.8% of the patients had stage IB1 disease, 68.3% squamous cell carcinomas...

  14. Have We Made It? Investigating Value-Creating Strategies in Early Internationalizing Ventures

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Juho, Anita

    2016-01-01

    . Following an intensity sampling strategy, we purposefully selected information-rich, but not extreme two-case companies. We initially collected unobtrusive data in the form of running records and mass-media news reports from the inception of the case companies. We then conducted in-depth interviews with key...... decision makers of the case companies, namely their co-founders and CEOs. We employed critical incident technique guidelines for data analysis. Grounded in data, the following constructs emerged related to value creation: strategic experimentation, gestalt tensions, and legitimacy lies. Entrepreneurs...... experiment with and reconfigure their venture at several levels: goal (vision), decision (strategic) and behavioral (tactical) levels of the organizational gestalt in order to reach a threshold level of practiced activity. Entrepreneurs’ strategic experimentation efforts are fueled by tensions that exist...

  15. Integrative analyses reveal novel strategies in HPV11,-16 and-45 early infection

    DEFF Research Database (Denmark)

    Kaczkowski, Bogumil; Rossing, Maria; Andersen, Ditte

    2012-01-01

    of genes not previously implicated in HPV biology, such as the PSG family and ANKRD1, and of genes implicated in the biology of other viruses, e. g. MX1, IFI44 and DDX60. Carcinogenesis-related genes, e. g. ABL2, MGLL and CYR61, were upregulated by high-risk HPV16 and -45. The integrative analysis revealed...... the suppression of DNA repair by HPV11 and -16, and downregulation of cytoskeleton genes by all HPV types. Various signalling pathways were affected by the HPVs: IL-2 by HPV11; JAK-STAT by HPV16; and TGF-beta, NOTCH and tyrosine kinase signalling by HPV45. This study uncovered novel strategies employed by HPV...... to establish infection and promote uncontrolled growth....

  16. Investigating alternatives to the fish early-life stage test: a strategy for discovering and annotating adverse outcome pathways for early fish development.

    Science.gov (United States)

    Villeneuve, Daniel; Volz, David C; Embry, Michelle R; Ankley, Gerald T; Belanger, Scott E; Léonard, Marc; Schirmer, Kristin; Tanguay, Robert; Truong, Lisa; Wehmas, Leah

    2014-01-01

    The fish early-life stage (FELS) test (Organisation for Economic Co-operation and Development [OECD] test guideline 210) is the primary test used internationally to estimate chronic fish toxicity in support of ecological risk assessments and chemical management programs. As part of an ongoing effort to develop efficient and cost-effective alternatives to the FELS test, there is a need to identify and describe potential adverse outcome pathways (AOPs) relevant to FELS toxicity. To support this endeavor, the authors outline and illustrate an overall strategy for the discovery and annotation of FELS AOPs. Key events represented by major developmental landmarks were organized into a preliminary conceptual model of fish development. Using swim bladder inflation as an example, a weight-of-evidence-based approach was used to support linkage of key molecular initiating events to adverse phenotypic outcomes and reduced young-of-year survival. Based on an iterative approach, the feasibility of using key events as the foundation for expanding a network of plausible linkages and AOP knowledge was explored and, in the process, important knowledge gaps were identified. Given the scope and scale of the task, prioritization of AOP development was recommended and key research objectives were defined relative to factors such as current animal-use restrictions in the European Union and increased demands for fish toxicity data in chemical management programs globally. The example and strategy described are intended to guide collective efforts to define FELS-related AOPs and develop resource-efficient predictive assays that address the toxicological domain of the OECD 210 test. © 2013 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  17. Quantifying the invasiveness of species

    Directory of Open Access Journals (Sweden)

    Robert Colautti

    2014-04-01

    Full Text Available The success of invasive species has been explained by two contrasting but non-exclusive views: (i intrinsic factors make some species inherently good invaders; (ii species become invasive as a result of extrinsic ecological and genetic influences such as release from natural enemies, hybridization or other novel ecological and evolutionary interactions. These viewpoints are rarely distinguished but hinge on distinct mechanisms leading to different management scenarios. To improve tests of these hypotheses of invasion success we introduce a simple mathematical framework to quantify the invasiveness of species along two axes: (i interspecific differences in performance among native and introduced species within a region, and (ii intraspecific differences between populations of a species in its native and introduced ranges. Applying these equations to a sample dataset of occurrences of 1,416 plant species across Europe, Argentina, and South Africa, we found that many species are common in their native range but become rare following introduction; only a few introduced species become more common. Biogeographical factors limiting spread (e.g. biotic resistance, time of invasion therefore appear more common than those promoting invasion (e.g. enemy release. Invasiveness, as measured by occurrence data, is better explained by inter-specific variation in invasion potential than biogeographical changes in performance. We discuss how applying these comparisons to more detailed performance data would improve hypothesis testing in invasion biology and potentially lead to more efficient management strategies.

  18. Newborn hearing screening and strategy for early detection of hearing loss in infants.

    Science.gov (United States)

    Jakubíková, Janka; Kabátová, Zuzana; Pavlovcinová, Gabriela; Profant, Milan

    2009-04-01

    More than 80% of permanent hearing losses (HL) in children are congenital. Newborn hearing screening (NHS) is the best method for early detection of suspected hearing loss. If the NHS is not universal more than 30% permanent hearing losses are not identified. There are various methods of NHS: otoacoustic emissions (TEOAE, DPOAE) and automatic auditory brainstem response (AABR). After hearing screening, and when hearing loss is suspected, tympanometry and audiological methods then used for determination of hearing threshold; these include ABR, ASSR or/and behavioral methods. The goal of this study is to evaluate the influence of UNHS on the early detection of hearing loss in children before and after the implementation of obligatory universal newborn hearing screening in Slovakia, and also on the etiologic evaluation of hearing impaired infants identified by screening. In Slovakia NHS started in 1998 and was provided in ENT departments. From May 1, 2006 UNHS has been mandatory in Slovakia, using two stages TEOAE in all newborn departments in Slovakia (64 newborn departments). In year 2005--42% of newborns in Slovakia were screened, in 2006--66% newborns and in 2007--94, 99% (three small newborn departments do not yet have equipment for OAE screening). For determination of hearing thresholds ASSR are used in two ENT departments and ABR in the other four ENT departments. Comparing the number of identified cases with bilateral severe permanent HL or deafness before and after UNHS, 22.8% more cases of PHL were identified in the first year of UNHS. Also the average age of diagnosis of PHL was lower. In the year 2007, 94% of newborns were screened. We found 0.947/1000 newborns with bilateral severe PHL (35.9%) more than before UNHS). After audiologic and etiologic assessment of the 76 infants who failed screening, 5 (6.58%) were found to have normal hearing, 16 (22.54%) had unilateral and 55 (77.46%) had bilateral SNHL. A non-syndromic genetic cause was present in 25

  19. Clearing invasive alien plants as a cost-effective strategy for water catchment management: The case of the Olifants river catchment, South Africa

    Directory of Open Access Journals (Sweden)

    Tshepo Morokong

    2016-12-01

    Full Text Available Invasive alien plants have a negative impact on ecosystem goods and services derived from ecosystems. Consequently, the aggressive spread of invasive alien plants (IAPs in the river catchments of South Africa is a major threat to, inter alia, water security. The Olifants River catchment is one such a catchment that is under pressure because of the high demand for water from mainly industrial sources and unsustainable land-use, which includes IAPs. This study considered the cost-effectiveness of clearing IAPs and compared these with the cost of a recently constructed dam. The methods used for data collection were semistructured interviews, site observation, desktop data analysis, and a literature review to assess the impact of IAPs on the catchment’s water supply. The outcomes of this study indicate that clearing invasive alien plants is a cost-effective intervention with a Unit Reference Value (URV of R1.44/m3, which compares very favourably with that of the De Hoop dam, the URV for which is R2.93/m3. These results suggest that clearing invasive alien plants is a cost-effective way of catchment management, as the opportunity cost of not doing so (forfeiting water to the value of R2.93/m3 is higher than that of protecting the investment in the dam.

  20. Project first and eye on the sky: strategies for teaching space science in the early grades

    Science.gov (United States)

    Paglierani, R.; Hawkins, I.

    Elementary educators typically have only limited opportunity to teach substantive science units. This is due, in great part, to the current primary focus on literacy and mathematics instruction in the early grades. It is not surprising then, that the time and resources allocated to science teaching are significantly less than those allocated to language arts and mathematics. The integration of elementary science curricula with language arts provides one means of addressing the challenge of maintaining a robust science presence in the elementary classroom. Project FIRST's Eye on the Sky suggests a model for the successful integration of science instruction with language arts through inquiry-based learning. The model has been adopted by other Education/Public Outreach efforts, most recently, the Cassini- Huygens Mission and the Space Telescope Institute. We will present Eye on the Sky: Our Star the Sun, a suite of integrated, inquiry-based lessons designed specifically for K-4 students and discuss data showing the program's impact on the user audience. These materials offer an exciting opportunity to explore the dynamic Sun and share research discoveries of NASA's Sun-Earth Connection with the elementary education community. The lessons were developed and tested by UC Berkeley educators and NASA scientists in partnership with classroom teachers. We will review the program components and examine the benefits and challenges inherent in implementing such a program in the elementary school setting.

  1. Why are Dutch rheumatologists reluctant to use the COBRA treatment strategy in early rheumatoid arthritis?

    Science.gov (United States)

    van Tuyl, Lilian H D; Plass, Anne Marie C; Lems, Willem F; Voskuyl, Alexandre E; Dijkmans, Ben A C; Boers, Maarten

    2007-01-01

    Background The Combinatietherapie Bij Reumatoide Artritis (COBRA) trial has proved that combination therapy with prednisolone, methotrexate and sulphasalazine is superior to sulphasalazine monotherapy in suppressing disease activity and radiological progression of early rheumatoid arthritis (RA). In addition, 5 years of follow‐up proved that COBRA therapy results in sustained reduction of the rate of radiological progression. Despite this evidence, Dutch rheumatologists seem reluctant to prescribe COBRA therapy. Objective To explore the reasons for the reluctance in Dutch rheumatologists to prescribe COBRA therapy. Methods A short structured questionnaire based on social–psychological theories of behaviour was sent to all Dutch rheumatologists (n = 230). Results The response rate was 50%. COBRA therapy was perceived as both effective and safe, but complex to administer. Furthermore, rheumatologists expressed their concern about the large number of pills that had to be taken, the side effects of high‐dose prednisolone and the low dose of methotrexate. Although the average attitude towards the COBRA therapy was slightly positive (above the neutral point), the majority of responding rheumatologists had a negative intention (below the neutral point) to prescribe COBRA therapy in the near future. Conclusion The reluctance of Dutch rheumatologists to prescribe effective COBRA therapy may be due to perceptions of complexity of the treatment schedule and negative patient‐related consequences of the therapy. PMID:17392349

  2. Parenting styles and coping strategies among patients with early detected and treated congenital hypothyroidism.

    Science.gov (United States)

    Pardo Campos, María L; Musso, Mariel; Keselman, Ana; Gruñeiro, Laura; Bergadá, Ignacio; Chiesa, Ana

    2018-04-01

    Congenital hypothyroidism (CH), as any chronic disease, has an impact on the parent-child relationship and on the child's resources to cope with conflicting situations. To describe parenting styles according to the perception of children with CH and their coping strategies. Children aged 9-10 years who had CH detected by newborn screening and had received adequate treatment and a group without CH (control group). The Argentine Coping Questionnaire, the Argentine Scale for the Perception of Parent Relations, and the comprehension subtest of the Wechsler Intelligence Scale for Children III (WISC III) were used. Results were compared using a multivariate analysis of variance (MANOVA). Sixty children with CH were included; they perceived that their mothers exercised a strict control and that their fathers showed more acceptance. They sought more support and became paralyzed more often in conflicting situations than the 60 children without CH. These findings may be associated with a higher level of dependence. They should be taken into consideration in CH care. Sociedad Argentina de Pediatría.

  3. Predictive factors for lymph node metastasis in poorly differentiated early gastric cancer and their impact on the surgical strategy

    Science.gov (United States)

    Li, Hua; Lu, Ping; Lu, Yang; Liu, Cai-Gang; Xu, Hui-Mian; Wang, Shu-Bao; Chen, Jun-Qing

    2008-01-01

    AIM: To identify the predictive clinicopathological factors for lymph node metastasis (LNM) in poorly differentiated early gastric cancer (EGC) and to further expand the possibility of using endoscopic mucosal resection (EMR) for the treatment of poorly differentiated EGC. METHODS: Data were collected from 85 poorly-differentiated EGC patients who were surgically treated. Association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses. RESULTS: Univariate analysis showed that tumor size (OR = 5.814, 95% CI = 1.050 - 32.172, P = 0.044), depth of invasion (OR = 10.763, 95% CI = 1.259 - 92.026, P = 0.030) and lymphatic vessel involvement (OR = 61.697, 95% CI = 2.144 - 175.485, P = 0.007) were the significant and independent risk factors for LNM. The LNM rate was 5.4%, 42.9% and 50%, respectively, in poorly differentiated EGC patients with one, two and three of the risk factors, respectively. No LNM was found in 25 patients without the three risk factors. Forty-four lymph nodes were found to have metastasis, 29 (65.9%) and 15 (34.1%) of the lymph nodes involved were within N1 and beyond N1, respectively, in 12 patients with LNM. CONCLUSION: Endoscopic mucosal resection alone may be sufficient to treat poorly differentiated intramucosal EGC (≤ 2.0 cm in diameter) with no histologically-confirmed lymphatic vessel involvement. When lymphatic vessels are involved, lymph node dissection beyond limited (D1) dissection or D1+ lymph node dissection should be performed depending on the tumor location. PMID:18636670

  4. Advantage and limitations of a minimally-invasive approach and early weight bearing in the treatment of tibial shaft fractures with locking plates.

    Science.gov (United States)

    Adam, P; Bonnomet, F; Ehlinger, M

    2012-09-01

    Intramedullary nailing is a common method of treating tibial shaft fractures. However, precise control of reduction at the proximal and distal quarters is difficult to achieve. The purpose of this study was to assess the results of plating using locking screws and the feasibility of a minimally-invasive approach. All patients with tibial shaft fracture treated by means of locking plates from January 2004 to October 2006. Thirty-two fractures were treated in 32 patients with a mean age of 43.8 years. Internal fixation with a locking plate and screw construct, using a minimally-invasive or standard approach. Surgical approach, time to weight bearing, complications and their type, time to bone union, alignment in the frontal and sagittal planes on anteroposterior and lateral radiographs. The minimally-invasive approach was performed in 28 cases and immediate full weight bearing allowed in 25 cases. At a mean follow-up of 27 months, two patients had died and two patients were lost to follow-up. The mean time to bone union was 9.1 weeks. Four cases had a complicated course: one infection, one compartment syndrome, one hardware breakage and one pseudarthrosis. Six cases ended up with valgus malunion exceeding 5° in the frontal plane, already present at the time of surgery. Where a minimally-invasive approach can be performed, immediate pain-free weight bearing can be allowed without further displacement at follow-up. The observed rate of malunion underlines the need for adequate reduction and shows that the rationale for success does not solely depend on the plate anatomic design but also on the skills of the operating surgeon. Level I university regional hospital Cohort study. Copyright © 2012. Published by Elsevier Masson SAS.

  5. "To Screen or not to Screen": Comparing the Health and Economic Benefits of Early Peanut Introduction Strategies in Five Countries.

    Science.gov (United States)

    Shaker, Marcus; Stukus, David; Chan, Edmond S; Fleischer, David M; Spergel, Jonathan M; Greenhawt, Matthew

    2018-03-30

    Early peanut introduction (EPI) in the first year of life is associated with reduced risk of developing peanut allergy in children with either severe eczema and/or egg allergy. However, EPI recommendations differ among countries with formal guidelines. Using simulation and Markov modeling over a 20-year horizon to attempt to explore optimal EPI strategies applied to the US population, we compared high-risk infant specific IgE peanut screening (US/Canadian) with the Australiasian Society for Clinical Immunology and Allergy (Australia/New Zealand) (ASCIA) and the United Kingdom Department of Health (UKDOH) published EPI approaches. Screening peanut skin testing of all children with early onset eczema and/or egg allergy before in-office peanut introduction was dominated by a no-screen approach, in terms of number of cases of peanut allergy prevented, QALY's, and healthcare costs, though screening resulted in a slightly lower rate of allergic reactions to peanut per-patient in high-risk children. Considering costs of peanut allergy in high-risk children, the per-patient cost of early introduction without screening over the model horizon was $6,556.69 (95%CI, $6,512.76-$6,600.62), compared with a cost of $7,576.32 (95%CI, $7,531.38-$7,621.26) for skin test screening prior to introduction. From a US societal perspective, screening prior to introduction cost $654,115,322 and resulted in 3,208 additional peanut allergy diagnoses. Both screening and non-screening approaches dominated deliberately delayed peanut introduction. A no-screening approach for EPI has superior health and economic benefits in terms of number of peanut allergy cases prevented, QALY's, and total health care costs compared to screening and in-office peanut introduction. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Strategies for improving early detection and diagnosis of neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Keane PA

    2015-02-01

    Full Text Available Pearse A Keane,1 Gabriella de Salvo,2 Dawn A Sim,1 Srini Goverdhan,2 Rupesh Agrawal,1 Adnan Tufail1 1NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, 2Department of Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK Abstract: Treatment of the neovascular form of age-related macular degeneration (AMD has been revolutionized by the introduction of such agents as ranibizumab, bevacizumab, and aflibercept. As a result, the incidence of legal blindness occurring secondary to AMD has fallen dramatically in recent years in many countries. While these agents have undoubtedly been successful in reducing visual impairment and blindness, patients with neovascular AMD typically lose some vision over time, and often lose the ability to read, drive, or perform other important activities of daily living. Efforts are therefore under way to develop strategies that allow for earlier detection and treatment of this disease. In this review, we begin by providing an overview of the rationale for, and the benefits of, early detection and treatment of neovascular AMD. To achieve this, we begin by providing an overview of the pathophysiology and natural history of choroidal neovascularization, before reviewing the evidence from both clinical trials and “real-world” outcome studies. We continue by highlighting an area that is often overlooked: the importance of patient education and awareness for early AMD detection. We conclude the review by reviewing an array of both established and emerging technologies for early detection of choroidal neovascularization, ranging from Amsler chart testing, to hyperacuity testing, to advanced imaging techniques, such as optical coherence tomography. Keywords: Amsler, detection, choroidal neovascularization, hyperacuity, optical coherence tomography

  7. Evaluation of a nutritional strategy to increase ovulation rate in merino ewes mated in late spring-early summer.

    Science.gov (United States)

    Nottle, M B; Kleemann, D O; Grosser, T I; Seamark, R F

    1997-07-01

    A nutritional strategy for increasing ovulation rate in Merino ewes mated in late spring-early summer was evaluated on two commercial farms. The strategy used the 'ram effect' to induce oestrus in seasonally anoestrus ewes and supplementary feeding of lupin grain six days prior to oestrus to increase ovulation rate. Ewes that had been isolated from rams for 6 weeks were exposed to vasectomised rams for 2 weeks and then mated to fertile rams for 6 weeks. Feeding 500 g lupins/head/day for 14 days commencing 12 days after the introduction of vasectomised rams, increased the number of ovulations from 126 to 146 per 100 ewes exposed to rams (P < 0.05). This increase was reflected in an improvement in fecundity (lambs born per ewe lambing; P < 0.05) but not fertility (ewes lambing per ewe mated to rams). Net reproductive performance (the product of fertility, fecundity and lamb survival) was increased by 11 lambs weaned per 100 ewes exposed to rams due to lupin supplementation at mating.

  8. Combined effect of therapeutic strategies for bleeding injury on early survival, transfusion needs and correction of coagulopathy.

    Science.gov (United States)

    Balvers, K; van Dieren, S; Baksaas-Aasen, K; Gaarder, C; Brohi, K; Eaglestone, S; Stanworth, S; Johansson, P I; Ostrowski, S R; Stensballe, J; Maegele, M; Goslings, J C; Juffermans, N P

    2017-02-01

    The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on trauma-induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, tranexamic acid and products containing fibrinogen on the outcome of injured patients with bleeding. A prospective multicentre observational study was performed in six level 1 trauma centres. Injured patients who received at least 4 units of red blood cells (RBCs) were analysed and divided into groups receiving a low (less than 1 : 1) or high (1 or more : 1) ratio of plasma or platelets to RBCs, and in receipt or not of tranexamic acid or fibrinogen products (fibrinogen concentrates or cryoprecipitate). Logistic regression models were used to assess the effect of transfusion strategies on the outcomes 'alive and free from massive transfusion' (at least 10 units of RBCs in 24 h) and early 'normalization of coagulopathy' (defined as an international normalized ratio of 1·2 or less). A total of 385 injured patients with ongoing bleeding were included in the study. Strategies that were independently associated with an increased number of patients alive and without massive transfusion were a high platelet to RBC ratio (odds ratio (OR) 2·67, 95 per cent c.i. 1·24 to 5·77; P = 0·012), a high plasma to RBC ratio (OR 2·07, 1·03 to 4·13; P = 0·040) and treatment with tranexamic acid (OR 2·71, 1·29 to 5·71; P = 0·009). No strategies were associated with correction of coagulopathy. A high platelet or plasma to RBC ratio, and use of tranexamic acid were associated with a decreased need for massive transfusion and increased survival in injured patients with bleeding. Early normalization of coagulopathy was not seen for any transfusion ratio, or for use of tranexamic acid or fibrinogen products. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  9. NASA and USGS invest in invasive species modeling to evaluate habitat for Africanized Honey Bees

    Science.gov (United States)

    2009-01-01

    Invasive non-native species, such as plants, animals, and pathogens, have long been an interest to the U.S. Geological Survey (USGS) and NASA. Invasive species cause harm to our economy (around $120 B/year), the environment (e.g., replacing native biodiversity, forest pathogens negatively affecting carbon storage), and human health (e.g., plague, West Nile virus). Five years ago, the USGS and NASA formed a partnership to improve ecological forecasting capabilities for the early detection and containment of the highest priority invasive species. Scientists from NASA Goddard Space Flight Center (GSFC) and the Fort Collins Science Center developed a longterm strategy to integrate remote sensing capabilities, high-performance computing capabilities and new spatial modeling techniques to advance the science of ecological invasions [Schnase et al., 2002].

  10. Decision tree analysis of treatment strategies for mild and moderate cases of clinical mastitis occurring in early lactation.

    Science.gov (United States)

    Pinzón-Sánchez, C; Cabrera, V E; Ruegg, P L

    2011-04-01

    The objective of this study was to develop a decision tree to evaluate the economic impact of different durations of intramammary treatment for the first case of mild or moderate clinical mastitis (CM) occurring in early lactation with various scenarios of pathogen distributions and use of on-farm culture. The tree included 2 decision and 3 probability events. The first decision evaluated use of on-farm culture (OFC; 2 programs using OFC and 1 not using OFC) and the second decision evaluated treatment strategies (no intramammary antimicrobials or antimicrobials administered for 2, 5, or 8 d). The tree included probabilities for the distribution of etiologies (gram-positive, gram-negative, or no growth), bacteriological cure, and recurrence. The economic consequences of mastitis included costs of diagnosis and initial treatment, additional treatments, labor, discarded milk, milk production losses due to clinical and subclinical mastitis, culling, and transmission of infection to other cows (only for CM caused by Staphylococcus aureus). Pathogen-specific estimates for bacteriological cure and milk losses were used. The economically optimal path for several scenarios was determined by comparison of expected monetary values. For most scenarios, the optimal economic strategy was to treat CM caused by gram-positive pathogens for 2 d and to avoid antimicrobials for CM cases caused by gram-negative pathogens or when no pathogen was recovered. Use of extended intramammary antimicrobial therapy (5 or 8 d) resulted in the least expected monetary values. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  11. QUANTIFYING AND MODELING THE RISK OF DISTURBANCE TO ECOSYSTEMS CAUSED BY INVASIVE SPECIES

    Science.gov (United States)

    Invasive species are biological pollutants that threaten ecosystem health. Identifying the mechanisms of invasive and developing predictive models of invasion will be critical to developing risk management strategies for limiting the economic and environmental damage caused by i...

  12. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM): novel biological insights and development of early treatment strategies.

    Science.gov (United States)

    Korde, Neha; Kristinsson, Sigurdur Y; Landgren, Ola

    2011-05-26

    Monoclonal gammopathy of unknown significance (MGUS) and smoldering multiple myeloma (SMM) are asymptomatic plasma cell dyscrasias, with a propensity to progress to symptomatic MM. In recent years there have been improvements in risk stratification models (involving molecular markers) of both disorders, which have led to better understanding of the biology and probability of progression of MGUS and SMM. In the context of numerous molecular events and heterogeneous risk of progression, developing individualized risk profiles for patients with MGUS and SMM represents an ongoing challenge that has to be addressed by prospective clinical monitoring and extensive correlative science. In this review we discuss the current standard of care of patients with MGUS and SMM, the use of risk models, including flow cytometry and free-light chain analyses, for predicting risk of progression. Emerging evidence from molecular studies on MGUS and SMM, involving cytogenetics, gene-expression profiling, and microRNA as well as molecular imaging is described. Finally, future directions for improving individualized management of MGUS and SMM patients, as well as the potential for developing early treatment strategies designed to delay and prevent development of MM are discussed.

  13. Integrating Antiretroviral Strategies for Human Immunodeficiency Virus Prevention: Post- and Pre-Exposure Prophylaxis and Early Treatment.

    Science.gov (United States)

    Grant, Robert M; Smith, Dawn K

    2015-12-01

    Best practices for integrating human immunodeficiency virus (HIV) testing and antiretroviral interventions for prevention and treatment are suggested based on research evidence and existing normative guidance. The goal is to provide high-impact prevention services during periods of substantial risk. Antiretroviral medications are recommended for postexposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), and treatment of HIV infection. We reviewed research evidence and current normative guidelines to identify best practices for integrating these high-impact prevention strategies. More sensitive HIV tests used for screening enable earlier diagnosis and treatment of HIV infection, more appropriate counseling, and help limit drug resistance. A fully suppressive PEP regimen should be initiated based on exposure history or physical findings when sensitive diagnostic testing is delayed or not available and antibody tests are negative. Transitions from PEP to PrEP are often warranted because HIV exposure events may continue to occur. This algorithmic approach to integrating PEP, PrEP, and early treatment decisions may increase the uptake of these interventions by a greater number and diversity of knowledgeable healthcare providers.

  14. Plant invasions in protected areas of tropical pacific islands, with special reference to Hawaii

    Science.gov (United States)

    Hughes, R. Flint; Meyer, Jean-Yves; Loope, Lloyd L.

    2013-01-01

    Isolated tropical islands are notoriously vulnerable to plant invasions. Serious management for protection of native biodiversity in Hawaii began in the 1970s, arguably at Hawaii Volcanoes National Park. Concerted alien plant management began there in the 1980s and has in a sense become a model for protected areas throughout Hawaii and Pacific Island countries and territories. We review the relative successes of their strategies and touch upon how their experience has been applied elsewhere. Protected areas in Hawaii are fortunate in having relatively good resources for addressing plant invasions, but many invasions remain intractable, and invasions from outside the boundaries continue from a highly globalised society with a penchant for horticultural novelty. There are likely few efforts in most Pacific Islands to combat alien plant invasions in protected areas, but such areas may often have fewer plant invasions as a result of their relative remoteness and/or socio-economic development status. The greatest current needs for protected areas in this region may be for establishment of yet more protected areas, for better resources to combat invasions in Pacific Island countries and territories, for more effective control methods including biological control programme to contain intractable species, and for meaningful efforts to address prevention and early detection of potential new invaders.

  15. The mathematics behind biological invasions

    CERN Document Server

    Lewis, Mark A; Potts, Jonathan R

    2016-01-01

    This book investigates the mathematical analysis of biological invasions. Unlike purely qualitative treatments of ecology, it draws on mathematical theory and methods, equipping the reader with sharp tools and rigorous methodology. Subjects include invasion dynamics, species interactions, population spread, long-distance dispersal, stochastic effects, risk analysis, and optimal responses to invaders. While based on the theory of dynamical systems, including partial differential equations and integrodifference equations, the book also draws on information theory, machine learning, Monte Carlo methods, optimal control, statistics, and stochastic processes. Applications to real biological invasions are included throughout. Ultimately, the book imparts a powerful principle: that by bringing ecology and mathematics together, researchers can uncover new understanding of, and effective response strategies to, biological invasions. It is suitable for graduate students and established researchers in mathematical ecolo...

  16. Prophylaxis against radiation injury. The use of elemental diet prior to and during radiotherapy for invasive bladder cancer and in early postoperative feeding following radical cystectomy and ileal conduit

    International Nuclear Information System (INIS)

    McArdle, A.H.; Reid, E.C.; Laplante, M.P.; Freeman, C.R.

    1986-01-01

    Previous studies done in animals have shown that significant prophylaxis against radiation injury could be afforded by feeding an elemental diet (ED) for three days before and during radiation. In the present study 20 patients were fed an ED for three days before and for the four days during radiotherapy (five fractions of 400 rad [4 Gy] each) prior to radical cystectomy and ileal conduit for invasive bladder cancer; ED feeding was recommenced 24 hours postoperatively via a feeding jejunostomy. The ED-fed patients exhibited positive nitrogen balance preoperatively and had an early return to positive nitrogen balance postoperatively (3.60 +/- 0.32 days). There was also prompt return of bowel sounds (3.00 +/- 0.32 days). Histologically and ultrastructurally, biopsy specimens of the ileal mucosa showed normal morphologic findings, with maintenance of normal levels of enzyme activity in the brush border. Severe or bloody diarrhea was absent in these patients. These data suggest that ED feeding provides prophylaxis against the acute phase of radiation injury in patients undergoing high-dose, short-course radiotherapy for invasive bladder cancer and that it is a safe and feasible means of postoperative nutritional support, even in the presence of a fresh bowel anastomosis

  17. The Need for an Information Communication and Advocacy Strategy to Guide a Research Agenda to Address Burden of Invasive Nontyphoidal Salmonella Infections in Africa.

    Science.gov (United States)

    Imran Khan, M; Freeman, Alexander J; Gessner, Bradford D; Sahastrabuddhe, Sushant

    2015-11-01

    Invasive nontyphoidal salmonellosis (iNTS) is often not recognized clinically, and prevention of iNTS is largely ignored by policy planners and decision makers. During 2010, an estimated 3.4 million cases and 681,316 deaths occurred worldwide due to iNTS, with the largest estimated disease burden in resource-limited areas of sub-Saharan Africa. These figures likely underestimate global burden for several reasons, further complicating efforts to raise awareness of iNTS. To increase disease recognition and facilitate development of interventions, a communication and advocacy plan should be developed and implemented by actors in different sectors of global health, including researchers and scientists, funders, vaccine manufacturers, civil society organizations, and government officials from highly affected countries. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Reduced miR-433 expression is associated with advanced stages and early relapse of colorectal cancer and restored miR-433 expression suppresses the migration, invasion and proliferation of tumor cells in vitro and in nude mice.

    Science.gov (United States)

    Zhang, Jian; Zhang, Lei; Zhang, Tong; Dong, Xin-Min; Zhu, Yu; Chen, Long-Hua

    2018-05-01

    The expression of microRNA (miR-433) is altered in various types of human cancer. The present study analyzed the prognostic and biological value of miR-433 expression in colorectal cancer using reverse transcription-quantitative polymerase chain reaction in 125 colorectal tissue specimens (including a test cohort of 40 cases of paired colorectal cancer and adjacent normal mucosae and a confirmation cohort of 85 cases of stage I-III colorectal cancer). In vitro and nude mouse xenograft experiments were subsequently used to assess the effects of miR-433 expression on the regulation of colorectal cancer cell proliferation, adhesion, migration, and invasion. The data indicated that miR-433 expression was significantly downregulated in colorectal cancer tissues in the test and confirmation patient cohorts and that low miR-433 expression was associated with advanced tumor stage and early relapse. Furthermore, the restoration of miR-433 expression was able to significantly inhibit the proliferation of tumor cells by inducing G1-S cell cycle arrest, suppressing cyclinD1 and CDK4 expression, and markedly inhibited the migratory and invasive capacities of tumor cells in vitro . The restoration of miR-433 expression or liposome-based delivery of miR-433 mimics suppressed the growth of colorectal cancer cell xenografts in nude mice. In conclusion, miR-433 may be a putative tumor suppressor in colorectal cancer, and the detection of low miR-433 expression will be investigated in further studies as a putative biomarker for the detection of early relapse in patients with colorectal cancer.

  19. Genetic pharmacotherapy as an early CNS drug development strategy: testing glutaminase inhibition for schizophrenia treatment in adult mice

    Directory of Open Access Journals (Sweden)

    Susana eMingote

    2016-01-01

    Full Text Available Genetic pharmacotherapy is an early drug development strategy for the identification of novel CNS targets in mouse models prior to the development of specific ligands. Here for the first time, we have implemented this strategy to address the potential therapeutic value of a glutamate-based pharmacotherapy for schizophrenia involving inhibition of the glutamate recycling enzyme phosphate-activated glutaminase. Mice constitutively heterozygous for GLS1, the gene encoding glutaminase, manifest a schizophrenia resilience phenotype, a key dimension of which is an attenuated locomotor response to propsychotic amphetamine challenge. If resilience is due to glutaminase deficiency in adulthood, then glutaminase inhibitors should have therapeutic potential. However, this has been difficult to test given the dearth of neuroactive glutaminase inhibitors. So, we used genetic pharmacotherapy to test the therapeutic potential of glutaminase inhibition. We specifically asked whether adult induction of GLS1 heterozygosity would attenuate amphetamine responsiveness. We generated conditional floxGLS1 mice and crossed them with global CAG ERT2 cre/+ mice to produce GLS1 iHET mice, susceptible to tamoxifen induction of GLS1 heterozygosity. One month after tamoxifen treatment of adult GLS1 iHET mice, we found a 50% reduction in GLS1 allelic abundance and glutaminase mRNA levels in the brain. While GLS1 iHET mice showed some recombination prior to tamoxifen, there was no impact on mRNA levels. We then asked whether induction of GLS heterozygosity would attenuate the locomotor response to propsychotic amphetamine challenge. Before tamoxifen, control and GLS1 iHET mice did not differ in their response to amphetamine. One month after tamoxifen treatment, amphetamine-induced hyperlocomotion was blocked in GLS1 iHET mice. The block was largely maintained after 5 months. Thus, a genetically induced glutaminase reduction — mimicking pharmacological inhibition — strongly

  20. Invasive aspergillosis in paediatric oncology patients.

    Science.gov (United States)

    Muda, Z; Ibrahim, H; Abdulrahman, E J; Menon, B S; Zahari, Z; Zaleha, A M; Talib, A

    2008-12-01

    Invasive aspergillosis predominantly occurs in immunocompromised patients and is often resistant to different therapeutically strategies. However, mortality significantly increases if the central nervous system is affected. In this report we describe two cases of invasive aspergilosis, one with kidney involvement with a successful treatment while the other with pulmonary and cerebral involvement with a grave outcome.

  1. Principles for ecologically based invasive plant management

    Science.gov (United States)

    Jeremy J. James; Brenda S. Smith; Edward A. Vasquez; Roger L. Sheley

    2010-01-01

    Land managers have long identified a critical need for a practical and effective framework for designing restoration strategies, especially where invasive plants dominate. A holistic, ecologically based, invasive plant management (EBIPM) framework that integrates ecosystem health assessment, knowledge of ecological processes, and adaptive management into a successional...

  2. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.

    Science.gov (United States)

    Meissner, Mark H; Gloviczki, Peter; Comerota, Anthony J; Dalsing, Michael C; Eklof, Bo G; Gillespie, David L; Lohr, Joann M; McLafferty, Robert B; Murad, M Hassan; Padberg, Frank; Pappas, Peter; Raffetto, Joseph D; Wakefield, Thomas W

    2012-05-01

    The anticoagulant treatment of acute deep venous thrombosis (DVT) has been historically directed toward the prevention of recurrent venous thromboembolism. However, such treatment imperfectly protects against late manifestations of the postthrombotic syndrome. By restoring venous patency and preserving valvular function, early thrombus removal strategies can potentially decrease postthrombotic morbidity. A committee of experts in venous disease was charged by the Society for Vascular Surgery and the American Venous Forum to develop evidence-based practice guidelines for early thrombus removal strategies, including catheter-directed pharmacologic thrombolysis, pharmacomechanical thrombolysis, and surgical thrombectomy. Evidence-based recommendations are based on a systematic review and meta-analysis of the relevant literature, supplemented when necessary by less rigorous data. Recommendations are made according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, incorporating the strength of the recommendation (strong: 1; weak: 2) and an evaluation of the level of the evidence (A to C). On the basis of the best evidence currently available, we recommend against routine use of the term "proximal venous thrombosis" in favor of more precise characterization of thrombi as involving the iliofemoral or femoropopliteal venous segments (Grade 1A). We further suggest the use of early thrombus removal strategies in ambulatory patients with good functional capacity and a first episode of iliofemoral DVT of venous outflow obstruction (Grade 1A). We suggest pharmacomechanical strategies over catheter-directed pharmacologic thrombolysis alone if resources are available and that surgical thrombectomy be considered if thrombolytic therapy is contraindicated (Grade 2C). Most data regarding early thrombus removal strategies are of low quality but do suggest patient-important benefits with respect to reducing postthrombotic morbidity. We

  3. Nutritional strategies to combat physiological imbalance of dairy cows during early lactation: The effect of changes in dietary protein to starch-ratios

    DEFF Research Database (Denmark)

    Moyes, Kasey; Friggens, Nic; Ingvartsen, Klaus Lønne

    2010-01-01

    Thirty Danish Holstein cows were used to determine how cows in early lactation adapt to changes in protein to starch supply in order to manipulate metabolism to combat physiological imbalance. During weeks 4 through 6 of lactation, 10 cows were fed either a high protein to starch ratio (high) diet...... for the low, control and high diets, respectively. Besides milk urea nitrogen, no other production or metabolic parameters were affected by treatment. In conclusion, manipulation of dietary protein to starch is not a potential strategy to combat physiological imbalance during early lactation...

  4. Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial

    DEFF Research Database (Denmark)

    Ørnbjerg, L M; Østergaard, M; Jensen, T

    2017-01-01

    This study aims to investigate 1-year hand bone loss (HBL1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/- adalimumab and to determine if HBL6months is associated with radiographic progression after 2...... associated with ∆TSS after 2 years (β = -0.086 (95% confidence interval = -0.15; -0.025) TSS unit/mg/cm(2) increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92-1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy...

  5. A novel measles outbreak control strategy in the Netherlands in 2013-2014 using a national electronic immunization register: A study of early MMR uptake and its determinants.

    Science.gov (United States)

    Nic Lochlainn, Laura M; Woudenberg, Tom; van Lier, Alies; Zonnenberg, Irmgard; Philippi, Marvin; de Melker, Hester E; Hahné, Susan J M

    2017-10-13

    During a large measles outbreak in the Netherlands in 2013-2014, infants aged 6-14months living in municipalities with low (<90%) measles-mumps-rubella (MMR) coverage were individually invited for an early MMR using the national electronic immunization register, Præventis. We estimated uptake of early MMR prior to and during the 2013-2014 outbreak and assessed determinants for early MMR vaccination. We obtained vaccination records from Præventis, and defined early MMR as vaccination before 415days (13months) of age. A multi-level multivariable logistic regression model, restricted to infants with three diphtheria-pertussis-tetanus-polio (DPTP) vaccinations was used to examine the association between early MMR uptake and sex, parents' country of birth, socioeconomic status (SES; at postcode level) and voting proportions for the Reformed Political Party (SGP; at municipal level), used as a proxy for religious objections towards vaccination. In the 29 municipalities with low MMR coverage, uptake of early MMR was 0.5-2.2% prior to the outbreak. Between July 2013 and March 2014, 5,800 (57%) invited infants received an early MMR. Among infants with three DPTP, 70% received an early MMR. Only 1% of infants without prior DPTP received an early MMR. Lower early MMR uptake was associated with a higher SGP voter-ship (OR 0.89 per 5% increase, 95%CI 0.83-0.96), parents' with unknown country of birth (OR 0.66 95%CI 0.47-0.93) and compared with very high SES, high SES had significantly lower early MMR uptake (OR 0.66 95%CI 0.50-0.87). This is the first study describing use of Præventis during an outbreak and to assess determinants of early MMR uptake. More than half of invited infants obtained an early MMR. SES, parents' with unknown country of birth and religious objections towards vaccination were found to be associated with lower early MMR uptake. In future outbreaks, these determinants could be used to tailor intervention strategies. Copyright © 2017. Published by

  6. A 2-stage ovarian cancer screening strategy using the Risk of Ovarian Cancer Algorithm (ROCA) identifies early-stage incident cancers and demonstrates high positive predictive value.

    Science.gov (United States)

    Lu, Karen H; Skates, Steven; Hernandez, Mary A; Bedi, Deepak; Bevers, Therese; Leeds, Leroy; Moore, Richard; Granai, Cornelius; Harris, Steven; Newland, William; Adeyinka, Olasunkanmi; Geffen, Jeremy; Deavers, Michael T; Sun, Charlotte C; Horick, Nora; Fritsche, Herbert; Bast, Robert C

    2013-10-01

    A 2-stage ovarian cancer screening strategy was evaluated that incorporates change of carbohydrate antigen 125 (CA125) levels over time and age to estimate risk of ovarian cancer. Women with high-risk scores were referred for transvaginal ultrasound (TVS). A single-arm, prospective study of postmenopausal women was conducted. Participants underwent an annual CA125 blood test. Based on the Risk of Ovarian Cancer Algorithm (ROCA) result, women were triaged to next annual CA125 test (low risk), repeat CA125 test in 3 months (intermediate risk), or TVS and referral to a gynecologic oncologist (high risk). A total of 4051 women participated over 11 years. The average annual rate of referral to a CA125 test in 3 months was 5.8%, and the average annual referral rate to TVS and review by a gynecologic oncologist was 0.9%. Ten women underwent surgery on the basis of TVS, with 4 invasive ovarian cancers (1 with stage IA disease, 2 with stage IC disease, and 1 with stage IIB disease), 2 ovarian tumors of low malignant potential (both stage IA), 1 endometrial cancer (stage I), and 3 benign ovarian tumors, providing a positive predictive value of 40% (95% confidence interval = 12.2%, 73.8%) for detecting invasive ovarian cancer. The specificity was 99.9% (95% confidence interval = 99.7%, 100%). All 4 women with invasive ovarian cancer were enrolled in the study for at least 3 years with low-risk annual CA125 test values prior to rising CA125 levels. ROCA followed by TVS demonstrated excellent specificity and positive predictive value in a population of US women at average risk for ovarian cancer. Copyright © 2013 American Cancer Society.

  7. Implementation of a cost-effective strategy to prevent neonatal early-onset group B haemolytic streptococcus disease in the Netherlands.

    Science.gov (United States)

    Kolkman, Diny G E; Rijnders, Marlies E B; Wouters, Maurice G A J; van den Akker-van Marle, M Elske; van der Ploeg, Cpb Kitty; de Groot, Christianne J M; Fleuren, Margot A H

    2013-07-30

    Early-onset Group B haemolytic streptococcus infection (EOGBS) is an important cause of neonatal morbidity and mortality in the first week of life. Primary prevention of EOGBS is possible with intra-partum antibiotic prophylaxis (IAP.) Different prevention strategies are used internationally based on identifying pregnant women at risk, either by screening for GBS colonisation and/or by identifying risk factors for EOGBS in pregnancy or labour. A theoretical cost-effectiveness study has shown that a strategy with IAP based on five risk factors (risk-based strategy) or based on a positive screening test in combination with one or more risk factors (combination strategy) was the most cost-effective approach in the Netherlands. IAP for all pregnant women with a positive culture in pregnancy (screening strategy) and treatment in line with the current Dutch guideline (IAP after establishing a positive culture in case of pre-labour rupture of membranes or preterm birth and immediate IAP in case of intra-partum fever, previous sibling with EOGBS or GBS bacteriuria), were not cost-effective. Cost-effectiveness was based on the assumption of 100% adherence to each strategy. However, adherence in daily practice will be lower and therefore have an effect on cost-effectiveness. The aims are to: a.) implement the current Dutch guideline, the risk-based strategy and the combination strategy in three pilot regions and b.) study the effects of these strategies in daily practice. Regions where all the care providers in maternity care implement the allocated strategy will be randomised. Before the introduction of the strategy, there will be a pre-test (use of the current guideline) involving 105 pregnant women per region. This will be followed by a post-test (use of the allocated strategy) involving 315 women per region. The outcome measures are: 1.) adherence to the specific prevention strategy and the determinants of adherence among care providers and pregnant women, 2.) outcomes

  8. Investigating Alternatives to the Fish Early Life-Stage Test: A Strategy for Discovering and Annotating Adverse Outcome Pathways for Early Fish Development

    Science.gov (United States)

    The fish early life-stage (FELS) test (OECD Test Guideline 210) is the primary test used internationally to estimate chronic fish toxicity in support of ecological risk assessments and chemical management programs. As part of an on-going effort to develop efficient and cost-effec...

  9. Patterns of Primary Tumor Invasion and Regional Lymph Node Spread Based on Magnetic Resonance Imaging in Early-Stage Nasal NK/T-cell Lymphoma: Implications for Clinical Target Volume Definition and Prognostic Significance

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Run-Ye [Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Liu, Kang [Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Wang, Wei-Hu; Jin, Jing; Song, Yong-Wen; Wang, Shu-Lian; Liu, Yue-Ping; Ren, Hua; Fang, Hui; Liu, Qing-Feng; Yang, Yong; Chen, Bo; Qi, Shu-Nan; Lu, Ning-Ning; Tang, Yu; Tang, Yuan; Li, Ning [Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Ouyang, Han [Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Li, Ye-Xiong, E-mail: yexiong12@163.com [Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China)

    2017-01-01

    Purpose: This study aimed to determine the pathways of primary tumor invasion (PTI) and regional lymph node (LN) spread based on magnetic resonance imaging (MRI) in early-stage nasal NK/T-cell lymphoma (NKTCL), to improve clinical target volume (CTV) delineation and evaluate the prognostic value of locoregional extension patterns. Methods and Materials: A total of 105 patients with newly diagnosed early-stage nasal NKTCL who underwent pretreatment MRI were retrospectively reviewed. All patients received radiation therapy with or without chemotherapy. Results: The incidences of PTI and regional LN involvement were 64.7% and 25.7%, respectively. Based on the incidence of PTI, involved sites surrounding the nasal cavity were classified into 3 risk subgroups: high-risk (>20%), intermediate-risk (5%-20%), and low-risk (<5%). The most frequently involved site was the nasopharynx (35.2%), followed by the maxillary (21.9%) and ethmoid (21.9%) sinuses. Local disease and regional LN spread followed an orderly pattern without LN skipping. The retropharyngeal nodes (RPNs) were most frequently involved (19.0%), followed by level II (11.4%). The 5-year overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) rates for all patients were 72.8%, 65.2%, and 90.0%, respectively. The presence of PTI and regional LN involvement based on MRI significantly and negatively affected PFS and OS. Conclusions: Early-stage nasal NKTCL presents with a high incidence of PTI but a relatively low incidence of regional LN spread. Locoregional spread followed an orderly pattern, and PTI and regional LN spread are powerful prognostic factors for poorer survival outcomes. CTV reduction may be feasible for selected patients.

  10. 'Stay home for as long as possible': midwives' priorities and strategies in communicating with first-time mothers in early labour.

    Science.gov (United States)

    Eri, Tine S; Blystad, Astrid; Gjengedal, Eva; Blaaka, Gunnhild

    2011-12-01

    To explore the priorities and strategies midwives in a labour ward use in their communication with primiparous women who seek contact in the early phase of labour. A qualitative study using focus groups. Norway. 18 Midwives. Five themes that seemed to constitute the key elements in the communication were identified. The themes were designated 'Getting the picture', 'Normalising the situation', 'Giving concrete advice', 'Letting the woman make the decision', and 'Staying at home for as long as possible'. The findings of this study indicate that the midwives' overall strategy was to encourage women to remain out of hospital for as long as possible 'for their own good'. This strategy seems to rely on knowledge derived from non-contextual science within the dominant medical childbirth paradigm, and might not meet women's needs in early labour. When women are admitted in early labour, midwives should be able to 'protect' these women from unnecessary interventions and do so in partnership with the women themselves rather than accepting that women's mere presence in the labour ward yields complications and increases the likelihood of caesarean section. From the findings of this study, it is reasonable to ask whether an obstacle to this course might be the midwives' subordination to the medical paradigm. This causes midwives to function as 'gatekeepers' to the medical system instead of working in accordance with the philosophy of midwifery: 'for women's own good'. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Novel circulating microRNA signature as a potential non-invasive multi-marker test in ER-positive early-stage breast cancer

    DEFF Research Database (Denmark)

    Kodahl, Annette R; Lyng, Maria Bibi; Binder, Harald

    2014-01-01

    controls using LNA-based quantitative real-time PCR (qRT-PCR). A signature of miRNAs was subsequently validated in an independent set of 111 serum samples from 60 patients with early-stage breast cancer and 51 healthy controls and further tested for reproducibility in 3 independent data sets from the GEO...... Database. RESULTS: A multivariable signature consisting of 9 miRNAs (miR-15a, miR-18a, miR-107, miR-133a, miR-139-5p, miR-143, miR-145, miR-365, miR-425) was identified that provided considerable discrimination between breast cancer patients and healthy controls. Further, the ability of the 9 mi......RNA signature to stratify samples from breast cancer patients and healthy controls was confirmed in the validation set (p = 0.012) with a corresponding AUC = 0.665 in the ROC-curve analysis. No association between miRNA expression and tumor grade, tumor size, menopausal- or lymph node status was observed...

  12. Non-Invasive, Quantitative, and Remote Detection of Early Radiation Cataracts for Applications in Bio-Astronautics and Bio-Informatics

    Science.gov (United States)

    Ansari, Rafat R.; Giblin, Frank J.; King, James F.; Singh, B. (Technical Monitor)

    2002-01-01

    Human exploration of Mars may be a possibility in the next twenty years. Maintaining good vision is an essential aspect of achieving a successful mission. Continuous radiation exposure is a risk factor for radiation-induced cataracts in astronauts. A compact device based on the technique of dynamic light scattering (DLS) is designed for monitoring an astronaut's ocular health during long-duration space travel. Preliminary data on the simulated effects of ionizing radiation exposure to the ocular tissues of nonhuman animals and results on the sensitivity of DLS over established clinical procedures in investigating cataracts are presented. This capability of early diagnosis, unmatched by any other clinical technique in use today, may enable prompt initiation of preventive/curative therapy. An internet web based system integrating photon correlation data and controlling the hardware to monitor cataract development in vivo at a remote site in real time (teleophthalmology) is currently being developed. Cataract studies on-board the International Space Station (ISS) will be helpful in designing better protective radiation shields for future space vehicles and space suits.

  13. Expression of Thiaminase in Zebrafish (Danio rerio) is Lethal and Has Implications for Use as a Biocontainment Strategy in Aquaculture and Invasive Species.

    Science.gov (United States)

    Noble, Sandra; Saxena, Vishal; Ekker, Marc; Devlin, Robert

    2017-12-01

    As the world increasingly relies on aquaculture operations to meet rising seafood demands, reliable biocontainment measures for farmed fish stocks are desired to minimize ecological impacts arising from interactions of cultured fish with wild populations. One possible biocontainment strategy is to induce a dietary dependence on a vitamin, such as thiamine (vitamin B1), required for survival. Fish expressing thiaminase (an enzyme that degrades thiamine) within a confined aquaculture facility could receive supplemental thiamine to allow survival and normal growth, whereas escapees lacking this dietary rescue would die from thiamine deficiency. To test the concept and efficacy of such a dietary dependency system (for potential future use in larger aquaculture species), we expressed thiaminase in zebrafish as a test model. We drove the expression of thiaminase under the strong ubiquitous and constitutive control of the CMV promoter which resulted in non-viable fish, indicating that the thiaminase sequence kills fish. However, the CMV promoter is too strong to allow conditional survival since the lethality could not be rescued by exogenous thiamine provided as a supplement to typical food. In addition, microinjection of 0.5 pg of thiaminase mRNA in zebrafish embryos at the one-cell stage resulted in 50% larval mortality at 5 days post-fertilization (dpf), which was partially rescued by thiamine supplementation. Evaluating the efficacy of biocontainment strategies helps assess which methods can reliably prevent ecological impacts arising from breaches in physical containment systems that release engineered organisms to nature, and consequently provides critical information for use in regulatory risk assessment processes.

  14. Unconventional gas development facilitates plant invasions.

    Science.gov (United States)

    Barlow, Kathryn M; Mortensen, David A; Drohan, Patrick J; Averill, Kristine M

    2017-11-01

    Vegetation removal and soil disturbance from natural resource development, combined with invasive plant propagule pressure, can increase vulnerability to plant invasions. Unconventional oil and gas development produces surface disturbance by way of well pad, road, and pipeline construction, and increased traffic. Little is known about the resulting impacts on plant community assembly, including the spread of invasive plants. Our work was conducted in Pennsylvania forests that overlay the Marcellus and Utica shale formations to determine if invasive plants have spread to edge habitat created by unconventional gas development and to investigate factors associated with their presence. A piecewise structural equation model was used to determine the direct and indirect factors associated with invasive plant establishment on well pads. The model included the following measured or calculated variables: current propagule pressure on local access roads, the spatial extent of the pre-development road network (potential source of invasive propagules), the number of wells per pad (indicator of traffic density), and pad age. Sixty-one percent of the 127 well pads surveyed had at least one invasive plant species present. Invasive plant presence on well pads was positively correlated with local propagule pressure on access roads and indirectly with road density pre-development, the number of wells, and age of the well pad. The vast reserves of unconventional oil and gas are in the early stages of development in the US. Continued development of this underground resource must be paired with careful monitoring and management of surface ecological impacts, including the spread of invasive plants. Prioritizing invasive plant monitoring in unconventional oil and gas development areas with existing roads and multi-well pads could improve early detection and control of invasive plants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. On the relationship between math anxiety and math achievement in early elementary school: The role of problem solving strategies.

    Science.gov (United States)

    Ramirez, Gerardo; Chang, Hyesang; Maloney, Erin A; Levine, Susan C; Beilock, Sian L

    2016-01-01

    Even at young ages, children self-report experiencing math anxiety, which negatively relates to their math achievement. Leveraging a large dataset of first and second grade students' math achievement scores, math problem solving strategies, and math attitudes, we explored the possibility that children's math anxiety (i.e., a fear or apprehension about math) negatively relates to their use of more advanced problem solving strategies, which in turn relates to their math achievement. Our results confirm our hypothesis and, moreover, demonstrate that the relation between math anxiety and math problem solving strategies is strongest in children with the highest working memory capacity. Ironically, children who have the highest cognitive capacity avoid using advanced problem solving strategies when they are high in math anxiety and, as a result, underperform in math compared with their lower working memory peers. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Outcomes of sentinel lymph node dissection alone vs. axillary lymph node dissection in early stage invasive lobular carcinoma: a retrospective study of the surveillance, epidemiology and end results (SEER database.

    Directory of Open Access Journals (Sweden)

    Jun Wang

    Full Text Available The American College of Surgeons Oncology Group (ACOSOG Z0011 trial demonstrated no difference in local-regional recurrence (LRR, disease-specific survival (DSS or overall survival (OS for sentinel lymph node dissection (SLND and completion axillary lymph node dissection (ALND among patients undergoing breast-conserving therapy for clinical T1-T2, N0 breast cancer with 1 or 2 positive SLNs. However, Only 7% of study participants had invasive lobular carcinoma (ILC. Because ILC has a different pattern of metastases, frequently presenting as small foci requiring immunohistochemistry for detection, the applicability of ACOSOG Z0011 trial data to ILC patients is unclear.We identified all ILC patients in the Surveillance, Epidemiology, and End Results (SEER database (1998-2009 who met the ACOSOG Z0011 eligibility criteria. Patients were evaluated on the basis of the extent of axillary surgery (SLND alone or ALND, and the clinical outcomes of these 2 groups were compared.1269 patients (393 SLND and 876 ALND were identified from the SEER database. At a median follow-up time of 71 months, there were no differences in OS or disease-specific survival between the two groups.SLND alone may result in outcomes comparable to those achieved with ALND for patients with early-stage ILC who meet the ACOSOG Z0011 eligibility criteria.

  17. Radiologic aspects in invasive aspergillosis

    International Nuclear Information System (INIS)

    Feger, C.; Kerviler, E. de; Zagdanski, A.M.; Attal, P.; Cyna-Gorse, F.; Frija, J.; Laval-Jeantet, M.

    1994-01-01

    Invasive aspergillosis is a life-threatening illness, whose diagnosis is difficult: clinical signs are indeed not specific, and biological and mycological exams are not always conclusive. Radiological exams are essential for the diagnosis of this disease allowing to start an early intensive appropriate therapy. According to the literature and to their own experience the authors report the main radiological patterns with emphasis on the pulmonary and cerebral affections. (authors). 26 refs., 5 figs

  18. Modelling the introduction and spread of non-native species: international trade and climate change drive ragweed invasion.

    Science.gov (United States)

    Chapman, Daniel S; Makra, László; Albertini, Roberto; Bonini, Maira; Páldy, Anna; Rodinkova, Victoria; Šikoparija, Branko; Weryszko-Chmielewska, Elżbieta; Bullock, James M

    2016-09-01

    Biological invasions are a major driver of global change, for which models can attribute causes, assess impacts and guide management. However, invasion models typically focus on spread from known introduction points or non-native distributions and ignore the transport processes by which species arrive. Here, we developed a simulation model to understand and describe plant invasion at a continental scale, integrating repeated transport through trade pathways, unintentional release events and the population dynamics and local anthropogenic dispersal that drive subsequent spread. We used the model to simulate the invasion of Europe by common ragweed (Ambrosia artemisiifolia), a globally invasive plant that causes serious harm as an aeroallergen and crop weed. Simulations starting in 1950 accurately reproduced ragweed's current distribution, including the presence of records in climatically unsuitable areas as a result of repeated introduction. Furthermore, the model outputs were strongly correlated with spatial and temporal patterns of ragweed pollen concentrations, which are fully independent of the calibration data. The model suggests that recent trends for warmer summers and increased volumes of international trade have accelerated the ragweed invasion. For the latter, long distance dispersal because of trade within the invaded continent is highlighted as a key invasion process, in addition to import from the native range. Biosecurity simulations, whereby transport through trade pathways is halted, showed that effective control is only achieved by early action targeting all relevant pathways. We conclude that invasion models would benefit from integrating introduction processes (transport and release) with spread dynamics, to better represent propagule pressure from native sources as well as mechanisms for long-distance dispersal within invaded continents. Ultimately, such integration may facilitate better prediction of spatial and temporal variation in invasion

  19. [Clinical significance of early percutaneous coronary intervention in patients with Braunwald III-B type unstable angina pectoris].

    Science.gov (United States)

    Nozaki, Katsuhiro; Nakao, Koichi; Horiuchi, Kenji; Kasanuki, Hiroshi; Honda, Takashi

    2003-06-01

    To assess the efficacy of early invasive strategy for the treatment of Braunwald III-B type unstable angina pectoris. This study included 573 consecutive patients of whom 267 underwent percutaneous coronary intervention (PCI) (312 lesions). The patients were divided into two groups, 95 treated with the early invasive strategy of coronary angiography within 24 hr of admission (Group PCI-I) and the remaining 172 treated with the early conservative strategy of coronary angiography 24 hr after admission (Group PCI-C). No significant differences were noted in the baseline characteristics of the two groups except for ST segment elevation on electrocardiography at presentation, which occurred significantly less frequently in Group PCI-C (36.8% vs 8.1%, p strategy for unstable angina pectoris were almost equivalent to those of the early conservative strategy, despite more frequent ST segmental elevation at admission in Group PCI-I. These findings suggest that the early invasive strategy for unstable angina pectoris may be acceptable even in the current Japanese clinical setting without the use of GP IIb/IIIa receptor antagonist, low molecular weight heparin or clopidogrel.

  20. Defining a strategy to evaluate cervical cancer prevention and early detection in the era of HPV vaccination.

    Science.gov (United States)

    Howlett, Roberta I; Miller, Anthony B; Pasut, George; Mai, Verna

    2009-05-01

    The purpose of this paper is to outline the short-, medium- and long-term requirements of a strategy to evaluate the impact of HPV immunization and to define a framework to facilitate planning and evaluation. This strategy was developed in Ontario from January to August 2008. Literature review was completed to assess existing material relevant to vaccine evaluation, and HPV vaccine specifically. Scientists and epidemiologists within our organization attended meetings to brainstorm and identify key requirements for vaccine evaluation. Other selected internal and external experts were consulted to review preliminary lists of potential indicators and questions for inclusion in an evaluation strategy. Results are reported in three sections--literature review, proposed evaluation framework and data requirements. The first vaccine evaluation strategy that integrates primary and secondary prevention of cervical cancer is presented. Among women who are neither screened nor immunized, customized interventions will be required to ensure that they are aware of potential risks and benefits. This evaluation strategy may serve as a useful outline for jurisdictions in Canada and elsewhere. This new paradigm of combined primary and secondary intervention will encourage cooperation for effective evaluation of an integrated approach for control of cervical cancer and other HPV-related disease.

  1. Expression profiling of migrated and invaded breast cancer cells predicts early metastatic relapse and reveals Krüppel-like factor 9 as a potential suppressor of invasive growth in breast cancer

    Science.gov (United States)

    Limame, Ridha; de Beeck, Ken Op; Van Laere, Steven; Croes, Lieselot; De Wilde, Annemieke; Dirix, Luc; Van Camp, Guy; Peeters, Marc; De Wever, Olivier; Lardon, Filip; Pauwels, Patrick

    2014-01-01

    Cell motility and invasion initiate metastasis. However, only a subpopulation of cancer cells within a tumor will ultimately become invasive. Due to this stochastic and transient nature, in an experimental setting, migrating and invading cells need to be isolated from the general population in order to study the gene expression profiles linked to these processes. This report describes microarray analysis on RNA derived from migrated or invaded subpopulations of triple negative breast cancer cells in a Transwell set-up, at two different time points during motility and invasion, pre-determined as “early” and “late” in real-time kinetic assessments. Invasion- and migration-related gene expression signatures were generated through comparison with non-invasive cells, remaining at the upper side of the Transwell membranes. Late-phase signatures of both invasion and migration indicated poor prognosis in a series of breast cancer data sets. Furthermore, evaluation of the genes constituting the prognostic invasion-related gene signature revealed Krüppel-like factor 9 (KLF9) as a putative suppressor of invasive growth in breast cancer. Next to loss in invasive vs non-invasive cell lines, KLF9 also showed significantly lower expression levels in the “early” invasive cell population, in several public expression data sets and in clinical breast cancer samples when compared to normal tissue. Overexpression of EGFP-KLF9 fusion protein significantly altered morphology and blocked invasion and growth of MDA-MB-231 cells in vitro. In addition, KLF9 expression correlated inversely with mitotic activity in clinical samples, indicating anti-proliferative effects. PMID:25593984

  2. Invasive aspergillosis in near drowning nonneutropenic patient.

    Science.gov (United States)

    Munta, Kartik; Gopal, Palepu B N; Vigg, Ajit

    2015-12-01

    Invasive aspergillosis in immunosuppressed people has been well documented, but to diagnose and treat in an immunocompetent individual after near drowning, it requires early suspicion and proper empirical treatment. We report a case diagnosed to have invasive aspergillosis with systemic dissemination of the infection to the brain, gluteal muscles, and kidneys after a fall in a chemical tank of a paper manufacturing company. He was ventilated for acute respiratory distress syndrome and managed with antibiotics and vasopressors. Due to nonresolving pneumonia and positive serum galactomannan, trans-tracheal biopsy was performed which confirmed invasive aspergillosis and was treated with antifungals. With the availability of galactomannan assay and better radiological investigative modalities, occurrence of such invasive fungal infections in cases of drowning patients should be considered early in such patients and treated with appropriate antifungals.

  3. Move, Act, Play, Sing (MAPS): Exploring Early Childhood Arts Teaching and Learning Strategies and Concepts through Community Arts Interventions

    Science.gov (United States)

    Lines, David; Naughton, Chris; Roder, John; Matapo, Jacoba; Whyte, Marjolein; Liao, Tiffany

    2014-01-01

    This project/report worked with three early childhood education centres who have adopted the Reggio Emilia philosophy of educational practice. Each centre works with children and parents in close collaboration and all the staff and centre management are committed to the project. The aim of this project was to work with each centre in developing…

  4. Transition to Early Childhood Education: Parents' Use of Coping Strategies in Dealing with Children's Adjustment Difficulties in Hong Kong

    Science.gov (United States)

    Lam, Mei Seung

    2014-01-01

    The transition from home to early childhood education can be stressful for both children and parents. How parents cope with this potentially stressful event affects both the children's adaptation and the parents' lives during the preschooler stage of the family lifecycle. This paper examines how parents respond to their children's adjustment…

  5. Development of an alternative testing strategy for the fish early life-stage (FELS) test using the AOP framework

    Science.gov (United States)

    Currently, the fish early life-stage (FELS) test (OECD 210) is the primary guideline used to estimate chronic toxicity of regulated chemicals. Although already more cost-efficient than adult fish tests, the FELS test has some important drawbacks. Both industry and regulatory inst...

  6. Hydrological and thermal effects of hydropeaking on early life stages of salmonids: A modelling approach for implementing mitigation strategies.

    Science.gov (United States)

    Casas-Mulet, Roser; Saltveit, Svein Jakob; Alfredsen, Knut Tore

    2016-12-15

    Alterations in hydrological and thermal regimes can potentially affect salmonid early life stages development and survival. The dewatering of salmon spawning redds due to hydropeaking can lead to mortality in early life stages, with higher impact on the alevins as they have lower tolerance to dewatering than the eggs. Flow-related mitigation measures can reduce early life stage mortality. We present a set of modelling tools to assess impacts and mitigation options to minimise the risk of mortality in early life stages in hydropeaking rivers. We successfully modelled long-term hydrological and thermal alterations and consequences for development rates. We estimated the risk of early life stages mortality and assessed the cost-effectiveness of implementing three release-related mitigation options (A,B,C). The economic cost of mitigation was low and ranged between 0.7% and 2.6% of the annual hydropower production. Options reducing the flow during spawning (B and C) in addition to only release minimum flows during development (A) were considered more effective for egg and alevin survival. Options B and C were however constraint by water availability in the system for certain years, and therefore only option A was always feasible. The set of modelling tools used in this study were satisfactory and their applications can be useful especially in systems where little field data is available. Targeted measures built on well-informed modelling tools can be tested on their effectiveness to mitigate dewatering effects vs. the hydropower system capacity to release or conserve water for power production. Environmental flow releases targeting specific ecological objectives can provide better cost-effective options than conventional operational rules complying with general legislation. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. A Probability Co-Kriging Model to Account for Reporting Bias and Recognize Areas at High Risk for Zebra Mussels and Eurasian Watermilfoil Invasions in Minnesota

    Directory of Open Access Journals (Sweden)

    Kaushi S. T. Kanankege

    2018-01-01

    Full Text Available Zebra mussels (ZMs (Dreissena polymorpha and Eurasian watermilfoil (EWM (Myriophyllum spicatum are aggressive aquatic invasive species posing a conservation burden on Minnesota. Recognizing areas at high risk for invasion is a prerequisite for the implementation of risk-based prevention and mitigation management strategies. The early detection of invasion has been challenging, due in part to the imperfect observation process of invasions including the absence of a surveillance program, reliance on public reporting, and limited resource availability, which results in reporting bias. To predict the areas at high risk for invasions, while accounting for underreporting, we combined network analysis and probability co-kriging to estimate the risk of ZM and EWM invasions. We used network analysis to generate a waterbody-specific variable representing boater traffic, a known high risk activity for human-mediated transportation of invasive species. In addition, co-kriging was used to estimate the probability of species introduction, using waterbody-specific variables. A co-kriging model containing distance to the nearest ZM infested location, boater traffic, and road access was used to recognize the areas at high risk for ZM invasions (AUC = 0.78. The EWM co-kriging model included distance to the nearest EWM infested location, boater traffic, and connectivity to infested waterbodies (AUC = 0.76. Results suggested that, by 2015, nearly 20% of the waterbodies in Minnesota were at high risk of ZM (12.45% or EWM (12.43% invasions, whereas only 125/18,411 (0.67% and 304/18,411 (1.65% are currently infested, respectively. Prediction methods presented here can support decisions related to solving the problems of imperfect detection, which subsequently improve the early detection of biological invasions.

  8. A Probability Co-Kriging Model to Account for Reporting Bias and Recognize Areas at High Risk for Zebra Mussels and Eurasian Watermilfoil Invasions in Minnesota.

    Science.gov (United States)

    Kanankege, Kaushi S T; Alkhamis, Moh A; Phelps, Nicholas B D; Perez, Andres M

    2017-01-01

    Zebra mussels (ZMs) ( Dreissena polymorpha ) and Eurasian watermilfoil (EWM) ( Myriophyllum spicatum ) are aggressive aquatic invasive species posing a conservation burden on Minnesota. Recognizing areas at high risk for invasion is a prerequisite for the implementation of risk-based prevention and mitigation management strategies. The early detection of invasion has been challenging, due in part to the imperfect observation process of invasions including the absence of a surveillance program, reliance on public reporting, and limited resource availability, which results in reporting bias. To predict the areas at high risk for invasions, while accounting for underreporting, we combined network analysis and probability co-kriging to estimate the risk of ZM and EWM invasions. We used network analysis to generate a waterbody-specific variable representing boater traffic, a known high risk activity for human-mediated transportation of invasive species. In addition, co-kriging was used to estimate the probability of species introduction, using waterbody-specific variables. A co-kriging model containing distance to the nearest ZM infested location, boater traffic, and road access was used to recognize the areas at high risk for ZM invasions (AUC = 0.78). The EWM co-kriging model included distance to the nearest EWM infested location, boater traffic, and connectivity to infested waterbodies (AUC = 0.76). Results suggested that, by 2015, nearly 20% of the waterbodies in Minnesota were at high risk of ZM (12.45%) or EWM (12.43%) invasions, whereas only 125/18,411 (0.67%) and 304/18,411 (1.65%) are currently infested, respectively. Prediction methods presented here can support decisions related to solving the problems of imperfect detection, which subsequently improve the early detection of biological invasions.

  9. Contrasting Strategies of Alfalfa Stem Elongation in Response to Fall Dormancy in Early Growth Stage: The Tradeoff between Internode Length and Internode Number

    Science.gov (United States)

    Wang, Zongli; Sun, Qizhong

    2015-01-01

    Fall dormancy (FD) in alfalfa (Medicago sativa L.) can be described using 11 FD ratings, is widely used as an important indicator of stress resistance, productive performance and spring growth. However, the contrasting growth strategies in internode length and internode number in alfalfa cultivars with different FD rating are poorly understood. Here, a growth chamber study was conducted to investigate the effect of FD on plant height, aboveground biomass, internode length, and internode number in alfalfa individuals in the early growth stages. In order to simulate the alfalfa growth environment in the early stage, 11 alfalfa cultivars with FD ratings from one to 11 were chosen and seeded at the greenhouse, and then were transplanted into an artificial growth chamber. The experimental design was a randomized complete block in a split-plot arrangement with three replicates. Plant height, above-ground biomass, internode length, and internode number were measured in early growth stage in all individuals. Our findings showed that plant height and the aboveground biomass of alfalfa did not significantly differ among 11 different FD rated cultivars. Also, internode length and internode number positively affected plant height and the aboveground biomass of alfalfa individuals and the average internode length significantly increased with increasing FD rating. However, internode number tended to sharply decline when the FD rating increased. Moreover, there were no correlations, slightly negative correlations, and strongly negative correlations between internode length and internode number in alfalfa individuals among the three scales, including within-FD ratings, within-FD categories and inter-FD ratings, respectively. Therefore, our results highlighted that contrasting growth strategies in stem elongation were adopted by alfalfa with different FD ratings in the early growth stage. Alfalfa cultivars with a high FD rating have longer internodes, whereas more dormant alfalfa

  10. Aggressive Behaviour in Early Elementary School Children: Relations to Authoritarian Parenting, Children's Negative Emotionality and Coping Strategies

    Science.gov (United States)

    Chan, Siu Mui

    2010-01-01

    This study examined whether authoritarian parenting, children's negative emotionality and negative coping strategies independently or jointly predict children's aggressive behaviour at school. Participants included the teachers and mothers of 185 Hong Kong resident Chinese children (90 girls and 95 boys), aged 6-8. Teachers rated the children's…

  11. A treat-to-target strategy with methotrexate and intra-articular triamcinolone with or without adalimumab effectively reduces MRI synovitis, osteitis and tenosynovitis and halts structural damage progression in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Axelsen, Mette Bjørndal; Eshed, Iris; Hørslev-Petersen, Kim

    2014-01-01

    To investigate whether a treat-to-target strategy with methotrexate and intra-articular glucocorticosteroid injections suppresses MRI inflammation and halts structural damage progression in patients with early rheumatoid arthritis (ERA), and whether adalimumab provides an additional effect....

  12. Prevailing Trends in Haptic Feedback Simulation for Minimally Invasive Surgery.

    Science.gov (United States)

    Pinzon, David; Byrns, Simon; Zheng, Bin

    2016-08-01

    Background The amount of direct hand-tool-tissue interaction and feedback in minimally invasive surgery varies from being attenuated in laparoscopy to being completely absent in robotic minimally invasive surgery. The role of haptic feedback during surgical skill acquisition and its emphasis in training have been a constant source of controversy. This review discusses the major developments in haptic simulation as they relate to surgical performance and the current research questions that remain unanswered. Search Strategy An in-depth review of the literature was performed using PubMed. Results A total of 198 abstracts were returned based on our search criteria. Three major areas of research were identified, including advancements in 1 of the 4 components of haptic systems, evaluating the effectiveness of haptic integration in simulators, and improvements to haptic feedback in robotic surgery. Conclusions Force feedback is the best method for tissue identification in minimally invasive surgery and haptic feedback provides the greatest benefit to surgical novices in the early stages of their training. New technology has improved our ability to capture, playback and enhance to utility of haptic cues in simulated surgery. Future research should focus on deciphering how haptic training in surgical education can increase performance, safety, and improve training efficiency. © The Author(s) 2016.

  13. Xenohormesis in early life: New avenues of research to explore anti-aging strategies through the maternal diet.

    Science.gov (United States)

    de Medina, Philippe

    2017-11-01

    Aging is a progressive internal physiological deterioration of the organism, leading to the occurrence of age-related lethal diseases. It has become a major societal challenge to understand the processes that drive aging and to develop rational pharmacological agents and dietary approaches to fight against age-related deterioration and diseases. Interestingly, several lines of evidence highlight an influence of the developmental period on the risk of age-related diseases later in life. This field is known as the developmental origins of health and disease. Following this logic, studying the modification of maternal diet during early life may provide innovative new anti-aging approaches. Nutritional and psychological stresses during gestation are associated with poorer offspring health conditions in late life, and must be avoided during pregnancy. Besides these recommendations, very little has been published about the possible use of maternal diet to program offspring for healthy aging and an extended lifespan. Such health benefits may be provided by different foreign molecules, and particularly the phytochemicals produced by stressed plants, or xenohormetins. The xenohormesis hypothesis proposes that xenohormetins are signals of environmental change and trigger a beneficial adaptive response in individuals who consume them. No studies to date have investigated whether the consumption of stressed plants during pregnancy and lactation could provide chemical cues that impact early life programming and thus influence the future health and lifespan of offspring. Investigating the effect of xenohormesis in early life will involve adding edible plants exposed to different stressors (i.e. UV light, heat, ozone, etc.) to maternal diet and the exposure of offspring to this xenohormetin-enriched maternal diet at different periods of their prenatal life. The hypothesis proposed in this article is a potential tool to decipher the possible impact of xenohormesis during early

  14. An exploration of the coping strategies of early adolescents in two Gauteng schools / Anneté Nel

    OpenAIRE

    Nel, Anneté

    2014-01-01

    In the South African context adolescents need to cope with societal and family-related stressors seen as everyday stressors, such as parental divorce, violence in communities, bereavement and pressure in schools. Research has shown that these everyday stressors could have negative effects on their well-being. It was further seen that such a high exposure to everyday stress like school-based stressors leads to an increase in unhealthy behaviour, such as smoking and alcohol use in early adolesc...

  15. E-commerce trade in invasive plants.

    Science.gov (United States)

    Humair, Franziska; Humair, Luc; Kuhn, Fabian; Kueffer, Christoph

    2015-12-01

    Biological invasions are a major concern in conservation, especially because global transport of species is still increasing rapidly. Conservationists hope to anticipate and thus prevent future invasions by identifying and regulating potentially invasive species through species risk assessments and international trade regulations. Among many introduction pathways of non-native species, horticulture is a particularly important driver of plant invasions. In recent decades, the horticultural industry expanded globally and changed structurally through the emergence of new distribution channels, including internet trade (e-commerce). Using an automated search algorithm, we surveyed, on a daily basis, e-commerce trade on 10 major online auction sites (including eBay) of approximately three-fifths of the world's spermatophyte flora. Many recognized invasive plant species (>500 species) (i.e., species associated with ecological or socio-economic problems) were traded daily worldwide on the internet. A markedly higher proportion of invasive than non-invasive species were available online. Typically, for a particular plant family, 30-80% of recognized invasive species were detected on an auction site, but only a few percentages of all species in the plant family were detected on a site. Families that were more traded had a higher proportion of invasive species than families that were less traded. For woody species, there was a significant positive relationship between the number of regions where a species was sold and the number of regions where it was invasive. Our results indicate that biosecurity is not effectively regulating online plant trade. In the future, automated monitoring of e-commerce may help prevent the spread of invasive species, provide information on emerging trade connectivity across national borders, and be used in horizon scanning exercises for early detection of new species and their geographic source areas in international trade. © 2015 Society for

  16. "You Didn't Teach Me, You Showed Me": Variations in Sibling Teaching Strategies in Early and Middle Childhood

    Science.gov (United States)

    Recchia, Holly E.; Howe, Nina; Alexander, Stephanie

    2009-01-01

    This study examined siblings' teaching strategies in 72 dyads (firstborn and second born, M ages = 81.64 and 56.31 months) as a function of dyad age, age gap between siblings, and teacher birth order. One child per dyad was randomly assigned to teach her or his sibling to construct a tractor toy. Interactions were coded for the topic of teachers'…

  17. Exploring corporate culture and strategy: Sainsbury at home and abroad during the early to mid 1990s

    OpenAIRE

    R Shackleton

    1998-01-01

    In this paper the UK food retailer, J Sainsbury plc, is used as anexample to illustrate the intimate power relationship between corporate culture and corporate strategy, and it is argued that corporate culture plays a key role in determining the economic performance of firms. Specifically, it is shown how corporate culture can concurrently be advantageous and burdensome within the same firm. Indeed, it is argued that the strength of Sainsbury's corporate culture prevented it from reacting to ...

  18. Is there a role for antibody testing in the diagnosis of invasive candidiasis?

    Science.gov (United States)

    Quindós, Guillermo; Moragues, María Dolores; Pontón, José

    2004-03-01

    During the last decades, the use of antibody tests for the diagnosis of invasive mycoses has declined as a consequence of the general belief that they are insensitive and non-specific. However, there is a clear evidence that antibodies can be detected in highly immunodeficient patients (such as bone marrow transplant recipients), and that those antibodies are useful for the diagnosis. Antibody tests are currently in use as diagnostic tools for some primary mycoses, such as the endemic mycoses, aspergilloma, allergic bronchopulmonary aspergilosis and sporothrichosis. For invasive candidiasis, diagnostic methods must differentiate Candida colonization of mucous membranes or superficial infection from tissue invasion by this microorganism. Substantial progress has been made in diagnosis of invasive candidiasis with the development of a variety of methods for the detection of antibodies and antigens. However, no single test has found widespread clinical use and there is a consensus that diagnosis based on a single specimen lacks sensitivity. It is necessary to test sequential samples taken while the patient is at greatest risk for developing invasive candidiasis to optimize the diagnosis. Results obtained from a panel of diagnostic tests in association with clinical aspects will likely be the most useful strategy for early diagnosis and therapy.

  19. HIV treatment as prevention: debate and commentary--will early infection compromise treatment-as-prevention strategies?

    Directory of Open Access Journals (Sweden)

    Myron S Cohen

    Full Text Available Universal HIV testing and immediate antiretroviral therapy for infected individuals has been proposed as a way of reducing the transmission of HIV and thereby bringing the HIV epidemic under control. It is unclear whether transmission during early HIV infection--before individuals are likely to have been diagnosed with HIV and started on antiretroviral therapy--will compromise the effectiveness of treatment as prevention. This article presents two opposing viewpoints by Powers, Miller, and Cohen, and Williams and Dye, followed by a commentary by Fraser.

  20. Yes to early detection of cancer - no to routine mammography examinations. Parting from wishful thinking, turning to new strategies

    CERN Document Server

    Dersee, T; Koehnlein, W; Kuni, H; Lengfelder, E; Pflugbeil, S; Schmitz-Feuerhake, I

    2002-01-01

    Many experts find it difficult to accept what experience has shown, namely that routine mammography examinations have lowered neither the breast cancer fatality rate nor the crude death rate. One aspect that has been neglected in propagating screenings is the high radiation sensitivity of genetically predisposed females (0.5% - 1.0%). These females should not be exposed to repeated X-rays for screening purposes. True preventive measures, which promise significant effects, include the avoidance of radiation exposure, especially during the early stages of life, and a restrictive use of oestrogen substitution therapies.

  1. Yes to early detection of cancer - no to routine mammography examinations. Parting from wishful thinking, turning to new strategies

    International Nuclear Information System (INIS)

    Dersee, T.; Dieckmann, H.; Koehnlein, W.; Kuni, H.; Lengfelder, E.; Pflugbeil, S.; Schmitz-Feuerhake, I.

    2002-01-01

    Many experts find it difficult to accept what experience has shown, namely that routine mammography examinations have lowered neither the breast cancer fatality rate nor the crude death rate. One aspect that has been neglected in propagating screenings is the high radiation sensitivity of genetically predisposed females (0.5% - 1.0%). These females should not be exposed to repeated X-rays for screening purposes. True preventive measures, which promise significant effects, include the avoidance of radiation exposure, especially during the early stages of life, and a restrictive use of oestrogen substitution therapies

  2. A model-based assessment of the cost–utility of strategies to identify Lynch syndrome in early-onset colorectal cancer patients

    International Nuclear Information System (INIS)

    Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

    2015-01-01

    Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2. Individuals with Lynch syndrome have an increased risk of colorectal cancer, endometrial cancer, ovarian and other cancers. Lynch syndrome remains underdiagnosed in the UK. Reflex testing for Lynch syndrome in early-onset colorectal cancer patients is proposed as a method to identify more families affected by Lynch syndrome and offer surveillance to reduce cancer risks, although cost-effectiveness is viewed as a barrier to implementation. The objective of this project was to estimate the cost–utility of strategies to identify Lynch syndrome in individuals with early-onset colorectal cancer in the NHS. A decision analytic model was developed which simulated diagnostic and long-term outcomes over a lifetime horizon for colorectal cancer patients with and without Lynch syndrome and for relatives of those patients. Nine diagnostic strategies were modelled which included microsatellite instability (MSI) testing, immunohistochemistry (IHC), BRAF mutation testing (methylation testing in a scenario analysis), diagnostic mutation testing and Amsterdam II criteria. Biennial colonoscopic surveillance was included for individuals diagnosed with Lynch syndrome and accepting surveillance. Prophylactic hysterectomy with bilateral salpingo-oophorectomy (H-BSO) was similarly included for women diagnosed with Lynch syndrome. Costs from NHS and Personal Social Services perspective and quality-adjusted life years (QALYs) were estimated and discounted at 3.5% per annum. All strategies included for the identification of Lynch syndrome were cost-effective versus no testing. The strategy with the greatest net health benefit was MSI followed by BRAF followed by diagnostic genetic testing, costing £5,491 per QALY gained over no testing. The effect of prophylactic H-BSO on health-related quality of life (HRQoL) is uncertain and could

  3. A model-based assessment of the cost-utility of strategies to identify Lynch syndrome in early-onset colorectal cancer patients.

    Science.gov (United States)

    Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

    2015-04-25

    Lynch syndrome is an autosomal dominant cancer predisposition syndrome caused by mutations in the DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2. Individuals with Lynch syndrome have an increased risk of colorectal cancer, endometrial cancer, ovarian and other cancers. Lynch syndrome remains underdiagnosed in the UK. Reflex testing for Lynch syndrome in early-onset colorectal cancer patients is proposed as a method to identify more families affected by Lynch syndrome and offer surveillance to reduce cancer risks, although cost-effectiveness is viewed as a barrier to implementation. The objective of this project was to estimate the cost-utility of strategies to identify Lynch syndrome in individuals with early-onset colorectal cancer in the NHS. A decision analytic model was developed which simulated diagnostic and long-term outcomes over a lifetime horizon for colorectal cancer patients with and without Lynch syndrome and for relatives of those patients. Nine diagnostic strategies were modelled which included microsatellite instability (MSI) testing, immunohistochemistry (IHC), BRAF mutation testing (methylation testing in a scenario analysis), diagnostic mutation testing and Amsterdam II criteria. Biennial colonoscopic surveillance was included for individuals diagnosed with Lynch syndrome and accepting surveillance. Prophylactic hysterectomy with bilateral salpingo-oophorectomy (H-BSO) was similarly included for women diagnosed with Lynch syndrome. Costs from NHS and Personal Social Services perspective and quality-adjusted life years (QALYs) were estimated and discounted at 3.5% per annum. All strategies included for the identification of Lynch syndrome were cost-effective versus no testing. The strategy with the greatest net health benefit was MSI followed by BRAF followed by diagnostic genetic testing, costing £5,491 per QALY gained over no testing. The effect of prophylactic H-BSO on health-related quality of life (HRQoL) is uncertain and could outweigh

  4. The Strategy and Early Clinical Outcome of Percutaneous Full-Endoscopic Interlaminar or Extraforaminal Approach for Treatment of Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Weijun Kong

    2016-01-01

    Full Text Available Objective is to analyze the surgical strategy, safety, and clinical results of percutaneous full-endoscopic discectomy through interlaminar or extraforaminal puncture technique for LDH. Preoperative CT and MRI were analyzed, which were based on the main location of the herniated disc and its relationship with compressed nerve root. Sixty-two patients satisfied the inclusion criteria during the period from August 2012 to March 2014. We use percutaneous full-endoscopic discectomy through different puncture technique to remove the protrusive NP for LDH. Sixty patients completed the full-endoscopic operation successfully. Their removed disc tissue volume ranged from 1.5 mL to 3.8 mL each time. Postoperative ODI and VAS of low back and sciatica pain were significantly decreased in each time point compared to preoperative ones. No nerve root injury, infection, and other complications occurred. The other two patients were shifted to open surgery. No secondary surgery was required and 91.6% of excellent-to-good ratio was achieved on the basis of Macnab criteria at postoperative 12 months. Acquired benefits are fewer complications, rapid recovery, complete NP removal, effective nerve root decompression, and satisfactory cosmetic effect as well. This is a safe, effective, and rational minimally invasive spine-surgical technology with excellent clinical outcome.

  5. Early intervention and identification strategies for young people at risk of developing mental health issues: working in partnership with schools in Birmingham, UK.

    Science.gov (United States)

    Palmer, Colin J; Connor, Charlotte; Newton, Benjamin John; Patterson, Paul; Birchwood, Max

    2017-12-01

    This study explores the mental health needs of teachers and how these might impact on their capacity to provide early identification and intervention strategies to support their student's emotional well-being. The present study surveyed a sample of UK teachers (N = 320) to explore the impact of work-related stress on their mental health and their ability to provide early intervention support for their students. Our survey showed high levels of work-related stress due to time pressures and excessive workloads; many teachers failed to seek help for their stress often due to stigmatic attitudes and fear of negative response by senior management. Such factors led some to withdraw from taking on extra responsibilities with regard to student support and to consider leaving the teaching profession altogether. Coping mechanisms included the use of alcohol and tobacco, with only a small minority receiving access to psychological therapies. High levels of work-related stress in teachers can have serious consequences for their mental health and impede their ability to provide effective early intervention support for their student's emotional well-being. Improvements in mental health training for teachers and greater assistance for their own mental health needs are necessary. © 2015 Wiley Publishing Asia Pty Ltd.

  6. Dynamic models in research and management of biological invasions.

    Science.gov (United States)

    Buchadas, Ana; Vaz, Ana Sofia; Honrado, João P; Alagador, Diogo; Bastos, Rita; Cabral, João A; Santos, Mário; Vicente, Joana R

    2017-07-01

    Invasive species are increasing in number, extent and impact worldwide. Effective invasion management has thus become a core socio-ecological challenge. To tackle this challenge, integrating spatial-temporal dynamics of invasion processes with modelling approaches is a promising approach. The inclusion of dynamic processes in such modelling frameworks (i.e. dynamic or hybrid models, here defined as models that integrate both dynamic and static approaches) adds an explicit temporal dimension to the study and management of invasions, enabling the prediction of invasions and optimisation of multi-scale management and governance. However, the extent to which dynamic approaches have been used for that purpose is under-investigated. Based on a literature review, we examined the extent to which dynamic modelling has been used to address invasions worldwide. We then evaluated how the use of dynamic modelling has evolved through time in the scope of invasive species management. The results suggest that modelling, in particular dynamic modelling, has been increasingly applied to biological invasions, especially to support management decisions at local scales. Also, the combination of dynamic and static modelling approaches (hybrid models with a spatially explicit output) can be especially effective, not only to support management at early invasion stages (from prevention to early detection), but also to improve the monitoring of invasion processes and impact assessment. Further development and testing of such hybrid models may well be regarded as a priority for future research aiming to improve the management of invasions across scales. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Subcompartmentalisation of proteins in the rhoptries correlates with ordered events of erythrocyte invasion by the blood stage malaria parasite.

    Directory of Open Access Journals (Sweden)

    Elizabeth S Zuccala

    Full Text Available Host cell infection by apicomplexan parasites plays an essential role in lifecycle progression for these obligate intracellular pathogens. For most species, including the etiological agents of malaria and toxoplasmosis, infection requires active host-cell invasion dependent on formation of a tight junction - the organising interface between parasite and host cell during entry. Formation of this structure is not, however, shared across all Apicomplexa or indeed all parasite lifecycle stages. Here, using an in silico integrative genomic search and endogenous gene-tagging strategy, we sought to characterise proteins that function specifically during junction-dependent invasion, a class of proteins we term invasins to distinguish them from adhesins that function in species specific host-cell recognition. High-definition imaging of tagged Plasmodium falciparum invasins localised proteins to multiple cellular compartments of the blood stage merozoite. This includes several that localise to distinct subcompartments within the rhoptries. While originating from the same organelle, however, each has very different dynamics during invasion. Apical Sushi Protein and Rhoptry Neck protein 2 release early, following the junction, whilst a novel rhoptry protein PFF0645c releases only after invasion is complete. This supports the idea that organisation of proteins within a secretory organelle determines the order and destination of protein secretion and provides a localisation-based classification strategy for predicting invasin function during apicomplexan parasite invasion.

  8. Combined effect of therapeutic strategies for bleeding injury on early survival, transfusion needs and correction of coagulopathy

    DEFF Research Database (Denmark)

    Balvers, K.; van Dieren, S.; Baksaas-Aasen, K.

    2017-01-01

    Background: The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on trauma-induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, tranexamic acid and products containing......) or high (1 or more : 1) ratio of plasma or platelets to RBCs, and in receipt or not of tranexamic acid or fibrinogen products (fibrinogen concentrates or cryoprecipitate). Logistic regression models were used to assess the effect of transfusion strategies on the outcomes ‘alive and free from massive...... number of patients alive and without massive transfusion were a high platelet to RBC ratio (odds ratio (OR) 2·67, 95 per cent c.i. 1·24 to 5·77; P = 0·012), a high plasma to RBC ratio (OR 2·07, 1·03 to 4·13; P = 0·040) and treatment with tranexamic acid (OR 2·71, 1·29 to 5·71; P = 0·009). No strategies...

  9. Worldwide Alien Invasion: A Methodological Approach to Forecast the Potential Spread of a Highly Invasive Pollinator.

    Directory of Open Access Journals (Sweden)

    André L Acosta

    Full Text Available The ecological impacts of alien species invasion are a major threat to global biodiversity. The increasing number of invasion events by alien species and the high cost and difficulty of eradicating invasive species once established require the development of new methods and tools for predicting the most susceptible areas to invasion. Invasive pollinators pose serious threats to biodiversity and human activity due to their close relationship with many plants (including crop species and high potential competitiveness for resources with native pollinators. Although at an early stage of expansion, the bumblebee species Bombus terrestris is becoming a representative case of pollinator invasion at a global scale, particularly given its high velocity of invasive spread and the increasing number of reports of its impacts on native bees and crops in many countries. We present here a methodological framework of habitat suitability modeling that integrates new approaches for detecting habitats that are susceptible to Bombus terrestris invasion at a global scale. Our approach did not include reported invaded locations in the modeling procedure; instead, those locations were used exclusively to evaluate the accuracy of the models in predicting suitability over regions already invaded. Moreover, a new and more intuitive approach was developed to select the models and evaluate different algorithms based on their performance and predictive convergence. Finally, we present a comprehensive global map of susceptibility to Bombus terrestris invasion that highlights priority areas for monitoring.

  10. Discovering Novel Alternaria solani Succinate Dehydrogenase Inhibitors by in Silico Modeling and Virtual Screening Strategies to Combat Early Blight

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    Sehrish Iftikhar

    2017-11-01

    Full Text Available Alternaria blight is an important foliage disease caused by Alternaria solani. The enzyme Succinate dehydrogenase (SDH is a potential drug target because of its role in tricarboxylic acid cycle. Hence targeting Alternaria solani SDH enzyme could be efficient tool to design novel fungicides against A. solani. We employed computational methodologies to design new SDH inhibitors using homology modeling; pharmacophore modeling and structure based virtual screening. The three dimensional SDH model showed good stereo-chemical and structural properties. Based on virtual screening results twelve commercially available compounds were purchased and tested in vitro and in vivo. The compounds were found to inhibit mycelial growth of A. solani. Moreover in vitro trials showed that inhibitory effects were enhanced with increase in concentrations. Similarly increased disease control was observed in pre-treated potato tubers. Hence the applied in silico strategy led us to identify novel fungicides.

  11. [The strategies of the symbolic struggle for the training of the visiting nurse in the early twentieth century].

    Science.gov (United States)

    Ayres, Lílian Fernandes Arial; Amorim, Wellington Mendonça de; Piva, Teresa Cristina de Carvalho; Porto, Fernando Rocha

    2012-09-01

    Based on the historical and social perspective, the scope of this documentary study were the strategies of the symbolic struggle for the training of agents in home visitation in the Courses for Visiting Nurses of the Brazilian Red Cross and the National Department of Public Health in Rio de Janeiro (Federal District), with repercussions in the Department of Health and Welfare of the State of Pernambuco between 1920 and 1926. We adopted the thinking of sociologist Pierre Bourdieu as a theoretical benchmark, showing the symbolic struggle in the field of public health between sanitarians Amaury de Medeiros and José P. Fontenelle and public health nurse Ethel Parsons, to analyze who was responsible for the scientific authority and competence of the training of visiting nurses.

  12. Cost effectiveness of screening strategies for early identification of HIV and HCV infection in injection drug users.

    Directory of Open Access Journals (Sweden)

    Lauren E Cipriano

    Full Text Available To estimate the cost, effectiveness, and cost effectiveness of HIV and HCV screening of injection drug users (IDUs in opioid replacement therapy (ORT.Dynamic compartmental model of HIV and HCV in a population of IDUs and non-IDUs for a representative U.S. urban center with 2.5 million adults (age 15-59.We considered strategies of screening individuals in ORT for HIV, HCV, or both infections by antibody or antibody and viral RNA testing. We evaluated one-time and repeat screening at intervals from annually to once every 3 months. We calculated the number of HIV and HCV infections, quality-adjusted life years (QALYs, costs, and incremental cost-effectiveness ratios (ICERs.Adding HIV and HCV viral RNA testing to antibody testing averts 14.8-30.3 HIV and 3.7-7.7 HCV infections in a screened population of 26,100 IDUs entering ORT over 20 years, depending on screening frequency. Screening for HIV antibodies every 6 months costs $30,700/QALY gained. Screening for HIV antibodies and viral RNA every 6 months has an ICER of $65,900/QALY gained. Strategies including HCV testing have ICERs exceeding $100,000/QALY gained unless awareness of HCV-infection status results in a substantial reduction in needle-sharing behavior.Although annual screening for antibodies to HIV and HCV is modestly cost effective compared to no screening, more frequent screening for HIV provides additional benefit at less cost. Screening individuals in ORT every 3-6 months for HIV infection using both antibody and viral RNA technologies and initiating ART for acute HIV infection appears cost effective.

  13. Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency.

    Science.gov (United States)

    von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

    2017-09-10

    Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

  14. The impact of lobular carcinoma in situ in association with invasive breast cancer on the rate of local recurrence in patients with early-stage breast cancer treated with breast-conserving therapy

    International Nuclear Information System (INIS)

    Jolly, Shruti; Kestin, Larry L.; Goldstein, Neal S.; Vicini, Frank A.

    2006-01-01

    Purpose: The significance of lobular carcinoma in situ (LCIS) associated with invasive breast cancer in patients undergoing breast-conserving therapy (BCT) remains controversial. We examined the impact of the presence and extent of LCIS associated with invasive breast cancer on clinical outcome in BCT patients. Methods and Materials: From 1980 to 1996, 607 cases of invasive breast cancer were treated with BCT. All slides were reviewed by a single pathologist. Positive margin was defined as presence of invasive carcinoma/ductal carcinoma in situ at the inked margin. Multiple clinical, pathologic, and treatment-related variables were analyzed for their association with ipsilateral breast tumor recurrence (IBTR) and true recurrence/marginal miss (TR/MM). Median follow-up was 8.7 years. Results: Fifty-six patients (9%) had LCIS in association with invasive cancer. On univariate analysis, positive final margin, positive/no reexcision, smaller maximum specimen dimension, and the presence of LCIS predicted for IBTR. The 10-year IBTR rate was 14% for cases with LCIS vs. 7% without LCIS (p = 0.04). On multivariate analysis, positive margin (p < 0.01), positive/no reexcision (p = 0.04), and presence of LCIS (p = 0.02) remained independently associated with IBTR; positive margin (p < 0.01) and LCIS (p = 0.04) were also associated with TR/MM failure. When examining only cases with negative final margins, the presence of LCIS remained associated with higher IBTR and TR/MM rates (p < 0.01). Conclusion: The presence of LCIS was independently associated with higher rate of IBTR and TR/MM after BCT for invasive breast cancer. LCIS may have significant premalignant potential and progress to an invasive IBTR at the site of index lesion. The adequacy of excision of LCIS associated with invasive carcinoma should be considered in patients undergoing BCT

  15. Strategies for the early detection of drug-induced hepatic steatosis in preclinical drug safety evaluation studies

    International Nuclear Information System (INIS)

    Amacher, David E.

    2011-01-01

    Hepatic steatosis is characterized by the accumulation of lipid droplets in the liver. Although relatively benign, simple steatosis can eventually lead to the development of steatohepatitis, a more serious condition characterized by fibrosis, cirrhosis, and eventual liver failure if the underlying cause is not eliminated. According to the 'two hit' theory of steatohepatitis, the initial hit involves fat accumulation in the liver, and a second hit leads to inflammation and subsequent tissue injury. Because some xenobiotics target liver fatty acid metabolism, especially mitochondrial β-oxidation, it is important to avoid potential drug candidates that can contribute to either the initiation of liver steatosis or progression to the more injurious steatohepatitis. The gold standard for the detection of these types of hepatic effects is histopathological examination of liver tissue. In animal studies, these examinations are slow, restricted to a single sampling time, and limited tissue sections. Recent literature suggests that rapid in vitro screening methods can be used early in the drug R and D process to identify compounds with steatotic potential. Further, progress in the identification of potential serum or plasma protein biomarkers for these liver changes may provide additional in vivo tools to the preclinical study toxicologist. This review summarizes recent developments for in vitro screening and in vivo biomarker detection for steatotic drug candidates.

  16. Chitosan-based dressings loaded with neurotensin--an efficient strategy to improve early diabetic wound healing.

    Science.gov (United States)

    Moura, Liane I F; Dias, Ana M A; Leal, Ermelindo C; Carvalho, Lina; de Sousa, Hermínio C; Carvalho, Eugénia

    2014-02-01

    One important complication of diabetes mellitus is chronic, non-healing diabetic foot ulcers (DFUs). This study aims to develop and use dressings based on chitosan derivatives for the sustained delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. Three different derivatives, namely N-carboxymethyl chitosan, 5-methyl pyrrolidinone chitosan (MPC) and N-succinyl chitosan, are presented as potential biomaterials for wound healing applications. Our results show that MPC has the best fluid handling capacity and delivery profile, also being non-toxic to Raw 264.7 and HaCaT cells. NT-loaded and non-loaded MPC dressings were applied to control/diabetic wounds to evaluate their in vitro/in vivo performance. The results show that the former induced more rapid healing (50% wound area reduction) in the early phases of wound healing in diabetic mice. A NT-loaded MPC foam also reduced expression of the inflammatory cytokine TNF-α (Pdiabetic skin (P<0.001), significantly increasing fibroblast migration and collagen (COL1A1, COL1A2 and COL3A1) expression and deposition. These results suggest that MPC-based dressings may work as an effective support for sustained NT release to reduce DFUs. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  17. The effect of tobacco smoking and treatment strategy on the one-year mortality of patients with acute non-ST-segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Roislien Jo

    2010-12-01

    Full Text Available Abstract Background The aim of the present study was to investigate whether a previously shown survival benefit resulting from routine early invasive management of unselected patients with acute non-ST-segment elevation myocardial infarction (NSTEMI may differ according to smoking status and age. Methods Post-hoc analysis of a prospective observational cohort study of consecutive patients admitted for NSTEMI in 2003 (conservative strategy cohort [CS]; n = 185 and 2006 (invasive strategy cohort [IS]; n = 200. A strategy for transfer to a high-volume invasive center and routine early invasive management was implemented in 2005. Patients were subdivided into current smokers and non-smokers (including ex-smokers on admission. Results The one-year mortality rate of smokers was reduced from 37% in the CS to 6% in the IS (p Conclusions The treatment effect of an early invasive strategy in unselected patients with NSTEMI was more pronounced among smokers than non-smokers. The benefit for smokers was not entirely explained by differences in baseline confounders, such as their younger age.

  18. Using economic instruments to develop effective management of invasive species: insights from a bioeconomic model.

    Science.gov (United States)

    McDermott, Shana M; Irwin, Rebecca E; Taylor, Brad W

    2013-07-01

    Economic growth is recognized as an important factor associated with species invasions. Consequently, there is increasing need to develop solutions that combine economics and ecology to inform invasive species management. We developed a model combining economic, ecological, and sociological factors to assess the degree to which economic policies can be used to control invasive plants. Because invasive plants often spread across numerous properties, we explored whether property owners should manage invaders cooperatively as a group by incorporating the negative effects of invader spread in management decisions (collective management) or independently, whereby the negative effects of invasive plant spread are ignored (independent management). Our modeling approach used a dynamic optimization framework, and we applied the model to invader spread using Linaria vulgaris. Model simulations allowed us to determine the optimal management strategy based on net benefits for a range of invader densities. We found that optimal management strategies varied as a function of initial plant densities. At low densities, net benefits were high for both collective and independent management to eradicate the invader, suggesting the importance of early detection and eradication. At moderate densities, collective management led to faster and more frequent invader eradication compared to independent management. When we used a financial penalty to ensure that independent properties were managed collectively, we found that the penalty would be most feasible when levied on a property's perimeter boundary to control spread among properties. At the highest densities, the optimal management strategy was "do nothing" because the economic costs of removal were too high relative to the benefits of removal. Spatial variation in L. vulgaris densities resulted in different optimal management strategies for neighboring properties, making a formal economic policy to encourage invasive species removal

  19. A Case of Impalement Brain Injury That Could Achieve Good Neurological Outcome by Introducing Early Sedation and Immobilization Strategy

    Directory of Open Access Journals (Sweden)

    Wataru Takayama

    2018-01-01

    Full Text Available Impalement brain injury is rare, and the initial management of this condition is not well-established. We present a case of a well-managed brain injury caused by impalement with a metal bar. A 29-year-old man whose head had been impaled by a metal bar was transferred to our hospital. Upon arrival, he was agitated, with an unsteady gait and prominent odor of alcohol on his breath. He exhibited normal vital signs and neurological findings, except for his level of consciousness. To address the risk of secondary brain injury caused by movement of the foreign body, we immediately administered a sedative agent and muscle relaxant after the initial neurological evaluation. The imaging evaluation revealed the insertion of a metal bar into the right frontal lobe at a depth of >100 mm through the frontal bone; however, there was no apparent major vessel injury-related complication. Three hours after arrival at the hospital, a craniotomy was performed to remove the foreign body. The patient’s postoperative course was uneventful, and he was discharged after rehabilitation without any neurological deficits. The strategy of immediate immobilization to prevent the secondary brain injury is important in the initial management of a patient who has survived an impalement brain injury and presented to an emergency department.

  20. Detection of Circulating Mucorales DNA in Critically Ill Burn Patients: Preliminary Report of a Screening Strategy for Early Diagnosis and Treatment.

    Science.gov (United States)

    Legrand, Matthieu; Gits-Muselli, Maud; Boutin, Louis; Garcia-Hermoso, Dea; Maurel, Véronique; Soussi, Sabri; Benyamina, Mourad; Ferry, Axelle; Chaussard, Maïté; Hamane, Samia; Denis, Blandine; Touratier, Sophie; Guigue, Nicolas; Fréalle, Emilie; Jeanne, Mathieu; Shaal, Jean-Vivien; Soler, Charles; Mimoun, Maurice; Chaouat, Marc; Lafaurie, Matthieu; Mebazaa, Alexandre; Bretagne, Stéphane; Alanio, Alexandre

    2016-11-15

    Invasive wound mucormycosis (IWM) is associated with an extremely poor outcome among critically ill burn patients. We describe the detection of circulating Mucorales DNA (cmDNA) for the early diagnosis of IWM in those patients and report the potential value of detecting cmDNA for treatment guidance.  Severely ill burn patients admitted to our tertiary referral center between October 2013 and February 2016 were included. Retrospective plasma samples were tested for the presence of cmDNA by quantitative real-time polymerase chain reaction (qPCR). Patients were then prospectively screened twice a week, and liposomal amphotericin-B therapy initiated based on a positive qPCR. The primary endpoint was the time between cmDNA detection and standard diagnosis. Secondary endpoints were the time from cmDNA detection and treatment initiation and mortality.  Seventy-seven patients (418 samples) were included. The average age was 46 (28-60) years, abbreviated burn severity index was 8 (7-10), and simplified acute physiology score was 33 (23-46). The total body surface area was 33% (22%-52%). cmDNA was detected 11 (4.5-15) days before standard diagnosis. The in-hospital mortality was 62% for patients with IWM and 24% for those without (P = .03). The mortality due to IWM was 80% during period A and 33% during period B (P = .46).  This study suggests that the detection of cmDNA allows earlier diagnosis of IWM in severely ill burn patients and earlier initiation of treatment. Further studies are needed to confirm the impact of earlier treatment initiation on patient outcome. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  1. The early warning application role in facing the environmental crisis and disasters: "Preliminarily risk management strategy for the greater city of Cairo"

    Directory of Open Access Journals (Sweden)

    Ghoneem Yousef M.

    2013-01-01

    Full Text Available Natural disasters are inevitable and it is almost impossible to fully recoup the damage caused by the disasters. But it is possible to minimize the potential risk by developing disaster early warning strategies, methods using the new technology applications which play a crucial role in efficient mitigation and management of disasters. This paper describes the importance of the remote sensing and Geographical Information System (GIS in evolving a suitable strategy for disaster, crises and risk management using these technologies. The main objective of this paper is to make a Preliminary risk management plan (it is a logical and systematic method of identifying, analyzing, treating and monitoring the risks involved in any activity or process. This process helps Administrations to focus on priorities and in decisions on deploying limited resources to deal with the highest risks using the Environmental risk map of the greater city of Cairo demonstrating the most high-risk administrative areas in the city, supported by field evidence and different sources of information. to reduce the loss of life and property and protect the Nation from all hazards, including natural disasters and other man-made disasters, by leading and supporting the Nation in a risk-based, comprehensive emergency management system of preparedness, protection, response, recovery, and mitigation. This study has shown that how can the early warning Applications can be useful in analyzing, Integrating and managing different datasets for predicting the environmental crises and disasters that may affect the urbanism inside the city and help in the preparation of the Risk management plan.

  2. High HIV incidence in men who have sex with men following an early syphilis diagnosis: is there room for pre-exposure prophylaxis as a prevention strategy?

    Science.gov (United States)

    Girometti, Nicolò; Gutierrez, Angela; Nwokolo, Nneka; McOwan, Alan; Whitlock, Gary

    2017-08-01

    HIV pre-exposure prophylaxis (PrEP) is becoming a pivotal strategy for HIV prevention. Understanding the impact of risk factors for HIV transmission to identify those at highest risk would favour the implementation of PrEP, currently limited by costs. In this service evaluation, we estimated the incidence of bacterial STIs in men who have sex with men (MSM) diagnosed with early syphilis attending a London sexual health clinic according to their HIV status. In addition, we estimated the incidence of HIV infection in HIV-negative MSM, following a diagnosis of early syphilis. We undertook a retrospective case note review of all MSM patients diagnosed with early syphilis between January and June 2014. A number of sexual health screens and diagnoses of chlamydia, gonorrhoea and HIV were prospectively analysed following the syphilis diagnosis. 206 MSM were diagnosed with early syphilis. 110 (53%) were HIV-negative at baseline, 96 (47%) were HIV-positive. Only age (37 vs 32 years, p=0.0005) was significantly different according to HIV status of MSM at baseline. In HIV-negative versus HIV-positive MSM, incidence of rectal chlamydia infection at follow-up was 27 cases vs 50/100 person-years of follow-up (PYFU) (p=0.0039), 33 vs 66/100 PYFU (p=0.0044) for rectal gonorrhoea and 10 vs 26/100 PYFU (p=0.0044) for syphilis reinfection, respectively. Total follow-up for 110 HIV-negative MSM was 144 person-years. HIV incidence was 8.3/100 PYFU (CI 4.2 to 14). A diagnosis of early syphilis carries a high risk of consequent HIV seroconversion and should warrant prioritised access to prevention measures such as PrEP and regular STI screening to prevent HIV transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. New Tobacco and Tobacco-Related Products: Early Detection of Product Development, Marketing Strategies, and Consumer Interest.

    Science.gov (United States)

    Staal, Yvonne Cm; van de Nobelen, Suzanne; Havermans, Anne; Talhout, Reinskje

    2018-05-28

    A wide variety of new tobacco and tobacco-related products have emerged on the market in recent years. To understand their potential implications for public health and to guide tobacco control efforts, we have used an infoveillance approach to identify new tobacco and tobacco-related products. Our search for tobacco(-related) products consists of several tailored search profiles using combinations of keywords such as "e-cigarette" and "new" to extract information from almost 9000 preselected sources such as websites of online shops, tobacco manufacturers, and news sites. Developments in e-cigarette design characteristics show a trend toward customization by possibilities to adjust temperature and airflow, and by the large variety of flavors of e-liquids. Additionally, more e-cigarettes are equipped with personalized accessories, such as mobile phones, applications, and Bluetooth. Waterpipe products follow the trend toward electronic vaping. Various heat-not-burn products were reintroduced to the market. Our search for tobacco(-related) products was specific and timely, though advances in product development require ongoing optimization of the search strategy. Our results show a trend toward products resembling tobacco cigarettes vaporizers that can be adapted to the consumers' needs. Our search for tobacco(-related) products could aid in the assessment of the likelihood of new products to gain market share, as a possible health risk or as an indicator for the need on independent and reliable information of the product to the general public. ©Yvonne CM Staal, Suzanne van de Nobelen, Anne Havermans, Reinskje Talhout. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 28.05.2018.

  4. In-season monitoring of hip and groin strength, health and function in elite youth soccer: Implementing an early detection and management strategy over two consecutive seasons.

    Science.gov (United States)

    Wollin, Martin; Thorborg, Kristian; Welvaert, Marijke; Pizzari, Tania

    2018-03-14

    The primary purpose of this study was to describe an early detection and management strategy when monitoring in-season hip and groin strength, health and function in soccer. Secondly to compare pre-season to in-season test results. Longitudinal cohort study. Twenty-seven elite male youth soccer players (age: 15.07±0.73years) volunteered to participate in the study. Monitoring tests included: adductor strength, adductor/abductor strength ratio and hip and groin outcome scores (HAGOS). Data were recorded at pre-season and at 22 monthly intervals in-season. Thresholds for alerts to initiate further investigations were defined as any of the following: adductor strength reductions >15%, adductor/abductor strength ratio time-point one (ptime-loss were classified minimal or mild. In-season monitoring aimed at early detection and management of hip and groin strength, health and function appears promising. Hip and groin strength, health and function improved quickly from pre-season to in-season in a high-risk population for ongoing hip and groin problems. Copyright © 2018 Sports Medicine Australia. All rights reserved.

  5. Five-year evolution of reperfusion strategies and early mortality in patients with ST-segment elevation myocardial infarction in France.

    Science.gov (United States)

    El Khoury, Carlos; Bochaton, Thomas; Flocard, Elodie; Serre, Patrice; Tomasevic, Danka; Mewton, Nathan; Bonnefoy-Cudraz, Eric

    2017-10-01

    To assess 5-year evolutions in reperfusion strategies and early mortality in patients with ST-segment elevation myocardial infarction. Using data from the French RESCUe network, we studied patients with ST-segment elevation myocardial infarction treated in mobile intensive care units between 2009 and 2013. Among 2418 patients (median age 62 years; 78.5% male), 2119 (87.6%) underwent primary percutaneous coronary intervention and 299 (12.4%) pre-hospital thrombolysis (94.0% of whom went on to undergo percutaneous coronary intervention). Use of primary percutaneous coronary intervention increased from 78.4% in 2009 to 95.9% in 2013 ( P trend 90 minutes delay group (83.0% in 2009 to 97.7% in 2013; P trend <0.001 versus 34.1% in 2009 to 79.2% in 2013; P trend <0.001). In-hospital (4-6%) and 30-day (6-8%) mortalities remained stable from 2009 to 2013. In the RESCUe network, the use of primary percutaneous coronary intervention increased from 2009 to 2013, in line with guidelines, but there was no evolution in early mortality.

  6. Invasive cervical root resorption: Engineering the lost tissue by regeneration

    Directory of Open Access Journals (Sweden)

    Dexton Antony Johns

    2013-01-01

    Full Text Available Invasive cervical resorption (ICR is a localized resorptive process that commences on the surface of the root below the epithelial attachment and the coronal aspect of the supporting alveolar process, namely the zone of the connective tissue attachment′ early diagnosis, elimination of the resorption and restorative management are the keys to a successful outcome. Treatment done was a combined non-surgical root canal therapy, surgical treatment to expose the resorptive defect and the resorptive defect was filled up with reverse sandwich technique and finally the bony defect filled with platelet rich fibrin (PRF, hydroxylapatite and PRF membrane. Significant bone fill was obtained in our case after a 2 year follow-up period. This case report presents a treatment strategy that might improve the healing outcomes for patients with ICR.

  7. Two non-invasive diagnostic tools for invasive aspergilosis: (1-3)-beta-D-glucan and the galactomannan assay.

    Science.gov (United States)

    Kelaher, Amy

    2006-01-01

    Invasive aspergillosis (IA) is a serious cause of morbidity and mortality among immunocompromised patients. Prompt and non-invasive methods for diagnosing IA are needed to improve the management of this life-threatening infection in patients with hematological disorders. In summary, this retrospective review of studies performed on the two assays finds that both assays have high sensitivity and specificity but are more useful when used together as a diagnostic strategy for patients with invasive aspergillosis.

  8. Non-invasive physical treatments for chronic/recurrent headache.

    NARCIS (Netherlands)

    Bronfort, G.; Nilsson, N.; Haas, M.; Evans, R.; Goldsmith, C. H.; Assendelft, W. J.; Bouter, L. M.

    2004-01-01

    BACKGROUND: Non-invasive physical treatments are often used to treat common types of chronic/recurrent headache. OBJECTIVES: To quantify and compare the magnitude of short- and long-term effects of non-invasive physical treatments for chronic/recurrent headaches. SEARCH STRATEGY: We searched the

  9. Science priorities for reducing the threat of invasive species

    Science.gov (United States)

    E. A. Chornesky; A. M. Bartuska; G. H. Aplet; J. Cummings-Carlson; F. W. Davis; J. Eskow; D. R. Gordon; K. W. Gottschalk; R. A. Haack; A. J. Hansen; R. N. Mack; F. J. Rahel; M. A. Shannon; L. A. Wainger; T. B. Wigley

    2005-01-01

    Invasive species pose a major, yet poorly addressed, threat to sustainable forestry. Here we set forth an interdisciplinary science strategy of research, development, and applications to reduce this threat. To spur action by public and private entities that too often are slow, reluctant, or unable to act, we recommend (a) better integrating invasive species into...

  10. Use of noninvasive and invasive mechanical ventilation in cardiogenic shock

    DEFF Research Database (Denmark)

    Hongisto, Mari; Lassus, Johan; Tarvasmaki, Tuukka

    2017-01-01

    BACKGROUND: Despite scarce data, invasive mechanical ventilation (MV) is widely recommended over non-invasive ventilation (NIV) for ventilatory support in cardiogenic shock (CS). We assessed the real-life use of different ventilation strategies in CS and their influence on outcome focusing on the...

  11. Chapter 8: Invasive fungal rhinosinusitis.

    Science.gov (United States)

    Duggal, Praveen; Wise, Sarah K

    2013-01-01

    Invasive fungal rhinosinusitis (IFRS) is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in the acute fulminant form. Early symptoms can often mimic rhinosinusitis, while late symptoms can cause significant morbidity and mortality. Swelling and mucosal thickening can quickly progress to pale or necrotic tissue in the nasal cavity and sinuses, and the disease can rapidly spread and invade the palate, orbit, cavernous sinus, cranial nerves, skull base, carotid artery, and brain. IFRS can be life threatening if left undiagnosed or untreated. While the acute fulminant form of IFRS is the most rapidly progressive and destructive, granulomatous and chronic forms also exist. Diagnosis of IFRS often mandates imaging studies in conjunction with clinical, endoscopic, and histopathological examination. Treatment of IFRS consists of reversing the underlying immunosuppression, antifungal therapy, and aggressive surgical debridement. With early diagnosis and treatment, IFRS can be treated and increase patient survival.

  12. Manipulation of the Growth Hormone-Insulin-Like Growth Factor (GH-IGF) Axis: A Treatment Strategy to Reverse the Effects of Early Life Developmental Programming.

    Science.gov (United States)

    Reynolds, Clare M; Perry, Jo K; Vickers, Mark H

    2017-08-08

    Evidence from human clinical, epidemiological, and experimental animal models has clearly highlighted a link between the early life environment and an increased risk for a range of cardiometabolic disorders in later life. In particular, altered maternal nutrition, including both undernutrition and overnutrition, spanning exposure windows that cover the period from preconception through to early infancy, clearly highlight an increased risk for a range of disorders in offspring in later life. This process, preferentially termed "developmental programming" as part of the developmental origins of health and disease (DOHaD) framework, leads to phenotypic outcomes in offspring that closely resemble those of individuals with untreated growth hormone (GH) deficiency, including increased adiposity and cardiovascular disorders. As such, the use of GH as a potential intervention strategy to mitigate the effects of developmental malprogramming has received some attention in the DOHaD field. In particular, experimental animal models have shown that early GH treatment in the setting of poor maternal nutrition can partially rescue the programmed phenotype, albeit in a sex-specific manner. Although the mechanisms remain poorly defined, they include changes to endothelial function, an altered inflammasome, changes in adipogenesis and cardiovascular function, neuroendocrine effects, and changes in the epigenetic regulation of gene expression. Similarly, GH treatment to adult offspring, where an adverse metabolic phenotype is already manifest, has shown efficacy in reversing some of the metabolic disorders arising from a poor early life environment. Components of the GH-insulin-like growth factor (IGF)-IGF binding protein (GH-IGF-IGFBP) system, including insulin-like growth factor 1 (IGF-1), have also shown promise in ameliorating programmed metabolic disorders, potentially acting via epigenetic processes including changes in miRNA profiles and altered DNA methylation. However, as

  13. Deeply invasive candidiasis.

    NARCIS (Netherlands)

    Ostrosky-Zeichner, L.; Rex, J.H.; Bennett, J.; Kullberg, B.J.

    2002-01-01

    The incidence of invasive candidiasis is on the rise because of increasing numbers of immunocompromised hosts and more invasive medical technology. Recovery of Candida spp from several body sites in a critically ill or immunocompromised patient should raise the question of disseminated disease.

  14. Cryptic invasions: a review

    Czech Academy of Sciences Publication Activity Database

    Morais, Pedro Miguel; Reichard, Martin

    613-614, February (2018), s. 1438-1448 ISSN 0048-9697 R&D Projects: GA ČR GA13-05872S Institutional support: RVO:68081766 Keywords : Conspecific invader * Biological invasions * Bibliometric * Invasiveness Subject RIV: EG - Zoology OBOR OECD: Environmental sciences (social aspects to be 5.7) Impact factor: 4.900, year: 2016

  15. Factors influencing plant invasiveness

    Science.gov (United States)

    Yvette Ortega; Dean Pearson

    2009-01-01

    Invasiveness of spotted knapweed and biological control agents. Dean and Yvette are examining the influence of drought on the invasiveness of spotted knapweed (Centaurea maculosa) and its susceptibility to herbivory by biological control agents. In collaboration with the University of Montana and Forest Health Protection, researchers have constructed 150...

  16. Current research in perineural invasion of cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Deng Xi-Yun

    2010-03-01

    Full Text Available Abstract Background Perineural invasion is a common path for cholangiocarcinoma (CCA metastasis, and it is highly correlated with postoperative recurrence and poor prognosis. It is often an early event in a disease that is commonly diagnosed in advanced stages, and thus it could offer a timely therapeutic and diagnostic target if better understood. This article systematically reviews the progress of CCA neural invasion-related molecules. Methods Studies were identified by searching MEDLINE and PubMed databases for articles from January 1990 to December 2009, using the keywords "cholangiocarcinoma," "perineural invasion," "nerve growth factor"(NGF, "neural cell adhesion molecule" (NCAM, "matrix metalloproteinase"(MMP, "neurotransmitter," "acetylcholine" (Ach, and "transforming growth factor" (TGF." Additional papers and book chapters were identified by a manual search of references from the key articles. Results From above we found that the molecules NGF, NCAM, MMP, Ach and TGF may have prognostic significance in, and offer clues to the mechanism of CCA neural invasion. Conclusions Cholangiocarcinoma's increasing worldwide incidence is especially poignant in view of both the lacking effective therapies, and the fact that it is commonly diagnosed in advanced stages. As CCA neural invasion often appears early, more complete characterization of its molecular pathology could lead to the identification of targets for the diagnosis and therapy of this devastating malignancy.

  17. Five potential consequences of climate change for invasive species.

    Science.gov (United States)

    Hellmann, Jessica J; Byers, James E; Bierwagen, Britta G; Dukes, Jeffrey S

    2008-06-01

    Scientific and societal unknowns make it difficult to predict how global environmental changes such as climate change and biological invasions will affect ecological systems. In the long term, these changes may have interacting effects and compound the uncertainty associated with each individual driver. Nonetheless, invasive species are likely to respond in ways that should be qualitatively predictable, and some of these responses will be distinct from those of native counterparts. We used the stages of invasion known as the "invasion pathway" to identify 5 nonexclusive consequences of climate change for invasive species: (1) altered transport and introduction mechanisms, (2) establishment of new invasive species, (3) altered impact of existing invasive species, (4) altered distribution of existing invasive species, and (5) altered effectiveness of control strategies. We then used these consequences to identify testable hypotheses about the responses of invasive species to climate change and provide suggestions for invasive-species management plans. The 5 consequences also emphasize the need for enhanced environmental monitoring and expanded coordination among entities involved in invasive-species management.

  18. Modelling Hotspots for Invasive Alien Plants in India.

    Science.gov (United States)

    Adhikari, Dibyendu; Tiwary, Raghuvar; Barik, Saroj Kanta

    2015-01-01

    Identification of invasion hotspots that support multiple invasive alien species (IAS) is a pre-requisite for control and management of invasion. However, till recently it remained a methodological challenge to precisely determine such invasive hotspots. We identified the hotspots of alien species invasion in India through Ecological Niche Modelling (ENM) using species occurrence data from the Global Biodiversity Information Facility (GBIF). The predicted area of invasion for selected species were classified into 4 categories based on number of model agreements for a region i.e. high, medium, low and very low. About 49% of the total geographical area of India was predicted to be prone to invasion at moderate to high levels of climatic suitability. The intersection of anthropogenic biomes and ecoregions with the regions of 'high' climatic suitability was classified as hotspot of alien plant invasion. Nineteen of 47 ecoregions of India, harboured such hotspots. Most ecologically sensitive regions of India, including the 'biodiversity hotspots' and coastal regions coincide with invasion hotspots, indicating their vulnerability to alien plant invasion. Besides demonstrating the usefulness of ENM and open source data for IAS management, the present study provides a knowledge base for guiding the formulation of an effective policy and management strategy for controlling the invasive alien species.

  19. Alien invasive birds.

    Science.gov (United States)

    Brochier, B; Vangeluwe, D; van den Berg, T

    2010-08-01

    A bird species is regarded as alien invasive if it has been introduced, intentionally or accidentally, to a location where it did not previously occur naturally, becomes capable of establishing a breeding population without further intervention by humans, spreads and becomes a pest affecting the environment, the local biodiversity, the economy and/or society, including human health. European Starling (Sturnus vulgaris), Common Myna (Acridotheres tristis) and Red-vented Bulbul (Pycnonotus cafer) have been included on the list of '100 of the World's Worst Invasive Alien Species', a subset of the Global Invasive Species Database. The 'Delivering Alien Invasive Species Inventories for Europe' project has selected Canada Goose (Branta canadensis), Ruddy Duck (Oxyura jamaicensis), Rose-ringed Parakeet (Psittacula krameri) and Sacred Ibis (Threskiornis aethiopicus) as among 100 of the worst invasive species in Europe. For each of these alien bird species, the geographic range (native and introduced range), the introduction pathway, the general impacts and the management methods are presented.

  20. Minimally invasive orthognathic surgery.

    Science.gov (United States)

    Resnick, Cory M; Kaban, Leonard B; Troulis, Maria J

    2009-02-01

    Minimally invasive surgery is defined as the discipline in which operative procedures are performed in novel ways to diminish the sequelae of standard surgical dissections. The goals of minimally invasive surgery are to reduce tissue trauma and to minimize bleeding, edema, and injury, thereby improving the rate and quality of healing. In orthognathic surgery, there are two minimally invasive techniques that can be used separately or in combination: (1) endoscopic exposure and (2) distraction osteogenesis. This article describes the historical developments of the fields of orthognathic surgery and minimally invasive surgery, as well as the integration of the two disciplines. Indications, techniques, and the most current outcome data for specific minimally invasive orthognathic surgical procedures are presented.

  1. Respective impact of implementation of prevention strategies, colonization with multiresistant bacteria and antimicrobial use on the risk of early- and late-onset VAP: An analysis of the OUTCOMEREA network

    OpenAIRE

    Ibn Saied, Wafa; Souweine, Bertrand; Garrouste-Orgeas, Maité; Ruckly, Stéphane; Darmon, Michael; Bailly, Sébastien; Cohen, Yves; Azoulay, Elie; Schwebel, Carole; Radjou, Aguila; Kallel, Hatem; Adrie, Christophe; Dumenil, Anne-Sylvie; Argaud, Laurent; Marcotte, Guillaume

    2017-01-01

    International audience; Rationale: The impact of prevention strategies and risk factors for early-onset (EOP) versus late-onset (LOP) ventilator -associated pneumonia (VAP) are still debated.Objectives: To evaluate, in a multicenter cohort, the risk factors for EOP and LOP, as the evolution of prevention strategies.Methods: 7,784 patients with mechanical ventilation (MV) for at least 48 hours were selected into the multicenter prospective OUTCOMEREA database (1997-2016). VAP occurring between...

  2. Minimal Invasive Urologic Surgery and Postoperative Ileus

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-07-01

    Full Text Available Postoperative ileus (POI is the most common cause of prolonged length of hospital stays (LOS and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress in the future. In the field of gastrointestinal surgery, several studies had reported lower incidence rates for POI following minimal invasive surgery compared to conventional open procedures. In contrast, little is known about the effect of minimal invasive approach on the recovery of bowel motility after urologic surgery. We performed an overview of the potential benefit of minimal invasive approach on POI for urologic procedures. The mechanisms and risk factors responsible for the onset of POI are discussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radical cystectomy but it is rarely of clinical significance for other minimal invasive interventions. Laparoscopy or robotic assisted laparoscopic techniques when studied individually may reduce to their own the duration and prevent the onset of POI in a subset of procedures. The potential influence of age and urinary diversion type on postoperative ileus is contradictory in the literature. There is some evidence suggesting that BMI, blood loss, urinary extravasation, existence of a major complication, bowel resection, operative time and transperitoneal approach are independent risk factors for POI. Treatment of POI remains elusive. One of the most important and effective management strategies for patients undergoing radical cystectomy has been the development and use of enhanced recovery programs. An optimal rational strategy to shorten the duration of POI should incorporate minimal invasive approach when appropriate into multimodal fast track programs designed to reduce POI and shorten LOS.

  3. Reduced benefit from mnemonic strategies in early-stage Alzheimer's disease: a brief testing-the-limits paradigm for clinical practice.

    Science.gov (United States)

    Uttner, Ingo; Schurig, Niklas; von Arnim, Christine A F; Lange-Asschenfeldt, Christian; Tumani, Hayrettin; Riepe, Matthias W

    2010-10-01

    Discriminating incipient Alzheimer's disease (AD) from major depression (MD) and age related memory decline is a challenge in clinical practice. Since AD is characterized by an early loss of neuronal and functional plasticity, a dynamic test strategy, such as the testing-the-limits (TtL) approach, that measures learning capacity can be a helpful diagnostic tool. To evaluate this, a short recognition paradigm consisting of a pre-test (baseline) and two post-test conditions with an interposed encoding instruction was developed and administered to individuals with incipient AD (n = 19; Mini Mental Status Examination (MMSE) 26.5), patients with depressive disorders (n = 11; MMSE 30), and healthy controls (n = 11; MMSE 30). In addition, participants completed a set of traditional neuropsychological tests that focused on the subjects' cognitive baseline performance. Intergroup comparisons (Kruskal-Wallis, U test) revealed significantly higher post-test failure rates in AD patients. Pre-test performance of MD and AD patients did not differ. Intra-group comparisons (Friedman, Wilcoxon test) showed that all three subject samples benefit from intervention in post-test 1. In contrast to MD and healthy individuals, who revealed significantly lower failure rates in post-test 2 compared to the pre-test, AD patients did not improve. Out of the 15 traditional test scores obtained, only two discriminated simultaneously between AD and each of the other groups. Our data confirm the finding of an impaired cognitive plasticity already present in very early stages of AD and illustrate the efficiency of a dynamic test approach in identifying incipient dementia.

  4. Effect of Treat-to-target Strategies Aiming at Remission of Arterial Stiffness in Early Rheumatoid Arthritis: A Randomized Controlled Study.

    Science.gov (United States)

    Tam, Lydia Ho-Pui; Shang, Qing; Li, Edmund Kwok-Ming; Wong, Priscilla Ching-Han; Kwok, Kitty Yan; Kun, Emily Wai-Lin; Yim, Isaac Cheuk-Wan; Lee, Violet Ka-Lai; Yip, Ronald Man-Lung; Pang, Steve Hin-Ting; Lao, Virginia Weng-Nga; Mak, Queenie Wah-Yan; Cheng, Isaac Tsz-Ho; Lau, Xerox Sze-Lok; Li, Tena Ka-Yan; Zhu, Tracy Yaner; Lee, Alex Pui-Wai; Tam, Lai-Shan

    2018-05-15

    To determine the efficacy of 2 tight control treatment strategies aiming at Simplified Disease Activity Score (SDAI) remission (SDAI ≤ 3.3) compared to 28-joint count Disease Activity Score (DAS28) remission (DAS28 < 2.6) in the prevention of arterial stiffness in patients with early rheumatoid arthritis (RA). This was an open-label study in which 120 patients with early RA were randomized to receive 1 year of tight control treatment. Group 1 (n = 60) aimed to achieve SDAI ≤ 3.3 and Group 2 (n = 60), DAS28 < 2.6. Pulse wave velocity (PWV) and augmentation index (AIx) were measured at baseline and 12 months. A posthoc analysis was also performed to ascertain whether achieving sustained remission could prevent progression in arterial stiffness. The proportions of patients receiving methotrexate monotherapy were significantly lower in Group 1 throughout the study period. At 12 months, the proportions of patients achieving DAS28 and SDAI remission, and the change in PWV and AIx, were comparable between the 2 groups. In view of the lack of differences between the 2 groups, a posthoc analysis was performed at Month 12, including all 110 patients with PWV, to elucidate the independent predictors associated with the change in PWV. Multivariate analysis revealed that achieving sustained DAS28 remission at months 6, 9, and 12 and a shorter disease duration were independent explanatory variables associated with less progression of PWV. With limited access to biologic disease-modifying antirheumatic drugs, treatment efforts toward DAS28 and SDAI remission had similar effects in preventing the progression of arterial stiffness at 1 year. However, achieving sustained DAS28 remission was associated with a significantly greater improvement in PWV. [Clinical Trial registration: Clinicaltrial.gov NCT01768923.].

  5. Innovative strategies using communications technologies to engage gay men and other men who have sex with men into early HIV testing and treatment in Thailand.

    Science.gov (United States)

    Anand, Tarandeep; Nitpolprasert, Chattiya; Ananworanich, Jintanat; Pakam, Charnwit; Nonenoy, Siriporn; Jantarapakde, Jureeporn; Sohn, Annette H; Phanuphak, Praphan; Phanuphak, Nittaya

    2015-04-01

    One-in-three men who have sex with men (MSM) surveyed between 2007 and 2010 in Bangkok were HIV infected; 54% of new infections in Thailand are expected to be among MSM. Although MSM are the top internet-accessing population in Thailand, it has not been optimally used to scale up early HIV testing and counselling (HTC) and linkage to treatment. Thailand needs innovative technology-based strategies to help address the exploding epidemic of HIV among gay men and other MSM. Adam's Love, an innovative web-based communications strategy, was launched in 2011 by the Thai Red Cross AIDS Research Centre. It includes a dedicated website, integrated social media and web message boards for online counselling, recruitment and appointment making, a club membership programme offering non-financial incentives for HTC, targeted marketing and promotions, and collaboration with MSM-friendly clinics and private hospitals to improve accessibility of HTC services. Between September 2011 and January 2015, the website engaged 1.69 million viewers, and gained more than 8 million page views. An estimated 11,120 gay men and other MSM received online counselling; 8,288 MSM were referred to HTC services; 1,223 to STI testing services; and 1,112 MSM living with HIV were advised regarding HIV treatment. In total, 1,181 MSM recruited online were enrolled in the club membership programme, and 15.5% were diagnosed with HIV. The Adam's Love programme has successfully demonstrated the potential for utilising 'online-to-offline' recruitment models in Thailand, and has attracted national and regional recognition as a trusted resource on HIV and referral to testing and care.

  6. Integrating spread dynamics and economics of timber production to manage Chinese tallow invasions in southern U.S. forestlands.

    Directory of Open Access Journals (Sweden)

    Hsiao-Hsuan Wang

    Full Text Available Economic costs associated with the invasion of nonnative species are of global concern. We estimated expected costs of Chinese tallow (Triadica sebifera (L. Small invasions related to timber production in southern U.S. forestlands under different management strategies. Expected costs were confined to the value of timber production losses plus costs for search and control. We simulated management strategies including (1 no control (NC, and control beginning as soon as the percentage of invaded forest land exceeded (2 60 (Low Control, (3 25 (Medium Control, or (4 0 (High Control using a spatially-explicit, stochastic, bioeconomic model. With NC, simulated invasions spread northward and westward into Arkansas and along the Gulf of Mexico to occupy ≈1.2 million hectares within 20 years, with associated expected total costs increasing exponentially to ≈$300 million. With LC, MC, and HC, invaded areas reached ≈275, 34, and 2 thousand hectares after 20 years, respectively, with associated expected costs reaching ≈$400, $230, and $200 million. Complete eradication would not be cost-effective; the minimum expected total cost was achieved when control began as soon as the percentage of invaded land exceeded 5%. These results suggest the importance of early detection and control of Chinese tallow, and emphasize the importance of integrating spread dynamics and economics to manage invasive species.

  7. A Mixed Methods Study of Early Childhood Preservice Teachers: Beliefs about Poverty, Perceived Learning from Specific Instructional Strategies, and Preparedness to Serve Children and Families in Poverty

    Science.gov (United States)

    van Schagen Johnson, Amy

    2016-01-01

    A large number of young children experiencing poverty are receiving some type of formal early care and education. Effective early childhood teachers are an important component to providing high quality early childhood education. Yet, limited research has examined from the preservice teacher perspective how early childhood teacher preparation…

  8. Evaluación de la fibrosis hepática en la hepatitis crónica por virus C mediante la aplicación prospectiva del Sabadell's NIHCED score: Sabadell's Non Invasive, Hepatitis C Related-Cirrhosis Early Detection Score Prospective evaluation of liver fibrosis in chronic viral hepatitis C infection using the Sabadell NIHCED: non-invasive hepatitis C related cirrhosis early detection index

    Directory of Open Access Journals (Sweden)

    G. Bejarano

    2009-05-01

    Full Text Available Introducción: la hepatitis crónica por VHC cursa de forma asintomática desarrollando cirrosis hepática y sus complicaciones en un 20-40% de los casos. En estudios previos se ha demostrado que la fibrosis avanzada es un factor pronóstico fundamental. El método gold standard para la valoración del grado de fibrosis es la biopsia hepática. Nuestro grupo ha validado un índice predictivo, el NIHCED (Sabadell's Non Invasive, Hepatitis C related-Cirrosis Early Detection Score, basado en datos demográficos, analíticos y ecográficos para determinar la presencia de cirrosis. Objetivo: nuestro objetivo es el de evaluar si el NIHCED predice la presencia de fibrosis avanzada en los pacientes con hepatitis crónica por virus C. Material y métodos: estudio prospectivo donde se incluyeron pacientes con hepatitis crónica por VHC. Se les realizó una biopsia hepática y el NIHCED. El grado de fibrosis se correlacionó con el valor del NIHCED mediante curva de ROC y el coeficiente de correlación de Spearman. Resultados: se incluyeron un total de 321 pacientes (ratio hombre/mujer 1,27 con una edad media de 48 ± 14 años. La biopsia hepática mostró que 131 (30,5% no tenían fibrosis o era expansión portal, mientras que 190 (69,5% tenían fibrosis avanzada o cirrosis. Para un punto de corte de 6 puntos, la sensibilidad fue del 72%, especificidad del 76,3%, VPP del 81%, VPN del 63,7% y una precisión diagnóstica del 72,5%, con un área bajo la curva fue de 0,787 y un coeficiente de correlación de Spearman de r = 0,65. Conclusiones: el NIHCED predice la presencia de fibrosis avanzada en un elevado porcentaje de pacientes sin necesidad de realizar biopsia hepática.Introduction: liver disease resulting from chronic hepatitis C virus (HCV infection follows an asymptomatic course towards cirrhosis and its complications in 20-40% of cases. Earlier studies demonstrated that advanced fibrosis is a prognostic factor. The "gold standard" for the evaluation

  9. Early Rehabilitation After Stroke: a Narrative Review.

    Science.gov (United States)

    Coleman, Elisheva R; Moudgal, Rohitha; Lang, Kathryn; Hyacinth, Hyacinth I; Awosika, Oluwole O; Kissela, Brett M; Feng, Wuwei

    2017-11-07

    Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain's dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits. Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge. The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.

  10. The Invasive Species Forecasting System

    Science.gov (United States)

    Schnase, John; Most, Neal; Gill, Roger; Ma, Peter

    2011-01-01

    The Invasive Species Forecasting System (ISFS) provides computational support for the generic work processes found in many regional-scale ecosystem modeling applications. Decision support tools built using ISFS allow a user to load point occurrence field sample data for a plant species of interest and quickly generate habitat suitability maps for geographic regions of management concern, such as a national park, monument, forest, or refuge. This type of decision product helps resource managers plan invasive species protection, monitoring, and control strategies for the lands they manage. Until now, scientists and resource managers have lacked the data-assembly and computing capabilities to produce these maps quickly and cost efficiently. ISFS focuses on regional-scale habitat suitability modeling for invasive terrestrial plants. ISFS s component architecture emphasizes simplicity and adaptability. Its core services can be easily adapted to produce model-based decision support tools tailored to particular parks, monuments, forests, refuges, and related management units. ISFS can be used to build standalone run-time tools that require no connection to the Internet, as well as fully Internet-based decision support applications. ISFS provides the core data structures, operating system interfaces, network interfaces, and inter-component constraints comprising the canonical workflow for habitat suitability modeling. The predictors, analysis methods, and geographic extents involved in any particular model run are elements of the user space and arbitrarily configurable by the user. ISFS provides small, lightweight, readily hardened core components of general utility. These components can be adapted to unanticipated uses, are tailorable, and require at most a loosely coupled, nonproprietary connection to the Web. Users can invoke capabilities from a command line; programmers can integrate ISFS's core components into more complex systems and services. Taken together, these

  11. Building strategies for tsunami scenarios databases to be used in a tsunami early warning decision support system: an application to western Iberia

    Science.gov (United States)

    Tinti, S.; Armigliato, A.; Pagnoni, G.; Zaniboni, F.

    2012-04-01

    One of the most challenging goals that the geo-scientific community is facing after the catastrophic tsunami occurred on December 2004 in the Indian Ocean is to develop the so-called "next generation" Tsunami Early Warning Systems (TEWS). Indeed, the meaning of "next generation" does not refer to the aim of a TEWS, which obviously remains to detect whether a tsunami has been generated or not by a given source and, in the first case, to send proper warnings and/or alerts in a suitable time to all the countries and communities that can be affected by the tsunami. Instead, "next generation" identifies with the development of a Decision Support System (DSS) that, in general terms, relies on 1) an integrated set of seismic, geodetic and marine sensors whose objective is to detect and characterise the possible tsunamigenic sources and to monitor instrumentally the time and space evolution of the generated tsunami, 2) databases of pre-computed numerical tsunami scenarios to be suitably combined based on the information coming from the sensor environment and to be used to forecast the degree of exposition of different coastal places both in the near- and in the far-field, 3) a proper overall (software) system architecture. The EU-FP7 TRIDEC Project aims at developing such a DSS and has selected two test areas in the Euro-Mediterranean region, namely the western Iberian margin and the eastern Mediterranean (Turkish coasts). In this study, we discuss the strategies that are being adopted in TRIDEC to build the databases of pre-computed tsunami scenarios and we show some applications to the western Iberian margin. In particular, two different databases are being populated, called "Virtual Scenario Database" (VSDB) and "Matching Scenario Database" (MSDB). The VSDB contains detailed simulations of few selected earthquake-generated tsunamis. The cases provided by the members of the VSDB are computed "real events"; in other words, they represent the unknowns that the TRIDEC

  12. A Landscape Approach to Invasive Species Management.

    Directory of Open Access Journals (Sweden)

    Miguel Lurgi

    Full Text Available Biological invasions are not only a major threat to biodiversity, they also have major impacts on local economies and agricultural production systems. Once established, the connection of local populations into metapopulation networks facilitates dispersal at landscape scales, generating spatial dynamics that can impact the outcome of pest-management actions. Much planning goes into landscape-scale invasive species management. However, effective management requires knowledge on the interplay between metapopulation network topology and management actions. We address this knowledge gap using simulation models to explore the effectiveness of two common management strategies, applied across different extents and according to different rules for selecting target localities in metapopulations with different network topologies. These management actions are: (i general population reduction, and (ii reduction of an obligate resource. The reduction of an obligate resource was generally more efficient than population reduction for depleting populations at landscape scales. However, the way in which local populations are selected for management is important when the topology of the metapopulation is heterogeneous in terms of the distribution of connections among local populations. We tested these broad findings using real-world scenarios of European rabbits (Oryctolagus cuniculus infesting agricultural landscapes in Western Australia. Although management strategies targeting central populations were more effective in simulated heterogeneous metapopulation structures, no difference was observed in real-world metapopulation structures that are highly homogeneous. In large metapopulations with high proximity and connectivity of neighbouring populations, different spatial management strategies yield similar outcomes. Directly considering spatial attributes in pest-management actions will be most important for metapopulation networks with heterogeneously

  13. A Landscape Approach to Invasive Species Management.

    Science.gov (United States)

    Lurgi, Miguel; Wells, Konstans; Kennedy, Malcolm; Campbell, Susan; Fordham, Damien A

    2016-01-01

    Biological invasions are not only a major threat to biodiversity, they also have major impacts on local economies and agricultural production systems. Once established, the connection of local populations into metapopulation networks facilitates dispersal at landscape scales, generating spatial dynamics that can impact the outcome of pest-management actions. Much planning goes into landscape-scale invasive species management. However, effective management requires knowledge on the interplay between metapopulation network topology and management actions. We address this knowledge gap using simulation models to explore the effectiveness of two common management strategies, applied across different extents and according to different rules for selecting target localities in metapopulations with different network topologies. These management actions are: (i) general population reduction, and (ii) reduction of an obligate resource. The reduction of an obligate resource was generally more efficient than population reduction for depleting populations at landscape scales. However, the way in which local populations are selected for management is important when the topology of the metapopulation is heterogeneous in terms of the distribution of connections among local populations. We tested these broad findings using real-world scenarios of European rabbits (Oryctolagus cuniculus) infesting agricultural landscapes in Western Australia. Although management strategies targeting central populations were more effective in simulated heterogeneous metapopulation structures, no difference was observed in real-world metapopulation structures that are highly homogeneous. In large metapopulations with high proximity and connectivity of neighbouring populations, different spatial management strategies yield similar outcomes. Directly considering spatial attributes in pest-management actions will be most important for metapopulation networks with heterogeneously distributed links. Our

  14. Invasive alien birds in Denmark

    DEFF Research Database (Denmark)

    Fox, Anthony David; Heldbjerg, Henning; Nyegaard, Timme

    2015-01-01

    Avian Introduced Alien Species (IAS) constitute a threat to the integrity of native biodiversity, the economy and human health, so here we briefly review some of the problems posed by such species around the world in relation to such bird species in Denmark. A new European Union Regulation...... on Invasive Alien Species implemented in January 2015 establishes a framework for actions to combat alien species, which requires Member States to prevent the spread of alien species, provide early warning and rapid responses to their presence and management of established alien species where they occur. We...... show the importance of mechanisms such as DOF’s (Dansk Ornitologisk Forening, BirdLife Denmark) Atlas project, Common Bird Census (breeding and wintering species) and DOFbasen to contribute data on the current geographical and numerical distribution of the few serious alien avian species already...

  15. Invasive alien birds in Denmark

    DEFF Research Database (Denmark)

    Nyegaard, Timme; Heldbjerg, Henning; Fox, Anthony David

    Avian Introduced Alien Species (IAS) constitute a threat to the integrity of native biodiversity, the economy and human health, so here we briefly review some of the problems posed by such species around the world in relation to bird species in Denmark. A new European Union Regulation on Invasive...... Alien Species implemented in January 2015 requires a framework for actions to combat alien species, which requires Member States to prevent the spread of alien species, provide early warning and rapid responses to their presence and management of established alien species where they occur. We show...... the importance of mechanisms such as DOFs (Danish Ornithological Society, BirdLife Denmark) Atlas project, Common Bird Monitoring (breeding and wintering species) and DOFbasen to contribute data on the current geographical and numerical distribution of the few serious alien avian species already present...

  16. The clinical pathologic research of invasive pituitary adenomas

    International Nuclear Information System (INIS)

    Guo Lingchuan; Zheng Yushuang; Wang Shouli; Hui Guozhen; Li Xiangdong

    2012-01-01

    Objective: To study the pathological morphologic characteristics of invasive pituitary tumor and the affect of vascularization to the tumor's invasion. Methods: One hundred and thirty cases of pituitary adenoma patients were divided into two groups, including invasive pituitary adenomas and non-invasive pituitary adenomas, and the clinical data of two groups were analysed and compared. Results : The difference was statistically significant between the invasive group and the non-invasive group in the incidence rate of pathological morphologic characteristics such as high nuclear cytoplasmic ratio, cell pleomorphism, nuclear atypia and nucleoli appearance (P<0.05); there were nuclear atypia and nucleolus margination in the invasive group through electron microscopy. And there was statistical significant difference in rate of MVD expression which was higher in the invasive group than that of noninvasive group (P<0.05). Conclusion: The pathological morphologic characteristics of pituitary tumor and the high expression of MVD are significantly reference valuable in tumor aggression diagnosis, which provides valuable indicators for early clinical diagnosis of tumor invasion. (authors)

  17. Minimally Invasive Surgery in Thymic Malignances

    Directory of Open Access Journals (Sweden)

    Wentao FANG

    2018-04-01

    Full Text Available Surgery is the most important therapy for thymic malignances. The last decade has seen increasing adoption of minimally invasive surgery (MIS for thymectomy. MIS for early stage thymoma patients has been shown to yield similar oncological results while being helpful in minimize surgical trauma, improving postoperative recovery, and reduce incisional pain. Meanwhile, With the advance in surgical techniques, the patients with locally advanced thymic tumors, preoperative induction therapies or recurrent diseases, may also benefit from MIS in selected cases.

  18. Multiple mechanisms enable invasive species to suppress native species.

    Science.gov (United States)

    Bennett, Alison E; Thomsen, Meredith; Strauss, Sharon Y

    2011-07-01

    Invasive plants represent a significant threat to ecosystem biodiversity. To decrease the impacts of invasive species, a major scientific undertaking of the last few decades has been aimed at understanding the mechanisms that drive invasive plant success. Most studies and theories have focused on a single mechanism for predicting the success of invasive plants and therefore cannot provide insight as to the relative importance of multiple interactions in predicting invasive species' success. We examine four mechanisms that potentially contribute to the success of invasive velvetgrass Holcus lanatus: direct competition, indirect competition mediated by mammalian herbivores, interference competition via allelopathy, and indirect competition mediated by changes in the soil community. Using a combination of field and greenhouse approaches, we focus on the effects of H. lanatus on a common species in California coastal prairies, Erigeron glaucus, where the invasion is most intense. We found that H. lanatus had the strongest effects on E. glaucus via direct competition, but it also influenced the soil community in ways that feed back to negatively influence E. glaucus and other native species after H. lanatus removal. This approach provided evidence for multiple mechanisms contributing to negative effects of invasive species, and it identified when particular strategies were most likely to be important. These mechanisms can be applied to eradication of H. lanatus and conservation of California coastal prairie systems, and they illustrate the utility of an integrated set of experiments for determining the potential mechanisms of invasive species' success.

  19. Resource competition in plant invasions: emerging patterns and research needs.

    Science.gov (United States)

    Gioria, Margherita; Osborne, Bruce A

    2014-01-01

    Invasions by alien plants provide a unique opportunity to examine competitive interactions among plants. While resource competition has long been regarded as a major mechanism responsible for successful invasions, given a well-known capacity for many invaders to become dominant and reduce plant diversity in the invaded communities, few studies have measured resource competition directly or have assessed its importance relative to that of other mechanisms, at different stages of an invasion process. Here, we review evidence comparing the competitive ability of invasive species vs. that of co-occurring native plants, along a range of environmental gradients, showing that many invasive species have a superior competitive ability over native species, although invasive congeners are not necessarily competitively superior over native congeners, nor are alien dominants are better competitors than native dominants. We discuss how the outcomes of competition depend on a number of factors, such as the heterogeneous distribution of resources, the stage of the invasion process, as well as phenotypic plasticity and evolutionary adaptation, which may result in increased or decreased competitive ability in both invasive and native species. Competitive advantages of invasive species over natives are often transient and only important at the early stages of an invasion process. It remains unclear how important resource competition is relative to other mechanisms (competition avoidance via phenological differences, niche differentiation in space associated with phylogenetic distance, recruitment and dispersal limitation, indirect competition, and allelopathy). Finally, we identify the conceptual and methodological issues characterizing competition studies in plant invasions, and we discuss future research needs, including examination of resource competition dynamics and the impact of global environmental change on competitive interactions between invasive and native species.

  20. Resource competition in plant invasions: emerging patterns and research needs

    Science.gov (United States)

    Gioria, Margherita; Osborne, Bruce A.

    2014-01-01

    Invasions by alien plants provide a unique opportunity to examine competitive interactions among plants. While resource competition has long been regarded as a major mechanism responsible for successful invasions, given a well-known capacity for many invaders to become dominant and reduce plant diversity in the invaded communities, few studies have measured resource competition directly or have assessed its importance relative to that of other mechanisms, at different stages of an invasion process. Here, we review evidence comparing the competitive ability of invasive species vs. that of co-occurring native plants, along a range of environmental gradients, showing that many invasive species have a superior competitive ability over native species, although invasive congeners are not necessarily competitively superior over native congeners, nor are alien dominants are better competitors than native dominants. We discuss how the outcomes of competition depend on a number of factors, such as the heterogeneous distribution of resources, the stage of the invasion process, as well as phenotypic plasticity and evolutionary adaptation, which may result in increased or decreased competitive ability in both invasive and native species. Competitive advantages of invasive species over natives are often transient and only important at the early stages of an invasion process. It remains unclear how important resource competition is relative to other mechanisms (competition avoidance via phenological differences, niche differentiation in space associated with phylogenetic distance, recruitment and dispersal limitation, indirect competition, and allelopathy). Finally, we identify the conceptual and methodological issues characterizing competition studies in plant invasions, and we discuss future research needs, including examination of resource competition dynamics and the impact of global environmental change on competitive interactions between invasive and native species. PMID

  1. Biological invasions: recommendations for U.S. policy and management.

    Science.gov (United States)

    Lodge, David M; Williams, Susan; MacIsaac, Hugh J; Hayes, Keith R; Leung, Brian; Reichard, Sarah; Mack, Richard N; Moyle, Peter B; Smith, Maggie; Andow, David A; Carlton, James T; McMichael, Anthony

    2006-12-01

    The Ecological Society of America has evaluated current U.S. national policies and practices on biological invasions in light of current scientific knowledge. Invasions by harmful nonnative species are increasing in number and area affected; the damages to ecosystems, economic activity, and human welfare are accumulating. Without improved strategies based on recent scientific advances and increased investments to counter invasions, harm from invasive species is likely to accelerate. Federal leadership, with the cooperation of state and local governments, is required to increase the effectiveness of prevention of invasions, detect and respond quickly to new potentially harmful invasions, control and slow the spread of existing invasions, and provide a national center to ensure that these efforts are coordinated and cost effective. Specifically, the Ecological Society of America recommends that the federal government take the following six actions: (1) Use new information and practices to better manage commercial and other pathways to reduce the transport and release of potentially harmful species; (2) Adopt more quantitative procedures for risk analysis and apply them to every species proposed for importation into the country; (3) Use new cost-effective diagnostic technologies to increase active surveillance and sharing of information about invasive species so that responses to new invasions can be more rapid and effective; (4) Create new legal authority and provide emergency funding to support rapid responses to emerging invasions; (5) Provide funding and incentives for cost-effective programs to slow the spread of existing invasive species in order to protect still uninvaded ecosystems, social and industrial infrastructure, and human welfare; and (6) Establish a National Center for Invasive Species Management (under the existing National Invasive Species Council) to coordinate and lead improvements in federal, state, and international policies on invasive species

  2. Exotic invasive plants

    Science.gov (United States)

    Carolyn Hull Sieg; Barbara G. Phillips; Laura P. Moser

    2003-01-01

    Ecosystems worldwide are threatened by nonnative plant invasions that can cause undesirable, irreversible changes. They can displace native plants and animals, out-cross with native flora, alter nutrient cycling and other ecosystem functions, and even change an ecosystem's flammability (Walker and Smith 1997). After habitat loss, the spread of exotic species is...

  3. Minimally invasive distal pancreatectomy

    NARCIS (Netherlands)

    Røsok, Bård I.; de Rooij, Thijs; van Hilst, Jony; Diener, Markus K.; Allen, Peter J.; Vollmer, Charles M.; Kooby, David A.; Shrikhande, Shailesh V.; Asbun, Horacio J.; Barkun, Jeffrey; Besselink, Marc G.; Boggi, Ugo; Conlon, Kevin; Han, Ho Seong; Hansen, Paul; Kendrick, Michael L.; Kooby, David; Montagnini, Andre L.; Palanivelu, Chinnasamy; Wakabayashi, Go; Zeh, Herbert J.

    2017-01-01

    The first International conference on Minimally Invasive Pancreas Resection was arranged in conjunction with the annual meeting of the International Hepato-Pancreato-Biliary Association (IHPBA), in Sao Paulo, Brazil on April 19th 2016. The presented evidence and outcomes resulting from the session

  4. Pathogenesis of invasive candidiasis.

    NARCIS (Netherlands)

    Veerdonk, F.L. van de; Kullberg, B.J.; Netea, M.G.

    2010-01-01

    PURPOSE OF REVIEW: Disseminated candidiasis remains a life-threatening disease in the ICU. The development of invasive disease with Candida albicans is dependent on multiple factors, such as colonization and efficient host defense at the mucosa. In the present review, we describe the host defense

  5. Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

    Science.gov (United States)

    Bruner, David I.; Pritchard, Amy M.; Clarke, Jonathan

    2013-01-01

    While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia. PMID:24106538

  6. The CIMESTRA study: intra-articular glucocorticosteroids and synthetic DMARDs in a treat-to-target strategy in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Horslev-Petersen, K.

    2012-01-01

    Objective. Treatment of early rheumatoid arthritis (RA) include aiming at disease control with early use of methotrexate (MTX) in monotherapy or in combination with glucocorticoids or other disease-modifying drugs (DMARDs). The CIMESTRA study applied an aggressive treatment with DMARD and intra-a...

  7. Stably Integrated luxCDABE for Assessment of Salmonella Invasion Kinetics

    Directory of Open Access Journals (Sweden)

    Kelly N. Flentie

    2008-09-01

    Full Text Available Salmonella Typhimurium is a common cause of gastroenteritis in humans and also localizes to neoplastic tumors in animals. Invasion of specific eukaryotic cells is a key mechanism of Salmonella interactions with host tissues. Early stages of gastrointestinal cell invasion are mediated by a Salmonella type III secretion system, powered by the adenosine triphosphatase invC. The aim of this work was to characterize the invC dependence of invasion kinetics into disparate eukaryotic cells traditionally used as models of gut epithelium or neoplasms. Thus, a nondestructive real-time assay was developed to report eukaryotic cell invasion kinetics using lux+ Salmonella that contain chromosomally integrated luxCDABE genes. Bioluminescence-based invasion assays using lux+ Salmonella exhibited inoculum dose-response correlation, distinguished invasion-competent from invasion-incompetent Salmonella, and discriminated relative Salmonella invasiveness in accordance with environmental conditions that induce invasion gene expression. In standard gentamicin protection assays, bioluminescence from lux+ Salmonella correlated with recovery of colony-forming units of internalized bacteria and could be visualized by bioluminescence microscopy. Furthermore, this assay distinguished invasion-competent from invasion-incompetent bacteria independent of gentamicin treatment in real time. Bioluminescence reported Salmonella invasion of disparate eukaryotic cell lines, including neoplastic melanoma, colon adenocarcinoma, and glioma cell lines used in animal models of malignancy. In each case, Salmonella invasion of eukaryotic cells was invC dependent.

  8. An annotated bibliography of invasive tree pathogens Sirococcus clavigignenti-juglandacearum, Phytophthora alni, and Phytophthora quercina and a regulatory policy and management practices for invasive species

    Science.gov (United States)

    T.M. Seeland; M.E. Ostry; R. Venette; J. Juzwik

    2006-01-01

    Provides a database of selected literature pertaining to the prevention, early detection and rapid response, control and management, and rehabilitation and restoration related to three invasive fungal pathogens of forest trees. Literature addressing regulatory policy and management practices for invasive species is also included.

  9. Management of invasive species

    DEFF Research Database (Denmark)

    Schou, Jesper Sølver; Jensen, Frank

    impact of the establishment of this invasive species is a substantial increase in the number of allergy cases, which we use as a measure of the physical damage. As valuation methods, we use both the cost-of-illness method and the benefit transfer method to quantify the total gross benefits of the two...... policy actions. Based on the idea of an invasion function, we identify the total and average net benefit under both prevention and mitigation. For both policy actions, the total and average net benefits are significantly positive irrespective of the valuation method used; therefore, both prevention...... and mitigation are beneficial policy actions. However, the total and average net benefits under mitigation are larger than the benefits under prevention, implying that the former policy action is more beneficial. Despite this result, we conclude that prevention, not mitigation, shall be used because...

  10. Symptom management strategies for men with early-stage prostate cancer: results from the Prostate Cancer Patient Education Program (PC PEP).

    Science.gov (United States)

    Vij, Alok; Kowalkowski, Marc A; Hart, Tae; Goltz, Heather Honoré; Hoffman, David J; Knight, Sara J; Caroll, Peter R; Latini, David M

    2013-12-01

    While the literature on prostate cancer health-related quality of life has grown extensively, little is known about symptom management strategies used by men to manage treatment-related side effects and the effectiveness of those strategies. We collected 628 symptom management reports from 98 men treated for localized prostate cancer. Participants were recruited from email lists and a prostate cancer clinic in Northern California. Data were collected using the Critical Incident Technique. Symptom management reports were assigned to categories of urinary, sexual, bowel, mental health, systemic, or "other." We calculated descriptive statistics by symptom type and management strategy effectiveness. The most common symptoms were urinary (26 %) and sexual (23 %). Participants' symptom management strategies varied widely, from medical and surgical interventions (20 %) to behavioral strategies (11 %) to diet and lifestyle interventions (12 %). The effectiveness of symptom management strategies varied, with sexual symptoms being managed effectively only 47 % of the time to mental health symptom management strategies considered effective 89 % of the time. Doing nothing was a commonly reported (15 %) response to symptoms and was effective only 14 % of the time. Men report the least effectiveness in symptom management for sexual dysfunction after prostate cancer treatment. Including men's experience with managing treatment side effects may be an important way to improve survivorship programs and make them more acceptable to men. More work is needed to find out why men frequently do nothing in response to symptoms when effective solutions exist and how providers can successfully engage such men.

  11. Plant invasions: Merging the concepts of species invasiveness and community invasibility

    Czech Academy of Sciences Publication Activity Database

    Richardson, D. M.; Pyšek, Petr

    2006-01-01

    Roč. 30, č. 3 (2006), s. 409-431 ISSN 0309-1333 Institutional research plan: CEZ:AV0Z60050516 Keywords : plant invasions * species invasiveness * community invasibility Subject RIV: EF - Botanics Impact factor: 1.278, year: 2006

  12. Propagule pressure governs establishment of an invasive herb

    Science.gov (United States)

    Ramula, Satu; Jauni, Miia; van Ooik, Tapio

    2015-10-01

    The success of plant invasions may be limited by the availability of propagules and/or of suitable microsites, with microsite availability being affected by, for example, disturbance and interspecific competition. A mechanistic understanding of the contributions of propagule pressure and microsite limitation to plant invasions is therefore required to minimise future invasions. Here, we investigated the relative roles of propagule pressure, the availability of microsites, and their interaction on the establishment of an invasive herb, Lupinus polyphyllus, in two geographic regions representing different climate and growth conditions in Finland (a more productive southern region and a harsher central region). We carried out a field experiment in 14 L. polyphyllus populations, in which we manipulated both propagule pressure and disturbance. In a complementary greenhouse experiment, we manipulated propagule pressure and interspecific competition. Seedling establishment of L. polyphyllus was higher in the more productive southern region than in the harsher central region. The number of L. polyphyllus seedlings increased with increasing propagule pressure regardless of disturbance or interspecific competition. However, the number of L. polyphyllus seedlings per sown seed (relative establishment) tended to decrease with increasing propagule pressure, indicating that the positive effect of propagule pressure on early invasion is partially counteracted by density-dependent mortality at high seed densities. Our results highlight the dominant role of propagule pressure over disturbance and interspecific competition in the establishment of L. polyphyllus, suggesting that the early stage of invasion is limited by the availability of propagules rather than the availability of suitable microsites.

  13. Aiming for a simpler early arthritis MRI protocol

    DEFF Research Database (Denmark)

    Stomp, Wouter; Krabben, Annemarie; van der Heijde, Désirée

    2015-01-01

    PURPOSE: To evaluate whether intravenous gadolinium (Gd) contrast administration can be eliminated when evaluating synovitis and tenosynovitis in early arthritis patients, thereby decreasing imaging time, cost, and invasiveness. MATERIALS AND METHODS: Wrist MRIs of 93 early arthritis patients wer...

  14. Early Detection of Autism (ASD) by a Non-invasive Quick Measurement of Markedly Reduced Acetylcholine & DHEA and Increased β-Amyloid (1-42), Asbestos (Chrysotile), Titanium Dioxide, Al, Hg & often Coexisting Virus Infections (CMV, HPV 16 and 18), Bacterial Infections etc. in the Brain and Corresponding Safe Individualized Effective Treatment.

    Science.gov (United States)

    Omura, Yoshiaki; Lu, Dominic; Jones, Marilyn K; Nihrane, Ahdallah; Duvvi, Harsha; Shimotsuura, Yasuhiro; Ohki, Motomu

    2015-01-01

    A brief historical background on Autism & some of the important symptoms associated with Autism are summarized. Using strong Electro Magnetic Field Resonance Phenomenon between 2 identical molecules with identical weight (which received U.S. Patent) non-invasively & rapidly we can detect various molecules including neurotransmitters, bacteria, virus, fungus, metals & abnormal molecules. Simple non- invasive measurement of various molecules through pupils & head of diagnosed or suspected Autism patients indicated that in Autism patients following changes were often found: 1) Acetylcholine is markedly reduced; 2) Alzheimer's disease markers (i.e. β-Amyloid (1-42), Tau Protein, Apolipoprotein (Apo E4)) are markedly increased; 3) Chrysotile Asbestos is increased; 4) Titanium Dioxide (TiO2) is moderately increased; 5) Al is moderately increased; 6) Hg is moderately increased; 7) Dopamine, Serotonin & GABA are significantly reduced (up to about 1/10 of normal); 8) Often viral infections (such as CMV, HHV-6, HPV-16, HPV-18, etc.), and Bacterial infections (such as Chlamydia trachomatis, Mycobacterium TB, Borrelia Burgdorferi, etc.) coexist. Research by others on Autism spectrum disorder (ASD) shows that it is a group of complex neurodevelopmental disorders, with about 70% of ASD patients also suffering from gastro-intestinal problems. While Alzheimer disease (AD) is characterized by formation of 1) Amyloid plaques, 2) Neurofibrillary tangles inside of neurons, and 3) Loss of connections between neurons. More than 90% of AD develops in people over the age of 65. These 3 characteristics often progressively worsen over time. Although Autism Spectrum Disorder and Alzheimer's disease are completely different diseases they have some similar biochemical changes. Eight examples of such measurement & analysis are shown for comparison. Most of Autism patients improved significantly by removing the source or preventing intake of Asbestos, TiO2, Al & Hg or enhancing urinary output

  15. Experimental approaches for evaluating the invasion risk of biofuel crops

    International Nuclear Information System (INIS)

    Luke Flory, S; Sollenberger, Lynn E; Lorentz, Kimberly A; Gordon, Doria R

    2012-01-01

    There is growing concern that non-native plants cultivated for bioenergy production might escape and result in harmful invasions in natural areas. Literature-derived assessment tools used to evaluate invasion risk are beneficial for screening, but cannot be used to assess novel cultivars or genotypes. Experimental approaches are needed to help quantify invasion risk but protocols for such tools are lacking. We review current methods for evaluating invasion risk and make recommendations for incremental tests from small-scale experiments to widespread, controlled introductions. First, local experiments should be performed to identify conditions that are favorable for germination, survival, and growth of candidate biofuel crops. Subsequently, experimental introductions in semi-natural areas can be used to assess factors important for establishment and performance such as disturbance, founder population size, and timing of introduction across variable habitats. Finally, to fully characterize invasion risk, experimental introductions should be conducted across the expected geographic range of cultivation over multiple years. Any field-based testing should be accompanied by safeguards and monitoring for early detection of spread. Despite the costs of conducting experimental tests of invasion risk, empirical screening will greatly improve our ability to determine if the benefits of a proposed biofuel species outweigh the projected risks of invasions. (letter)

  16. Minimally Invasive Parathyroidectomy

    Directory of Open Access Journals (Sweden)

    Lee F. Starker

    2011-01-01

    Full Text Available Minimally invasive parathyroidectomy (MIP is an operative approach for the treatment of primary hyperparathyroidism (pHPT. Currently, routine use of improved preoperative localization studies, cervical block anesthesia in the conscious patient, and intraoperative parathyroid hormone analyses aid in guiding surgical therapy. MIP requires less surgical dissection causing decreased trauma to tissues, can be performed safely in the ambulatory setting, and is at least as effective as standard cervical exploration. This paper reviews advances in preoperative localization, anesthetic techniques, and intraoperative management of patients undergoing MIP for the treatment of pHPT.

  17. Biological traits explain the distribution and colonisation ability of the invasive shore crab Hemigrapsus takanoi

    Science.gov (United States)

    Gothland, M.; Dauvin, J. C.; Denis, L.; Dufossé, F.; Jobert, S.; Ovaert, J.; Pezy, J. P.; Tous Rius, A.; Spilmont, N.

    2014-04-01

    Comprehending marine invasions requires a better knowledge of the biological traits of invasive species, and the future spread of invasive species may be predicted through comprehensive overviews of their distribution. This study thus presents the current distribution of a non-indigenous species, the Asian shore crab Hemigrapsus takanoi, as well as the species population characteristics (size distribution and cohorts), based on a five-year survey (2008-2012) along the French coast of the English Channel. Two large populations were found near harbours: one on the Opal Coast (where density reached 61 ± 22 ind.m-2, mean ± s.d., in Dunkirk harbour) and one on the Calvados coast (density up to 26 ± 6 ind.m-2, mean ± s.d, in Honfleur harbour). H. takanoi exhibited a short life cycle, a rapid growth, an early sexual maturity and a high adult mortality. These features, combined with previously described high fecundity and high dispersal ability, endow this species with an 'r-selected strategy'. This strategy, which usually characterises species with a high colonisation ability, would explain the success of H. takanoi for colonising the French coast of the Channel. However, the species was found only in harbours and their vicinity; H. takanoi thus exhibited a discontinuous distribution along the 700 km of coastline. These results are discussed regarding sediment preference and potential introduction vectors. Hemigrapsus takanoi is now considered as established on the French coast and further studies are needed to evaluate the consequences of its introduction on the structure and functioning of the impacted shores.

  18. The diagnosis and management of pre-invasive breast disease: Promise of new technologies in understanding pre-invasive breast lesions

    International Nuclear Information System (INIS)

    Jeffrey, Stefanie S; Pollack, Jonathan R

    2003-01-01

    Array-based comparative genomic hybridization, RNA expression profiling, and proteomic analyses are new molecular technologies used to study breast cancer. Invasive breast cancers were originally evaluated because they provided ample quantities of DNA, RNA, and protein. The application of these technologies to pre-invasive breast lesions is discussed, including methods that facilitate their implementation. Data indicate that atypical ductal hyperplasia and ductal carcinoma in situ are precursor lesions molecularly similar to adjacent invasive breast cancer. It is expected that molecular technologies will identify breast tissue at risk for the development of unfavorable subtypes of invasive breast cancer and reveal strategies for targeted chemoprevention or eradication

  19. Microbiome change by symbiotic invasion in lichens

    Science.gov (United States)

    Maier, Stefanie; Wedin, Mats; Fernandez-Brime, Samantha; Cronholm, Bodil; Westberg, Martin; Weber, Bettina; Grube, Martin

    2016-04-01

    Alphaproteobacteria with a concomitant increase in Betaproteobacteria. Armatimonadia, Spartobacteria and Acidobacteria also decreased during the infection of Cladonia by Diploschistes. The lichens differed in photobiont specificity. C. symphycarpa was associated with the same algal species at all sites, but D. muscorum had a flexible strategy with different photobiont combinations at each site. This symbiotic invasion system suggests that partners can be reorganized in BSC and selected for maintaining potential roles rather than depending on particular species.

  20. Including a Client Sexual Health Pathway in a National Youth Mental Health Early Intervention Service--Project Rationale and Implementation Strategy

    Science.gov (United States)

    Edwards, C. A.; Britton, M. L.; Jenkins, L.; Rickwood, D. J.; Gillham, K. E.

    2014-01-01

    Young people have higher rates of sexually transmissible infections (STIs) than the general population. Research has shown that there is a clear link between emotional distress, depression, substance abuse and sexual risk taking behaviours in young people. "headspace" is a youth mental health early intervention service operating in more…

  1. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo

    2012-01-01

    To investigate the short-term and long-term efficacy of intra-articular betamethasone injections, and the impact of joint area, repeated injections, MRI pathology, anticyclic citrullinated peptide (CCP) and immunoglobulin M rheumatoid factor (IgM-RF) status in patients with early rheumatoid arthr...

  2. Adjuvant Trastuzumab Therapy for Early HER2-Positive Breast Cancer in Iran: A Cost-Effectiveness and Scenario Analysis for an Optimal Treatment Strategy

    NARCIS (Netherlands)

    A. Ansaripour (Amir); C.A. Uyl-de Groot (Carin); W.K. Redekop (Ken)

    2017-01-01

    textabstractIntroduction: Clinical guidelines have recommended a 1-year trastuzumab regimen as standard care for early human epidermal growth factor receptor 2 (HER2)-positive breast cancer; however, this recommendation can have a dramatic impact on total drug expenditures in middle-income countries

  3. Alternatives to the Fish Early Life-Stage Test: A Research Strategy for Discovering and Annotating Adverse Outcome Pathways During Fish Development

    Science.gov (United States)

    The OECD 210 fish early life]stage (FELS) test is the primary guideline test used to estimate chronic fish toxicity, as well as support ecological risk assessments and chemical management programs around the world. As a step toward developing alternatives to the FELS test, a HES...

  4. Occupational Well-Being and Stress among Early Childhood Professionals: The Use of an Innovative Strategy to Measure Stress Reactivity in the Workplace

    Science.gov (United States)

    Nislin, M.; Sajaniemi, N.; Sims, M.; Suhonen, E.; Maldonado, E. F.; Hyttinen, S.; Hirvonen, A.

    2016-01-01

    The aim of this study was to examine early childhood professionals' (ECPs) work engagement, burnout and stress regulation in integrated special day-care groups. The participants consisted of 89 ECPs from 21 integrated special day-care groups in Helsinki, Finland. ECPs' work-related well-being was assessed using self-report questionnaires that…

  5. Seed bank survival of an invasive species, but not of two native species, declines with invasion.

    Science.gov (United States)

    Orrock, John L; Christopher, Cory C; Dutra, Humberto P

    2012-04-01

    Soil-borne seed pathogens may play an important role in either hindering or facilitating the spread of invasive exotic plants. We examined whether the invasive shrub Lonicera maackii (Caprifoliaceae) affected fungi-mediated mortality of conspecific and native shrub seeds in a deciduous forest in eastern Missouri. Using a combination of L. maackii removal and fungicide treatments, we found no effect of L. maackii invasion on seed viability of the native Symphoricarpos orbiculatus (Caprifoliaceae) or Cornus drummondii (Cornaceae). In contrast, fungi were significant agents of L. maackii seed mortality in invaded habitats. Losses of L. maackii to soil fungi were also significant in invaded habitats where L. maackii had been removed, although the magnitude of the effect of fungi was lower, suggesting that changes in soil chemistry or microhabitat caused by L. maackii were responsible for affecting fungal seed pathogens. Our work suggests that apparent competition via soil pathogens is not an important factor contributing to impacts of L. maackii on native shrubs. Rather, we found that fungal seed pathogens have density-dependent effects on L. maackii seed survival. Therefore, while fungal pathogens may provide little biotic resistance to early invasion by L. maackii, our study illustrates that more work is needed to understand how changes in fungal pathogens during the course of an invasion contribute to the potential for restoration of invaded systems. More generally, our study suggests that increased rates of fungal pathogen attack may be realized by invasive plants, such as L. maackii, that change the chemical or physical environment of the habitats they invade.

  6. Enhancing early detection of exotic pests in agricultural and forest ecosystems using an urban-gradient framework.

    Science.gov (United States)

    Colunga-Garcia, Manuel; Magarey, Roger A; Haack, Robert A; Gage, Stuart H; Qi, Jiaquo

    2010-03-01

    Urban areas are hubs of international transport and therefore are major gateways for exotic pests. Applying an urban gradient to analyze this pathway could provide insight into the ecological processes involved in human-mediated invasions. We defined an urban gradient for agricultural and forest ecosystems in the contiguous United States to (1) assess whether ecosystems nearer more urbanized areas were at greater risk of invasion, and (2) apply this knowledge to enhance early detection of exotic pests. We defined the gradient using the tonnage of imported products in adjacent urban areas and their distance to nearby agricultural or forest land. County-level detection reports for 39 exotic agricultural and forest pests of major economic importance were used to characterize invasions along the gradient. We found that counties with more exotic pests were nearer the urban end of the gradient. Assuming that the exotic species we analyzed represent typical invaders, then early detection efforts directed at 21-26% of U.S. agricultural and forest land would likely be able to detect 70% of invaded counties and 90% of the selected species. Applying an urban-gradient framework to current monitoring strategies should enhance early detection efforts of exotic pests, facilitating optimization in allocating resources to areas at greater risk of future invasions.

  7. Status and management of non-native plant invasion in three of the largest national parks in the United States

    Directory of Open Access Journals (Sweden)

    Scott Abella

    2015-06-01

    Full Text Available Globally, invasion by non-native plants threatens resources that nature reserves are designated to protect. We assessed the status of non-native plant invasion on 1,662, 0.1-ha plots in Death Valley National Park, Mojave National Preserve, and Lake Mead National Recreation Area. These parks comprise 2.5 million ha, 23% of the national park land in the contiguous USA. At least one non-native species inhabited 82% of plots. Thirty-one percent of plots contained one non-native species, 30% two, 17% three, and 4% four to ten non-native species. Red brome (Bromus rubens, an ‘ecosystem engineer’ that alters fire regimes, was most widespread, infesting 60% of plots. By identifying frequency of species through this assessment, early detection and treatment can target infrequent species or minimally invaded sites, while containment strategies could focus on established invaders. We further compared two existing systems for prioritizing species for management and found that a third of species on plots had no rankings available. Moreover, rankings did not always agree between ranking systems for species that were ranked. Presence of multiple non-native species complicates treatment, and while we found that 40% of plots contained both forb and grass invaders, exploiting accelerated phenology of non-natives (compared to native annuals might help manage multi-species invasions. Large sizes of these parks and scale of invasion are formidable challenges for management. Yet, precisely because of their size, these reserves represent opportunities to conserve large landscapes of native species by managing non-native plant invasions.

  8. Canadian Clinical Practice Guidelines for Invasive Candidiasis in Adults

    Directory of Open Access Journals (Sweden)

    Eric J Bow

    2010-01-01

    Full Text Available Candidemia and invasive candidiasis (C/IC are life-threatening opportunistic infections that add excess morbidity, mortality and cost to the management of patients with a range of potentially curable underlying conditions. The Association of Medical Microbiology and Infectious Disease Canada developed evidence-based guidelines for the approach to the diagnosis and management of these infections in the ever-increasing population of at-risk adult patients in the health care system. Over the past few years, a new and broader understanding of the epidemiology and pathogenesis of C/IC has emerged and has been coupled with the availability of new antifungal agents and defined strategies for targeting groups at risk including, but not limited to, acute leukemia patients, hematopoietic stem cell transplants and solid organ transplants, and critical care unit patients. Accordingly, these guidelines have focused on patients at risk for C/IC, and on approaches of prevention, early therapy for suspected but unproven infection, and targeted therapy for probable and proven infection.

  9. The Effects of Parental Involvement, Trust in Parents, Trust in Students and Pupil Control Ideology on Conflict Management Strategies of Early Childhood Teachers

    Science.gov (United States)

    Karakus, Mehmet; Savas, Ahmet Cezmi

    2012-01-01

    In this study it was aimed to determine the effects of parental involvement, teachers' trust in parents and students, and teachers' pupil control ideology on the conflict management strategies used by teachers in classroom management. Data were collected from a sample of 254 teachers through paper and pencil questionnaires. Data were analyzed with…

  10. Secondary invasions of noxious weeds associated with control of invasive Tamarix are frequent, idiosyncratic and persistent

    Science.gov (United States)

    González, Eduardo; Sher, Anna A.; Anderson, Robert M.; Bay, Robin F.; Bean, Daniel W.; Bissonnete, Gabriel J.; Cooper, David J.; Dohrenwend, Kara; Eichhorst, Kim D.; El Waer, Hisham; Kennard, Deborah K.; Harms-Weissinger, Rebecca; Henry, Annie L.; Makarick, Lori J.; Ostoja, Steven M.; Reynolds, Lindsay V.; Robinson, W. Wright; Shafroth, Patrick B.; Tabacchi, Erich

    2017-01-01

    Control of invasive species within ecosystems may induce secondary invasions of non-target invaders replacing the first alien. We used four plant species listed as noxious by local authorities in riparian systems to discern whether 1) the severity of these secondary invasions was related to the control method applied to the first alien; and 2) which species that were secondary invaders persisted over time. In a collaborative study by 16 research institutions, we monitored plant species composition following control of non-native Tamarix trees along southwestern U.S. rivers using defoliation by an introduced biocontrol beetle, and three physical removal methods: mechanical using saws, heavy machinery, and burning in 244 treated and 79 untreated sites across six U.S. states. Physical removal favored secondary invasions immediately after Tamarix removal (0–3 yrs.), while in the biocontrol treatment, secondary invasions manifested later (> 5 yrs.). Within this general trend, the response of weeds to control was idiosyncratic; dependent on treatment type and invader. Two annual tumbleweeds that only reproduce by seed (Bassia scoparia and Salsola tragus) peaked immediately after physical Tamarix removal and persisted over time, even after herbicide application. Acroptilon repens, a perennial forb that vigorously reproduces by rhizomes, and Bromus tectorum, a very frequent annual grass before removal that only reproduces by seed, were most successful at biocontrol sites, and progressively spread as the canopy layer opened. These results demonstrate that strategies to control Tamarix affect secondary invasions differently among species and that time since disturbance is an important, generally overlooked, factor affecting response.

  11. Learning strategy refinement reverses early sensory cortical map expansion but not behavior: Support for a theory of directed cortical substrates of learning and memory.

    Science.gov (United States)

    Elias, Gabriel A; Bieszczad, Kasia M; Weinberger, Norman M

    2015-12-01

    Primary sensory cortical fields develop highly specific associative representational plasticity, notably enlarged area of representation of reinforced signal stimuli within their topographic maps. However, overtraining subjects after they have solved an instrumental task can reduce or eliminate the expansion while the successful behavior remains. As the development of this plasticity depends on the learning strategy used to solve a task, we asked whether the loss of expansion is due to the strategy used during overtraining. Adult male rats were trained in a three-tone auditory discrimination task to bar-press to the CS+ for water reward and refrain from doing so during the CS- tones and silent intertrial intervals; errors were punished by a flashing light and time-out penalty. Groups acquired this task to a criterion within seven training sessions by relying on a strategy that was "bar-press from tone-onset-to-error signal" ("TOTE"). Three groups then received different levels of overtraining: Group ST, none; Group RT, one week; Group OT, three weeks. Post-training mapping of their primary auditory fields (A1) showed that Groups ST and RT had developed significantly expanded representational areas, specifically restricted to the frequency band of the CS+ tone. In contrast, the A1 of Group OT was no different from naïve controls. Analysis of learning strategy revealed this group had shifted strategy to a refinement of TOTE in which they self-terminated bar-presses before making an error ("iTOTE"). Across all animals, the greater the use of iTOTE, the smaller was the representation of the CS+ in A1. Thus, the loss of cortical expansion is attributable to a shift or refinement in strategy. This reversal of expansion was considered in light of a novel theoretical framework (CONCERTO) highlighting four basic principles of brain function that resolve anomalous findings and explaining why even a minor change in strategy would involve concomitant shifts of involved brain

  12. LEARNING STRATEGY REFINEMENT REVERSES EARLY SENSORY CORTICAL MAP EXPANSION BUT NOT BEHAVIOR: SUPPORT FOR A THEORY OF DIRECTED CORTICAL SUBSTRATES OF LEARNING AND MEMORY

    Science.gov (United States)

    Elias, Gabriel A.; Bieszczad, Kasia M.; Weinberger, Norman M.

    2015-01-01

    Primary sensory cortical fields develop highly specific associative representational plasticity, notably enlarged area of representation of reinforced signal stimuli within their topographic maps. However, overtraining subjects after they have solved an instrumental task can reduce or eliminate the expansion while the successful behavior remains. As the development of this plasticity depends on the learning strategy used to solve a task, we asked whether the loss of expansion is due to the strategy used during overtraining. Adult male rats were trained in a three-tone auditory discrimination task to bar-press to the CS+ for water reward and refrain from doing so during the CS− tones and silent intertrial intervals; errors were punished by a flashing light and time-out penalty. Groups acquired this task to a criterion within seven training sessions by relying on a strategy that was “bar-press from tone-onset-to-error signal” (“TOTE”). Three groups then received different levels of overtraining: Group ST, none; Group RT, one week; Group OT, three weeks. Post-training mapping of their primary auditory fields (A1) showed that Groups ST and RT had developed significantly expanded representational areas, specifically restricted to the frequency band of the CS+ tone. In contrast, the A1 of Group OT was no different from naïve controls. Analysis of learning strategy revealed this group had shifted strategy to a refinement of TOTE in which they self-terminated bar-presses before making an error (“iTOTE”). Across all animals, the greater the use of iTOTE, the smaller was the representation of the CS+ in A1. Thus, the loss of cortical expansion is attributable to a shift or refinement in strategy. This reversal of expansion was considered in light of a novel theoretical framework (CONCERTO) highlighting four basic principles of brain function that resolve anomalous findings and explaining why even a minor change in strategy would involve concomitant shifts of

  13. Thrombolysis in the age of Primary Percutaneous Coronary Intervention: Mini-Review and Meta-analysis of Early PCI.

    Science.gov (United States)

    Al Shammeri, O; Garcia, LA

    2013-01-01

    Primary Percutaneous Coronary Intervention (PCI) is the treatment of choice for ST-segment Elevation Myocardial Infarction (STEMI) if performed within 90 minutes from first medical contact. However, primary PCI is only available for less than 25% of patients with STEMI. Early PCI or Pharmaco-invasive strategy has evolved from facilitated PCI but with more delayed timing from thrombolysis to PCI. Assess the safety and effectiveness of Early PCI. We reviewed the data of the available therapy options for patients with STEMI. Then we performed a meta-analysis for all randomized controlled trials of early PCI versus standard therapy. Five studies fulfilled our inclusion criteria. Our meta-analysis showed improved cardiovascular events with early PCI compared to standard therapy (odd ratio of 0.54; 95% Confidence interval 0.47-0.7, pearly PCI 4 to 24 hours after successful thrombolysis. Early PCI should be done to all STEMI patients within 24 hours after successful thrombolysis.

  14. Non-invasive diagnosis and management of ectopic pregnancy

    NARCIS (Netherlands)

    van Mello, N.M.

    2013-01-01

    The work presented in this thesis begins with a focus on non-invasive diagnostic methods for ectopic pregnancy. The heterogeneity found in studies on diagnostic tests for ectopic pregnancy has led to an international recommendation on uniform definitions of early pregnancy complications. Hereafter,

  15. Women with acute coronary syndrome are less invasively examined and subsequently less treated than men

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Galatius, Søren; Madsen, Mette

    2010-01-01

    AIMS: To investigate if gender bias is present in today's setting of an early invasive strategy for patients with acute coronary syndrome in Denmark (population 5 million). METHODS AND RESULTS: We identified all patients admitted to Danish hospitals with acute coronary syndrome in 2005-07 (9561...... women and 16 406 men). Cox proportional hazard models were used to estimate the gender differences in coronary angiography (CAG) rate and subsequent revascularization rate within 60 days of admission. Significantly less women received CAG (cumulative incidence 64% for women vs. 78% for men, P ....66-0.71, P coronary angiogram. However, after adjustment for the number of significant stenoses, age, and comorbidity women were still less likely to be revascularized (HR 0.91, 95% CI 0.87-0.95, P...

  16. Treatment and prevention of invasive pneumococcal disease.

    Science.gov (United States)

    Domínguez-Alegría, A R; Pintado, V; Barbolla, I

    2018-02-12

    Invasive pneumococcal disease is a severe infection that mainly affects patients with associated comorbidity. The paediatric conjugate vaccination has resulted in a change in the adult vaccination strategy. The antibiotic resistance of pneumococcus is not currently a severe problem. Nevertheless, the World Health Organisation has included pneumococcus among the bacteria whose treatment requires the introduction of new drugs, such as ceftaroline and ceftobiprole. Although the scientific evidence is still limited, the combination of beta-lactams and macrolides is recommended as empiric therapy for bacteraemic pneumococcal pneumonia. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  17. Minimally Invasive Spine Surgery in Small Animals.

    Science.gov (United States)

    Hettlich, Bianca F

    2018-01-01

    Minimally invasive spine surgery (MISS) seems to have many benefits for human patients and is currently used for various minor and major spine procedures. For MISS, a change in access strategy to the target location is necessary and it requires intraoperative imaging, special instrumentation, and magnification. Few veterinary studies have evaluated MISS for canine patients for spinal decompression procedures. This article discusses the general requirements for MISS and how these can be applied to veterinary spinal surgery. The current veterinary MISS literature is reviewed and suggestions are made on how to apply MISS to different spinal locations. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. A comparison of non-invasive versus invasive methods of ...

    African Journals Online (AJOL)

    Puneet Khanna

    for Hb estimation from the laboratory [total haemoglobin mass (tHb)] and arterial blood gas (ABG) machine (aHb), using ... A comparison of non-invasive versus invasive methods of haemoglobin estimation in patients undergoing intracranial surgery. 161 .... making decisions for blood transfusions based on these results.

  19. Impacts of a water stress followed by an early frost event on beech (Fagus sylvatica L.) susceptibility to Scolytine ambrosia beetles - Research strategy and first results

    Science.gov (United States)

    La Spina, Sylvie; de Cannière, Charles; Molenberg, Jean-Marc; Vincke, Caroline; Deman, Déborah; Grégoire, Jean-Claude

    2010-05-01

    Climate change tends to induce more frequent abiotic and biotic extreme events, having large impacts on tree vitality. Weakened trees are then more susceptible to secondary insect outbreaks, as it happened in Belgium in the early 2000s: after an early frost event, secondary Scolytine ambrosia beetles attacks were observed on beech trees. In this study, we test if a combination of stress, i.e. a soil water deficit preceding an early frost, could render trees more attractive to beetles. An experimental study was set in autumn 2008. Two parcels of a beech forest were covered with plastic tents to induce a water stress by rain interception. The parcels were surrounded by 2-meters depth trenches to avoid water supply by streaming. Soil water content and different indicators of tree water use (sap flow, predawn leaf water potential, tree radial growth) were followed. In autumn 2010, artificial frost injuries will be inflicted to trees using dry ice. Trees attractivity for Scolytine insects, and the success of insect colonization will then be studied. The poster will focus on experiment setting and first results (impacts of soil water deficit on trees).

  20. Non-invasive tissue oximetry following unilateral DIEP-flap reconstruction: A pilot evaluation

    Directory of Open Access Journals (Sweden)

    N.P.A. Vranken

    2017-06-01

    Conclusion: Continuous non-invasive tissue oxygen saturation is suitable for postoperative monitoring of DIEP-flaps, and StO2 pattern may aid in early identification of vascular compromise in DIEP-flaps.

  1. Early Retirement Payoff

    Science.gov (United States)

    Fitzpatrick, Maria D.; Lovenheim, Michael F.

    2014-01-01

    As public budgets have grown tighter over the past decade, states and school districts have sought ways to control the growth of spending. One increasingly common strategy employed to rein in costs is to offer experienced teachers with high salaries financial incentives to retire early. Although early retirement incentive (ERI) programs have been…

  2. Mechanisms of cellular invasion by intracellular parasites.

    Science.gov (United States)

    Walker, Dawn M; Oghumu, Steve; Gupta, Gaurav; McGwire, Bradford S; Drew, Mark E; Satoskar, Abhay R

    2014-04-01

    Numerous disease-causing parasites must invade host cells in order to prosper. Collectively, such pathogens are responsible for a staggering amount of human sickness and death throughout the world. Leishmaniasis, Chagas disease, toxoplasmosis, and malaria are neglected diseases and therefore are linked to socio-economical and geographical factors, affecting well-over half the world's population. Such obligate intracellular parasites have co-evolved with humans to establish a complexity of specific molecular parasite-host cell interactions, forming the basis of the parasite's cellular tropism. They make use of such interactions to invade host cells as a means to migrate through various tissues, to evade the host immune system, and to undergo intracellular replication. These cellular migration and invasion events are absolutely essential for the completion of the lifecycles of these parasites and lead to their for disease pathogenesis. This review is an overview of the molecular mechanisms of protozoan parasite invasion of host cells and discussion of therapeutic strategies, which could be developed by targeting these invasion pathways. Specifically, we focus on four species of protozoan parasites Leishmania, Trypanosoma cruzi, Plasmodium, and Toxoplasma, which are responsible for significant morbidity and mortality.

  3. The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment

    OpenAIRE

    Beatrice A. Boucher; Elizabeth Manafò; Meaghan R. Boddy; Lynn Roblin; Rebecca Truscott

    2017-01-01

    Introduction: To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS) integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes ...

  4. Exotic annual Bromus invasions: Comparisons among species and ecoregions in the western United States [Chapter 2

    Science.gov (United States)

    Matthew L. Brooks; Cynthia S. Brown; Jeanne C. Chambers; Carla M. D' Antonio; Jon E. Keeley; Jayne Belnap

    2016-01-01

    Exotic annual Bromus species are widely recognized for their potential to invade, dominate, and alter the structure and function of ecosystems. In this chapter, we summarize the invasion potential, ecosystem threats, and management strategies for different Bromus species within each of five ecoregions of the western United States. We characterize invasion...

  5. Cytomegalovirus reactivation is associated with a lower rate of early relapse in myeloid malignancies independent of in-vivo T cell depletion strategy.

    Science.gov (United States)

    Hilal, Talal; Slone, Stacey; Peterson, Shawn; Bodine, Charles; Gul, Zartash

    2017-06-01

    The association between cytomegalovirus (CMV) reactivation and relapse risk has not been evaluated in relation to T cell depletion strategies. We evaluated 93 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) and analyzed the association between T cell depletion strategies with the cumulative incidence of relapse and CMV reactivation. A total of 33% of patients who received ATG vs. 34% who received alemtuzumab developed CMV reactivation. The cumulative incidence of relapse was 3% at 1year and 20% at 3 years in patients with CMV reactivation vs. 30% at 1year and 38% at 3 years in patients without CMV reactivation (p=0.02). When analyzed separately, this effect persisted in the myeloid, but not the lymphoid group. There was a numerical trend towards increased non-relapse mortality (NRM) in patients with CMV reactivation, especially in the myeloid group. The choice of T cell depleting agent and the rate of CMV reactivation were not associated with different overall survival (OS) rates. These results suggest that the choice of T cell depletion strategy may have similar effects on rates of CMV reactivation, disease relapse, and survival. Further studies examining these variables in patients not exposed to in-vivo T cell depleting agents may be of interest. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Klebsiella pneumoniae Invasive Syndrome

    Directory of Open Access Journals (Sweden)

    Vasco Evangelista

    2018-01-01

    Full Text Available Klebsiella pneumoniae invasive syndrome (KPIS is a rare clinical condition characterized by primary liver abscess associated with metastatic infection. Most case reports are from Southeast Asia, with only one case described in Portugal. The Authors present the case of a 44-year-old man with a history of fever, dry cough and cervicalgia. A thoracic computed tomography (CT scan showed multiple pulmonary and hepatic nodules, suggestive of metastatic malignancy. Both blood cultures and bronchoalveolar lavage were positive for Klebsiella pneumoniae. Imaging studies were repeated during his hospital stay, showing a reduction in both number and volume of identified lesions, thus revealing their infectious nature. This case illustrates how much this entity can mimic other illnesses.

  7. Lantana camara L. (Verbenaceae) invasion along streams in a ...

    Indian Academy of Sciences (India)

    Streams are periodically disturbed due to flooding, act as edges between habitats and also facilitate the dispersal of propagules, thus being potentially more vulnerable to invasions than adjoining regions. We used a landscape-wide transect-based sampling strategy and a mixed effects modelling approach to understand ...

  8. A management guide for invasive plants in southern forests

    Science.gov (United States)

    James H. Miller; Steven T. Manning; Stephen F. Enloe

    2013-01-01

    Invasions of nonnative plants into forests of the Southern United States continue to spread and include new species, increasingly eroding forest productivity, hindering forest use and management activities, and degrading diversity and wildlife habitat. This book provides the latest information on how to organize and enact prevention programs, build strategies,...

  9. Cognitive function in early HIV infection.

    Science.gov (United States)

    Prakash, Aanchal; Hou, Jue; Liu, Lei; Gao, Yi; Kettering, Casey; Ragin, Ann B

    2017-04-01

    This study aimed to examine cognitive function in acute/early HIV infection over the subsequent 2 years. Fifty-six HIV+ subjects and 21 seronegative participants of the Chicago Early HIV Infection Study were evaluated using a comprehensive neuropsychological assessment at study enrollment and at 2-year follow-up. Cognitive performance measures were compared in the groups using t tests and mixed-effect models. Patterns of relationship with clinical measures were determined between cognitive function and clinical status markers using Spearman's correlations. At the initial timepoint, the HIV group demonstrated significantly weaker performance on measures of verbal memory, visual memory, psychomotor speed, motor speed, and executive function. A similar pattern was found when cognitive function was examined at follow-up and across both timepoints. The HIV subjects had generally weaker performance on psychomotor speed, executive function, motor speed, visual memory, and verbal memory. The rate of decline in cognitive function across the 2-year follow-up period did not differ between groups. Correlations between clinical status markers and cognitive function at both timepoints showed weaker performance associated with increased disease burden. Neurocognitive difficulty in chronic HIV infection may have very early onset and reflect consequences of initial brain viral invasion and neuroinflammation during the intense, uncontrolled viremia of acute HIV infection. Further characterization of the changes occurring in initial stages of infection and the risk and protective factors for cognitive function could inform new strategies for neuroprotection.

  10. Dietary Flexibility Aids Asian Earthworm Invasion in North American Forests

    Science.gov (United States)

    On a local scale, invasiveness of introduced species and invasibility of habitats together determine invasion success. A key issue in invasion ecology has been how to quantify the contribution of species invasiveness and habitat invasibility separately. Conventional approaches, s...

  11. Prospective Clinical Utility Study of the Use of the 21-Gene Assay in Adjuvant Clinical Decision Making in Women With Estrogen Receptor-Positive Early Invasive Breast Cancer: Results From the SWITCH Study.

    Science.gov (United States)

    Gligorov, Joseph; Pivot, Xavier B; Jacot, William; Naman, Hervé L; Spaeth, Dominique; Misset, Jean-Louis; Largillier, Rémy; Sautiere, Jean-Loup; de Roquancourt, Anne; Pomel, Christophe; Rouanet, Philippe; Rouzier, Roman; Penault-Llorca, Frederique M

    2015-08-01

    The 21-gene Oncotype DX Recurrence Score assay is a validated assay to help decide the appropriate treatment for estrogen receptor-positive (ER+), early-stage breast cancer (EBC) in the adjuvant setting. The choice of adjuvant treatments might vary considerably in different countries according to various treatment guidelines. This prospective multicenter study is the first to assess the impact of the Oncotype DX assay in the French clinical setting. A total of 100 patients with ER+, human epidermal growth factor receptor 2-negative EBC, and node-negative (pN0) disease or micrometastases in up to 3 lymph nodes (pN1mi) were enrolled. Treatment recommendations, physicians' confidence before and after knowing the Recurrence Score value, and physicians' perception of the assay were recorded. Of the 100 patients, 95 were evaluable (83 pN0, 12 pN1mi). Treatment recommendations changed in 37% of patients, predominantly from chemoendocrine to endocrine treatment alone. The proportion of patients recommended chemotherapy decreased from 52% pretest to 25% post-test. Of patients originally recommended chemotherapy, 61% were recommended endocrine treatment alone after receiving the Recurrence Score result. For both pN0 and pN1mi patients, post-test recommendations appeared to follow the Recurrence Score result for low and high values. Physicians' confidence improved significantly. These are the first prospective data on the impact of the Oncotype DX assay on adjuvant treatment decisions in France. Using the assay was associated with a significant change in treatment decisions and an overall reduction in chemotherapy use. These data are consistent with those presented from European and non-European studies. ©AlphaMed Press.

  12. Microbial ecology of biological invasions

    NARCIS (Netherlands)

    Van der Putten, W.H.; Klironomos, J.N.; Wardle, D.A.

    2007-01-01

    Invasive microbes, plants and animals are a major threat to the composition and functioning of ecosystems; however, the mechanistic basis of why exotic species can be so abundant and disruptive is not well understood. Most studies have focused on invasive plants and animals, although few have

  13. Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies.

    Science.gov (United States)

    Sasaki, Nobuo; Meyer, Matthew J; Eikermann, Matthias

    2013-04-01

    Postoperative pulmonary complications are responsible for significant increases in hospital cost as well as patient morbidity and mortality; respiratory muscle dysfunction represents a contributing factor. Upper airway dilator muscles functionally resist the upper airway collapsing forces created by the respiratory pump muscles. Standard perioperative medications (anesthetics, sedatives, opioids, and neuromuscular blocking agents), interventions (patient positioning, mechanical ventilation, and surgical trauma), and diseases (lung hyperinflation, obesity, and obstructive sleep apnea) have differential effects on the respiratory muscle subgroups. These effects on the upper airway dilators and respiratory pump muscles impair their coordination and function and can result in respiratory failure. Perioperative management strategies can help decrease the incidence of postoperative respiratory muscle dysfunction. Such strategies include minimally invasive procedures rather than open surgery, early and optimal mobilizing of respiratory muscles while on mechanical ventilation, judicious use of respiratory depressant anesthetics and neuromuscular blocking agents, and noninvasive ventilation when possible.

  14. Potential utility of environmental DNA for early detection of Eurasian watermilfoil (Myriophyllum spicatum)

    Science.gov (United States)

    Newton, Jeremy; Sepulveda, Adam; Sylvester, K; Thum, Ryan

    2016-01-01

    EWM invasions have negative impacts on native biodiversity, recreational boating, fishing, and other types of aquatic tourism (e.g., Eiswerth et al. 2000). On a broader scale, EWM can also be harmful to man-made aquatic infrastructure, such as hydroelectric dams. If an EWM invasion can be detected in an early stage where eradication is still a possibility, many of these negative consequences can be limited or prevented altogether (e.g., Madsen et al. 2002). The purpose of this research was to develop and validate a traditional polymerase chain reaction (PCR) assay for the detection of pure and hybridized EWM DNA using both laboratory and field experiments. We performed a pilot experiment in outdoor tanks to determine the basic functionality and sensitivity of the assay. Following this initial test, we collected field samples from Michigan and Montana lakes with and without known EWM populations. Taken together, our findings suggest that eDNA techniques have potential to be a useful strategy for the early detection of EWM.

  15. A comparison of eight country plans for the Invasive Indo-Pacific Lionfish in the Wider Caribbean

    Directory of Open Access Journals (Sweden)

    Roxanne E. Graham

    2017-10-01

    Full Text Available The effects of climate change and marine invasive species have posed a major threat to significant ecological, aesthetic, economic and amenity value to the countries and territories of the Wider Caribbean Region. Today, the Caribbean Sea is plagued with the invasive lionfish (Pterois volitans and P. miles. As the range and abundance of the lionfish throughout the Caribbean has grown, recognition of the grave threat it poses to the native marine ecosystems has prompted the development of lionfish management plans across the region. The efforts of eight countries in the region to manage lionfish are evaluated using the US Environmental Protection Agency Aquatic Invasive Species framework and the inclusion of climate change and/or changing conditions. The countries and overseas territories evaluated were Anguilla, Bahamas, Cayman Islands, Grenada, St. Eustatius, St. Lucia, St. Vincent and the US Virgin Islands. Although specific strategies differed amongst the islands depending upon needs, culture, and individual circumstances, most of the plans included aspects of education and outreach, control and monitoring protocols, and research and information management. Areas that were found to be notably weak to nonexistent included leadership, prevention, early detection and rapid response and restoration; This comparative analysis provides opportunities for knowledge sharing and intra- and inter-country cooperation, facilitating the transfer and development of interventions that contribute to the conservation of significant island biodiversity.

  16. Long time behavior of a PDE model for invasive species control

    KAUST Repository

    Parshad, R.D.

    2011-01-01

    The Trojan Y Chromosome strategy (TYC) is a theoretical method for eradication of invasive species. It requires constant introduction of artificial individuals into a target population, causing a shift in the sex ratio, that ultimately leads

  17. Screening, early detection, education, and trends for melanoma: current status (2007-2013) and future directions: Part I. Epidemiology, high-risk groups, clinical strategies, and diagnostic technology.

    Science.gov (United States)

    Mayer, Jonathan E; Swetter, Susan M; Fu, Teresa; Geller, Alan C

    2014-10-01

    While most cancers have shown both decreased incidence and mortality over the past several decades, the incidence of melanoma has continued to grow, and mortality has only recently stabilized in the United States and in many other countries. Certain populations, such as men >60 years of age and lower socioeconomic status groups, face a greater burden from disease. For any given stage and across all ages, men have shown worse melanoma survival than women, and low socioeconomic status groups have increased levels of mortality. Novel risk factors can help identify populations at greatest risk for melanoma and can aid in targeted early detection. Risk assessment tools have been created to identify high-risk patients based on various factors, and these tools can reduce the number of patients needed to screen for melanoma detection. Diagnostic techniques, such as dermatoscopy and total body photography, and new technologies, such as multispectral imaging, may increase the accuracy and reliability of early melanoma detection. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Respective impact of implementation of prevention strategies, colonization with multiresistant bacteria and antimicrobial use on the risk of early- and late-onset VAP: An analysis of the OUTCOMEREA network.

    Directory of Open Access Journals (Sweden)

    Wafa Ibn Saied

    Full Text Available The impact of prevention strategies and risk factors for early-onset (EOP versus late-onset (LOP ventilator-associated pneumonia (VAP are still debated.To evaluate, in a multicenter cohort, the risk factors for EOP and LOP, as the evolution of prevention strategies.7,784 patients with mechanical ventilation (MV for at least 48 hours were selected into the multicenter prospective OUTCOMEREA database (1997-2016. VAP occurring between the 3rd and 6th day of MV defined EOP, while those occurring after defined LOPs. We used a Fine and Gray subdistribution model to take the successful extubation into account as a competing event.Overall, 1,234 included patients developed VAP (EOP: 445 (36%; LOP: 789 (64%. Male gender was a risk factor for both EOP and LOP. Factors specifically associated with EOP were admission for respiratory distress, previous colonization with multidrug-resistant Pseudomonas aeruginosa, chest tube and enteral feeding within the first 2 days of MV. Antimicrobials administrated within the first 2 days of MV were all protective of EOP. ICU admission for COPD exacerbation or pneumonia were early risk factors for LOP, while imidazole and vancomycin use within the first 2 days of MV were protective factors. Late risk factors (between the 3rd and the 6th day of MV were the intra-hospital transport, PAO2-FIO2<200 mmHg, vasopressor use, and known colonization with methicillin-resistant Staphylococcus aureus. Among the antimicrobials administered between the 3rd and the 6th day, fluoroquinolones were the solely protective one.Contrarily to LOP, the risk of EOP decreased across the study time periods, concomitantly with an increase in the compliance with bundle of prevention measures.VAP risk factors are mostly different according to the pneumonia time of onset, which should lead to differentiated prevention strategies.

  19. Contemporary evolution strategies

    CERN Document Server

    Bäck, Thomas; Krause, Peter

    2013-01-01

    Evolution strategies have more than 50 years of history in the field of evolutionary computation. Since the early 1990s, many algorithmic variations of evolution strategies have been developed, characterized by the fact that they use the so-called derandomization concept for strategy parameter adaptation. Most importantly, the covariance matrix adaptation strategy (CMA-ES) and its successors are the key representatives of this group of contemporary evolution strategies. This book provides an overview of the key algorithm developments between 1990 and 2012, including brief descriptions of the a

  20. Minimally Invasive Dentistry

    Science.gov (United States)

    ... all contributors to decay. Your dentist will then use strategies to prevent or reduce your risk for tooth decay. For instance, if ... require anesthesia. It resembles microscopic sand blasting and uses a stream of air combined with a super-fine ... Usually made of plastic resin, dental sealants protect teeth from bacteria that ...

  1. Invasive Glioblastoma Cells Acquire Stemness and Increased Akt Activation

    Directory of Open Access Journals (Sweden)

    Jennifer R. Molina

    2010-06-01

    Full Text Available Glioblastoma multiforme (GBM is the most frequent and most aggressive brain tumor in adults. The dismal prognosis is due to postsurgery recurrences arising from escaped invasive tumor cells. The signaling pathways activated in invasive cells are under investigation, and models are currently designed in search for therapeutic targets. We developed here an in vivo model of human invasive GBM in mouse brain from a GBM cell line with moderate tumorigenicity that allowed simultaneous primary tumor growth and dispersal of tumor cells in the brain parenchyma. This strategy allowed for the first time the isolation and characterization of matched sets of tumor mass (Core and invasive (Inv cells. Both cell populations, but more markedly Inv cells, acquired stem cell markers, neurosphere renewal ability, and resistance to rapamycin-induced apoptosis relative to parental cells. The comparative phenotypic analysis between Inv and Core cells showed significantly increased tumorigenicity in vivo and increased invasion with decreased proliferation in vitro for Inv cells. Examination of a large array of signaling pathways revealed extracellular signal-regulated kinase (Erk down-modulation and Akt activation in Inv cells and an opposite profile in Core cells. Akt activation correlated with the increased tumorigenicity, stemness, and invasiveness, whereas Erk activation correlated with the proliferation of the cells. These results underscore complementary roles of the Erk and Akt pathways for GBM proliferation and dispersal and raise important implications for a concurrent inhibitory therapy.

  2. Invasive lionfish reduce native fish abundance on a regional scale

    Science.gov (United States)

    Ballew, Nicholas G.; Bacheler, Nathan M.; Kellison, G. Todd; Schueller, Amy M.

    2016-08-01

    Invasive lionfish pose an unprecedented threat to biodiversity and fisheries throughout Atlantic waters off of the southeastern United States, the Caribbean, and the Gulf of Mexico. Here, we employ a spatially replicated Before-After-Control-Impact analysis with temporal pairing to quantify for the first time the impact of the lionfish invasion on native fish abundance across a broad regional scale and over the entire duration of the lionfish invasion (1990-2014). Our results suggest that 1) lionfish-impacted areas off of the southeastern United States are most prevalent off-shore near the continental shelf-break but are also common near-shore and 2) in impacted areas, lionfish have reduced tomtate (a native forage fish) abundance by 45% since the invasion began. Tomtate served as a model native fish species in our analysis, and as such, it is likely that the lionfish invasion has had similar impacts on other species, some of which may be of economic importance. Barring the development of a control strategy that reverses the lionfish invasion, the abundance of lionfish in the Atlantic, Caribbean, and Gulf of Mexico will likely remain at or above current levels. Consequently, the effect of lionfish on native fish abundance will likely continue for the foreseeable future.

  3. A new strategy of CyberKnife treatment system based radiosurgery followed by early use of adjuvant bevacizumab treatment for brain metastasis with extensive cerebral edema.

    Science.gov (United States)

    Wang, Yang; Wang, Enmin; Pan, Li; Dai, Jiazhong; Zhang, Nan; Wang, Xin; Liu, Xiaoxia; Mei, Guanghai; Sheng, Xiaofang

    2014-09-01

    Bevacizumab blocks the effects of vascular endothelial growth factor in leakage-prone capillaries and has been suggested as a new treatment for cerebral radiation edema and necrosis. CyberKnife is a new, frameless stereotactic radiosurgery system. This work investigated the safety and efficacy of CyberKnife followed by early bevacizumab treatment for brain metastasis with extensive cerebral edema. The eligibility criteria of the patients selected for radiosurgery followed by early use of adjuvant bevacizumab treatment were: (1) brain tumors from metastasis with one solitary brain lesion and symptomatic extensive cerebral edema; (2) >18 years of age; (3) the patient refused surgery due to the physical conditions and the risk of surgery; (4) no contraindications for bevacizumab. (5) bevacizumab was applied for a minimum of 2 injections and a maximum of 6 injections with a 2-week interval between treatments, beginning within 2 weeks of the CyberKnife therapy; (6) Karnofsky performance status (KPS) ≥30. Tumor size and edema were monitored by magnetic resonance imaging (MRI). Dexamethasone dosage, KPS, adverse event occurrence and associated clinical outcomes were also recorded. Eight patients were accrued for this new treatment. Radiation dose ranged from 20 to 33 Gy in one to five sessions, prescribed to the 61-71 % isodose line. Bevacizumab therapy was administered 3-10 days after completion of CyberKnife treatment for a minimum of two cycles (5 mg/kg, at 2-week intervals). MRI revealed average reductions of 55.8 % (post-gadolinium) and 63.4 % (T2/FLAIR). Seven patients showed significant clinical neurological improvements. Dexamethasone was reduced in all patients, with five successfully discontinuing dexamethasone treatment 4 weeks after bevacizumab initiation. Hypertension, a bevacizumab-related adverse event, occurred in one patient. After 3-8 months, all patients studied were alive and primary brain metastases were under control, 2 developed new brain

  4. Risk communication and decision-making in the prevention of invasive breast cancer.

    Science.gov (United States)

    Partridge, Ann H

    2017-08-01

    Risk communication surrounding the prevention of invasive breast cancer entails not only understanding of the disease, risks and opportunities for intervention. But it also requires understanding and implementation of optimal strategies for communication with patients who are making these decisions. In this article, available evidence for the issues surrounding risk communication and decision making in the prevention of invasive breast cancer are reviewed and strategies for improvement are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Minimally invasive approaches for gastric cancer-Korean experience.

    Science.gov (United States)

    Yang, Han-Kwang; Suh, Yun-Suhk; Lee, Hyuk-Joon

    2013-03-01

    Laparoscopic surgery in Korea increased rapidly because of the early detection of gastric cancer by the development of diagnostic tools and nationwide screening. The Korean Laparoscopic Gastrointestinal Surgery Study Group (KLASS group) played a leading role in various projects related with minimally invasive surgery. The justification of minimally invasive procedures including robotic surgery, sentinel-node biopsy, or single-port surgery/Natural Orifice Transluminal Endoscopic Surgery (NOTES) must be predetermined by the clinical trial before a wide application, and the medical industry as well as surgeons should have great responsibility. Copyright © 2012 Wiley Periodicals, Inc.

  6. MSX2 Induces Trophoblast Invasion in Human Placenta.

    Directory of Open Access Journals (Sweden)

    Hao Liang

    Full Text Available Normal implantation depends on appropriate trophoblast growth and invasion. Inadequate trophoblast invasion results in pregnancy-related disorders, such as early miscarriage and pre-eclampsia, which are dangerous to both the mother and fetus. Msh Homeobox 2 (MSX2, a member of the MSX family of homeobox proteins, plays a significant role in the proliferation and differentiation of various cells and tissues, including ectodermal organs, teeth, and chondrocytes. Recently, MSX2 was found to play important roles in the invasion of cancer cells into adjacent tissues via the epithelial-mesenchymal transition (EMT. However, the role of MSX2 in trophoblastic invasion during placental development has yet to be explored. In the present study, we detected MSX2 expression in cytotrophoblast, syncytiotrophoblast, and extravillous cytotrophoblast cells of first or third trimester human placentas via immunohistochemistry analysis. Furthermore, we found that the in vitro invasive ability of HTR8/SVneo cells was enhanced by exogenous overexpression of MSX2, and that this effect was accompanied by increased protein expression of matrix metalloproteinase-2 (MMP-2, vimentin, and β-catenin. Conversely, treatment of HTR8/SVneo cells with MSX2-specific siRNAs resulted in decreased protein expression of MMP-2, vimentin, and β-catenin, and reduced invasion levels in a Matrigel invasion test. Notably, however, treatment with the MSX2 overexpression plasmid and the MSX2 siRNAs had no effect on the mRNA expression levels of β-catenin. Meanwhile, overexpression of MSX2 and treatment with the MSX2-specific siRNA resulted in decreased and increased E-cadherin expression, respectively, in JEG-3 cells. Lastly, the protein expression levels of MSX2 were significantly lower in human pre-eclamptic placental villi than in the matched control placentas. Collectively, our results suggest that MSX2 may induce human trophoblast cell invasion, and dysregulation of MSX2 expression may

  7. Redefining early gastric cancer.

    Science.gov (United States)

    Barreto, Savio G; Windsor, John A

    2016-01-01

    The problem is that current definitions of early gastric cancer allow the inclusion of regional lymph node metastases. The increasing use of endoscopic submucosal dissection to treat early gastric cancer is a concern because regional lymph nodes are not addressed. The aim of the study was thus to critically evaluate current evidence with regard to tumour-specific factors associated with lymph node metastases in "