WorldWideScience

Sample records for evolving treatment paradigm

  1. Navigating the evolving paradigms in the diagnosis and treatment of myeloproliferative disorders.

    Science.gov (United States)

    Mesa, Ruben A

    2007-01-01

    The diagnosis and management of the BCR-ABL-negative myeloproliferative disorders (MPDs) of polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) are at an explosive crossroads of scientific investigation and evolving paradigms since the discovery of the tyrosine kinase-activating JAK2V617F mutation in 2005. Additional discovery of relevant molecular lesions (JAK2 exon 12 mutations and c-MplW515L/K) have only further enriched our understanding of MPD pathogenesis. The improved diagnostic certainty these molecular markers provide have resulted in the modification, and simplification, of the World Health Organization (WHO) diagnostic algorithms for MPDs. Despite these scientific advances, however, the initial management of MPDs continues to rely upon a risk-based strategy to minimize the risk of vascular events with control of erythrocytosis, targeted antiplatelet therapy, and risk-based myelosuppressive therapy. No current medical therapy has altered the natural trend of the MPDs to lead to overt severe myelofibrosis or acute leukemia. Investigations into targeted therapies for MPDs are proceeding at a brisk pace with agents aimed at immunomodulation, decreasing marrow stromal reaction to the aberrant clone, DNA hypomethylation, or the inhibition of tyrosine kinases. Specific inhibition of JAK2 itself appears promising by in vitro investigations, and clinical trials with multiple agents are planned to commence enrollment in 2007. The potential impact of JAK2 inhibitors on the manifestations of the MPDs is unclear, but is awaited with great interest.

  2. Evolving refractory major depressive disorder diagnostic and treatment paradigms: toward closed-loop therapeutics.

    Science.gov (United States)

    Ward, Matthew P; Irazoqui, Pedro P

    2010-01-01

    Current antidepressant therapies do not effectively control or cure depressive symptoms. Pharmaceutical therapies altogether fail to address an estimated 4 million Americans who suffer from a recurrent and severe treatment-resistant form of depression known as refractory major depressive disorder. Subjective diagnostic schemes, differing manifestations of the disorder, and antidepressant treatments with limited theoretical bases each contribute to the general lack of therapeutic efficacy and differing levels of treatment resistance in the refractory population. Stimulation-based therapies, such as vagus nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation, are promising treatment alternatives for this treatment-resistant subset of patients, but are plagued with inconsistent reports of efficacy and variable side effects. Many of these problems stem from the unknown mechanisms of depressive disorder pathogenesis, which prevents the development of treatments that target the specific underlying causes of the disorder. Other problems likely arise due to the non-specific stimulation of various limbic and paralimbic structures in an open-loop configuration. This review critically assesses current literature on depressive disorder diagnostic methodologies, treatment schemes, and pathogenesis in order to emphasize the need for more stringent depressive disorder classifications, quantifiable biological markers that are suitable for objective diagnoses, and alternative closed-loop treatment options tailored to well-defined forms of the disorder. A closed-loop neurostimulation device design framework is proposed, utilizing symptom-linked biomarker abnormalities as control points for initiating and terminating a corrective electrical stimulus which is autonomously optimized for correcting the magnitude and direction of observed biomarker abnormality.

  3. Evolving conservation paradigms for the Anthropocene

    Science.gov (United States)

    Ariel E. Lugo

    2014-01-01

    The Anthropocene will have fundamental effects on the species composition, function, and structure of the ecosystems of the world. Land management agencies such as the USDA Forest Service will need to adapt their policies and conservation activities to avoid engaging in continuous conflict with natural processes and unfamiliar biotic assemblages. Conservation paradigms...

  4. The Evolving Paradigm in the Management of Intracranial Atherosclerotic Disease

    Directory of Open Access Journals (Sweden)

    Ali K. Ozturk

    2012-01-01

    Full Text Available Intracranial atherosclerotic disease (ICAD is a major cause of ischemic stroke worldwide and represents a significant health problem. The pathogenesis and natural history of ICAD are poorly understood, and rigorous treatment paradigms do not exist as they do for extracranial atherosclerosis. Currently, the best treatment for ICAD remains aspirin therapy, but many patients who are placed on aspirin continue to experience recurrent strokes. As microsurgical and endovascular techniques continue to evolve, the role of extracranial to intracranial bypass operations and stenting are increasingly being reconsidered. We performed a PubMed review of the English literature with a particular focus on treatment options for ICAD and present evidence-based data for the role of surgery and stenting in ICAD against medical therapy alone.

  5. Use of second- and third-generation tyrosine kinase inhibitors in the treatment of chronic myeloid leukemia: an evolving treatment paradigm.

    Science.gov (United States)

    Jabbour, Elias; Kantarjian, Hagop; Cortes, Jorge

    2015-06-01

    Although imatinib remains the gold standard for first-line treatment of chronic myeloid leukemia (CML), increasing recognition of imatinib resistance and intolerance has led to the development of additional tyrosine kinase inhibitors (TKIs), which have demonstrated effectiveness as salvage therapies or alternative first-line treatments. Although additional options represent progress, the availability of 3 second-generation TKIs (dasatinib, nilotinib, and bosutinib) and 1 third-generation TKI (ponatinib) has added complexity to the treatment paradigm for CML, particularly CML in the chronic phase. Two second-generation agents (dasatinib and nilotinib) are approved for use as first-line and subsequent therapy. Thus, the appropriate sequencing of TKIs is a frequent quandary, and is incompletely addressed in clinical guidelines. Here, we review studies that might guide selection of a second- or third-generation TKI after failure of TKI therapy in patients with chronic-phase CML. These studies evaluate prognostic factors such as first-line cytogenetic response and BCR-ABL1 mutation status, which might help physicians identify patients who are likely to respond to second-generation TKIs, and those for whom ponatinib or an investigational agent might be more appropriate. We summarize evidence to date that suggests that use of a second-generation TKI as third-line therapy confers limited value in most CML patients, and we also explore the utility of current event-free survival versus traditional outcomes to predict long-term benefits of sequential TKI use. Finally, we present 3 case studies to illustrate how prognostic factors and other considerations (eg, tolerability) can be used to individualize subsequent therapy in cases of TKI resistance or intolerance. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Evolvable mathematical models: A new artificial Intelligence paradigm

    Science.gov (United States)

    Grouchy, Paul

    We develop a novel Artificial Intelligence paradigm to generate autonomously artificial agents as mathematical models of behaviour. Agent/environment inputs are mapped to agent outputs via equation trees which are evolved in a manner similar to Symbolic Regression in Genetic Programming. Equations are comprised of only the four basic mathematical operators, addition, subtraction, multiplication and division, as well as input and output variables and constants. From these operations, equations can be constructed that approximate any analytic function. These Evolvable Mathematical Models (EMMs) are tested and compared to their Artificial Neural Network (ANN) counterparts on two benchmarking tasks: the double-pole balancing without velocity information benchmark and the challenging discrete Double-T Maze experiments with homing. The results from these experiments show that EMMs are capable of solving tasks typically solved by ANNs, and that they have the ability to produce agents that demonstrate learning behaviours. To further explore the capabilities of EMMs, as well as to investigate the evolutionary origins of communication, we develop NoiseWorld, an Artificial Life simulation in which interagent communication emerges and evolves from initially noncommunicating EMM-based agents. Agents develop the capability to transmit their x and y position information over a one-dimensional channel via a complex, dialogue-based communication scheme. These evolved communication schemes are analyzed and their evolutionary trajectories examined, yielding significant insight into the emergence and subsequent evolution of cooperative communication. Evolved agents from NoiseWorld are successfully transferred onto physical robots, demonstrating the transferability of EMM-based AIs from simulation into physical reality.

  7. Results of volume-staged fractionated Gamma Knife radiosurgery for large complex arteriovenous malformations: obliteration rates and clinical outcomes of an evolving treatment paradigm.

    Science.gov (United States)

    Franzin, Alberto; Panni, Pietro; Spatola, Giorgio; Vecchio, Antonella Del; Gallotti, Alberto L; Gigliotti, Carmen R; Cavalli, Andrea; Donofrio, Carmine A; Mortini, Pietro

    2016-12-01

    OBJECTIVE There are few reported series regarding volume-staged Gamma Knife radiosurgery (GKRS) for the treatment of large, complex, cerebral arteriovenous malformations (AVMs). The object of this study was to report the results of using volume-staged Gamma Knife radiosurgery for patients affected by large and complex AVMs. METHODS Data from 20 patients with large AVMs were prospectively included in the authors' AVM database between 2004 and 2012. A staging strategy was used when treating lesion volumes larger than 10 cm(3). Hemorrhage and seizures were the presenting clinical feature for 6 (30%) and 8 (40%) patients, respectively. The median AVM volume was 15.9 cm(3) (range 10.1-34.3 cm(3)). The mean interval between stages (± standard deviation) was 15 months (± 9 months). The median margin dose for each stage was 20 Gy (range 18-25 Gy). RESULTS Obliteration was confirmed in 8 (42%) patients after a mean follow-up of 45 months (range 19-87 months). A significant reduction (> 75%) of the original nidal volume was achieved in 4 (20%) patients. Engel Class I-II seizure status was reported by 75% of patients presenting with seizures (50% Engel Class I and 25% Engel Class II) after radiosurgery. After radiosurgery, 71.5% (5/7) of patients who had presented with a worsening neurological deficit reported a complete resolution or amelioration. None of the patients who presented acutely because of hemorrhage experienced a new bleeding episode during follow-up. One (5%) patient developed radionecrosis that caused sensorimotor hemisyndrome. Two (10%) patients sustained a bleeding episode after GKRS, although only 1 (5%) was symptomatic. High nidal flow rate and a time interval between stages of less than 11.7 months were factors significantly associated with AVM obliteration (p = 0.021 and p = 0.041, respectively). Patient age younger than 44 years was significantly associated with a greater than 75% reduction in AVM volume but not with AVM obliteration (p = 0

  8. Evolving Paradigms in the Networked World and their implications ...

    African Journals Online (AJOL)

    information society, e-government, digital divide, and e-learning/digital scholarship. This paper provides an overview of the paradigm shifts sweeping the information landscape in the networked world and the implications for the creation and management of information, especially in African libraries. African Journal of ...

  9. Evolving paradigms in the pathogenesis of HIV-1-associated dementia.

    Science.gov (United States)

    Fischer-Smith, Tracy; Rappaport, Jay

    2005-12-02

    HIV-1-associated dementia (HIV-D) remains a significant consequence of HIV-1 infection and AIDS. Since the clinical introduction of highly active antiretroviral therapy (HAART), the incidence of HIV-D has decreased, yet the prevalence has increased as patients are living longer under treatment. Additionally, a less severe form of HIV-D, minor cognitive motor disorder, has become an increasing issue. Two different models have been proposed for virus entry in the central nervous system (CNS) in HIV-D. In the 'Trojan horse' model, the virus enters the CNS early carried by macrophages and infects resident glia; later in the course of infection, virus replication is activated and additional monocyte/macrophages are recruited into the CNS via cytokine/chemokine networks and endothelial-cell-leukocyte interactions at the blood-brain barrier. In the 'late invasion' model, an inherently invasive activated monocyte subset is expanded from bone marrow as a result of immune dysregulation in the periphery in the setting of AIDS. In this review we discuss these two separate, although not mutually exclusive, means for virus entry and persistence in the CNS. Additionally, we explore mechanisms for neuronal injury and apoptosis, including the role of virus, viral and host proteins, oxidative stress and products of infected or uninfected activated microglia and astrocytes. Potential therapeutic strategies are also briefly discussed.

  10. Contemporary Treatment Paradigms in Keratoconus.

    Science.gov (United States)

    McGhee, Charles N J; Kim, Bia Z; Wilson, Peter J

    2015-10-01

    The past 20 years have witnessed an explosion in our knowledge of keratoconus, accompanied by a radical transformation of management options. A 2-hit hypothesis proposes an underlying genetic predisposition coupled with external environmental factors, including eye rubbing and atopy. The variable prevalence and natural history have been better defined including significant cone progression in middle age. Therefore, current management must include early diagnosis, regular monitoring, and treatment of environmental cofactors. Spectacles and contact lenses remain fundamental to the optical management of keratoconus. Intrastromal corneal ring segments have been increasingly used, providing improvement in the corneal shape, corrected visual acuity, and contact lens wear. However, like contact lenses, intrastromal corneal ring segments do not treat the underlying disease process. Therefore, current approaches must also consider treatments to minimize keratoconus progression. Fortunately, there is increasing evidence that corneal collagen crosslinking will halt or slow progression in most cases. Until relatively recently, penetrating keratoplasty was the preferred intervention for advanced keratoconus, with long-term success in the region of 90%; however, the greatest risk of failure remains endothelial allograft rejection. Deep anterior lamellar keratoplasty has emerged in the new millennium as a preferred approach to conserve the host endothelium and avoid rejection. Nonetheless, the overall superiority of deep anterior lamellar keratoplasty compared with penetrating keratoplasty, in terms of optical and survival benefits, is still debated. This perspective provides an overview of our current knowledge of keratoconus and current management options. A step-ladder approach to managing keratoconus is outlined to provide the practitioner with a contemporary management paradigm.

  11. The evolving role of the health care supervisor: shifting paradigms, changing perceptions, and other traps.

    Science.gov (United States)

    McConnell, C R

    1996-09-01

    As health care comes under mounting pressure to reduce costs, organizations are restructuring. Delivery systems are changing. As layoffs occur and changes are made in numbers and responsibilities of managers, supervisors find themselves in dramatically changing roles. Job security has become as illusory in health care as elsewhere. Morale among health workers is sagging, and motivational concerns are increasing. The supervisor has been put in the position of having to do more with less and to do it in the face of demoralized forces. The paradigms that were once operational are shifting, and the evolving role of the health care supervisor suggests that a completely new set of paradigms is taking over that suggests the supervisor's future security lies in the ability to learn new things and to shift and change with the environment.

  12. 78 FR 69694 - Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity...

    Science.gov (United States)

    2013-11-20

    ... morbid obesity and other metabolic diseases as well as evolving approaches for the regulation and... Devices in the Treatment of Obesity and Metabolic Diseases: How To Estimate and Reward True Patient... ``Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity and...

  13. Evolving paradigm of illnesses presented to medical Intensive Care Unit in body builders: Cases from tertiary care center.

    Science.gov (United States)

    Garg, Sunil Kumar

    2015-04-01

    Bodybuilding is the use of progressive resistance exercise to control and develop one's musculature. With the rise in number of persons adopting this activity, there is evolving paradigm of illnesses presented to intensive care in this population subset. Strict adherence to details of bodybuilding and avoidance of unsupervised medications are essential to prevent untoward effects.

  14. An evolving new paradigm: endothelial cells--conditional innate immune cells.

    Science.gov (United States)

    Mai, Jietang; Virtue, Anthony; Shen, Jerry; Wang, Hong; Yang, Xiao-Feng

    2013-08-22

    Endothelial cells (ECs) are a heterogeneous population that fulfills many physiological processes. ECs also actively participate in both innate and adaptive immune responses. ECs are one of the first cell types to detect foreign pathogens and endogenous metabolite-related danger signals in the bloodstream, in which ECs function as danger signal sensors. Treatment with lipopolysaccharide activates ECs, causing the production of pro-inflammatory cytokines and chemokines, which amplify the immune response by recruiting immune cells. Thus, ECs function as immune/inflammation effectors and immune cell mobilizers. ECs also induce cytokine production by immune cells, in which ECs function as immune regulators either by activating or suppressing immune cell function. In addition, under certain conditions, ECs can serve as antigen presenting cells (antigen presenters) by expressing both MHC I and II molecules and presenting endothelial antigens to T cells. These facts along with the new concept of endothelial plasticity suggest that ECs are dynamic cells that respond to extracellular environmental changes and play a meaningful role in immune system function. Based on these novel EC functions, we propose a new paradigm that ECs are conditional innate immune cells. This paradigm provides a novel insight into the functions of ECs in inflammatory/immune pathologies.

  15. An evolving new paradigm: endothelial cells – conditional innate immune cells

    Science.gov (United States)

    2013-01-01

    Endothelial cells (ECs) are a heterogeneous population that fulfills many physiological processes. ECs also actively participate in both innate and adaptive immune responses. ECs are one of the first cell types to detect foreign pathogens and endogenous metabolite-related danger signals in the bloodstream, in which ECs function as danger signal sensors. Treatment with lipopolysaccharide activates ECs, causing the production of pro-inflammatory cytokines and chemokines, which amplify the immune response by recruiting immune cells. Thus, ECs function as immune/inflammation effectors and immune cell mobilizers. ECs also induce cytokine production by immune cells, in which ECs function as immune regulators either by activating or suppressing immune cell function. In addition, under certain conditions, ECs can serve as antigen presenting cells (antigen presenters) by expressing both MHC I and II molecules and presenting endothelial antigens to T cells. These facts along with the new concept of endothelial plasticity suggest that ECs are dynamic cells that respond to extracellular environmental changes and play a meaningful role in immune system function. Based on these novel EC functions, we propose a new paradigm that ECs are conditional innate immune cells. This paradigm provides a novel insight into the functions of ECs in inflammatory/immune pathologies. PMID:23965413

  16. Tracking the rise of the "expert patient" in evolving paradigms of HIV care.

    Science.gov (United States)

    Kielmann, Karina; Cataldo, Fabian

    2010-01-01

    In the context of rolling out antiretroviral treatment programmes in resource-constrained settings, "expert patients" are hailed as an important step towards greater involvement of people living with HIV (PLHIV) in HIV care, and in addressing the human resources crisis. The rise of the "expert patient" in HIV care partly echoes the move towards greater patient agency and self-management that informs health services delivery in industrialised countries. However, the "expert patient" also represents a particular moment in the trajectory of PLHIVs' quest for greater access to treatment and health care. In this paper, we examine the unique evolution and 'instrumentalisation' of PLHIV in public health in relation to shifts in the epidemiology, interventions and socio-political response related to HIV since the 1980s. Synthesised broadly as "risk-based", "empowerment", "structural" and "activist" approaches, four key paradigms are identified that attribute different levels of citizenship for PLHIV, that is the motivation, agency and responsibility to act not only on their own interests, but also on behalf of collective interests in HIV prevention and care. We problematise the concept of the patient-citizen by drawing attention to the context-specificity of such notions as patient identity, capacity and rights as well as the structural realities of access to treatment, and broader engagement with the health system. We conclude by offering some thoughts on the applicability of 'expert patient' approaches across a broad range of settings.

  17. EVOLVE

    CERN Document Server

    Deutz, André; Schütze, Oliver; Legrand, Pierrick; Tantar, Emilia; Tantar, Alexandru-Adrian

    2017-01-01

    This book comprises nine selected works on numerical and computational methods for solving multiobjective optimization, game theory, and machine learning problems. It provides extended versions of selected papers from various fields of science such as computer science, mathematics and engineering that were presented at EVOLVE 2013 held in July 2013 at Leiden University in the Netherlands. The internationally peer-reviewed papers include original work on important topics in both theory and applications, such as the role of diversity in optimization, statistical approaches to combinatorial optimization, computational game theory, and cell mapping techniques for numerical landscape exploration. Applications focus on aspects including robustness, handling multiple objectives, and complex search spaces in engineering design and computational biology.

  18. The evolving paradigm of revascularization for wound healing: which intervention for which wound?

    Science.gov (United States)

    Kirksey, Lee; Troiano, Michael

    2011-03-01

    Chronic limb ischemia (CLI) presents a therapeutic challenge. A collaborative multidisciplinary model utilizes the collective skills of the vascular surgeon, podiatrist, and plastic surgeon to achieve optimal outcomes. As treatment paradigms continue to evolve toward minimally invasive approaches, a thoughtful comparison of the available options is essential for wound care specialists. Minimally invasive, catheter-based options offer less morbidity with reduced patency compared to traditional, open bypass. Individualized selection of the most appropriate revascularization option should be made after careful consideration of the wound severity, anatomic location of occlusive disease and patient comorbidities.

  19. Paradigm shifts in orthodontic treatment with mini-implant anchorage

    Directory of Open Access Journals (Sweden)

    Johnny Joung-Lin Liaw

    2015-01-01

    Full Text Available After the applications of mini-implant anchorage, the envelope of orthodontic treatment was expanded and some treatment modes were changed because of more predictable tooth movement with empowered anchorage. The author tried to share his experience of TADs applications for clarifying the paradigm shifts of orthodontic treatment assisted with the mini-implant anchorage.

  20. Restorative proctocolectomy: an example of how surgery evolves in response to paradigm shifts in care.

    Science.gov (United States)

    Remzi, F H; Lavryk, O A; Ashburn, J H; Hull, T L; Lavery, I C; Dietz, D W; Kessler, H; Church, J M

    2017-11-01

    Surgical technique constantly evolves in response to the pressure of progress. Ileal pouch anal anastomosis (IPAA) is a good example. We analysed the effect of changes in practice on the technique of IPAA and its outcomes. Patients undergoing primary IPAA at this institution were divided into three groups by date of the IPAA: those operated from 1983 to 1993, from 1994 to 2004 and from 2005 to 2015. Demographics, patient comorbidity, surgical techniques, postoperative outcomes, pouch function and quality of life were analysed. In all, 4525 patients had a primary IPAA. With each decade, increasing numbers of surgeons were involved (decade I, 8; II, 16; III, 31), patients tended to be sicker (higher American Society of Anesthesiologists score) and three-staged pouches became more common. After an initial popularity of the S pouch, J pouches became dominant and a mucosectomy rate of 12% was standard. The laparoscopic technique blossomed in the last decade. 90-day postoperative morbidity by decade was 38.3% vs 50% vs 48% (P < 0.0001), but late morbidity decreased from 74.2% through 67.1% to 30% (P < 0.0001). Functional results improved, but quality of life scores did not. Pouch survival rate at 10 years was maintained (94% vs 95.2% vs 95.2%; P = 0.06). IPAA is still evolving. Despite new generations of surgeons, a more accurate diagnosis, appropriate staging and the laparoscopic technique have made IPAA a safer, more effective and enduring operation. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  1. Breast cancer treatment: evolving approaches but stable results.

    Science.gov (United States)

    Chism, S E; Brown, B S; Hoyle, B A

    1986-12-01

    This report describes the outcome of 530 women with breast cancer diagnosed from 1968 through 1983 and represents a demographic population rather than a referred selected one. The data represents the results of evolving breast cancer treatment approaches during the past 2 decades and is particularly useful as a measure of the total population denominator, free of selection factors that confound reports detailing a surgical, radiation, or chemotherapy experience. During the time interval reviewed, the standard treatment approach of the primary changed from radical mastectomy to biopsy and radiation therapy. Chemotherapy policy evolved from single agent treatment for relapse to multiple drug programs as adjuvant or for relapse. The major findings were: The 5-, 10-, and 15-year survival rates for the intervals 1972-75, 1976-79, and 1980-83 were slightly better than the earliest interval 1968-71, but with no statistically significant improvement. The frequency of favorable disease (Stages Tis, 1) increased from 16 to 31 percent during the interval but the mean age remained the same suggesting that patient education programs, availability of health insurance, or mammography may have lead to identifying patients with more favorable disease. Mastectomy has been replaced by breast conserving surgery and radiation as the most common treatment of the primary. Patients treated by surgery and biopsy/radiation had identical survival outcomes. It was not possible to detect improved survival that could be ascribed to the adoption of multiple agent chemotherapy but the magnitude of the effect is calculated to be on the order of 2% of the total patient population diagnosed. Death due to breast cancer decreases with time after diagnosis but is still 4% per year, 10 years after treatment. The findings suggest that progress has been made in detection, breast conservation, and palliation of symptoms in many subpopulations, but the end results for the total breast cancer population have

  2. Patient Satisfaction in Prosthodontic Treatment: Multidimensional Paradigm

    OpenAIRE

    Sangappa, Sunila Bukanakere

    2011-01-01

    A number of different factors contribute to an efficient clinical outcome in prosthetic dentistry. Differences between patient’s and prosthodontist’s perception of treatment display great variability. Patient satisfaction in prosthetic dentistry is a multidimensional concept as is patient’s perception of dental care. Patient satisfaction can be assessed if it is carefully defined. In the prosthodontic treatment context patient satisfaction can be expected to interact with the patient’s entire...

  3. Nanotechnology, a new paradigm in atherosclerosis treatment.

    Science.gov (United States)

    Martín Giménez, Virna M; Ruiz-Roso, María Belén; Camargo, Alejandra Beatriz; Kassuha, Diego; Manucha, Walter

    Atherosclerosis, a known and prevalent disease, causes progressive deterioration of affected vessels, inducing a blood flow reduction with different complications, and its symptoms usually manifest in advanced stages of the disease. Therefore, the classic therapeutic alternatives are insufficient because the damages are many times irreversible. For this reason, there is a need to implement intelligent forms of drug administration and develop new therapeutic targets that reduce the progression of atherosclerotic lesion. The implementation of new tools for prevention, diagnosis and treatment of this cardiovascular disease is of special interest, focusing our attention on achieving a more effective control of the immune system. Finally, this review highlights the latest knowledge about nanotechnology as a powerful, modern, and promising therapeutic alternative applied to atherosclerotic disease, as well as warning of the potential complications with their use. Copyright © 2016 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Exploring open innovation with a patient focus in drug discovery: an evolving paradigm of patient engagement.

    Science.gov (United States)

    Allarakhia, Minna

    2015-06-01

    It is suggested in this article that patient engagement should occur further upstream during the drug discovery stage. 'Lead patients', namely those patients who are proactive with respect to their health, possess knowledge of their disease and resulting symptoms. They are also well informed about the conventional as well as non-conventional treatments for disease management; and so can provide a nuanced perspective to drug design. Understanding how patients view the management of their diseases and how they view the use of conventional versus non-conventional interventions is of imperative importance to researchers. Indeed, this can provide insight into how conventional treatments might be designed from the outset to encourage compliance and positive health outcomes. Consequently, a continuum of lead patient engagement is employed that focuses on drug discovery processes ranging from participative, informative to collaborative engagement. This article looks at a variety of open innovation models that are currently employed across this engagement spectrum. It is no longer sufficient for industry stakeholders to consider conventional therapies as the only mechanisms being sought after by patients. Without patient engagement, the industry risks being re-prioritized in terms of its role in the patient journey towards not only recovery of health, but also sustained health and wellness before disease onset.

  5. Evolving serodiagnostics by rationally designed peptide arrays: the Burkholderia paradigm in Cystic Fibrosis

    Science.gov (United States)

    Peri, Claudio; Gori, Alessandro; Gagni, Paola; Sola, Laura; Girelli, Daniela; Sottotetti, Samantha; Cariani, Lisa; Chiari, Marcella; Cretich, Marina; Colombo, Giorgio

    2016-09-01

    Efficient diagnosis of emerging and novel bacterial infections is fundamental to guide decisions on therapeutic treatments. Here, we engineered a novel rational strategy to design peptide microarray platforms, which combines structural and genomic analyses to predict the binding interfaces between diverse protein antigens and antibodies against Burkholderia cepacia complex infections present in the sera of Cystic Fibrosis (CF) patients. The predicted binding interfaces on the antigens are synthesized in the form of isolated peptides and chemically optimized for controlled orientation on the surface. Our platform displays multiple Burkholderia-related epitopes and is shown to diagnose infected individuals even in presence of superinfections caused by other prevalent CF pathogens, with limited cost and time requirements. Moreover, our data point out that the specific patterns determined by combined probe responses might provide a characterization of Burkholderia infections even at the subtype level (genomovars). The method is general and immediately applicable to other bacteria.

  6. Current paradigms and Evolving concepts in metastatic castration-resistant prostate cancer

    Science.gov (United States)

    Pal, Sumanta Kumar; Sartor, Oliver

    2011-01-01

    Until recently, docetaxel-based therapy represented the only therapy shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC). The past year and a half has been marked by unprecedented progress in treatments for this disease. Three positive phase III clinical trials have emerged, each evaluating agents (sipuleucel-T, cabazitaxel and abiraterone) with distinct mechanisms of action. Herein, the three pivotal trials are described alongside both past and current large phase III studies conducted in this mCRPC. The overall survival for patients with mCRPC treated in current clinical trials is considerably longer than noted in the past. We note that more recent trials with older agents have also shown improved survival and discuss potential non-therapeutic biases that influence this critical measure of outcome. The necessity for utilizing randomized trials when evaluating new therapeutics is emphasized given the changing prognosis in this mCRPC. PMID:21602834

  7. The differential diagnosis of low back pain: a primer on the evolving paradigm.

    Science.gov (United States)

    Amirdelfan, Kasra; McRoberts, Porter; Deer, Timothy R

    2014-10-01

    The issue of low back pain (LBP) is as common as it is perplexing. LBP is thought to be a chronic issue in approximately 10% of the U.S. population. This condition has wide-reaching social and economical reverberations. Despite the availability of modern diagnostic tools, the cause of the pain generator is often unidentifiable. The authors were asked to create an overview of the etiology of LBP for physicians who implant neurostimulation devices for the treatment of chronic pain patients. Some prevalence data, based on the current available literature, have been provided for the more common structural conditions causing LBP. However, a comprehensive review of prevalence of various conditions and their respective manifestations as LBP is beyond the scope of this article. A review was performed of frequently cited articles with search terms for "low back pain" using PubMed, Medline, and Google Scholar. The authors also reviewed other literature from commonly utilized sources in the field of interventional pain medicine such as the journals of Neuromodulation, Pain Medicine, Spine, and Neurosurgery in the publication date range of 1975 to the present. Moreover, recent edition textbooks of other specialties such as obstetrics and gynecology, neurology, internal medicine, and surgery were referenced to develop a comprehensive list of the differential diagnoses. In order to capture the broad scope of information presented in this article, the criteria used to choose the references included published peer-reviewed articles that provided information on LBP as a symptom of a case report to common presentations of various conditions as described in a number of current, and commonly used, textbooks in their specialty. The article serves as a reference for commonly cited causes of LBP as well as less common conditions presenting with LBP as a possible symptom, which may occur as a solitary pain generator or in combination with other etiologies. The information is structured

  8. Management of the Regional Lymph Nodes Following Breast-Conservation Therapy for Early-Stage Breast Cancer: An Evolving Paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Laura E.G. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Punglia, Rinaa S.; Wong, Julia S. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Bellon, Jennifer R., E-mail: jbellon@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2014-11-15

    Radiation therapy to the breast following breast conservation surgery has been the standard of care since randomized trials demonstrated equivalent survival compared to mastectomy and improved local control and survival compared to breast conservation surgery alone. Recent controversies regarding adjuvant radiation therapy have included the potential role of additional radiation to the regional lymph nodes. This review summarizes the evolution of regional nodal management focusing on 2 topics: first, the changing paradigm with regard to surgical evaluation of the axilla; second, the role for regional lymph node irradiation and optimal design of treatment fields. Contemporary data reaffirm prior studies showing that complete axillary dissection may not provide additional benefit relative to sentinel lymph node biopsy in select patient populations. Preliminary data also suggest that directed nodal radiation therapy to the supraclavicular and internal mammary lymph nodes may prove beneficial; publication of several studies are awaited to confirm these results and to help define subgroups with the greatest likelihood of benefit.

  9. Wegener granulomatosis (granulomatosis with polyangiitis): evolving concepts in treatment.

    Science.gov (United States)

    Lynch, Joseph P; Tazelaar, Henry

    2011-06-01

    Wegener granulomatosis (WG), the most common of the pulmonary granulomatous vasculitides, typically involves the upper respiratory tract, lower respiratory tract (bronchi and lung), and kidney, with varying degrees of disseminated vasculitis. THE TERM GRANULOMATOSIS WITH POLYANGIITIS (WEGENER) WAS RECENTLY PROPOSED TO REPLACE THE OLDER TERM, WG. THE TERM GRANULOMATOSIS WITH POLYANGIITIS CAN BE ABBREVIATED TO GPA, WITH THE IDEA THAT THE EPONYM WEGENER WOULD BE OMITTED OVER TIME. Cardinal histologic features include a necrotizing vasculitis involving small vessels, extensive "geographic" necrosis, and granulomatous inflammation. Clinical manifestations of WG are protean; virtually any organ can be involved. The spectrum and severity of the disease are heterogeneous, ranging from indolent disease involving only one site to fulminant, multiorgan vasculitis. The pathogenesis of WG has not been elucidated, but both cellular and humoral components are involved. Circulating antibodies against cytoplasmic components of neutrophils [anti-neutrophil cytoplasmic antibodies (c-ANCAs)] likely play a role in the pathogenesis, and often correlate with activity of the disease. Treatment strategies are evolving. Cyclophosphamide (CYC) plus corticosteroids (CSs) is the mainstay of therapy for generalized, multisystemic WG. Historically, the combination of CYC plus CS was used for a minimum of 12 months, but concern about late toxicities associated with CYC has led to novel treatment approaches. Currently, short-course (3 to 6 months) induction treatment with CYC plus CS, followed by maintenance therapy with less toxic agents (e.g., methotrexate, azathioprine) is recommended. Further, methotrexate combined with CS may be adequate for limited, non-life-threatening WG. Recent studies suggest that rituximab may be useful for induction therapy or CYC-refractory WG. The role of other immunomodulatory agents (including trimethoprim-sulfamethoxazole) is also explored. © Thieme Medical

  10. Evolving treatment strategies for management of cardiorenal syndrome.

    Science.gov (United States)

    Dandamudi, Sanjay; Chen, Horng H

    2011-12-01

    aspects about our evolving understanding of the cardiorenal system are the innovative treatments that have emerged as a result. The creation of chimeric natriuretic peptides, targeted intra-renal pharmacotherapy, the novel use of phosphodiesterase inhibitors, and combination treatment strategies demonstrate that despite our varied success in treating cardiorenal syndrome in the past, there are highly encouraging translational therapies rapidly developing in the pipeline.

  11. Paradigms of mangroves in treatment of anthropogenic wastewater pollution.

    Science.gov (United States)

    Ouyang, Xiaoguang; Guo, Fen

    2016-02-15

    Mangroves have been increasingly recognized for treating wastewater from aquaculture, sewage and other sources with the overwhelming urbanization trend. This study clarified the three paradigms of mangroves in disposing wastewater contaminants: natural mangroves, constructed wetlands (including free water surface and subsurface flow) and mangrove-aquaculture coupling systems. Plant uptake is the common major mechanism for nutrient removal in all the paradigms as mangroves are generally nitrogen and phosphorus limited. Besides, sediments accrete and provide substrates for microbial activities, thereby removing organic matter and nutrients from wastewater in natural mangroves and constructed wetlands. Among the paradigms, the mangrove-aquaculture coupling system was determined to be the optimal alternative for aquaculture wastewater treatment by multi-criterion decision making. Sensitivity analysis shows variability of alternative ranking but underpins the coupling system as the most environment-friendly and cost-efficient option. Mangrove restoration is expected to be achievable if aquaculture ponds are planted with mangrove seedlings, creating the coupling system. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Evolving Techniques for Surgical Treatment of Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Andrea Tubaro

    2015-05-01

    Full Text Available The management of lower urinary tract symptoms due to benign prostatic hyperplasia (BPH is one of the most topical areas in urology. Although most patients are adequately managed conservatively, many still require surgery to reduce bladder outlet obstruction or relieve symptoms by removing the inflamed adenomatous tissue. Transurethral resection of the prostate (TURP remains the gold standard treatment in all national and international guidelines, with open prostatectomy and laser enucleation reserved for patients with a prostate >80 ml. The current trend in the surgical management of BPH is threefold: replacing open prostatectomy with transurethral enucleation of the adenoma, managing high-risk patients by photoselective vaporisation of the prostate thus minimising blood loss, and moving BPH surgery to ambulatory day surgery and one-day surgery units in selected patients. Laser enucleation has been pioneered using the Holmium laser, although the GreenLightTM laser has been recently proposed as an alternative approach. The absence of any bleeding in photovaporisation of the prostate allows surgery to be performed in a growing population of patients on anti-aggregant and anticoagulant medications. Randomised trials of the GreenLight XPSTM laser with the MoXy™ fibre versus TURP proved the effectiveness of photovaporisation in the surgical management of BPH and suggested that 50% of patients could be discharged within 24 hours. The demand for BPH surgery remains high and urologists have rapidly adapted to the increasing demand for minimally invasive surgery. Prostate surgery evolved from a heroic procedure that remained in the memories of the entire patient family for life into a day-case procedure, and the future hopefully holds ejaculation-sparing surgery.

  13. Research Review: Gender identity in youth: treatment paradigms and controversies.

    Science.gov (United States)

    Turban, Jack L; Ehrensaft, Diane

    2017-10-26

    Pediatric gender identity has gained increased attention over the past several years in the popular media, political arena, and medical literature. This article reviews terminology in this evolving field, traditional models of gender identity development and their limitations, epidemiology and natural history of cross-gender identification among children and adolescents, co-occurring conditions and behaviors, research into the biological and psychosocial determinants of cross-gender identification, and research into the options regarding and benefits of clinical approaches to gender incongruent youth. Based on a critical review of the extant literature, both theoretical and empirical, that addresses the issue of pediatric gender identity, the authors synthesized what is presently known and what is in need of further research in order to elucidate the developmental trajectory and clinical needs of gender diverse youth. The field of pediatric gender identity has evolved substantially over the past several years. New research suggests that cross-gender identification is prevalent (approximately 1% of youth). These youth suffer disproportionately high rates of anxiety, depression, and suicidality. Although research into the etiology of cross-gender identification is limited, emerging data have shown that affirmative treatment protocols may improve the high rates of mental health difficulties seen among these patients. The field of pediatric gender identity has evolved dramatically. Emerging data suggest that these patients' high rates of anxiety, depression, and suicidality appear to be improved with affirmative protocols, although future longitudinal data are needed. © 2017 Association for Child and Adolescent Mental Health.

  14. New guidelines for topical NSAIDs in the osteoarthritis treatment paradigm.

    Science.gov (United States)

    Altman, Roy D

    2010-12-01

    Osteoarthritis (OA), the most common form of arthritis, often affects hands, hips, and knees and involves an estimated 26.9 million US adults. Women have a higher prevalence of OA, and the risk of developing OA increases with age, obesity, and joint malalignment. OA typically presents with pain and reduced function. Therapeutic programs are often multimodal and must take into account pharmaceutical toxicities and patient comorbidities. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with cardiovascular, gastrointestinal, and renal adverse events. Topical NSAIDs offer efficacy with reduced systemic drug exposure. This is a review of current guideline recommendations regarding the use of topical NSAIDs in OA of the hand and knee. Articles were identified by PubMed search (January 1, 2000 to May 21, 2010). Several current guidelines for management of OA recommend topical NSAIDs, indicating them as a safe and effective treatment. One guideline recommends that topical NSAIDs be considered as first-line pharmacologic therapy. A US guideline for knee OA recommends topical NSAIDs in older patients and in patients with increased gastrointestinal risk. The consensus across US and European OA guidelines is that topical NSAIDs are a safe and effective treatment for OA. Because the research base on topical NSAIDs for OA is small, guidelines will continue to evolve.

  15. Evolving concepts in the treatment of relapsing multiple sclerosis

    DEFF Research Database (Denmark)

    Comi, Giancarlo; Radaelli, Marta; Soelberg Sørensen, Per

    2017-01-01

    In the past 20 years the treatment scenario of multiple sclerosis has radically changed. The increasing availability of effective disease-modifying therapies has shifted the aim of therapeutic interventions from a reduction in relapses and disability accrual, to the absence of any sign of clinical...

  16. Evolving role of immunotherapy in the treatment of refractory warts

    Directory of Open Access Journals (Sweden)

    Devinder M Thappa

    2016-01-01

    Full Text Available Cutaneous and genital warts are common dermatological conditions caused by the human papilloma virus (HPV. Although it is a benign condition, it causes disfigurement, has a tendency to koebnerize, and can be transmitted to others. This makes adequate and timely treatment important. There are several conventional treatments available with variable response. Topical and systemic immunotherapy has now found a significant place in the treatment of warts because of its nondestructive action, ease of use, and promising results. Through this review, we would like to present a brief overview of the various immunotherapeutic agents used. These include more established agents such as imiquimod, Mycobacterium w vaccine, bacillus Calmette-Guérin vaccine, measles, mumps, and rubella vaccine, Candida antigen, trichophyton antigen, tuberculin, zinc, cimetidine, levamisole, HPV vaccine, and autoimplantation therapy. Other agents such as contact immunotherapy which is sparsely used now than before and newer agents such as Corynebacterium parvum, sinecatechins, echinacea, propolis, glycyrrizinic acid, and Vitamin D have also been discussed. The mechanism of action of these agents, along with their dosage, mode of administration, duration of use, expected outcomes and comparative efficacy, evidence for their use, and expected side effects, if any, are reviewed.

  17. Cardiac Involvement in Sarcoidosis: Evolving Concepts in Diagnosis and Treatment

    Science.gov (United States)

    Lynch, Joseph P.; Hwang, Jennifer; Bradfield, Jason; Fishbein, Michael; Shivkumar, Kalyanam; Tung, Roderick

    2014-01-01

    Clinically evident sarcoidosis involving the heart has been noted in at least 2 to 7% of patients with sarcoidosis, but occult involvement is much higher (> 20%). Cardiac sarcoidosis is often not recognized antemortem, as sudden death may be the presenting feature. Cardiac involvement may occur at any point during the course of sarcoidosis and may occur in the absence of pulmonary or systemic involvement. Sarcoidosis can involve any part of the heart, with protean manifestations. Prognosis of cardiac sarcoidosis is related to extent and site(s) of involvement. Most deaths due to cardiac sarcoidosis are due to arrhythmias or conduction defects, but granulomatous infiltration of the myocardium may be lethal. The definitive diagnosis of isolated cardiac sarcoidosis is difficult. The yield of endomyocardial biopsies is low; treatment of cardiac sarcoidosis is often warranted even in the absence of histologic proof. Radionuclide scans are integral to the diagnosis. Currently, 18F-fluorodeoxyglucose positron emission tomography/computed tomography and gadolinium-enhanced magnetic resonance imaging scans are the key imaging modalities to diagnose cardiac sarcoidosis. The prognosis of cardiac sarcoidosis is variable, but mortality rates of untreated cardiac sarcoidosis are high. Although randomized therapeutic trials have not been done, corticosteroids (alone or combined with additional immunosuppressive medications) remain the mainstay of treatment. Because of the potential for sudden cardiac death, implantable cardioverter-defibrillators should be placed in any patient with cardiac sarcoidosis and serious ventricular arrhythmias or heart block, and should be considered for cardiomyopathy. Cardiac transplantation is a viable option for patients with end-stage cardiac sarcoidosis refractory to medical therapy. PMID:25007089

  18. Treatment of Children with Speech Oral Placement Disorders (OPDs): A Paradigm Emerges

    Science.gov (United States)

    Bahr, Diane; Rosenfeld-Johnson, Sara

    2010-01-01

    Epidemiological research was used to develop the Speech Disorders Classification System (SDCS). The SDCS is an important speech diagnostic paradigm in the field of speech-language pathology. This paradigm could be expanded and refined to also address treatment while meeting the standards of evidence-based practice. The article assists that process…

  19. Moving towards precision orthodontics: An evolving paradigm shift in the planning and delivery of customized orthodontic therapy.

    Science.gov (United States)

    Jheon, A H; Oberoi, S; Solem, R C; Kapila, S

    2017-06-01

    Advances in precision medicine portend similar progress in orthodontics and will be increasingly harnessed to achieve customized treatment approaches and enhance treatment efficiencies. Our goal is to provide a background on emerging advances in computer technologies and biomedicine and highlight their current and likely future applications to precision orthodontics. A review of orthodontically relevant technologies and advances in pertinent biological research was undertaken. Innovations in computer hardware and software, and 3D imaging technologies offer the ability for customized treatment and biomechanical planning that will be more fully realized within the next few decades. These technologies combined with 3D printing are already being applied to customized appliance fabrication such as aligners and retainers. The future prospects for custom fabrication of orthodontic brackets of appropriate material properties and smart devices are highly desirable and compelling goals. Within biomedicine, the fundamental understanding of cartilage growth and bone biology is currently being tested in animal models to modify mandibular growth and modulate tooth movement, respectively. Some of these discoveries will ultimately have clinical applications in orthodontics including for growth modification, accelerating orthodontic tooth movement, and enhancing anchorage or retention of teeth. Additional genomic and proteomic information will add to further customization of orthodontic diagnosis and treatments. Over the coming decades, precision orthodontics will continue to benefit from advances in many fields and will require the integration of advances in technology, and biomedical and clinical research to deliver optimal, efficient, safe, and reproducible personalized orthodontic treatment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Consent and medical treatment: The legal paradigm in India

    Directory of Open Access Journals (Sweden)

    Omprakash V Nandimath

    2009-01-01

    Full Text Available The element of consent is one of the critical issues in medical treatment. The patient has a legal right to autonomy and self determination enshrined within Article 21 of the Indian Constitution. He can refuse treatment except in an emergency situation where the doctor need not get consent for treatment. The consent obtained should be legally valid. A doctor who treats without valid consent will be liable under the tort and criminal laws. The law presumes the doctor to be in a dominating position, hence the consent should be obtained after providing all the necessary information.

  1. Recent advances and novel treatment paradigms in acute lymphocytic leukemia.

    Science.gov (United States)

    Papadantonakis, Nikolaos; Advani, Anjali S

    2016-10-01

    This is an exciting time in the treatment of acute lymphoblastic leukemia (ALL) given the advances in the relapsed/refractory setting. The development of antibody treatments (including antibody drug conjugates with toxins) offers a different treatment approach compared with conventional chemotherapy regimens. Moreover, the use of bispecific T-cell-engager antibodies (BiTEs) such as blinatumomab harness the cytotoxic activity of T cells against CD19-positive lymphoblasts. Another strategy involves the use of chimeric antigen receptor (CAR) T cells. CAR T cells have demonstrated promising results in the relapsed/refractory setting. However, the use of BiTEs and CAR T cells is also associated with a distinct set of adverse reactions that must be taken into account by the treating physician. Apart from the above strategies, the use of other targeted therapies has attracted interest. Namely, the discovery of the Philadelphia (Ph)-like signature in children and young adults with ALL has led to the use of tyrosine kinase inhibitors (TKI) in these patients. The different drugs and strategies that are being tested in the relapsed/refractory ALL setting pose a unique challenge in identifying the optimum sequence of treatment and determining which approaches should be considered for frontline treatment.

  2. New treatment paradigm of combined raloxifene and conjugated ...

    African Journals Online (AJOL)

    Marwa N. Emam

    2016-07-25

    Jul 25, 2016 ... Abstract Introduction: The decreased ovarian estrogen production that occurs at menopause, results in osteoporosis and climacteric manifestations, and decreases women's quality of life. The hormone replacement therapy (HRT) is the primary treatment options but has been associated with increased ...

  3. New treatment paradigm of combined raloxifene and conjugated ...

    African Journals Online (AJOL)

    Introduction: The decreased ovarian estrogen production that occurs at menopause, results in osteoporosis and climacteric manifestations, and decreases women's quality of life. The hormone replacement therapy (HRT) is the primary treatment options but has been associated with increased oncogenic potential. The tissue ...

  4. Treatment paradigms for cataplexy in narcolepsy: past, present, and future

    Directory of Open Access Journals (Sweden)

    Swick TJ

    2015-12-01

    Full Text Available Todd J Swick1–4 1Department of Neurology, University of Texas School of Medicine-Houston, Houston; 2The Sleep Center at North Cypress Medical Center, Cypress; 3Apnix Sleep Diagnostics, Houston; 4Neurology and Sleep Medicine Consultants, Houston, TX, USA Abstract: Cataplexy is defined as episodes of sudden loss of voluntary muscle tone triggered by emotions generally lasting <2 minutes. Cataplexy is most commonly associated with and considered pathognomonic for narcolepsy, a sleep disorder affecting ~0.05% of the general population. Knowledge of the pathophysiology of cataplexy has advanced through study of canine, murine, and human models. It is now generally considered that loss of signaling by hypothalamic hypocretin/orexin-producing neurons plays a key role in the development of cataplexy. Although the cause of hypocretin/orexin neuron loss in narcolepsy with cataplexy is unknown, an autoimmune etiology is widely hypothesized. Despite these advances, a literature review shows that treatment of cataplexy remains limited. Multiple classes of antidepressants have been commonly used off-label for cataplexy in narcolepsy and are suggested for this use in expert consensus guidelines based on traditional practice, case reports, and small trials. However, systematic research evidence supporting antidepressants for cataplexy is lacking. The single pharmacotherapy indicated for cataplexy and the guideline-recommended first-line treatment in Europe and the US is sodium oxybate, the sodium salt of gamma-hydroxybutyrate. Clinical trial evidence of its efficacy and safety in cataplexy is robust, and it is hypothesized that its therapeutic effects may occur through gamma-aminobutyric acid receptor type B-mediated effects at noradrenergic, dopaminergic, and thalamocortical neurons. Additional possible mechanisms for cataplexy therapy suggested by preliminary research include antagonism of the histamine H3 autoreceptor with pitolisant and intravenous

  5. Skull base chondrosarcoma: evidence-based treatment paradigms.

    Science.gov (United States)

    Bloch, Orin; Parsa, Andrew T

    2013-01-01

    Chondrosarcomas are indolent but invasive chondroid malignancies that can form in the skull base. Standard management of chondrosarcoma involves surgical resection and adjuvant radiation therapy. This review evaluates evidence from the literature to assess the importance of the surgical approach and extent of resection on outcomes for patients with skull base chondrosarcoma. Also evaluated is the ability of the multiple modalities of radiation therapy, such as conventional fractionated radiotherapy, proton beam, and stereotactic radiosurgery, to control tumor growth. Finally, emerging therapies for the treatment of skull-base chondrosarcoma are discussed. Copyright © 2013. Published by Elsevier Inc.

  6. Evolution of Comprehensive Care, Part 3. Periodontal Treatment Continues to Evolve.

    Science.gov (United States)

    Kurtzman, Gregori M; Hughes, Mary K

    2015-05-01

    Perio treatment has evolved beyond simple scaling with hand instruments. Ultrasonics and diode lasers have improved both the efficiency of treatment as well as treatment prognosis to arresting the disease process and gaining clinical attachment and decreasing pocket depth. Add to this the benefits of adjunct medicaments both at time of treatment via site placement and during routine home care by the patient, and we are able to tip treatment outcome in a more favorable direction. Periodontology has been closely linked to systemic health both as a causative agent to health issues and as a secondary site for some medical conditions. Dentistry has truly--and finally--become a part of total healthcare.

  7. Treatment paradigms for cataplexy in narcolepsy: past, present, and future

    Science.gov (United States)

    Swick, Todd J

    2015-01-01

    Cataplexy is defined as episodes of sudden loss of voluntary muscle tone triggered by emotions generally lasting narcolepsy, a sleep disorder affecting ~0.05% of the general population. Knowledge of the pathophysiology of cataplexy has advanced through study of canine, murine, and human models. It is now generally considered that loss of signaling by hypothalamic hypocretin/orexin-producing neurons plays a key role in the development of cataplexy. Although the cause of hypocretin/orexin neuron loss in narcolepsy with cataplexy is unknown, an autoimmune etiology is widely hypothesized. Despite these advances, a literature review shows that treatment of cataplexy remains limited. Multiple classes of antidepressants have been commonly used off-label for cataplexy in narcolepsy and are suggested for this use in expert consensus guidelines based on traditional practice, case reports, and small trials. However, systematic research evidence supporting antidepressants for cataplexy is lacking. The single pharmacotherapy indicated for cataplexy and the guideline-recommended first-line treatment in Europe and the US is sodium oxybate, the sodium salt of gamma-hydroxybutyrate. Clinical trial evidence of its efficacy and safety in cataplexy is robust, and it is hypothesized that its therapeutic effects may occur through gamma-aminobutyric acid receptor type B-mediated effects at noradrenergic, dopaminergic, and thalamocortical neurons. Additional possible mechanisms for cataplexy therapy suggested by preliminary research include antagonism of the histamine H3 autoreceptor with pitolisant and intravenous immunoglobulin therapy for amelioration of the presumed autoimmune-mediated hypocretin/orexin cell loss. Further research and development of therapeutic approaches to cataplexy are needed. PMID:26715865

  8. Fibromyalgia: should the treatment paradigm be monotherapy or combination pharmacotherapy?

    Science.gov (United States)

    Mease, Philip J; Seymour, Kristin

    2008-12-01

    Fibromyalgia (FM) is a disorder characterized by chronic widespread pain, tenderness, and associated symptoms such as fatigue, sleep disturbance, mood disorder, and cognitive dysfunction. Research on the pathophysiology of FM has focused on dysregulation of sensory processing in the central nervous system, as well as genetic and sociobiologic background factors. Abnormalities include excessive pronociceptive input and deficiency of modulatory signaling via noradrenergic and serotonergic pathways. Effective pharmacotherapy of FM includes medications that inhibit pronociceptive input and augment modulatory signaling. Several other dysregulated pathways may be involved and be potential targets for therapeutic intervention. This article reviews positive results of recent monotherapy trials of several norepinephrine and serotonin reuptake inhibitors. Although there has been little assessment of combination therapy in FM, this review outlines the basis for rational treatment using this approach (in order to most effectively treat multiple symptom domains). Controlled monotherapy trials of medications currently being approved for FM demonstrate significant effect on pain, patient global impression of change, and function. Trials are currently being developed to assess the potential additive or synergistic effects of combined central pharmacotherapy and to assess the safety and tolerability of this approach.

  9. Quest for biomarkers of treatment-resistant depression: shifting the paradigm toward risk

    DEFF Research Database (Denmark)

    Smith, Donald F.

    2013-01-01

    as well as brain-derived neurotropic factor. Additional approaches to identifying biomarkers of TRD have dealt with cerebrospinal fluid analysis, magnetic resonance imaging, and positron emission tomography. Some studies have also investigated potential genetic and epigenetic factors inTRD. Most studies...... have, however, used a post hoc experimental design that failed to determine the association between biomarkers and the initial risk ofTRD. Particular ttention in future studies should be on shifting the experimental paradigm oward procedures that can determine the risk for developing treatment...

  10. Molecular Markers and Targeted Therapeutics in Metastatic Tumors of the Spine: Changing the Treatment Paradigms.

    Science.gov (United States)

    Goodwin, C Rory; Abu-Bonsrah, Nancy; Rhines, Laurence D; Verlaan, Jorrit-Jan; Bilsky, Mark H; Laufer, Ilya; Boriani, Stefano; Sciubba, Daniel M; Bettegowda, Chetan

    2016-10-15

    A review of the literature. The aim of this study was to discuss the evolution of molecular signatures and the history and development of targeted therapeutics in metastatic tumor types affecting the spinal column. Molecular characterization of metastatic spine tumors is expected to usher in a revolution in diagnostic and treatment paradigms. Molecular characterization will provide critical information that can be used for initial diagnosis, prognosticating the ideal treatment strategy, assessment of treatment efficacy, surveillance and monitoring recurrence, and predicting complications, clinical outcome, and overall survival in patients diagnosed with metastatic cancers to the spinal column. A review of the literature was performed focusing on illustrative examples of the role that molecular-based therapeutics have played in clinical outcomes for patients diagnosed with metastatic tumor types affecting the spinal column. The impact of molecular therapeutics including receptor tyrosine kinases and immune checkpoint inhibitors and the ability of molecular signatures to provide prognostic information are discussed in metastatic breast cancer, lung cancer, prostate cancer, melanoma, and renal cell cancer affecting the spinal column. For the providers who will ultimately counsel patients diagnosed with metastases to the spinal column, molecular advancements will radically alter the management/surgical paradigms utilized. Ultimately, the translation of these molecular advancements into routine clinical care will greatly improve the quality and quantity of life for patients diagnosed with spinal malignancies and provide better overall outcomes and counseling for treating physicians. N/A.

  11. Radium-223 dichloride: a new paradigm in the treatment of prostate cancer.

    Science.gov (United States)

    Anido Herranz, Urbano; Fernández Calvo, Ovidio; Afonso Afonso, Francisco Javier; Rodríguez Martínez de Llano, Sofía; Lázaro Quintela, Martín; León Mateos, Luis; Vázquez Estévez, Sergio; Antón Aparicio, Luis Miguel

    2015-03-01

    Radionuclides have been widely used for cancer treatment. Recently, new research about radium-223 dichloride has been conducted in prostate cancer, which reveals that it is the first radiopharmaceutical to demonstrate an improvement in overall survival and time to first symptomatic skeletal event in patients with castration resistant prostate cancer with symptomatic bone metastases. This fact has created a new paradigm in the treatment of prostate cancer landscape, where only chemotherapy and hormone therapy had a role, while β-emitters had been confined exclusively to the role of pain relief with no impact on survival. The aim of this review is to outline current treatment approaches for advanced prostate cancer with a focus on the role of radium-223 dichloride, reviewing patients' profile that make them suitable to therapy and chances for further studies.

  12. Cavernous carotid aneurysms: a new treatment paradigm in the era of flow diversion.

    Science.gov (United States)

    Raper, Daniel M S; Ding, Dale; Peterson, Eric C; Crowley, Richard W; Liu, Kenneth C; Chalouhi, Nohra; Hasan, David M; Dumont, Aaron S; Jabbour, Pascal; Starke, Robert M

    2017-02-01

    Cavernous carotid aneurysms can cause significant symptomatology through mass effect and may rupture, resulting in carotid-cavernous fistula or epistaxis. Traditional treatment options included endovascular or surgical parent vessel occlusion, or embolization; in the last decade, the development of flow-diverting stents has changed the management paradigm for these lesions. Areas covered: In this review, we summarize the natural history, clinical presentation, and evolution of treatment options for cavernous carotid aneurysms and discuss developments likely to influence treatment strategies in the future. We performed a Medline search for relevant review articles and original reports and additional searches based on review of referenced articles, abstracts, and conference presentations. Expert commentary: Long-term data are still required to fully assess the efficacy of endoluminal reconstruction using flow diversion, but this approach appears to offer an attractive therapy for many cavernous carotid aneurysms requiring intervention.

  13. Radio-immunotherapy and chemo-immunotherapy as a novel treatment paradigm in malignant pleural mesothelioma

    Science.gov (United States)

    Wu, Licun

    2017-01-01

    Malignant pleural mesothelioma (MPM) is an aggressive neoplasm with poor outcome. Novel radical radiation techniques using intensity modulated radiation therapy (IMRT) have become an important component of therapy in mesothelioma. Immunotherapy also provides new therapeutic options. However, how best to integrate immunotherapy with standard therapy such as radiation, chemotherapy and surgery remains unknown. A change of paradigm from adjuvant normofractionation to induction accelerated hypofractionated hemithoracic radiation could provide a platform to combine immunotherapy due to the potential benefit of short course high dose radiation on the immune system. Immunotherapy can also be combined with chemotherapy. Although chemotherapy is generally considered immunosuppressive, some chemotherapeutic agents do induce cell death that can be immunogenic and stimulate a specific immune response against the tumor. Immunotherapy could also be used in between cycles of chemotherapy to limit tumor cell repopulation and optimize the results of both treatments. The integration of immunotherapy into a multimodality approach is opening new avenue of treatment for mesothelioma. PMID:28713677

  14. Towards a Paradigm Shift in the Treatment of Chronic Chagas Disease

    Science.gov (United States)

    Alarcón de Noya, B.; Araujo-Jorge, T.; Grijalva, M. J.; Guhl, F.; López, M. C.; Ramsey, J. M.; Ribeiro, I.; Schijman, A. G.; Sosa-Estani, S.; Torrico, F.; Gascon, J.

    2014-01-01

    Treatment for Chagas disease with currently available medications is recommended universally only for acute cases (all ages) and for children up to 14 years old. The World Health Organization, however, also recommends specific antiparasite treatment for all chronic-phase Trypanosoma cruzi-infected individuals, even though in current medical practice this remains controversial, and most physicians only prescribe palliative treatment for adult Chagas patients with dilated cardiomyopathy. The present opinion, prepared by members of the NHEPACHA network (Nuevas Herramientas para el Diagnóstico y la Evaluación del Paciente con Enfermedad de Chagas/New Tools for the Diagnosis and Evaluation of Chagas Disease Patients), reviews the paradigm shift based on clinical and immunological evidence and argues in favor of antiparasitic treatment for all chronic patients. We review the tools needed to monitor therapeutic efficacy and the potential criteria for evaluation of treatment efficacy beyond parasitological cure. Etiological treatment should now be mandatory for all adult chronic Chagas disease patients. PMID:24247135

  15. Endovascular treatment paradigm of carotid blowout syndrome: Review of 8-years experience

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Wing Suet, E-mail: wws351@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Lai, Vincent, E-mail: vincentlai@hkcr.org [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Lau, Hin Yue, E-mail: lhy460@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Wong, Yiu Chung, E-mail: wongyc6@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Poon, Wai Lun, E-mail: poonwl@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Tan, Chong Boon, E-mail: tancb@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong)

    2013-01-15

    Objectives: Endovascular treatment is effective in treating carotid blowout syndrome (CBS). We reviewed our experience in addressing CBS over eight years and presented an account of the treatment paradigm and management algorithm. Method: All cases of CBS from 2003 to 2010 with endovascular treatment performed in our center were reviewed. 15 CBS in 14 patients were recruited. Based on our management algorithm, treatment regimen was stratified into deconstructive or constructive methods. Their clinical presentations, angiographic features, angiographic and clinical outcomes were reviewed. Results: 10 patients were treated with deconstructive method by means of permanent vessel occlusion (PVO) and 4 patients were treated with constructive method by means of placement of covered stent (n = 3) or flow diverting device (n = 1). Immediate hemostasis was achieved in all cases. 7 (50%) patients, in whom 5 treated with PVO and 2 with covered stent, had favorable outcomes and survived at a median follow-up period of 4 months (range: 1–84 months). Conclusion: Permanent vessel occlusion remains the gold standard of treatment and tends to show a favorable long-term outcome. Off-label use of covered stent and flow-diverting device can produce satisfactory results should balloon occlusion test fail, but long-term follow up would be required for definitive assessment.

  16. Dextromethorphan in the treatment of early myoclonic encephalopathy evolving into migrating partial seizures in infancy

    Directory of Open Access Journals (Sweden)

    Yin-Hsuan Chien

    2012-05-01

    Full Text Available Epileptic encephalopathy with suppression-burst in electroencephalography (EEG can evolve into a few types of epileptic syndromes. We present here an unusual case of early myoclonic encephalopathy that evolved into migrating partial seizures in infancy. A female neonate initially had erratic myoclonus movements, hiccups, and a suppression-burst pattern in EEG that was compatible with early myoclonic encephalopathy. The seizures were controlled with dextromethorphan (20 mg/kg, and a suppression-burst pattern in EEG was reverted to relatively normal background activity. However, at 72 days of age, alternating focal tonic seizures, compatible with migrating partial seizures in infancy, were demonstrated by the 24-hour EEG recording. The seizures responded poorly to dextromethorphan. To our knowledge, this is the first reported case of early myoclonic encephalopathy evolving into migrating partial seizure in infancy. Whether it represents another age-dependent epilepsy evolution needs more clinical observation.

  17. Cartilage regeneration for treatment of osteoarthritis: a paradigm for nonsurgical intervention.

    Science.gov (United States)

    Tiku, Moti L; Sabaawy, Hatem E

    2015-06-01

    Osteoarthritis (OA) is associated with articular cartilage abnormalities and affects people of older age: preventative or therapeutic treatment measures for OA and related articular cartilage disorders remain challenging. In this perspective review, we have integrated multiple biological, morphological, developmental, stem cell and homeostasis concepts of articular cartilage to develop a paradigm for cartilage regeneration. OA is conceptually defined as an injury of cartilage that initiates chondrocyte activation, expression of proteases and growth factor release from the matrix. This regenerative process results in the local activation of inflammatory response genes in cartilage without migration of inflammatory cells or angiogenesis. The end results are catabolic and anabolic responses, and it is the balance between these two outcomes that controls remodelling of the matrix and regeneration. A tantalizing clinical clue for cartilage regrowth in OA joints has been observed in surgically created joint distraction. We hypothesize that cartilage growth in these distracted joints may have a biological connection with the size of organs and regeneration. Therefore we propose a novel, practical and nonsurgical intervention to validate the role of distraction in cartilage regeneration in OA. The approach permits normal wake-up activity while during sleep; the index knee is subjected to distraction with a pull traction device. Comparison of follow-up magnetic resonance imaging (MRI) at 3 and 6 months of therapy to those taken before therapy will provide much-needed objective evidence for the use of this mode of therapy for OA. We suggest that the paradigm presented here merits investigation for treatment of OA in knee joints.

  18. Foreign correspondence from Sub-Saharan Africa: An evolving communicational paradigm shift / Corresponsales extranjeros en África Subsahariana: Un paradigma comunicativo en evolución

    Directory of Open Access Journals (Sweden)

    Paulo Nuno Vicente

    2013-11-01

    Full Text Available A sizable portion of our everyday knowledge about Sub-Saharan Africa comes from the work of international news reporters. Even though these news actors play a critical role in the communication of the distant Other, frequently criticized for its representational deficits, scholar empirical research on the work of foreign correspondents has been considerably neglected: it is now decades old, it lacks a systematic examination of the on the ground realities of journalism in Africa and of the evolving work of professionals and Pro-Ams supported by networked digital media. This article analyses the evolving professional cultures and newswork of those individuals (micro. It inspects long-term trajectories in international journalism combined with short-term developments based on transformations on microelectronics and digitization. We conduct the first recorded Pan-African online survey on the work of international news reporters, collecting answers from 124 participants in 41 countries. These findings are complemented by semi-structured interviews with 43 professionals based in Nairobi, Dakar and Johannesburg. Our findings challenge the narrative of international news reporting as a dying breed. Instead, they support a nuanced view towards localized continuities and localized ruptures in contemporary post-industrial mediascape: its socio-demographics express a considerably precarious new economy of foreign correspondence –particularly, in the case of freelance workers– while the use of network-based digital media is driving the field towards the rising of a multilayered confederacy of distinct correspondences.Una parte importante de nuestro conocimiento cotidiano de África al sur del Sahara proviene de la labor de los periodistas internacionales. A pesar de que estos actores desempeñan un papel fundamental en la comunicación sobre los Otros distantes, frecuentemente criticados por su déficit de representación, el trabajo académico de

  19. Primary Spinal Germ Cell Tumors: A Case Analysis and Review of Treatment Paradigms

    Directory of Open Access Journals (Sweden)

    Joshua J. Loya

    2013-01-01

    Full Text Available Objective. Primary intramedullary spinal germ cell tumors are exceedingly rare. As such, there are no established treatment paradigms. We describe our management for spinal germ cell tumors and a review of the literature. Clinical Presentation. We describe the case of a 45-year-old man with progressive lower extremity weakness and sensory deficits. He was found to have enhancing intramedullary mass lesions in the thoracic spinal cord, and pathology was consistent with an intramedullary germ cell tumor. A video presentation of the case and surgical approach is provided. Conclusion. As spinal cord germinomas are highly sensitive to radiation and chemotherapy, a patient can be spared radical surgery. Diverse treatment approaches exist across institutions. We advocate biopsy followed by local radiation, with or without adjuvant chemotherapy, as the optimal treatment for these tumors. Histological findings have prognostic value if syncytiotrophoblastic giant cells (STGCs are found, which are associated with a higher rate of recurrence. The recurrence rate in STGC-positive spinal germinomas is 33% (2/6, whereas it is only 8% in STGC-negative tumors (2/24. We advocate limited volume radiotherapy combined with systemic chemotherapy in patients with high risk of recurrence. To reduce endocrine and neurocognitive side effects, cranio-spinal radiation should be used as a last resort in patients with recurrence.

  20. POTENTIAL PLACE OF SGLT2 INHIBITORS IN TREATMENT PARADIGMS FOR TYPE 2 DIABETES MELLITUS.

    Science.gov (United States)

    Handelsman, Yehuda

    2015-09-01

    Following the first Food and Drug Administration (FDA) approval in 2013, sodium glucose cotransporter 2 (SGLT2) inhibitors have generated much interest among physicians treating patients with type 2 diabetes mellitus (T2DM). Here, the role in treatment with this drug class is considered in the context of T2DM treatment paradigms. The clinical trials for the SGLT2 inhibitors are examined with a focus on canagliflozin, dapagliflozin, and empagliflozin. Evidence from clinical trials in patients with T2DM supports the use of SGLT2 inhibitors either as monotherapy or in addition to other glucose-lowering treatments as adjuncts to diet and exercise, and we have gained significant clinical experience in a relatively short time. The drugs appear to be useful in a variety of T2DM populations, contingent primarily on renal function. Most obviously, SGLT2 inhibitors appear to be well suited for patients with potential for hypoglycemia or weight gain. In clinical trials, patients treated with SGLT2 inhibitors have experienced moderate weight loss and a low risk of hypoglycemic events except when used in combination with an insulin secretagogue. In addition, SGLT2 inhibitors have been shown to reduce blood pressure, so they may be beneficial in patients with T2DM complicated by hypertension. SGLT2 inhibitors were incorporated into the 2015 American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) position statement on the management of hyperglycemia and received an even more prominent position in the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) comprehensive diabetes management guidelines and algorithm.

  1. Hybrid revascularization of complex multilevel disease: a paradigm shift in critical limb ischemia treatment.

    Science.gov (United States)

    Patel, S D; Donati, T; Zayed, H

    2014-10-01

    Critical limb ischemia frequently occurs on a background of extensive co-morbidities and carries a poor prognosis which requires urgent management. Disease severity and patient comorbidity influence the initial choice of management which according to traditional paradigms, is a choice between open or endovascular repair. Over the last decade hybrid intervention, which is the planned combined use of both open and endovascular techniques, has increasingly been used to tackle multilevel disease. In this review we look at the techniques and results of hybrid surgery. This technique is ideal for multilevel lesions, as it is minimally invasive, allows prompt limb revascularization as opposed to the delays inherent in staged procedures and it appears to be more convenient to patients. It also leads to reduced length of hospital stay and reduces overall cost. Most importantly it offers an alternative to open revascularization in medically high risk patients. The success and popularity of hybrid interventions has been underpinned by advances in stent and balloon technology and the advent of the hybrid operating theatre which has allowed multiple techniques to be used simultaneously. Iliac angioplasty and stenting is now the first line of treatment for TASC C/D iliac lesions with good technical success and long-term patency. In patients who also have common femoral disease, endarterectomy can be combined with iliac stenting and this has now almost replaced open bypass. Most series for a variety of hybrid procedures report good limb salvage rates, with morbidity and mortality data considered equal to or better than open bypass procedures. Careful patient selection and detailed preoperative planning are essential to achieve these excellent results. Studies have reported on prospective series or retrospective analysis for various hybrid techniques, including non randomized trials comparing hybrid and open surgical treatment. Ideally, a randomized controlled trial comparing open

  2. Harnessing cognitive neuroscience to develop new treatments for improving cognition in schizophrenia: CNTRICS selected cognitive paradigms for animal models.

    Science.gov (United States)

    Moore, Holly; Geyer, Mark A; Carter, Cameron S; Barch, Deanna M

    2013-11-01

    Over the past two decades, the awareness of the disabling and treatment-refractory effects of impaired cognition in schizophrenia has increased dramatically. In response to this still unmet need in the treatment of schizophrenia, the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) initiative was developed. The goal of CNTRICS is to harness cognitive neuroscience to develop a brain-based set of tools for measuring cognition in schizophrenia and to test new treatments. CNTRICS meetings focused on development of tasks with cognitive construct validity for use in both human and animal model studies. This special issue presents papers discussing the cognitive testing paradigms selected by CNTRICS for animal model systems. These paradigms are designed to measure cognitive constructs within the domains of perception, attention, executive function, working memory, object/relational long-term memory, and social/affective processes. Copyright © 2013. Published by Elsevier Ltd.

  3. Same-day {sup 90}Y radioembolization: implementing a new treatment paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Gabr, Ahmed; Kallini, Joseph Ralph; Gates, Vanessa L.; Hickey, Ryan; Desai, Kush; Thornburg, Bartley; Marshall, Karen; Salzig, Krystina; Williams, Melissa; Del Castillo, Carlene; Hohlastos, Elias; Lewandowski, Robert J. [Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Chicago, IL (United States); Kulik, Laura; Ganger, Daniel [Northwestern University, Department of Medicine, Division of Hepatology, Chicago, IL (United States); Baker, Talia [Northwestern University, Department of Surgery, Division of Transplantation, Comprehensive Transplant Center, Chicago, IL (United States); Salem, Riad [Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Chicago, IL (United States); Northwestern University, Department of Surgery, Division of Transplantation, Comprehensive Transplant Center, Chicago, IL (United States); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Department of Medicine, Division of Hematology and Oncology, Chicago, IL (United States)

    2016-12-15

    To assess the feasibility of conducting pretreatment mesenteric angiography, coil embolization, {sup 99m}Tc macroaggregated albumin ({sup 99m}Tc-MAA) scintigraphy, and {sup 90}Y radioembolization treatment in a single, same-day, combined outpatient encounter. This was a retrospective study of 78 patients treated during the period 2008 - 2015 who were managed in a single outpatient encounter under the guidance of the Interventional Radiology Department and The Nuclear Medicine Department. Pretreatment planning was performed by reviewing baseline imaging and estimated perfused liver volume bearing the tumor. The region of interest was estimated using 3-D software; this value was used for dosimetry planning. Maximum lung shunting fractions of 10 % for hepatocellular carcinoma and 5 % for liver metastases were assumed. Subsequently, hepatic angiography and {sup 99m}Tc-MAA scintigraphy were performed followed by {sup 90}Y treatment in one outpatient encounter. Total in-room procedure time was recorded. All patients underwent same-day angiography, {sup 99m}Tc-MAA scintigraphy and {sup 90}Y radioembolization. Of the 78 patients, 16 received multiple segmental treatments to both lobes, 44 received treatment to the right lobe, and 18 received treatment to the left lobe. The median dose was 106 Gy. The median number of {sup 90}Y vials needed was two (range one to six). The median in-room time was 160 min (75 - 250 min). The residential status of the patients was as follows, 18 % (14/78) were local residents, 55 % (43/78) traveled from outside the city limits, 18 % (14/78) were from out-of-state, and 9 % (7/78) were resident abroad. Of the 78 patients, 61 (77 %) had hepatocellular carcinoma, and 17 (22 %) had liver metastases. The median lung dose was 3.5 Gy. This study demonstrated the feasibility of same-day {sup 90}Y evaluation and treatment while maintaining the principles of safe and effective {sup 90}Y infusion including tumoricidal dosimetry (lobar, segmentectomy

  4. Same-day (90)Y radioembolization: implementing a new treatment paradigm.

    Science.gov (United States)

    Gabr, Ahmed; Kallini, Joseph Ralph; Gates, Vanessa L; Hickey, Ryan; Kulik, Laura; Desai, Kush; Thornburg, Bartley; Marshall, Karen; Salzig, Krystina; Williams, Melissa; Del Castillo, Carlene; Ganger, Daniel; Hohlastos, Elias; Baker, Talia; Lewandowski, Robert J; Salem, Riad

    2016-12-01

    To assess the feasibility of conducting pretreatment mesenteric angiography, coil embolization, (99m)Tc macroaggregated albumin ((99m)Tc-MAA) scintigraphy, and (90)Y radioembolization treatment in a single, same-day, combined outpatient encounter. This was a retrospective study of 78 patients treated during the period 2008 - 2015 who were managed in a single outpatient encounter under the guidance of the Interventional Radiology Department and The Nuclear Medicine Department. Pretreatment planning was performed by reviewing baseline imaging and estimated perfused liver volume bearing the tumor. The region of interest was estimated using 3-D software; this value was used for dosimetry planning. Maximum lung shunting fractions of 10 % for hepatocellular carcinoma and 5 % for liver metastases were assumed. Subsequently, hepatic angiography and (99m)Tc-MAA scintigraphy were performed followed by (90)Y treatment in one outpatient encounter. Total in-room procedure time was recorded. All patients underwent same-day angiography, (99m)Tc-MAA scintigraphy and (90)Y radioembolization. Of the 78 patients, 16 received multiple segmental treatments to both lobes, 44 received treatment to the right lobe, and 18 received treatment to the left lobe. The median dose was 106 Gy. The median number of (90)Y vials needed was two (range one to six). The median in-room time was 160 min (75 - 250 min). The residential status of the patients was as follows, 18 % (14/78) were local residents, 55 % (43/78) traveled from outside the city limits, 18 % (14/78) were from out-of-state, and 9 % (7/78) were resident abroad. Of the 78 patients, 61 (77 %) had hepatocellular carcinoma, and 17 (22 %) had liver metastases. The median lung dose was 3.5 Gy. This study demonstrated the feasibility of same-day (90)Y evaluation and treatment while maintaining the principles of safe and effective (90)Y infusion including tumoricidal dosimetry (lobar, segmentectomy), minimization of nontarget

  5. Melanoma metastasis: new concepts and evolving paradigms.

    Science.gov (United States)

    Damsky, W E; Theodosakis, N; Bosenberg, M

    2014-05-08

    Melanoma progression is typically depicted as a linear and stepwise process in which metastasis occurs relatively late in disease progression. Significant evidence suggests that in a subset of melanomas, progression is much more complex and less linear in nature. Epidemiologic and experimental observations in melanoma metastasis are reviewed here and are incorporated into a comprehensive model for melanoma metastasis, which takes into account the varied natural history of melanoma formation and progression.

  6. Evolving paradigm for fab revenue optimization

    Science.gov (United States)

    Akella, Ramakrishna; Fridgeirsdottir, Kristin; Skumanich, Andrew

    2002-07-01

    Historically for semiconductor processing, defects have been considered in a separate class as yield detractors and significant effort goes into detection, analysis and monitoring of defects. With the increase in complexity of nano technologies, defects now become a competent comprising only part of the overall picture of yield, or more importantly, of revenue. Given the acceleration decrease in feature sizes, there is a corresponding shift from emphasis on random defectivity to both systematical defectivity as well as parametric integrity. With the view that yield loss should be generalized to revenue loss of any type, it can then be understood that the notion of process monitoring generalizes to not just defect count, but also to be broader set of characteristic including device parameters. In this regards, the tool set for monitoring the process needs to be generalized to also include systematic and parametric inspection system. The model is that an inspection tool plus an associated algorithm is required for monitoring the variance in all critical elements. The fab must then optimize the set of tools and algorithms. Including integrated metrology tools in this optimization generalizes the revenue model further, but adds significant revenue enhancement opportunities. The issue and tradeoffs imply that the fabs must consider the full characterization needs in order to determine the proper mix of monitoring tools and algorithms.

  7. The Protection of Civilians: An Evolving Paradigm?

    Directory of Open Access Journals (Sweden)

    Stuart Gordon

    2013-08-01

    Full Text Available Whilst the protection of civilians (POC in conflict has been a recurring feature of the humanitarian discourse the same has not been true in military doctrines, where the protection of civilians has long been cast in terms of arms bearers upholding their responsibilities under international humanitarian law (IHL. However, opportunities for and pressures on military actors to develop more specific capacities and approaches in this field have grown: partly as a response to the changing nature, location and scope of conflict, particularly the increasing proportion of internal conflicts fought by irregular armed groups in urban environments. It is also a response to the scale and complexity of protection challenges in the Balkans, Rwanda, Darfur and Libya - each of which has clearly demonstrated that threats to civilians are complex and dynamic and that no single international actor is capable of mitigating them without significant support from other institutions (O’Callaghan and Pantuliano, 2007. Despite the enormous growth in opportunities for interaction between militaries and humanitarians there is only a very limited literature on their interaction over protection issues and evaluations of the emerging doctrines. Consequently this article charts the growth in military policies towards POC in the UN, UK, NATO and a range of other states as well as drawing attention to the challenges that still remain in operationalising responses.

  8. 78 FR 56719 - Challenging Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of...

    Science.gov (United States)

    2013-09-13

    ... morbid obesity and other metabolic diseases and evolving approaches for the regulation and reimbursement... morbid obesity and other metabolic diseases as well as evolving approaches for the regulation and...-regulation-and-reimbursement-workshop . For more information on the workshop, please visit FDA's Medical...

  9. An evolving integrative treatment program for military sexual trauma (MST) and one veteran's experience.

    Science.gov (United States)

    Ferdinand, Lisa G; Kelly, Ursula A; Skelton, Kelly; Stephens, Kisha J; Bradley, Bekh

    2011-01-01

    Military sexual trauma (MST) increases the risk for Posttraumatic Stress Disorder (PTSD) and multiple other comorbidities, presenting substantial challenges for nurses and psychiatric and medical clinicians. A specialized VA Medical Center outpatient program is patterned after Herman's three-phased, empirically-supported, recovery treatments. We use a case example of a female veteran MST survivor to illustrate our treatment model. She presented to our program meeting diagnostic criteria for PTSD, Major Depressive Disorder, and a history of substance abuse. Post-treatment she demonstrated improved scores on measures of PTSD, quality of life, and socialization. This model shows promise for treatment of MST survivors with PTSD.

  10. Evolving strategy in treatment of infantile hemangiomas: from steroids to propranolol

    Directory of Open Access Journals (Sweden)

    Serhan Kupeli

    2016-06-01

    Full Text Available Infantile hemangiomas are the most common vascular tumors of the early childhood. Increased incidence of infantile hemangiomas can be attributed to widespread use of assisted reproductive technologies. Majority of hemangiomas in infantile age group resolve spontaneously and only a small proportion of the cases with infantile hemangiomas requires treatment. GLUT-ONE acronym (Giant infantile hemangiomas, Liver and/or other visceral organ involvement, Ulcerated or bleeding infantile hemangiomas, Threatening of life, Organ dysfunctioning infantile hemangiomas, Non-localized infantile hemangiomas, Esthetic/cosmetic compromise can help clinicians for the rapid decision of treatment. Corticosteroids have long been the mainstay treatment for hemangiomatous lesions but after the description of antiproliferative effect of propranolol on severe infantile hemangiomas in 2008, propranolol has been the preferred choice of treatment in many centers. Future studies should be directed to answer the questions regarding the optimal duration of propranolol treatment to overcome recurrences and clinical and histopathological characteristics of infantile hemangiomas that failed treatment with propranolol. [Cukurova Med J 2016; 41(2.000: 354-359

  11. Evolving treatment approaches for the management of metastatic castration-resistant prostate cancer – role of radium-223

    Directory of Open Access Journals (Sweden)

    Mukherji D

    2014-05-01

    Full Text Available Deborah Mukherji,1 Imane El Dika,1 Sally Temraz,1 Mohammed Haidar,2 Ali Shamseddine11Department of Hematology/Oncology, 2Department of Nuclear Medicine, American University of Beirut Medical Center, Beirut, LebanonAbstract: Radium-223 is a first-in-class alpha particle-emitting radiopharmaceutical approved for the treatment of bone metastatic castration-resistant prostate cancer. Radium-223 is administered intravenously with no requirement for complex shielding and specifically targets areas of bone metastasis. In a randomized placebo-controlled Phase III study, treatment with radium-223 was shown to improve overall survival, time to skeletal-related events, and health-related quality of life. Apart from radium-223, the cytotoxic chemotherapy agents docetaxel and cabazitaxel, androgen biosynthesis inhibitor abiraterone acetate, novel anti-androgen enzalutamide, and immunotherapy sipuleucel-T have also been shown to improve survival of men with advanced prostate cancer in Phase III trials. This review will outline current treatment approaches for advanced prostate cancer with a focus on the role of radium-223 in changing treatment paradigms.Keywords: Alpharadin, alpha-emitting radionuclide, bone metastasis

  12. Combined and sequential treatment of oral and maxillofacial malignancies: an evolving concept and clinical protocol.

    Science.gov (United States)

    Zheng, Jia-wei; Qiu, Wei-liu; Zhang, Zhi-yuan

    2008-10-05

    To introduce the concept and rational regimens and present the latest development of combined treatment of oral and maxillofacial malignancies. Data sources The related published literature was searched through the CNKI database and MEDLINE using the terms of oral cancer, oral and maxillofacial malignancies, combined and sequential therapy, multidisciplinary approach. Study selection The available related literature was read and evaluated. Studies that met the inclusion criteria were selected. The results show that oral and maxillofacial malignancies diagnosed at an early stages (stages I and II) can be well treated with surgery alone and/or radiotherapy with optimal outcome, but advanced or recurrent diseases should be treated with rational combined and sequential treatment modalities. The use of concomitant chemoradiotherapy, taxane-containing, three-drug induction regimens and Cetuximab in combination with chemotherapy or radiotherapy demonstrated favorable results in previously untreated patients with head and neck squamous cell carcinoma. The concept of combined and sequential treatment of advanced oral and maxillofacial malignancies should be widely accepted, and the rational regimen for individual and each type of entity should be determined based on the anatomical site and the patient's performance status.

  13. An evolving scientific basis for the prevention and treatment of pediatric obesity

    Science.gov (United States)

    Katzmarzyk, PT; Barlow, S; Bouchard, C; Catalano, PM; Hsia, DS; Inge, TH; Lovelady, C; Raynor, H; Redman, LM; Staiano, AE; Spruijt-Metz, D; Symonds, ME; Vickers, M; Wilfley, D; Yanovski, JA

    2014-01-01

    The 2013 Pennington Biomedical Research Center’s Scientific Symposium focused on the treatment and management of pediatric obesity and was designed to (i) review recent scientific advances in the prevention, clinical treatment and management of pediatric obesity, (ii) integrate the latest published and unpublished findings and (iii) explore how these advances can be integrated into clinical and public health approaches. The symposium provided an overview of important new advances in the field, which led to several recommendations for incorporating the scientific evidence into practice. The science presented covered a range of topics related to pediatric obesity, including the role of genetic differences, epigenetic events influenced by in utero development, pre-pregnancy maternal obesity status, maternal nutrition and maternal weight gain on developmental programming of adiposity in offspring. Finally, the relative merits of a range of various behavioral approaches targeted at pediatric obesity were covered, together with the specific roles of pharmacotherapy and bariatric surgery in pediatric populations. In summary, pediatric obesity is a very challenging problem that is unprecedented in evolutionary terms; one which has the capacity to negate many of the health benefits that have contributed to the increased longevity observed in the developed world. PMID:24662696

  14. Endoscopic surgery in the treatment of crista galli pneumatization evolving with localizated frontal headaches

    Directory of Open Access Journals (Sweden)

    Socher, Jan Alessandro

    2014-01-01

    Full Text Available Introduction: The crista galli is part of the ethmoid bone and thus may suffer from the process of pneumatization. Pneumatization occurs in between 3% and 14% of patients, resulting from air cells in the frontal or ethmoid sinuses. Aim: To describe 3 cases of crista galli pneumatization in which the patients developed infection and were treated surgically by endoscopic techniques. Method: We present 3 case studies of patients complaining of severe frontal headaches. The patients underwent ENT evaluation, examination by video-endoscopy, and computed tomography, which identified crista galli pneumatization with mucosal thickening and the presence of fluid. Patients underwent treatment with antibiotics and corticosteroids; however, they showed no symptomatic improvement, displayed recurrence of symptoms, and maintained radiographic changes. Thus, patients then underwent drainage through the crista galli via an endoscopic procedure. Discussion: During surgery, mucopurulence and/or mucosal thickening and edema were identified in the pneumatized crista galli. There were no complications during or after surgery. Postoperatively, headache was improved in patients after a minimum follow-up of 6 months. Conclusion: Crista galli pneumatization can result in infection, simulating rhinosinusitis. When there is little response to drug therapy, endoscopic surgical treatment is required; the current cases demonstrate that this technique is safe and effective.

  15. An evolving scientific basis for the prevention and treatment of pediatric obesity.

    Science.gov (United States)

    Katzmarzyk, P T; Barlow, S; Bouchard, C; Catalano, P M; Hsia, D S; Inge, T H; Lovelady, C; Raynor, H; Redman, L M; Staiano, A E; Spruijt-Metz, D; Symonds, M E; Vickers, M; Wilfley, D; Yanovski, J A

    2014-07-01

    The 2013 Pennington Biomedical Research Center's Scientific Symposium focused on the treatment and management of pediatric obesity and was designed to (i) review recent scientific advances in the prevention, clinical treatment and management of pediatric obesity, (ii) integrate the latest published and unpublished findings and (iii) explore how these advances can be integrated into clinical and public health approaches. The symposium provided an overview of important new advances in the field, which led to several recommendations for incorporating the scientific evidence into practice. The science presented covered a range of topics related to pediatric obesity, including the role of genetic differences, epigenetic events influenced by in utero development, pre-pregnancy maternal obesity status, maternal nutrition and maternal weight gain on developmental programming of adiposity in offspring. Finally, the relative merits of a range of various behavioral approaches targeted at pediatric obesity were covered, together with the specific roles of pharmacotherapy and bariatric surgery in pediatric populations. In summary, pediatric obesity is a very challenging problem that is unprecedented in evolutionary terms; one which has the capacity to negate many of the health benefits that have contributed to the increased longevity observed in the developed world.

  16. Chronic Obstructive Pulmonary Disease-Evolving Concepts in Treatment: Advances in Pulmonary Rehabilitation.

    Science.gov (United States)

    Nici, Linda; ZuWallack, Richard

    2015-08-01

    Over the past three decades, pulmonary rehabilitation has risen to the stature as a gold standard for the treatment of chronic obstructive pulmonary disease (COPD). This rise is owing to both the development of science explaining mechanisms underlying its effectiveness and the demonstration of its substantial benefits across multiple outcome areas of importance to patients. Arguably, pulmonary rehabilitation provides the greatest improvements of any therapy in the areas of dyspnea-relief, exercise performance, and functional and health status. Emerging science also indicates that it reduces subsequent health care utilization and-when administered in the perihospital period-mortality risk. These beneficial effects are realized despite the fact that pulmonary rehabilitation has virtually no direct effect on lung function in COPD. Instead, this comprehensive, patient-centered intervention reduces the negative effects from systemic morbidity (such as muscle wasting) and comorbidity (such as depression and anxiety) that frequently accompany COPD. Two major components of pulmonary rehabilitation are exercise training and behavioral interventions. An example of the latter is a collaborative action plan for the early recognition and prompt treatment of the COPD exacerbation. Innovation in pulmonary rehabilitation includes (1) expanding its applicability, such as demonstrating effectiveness in the non-COPD respiratory patient, in milder COPD, in the periexacerbation period, and its provision in the home and community settings; (2) improving its process, such as refining the self-management and behavioral interventions, and the promotion of physical activity in the home and community settings; and (3) promoting its accessibility, such as exploring its potential usefulness in nontraditional settings (the home and community) and developing technology to assist in its implementation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. Outcomes of resection for colorectal cancer hepatic metastases stratified by evolving eras of treatment

    Directory of Open Access Journals (Sweden)

    Chan Kun-Ming

    2011-12-01

    Full Text Available Abstract Background and purpose The outcomes and management of colorectal cancer (CRC hepatic metastasis have undergone many evolutionary changes. In this study, we aimed to analyze the outcomes of patients with CRC hepatic metastasis in terms of the era of treatment. Methods We conducted a retrospective review of 279 patients who underwent liver resection (LR for CRC hepatic metastases. The prognoses of patients treated pre-2003 (era 1 and post-2003 (era 2 were examined. Results Of the patients included in the study, 210 (75.3% had CRC recurrence after LR. There was a significant difference in the ratio of CRC recurrence between the 2 eras (82.0% in era 1 vs. 69.5% in era 2; p = 0.008. Analysis of recurrence-free and overall survival rates also showed that the patient outcome was significantly better in the post-2003 era than in the pre-2003 era. Further analysis showed that a significantly higher percentage of patients in era 2 had received modern chemotherapeutic regimens including irinotecan and oxaliplatin, while patients in era 1 were mainly administered fluorouracil and leucovorin for adjuvant chemotherapy. Among patients with CRC recurrence, a significant ratio of those in era 2 underwent surgical resection for recurrent lesions, and these patients had a better survival curve than did patients without resection (34.1% vs. 2.2% for 5-year survival; p Conclusion The incidence of CRC recurrence after LR for hepatic metastasis remains very high. However, the management and outcomes of patients with CRC hepatic metastasis have greatly improved with time, suggesting that the current use of aggressive multimodality treatments including surgical resection combined with modern chemotherapeutic regimens effectively prolongs the life expectancy of these patients.

  18. The family void: treatment and theoretical aspects of the synchronous family paradigm.

    Science.gov (United States)

    Constantine, L L; Israel, J T

    1985-12-01

    The synchronous paradigm is a model of families whose members remain uninvolved and disconnected from each other yet somehow maintain relatively unvarying or even rigid patterns of behavior. In the synchronous paradigm, calm agreement and harmonious unity of action are valued above all. The concept of synchronous operation was first formulated by Constantine to solve certain theoretical problems growing out of the work of Kantor and Lehr. The theory has been elaborated upon through linkages established with other clinical and theoretical models of family dysfunction. Clinical experience in treating synchronous families has now contributed more detailed and practical understanding. Clinically, disabled synchronous families may present as bland, boring, or even death-like. They may have considerable difficulty accommodating to necessary developmental changes or to the demands of life crises, employing a variety of strategies to maintain the appearance of synchrony at the expense of adaptation. Their ability to ignore change and to absorb interventions can tax the abilities of even the most creative and energetic therapist. On the other hand, the quiet efficiency of the family and the social sensitivity of its members can be strong assets. Awareness of their strengths and special vulnerabilities can help the family therapist work more effectively with synchronous families.

  19. Phage Therapy: Combating Infections with Potential for Evolving from Merely a Treatment for Complications to Targeting Diseases

    Directory of Open Access Journals (Sweden)

    Andrzej Gorski

    2016-09-01

    Full Text Available Antimicrobial resistance is considered to be one of the greatest challenges of medicine and our civilization. Lack of progress in developing new anti-bacterial agents has greatly revived interest in using phage therapy to combat antibiotic-resistant infections. Although a number of clinical trials are underway and more are planned, the realistic perspective of registration of phage preparations and their entering the health market and significantly contributing to the current antimicrobial crisis is rather remote. Therefore, in addition to planning further clinical trials, our present approach of phage treatment carried out as experimental therapy (compassionate use should be expanded to address the growing and urgent needs of increasing cohorts of patients for whom no alternative treatment is currently available. During the past eleven years of our phage therapy center`s operation we have obtained relevant clinical and laboratory data which not only confirm the safety of the therapy but also provide important information shedding more light on many aspects of the therapy, contributing to its optimization and allowing for construction of the most appropriate clinical trials. New data on phage biology and interactions with the immune system suggest that in the future phage therapy may evolve from dealing with complications to targeting diseases. However, further studies are necessary to confirm this promising trend.

  20. Is it time for a new paradigm for systemic cancer treatment? Lessons from a century of cancer chemotherapy

    Directory of Open Access Journals (Sweden)

    Sarah eCrawford

    2013-06-01

    Full Text Available U.S. SEER data for age-adjusted mortality rates for all cancers combined for all races show only a modest overall 13% decline over the past 35 years. Moreover, the greatest contributor to cancer mortality is treatment resistant metastatic disease. The accepted therapeutic paradigm for the past half century for the treatment of advanced cancers has involved the use of systemic chemotherapy drugs cytotoxic for cycling cells (both normal and malignant during DNA synthesis and/or mitosis. The failure of this therapeutic modality to achieve high level, consistent rates of disease free survival for some of the most common cancers, including tumors of the lung, colon breast, brain, melanoma and others is the focus of this paper. A retrospective assessment of critical milestones in cancer chemotherapy indicates that most successful therapeutic regimens use cytotoxic cell cycle inhibitors in combined, maximum tolerated, dose dense acute treatment regimens originally developed to treat acute lymphoblastic leukemia and some lymphomas. Early clinical successes in this area led to their wholesale application to the treatment of solid tumor malignancies that, unfortunately, has not produced consistent, long-term high cure rates for many common cancers. Important differences in therapeutic sensitivity of leukemias/lymphomas versus solid tumors can be explained by key biological differences that define the treatment resistant solid tumor phenotype. A review of these clinical outcome data in the context of recent developments in our understanding of drug resistance mechanisms characteristic of solid tumors suggests the need for a new paradigm for the treatment of chemotherapy-resistant cancers. In contrast to reductionist approaches, the systemic approach targets both micro-environmental and systemic factors that drive and sustain tumor progression. These systemic factors include dysregulated inflammatory and oxidation pathways shown to be directly implicated in

  1. [Study on the skin-core evolvement of carbon fibers as a function of heat treatment temperature by Raman spectroscopy].

    Science.gov (United States)

    Liu, Fu-jie; Fan, Li-dong; Wang, Hao-jing; Zhu, Zhen-ping

    2008-08-01

    The skin-core evolvement of the carbon fibers was studied as a function of heat-treatment temperature though the analysis of Raman spectroscopy of the carbon fibers surface and core. It was found that the change of the Raman spectra of the carbon fibers core was similar to that on the surface with the increase in heat-treatment temperature. At 1600 degrees C, the Rs and Rc values were almost equal, indicating that the degrees of the graphitization of the carbon fibers surface and core were almost uniform. The Rs and Rc values decreased dramatically with the increase in heat-treatment temperature, and Rs decreased more. At 2800 degrees C, the Rs value came to 0.429, lowered 77.2%, while the Rc value then came to 1.101, lowered 38.7% only. It implied that the graphitization degree of the carbon fibers was enhanced with increasing the heat treatment temperature, and that of carbon fibers surface was enhanced more. The graphite characters of the carbon of the carbon fibers surface were different from that of the carbon fibers core. The former is close to soft carbon, which is easy to graphitize, while the latter is close to hard carbon, which is difficult to graphitize, and it may be resin carbon Skin-core structure gene Rsc (= Rs/Rc) which denoted the skin-core degree of the carbon fibers was first brought forward and adopted. The Rsc value is between 0 and 1. When the Rsc value is equal to 1, the carbon fibers are homogenous. When the Rsc value is close to zero, there are serious skin-core structures in the carbon fibers. The Rsc value reduced linearly with the increase in heat-treatment temperature, indicating that the homogeneous degrees of the carbon fibers decreased and the skin-core degrees of the carbon fibers increased. The crystallite size of the carbon fibers surface and core increased gradually with the increase in heat-treatment temperature, but the surface's increased more quickly, indicating that the carbon of the carbon fibers surface was easier to

  2. WSC-07: Evolving the Web Services Challenge

    NARCIS (Netherlands)

    Blake, M. Brian; Cheung, William K.W.; Jaeger, Michael C.; Wombacher, Andreas

    Service-oriented architecture (SOA) is an evolving architectural paradigm where businesses can expose their capabilities as modular, network-accessible software services. By decomposing capabilities into modular services, organizations can share their offerings at multiple levels of granularity

  3. Agricultural use of treated wastewater: the need for a paradigm shift in sanitation & treatment

    OpenAIRE

    Van, Lier, G; Huibers, F.P.

    2004-01-01

    Appropriate treated domestic sewage can be regarded as iseal for irrigation and fertilization purposes, particularly in the (semi)arid climate region. This contribution focuses on: 1) pathogens, various levels of interception; 2) basic wastewater treatment; 3) wastewater treatment for effluent use in irrigated agriculture; 4) effluent treatment for agricultural re-use

  4. Agricultural use of treated wastewater: the need for a paradigm shift in sanitation & treatment

    NARCIS (Netherlands)

    Lier, van J.B.; Huibers, F.P.

    2004-01-01

    Appropriate treated domestic sewage can be regarded as iseal for irrigation and fertilization purposes, particularly in the (semi)arid climate region. This contribution focuses on: 1) pathogens, various levels of interception; 2) basic wastewater treatment; 3) wastewater treatment for effluent use

  5. Incorporating bazedoxifene into the treatment paradigm for postmenopausal osteoporosis in Japan.

    Science.gov (United States)

    Ohta, H; Solanki, J

    2015-03-01

    The incidence of osteoporosis-related fractures in Asian countries is steadily increasing. Optimizing osteoporosis treatment is especially important in Japan, where the rate of aging is increasing rapidlyelderly population is increasing rapidly and life expectancy is among the longest in the world. There are several therapies currently available in Japan for the treatment of postmenopausal osteoporosis, each with a unique risk/benefit profile. A novel selective estrogen receptor modulator, bazedoxifene (BZA), was recently approved for the treatment of postmenopausal osteoporosis in Japan. Results from a 2-year, phase 2 trial in postmenopausal Japanese women showed that BZA significantly improved lumbar spine and total hip bone mineral density compared with placebo, while maintaining endometrial and breast safety, consistent with results from 2 global, phase 3 trials including a 2-year osteoporosis prevention study and a 3-year osteoporosis treatment study. In the pivotal 3-year treatment study, BZA significantly reduced the incidence of new vertebral fractures compared with placebo; in a post hoc analysis of a subgroup of women at higher risk of fractures, BZA significantly reduced the risk of nonvertebral fractures compared with placebo and raloxifene. A 2-year extension of the 3-year treatment study demonstrated the sustained efficacy of BZA over 5 years of treatment. BZA was generally safe and well tolerated in these studies. In a "super-aging" society such as Japan, long-term treatment for postmenopausal osteoporosis is a considerable need. BZA may be considered as a first choice for younger women anticipating long-term treatment, and also an appropriate option for older women who are unable or unwilling to take bisphosphonates.

  6. Maintaining evolvability.

    Science.gov (United States)

    Crow, James F

    2008-12-01

    Although molecular methods, such as QTL mapping, have revealed a number of loci with large effects, it is still likely that the bulk of quantitative variability is due to multiple factors, each with small effect. Typically, these have a large additive component. Conventional wisdom argues that selection, natural or artificial, uses up additive variance and thus depletes its supply. Over time, the variance should be reduced, and at equilibrium be near zero. This is especially expected for fitness and traits highly correlated with it. Yet, populations typically have a great deal of additive variance, and do not seem to run out of genetic variability even after many generations of directional selection. Long-term selection experiments show that populations continue to retain seemingly undiminished additive variance despite large changes in the mean value. I propose that there are several reasons for this. (i) The environment is continually changing so that what was formerly most fit no longer is. (ii) There is an input of genetic variance from mutation, and sometimes from migration. (iii) As intermediate-frequency alleles increase in frequency towards one, producing less variance (as p --> 1, p(1 - p) --> 0), others that were originally near zero become more common and increase the variance. Thus, a roughly constant variance is maintained. (iv) There is always selection for fitness and for characters closely related to it. To the extent that the trait is heritable, later generations inherit a disproportionate number of genes acting additively on the trait, thus increasing genetic variance. For these reasons a selected population retains its ability to evolve. Of course, genes with large effect are also important. Conspicuous examples are the small number of loci that changed teosinte to maize, and major phylogenetic changes in the animal kingdom. The relative importance of these along with duplications, chromosome rearrangements, horizontal transmission and polyploidy

  7. Voice outcomes following treatment of benign midmembranous vocal fold lesions using a nomenclature paradigm.

    Science.gov (United States)

    Akbulut, Sevtap; Gartner-Schmidt, Jackie L; Gillespie, Amanda I; Young, VyVy N; Smith, Libby J; Rosen, Clark A

    2016-02-01

    Benign midmembranous vocal fold lesions (BMVFLs) are common voice disorders, but interpretation of outcomes following treatment is difficult due to the lack of a standardized nomenclature system for these lesions. Outcome results are increasingly important to third party payers. This study aimed to investigate the outcomes of patients with BMVFLs using a previously validated nomenclature, and to provide incidences and outcome results for each diagnosis. A retrospective chart review of BMVFL patients was performed. Treatment was individualized but typically involved implementation of nonsurgical therapy followed by phonomicrosurgery as needed. A previously reported BMVFL stratification system was used. A total of 224 patients with BMVFLs were studied. Sixty-seven percent of all patients with a BMVFL underwent phonomicrosurgery. The most common BMVFL types were polyp and nonspecific vocal fold lesion. Pseudocyst represented 0.9% of the cohort. The Voice Handicap Index-10 (VHI-10) and acoustic data demonstrate a high degree of treatment success. The mean change in VHI-10 was greatest for cyst-subepithelial and polyp. Fibrous mass-ligamentous patients had the smallest mean change in VHI-10. Mean post-treatment VHI-10 scores of all the lesions except fibrous mass-ligamentous were within normal limits (<11). This study represents the first outcomes-based report of BMVFLs using a strictly defined nomenclature system for stratification of lesions. Ligamentous fibrous mass lesions have a decreased response to treatment compared to all other lesions. This study demonstrates the ability to return most BMVFL patients to normal speaking voice capabilities following treatment. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Interferon alfa in the treatment paradigm for non-muscle-invasive bladder cancer.

    Science.gov (United States)

    Lamm, Donald; Brausi, Maurizio; O'Donnell, Michael A; Witjes, J Alfred

    2014-01-01

    In this article, we review the various options for and the potential role of interferon alfa (IFN-α) in the treatment of non-muscle-invasive bladder cancer (NMIBC). PubMed was searched for journal articles on IFN-α use in treating bladder cancer. The references listed in the National Comprehensive Cancer Network guidelines were used as a guide to identify relevant publications on treatments for NMIBC. Transurethral resection with adjuvant intravesical chemotherapy or immunotherapy is the standard treatment option for NMIBC. Adjuvant IFN-α therapy has limited efficacy in preventing recurrences in intermediate-risk and high-risk patients; bacillus Calmette-Guérin (BCG) monotherapy is the recommended first-line treatment in these patients. Unfortunately, cancer progression or recurrence is a common outcome; radical cystectomy, which is often the lifesaving approach in such a scenario, is associated with significant morbidity, mortality, and decreased quality of life. Current alternatives to cystectomy include repeat intravesical immunotherapy, conventional instillation chemotherapy, and device-assisted intravesical chemotherapy. The efficacy of any chemotherapy after BCG failure, either conventional or device assisted, has not been established. BCG and IFN-α combination intravesical therapy has not been investigated thoroughly; based on available data, combination therapy appears to be most effective in patients with carcinoma in situ and may be preferentially considered as an alternative to radical cystectomy for patients with intermediate-risk or high-risk NMIBC who do not tolerate the standard BCG dose or experience BCG failure after 1 year of therapy. However, this approach requires close follow-up and should only be chosen after careful consideration of all risk factors. There is a lack of efficacious treatment options for patients with NMIBC recurrence or progression after initial BCG treatment. There is a need for well-designed clinical trials

  9. Interferon alfa in the treatment paradigm for non-muscle-invasive bladder cancer

    NARCIS (Netherlands)

    Lamm, D.; Brausi, M.; O'Donnell, M.A.; Witjes, J.A.

    2014-01-01

    OBJECTIVES: In this article, we review the various options for and the potential role of interferon alfa (IFN-alpha) in the treatment of non-muscle-invasive bladder cancer (NMIBC). METHODS: PubMed was searched for journal articles on IFN-alpha use in treating bladder cancer. The references listed in

  10. Preventing bleeds by treatment: new era for haemophilia changing the paradigm.

    Science.gov (United States)

    Marijke van den Berg, H

    2016-07-01

    Coagulation products have allowed patients with severe haemophilia to lead a normal life. This is, however, only true for patients who received an early diagnosis and could start with primary prophylaxis. The absence of a positive family history for haemophilia, in the majority of children with severe haemophilia, postpones the age that treatment can be started. This makes general awareness of the clinical presentation important and a proper diagnosis a prerequisite for progress. The long delay between joint bleeding and overt arthropathy has been an important factor in the delay of implementation of primary prophylaxis. After the development of guidelines on 'how to treat', implementation of the advised practice is needed. Data collection of current treatment regimens in haemophilia centres will support the further optimization of the care for persons with haemophilia and further optimize treatment guidelines. Episodic ('on demand') therapy as a treatment strategy for severe haemophilia needs reconsideration. In an era where clotting factor concentrates are abundant and gene therapy a reality, all patients with severe haemophilia should be offered a strategy of bleeding prevention. © 2016 John Wiley & Sons Ltd.

  11. New paradigms in the treatment of hepatic cholestasis: from UDCA to FXR, PXR and beyond

    NARCIS (Netherlands)

    Beuers, Ulrich; Trauner, Michael; Jansen, Peter; Poupon, Raoul

    2015-01-01

    Cholestasis is an impairment of bile formation/flow at the level of the hepatocyte and/or cholangiocyte. The first, and for the moment, most established medical treatment is the natural bile acid (BA) ursodeoxycholic acid (UDCA). This secretagogue improves, e.g. in intrahepatic cholestasis of

  12. Fatal water intoxication and cardiac arrest in runners during marathons: prevention and treatment based on validated clinical paradigms.

    Science.gov (United States)

    Siegel, Arthur J

    2015-10-01

    Cerebral edema due to exercise-associated hyponatremia and cardiac arrest due to atherosclerotic heart disease cause rare marathon-related fatalities in young female and middle-aged male runners, respectively. Studies in asymptomatic middle-aged male physician-runners during races identified inflammation due to skeletal muscle injury after glycogen depletion as the shared underlying cause. Nonosmotic secretion of arginine vasopressin as a neuroendocrine stress response to rhabdomyolysis mediates hyponatremia as a variant of the syndrome of inappropriate antidiuretic hormone secretion. Fatal hyponatremic encephalopathy in young female runners was curtailed using emergent infusion of intravenous hypertonic (3%) saline to reverse cerebral edema on the basis of this paradigm. This treatment was arrived at through a consensus process within the medical community. An increasing frequency of cardiac arrest and sudden death has been identified in middle-aged male runners in 2 studies since the year 2000. Same-aged asymptomatic male physician-runners showed post-race elevations in interleukin-6 and C-reactive protein, biomarkers that predict acute cardiac events in healthy persons. Hypercoagulability with in vivo platelet activation and release of cardiac troponin and N-terminal pro-brain natriuretic peptide were also observed post-race in these same subjects. High short-term risk for atherothrombosis during races as shown by stratification of biomarkers in asymptomatic men may render nonobstructive coronary atherosclerotic plaques vulnerable to rupture. Pre-race aspirin use in this high-risk subgroup is prudent according to conclusive evidence for preventing first acute myocardial infarctions in same-aged healthy male physicians. On the basis of validated clinical paradigms, taking a low-dose aspirin before a marathon and drinking to thirst during the race may avert preventable deaths in susceptible runners. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Totality of outcomes: A different paradigm in assessing interventions for treatment of tuberculosis

    Directory of Open Access Journals (Sweden)

    Grace Montepiedra

    2016-08-01

    Full Text Available Conventional analytic methods used for tuberculosis (TB outcomes research use standardized outcomes definitions and assess safety and efficacy separately. These methods are subject to important limitations. Conventionally utilized outcome definitions fail to capture important aspects of patients' treatment experience and obscure meaningful differences between patients.Assessing safety and efficacy separately fails to yield an objective risk–benefit comparison to guide clinical practice. We propose to address these issues through an analytic approach based on prioritized outcomes. This approach enables a more comprehensive and integrated assessment of TB interventions. It simultaneously considers a “totality of outcomes”, including clinical benefit, adverse events, and quality of life. These composite outcomes are ranked terms of overall desirability and compared using statistical methods for ordinal outcomes. Here we discuss the application of this approach to TB research, the considerations involved with prioritizing TB treatment outcomes, and the statistical methods involved in comparing prioritized outcomes. Keywords: Tuberculosis, Treatment outcome, Risk–benefit assessment

  14. Age-Related Macular Degeneration: New Paradigms for Treatment and Management of AMD

    Directory of Open Access Journals (Sweden)

    Luis Fernando Hernández-Zimbrón

    2018-01-01

    Full Text Available Age-related macular degeneration (AMD is a well-characterized and extensively studied disease. It is currently considered the leading cause of visual disability among patients over 60 years. The hallmark of early AMD is the formation of drusen, pigmentary changes at the macula, and mild to moderate vision loss. There are two forms of AMD: the “dry” and the “wet” form that is less frequent but is responsible for 90% of acute blindness due to AMD. Risk factors have been associated with AMD progression, and they are taking relevance to understand how AMD develops: (1 advanced age and the exposition to environmental factors inducing high levels of oxidative stress damaging the macula and (2 this damage, which causes inflammation inducing a vicious cycle, altogether causing central vision loss. There is neither a cure nor treatment to prevent AMD. However, there are some treatments available for the wet form of AMD. This article will review some molecular and cellular mechanisms associated with the onset of AMD focusing on feasible treatments for each related factor in the development of this pathology such as vascular endothelial growth factor, oxidative stress, failure of the clearance of proteins and organelles, and glial cell dysfunction in AMD.

  15. GHOST Protocol: Greatest Healing Opportunity for Soft Tissue, a Treatment Paradigm for Complex Sarcoma Reconstruction.

    Science.gov (United States)

    Kobraei, Edward M; Eberlin, Kyle R; Ricci, Joseph A; Reish, Richard G; Winograd, Jonathan M; Cetrulo, Curtis L

    2015-06-01

    Modern sarcoma treatment has created new challenges for plastic surgeons. This study was designed to review the recent experience and practice patterns following complex sarcoma resection at a large sarcoma center. All cases from October 2013 to October 2014 involving rare nonepithelial tumors, a multidisciplinary surgical team, radiation and/or chemotherapy treatments, and plastic surgical reconstruction were included in the analysis. In addition to evaluating clinical outcomes, cases were reviewed to identify factors associated with excellent or poor patient care. Review of these cases formed the basis of the greatest healing opportunity for soft tissue (GHOST) protocol. Our patient population included seven males (64%) and four females (36%). All except one patient was exposed to radiotherapy, chemotherapy, or some combination. Diverse procedures were used for reconstruction. Early complications occurred in two patients (18%), and late complications in four patients (36%). Sarcoma resection was found to be highly morbid in our series. Patients with poor preoperative nutritional status were more likely to experience complications postoperatively. The decision to stage a reconstruction was complex and influenced by several factors. Multimodal sarcoma treatments may involve highly morbid procedures and create complex wounds. The GHOST protocol is a useful reference for plastic surgeons.

  16. A three-paradigm treatment model using soft tissue mobilization and guided movement-awareness techniques for a patient with chronic low back pain: a case study.

    Science.gov (United States)

    Cottingham, J T; Maitland, J

    1997-09-01

    It is not uncommon for physical therapists to report difficulty in treating certain subjects with chronic idiopathic low back pain. The purpose of this case study is to present a three-paradigm model of intervention that may be adapted to the treatment of such cases. The model consists of: 1) relaxation paradigm, consisting of pain modulation procedures; 2) corrective paradigm, involving manual techniques and exercise to correct specific faulty biomechanical alignment(s) eg., pelvic asymmetry); and 3) integrative paradigm, utilizing guided movement/mobilization techniques for improving the subject's overall pattern of posture and movement. The case study of a young adult with chronic low back pain correlated with unilateral innominate bone rotation is presented to illustrate the three-paradigm approach. Over six sessions, the subject received a corrective (sessions 1-3) and an integrative treatment protocol (sessions 4-6) consisting of Rolf's method of soft tissue mobilization and Alexander's system of guided movement-awareness techniques. Before and after each session and after a 4-week follow-up, the subject was assessed for sacroiliac joint pain using a compression technique, anterior rotation of the innominate bones, pelvic angle in the standing position, and vagal tone as determined from heart rate variability. The therapist's visual analysis of sit-to-stand movement and the subject's self-reports of pain were noted. A corrective paradigm protocol of soft tissue mobilization and exercise was unsuccessful in eliminating the subject's assessed anterior rotation of the innominate bone and associated low back pain for more than 1-2 days posttreatment. Only after the implementation of a third paradigm movement/mobilization protocol did the subject begin to exhibit sustained improvement through a 4-week follow-up. Interpretations of the results, appropriate selection of corrective and integrative protocols, and physiological mechanisms are discussed.

  17. Patient variables and referral paradigms associated with osteoporosis screening and treatment in neurosurgical patients undergoing kyphoplasty.

    Science.gov (United States)

    Morr, Simon; Shakir, Hakeem J; Lipinski, Lindsay J; Dimopoulos, Vassilios G; Leonardo, Jody; Pollina, John

    2015-12-01

    OBJECT Vertebral fractures are the most common osteoporotic fracture. Bone density testing and medical treatment with bisphosphonates or parathormone are recommended for all patients with an osteoporotic fracture diagnosis. Inadequate testing and treatment of patients presenting with low-impact fractures have been reported in various specialties. Similar data are not available from academic neurosurgery groups. The authors assessed compliance with treatment and testing of osteoporosis in patients with vertebral compression fractures evaluated by the authors' academic neurosurgery service, and patient variable and health-systems factors associated with improved compliance. METHODS Data for patients who underwent percutaneous kyphoplasty for compression fractures was retrospectively collected. Diagnostic and medical interventions were tabulated. Pre-, intra-, and posthospital factors that had been theorized to affect the compliance of patients with osteoporosis-related therapies were tabulated and statistically analyzed. RESULTS Less than 50% of patients with kyphoplasty received such therapies. Age was not found to correlate with other variables. Referral from a specialist rather than a primary care physician was associated with a higher rate of bone density screening, as well as vitamin D and calcium therapy, but not bisphosphonate/parathormone therapy. Patients who underwent preoperative evaluation by their primary care physician were significantly more likely to receive bisphosphonates compared with those only evaluated by a hospitalist. Patients with unprovoked fractures were more likely to undergo multiple surgeries compared with those with minor trauma. CONCLUSIONS These results suggest poor compliance with current standard of care for medical therapies in patients with osteoporotic compression fractures undergoing kyphoplasty under the care of an academic neurosurgery service.

  18. The ketogenic diet as a treatment paradigm for diverse neurological disorders.

    Science.gov (United States)

    Stafstrom, Carl E; Rho, Jong M

    2012-01-01

    Dietary and metabolic therapies have been attempted in a wide variety of neurological diseases, including epilepsy, headache, neurotrauma, Alzheimer disease, Parkinson disease, sleep disorders, brain cancer, autism, pain, and multiple sclerosis. The impetus for using various diets to treat - or at least ameliorate symptoms of - these disorders stems from both a lack of effectiveness of pharmacological therapies, and also the intrinsic appeal of implementing a more "natural" treatment. The enormous spectrum of pathophysiological mechanisms underlying the aforementioned diseases would suggest a degree of complexity that cannot be impacted universally by any single dietary treatment. Yet, it is conceivable that alterations in certain dietary constituents could affect the course and impact the outcome of these brain disorders. Further, it is possible that a final common neurometabolic pathway might be influenced by a variety of dietary interventions. The most notable example of a dietary treatment with proven efficacy against a neurological condition is the high-fat, low-carbohydrate ketogenic diet (KD) used in patients with medically intractable epilepsy. While the mechanisms through which the KD works remain unclear, there is now compelling evidence that its efficacy is likely related to the normalization of aberrant energy metabolism. The concept that many neurological conditions are linked pathophysiologically to energy dysregulation could well provide a common research and experimental therapeutics platform, from which the course of several neurological diseases could be favorably influenced by dietary means. Here we provide an overview of studies using the KD in a wide panoply of neurologic disorders in which neuroprotection is an essential component.

  19. THE KETOGENIC DIET AS A TREATMENT PARADIGM FOR DIVERSE NEUROLOGICAL DISORDERS

    Directory of Open Access Journals (Sweden)

    Jong Min Rho

    2012-04-01

    Full Text Available Dietary and metabolic therapies have been attempted in a wide variety of neurological diseases, including epilepsy, headache, neurotrauma, Alzheimer disease, Parkinson disease, sleep disorders, brain cancer, autism, pain, and multiple sclerosis. The impetus for using various diets to treat – or at least ameliorate symptoms of – these disorders stems from both a lack of effectiveness of pharmacological therapies, and also the intrinsic appeal of implementing a more natural treatment. The enormous spectrum of pathophysiological mechanisms underlying the aforementioned diseases would suggest a degree of complexity that cannot be impacted universally by any single dietary treatment. Yet, it is conceivable that alterations in certain dietary constituents could affect the course and impact the outcome of these brain disorders. Further, it is possible that a final common neurometabolic pathway might be influenced by a variety of dietary interventions. The most notable example of a dietary treatment with proven efficacy against a neurological condition is the high-fat, low-carbohydrate ketogenic diet (KD used in patients with medically intractable epilepsy. While the mechanisms through which the KD works remain unclear, there is now compelling evidence that its efficacy is likely related to the normalization of aberrant energy metabolism. The concept that many neurological conditions are linked pathophysiologically to energy dysregulation could well provide a common research and experimental therapeutics platform, from which the course of several neurological diseases could be favorably influenced by dietary means. Here we provide an overview of studies using the KD in a wide panoply of neurologic disorders in which neuroprotection is an essential component.

  20. Management of pediatric intracranial gunshot wounds: predictors of favorable clinical outcome and a new proposed treatment paradigm.

    Science.gov (United States)

    Bandt, S Kathleen; Greenberg, Jacob K; Yarbrough, Chester K; Schechtman, Kenneth B; Limbrick, David D; Leonard, Jeffrey R

    2012-12-01

    There has been an increase in civilian gun violence since the late 1980s, with a disproportionately high increase occurring within the pediatric population. To date, no definite treatment paradigm exists for the management of these patients, nor is there a full understanding of the predictors of favorable clinical outcome in this population. The authors completed a retrospective review of all victims of intracranial gunshot injury from birth to age 18 years at a major metropolitan Level 1 trauma center (n = 48) from 2002 to 2011. The predictive values of widely accepted adult clinical and radiographic factors for poor prognosis were investigated. Eight statistically significant factors (p 100 mm Hg on arrival, absence of deep nuclei and/or third ventricular involvement, initial ICP injuries. The pediatric population tends to demonstrate more favorable outcomes following intracranial gunshot injury when compared with the adult population; therefore some patients may benefit from more aggressive treatment than is considered for adults. The St. Louis Scale for Pediatric Gunshot Wounds to the Head may provide critical data toward evidence-based guidelines for clinical decision making.

  1. The present and future disease burden of hepatitis C virus infections with today's treatment paradigm: Volume 4.

    Science.gov (United States)

    Chan, H L Y; Chen, C J; Omede, O; Al Qamish, J; Al Naamani, K; Bane, A; Tan, S S; Simonova, M; Cardenas, I; Derbala, M; Akin, O; Phillips, R O; Abdelmageed, M K; Abdulla, M; Adda, D; Al Baqali, A; Al Dweik, N; Al Ejji, K; Al Ghazzawi, I; Al Kaabi, S; Al Sadadi, M; Al Salman, J; AlBadri, M; Al-Busafi, S A; Al-Romaihi, H E; Ampofo, W; Antonov, K; Anyaike, C; Arome, F; Blach, S; Borodo, M M; Brandon, S M; Bright, B; Butt, M T; Chen, D S; Chen, P J; Chien, R N; Chuang, W L; Cuellar, D; Elbardiny, A A; Estes, C; Farag, E; Fung, J; Gamkrelidze, I; Garcia, V; Genov, J; Ghandour, Z; Ghuloom, M; Gomez, B; Gunter, J; Habeeb, J; Hajelssedig, O; Hamoudi, W; Himatt, S M; Hrstic, I; Hu, C C; Huang, C F; Hui, Y T; Jahis, R; Jelev, D; John, A K; Kaliaskarova, K S; Kamel, Y; Kao, J H; Khamis, J; Khattabi, H; Khoudri, I; Konysbekova, A; Kotzev, I; Lai, M S; Lao, W C; Layden, J; Lee, M H; Lesi, O; Li, M; Lo, A; Loo, C K; Lukšić, B; Maaroufi, A; Malu, A O; Mateva, L; Mitova, R; Mohamed, R; Morović, M; Murphy, K; Mustapha, B; Nersesov, A; Ngige, E; Njouom, R; Njoya, O; Nonković, D; Obekpa, S; Oguche, S; Okolo, E E; Omuemu, C; Ondoa, P; Opare-Sem, O; Owusu-Ofori, S; Prokopenko, Y N; Razavi, H; Razavi-Shearer, D; Razavi-Shearer, K; Redae, B; Reic, T; Rinke de Wit, T; Rios, C; Robbins, S; Roberts, L R; Sanad, S J; Schmelzer, J D; Sharma, M; Su, T H; Sultan, K; Tchernev, K; Tsang, O T Y; Tsang, S; Tzeuton, C; Ugoeze, S; Uzochukwu, B; Vi, R; Vince, A; Wani, H U; Wong, V W S; Workneh, A; Yacoub, R; Yesmembetov, K I; Youbi, M; Yuen, M F; Nde, H

    2017-10-01

    Factors influencing the morbidity and mortality associated with viremic hepatitis C virus (HCV) infection change over time and place, making it difficult to compare reported estimates. Models were developed for 17 countries (Bahrain, Bulgaria, Cameroon, Colombia, Croatia, Dominican Republic, Ethiopia, Ghana, Hong Kong, Jordan, Kazakhstan, Malaysia, Morocco, Nigeria, Qatar and Taiwan) to quantify and characterize the viremic population as well as forecast the changes in the infected population and the corresponding disease burden from 2015 to 2030. Model inputs were agreed upon through expert consensus, and a standardized methodology was followed to allow for comparison across countries. The viremic prevalence is expected to remain constant or decline in all but four countries (Ethiopia, Ghana, Jordan and Oman); however, HCV-related morbidity and mortality will increase in all countries except Qatar and Taiwan. In Qatar, the high-treatment rate will contribute to a reduction in total cases and HCV-related morbidity by 2030. In the remaining countries, however, the current treatment paradigm will be insufficient to achieve large reductions in HCV-related morbidity and mortality. © 2017 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

  2. Is Endoluminal Bariatric Therapy a New Paradigm of Treatment for Obesity?

    Science.gov (United States)

    Fanelli, Robert D; Andrew, Brandon D

    2016-04-01

    The prevalence of obesity has steadily increased throughout recent decades, and along with it, the costs of caring for the associated comorbid conditions has increased as well. Traditional bariatric surgical procedures generally are safe and effective, but patient acceptance, the risk of minor and sometimes serious complications, costs, and insurance coverage have limited the application of these techniques to the treatment of a minority of patients. Endoluminal techniques represent newer approaches to weight loss that can be used independently or in concert with traditional medical and surgical treatments for obesity, with varying degrees of success. It is anticipated that less invasiveness will increase the appeal across a broader representation of patients, perhaps increasing the number of obese patients who choose an intervention over medical management and possibly resulting in a greater total loss of excess body weight across a population; this may reduce costs involved in treating the complications of weight-related comorbidities. Acceptance of endoluminal bariatric procedures and devices will hinge on proving safety, efficacy, and value. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  3. Lake Recovery Through Reduced Sulfate Deposition: A New Paradigm for Drinking Water Treatment.

    Science.gov (United States)

    Anderson, Lindsay E; Krkošek, Wendy H; Stoddart, Amina K; Trueman, Benjamin F; Gagnon, Graham A

    2017-02-07

    This study examined sulfate deposition in Nova Scotia from 1999 to 2015, and its association with increased pH and organic matter in two protected surface water supplies (Pockwock Lake and Lake Major) located in Halifax, Nova Scotia. The study also examined the effect of lake water chemistry on drinking water treatment processes. Sulfate deposition in the region decreased by 68%, whereas pH increased by 0.1-0.4 units over the 16-year period. Average monthly color concentrations in Pockwock Lake and Lake Major increased by 1.7 and 3.8×, respectively. Accordingly, the coagulant demand increased by 1.5 and 3.8× for the water treatment plants supplied by Pockwock Lake and Lake Major. Not only was this coagulant increase costly for the utility, it also resulted in compromised filter performance, particularly for the direct-biofiltration plant supplied by Pockwock Lake that was found to already be operating at the upper limit of the recommended direct filtration thresholds for color, total organic carbon and coagulant dose. Additionally, in 2012-2013 geosmin occurred in Pockwock Lake, which could have been attributed to reduced sulfate deposition as increases in pH favor more diverse cyanobacteria populations. Overall, this study demonstrated the impact that ambient air quality can have on drinking water supplies.

  4. Transoral surgery for laryngo-pharyngeal cancer - The paradigm shift of the head and cancer treatment.

    Science.gov (United States)

    Tateya, Ichiro; Shiotani, Akihiro; Satou, Yasuo; Tomifuji, Masayuki; Morita, Shuko; Muto, Manabu; Ito, Juichi

    2016-02-01

    Transoral surgery is a less invasive treatment that is becoming a major strategy in the treatment of laryngo-pharyngeal cancer. It is a minimally invasive approach that has no skin incision and limits the extent of tissue dissection, disruption of speech and swallowing muscles, blood loss, damage to major neurovascular structures, and injury to normal tissue. Transoral approaches to the laryngo-pharynx, except for early glottis cancer, had been limited traditionally to tumors that can be observed directly and manipulated with standard instrumentation and lighting. Since the 1990s, transoral laser microsurgery (TLM) has been used as an organ preservation strategy with good oncological control and good functional results, although it has not been widely used because of its technical difficulty. Recently, transoral robotic surgery (TORS) is becoming popular as a new treatment modality for laryngo-pharyngeal cancer, and surgical robots are used widely in the world since United States FDA approval in 2009. In spite of the global spread of TORS, it has not been approved by the Japan FDA, which has led to the development of other low-cost transoral surgical techniques in Japan. Transoral videolaryngoscopic surgery (TOVS) was developed as a new transoral surgery system for laryngo-pharyngeal lesions to address the problems of TLM. In TOVS, a rigid endoscope is used to visualize the surgical field instead of a microscope and the advantages of TOVS include the wide operative field and working space achieved using the distending laryngoscope and videolaryngoscope. Also, with the spread of narrow band imaging (NBI), endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), which are widely used for superficial cancers in the gastrointestinal tract, have been applied for the superficial laryngo-pharyngeal cancer. Both EMR and ESD are performed mainly by gastroenterologists with a sharp dissector and magnifying endoscopy (ME)-NBI with minimal surgical margin

  5. Pathogen-driven gastrointestinal cancers: Time for a change in treatment paradigm?

    Directory of Open Access Journals (Sweden)

    Aituov Bauyrzhan

    2012-08-01

    Full Text Available Abstract The regulation of cancerous tumor development is converged upon by multiple pathways and factors. Besides environmental factors, gastrointestinal (GI tract cancer can be caused by chronic inflammation, which is generally induced by bacteria, viruses, and parasites. The role of these inducers in cancer development, cell differentiation and transformation, cell cycle deregulation, and in the expression of tumor-associated genes cannot be ignored. Although Helicobacter pylori activates many oncogenic pathways, particularly those in gastric and colorectal cancers, the role of viruses in tumor development is also significant. Viruses possess significant oncogenic potential to interfere with normal cell cycle control and genome stability, stimulating the growth of deregulated cells. An increasing amount of recent data also implies the association of GI cancers with bacterial colonization and viruses. This review focuses on host-cell interactions that facilitate primary mechanisms of tumorigenesis and provides new insights into novel GI cancer treatments.

  6. Endometrial cancer - reduce to the minimum. A new paradigm for adjuvant treatments?

    Directory of Open Access Journals (Sweden)

    Scheithauer Heike R

    2011-11-01

    Full Text Available Abstract Background Up to now, the role of adjuvant radiation therapy and the extent of lymph node dissection for early stage endometrial cancer are controversial. In order to clarify the current position of the given adjuvant treatment options, a systematic review was performed. Materials and methods Both, Pubmed and ISI Web of Knowledge database were searched using the following keywords and MESH headings: "Endometrial cancer", "Endometrial Neoplasms", "Endometrial Neoplasms/radiotherapy", "External beam radiation therapy", "Brachytherapy" and adequate combinations. Conclusion Recent data from randomized trials indicate that external beam radiation therapy - particularly in combination with extended lymph node dissection - or radical lymph node dissection increases toxicity without any improvement of overall survival rates. Thus, reduced surgical aggressiveness and limitation of radiotherapy to vaginal-vault-brachytherapy only is sufficient for most cases of early stage endometrial cancer.

  7. Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment

    Science.gov (United States)

    Lucente, Vincent; van Raalte, Heather; Murphy, Miles; Egorov, Vladimir

    2017-01-01

    Background Further progress in restoring a woman’s health may be possible if a patient with a damaged pelvic floor could undergo medical imaging and biomechanical diagnostic tests. The results of such tests could contribute to the analysis of multiple treatment options and suggest the optimal one for that patient. Aim To develop a new approach for the biomechanical characterization of vaginal conditions, muscles, and connective tissues in the female pelvic floor. Methods Vaginal tactile imaging (VTI) allows biomechanical assessment of the soft tissue along the entire length of the anterior, posterior, and lateral vaginal walls at rest, with manually applied deflection pressures and with muscle contraction, muscle relaxation, and Valsalva maneuver. VTI allows a large body of measurements to evaluate individual variations in tissue elasticity, support defects, as well as pelvic muscle function. Presuming that 1) the female pelvic floor organs are suspended by ligaments against which muscles contract to open or close the outlets and 2) damaged ligaments weaken the support and may reduce the force of muscle contraction, we made an attempt to characterize multiple pelvic floor structures from VTI data. Results All of the 138 women enrolled in the study were successfully examined with the VTI. The study subjects have had normal pelvic support or pelvic organ prolapse (stages I–IV). The average age of this group of subjects was 60±15 years. We transposed a set of 31 VTI parameters into a quantitative characterization of pelvic muscles and ligamentous structures. Interpretation of the acquired VTI data for normal pelvic floor support and prolapse conditions is proposed based on biomechanical assessment of the functional anatomy. Conclusion Vaginal tactile imaging allows biomechanical characterization of female pelvic floor structures and tissues in vivo, which may help to optimize treatment of the diseased conditions such as prolapse, incontinence, atrophy, and some

  8. A comprehensive behavioral theory of autistic children: paradigm for research and treatment.

    Science.gov (United States)

    Lovaas, O I; Smith, T

    1989-03-01

    Although behavioral treatment is the most effective intervention currently available for autistic children, there have been no attempts to present a comprehensive behavioral theory of autistic children since Ferster (1961). The present paper is intended to fill this gap. Behavioral work is distinguished from traditional work with autistic children in three ways: (a) it focuses on specific behaviors rather than on the diagnostic entity of autism; (b) it emphasizes the immediate environment rather than etiology or early history; and (c) research is inductive rather than hypothetico-deductive. The behavioral theory derived from such work has four tenets: (a) autistic children's behaviors are consistent with laws of learning derived from the behavior of other organisms; (b) autistic children have many separate behavioral difficulties best described as a developmental delay; (c) despite their difficulties, many autistic children learn as much as other human beings in certain environments; and (d) their difficulties can be viewed as a mismatch between a deviant nervous system and average or typical environments rather than as a disease. A number of practical and theoretical problems remain that require further research and that would add to the present theory.

  9. Is It Time to Change the Type 2 Diabetes Treatment Paradigm? Yes! GLP-1 RAs Should Replace Metformin in the Type 2 Diabetes Algorithm.

    Science.gov (United States)

    Abdul-Ghani, Muhammad; DeFronzo, Ralph A

    2017-08-01

    Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U.S. However, based on the release of newer agents over the recent past, some have suggested that the modern approach to disease management should be based upon identification of its etiology and correcting the underlying biological disturbances. That is, we should use interventions that normalize or at least ameliorate the recognized derangements in physiology that drive the clinical manifestation of disease, in this circumstance, hyperglycemia. Thus, it is argued that therapeutic interventions that target glycemia but do not correct the underlying pathogenic disturbances are unlikely to result in a sustained benefit on the disease process. In our field, there is an evolving debate regarding the suggested first step in diabetes management and a call for a new paradigm. Given the current controversy, we provide a Point-Counterpoint debate on this issue. In the point narrative below that precedes the counterpoint narrative, Drs. Abdul-Ghani and DeFronzo provide their argument that a treatment approach for type 2 diabetes based upon correcting the underlying pathophysiological abnormalities responsible for the development of hyperglycemia provides the best therapeutic strategy. Such an approach requires a change in the recommendation for first-line therapy from metformin to a GLP-1 receptor agonist. In the counterpoint narrative that follows Drs. Abdul-Ghani and DeFronzo's contribution, Dr. Inzucchi argues that, based on the medical

  10. Paradigm shift in cancer treatment: Cancer treatment as a metabolic disease – fusion of Eastern and Western medicine

    Directory of Open Access Journals (Sweden)

    Reo Hamaguchi

    2017-10-01

    Full Text Available Current standard therapies for cancer, including surgery, anti-cancer drugs, and radiotherapy, are thought to contribute to the improvement in the survival rates of cancer patients. However, such standard therapies have 3 major problems: in advanced cancers, it is unlikely that standard cancer treatments will cure the disease; adverse side effects that accompany standard cancer treatments put many patients in distress; and a large amount of medical expenditure is required for new and expensive anti-cancer drugs. These problems may be viewed as a result of establishing treatments without any consideration regarding the root cause of the cancer. Otto Warburg suggested that particular changes in the energy metabolism of cells, which are associated with a shortage of oxygen, are the root cause of cancer. Cancer cells have unique metabolic characteristics, and thus we believe that it is important to treat cancer as a metabolic disease. More specifically, not only is it important to suppress cancer cell metabolism, but it is also important to improve the chronic inflammation that is associated with the development and progression of cancer, and to support the functions of immune cells. This type of view of cancer treatment coincides with the principles of Chinese medicine, which has a history of 4000 years, such as “fuzheng quxie” and “zhibing qiuben”, which can assist in the establishment of cancer treatments for patients. In this article, we discuss cancer treatments from the view of cancer as a metabolic disease and their association with Chinese medicine, and introduce some clinical cases along with a review of the literature.

  11. Baseline characteristics and treatment of patients in Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF)

    Science.gov (United States)

    McMurray, John J V; Packer, Milton; Desai, Akshay S; Gong, Jianjian; Lefkowitz, Martin; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Solomon, Scott D; Swedberg, Karl; Zile, Michael R

    2014-01-01

    Aim To describe the baseline characteristics and treatment of the patients randomized in the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and morbidity in Heart Failure) trial, testing the hypothesis that the strategy of simultaneously blocking the renin–angiotensin–aldosterone system and augmenting natriuretic peptides with LCZ696 200 mg b.i.d. is superior to enalapril 10 mg b.i.d. in reducing mortality and morbidity in patients with heart failure and reduced ejection fraction. Methods Key demographic, clinical and laboratory findings, along with baseline treatment, are reported and compared with those of patients in the treatment arm of the Studies Of Left Ventricular Dysfunction (SOLVD-T) and more contemporary drug and device trials in heart failure and reduced ejection fraction. Results The mean age of the 8442 patients in PARADIGM-HF is 64 (SD 11) years and 78% are male, which is similar to SOLVD-T and more recent trials. Despite extensive background therapy with beta-blockers (93% patients) and mineralocorticoid receptor antagonists (60%), patients in PARADIGM-HF have persisting symptoms and signs, reduced health related quality of life, a low LVEF (mean 29 ± SD 6%) and elevated N-terminal-proB type-natriuretic peptide levels (median 1608 inter-quartile range 886–3221 pg/mL). Conclusion PARADIGM-HF will determine whether LCZ696 is more beneficial than enalapril when added to other disease-modifying therapies and if further augmentation of endogenous natriuretic peptides will reduce morbidity and mortality in heart failure and reduced ejection fraction. PMID:24828035

  12. Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF).

    Science.gov (United States)

    McMurray, John J V; Packer, Milton; Desai, Akshay S; Gong, Jianjian; Lefkowitz, Martin; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Solomon, Scott D; Swedberg, Karl; Zile, Michael R

    2014-07-01

    To describe the baseline characteristics and treatment of the patients randomized in the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and morbidity in Heart Failure) trial, testing the hypothesis that the strategy of simultaneously blocking the renin-angiotensin-aldosterone system and augmenting natriuretic peptides with LCZ696 200 mg b.i.d. is superior to enalapril 10 mg b.i.d. in reducing mortality and morbidity in patients with heart failure and reduced ejection fraction. Key demographic, clinical and laboratory findings, along with baseline treatment, are reported and compared with those of patients in the treatment arm of the Studies Of Left Ventricular Dysfunction (SOLVD-T) and more contemporary drug and device trials in heart failure and reduced ejection fraction. The mean age of the 8442 patients in PARADIGM-HF is 64 (SD 11) years and 78% are male, which is similar to SOLVD-T and more recent trials. Despite extensive background therapy with beta-blockers (93% patients) and mineralocorticoid receptor antagonists (60%), patients in PARADIGM-HF have persisting symptoms and signs, reduced health related quality of life, a low LVEF (mean 29 ± SD 6%) and elevated N-terminal-proB type-natriuretic peptide levels (median 1608 inter-quartile range 886-3221 pg/mL). PARADIGM-HF will determine whether LCZ696 is more beneficial than enalapril when added to other disease-modifying therapies and if further augmentation of endogenous natriuretic peptides will reduce morbidity and mortality in heart failure and reduced ejection fraction. © 2014 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

  13. Three paradigms of horror

    Directory of Open Access Journals (Sweden)

    Dejan Ognjanović

    2016-07-01

    Full Text Available Starting with the definition of horror as a literary genre the core story of which is based on a meeting with threatening Otherness whose influx into consensual reality and it’s tacit normality creates unrest and awakens fear in the protagonists and the audience, this paper defines the three key paradigms of the horror genre, based on the causes of fear, or rather the “monstrous” Otherness in them. Paradigm 1 concerns the “fear of one’s own self”: the root of the fear is inside, in the individual psyche, in the split, deceived, or in some other way unreliable self which is, consciously or unconsciously, harmful to others, and ultimately to itself. Paradigm 2 deals with the “Fear of others”: the root of fear is outside and is concerned with other people and other creatures which have an urge to occupy a certain human microcosm. Paradigm 3 is concerned with the “Fear of the numinous”: the root of the fear is mostly situated on the outside; however its shape is amorphous, ambivalent and unknowable. The “monster” is faceless; it touches on primary forces of the divine/demonic, and as such is situated on the very border between inside/outside. All three paradigms, with their main approaches and constitutive elements, are modulated through two basic possible treatments: the conservative and the progressive (liberal, which affords a total of six basic variations of horror. Starting from definitions given by John Carpenter, Robin Wood and his own, the author analyzes representative examples from horror literature and film for each paradigm and its variation, with a special accent on the image of Otherness and its connection to the norm, its intrusion into the status quo, anthropocentrism and the presence or absence of a happy ending. The paper demonstrates the richness of connotative potential within the horror genre and provides a basis for its taxonomy.

  14. Evolving Role of Endoscopic Retrograde Cholangiopancreatography in Management of Extrahepatic Hepatic Ductal Injuries due to Blunt Trauma: Diagnostic and Treatment Algorithms

    Directory of Open Access Journals (Sweden)

    Nikhil P. Jaik

    2008-01-01

    Full Text Available Extrahepatic hepatic ductal injuries (EHDIs due to blunt abdominal trauma are rare. Given the rarity of these injuries and the insidious onset of symptoms, EHDI are commonly missed during the initial trauma evaluation, making their diagnosis difficult and frequently delayed. Diagnostic modalities useful in the setting of EHDI include computed tomography (CT, abdominal ultrasonography (AUS, nuclear imaging (HIDA scan, and cholangiography. Traditional options in management of EHDI include primary ductal repair with or without a T-tube, biliary-enteric anastomosis, ductal ligation, stenting, and drainage. Simple drainage and biliary decompression is often the most appropriate treatment in unstable patients. More recently, endoscopic retrograde cholangiopancreatography (ERCP allowed for diagnosis and potential treatment of these injuries via stenting and/or papillotomy. Our review of 53 cases of EHDI reported in the English-language literature has focused on the evolving role of ERCP in diagnosis and treatment of these injuries. Diagnostic and treatment algorithms incorporating ERCP have been designed to help systematize and simplify the management of EHDI. An illustrative case is reported of blunt traumatic injury involving both the extrahepatic portion of the left hepatic duct and its confluence with the right hepatic duct. This injury was successfully diagnosed and treated using ERCP.

  15. Evolvable synthetic neural system

    Science.gov (United States)

    Curtis, Steven A. (Inventor)

    2009-01-01

    An evolvable synthetic neural system includes an evolvable neural interface operably coupled to at least one neural basis function. Each neural basis function includes an evolvable neural interface operably coupled to a heuristic neural system to perform high-level functions and an autonomic neural system to perform low-level functions. In some embodiments, the evolvable synthetic neural system is operably coupled to one or more evolvable synthetic neural systems in a hierarchy.

  16. A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health

    Directory of Open Access Journals (Sweden)

    Kendall-Tackett Kathleen

    2007-03-01

    Full Text Available Abstract Background Research in the field of psychoneuroimmunology (PNI has revealed that depression is associated with inflammation manifested by increased levels of proinflammatory cytokines. Discussion The old paradigm described inflammation as simply one of many risk factors for depression. The new paradigm is based on more recent research that has indicated that physical and psychological stressors increase inflammation. These recent studies constitute an important shift in the depression paradigm: inflammation is not simply a risk factor; it is the risk factor that underlies all the others. Moreover, inflammation explains why psychosocial, behavioral and physical risk factors increase the risk of depression. This is true for depression in general and for postpartum depression in particular. Puerperal women are especially vulnerable to these effects because their levels of proinflammatory cytokines significantly increase during the last trimester of pregnancy – a time when they are also at high risk for depression. Moreover, common experiences of new motherhood, such as sleep disturbance, postpartum pain, and past or current psychological trauma, act as stressors that cause proinflammatory cytokine levels to rise. Breastfeeding has a protective effect on maternal mental health because it attenuates stress and modulates the inflammatory response. However, breastfeeding difficulties, such as nipple pain, can increase the risk of depression and must be addressed promptly. Conclusion PNI research suggests two goals for the prevention and treatment of postpartum depression: reducing maternal stress and reducing inflammation. Breastfeeding and exercise reduce maternal stress and are protective of maternal mood. In addition, most current treatments for depression are anti-inflammatory. These include long-chain omega-3 fatty acids, cognitive therapy, St. John's wort, and conventional antidepressants.

  17. PARADIGMS IN CONSUMER BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Sabrina Oktoria Sihombing

    2011-05-01

    Full Text Available A paradigm influences what we see and conceive about certain facts. Paradigm can also influence what we accept as a truth. Yet, the debate over which paradigm and methodology is best suit for marketing and consumer behavior has begun since 1980s. Many researchers criticized the domination of logical empiricism paradigm and offered alternative paradigm to understand marketing and consumer behavior. This article discusses several paradigms and methodology, which are part of qualitative paradigm, and compares them with positivism paradigm. This article will also point to the importance of reconciliation between qualitative and quantitative paradigm in order to improve marketing and consumer behavior studies.

  18. The efficacy and safety of adjuvant interferon-alfa therapy in the evolving treatment landscape for resected high-risk melanoma.

    Science.gov (United States)

    Trinh, Van Anh; Zobniw, Chrystia; Hwu, Wen-Jen

    2017-08-01

    Patients with resected stage II or III melanoma are at high risk of recurrence, with 5-year mortality rate of 40-60%. Adjuvant interferon-alfa has demonstrated a small RFS and OS benefit versus observation in this patient population. However, the adjuvant treatment landscape is evolving rapidly. Areas covered: This review aims to summarize the safety and efficacy profiles of adjuvant IFNα/PEG-IFNα, revisit the controversy surrounding its application, and reappraise its position in the rapidly changing treatment landscape of resected melanoma. A literature search using PubMed database was undertaken using search words melanoma, interferon-alfa, pegylated interferon-alfa, adjuvant therapy. Expert opinion: Currently, there is no international consensus regarding the optimal dosing schedule for adjuvant IFNα, but HD IFNα-2b remains the most widely used regimen. The AEs of HD IFNα-2b are substantial; however, toxicity management experience amassed over the past 2 decades has significantly improved safety. Many exciting studies are ongoing to examine the roles of immune checkpoint inhibitors and BRAF-targeted therapies in the adjuvant setting and will further delineate the role of adjuvant IFNα.

  19. The evolving cancer stem cell paradigm: implications in veterinary oncology.

    Science.gov (United States)

    Pang, Lisa Y; Argyle, David J

    2015-08-01

    The existence of subpopulations of cells in cancer with increased tumour-initiating ability, self-renewal potential, and intrinsic resistance to conventional therapeutics formed the basis of the cancer stem cell model. Some tumours have since been viewed as aberrant tissues with a unidirectional hierarchical structure consisting of cancer stem cells at the apex, driving tumour growth, metastasis and relapse after therapy. Here, recent developments in cancer stem cell research are reviewed with a focus on tumour heterogeneity, cellular plasticity and cancer stem cell reprogramming. The impact of these findings on the cancer stem cell model is discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Immunizations: An Evolving Paradigm for Oral Health Care Providers.

    Science.gov (United States)

    Halpern, Leslie R; Mouton, Charles

    2017-04-01

    Oral health care professionals are at risk for the transmission of bacterial and viral microorganisms. Providers need to be knowledgeable about the exposure/transmission of life-threatening infections and options for prevention. This article is designed to increase the oral health care provider's awareness of the latest assessment of vaccine-preventable diseases that pose a high risk in the dental health care setting. Specific dosing strategies are suggested for the prevention of infections based on available evidence and epidemiologic changes. This information will provide a clear understanding for prevention of vaccine-preventable diseases that pose a public health consequence. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. [A change of paradigm in the treatment of Class II malocclusions in children and adolescents: the benefits of the Class II Corrector].

    Science.gov (United States)

    Amat, Philippe

    2017-09-01

    The treatment of class II malocclusions is the core of our clinical activity. What elements can clinician rely on to offer their patients, whether children or adolescents, a treatment of their class II malocclusion that is not only effective but also the most appropriate for each individual case? Which schedule and what therapeutic device should be used? Evidence-based orthodontics, along with a search for the best data on two-phase treatments, were used to judge the validity of the main objectives sought when correcting a Class II malocclusion in children or adolescents, including treatment of mandibular retrognathy. Published data show that the long-term effects of a first phase of treatment on the amount of mandibular growth are at best weak and clinically insignificant. This observation triggers a paradigm shift by refocusing patient treatment on the achievement of other therapeutic objectives. A new orthodontic appliance, the Clas II Corrector, is presented. Its advantages and its use are described and illustrated by means of clinical cases. Class II Corrector allows distalization of maxillary lateral areas, effectively limits undesirable dentoalveolar compensations and facilitates the rehabilitation of orofacial functions. In addition to its clinical efficacy, patients appreciate its small footprint, ease of wearing, and lack of impact on phonation. © EDP Sciences, SFODF, 2017.

  2. Designing Garments to Evolve Over Time

    DEFF Research Database (Denmark)

    Riisberg, Vibeke; Grose, Lynda

    2017-01-01

    This paper proposes a REDO of the current fashion paradigm by investigating how garments might be designed to evolve over time. The purpose is to discuss ways of expanding the traditional role of the designer to include temporal dimensions of creating, producing and using clothes and to suggest a...... to a REDO of design education, to further research and the future fashion and textile industry.......This paper proposes a REDO of the current fashion paradigm by investigating how garments might be designed to evolve over time. The purpose is to discuss ways of expanding the traditional role of the designer to include temporal dimensions of creating, producing and using clothes and to suggest...... a range of potential fashion futures that decouple from declining resources. In the first part literature on 'Past and Present' historical and current aspects of sustainability in fashion and textiles are presented. In the second part, three exploratory case studies are described: Two projects by students...

  3. Didaktiske paradigmer og refleksion

    DEFF Research Database (Denmark)

    Christensen, Torben Spanget

    2014-01-01

    this article. A possible utilitarian didactical paradigm, already indicated by Krogh as a historical paradigm prominent in our time, is also discussed. It is suggested that reflection could be seen as a normative response to the utilitarian paradigm, and not as a paradigm in its own right. It is concluded...... that reflection must be understood as an overarching cultural phenomenon and a very important qualification of all Nielsen’s paradigms, and also a possible utilitarian paradigm, because it has the potential to add dynamic elements to the more or less static didactic paradigms. Thus the semiotic analysis may...

  4. The management of incidental low-grade gliomas using magnetic resonance imaging: systematic review and optimal treatment paradigm.

    Science.gov (United States)

    Shah, Ashish H; Madhavan, Karthik; Heros, Deborah; Raper, Daniel M S; Iorgulescu, J Bryan; Lally, Brian E; Komotar, Ricardo J

    2011-12-01

    The discovery of incidental low-grade gliomas (LGGs) on MR imaging is rare, and currently there is no existing protocol for management of these lesions. Various studies have approached the dilemma of managing patients with incidental LGGs. While some advocate surgery and radiotherapy, others reserve surgery until there is radiological evidence of growth. For neurosurgeons and radiologists, determining the course of action after routine brain imaging poses not only a medical but also an ethical dilemma. The authors conducted a systematic review of case reports and case series in hopes of enhancing the current understanding of the management options for these rare lesions. A PubMed search was performed to include all relevant MR imaging studies in which management of suspected incidental LGG was reported. Comparisons were made between the surgical treatment arm and the active surveillance arm in terms of outcome, mode of discovery, reasons for treatment, and histology. Nine studies with 72 patients were included in this study (56 in the surgical arm and 16 in the active surveillance arm). Within the surgical arm, 49% remained deficit free after treatment, 25% showed evidence of tumor progression, 13% underwent a second treatment, and 7% died. The active surveillance group resulted in no unanticipated adverse events, with serial imaging revealing no tumor growth in all cases. Lesion regression was reported in 31% of this group. The surgical arm's mortality rate was 7% compared with 0% in the active surveillance arm. Treatment decisions for incidental LGG should be individualized based on presenting symptoms and radiological evidence of growth. The asymptomatic patient may be monitored safely with serial MR imaging and occasionally PET scanning before treatment is initiated. In patients presenting with nonspecific symptoms or concurrent symptomatic lesions, treatment may be initiated earlier to reduce potential morbidity. All treatment decisions must be tempered by

  5. Reinforcing the Afrocentric Paradigm: A Theoretical Project

    Science.gov (United States)

    Sams, Timothy E.

    2010-01-01

    Thomas Kuhn's 1962 groundbreaking work, "The Scientific Revolution," established the process for creating, and the components of, a disciplinary paradigm. This "scientific revolution" has evolved to become the standard for determining a field's claim to disciplinary status. In 2001 and 2003, Ama Mazama, used Kuhn's model to establish the…

  6. New Paradigm for the Treatment of Glucose Transporter 1 Deficiency Syndrome: Low Glycemic Index Diet and Modified High Amylopectin Cornstarch.

    Science.gov (United States)

    Almuqbil, Mohammed; Go, Cristina; Nagy, Laura L; Pai, Nisha; Mamak, Eva; Mercimek-Mahmutoglu, Saadet

    2015-09-01

    Glucose transporter 1 deficiency syndrome is an autosomal, dominantly inherited neurometabolic disorder caused by mutations in the SLC2A1 gene. Decreased glucose transport into the brain results in seizures and cognitive dysfunction. The ketogenic diet is the treatment of choice, but complicated with compliance problems. Stabilization of blood glucose levels by low glycemic index diet and modified high amylopectin cornstarch would provide steady-state glucose transport into the brain to prevent seizures and cognitive dysfunction in patients with glucose transporter 1 deficiency syndrome as an alternative treatment. We report a new glucose transporter 1 deficiency syndrome patient (c.988C>T; p. Arg330X in the SLC2A1) treated with modified high amylopectin cornstarch (Glycosade) and low glycemic index diet because of compliance problems with the ketogenic diet. She was diagnosed at 11.5 years of age and was treated with the ketogenic diet between ages 12 and 18 years. She was started on modified high amylopectin cornstarch at bedtime and low glycemic index diet with meals and snacks every 3-4 hours. Within the first 6 months of therapy, she improved in her seizures and cognitive functions, but experienced compliance problems afterwards. Neuropsychological assessment was stable at 12 months of therapy. This diet was easy to apply compared with the ketogenic diet and resulted in stable neuropsychological functioning of this glucose transporter 1 deficiency syndrome patient. Modified high amylopectin cornstarch and low glycemic index diet might be an alternative treatment in glucose transporter 1 deficiency syndrome patients with compliance problems to the ketogenic diet treatment, but additional patients should be treated to prove usefulness of this new treatment. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  7. Evolving Concepts of Asthma

    Science.gov (United States)

    Ray, Anuradha; Wenzel, Sally E.

    2015-01-01

    Our understanding of asthma has evolved over time from a singular disease to a complex of various phenotypes, with varied natural histories, physiologies, and responses to treatment. Early therapies treated most patients with asthma similarly, with bronchodilators and corticosteroids, but these therapies had varying degrees of success. Similarly, despite initial studies that identified an underlying type 2 inflammation in the airways of patients with asthma, biologic therapies targeted toward these type 2 pathways were unsuccessful in all patients. These observations led to increased interest in phenotyping asthma. Clinical approaches, both biased and later unbiased/statistical approaches to large asthma patient cohorts, identified a variety of patient characteristics, but they also consistently identified the importance of age of onset of disease and the presence of eosinophils in determining clinically relevant phenotypes. These paralleled molecular approaches to phenotyping that developed an understanding that not all patients share a type 2 inflammatory pattern. Using biomarkers to select patients with type 2 inflammation, repeated trials of biologics directed toward type 2 cytokine pathways saw newfound success, confirming the importance of phenotyping in asthma. Further research is needed to clarify additional clinical and molecular phenotypes, validate predictive biomarkers, and identify new areas for possible interventions. PMID:26161792

  8. Real-Life Treatment Paradigms Show Adalimumab Is Cost-Effective for the Management of Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Candace L. Beilman

    2016-01-01

    Full Text Available Background. Adalimumab is effective for the maintenance of remission in patients with moderate-to-severe ulcerative colitis (UC. Currently, biologic therapies are used in cases where patients fail conventional medical therapies. If biologic therapies are not available, patients often choose to remain in an unwell state rather than undergo colectomy. Objective. The aim of the study was to evaluate the cost-effectiveness of adalimumab in patients with UC where adalimumab was readily available compared to not available. Methods. A previously validated Markov model was used to simulate disease progression of patients with UC who are corticosteroid-dependent and/or did not respond to thiopurine therapy. Utility scores and transition probabilities between health states were determined by using data from randomized controlled trials and real-life observational studies. Costs were obtained from the Ontario Case Costing Initiative and the Alberta Health Schedule of Medical Benefits. Results. The incremental cost-effectiveness ratios for readily available adalimumab treatment of UC were $40,000 and $59,000 per quality-adjusted life year, compared with ongoing medical therapy in an unwell state, at 5-year and 10-year treatment time horizons, respectively. Conclusion. Considering real-life patient preferences to avoid colectomy, adalimumab is cost-effective according to a willingness-to-pay threshold of $80,000 for treatment of UC.

  9. Evolutionary psychology: the emperor's new paradigm.

    Science.gov (United States)

    Buller, David J

    2005-06-01

    For some evolutionary psychology is merely a field of inquiry, but for others it is a robust paradigm involving specific theories about the nature and evolution of the human mind. Proponents of this paradigm claim to have made several important discoveries regarding the evolved architecture of the mind. Highly publicized discoveries include a cheater-detection module, a psychological sex difference in jealousy, and motivational mechanisms underlying parental love and its lapses, which purportedly result in child maltreatment. In this article, I argue that the empirical evidence for these "discoveries" is inconclusive, at best. I suggest that, as the reigning paradigm in evolutionary psychology has produced questionable results, the evolutionary study of human psychology is still in need of a guiding paradigm.

  10. Rapid onset of antidepressant action: a new paradigm in the research and treatment of major depressive disorder.

    Science.gov (United States)

    Machado-Vieira, Rodrigo; Salvadore, Giacomo; Luckenbaugh, David A; Manji, Husseini K; Zarate, Carlos A

    2008-06-01

    Current therapeutics of depression are similar in their time to antidepressant action and often take weeks to months to achieve response and remission, which commonly results in considerable morbidity and disruption in personal, professional, family, and social life, as well as risk for suicidal behavior. Thus, treatment strategies presenting a rapid improvement of depressive symptoms--within hours or even a few days--and whose effects are sustained would have an enormous impact on public health. This article reviews the published data related to different aspects of rapid improvement of depressive symptoms. Literature for this review was obtained through a search of the MEDLINE database (1966-2007) using the following keywords and phrases: rapid response, antidepressant, time to, glutamate, sleep, therapeutics, latency, and depression. The data obtained were organized according to the following topics: clinical relevance and time course of antidepressant action, interventions showing evidence of rapid response and its potential neurobiological basis, and new technologies for better understanding rapid anti-depressant actions. A limited number of prospective studies evaluating rapid antidepressant actions have been conducted. Currently, only a few interventions have been shown to produce antidepressant response in hours or a few days. The neurobiological basis of these rapid antidepressant actions is only now being deciphered. Certain experimental treatments can produce antidepressant response in a much shorter period of time than existing medications. Understanding the molecular basis of these experimental interventions is likely to lead to the development of improved therapeutics rather than simply furthering our knowledge of current standard antidepressants.

  11. Deep friction massage to treat tendinopathy: a systematic review of a classic treatment in the face of a new paradigm of understanding.

    Science.gov (United States)

    Joseph, Michael F; Taft, Kathryn; Moskwa, Maria; Denegar, Craig R

    2012-11-01

    Systematic literature review. To assess the efficacy of deep friction massage (DFM) in the treatment of tendinopathy. Anecdotal evidence supports the efficacy of DFM for the treatment of tendinopathy. An advanced understanding of the etiopathogenesis of tendinopathy and the resultant paradigm shift away from an active inflammatory model has taken place since the popularization of the DFM technique by Cyriax for the treatment of "tendinitis." However, increasing mechanical load to the tendinopathic tissue, as well as reducing molecular cross-linking during the healing process via transverse massage, offers a plausible explanation for observed responses in light of the contemporary understanding of tendinopathy. The authors surveyed research articles in all languages by searching PubMed, Scopus, Pedro, CINAHL, PsycINFO, and the Cochrane Library using the terms deep friction massage, deep tissue massage, deep transverse massage, Cyriax, soft tissue mobilization, soft tissue mobilisation, cross friction massage, and transverse friction massage. They included 4 randomized comparison trials, 3 at the extensor carpi radialis brevis (ECRB) and 1 supraspinatus outlet tendinopathy; 2 nonrandomized comparison trials, both receiving DFM at the ECRB; and 3 prospective noncomparison trials-supraspinatus, ECRB, and Achilles tendons. Articles meeting inclusion criteria were assessed based on PEDro and Centre for Evidence-Based Medicine rating scales. Nine studies met the inclusion criteria. The heterogeneity of dependent measures did not allow for meta-analysis. The varied locations, study designs, etiopathogenesis, and outcome tools used to examine the efficacy of DFM make a unified conclusion tenuous. There is some evidence of benefit at the elbow in combination with a Mills manipulation, as well as for supraspinatus tendinopathy in the presence of outlet impingement and along with joint mobilization. The examination of DFM as a single modality of treatment in comparison with

  12. Evolving digital ecological networks.

    Directory of Open Access Journals (Sweden)

    Miguel A Fortuna

    Full Text Available "It is hard to realize that the living world as we know it is just one among many possibilities" [1]. Evolving digital ecological networks are webs of interacting, self-replicating, and evolving computer programs (i.e., digital organisms that experience the same major ecological interactions as biological organisms (e.g., competition, predation, parasitism, and mutualism. Despite being computational, these programs evolve quickly in an open-ended way, and starting from only one or two ancestral organisms, the formation of ecological networks can be observed in real-time by tracking interactions between the constantly evolving organism phenotypes. These phenotypes may be defined by combinations of logical computations (hereafter tasks that digital organisms perform and by expressed behaviors that have evolved. The types and outcomes of interactions between phenotypes are determined by task overlap for logic-defined phenotypes and by responses to encounters in the case of behavioral phenotypes. Biologists use these evolving networks to study active and fundamental topics within evolutionary ecology (e.g., the extent to which the architecture of multispecies networks shape coevolutionary outcomes, and the processes involved.

  13. Metastatic squamous cell non-small-cell lung cancer (NSCLC: disrupting the drug treatment paradigm with immunotherapies

    Directory of Open Access Journals (Sweden)

    Sarah L Scarpace

    2015-10-01

    Full Text Available Lung cancer is the third most commonly diagnosed cancer and the leading cause of cancer-related death in the United States. Unlike non-squamous NSCLC, squamous NSCLC rarely harbor epidermal growth factor receptor (EGFR and anaplastic lymphoma kinase (ALK mutations for which there are directed therapies, and until the recent approval of immunotherapies for squamous NSCLC, a limited number of traditional cytotoxic chemotherapy drugs have been FDA-approved for use in the treatment of advanced and metastatic squamous NSCLC. Immunotherapies directed at the programmed cell death-1 receptor (PD-1 or its ligand (PD-L1 (nivolumab and pembrolizumab have demonstrated efficacy in both nonsquamous and squamous cell NSCLC. Because of their similar mechanism of action against the PD-L1/PD-1 pathway, both drugs have similar toxicity profiles related to immune-mediated adverse reactions that can generally be monitored and managed with oral corticosteroids. This paper provides an overview of drug therapy options for squamous cell NSCLC with a focus on the evidence and clinical application of the anti-PD1 therapies. A comparison of the dosing, administration, indications, and differences in the measurement of PD-L1 expression in the clinical trials of nivolumab and pembrolizumab is also provided.

  14. An Obesity Dietary Quality Index Predicts Abdominal Obesity in Women: Potential Opportunity for New Prevention and Treatment Paradigms

    Directory of Open Access Journals (Sweden)

    Dolores M. Wolongevicz

    2010-01-01

    Full Text Available Background. Links between dietary quality and abdominal obesity are poorly understood. Objective. To examine the association between an obesity-specific dietary quality index and abdominal obesity risk in women. Methods. Over 12 years, we followed 288 Framingham Offspring/Spouse Study women, aged 30–69 years, without metabolic syndrome risk factors, cardiovascular disease, cancer, or diabetes at baseline. An 11-nutrient obesity-specific dietary quality index was derived using mean ranks of nutrient intakes from 3-day dietary records. Abdominal obesity (waist circumference >88 cm was assessed during follow-up. Results. Using multiple logistic regression, women with poorer dietary quality were more likely to develop abdominal obesity compared to those with higher dietary quality (OR 1.87; 95% CI, 1.01, 3.47; P for trend =.048 independent of age, physical activity, smoking, and menopausal status. Conclusions. An obesity-specific dietary quality index predicted abdominal obesity in women, suggesting targets for dietary quality assessment, intervention, and treatment to address abdominal adiposity.

  15. A New Treatment Paradigm: Neoadjuvant Radiosurgery Before Surgical Resection of Brain Metastases With Analysis of Local Tumor Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Asher, Anthony L., E-mail: asher@cnsa.com [Department of Neurosurgery, Levine Cancer Institute and Carolinas Medical Center, Charlotte, North Carolina (United States); Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina (United States); Burri, Stuart H. [Department of Radiation Oncology, Levine Cancer Institute and Carolinas Medical Center, Charlotte, North Carolina (United States); Wiggins, Walter F. [Wake Forest School of Medicine MD/PhD Program, Winston-Salem, North Carolina (United States); Kelly, Renee P. [Brain Tumor Fund for the Carolinas, Charlotte, North Carolina (United States); Boltes, Margaret O.; Mehrlich, Melissa [Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina (United States); Norton, H. James [Department of Biostatistics, Carolinas Medical Center, Charlotte, North Carolina (United States); Fraser, Robert W. [Department of Radiation Oncology, Levine Cancer Institute and Carolinas Medical Center, Charlotte, North Carolina (United States)

    2014-03-15

    Purpose: Resected brain metastases (BM) require radiation therapy to reduce local recurrence. Whole brain radiation therapy (WBRT) reduces recurrence, but with potential toxicity. Postoperative stereotactic radiosurgery (SRS) is a strategy without prospective data and problematic target delineation. SRS delivered in the preoperative setting (neoadjuvant, or NaSRS) allows clear target definition and reduction of intraoperative dissemination of tumor cells. Methods and Materials: Our treatment of resectable BM with NaSRS was begun in 2005. Subsequently, a prospective trial of NaSRS was undertaken. A total of 47 consecutively treated patients (23 database and 24 prospective trial) with a total of 51 lesions were reviewed. No statistical difference was observed between the 2 cohorts, and they were combined for analysis. The median follow-up time was 12 months (range, 1-58 months), and the median age was 57. A median of 1 day elapsed between NaSRS and resection. The median diameter of lesions was 3.04 cm (range, 1.34-5.21 cm), and the median volume was 8.49 cc (range, 0.89-46.7 cc). A dose reduction strategy was used, with a median dose of 14 Gy (range, 11.6-18 Gy) prescribed to 80% isodose. Results: Kaplan-Meier overall survival was 77.8% and 60.0% at 6 and 12 months. Kaplan-Meier local control was 97.8%, 85.6%, and 71.8% at 6, 12, and 24 months, respectively. Five of 8 failures were proved pathologically without radiation necrosis. There were no perioperative adverse events. Ultimately, 14.8% of the patients were treated with WBRT. Local failure was more likely with lesions >10 cc (P=.01), >3.4 cm (P=.014), with a trend in surface lesions (P=.066) and eloquent areas (P=.052). Six of the 8 failures had an obvious dural attachment or proximity to draining veins. Conclusions: NaSRS can be performed safely and effectively with excellent results without documented radiation necrosis. Local control was excellent even in the setting of large (>3 cm) lesions. The strong

  16. Local pulmonary administration of factor VIIa (rFVIIa in diffuse alveolar hemorrhage (DAH – a review of a new treatment paradigm

    Directory of Open Access Journals (Sweden)

    Nielsen JD

    2012-03-01

    without thromboembolic complication when FVIIa was administered locally via the air side, because the FVIIa does not penetrate the alveolo-capillary membrane to the blood-side. The incidence of DAH (in the US and Europe is 100,000–150,000, and 50,000 patients annually are at risk of developing DAH following hematopoietic stem cell transplant (HSCT and autoimmune diseases. Finally 50,000–100,000 patients may be falsely categorized as having acute respiratory distress syndrome/acute lung injury (ARDS/ALI because DAH and ARDS cannot be separated clinically. A new treatment paradigm of DAH is proposed as no other intervention has been able to ensure pulmonary hemostasis in DAH. The diagnosis of DAH is simple, a series of broncho-alveolar washes which become increasingly bloody. This test should be performed in all patients with pulmonary opacities in order to separate ARDS/ALI from DAH. FVIIa administrated via pulmonary route is "drug of choice", because it stops bleeding in the life-threatening syndrome DAH. Hemostasis is obtained after only one to two small doses of FVIIa (50 µg/kg body weight per dose and after hemostasis the oxygen transport quickly improves.Conclusion: Intrapulmonary administration of rFVIIa is recommended as the treatment of choice for DAH and blast lung injury (BLI because the treatment has been shown to be successful and uncomplicated in spite of the fact that only a small series of DAH has been documented.Keywords: coagulation factor FVIIa, diffuse alveolar hemorrhage, hemosiderosis, blast lung injury, local pulmonary treatment, biologics, bronchoalveolar lavage, diagnosis, algorithm, new treatment recommendation

  17. A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health

    OpenAIRE

    Kendall-Tackett, Kathleen

    2007-01-01

    Abstract Background Research in the field of psychoneuroimmunology (PNI) has revealed that depression is associated with inflammation manifested by increased levels of proinflammatory cytokines. Discussion The old paradigm described inflammation as simply one of many risk factors for depression. The new paradigm is based on more recent research that has indicated that physical and psychological stressors increase inflammation. These recent studies constitute an important shift in the depressi...

  18. Mentoring: An Evolving Relationship.

    Science.gov (United States)

    Block, Michelle; Florczak, Kristine L

    2017-04-01

    The column concerns itself with mentoring as an evolving relationship between mentor and mentee. The collegiate mentoring model, the transformational transcendence model, and the humanbecoming mentoring model are considered in light of a dialogue with mentors at a Midwest university and conclusions are drawn.

  19. Measurably evolving populations

    DEFF Research Database (Denmark)

    Drummond, Alexei James; Pybus, Oliver George; Rambaut, Andrew

    2003-01-01

    processes through time. Populations for which such studies are possible � measurably evolving populations (MEPs) � are characterized by sufficiently long or numerous sampled sequences and a fast mutation rate relative to the available range of sequence sampling times. The impact of sequences sampled through...... understanding of evolutionary processes in diverse organisms, from viruses to vertebrates....

  20. Paradigms of Intelligent Systems

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available This paper approaches the subject of paradigms for the categories of intelligent systems. First we can look at the term paradigm in its scientific meaning and then we make acquaintance with the main categories of intelligent systems (expert systems, intelligent systems based on genetic algorithms, artificial neuronal systems, fuzzy systems, hybrid intelligent systems. We will see that every system has one or more paradigms, but hybrid intelligent systems combine paradigms because they are made of different technologies. This research has been made under the guidance of Dr. Ioan AND ONE, Professor and Director of Research Laboratory.

  1. EVOLVE 2014 International Conference

    CERN Document Server

    Tantar, Emilia; Sun, Jian-Qiao; Zhang, Wei; Ding, Qian; Schütze, Oliver; Emmerich, Michael; Legrand, Pierrick; Moral, Pierre; Coello, Carlos

    2014-01-01

    This volume encloses research articles that were presented at the EVOLVE 2014 International Conference in Beijing, China, July 1–4, 2014.The book gathers contributions that emerged from the conference tracks, ranging from probability to set oriented numerics and evolutionary computation; all complemented by the bridging purpose of the conference, e.g. Complex Networks and Landscape Analysis, or by the more application oriented perspective. The novelty of the volume, when considering the EVOLVE series, comes from targeting also the practitioner’s view. This is supported by the Machine Learning Applied to Networks and Practical Aspects of Evolutionary Algorithms tracks, providing surveys on new application areas, as in the networking area and useful insights in the development of evolutionary techniques, from a practitioner’s perspective. Complementary to these directions, the conference tracks supporting the volume, follow on the individual advancements of the subareas constituting the scope of the confe...

  2. Evolvable Neural Software System

    Science.gov (United States)

    Curtis, Steven A.

    2009-01-01

    The Evolvable Neural Software System (ENSS) is composed of sets of Neural Basis Functions (NBFs), which can be totally autonomously created and removed according to the changing needs and requirements of the software system. The resulting structure is both hierarchical and self-similar in that a given set of NBFs may have a ruler NBF, which in turn communicates with other sets of NBFs. These sets of NBFs may function as nodes to a ruler node, which are also NBF constructs. In this manner, the synthetic neural system can exhibit the complexity, three-dimensional connectivity, and adaptability of biological neural systems. An added advantage of ENSS over a natural neural system is its ability to modify its core genetic code in response to environmental changes as reflected in needs and requirements. The neural system is fully adaptive and evolvable and is trainable before release. It continues to rewire itself while on the job. The NBF is a unique, bilevel intelligence neural system composed of a higher-level heuristic neural system (HNS) and a lower-level, autonomic neural system (ANS). Taken together, the HNS and the ANS give each NBF the complete capabilities of a biological neural system to match sensory inputs to actions. Another feature of the NBF is the Evolvable Neural Interface (ENI), which links the HNS and ANS. The ENI solves the interface problem between these two systems by actively adapting and evolving from a primitive initial state (a Neural Thread) to a complicated, operational ENI and successfully adapting to a training sequence of sensory input. This simulates the adaptation of a biological neural system in a developmental phase. Within the greater multi-NBF and multi-node ENSS, self-similar ENI s provide the basis for inter-NBF and inter-node connectivity.

  3. The Reception Learning Paradigm.

    Science.gov (United States)

    Novak, Joseph D.

    1979-01-01

    Presented is a paradigm for science education research. The paradigm advances the reception learning theory, where regularities to be learned are presented explicitly to the learner. A tool for the study of knowledge production in science education, the Gowin "V," is presented. (RE)

  4. The Generative Paradigm.

    Science.gov (United States)

    Loynes, Chris

    2002-01-01

    The "algorithmic" model of outdoor experiential learning is based in military tradition and characterized by questionable scientific rationale, production line metaphor, and the notion of learning as marketable commodity. Alternatives are the moral paradigm; the ecological paradigm "friluftsliv"; and the emerging…

  5. Of Paradigms and Power

    DEFF Research Database (Denmark)

    Carstensen, Martin B.; Matthijs, Matthias

    ? Despite the profound impact of Peter Hall’s approach to policy paradigms and social learning, there is a burgeoning consensus that transposing a rudimentary ‘Kuhnian’ understanding of paradigms into the context of public policy making leads to a notion of punctuated equilibrium style shifts as the only...... game in town. In effect, while Hall’s approach can account for inter-paradigm change with reference to exogenous shocks, it does not allow for significant ideational change to occur intra-paradigm. In order to remedy this, we suggest that the concept of ideational power be placed more centrally...... in the study of policy paradigms. To demonstrate the general applicability of our framework, the paper examines the evolution of British macroeconomic policy making since 1990. We show that various Prime Ministers and their Chancellors were able to reinterpret and redefine the dominant neoliberal understanding...

  6. Regolith Evolved Gas Analyzer

    Science.gov (United States)

    Hoffman, John H.; Hedgecock, Jud; Nienaber, Terry; Cooper, Bonnie; Allen, Carlton; Ming, Doug

    2000-01-01

    The Regolith Evolved Gas Analyzer (REGA) is a high-temperature furnace and mass spectrometer instrument for determining the mineralogical composition and reactivity of soil samples. REGA provides key mineralogical and reactivity data that is needed to understand the soil chemistry of an asteroid, which then aids in determining in-situ which materials should be selected for return to earth. REGA is capable of conducting a number of direct soil measurements that are unique to this instrument. These experimental measurements include: (1) Mass spectrum analysis of evolved gases from soil samples as they are heated from ambient temperature to 900 C; and (2) Identification of liberated chemicals, e.g., water, oxygen, sulfur, chlorine, and fluorine. REGA would be placed on the surface of a near earth asteroid. It is an autonomous instrument that is controlled from earth but does the analysis of regolith materials automatically. The REGA instrument consists of four primary components: (1) a flight-proven mass spectrometer, (2) a high-temperature furnace, (3) a soil handling system, and (4) a microcontroller. An external arm containing a scoop or drill gathers regolith samples. A sample is placed in the inlet orifice where the finest-grained particles are sifted into a metering volume and subsequently moved into a crucible. A movable arm then places the crucible in the furnace. The furnace is closed, thereby sealing the inner volume to collect the evolved gases for analysis. Owing to the very low g forces on an asteroid compared to Mars or the moon, the sample must be moved from inlet to crucible by mechanical means rather than by gravity. As the soil sample is heated through a programmed pattern, the gases evolved at each temperature are passed through a transfer tube to the mass spectrometer for analysis and identification. Return data from the instrument will lead to new insights and discoveries including: (1) Identification of the molecular masses of all of the gases

  7. Paradigms for machine learning

    Science.gov (United States)

    Schlimmer, Jeffrey C.; Langley, Pat

    1991-01-01

    Five paradigms are described for machine learning: connectionist (neural network) methods, genetic algorithms and classifier systems, empirical methods for inducing rules and decision trees, analytic learning methods, and case-based approaches. Some dimensions are considered along with these paradigms vary in their approach to learning, and the basic methods are reviewed that are used within each framework, together with open research issues. It is argued that the similarities among the paradigms are more important than their differences, and that future work should attempt to bridge the existing boundaries. Finally, some recent developments in the field of machine learning are discussed, and their impact on both research and applications is examined.

  8. Evolving treatment implementation among HIV-infected pregnant women and their partners: results from a national surveillance study in Italy, 2001-2015.

    Science.gov (United States)

    Floridia, Marco; Frisina, Valentina; Ravizza, Marina; Marconi, Anna Maria; Pinnetti, Carmela; Cetin, Irene; Sansone, Matilde; Molinari, Atim; Cervi, Francesca; Meloni, Alessandra; Luzi, Kety; Masuelli, Giulia; Tamburrini, Enrica

    2017-06-01

    The current global and national indications for antiretroviral treatment (ART, usually triple combination therapy) in adolescent and adults, including pregnant women, recommend early ART before immunologic decline, pre-exposure chemoprophylaxis (PrEP), and treatment of HIV-negative partners in serodiscordant couples. There is limited information on the implementation of these recommendations among pregnant women with HIV and their partners. The present analysis was performed in 2016, using data from clinical records of pregnant women with HIV, followed between 2001 and 2015 at hospital or university clinics within a large, nationally representative Italian cohort study. The study period was divided in three intervals of five years each (2001-2005, 2006-2010, 2011-2015), and the analysis evaluated temporal trends in rates of HIV diagnosis in pregnancy, maternal antiretroviral treatment at conception, prevalence of HIV infection among partners of pregnant women with HIV, and proportion of seronegative and seropositive male partners receiving antiretroviral treatment. The analysis included 2755 pregnancies in women with HIV. During the three time intervals considered the rate of HIV diagnosis in pregnancy (overall 23.3%), and the distribution of HIV status among male partners (overall 48.7% HIV-negative, 28.6% HIV-positive and 22.8% unknown) remained substantially unchanged. Significant increases were observed in the proportion of women with HIV diagnosed before pregnancy who were on antiretroviral treatment at conception (from 62.0% in 2001-2005 to 81.3% in 2011-2015, P HIV-positive partners on antiretroviral treatment (from 73.3% in 2001-2005 to 95.8% in 2011-2015, P = 0.002). Antiretroviral treatment was administered in 99.1% of the pregnancies that did not end early because of miscarriage, termination, or intrauterine death, and in 75.3% of those not ending in a live birth. No implementation of antiretroviral treatment was introduced among male HIV

  9. The evolving world of GLP-1 agonist therapies for type 2 diabetes.

    Science.gov (United States)

    Baynes, Kevin C R

    2010-04-01

    The glucagon-like peptide-1 (GLP-1) agonist drugs have attractions as a treatment for type 2 diabetes since they positively alter a number of key pathophysiological defects. These include increasing insulin release, reducing glucagon release, slowing gastric emptying and reducing food intake. In numerous clinical trials these agents have been shown to reduce DCCT-aligned HbA(1c) between 0.8% and 1.1% in patients with moderately controlled type 2 diabetes, whilst also being associated with some weight loss. Whilst medium-term safety and side-effect profiles are now well established, there are as yet no long-term studies on the safety of this group of drugs. The place of the GLP-1 agonists in the treatment paradigm for type 2 diabetes will evolve over the next decade.

  10. Fat: an evolving issue

    Directory of Open Access Journals (Sweden)

    John R. Speakman

    2012-09-01

    Work on obesity is evolving, and obesity is a consequence of our evolutionary history. In the space of 50 years, we have become an obese species. The reasons why can be addressed at a number of different levels. These include separating between whether the primary cause lies on the food intake or energy expenditure side of the energy balance equation, and determining how genetic and environmental effects contribute to weight variation between individuals. Opinion on whether increased food intake or decreased energy expenditure drives the obesity epidemic is still divided, but recent evidence favours the idea that food intake, rather than altered expenditure, is most important. There is more of a consensus that genetics explains most (probably around 65% of weight variation between individuals. Recent advances in genome-wide association studies have identified many polymorphisms that are linked to obesity, yet much of the genetic variance remains unexplained. Finding the causes of this unexplained variation will be an impetus of genetic and epigenetic research on obesity over the next decade. Many environmental factors – including gut microbiota, stress and endocrine disruptors – have been linked to the risk of developing obesity. A better understanding of gene-by-environment interactions will also be key to understanding obesity in the years to come.

  11. Evolving endoscopic surgery.

    Science.gov (United States)

    Sakai, Paulo; Faintuch, Joel

    2014-06-01

    Since the days of Albukasim in medieval Spain, natural orifices have been regarded not only as a rather repugnant source of bodily odors, fluids and excreta, but also as a convenient invitation to explore and treat the inner passages of the organism. However, surgical ingenuity needed to be matched by appropriate tools and devices. Lack of technologically advanced instrumentation was a strong deterrent during almost a millennium until recent decades when a quantum jump materialized. Endoscopic surgery is currently a vibrant and growing subspecialty, which successfully handles millions of patients every year. Additional opportunities lie ahead which might benefit millions more, however, requiring even more sophisticated apparatuses, particularly in the field of robotics, artificial intelligence, and tissue repair (surgical suturing). This is a particularly exciting and worthwhile challenge, namely of larger and safer endoscopic interventions, followed by seamless and scarless recovery. In synthesis, the future is widely open for those who use together intelligence and creativity to develop new prototypes, new accessories and new techniques. Yet there are many challenges in the path of endoscopic surgery. In this new era of robotic endoscopy, one will likely need a virtual simulator to train and assess the performance of younger doctors. More evidence will be essential in multiple evolving fields, particularly to elucidate whether more ambitious and complex pathways, such as intrathoracic and intraperitoneal surgery via natural orifice transluminal endoscopic surgery (NOTES), are superior or not to conventional techniques. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  12. Asymmetric evolving random networks

    Science.gov (United States)

    Coulomb, S.; Bauer, M.

    2003-10-01

    We generalize the Poissonian evolving random graph model of M. Bauer and D. Bernard (2003), to deal with arbitrary degree distributions. The motivation comes from biological networks, which are well-known to exhibit non Poissonian degree distributions. A node is added at each time step and is connected to the rest of the graph by oriented edges emerging from older nodes. This leads to a statistical asymmetry between incoming and outgoing edges. The law for the number of new edges at each time step is fixed but arbitrary. Thermodynamical behavior is expected when this law has a large time limit. Although (by construction) the incoming degree distributions depend on this law, this is not the case for most qualitative features concerning the size distribution of connected components, as long as the law has a finite variance. As the variance grows above 1/4, the average being < 1/2, a giant component emerges, which connects a finite fraction of the vertices. Below this threshold, the distribution of component sizes decreases algebraically with a continuously varying exponent. The transition is of infinite order, in sharp contrast with the case of static graphs. The local-in-time profiles for the components of finite size allow to give a refined description of the system.

  13. Evolving a photosynthetic organelle

    Directory of Open Access Journals (Sweden)

    Nakayama Takuro

    2012-04-01

    Full Text Available Abstract The evolution of plastids from cyanobacteria is believed to represent a singularity in the history of life. The enigmatic amoeba Paulinella and its 'recently' acquired photosynthetic inclusions provide a fascinating system through which to gain fresh insight into how endosymbionts become organelles. The plastids, or chloroplasts, of algae and plants evolved from cyanobacteria by endosymbiosis. This landmark event conferred on eukaryotes the benefits of photosynthesis - the conversion of solar energy into chemical energy - and in so doing had a huge impact on the course of evolution and the climate of Earth 1. From the present state of plastids, however, it is difficult to trace the evolutionary steps involved in this momentous development, because all modern-day plastids have fully integrated into their hosts. Paulinella chromatophora is a unicellular eukaryote that bears photosynthetic entities called chromatophores that are derived from cyanobacteria and has thus received much attention as a possible example of an organism in the early stages of organellogenesis. Recent studies have unlocked the genomic secrets of its chromatophore 23 and provided concrete evidence that the Paulinella chromatophore is a bona fide photosynthetic organelle 4. The question is how Paulinella can help us to understand the process by which an endosymbiont is converted into an organelle.

  14. Paradigm Change in Political Science.

    Science.gov (United States)

    Rodman, John

    1980-01-01

    Traces the shift of paradigms in the political science profession from the 1960s to 1980, examines the classical paradigm, compares it with modern paradigms, and reviews contemporary efforts to articulate a new paradigm which takes the ecological crisis into account. (Author/DB)

  15. Winnicott's paradigm outlined

    Directory of Open Access Journals (Sweden)

    Zeljko Loparic

    Full Text Available The main objective of this paper is to present a unified view of Winnicott’s contribution to psychoanalysis. Part I (Sections 1-4 starts off by recalling that, according to some important commentators, Winnicott introduced a change in paradigms in psychoanalysis. In order to show that this change can be viewed as an overall “switch in paradigms”, in the sense given by T. S. Kuhn, this paper presents an account of the Kuhn’s view of science and offers a reconstruction of Freud’s Oedipal, Triangular or “Toddler-in-the-Mother’s-Bed” Paradigm. Part II (Sections 5-13 shows that as early as the 1920’s Winnicott encountered insurmountable anomalies in the Oedipal paradigm and, for that reason, started what can be called revolutionary research for a new framework of psychoanalysis. This research led Winnicott, especially during the last period of his life, to produce an alternative dual or “Baby-on-the-Mother’s-Lap” Paradigm. This new paradigm is described in some detail, especially the paradigmatic dual mother-baby relation and Winnicott’s dominant theory of maturation. Final remarks are made regarding Winnicott’s heritage and the future of psychoanalysis.

  16. Mental Health Recovery Paradigm: Implications for Social Work.

    Science.gov (United States)

    Carpenter, Jenneth

    2002-01-01

    Article argues that the values and beliefs of the consumer-survivor recovery movement are closely aligned with those of the social work profession, and the movement offers social workers a more promising perspective from which to practice. Primary concepts and values of the evolving recovery paradigm are delineated; implications for direct…

  17. Architecting Security with Paradigm

    Science.gov (United States)

    Andova, Suzana; Groenewegen, Luuk P. J.; Verschuren, Jan H. S.; de Vink, Erik P.

    For large security systems a clear separation of concerns is achieved through architecting. Particularly the dynamic consistency between the architectural components should be addressed, in addition to individual component behaviour. In this paper, relevant dynamic consistency is specified through Paradigm, a coordination modeling language based on dynamic constraints. As it is argued, this fits well with security issues. A smaller example introduces the architectural approach towards implementing security policies. A larger casestudy illustrates the use of Paradigm in analyzing the FOO voting scheme. In addition, translating the Paradigm models into process algebra brings model checking within reach. Security properties of the examples discussed, are formally verified with the model checker Literal>mCRL2Literal>.

  18. Genomic profile of oral squamous cell carcinomas with an adjacent leukoplakia or with an erythroleukoplakia that evolved after the treatment of primary tumor: A report of two cases.

    Science.gov (United States)

    Ribeiro, Ilda P; Marques, Francisco; Barroso, Leonor; Rodrigues, Joana; Caramelo, Francisco; Melo, Joana B; Carreira, Isabel M

    2017-11-01

    Oral leukoplakia and erythroleukoplakia are common oral potentially malignant disorders diagnosed in the oral cavity. The specific outcome of these lesions remains to be elucidated, as their malignant transformation rate exhibits great variation. The ability to predict which of those potentially malignant lesions are likely to progress to cancer would be vital to guide their future clinical management. The present study reported two patients with tongue squamous cell carcinoma: Case study 1 was diagnosed with a simultaneous leukoplakia and case study 2 developed an erythroleukoplakia following the primary tumor treatment. Whole genome copy number alterations were analyzed using array comparative genomic hybridization. The present study determined more genomic imbalances in the tissues from leukoplakia and erythroleukoplakia compared with their respective tumors. The present study also identified in tumor and potentially malignant lesions common alterations of chromosomal regions and genes, including FBXL5, UGT2B15, UGT2B28, KANSL1, GSTT1 and DUSP22, being some of these typical aberrations described in oral cancer and others are linked to chemoradioresistance. Several putative genes associated with hallmarks of malignancy that may have an important role in predicting the progression of leukoplakia and erythroleukoplakia to squamous cell carcinoma, namely gains in BNIPL, MCL1, STAG2, CSPP1 and ZNRF3 genes were also identified.

  19. The regrammation of paradigms:

    DEFF Research Database (Denmark)

    Heltoft, Lars

    2017-01-01

    . This regrammation process involves semantic changes that must be described in terms of paradigm (re)organisation and cannot be captured in terms of changes along the parameters of the cline of grammaticalisation. Two main types of auxiliaries are distinguished: inflectional auxiliaries, with predication scope...

  20. The Paradigms of Programming

    Indian Academy of Sciences (India)

    of one variable, we might first design a multiple-precision arithmetic representation. Robert W Floyd, Turing ... paradigm of structured programming does serve to. extend one's powers of design, allowing the construction of ... Balzer, in his jeremiad against the state of software construction, went on to prophesy that automatic ...

  1. An Introduction to Paradigm

    NARCIS (Netherlands)

    S.C. van der Made-Potuijt; A. de Bruin (Arie)

    2002-01-01

    textabstractBy using Paradigm, it is possible to model cooperating processes and to make the communication between these processes very clear. This report gives a formal description of this modeling method using state-transition diagrams in order to model processes and homomorphismes and

  2. Shifting the paradigm

    DEFF Research Database (Denmark)

    Kiss, Katalin; Brozik, Anna; Kucsma, Nora

    2012-01-01

    ABCB6, a member of the adenosine triphosphate-binding cassette (ABC) transporter family, has been proposed to be responsible for the mitochondrial uptake of porphyrins. Here we show that ABCB6 is a glycoprotein present in the membrane of mature erythrocytes and in exosomes released from reticuloc...... paradigm linking the expression and function of ABCB6 to mitochondria....

  3. Programming Language Paradigms

    Directory of Open Access Journals (Sweden)

    Bartoníček Jan

    2014-01-01

    Full Text Available This paper's goal is to briefly explain the basic theory behind programming languages and their history while taking a close look at different programming paradigms that are used today as well as describing their differences, benefits, and drawbacks

  4. Natural selection promotes antigenic evolvability

    NARCIS (Netherlands)

    Graves, C.J.; Ros, V.I.D.; Stevenson, B.; Sniegowski, P.D.; Brisson, D.

    2013-01-01

    The hypothesis that evolvability - the capacity to evolve by natural selection - is itself the object of natural selection is highly intriguing but remains controversial due in large part to a paucity of direct experimental evidence. The antigenic variation mechanisms of microbial pathogens provide

  5. Disgust: Evolved function and structure

    NARCIS (Netherlands)

    Tybur, J.M.; Lieberman, D.; Kurzban, R.; DeScioli, P.

    2013-01-01

    Interest in and research on disgust has surged over the past few decades. The field, however, still lacks a coherent theoretical framework for understanding the evolved function or functions of disgust. Here we present such a framework, emphasizing 2 levels of analysis: that of evolved function and

  6. Evolving virtual creatures and catapults.

    Science.gov (United States)

    Chaumont, Nicolas; Egli, Richard; Adami, Christoph

    2007-01-01

    We present a system that can evolve the morphology and the controller of virtual walking and block-throwing creatures (catapults) using a genetic algorithm. The system is based on Sims' work, implemented as a flexible platform with an off-the-shelf dynamics engine. Experiments aimed at evolving Sims-type walkers resulted in the emergence of various realistic gaits while using fairly simple objective functions. Due to the flexibility of the system, drastically different morphologies and functions evolved with only minor modifications to the system and objective function. For example, various throwing techniques evolved when selecting for catapults that propel a block as far as possible. Among the strategies and morphologies evolved, we find the drop-kick strategy, as well as the systematic invention of the principle behind the wheel, when allowing mutations to the projectile.

  7. Computational Genetic Regulatory Networks Evolvable, Self-organizing Systems

    CERN Document Server

    Knabe, Johannes F

    2013-01-01

    Genetic Regulatory Networks (GRNs) in biological organisms are primary engines for cells to enact their engagements with environments, via incessant, continually active coupling. In differentiated multicellular organisms, tremendous complexity has arisen in the course of evolution of life on earth. Engineering and science have so far achieved no working system that can compare with this complexity, depth and scope of organization. Abstracting the dynamics of genetic regulatory control to a computational framework in which artificial GRNs in artificial simulated cells differentiate while connected in a changing topology, it is possible to apply Darwinian evolution in silico to study the capacity of such developmental/differentiated GRNs to evolve. In this volume an evolutionary GRN paradigm is investigated for its evolvability and robustness in models of biological clocks, in simple differentiated multicellularity, and in evolving artificial developing 'organisms' which grow and express an ontogeny starting fr...

  8. Evolving adrenal insufficiency

    Directory of Open Access Journals (Sweden)

    Ajitesh Roy

    2012-01-01

    Full Text Available Introduction: Tuberculosis is the most common cause of Addison′s disease in India. The exact status of adrenal reserve in tuberculosis is still an enigma and recovery of adrenal function is unpredictable. Objective: We report a case with a pre-Addisonian state and unchanged adrenal size after 1 year treatment. Materials and Methods: A 31-year patient with adrenal tuberculosis was diagnosed and treated with anti tubercular drugs (ATDs and steroid. Results: A 31-year male, presented with fever and weight loss for 3½ months with anorexia, nausea, hyperpigmentation of skin, and buccal mucosa and weakness with past h/o adequately treated pulmonary tuberculosis at 3 years of age. On examination, the patient was anemic. A non-tender, firm right (Rt. submandibular lymphnode was palpable. Investigations revealed: High erythrocyte sedimentation rate (ESR, negative HIV, and sputum for acid fast bacilli (AFB. Initial cortisol was high but subsequently became low with negative short synacthin test (SST. Computed tomography showed bilateral (B/L enlarged hypodense adrenal mass with inconclusive fine needle aspiration cytology (FNAC and negative AFB culture. Rt. submandibular lymph node FNAC showed caseating granuloma. ATDs and steroids were started, the lymphadenopathy regressed and symptoms subsided. However, after 1 year of treatment steroid withdrawal failed and adrenal size remained the same. Conclusion: The adrenal has considerable capacity to regenerate during active infection and ultimately become normal or smaller in size. However, in the case reported here, they failed to regress. Reversal of adrenal function following ATD is a controversial issue. Some studies have shown normalization following therapy, while others have contradicted it similar to the finding in our case.

  9. Computer-aided psychological treatments: evolving issues.

    Science.gov (United States)

    Marks, Isaac; Cavanagh, Kate

    2009-01-01

    Evidence is growing that several computer-aided psychotherapy (CP) systems can effectively improve a range of common mental health problems. Most clients find CP acceptable because of its convenience, confidentiality, and reduction of stigma. CP can be accessed in a clinic, but recently clients have used CP especially on the Internet at home, with brief support on a telephone helpline and/or by email. Brief and efficient screening and support greatly reduce attrition. CP's efficacy, and encouragement of its dissemination and implementation by some national funding bodies and governmental agencies, has led to its spread as a regular care option and is increasing access to psychological therapies in some countries. Transfer of this new approach from use in tight research studies to use as an integrated part of everyday care under widely varying conditions generates teething problems that are being managed in diverse ways across different centers. Anonymized Internet audit of CP outcomes facilitates effective care and clinical governance. This review examines the current state of the art as well as the science and broad applications of CP.

  10. Metabolic memory: Evolving concepts.

    Science.gov (United States)

    Misra, Anoop; Bloomgarden, Zachary

    2018-03-01

    The relationships of glycemic control over time with the development of complications have been investigated in several studies, but new areas of debate continue to arise. Does glycemic control have greater benefit when attained earlier than when attained later in the natural history of diabetes? Is it simply the duration of better or worse levels of glycemia that lead a given individual to have fewer or greater levels of complications? Might glycemic control have similar benefit throughout the duration of diabetes until irreversible damage occurs, perhaps varying by organ system (neurologic, renal, retinal, cardiovascular)? Specific benefits or adverse effects of treatment agents may further complicate the interpretation of what has been characterized as "metabolic memory." The notion of metabolic memory was based on findings of the Diabetes Control and Complications Trial (DCCT) of type 1 diabetes (T1D), in which the initial 2% HbA1c separation between the groups of patients randomized to intensive or conventional control was lost during the follow up Epidemiology of Diabetes Interventions and Complications (EDIC) study, when the two groups of participants returned to standard treatment and showed similar HbA1c levels but the initial intensively treated group continued to have lower rates of development of microvascular and, subsequently, macrovascular complications. Similarly, a decade after the conclusion of the UK Prospective Diabetes Study (UKPDS), patients with type 2 diabetes (T2D) in the intensive therapy group, despite showing similar levels of glycemic control to those receiving standard care, continued to have significant reductions in microvascular endpoints and reductions in myocardial infarction and all-cause mortality. A 6-year follow up of the Veteran's Administration Diabetes Trial suggested that the formerly intensively controlled subset were more likely to maintain an estimated glomerular filtration rate >60 ml/min/1.73m 2 than those randomized

  11. Towards a New Paradigm

    DEFF Research Database (Denmark)

    Marsh, Rob; Larsen, Vibeke Grupe; Hacker, Jake

    2010-01-01

    for developing a new paradigm for zero-energy architecture. There has been a radical transformation in building energy consumption over the last 30 years, with an absolute reduction in heat consumption and a rapid growth in electricity consumption, reflecting wider technological and social transformations......This paper argues that the understanding of architecture again needs to be widened if the architectural profession is to play an active role in combating climate change. The paper therefore examines past, present and future challenges for building energy consumption in Denmark as the basis...... in the future. With this background, a new paradigm for zero-energy architecture is developed that re-flects the architectural design process. In this way, the architectural focus early in the de-sign process on functional disposition, spatial quality and built form can act as the driving force in the movement...

  12. CHANGE OF ENERGY PARADIGM

    Directory of Open Access Journals (Sweden)

    Ionut PURICA

    2013-05-01

    Full Text Available We are at the beginning of a change of paradigm in the energy systems of the whole World. Both new resources being found and exploited and the new technologies for energy conversion, transport and distribution, along with the associated artificial intelligence systems, are starting to create new futures, with different living values, for the greatest machine created by men: the energy system. Some relevant elements are presented in the paper along with the position and the perspectives of Romania.

  13. When did oxygenic photosynthesis evolve?

    National Research Council Canada - National Science Library

    Roger Buick

    2008-01-01

    ...2.4 Ga ago, but when the photosynthetic oxygen production began is debatable. However, geological and geochemical evidence from older sedimentary rocks indicates that oxygenic photosynthesis evolved well before this oxygenation event...

  14. Marshal: Maintaining Evolving Models Project

    Data.gov (United States)

    National Aeronautics and Space Administration — SIFT proposes to design and develop the Marshal system, a mixed-initiative tool for maintaining task models over the course of evolving missions. Marshal-enabled...

  15. Natural selection promotes antigenic evolvability.

    Science.gov (United States)

    Graves, Christopher J; Ros, Vera I D; Stevenson, Brian; Sniegowski, Paul D; Brisson, Dustin

    2013-01-01

    The hypothesis that evolvability - the capacity to evolve by natural selection - is itself the object of natural selection is highly intriguing but remains controversial due in large part to a paucity of direct experimental evidence. The antigenic variation mechanisms of microbial pathogens provide an experimentally tractable system to test whether natural selection has favored mechanisms that increase evolvability. Many antigenic variation systems consist of paralogous unexpressed 'cassettes' that recombine into an expression site to rapidly alter the expressed protein. Importantly, the magnitude of antigenic change is a function of the genetic diversity among the unexpressed cassettes. Thus, evidence that selection favors among-cassette diversity is direct evidence that natural selection promotes antigenic evolvability. We used the Lyme disease bacterium, Borrelia burgdorferi, as a model to test the prediction that natural selection favors amino acid diversity among unexpressed vls cassettes and thereby promotes evolvability in a primary surface antigen, VlsE. The hypothesis that diversity among vls cassettes is favored by natural selection was supported in each B. burgdorferi strain analyzed using both classical (dN/dS ratios) and Bayesian population genetic analyses of genetic sequence data. This hypothesis was also supported by the conservation of highly mutable tandem-repeat structures across B. burgdorferi strains despite a near complete absence of sequence conservation. Diversification among vls cassettes due to natural selection and mutable repeat structures promotes long-term antigenic evolvability of VlsE. These findings provide a direct demonstration that molecular mechanisms that enhance evolvability of surface antigens are an evolutionary adaptation. The molecular evolutionary processes identified here can serve as a model for the evolution of antigenic evolvability in many pathogens which utilize similar strategies to establish chronic infections.

  16. Natural selection promotes antigenic evolvability.

    Directory of Open Access Journals (Sweden)

    Christopher J Graves

    Full Text Available The hypothesis that evolvability - the capacity to evolve by natural selection - is itself the object of natural selection is highly intriguing but remains controversial due in large part to a paucity of direct experimental evidence. The antigenic variation mechanisms of microbial pathogens provide an experimentally tractable system to test whether natural selection has favored mechanisms that increase evolvability. Many antigenic variation systems consist of paralogous unexpressed 'cassettes' that recombine into an expression site to rapidly alter the expressed protein. Importantly, the magnitude of antigenic change is a function of the genetic diversity among the unexpressed cassettes. Thus, evidence that selection favors among-cassette diversity is direct evidence that natural selection promotes antigenic evolvability. We used the Lyme disease bacterium, Borrelia burgdorferi, as a model to test the prediction that natural selection favors amino acid diversity among unexpressed vls cassettes and thereby promotes evolvability in a primary surface antigen, VlsE. The hypothesis that diversity among vls cassettes is favored by natural selection was supported in each B. burgdorferi strain analyzed using both classical (dN/dS ratios and Bayesian population genetic analyses of genetic sequence data. This hypothesis was also supported by the conservation of highly mutable tandem-repeat structures across B. burgdorferi strains despite a near complete absence of sequence conservation. Diversification among vls cassettes due to natural selection and mutable repeat structures promotes long-term antigenic evolvability of VlsE. These findings provide a direct demonstration that molecular mechanisms that enhance evolvability of surface antigens are an evolutionary adaptation. The molecular evolutionary processes identified here can serve as a model for the evolution of antigenic evolvability in many pathogens which utilize similar strategies to establish

  17. Competitiveness: new economic paradigm?

    Directory of Open Access Journals (Sweden)

    Marlene Peñaloza

    2016-10-01

    Full Text Available Nowadays competitiveness is made up of “the new” paradigm that allows to prevail in the global World. Thus, it is inevitable to ask, was it required to be competitive to be successful in the international trade arena? Recognizing the discussion about it and its theoretical-conceptual density, the present paper studies this old notion whose meaning, in essence, is always the same one. This applies even though new realities in the present world-wide atmosphere confer to it a distinguishing character and new and old players are forced to organize actions and bring efforts together to obtain the competitive supremacy.

  18. Challenging the Innovation Paradigm

    CERN Document Server

    Sveiby, Karl Erik; Segercrantz, Beata

    2012-01-01

    Innovation is almost always seen as a "good thing". Challenging the Innovation Paradigm is a critical analysis of the innovation frenzy and contemporary innovation research. The one-sided focus on desirable effects of innovation misses many opportunities to reduce the undesirable consequences. Authors in this book show how systemic effects outside the innovating firms reduce the net benefits of innovation for individual employees, customers, as well as for society as a whole - also the innovators' own organizations. This book analyzes the dominant discourses that construct and recons

  19. SUSTAINABLE DEVELOPMENT PARADIGM - SYNOPSIS

    Directory of Open Access Journals (Sweden)

    Constantinescu Andreea

    2014-07-01

    Full Text Available Even if sustainable development is a concept that gained quite recently its scientific prestige, through contribution of researchers its content has upgraded to a high degree of conceptual luggage and, through contribution from governance representatives, has gained an impressive good-practice background. Allowing the use of different methodological premises and conceptual tools, sustainable development paradigm is equipped with all the elements that would allow the opening of new horizons of knowledge. Based on the facility which can operate the concept of sustainable development, the European Union aims to develop both a more competitive economy based on environmental protection as well as a new governance of economic policy. This on one hand demonstrates the sustainable development ability to irradiate creativity towards the establishment of interdisciplinary bridges and on the other hand explains the growing interest of researchers interested in the problem of analyzing in detail this fruitful concept. Launched first as a theoretical framework to serve justify actions responsible for weighting economic growth, the concept of Sustainable Development has quickly become a topic of ethical debate circumscribed to the area of perfectibility of human nature to the necessity registry. In this regard, the philosophical content of this paradigm could not remain outside researchers concerns, who want to provide both policy makers and the general public a wide range of evidence to demonstrate the viability of this paradigm. Academia waits until maximization of the contribution of governance to achieve sustainable economic development, which consists in conjunction of this upward path with the momentum given by public policy sync, perfectly adapted for globalization era and all crises to come. However, because this concept based its structure and composition on three pillars, equally important economy, society and environment any attempt to strengthen

  20. Vascular access surveillance: case study of a false paradigm.

    Science.gov (United States)

    Paulson, William D; Moist, Louise; Lok, Charmaine E

    2013-01-01

    The hemodialysis vascular access surveillance controversy provides a case study of how enthusiasm for a new test or treatment can lead to adoption of a false paradigm. Paradigms are the beliefs and assumptions shared by those in a field of knowledge, and are commonly included in clinical practice guidelines. The guidelines of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative recommend that arteriovenous vascular accesses undergo routine surveillance for detection and correction of stenosis. This recommendation is based on the paradigm that surveillance of access blood flow or dialysis venous pressure combined with correction of stenosis improves access outcomes. However, the quality of evidence that supports this paradigm has been widely criticized. We tested the validity of the surveillance paradigm by applying World Health Organization (WHO) criteria for evaluating screening tests to a literature review of published vascular access studies. These criteria include four components: undesired condition, screening test, intervention, and desired outcome. The WHO criteria show that surveillance as currently practiced fails all four components and provides little or no significant benefit, suggesting that surveillance is a false paradigm. Once a paradigm is established, however, challenges to its validity are usually resisted even as new evidence indicates the paradigm is not valid. Thus, it is paramount to apply rigorous criteria when developing guidelines. Regulators may help promote needed changes in paradigms when cost and safety considerations coincide. © 2013 Wiley Periodicals, Inc.

  1. Geographic Object-Based Image Analysis - Towards a new paradigm

    Science.gov (United States)

    Blaschke, Thomas; Hay, Geoffrey J.; Kelly, Maggi; Lang, Stefan; Hofmann, Peter; Addink, Elisabeth; Queiroz Feitosa, Raul; van der Meer, Freek; van der Werff, Harald; van Coillie, Frieke; Tiede, Dirk

    2014-01-01

    The amount of scientific literature on (Geographic) Object-based Image Analysis - GEOBIA has been and still is sharply increasing. These approaches to analysing imagery have antecedents in earlier research on image segmentation and use GIS-like spatial analysis within classification and feature extraction approaches. This article investigates these development and its implications and asks whether or not this is a new paradigm in remote sensing and Geographic Information Science (GIScience). We first discuss several limitations of prevailing per-pixel methods when applied to high resolution images. Then we explore the paradigm concept developed by Kuhn (1962) and discuss whether GEOBIA can be regarded as a paradigm according to this definition. We crystallize core concepts of GEOBIA, including the role of objects, of ontologies and the multiplicity of scales and we discuss how these conceptual developments support important methods in remote sensing such as change detection and accuracy assessment. The ramifications of the different theoretical foundations between the 'per-pixel paradigm' and GEOBIA are analysed, as are some of the challenges along this path from pixels, to objects, to geo-intelligence. Based on several paradigm indications as defined by Kuhn and based on an analysis of peer-reviewed scientific literature we conclude that GEOBIA is a new and evolving paradigm.

  2. Geographic Object-Based Image Analysis - Towards a new paradigm.

    Science.gov (United States)

    Blaschke, Thomas; Hay, Geoffrey J; Kelly, Maggi; Lang, Stefan; Hofmann, Peter; Addink, Elisabeth; Queiroz Feitosa, Raul; van der Meer, Freek; van der Werff, Harald; van Coillie, Frieke; Tiede, Dirk

    2014-01-01

    The amount of scientific literature on (Geographic) Object-based Image Analysis - GEOBIA has been and still is sharply increasing. These approaches to analysing imagery have antecedents in earlier research on image segmentation and use GIS-like spatial analysis within classification and feature extraction approaches. This article investigates these development and its implications and asks whether or not this is a new paradigm in remote sensing and Geographic Information Science (GIScience). We first discuss several limitations of prevailing per-pixel methods when applied to high resolution images. Then we explore the paradigm concept developed by Kuhn (1962) and discuss whether GEOBIA can be regarded as a paradigm according to this definition. We crystallize core concepts of GEOBIA, including the role of objects, of ontologies and the multiplicity of scales and we discuss how these conceptual developments support important methods in remote sensing such as change detection and accuracy assessment. The ramifications of the different theoretical foundations between the ' per-pixel paradigm ' and GEOBIA are analysed, as are some of the challenges along this path from pixels, to objects, to geo-intelligence. Based on several paradigm indications as defined by Kuhn and based on an analysis of peer-reviewed scientific literature we conclude that GEOBIA is a new and evolving paradigm.

  3. New treatment paradigms in psoriatic arthritis: an update on new therapeutics approved by the U.S. Food and Drug Administration.

    Science.gov (United States)

    Felquer, Maria L Acosta; Soriano, Enrique R

    2015-03-01

    The purpose of this study is to give an overview of the new treatments approved by the U.S. Food and Drug Administration (FDA) for use in psoriatic arthritis (PsA). FDA has approved three new drugs for PsA: Certolizumab-pegol: a PEGylated Fc-free tumour necrosis factor inhibitor (TNFi); ustekinumab: an anti interleukin (IL)-12 and IL-23 mAb; and apremilast and oral phosphodiesterase 4 inhibitor. On well designed and extensive developing programmes, all three drugs proved to be effective for the treatment of most PsA manifestations, including peripheral arthritis, skin involvement, enthesitis, dactylitis, quality of life and radiographic progression in patients failing traditional disease modifying drugs (DMARDs) and TNFi. Safety profile of all three drugs seems to be reassuring until now, although long-term data are still not available. Although Certolizumab-pegol is likely to be placed among the other TNFi, ustekinumab and apremilast, due to lower efficacy on arthritis, are being more frequently used as second-line therapy after TNFi failure, especially among rheumatologists. There are new therapeutic options approved for the treatment of PsA. For the first time, well proved effective therapies with a different mechanism of action than the inhibition of TNF alpha are available for the treatment of this progressive disease.

  4. Microgrids in the Evolving Electricity Generation and DeliveryInfrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Marnay, Chris; Venkataramanan, Giri

    2006-02-01

    The legacy paradigm for electricity service in most of the electrified world today is based on the centralized generation-transmission-distribution infrastructure that evolved under a regulated environment. More recently, a quest for effective economic investments, responsive markets, and sensitivity to the availability of resources, has led to various degrees of deregulation and unbundling of services. In this context, a new paradigm is emerging wherein electricity generation is intimately embedded with the load in microgrids. Development and decay of the familiar macrogrid is discussed. Three salient features of microgrids are examined to suggest that cohabitation of micro and macro grids is desirable, and that overall energy efficiency can be increased, while power is delivered to loads at appropriate levels of quality.

  5. Changing environments or shifting paradigms? Strategic decision making toward water protection in Helsinki, 1850-2000.

    Science.gov (United States)

    Laakkonen, Simo; Laurila, Sari

    2007-04-01

    The study examines the history of strategic decision-making concerning water protection in Helsinki, 1850-2000. We identified five major strategic decisions that occurred during the study period. The results indicate that strategic decision-making evolves in long-term policy cycles that last on average 20-30 years. New policy cycles are caused by paradigm shifts. Paradigms are shared and predominant ways of understanding reality that help when groups must act to solve common and complex environmental problems. However the internal structure and external dynamics of paradigms are contradictory. Although paradigms serve initially as means to redefine problems and find creative solutions, as time goes by each paradigm seems to become also a barrier that restricts the introduction of new ways of thinking and acting. The power of paradigms lies in the fact that they can be defined as scientific but also social, political, or cultural agreements depending on the context.

  6. Environmental Informatics and Soft Computing Paradigm: Processing of Cocos Nucifera Shell Derived Activated Carbon for Treatment of Distillery Spent Wash—A Solution to Environmental Issue

    Directory of Open Access Journals (Sweden)

    N. B. Raut

    2014-01-01

    Full Text Available Soft computing techniques are very much needed to design the environmental related systems these days. Soft computing (SC is a set of computational methods that attempt to determine satisfactory approximate solutions to find a model for real-world problems. Techniques such as artificial neural networks, fuzzy logic, and genetic algorithms can be used in solving complex environmental problems. Self-organizing feature map (SOFM model is proposed in monitoring and collecting of the data that are real time and static datasets acquired through pollution monitoring sensors and stations in the distilleries. In the environmental monitoring systems the ultimate requirement is to establish controls for the sensor based data acquisition systems and needs interactive and dynamic reporting services. SOFM techniques are used for data analysis and processing. The processed data is used for control system which even feeds to the treatment systems. Cocos nucifera activated carbon commonly known as coconut shell activated carbon (CSC was utilized for the treatment of distillery spent wash. Batch and column studies were done to investigate the kinetics and effect of operating parameter on the rate of adsorption. Since the quantum of spent water generated from the sugar industry allied distillery units is huge, this low cost adsorbent is found to be an attractive economic option. Equilibrium adsorption date was generated to plot Langmuir and Tempkin adsorption isotherm. The investigation reveals that though with lower adsorption capacities CSC seems to be technically feasible solution for treating sugar distillery spent. Efforts are made in this paper to build informatics for derived activated carbon for solving the problem of treatment of distillery spent wash. Capsule. Coconut shell derived activated carbon was synthesized, characterized, and successfully employed as a low cost adsorbent for treatment of distillery spent wash.

  7. Development of oral agent in the treatment of multiple sclerosis: how the first available oral therapy, Fingolimod will change therapeutic paradigm approach

    Directory of Open Access Journals (Sweden)

    Gasperini C

    2012-07-01

    Full Text Available Claudio Gasperini,1 Serena Ruggieri21Department of Neurosciences, S Camillo Forlanini Hospital, 2Department of Neurology and Psychiatry, University of Rome “Sapienza,” Rome, ItalyAbstract: Multiple sclerosis (MS is a chronic inflammatory disorder of the central nervous system, traditionally considered to be an autoimmune, demyelinating disease. Based on this understanding, the initial therapeutic strategies were directed at immune modulation and inflammation control. At present, there are five licensed first-line disease-modifying drugs and two second-line treatments in MS. Currently available MS therapies have shown significant efficacy throughout many trials, but they produce different side-effect profiles in patients. Since they are well known and safe, they require regular and frequent parenteral administration and are associated with limited long-term treatment adherence. Thus, there is an important need for the development of new therapeutic strategies. Several oral compounds are in late-stage development for treating MS. Fingolimod (FTY720; Novartis, Basel, Switzerland is an oral sphingosine-1-phosphase receptor modulator which has demonstrated superior efficacy compared with placebo and interferon β-1a in Phase III studies and has been approved in the treatment of MS. We summarily review the oral compounds in study, focusing on the recent development, approval and the clinical experience with FTY720.Keywords: multiple sclerosis, oral compounds, fingolimod, fty720, sphingosine 1, phosphate, patient satisfaction

  8. The resilience of paradigm mixes

    DEFF Research Database (Denmark)

    Daugbjerg, Carsten; Farsund, Arild Aurvåg; Langhelle, Oluf

    2017-01-01

    This paper argues that a policy regime based on a paradigm mix may be resilient when challenged by changing power balances and new agendas. Controversies between the actors can be contained within the paradigm mix as it enables them to legitimize different ideational positions. Rather than engaging...... in conflict over the foundation of the regime, they are more likely to rebalance the paradigm blend. We show that despite being a mixture of two contradictory paradigms, the World Trade Organization (WTO) Agreement on Agriculture has proven resilient when the power balance within the WTO and the policy...

  9. Paradigm shift: Can TQM save DOD's procurement process?

    Science.gov (United States)

    Romeo, Ross V.

    1992-11-01

    The Department of Defense's (DOD) ambitious introduction of total quality management (TQM) will fail, unless they change their paradigm and reengineer how they do business. TQM implementation in the defense department and possibilities for reengineering DOD's management structure were investigated. This paper uses a case study to investigate DOD's procurement efficiency and effectiveness with information technology. The findings show DOD is faced with its greatest challenge since WWII in meeting the rapidly evolving environment of the 1990s and the 21st century.

  10. PARADIGM OF ACCOUNTING CHANGE

    Directory of Open Access Journals (Sweden)

    Constanta Iacob

    2016-12-01

    Full Text Available The words and phrases swop with each other and the apparent stability of a word’s meaning sometimes change in time. This explains why the generic term of accounting is used when referring to the qualities attributed to accounting,but also when it comes to organizing financial accounting function within the entity, and when referring concretely to keeping a double record with its specific means, methods and tools specific, respectively seen as a technical accounting.Speaking about the qualities of accounting, but also about the organizational form it takes, we note that there is a manifold meaning of the word accounting, which is why the purpose of this article is to demonstrate that the paradigm shift aimed at a new set of rules and if the rules changes, then we can change the very purpose of accounting.

  11. The Peter Pan paradigm

    Directory of Open Access Journals (Sweden)

    Larson Janet E

    2008-01-01

    Full Text Available Abstract Genetic and environmental agents that disrupt organogenesis are numerous and well described. Less well established, however, is the role of delay in the developmental processes that yield functionally immature tissues at birth. Evidence is mounting that organs do not continue to develop postnatally in the context of these organogenesis insults, condemning the patient to utilize under-developed tissues for adult processes. These poorly differentiated organs may appear histologically normal at birth but with age may deteriorate revealing progressive or adult-onset pathology. The genetic and molecular underpinning of the proposed paradigm reveals the need for a comprehensive systems biology approach to evaluate the role of maternal-fetal environment on organogenesis. You may delay, but time will not Benjamin Franklin USA Founding Father

  12. Structural Emergency Control Paradigm

    DEFF Research Database (Denmark)

    Vu, Thanh Long; Chatzivasileiadis, Spyros; Chiang, Hsiao-Dong

    2017-01-01

    demand and hopefully stabilize the system. This traditional emergency control results in interrupted service with severe economic damage to customers. Also, such control is usually less effective due to the lack of coordination among protective devices. In this paper, we propose a novel structural...... emergency control to render post-fault dynamics from the critical/emergency fault cleared state to the stable equilibrium point. This is a new control paradigm that does not rely on any continuous measurement or load shedding, as in the classical setup. Instead, the grid is made stable by discretely...... relocating the equilibrium point and its stability region, such that the system is consecutively attracted from the fault-cleared state back to the original equilibrium point. The proposed control is designed by solving linear and convex optimization problems, making it possibly scalable to large-scale power...

  13. Paradigms for parasite conservation.

    Science.gov (United States)

    Dougherty, Eric R; Carlson, Colin J; Bueno, Veronica M; Burgio, Kevin R; Cizauskas, Carrie A; Clements, Christopher F; Seidel, Dana P; Harris, Nyeema C

    2016-08-01

    Parasitic species, which depend directly on host species for their survival, represent a major regulatory force in ecosystems and a significant component of Earth's biodiversity. Yet the negative impacts of parasites observed at the host level have motivated a conservation paradigm of eradication, moving us farther from attainment of taxonomically unbiased conservation goals. Despite a growing body of literature highlighting the importance of parasite-inclusive conservation, most parasite species remain understudied, underfunded, and underappreciated. We argue the protection of parasitic biodiversity requires a paradigm shift in the perception and valuation of their role as consumer species, similar to that of apex predators in the mid-20th century. Beyond recognizing parasites as vital trophic regulators, existing tools available to conservation practitioners should explicitly account for the unique threats facing dependent species. We built upon concepts from epidemiology and economics (e.g., host-density threshold and cost-benefit analysis) to devise novel metrics of margin of error and minimum investment for parasite conservation. We define margin of error as the risk of accidental host extinction from misestimating equilibrium population sizes and predicted oscillations, while minimum investment represents the cost associated with conserving the additional hosts required to maintain viable parasite populations. This framework will aid in the identification of readily conserved parasites that present minimal health risks. To establish parasite conservation, we propose an extension of population viability analysis for host-parasite assemblages to assess extinction risk. In the direst cases, ex situ breeding programs for parasites should be evaluated to maximize success without undermining host protection. Though parasitic species pose a considerable conservation challenge, adaptations to conservation tools will help protect parasite biodiversity in the face of

  14. Fasting plasma triglycerides predict the glycaemic response to treatment of type 2 diabetes by gastric electrical stimulation. A novel lipotoxicity paradigm.

    Science.gov (United States)

    Lebovitz, H E; Ludvik, B; Yaniv, I; Haddad, W; Schwartz, T; Aviv, R

    2013-06-01

    Non-stimulatory, meal-mediated electrical stimulation of the stomach (TANTALUS-DIAMOND) improves glycaemic control and causes modest weight loss in patients with Type 2 diabetes who are inadequately controlled on oral anti-diabetic medications. The magnitude of the glycaemic response in clinical studies has been variable. A preliminary analysis of data from patients who had completed 6 months of treatment indicated that the glycaemic response to the electrical stimulation was inversely related to the baseline fasting plasma triglyceride level. An analysis of 40 patients who had had detailed longitudinal studies for 12 months. Twenty-two patients with fasting plasma triglycerides ≤ 1.7 mmol/l had mean decreases in HbA1c after 3, 6 and 12 months of gastric contraction modulation treatment of -15 ± 2.1 mmol/mol (-1.39 ± 0.20%), -16 ± 2.2 mmol/mol (-1.48 ± 0.20%) and -14 ± 3.0 mmol/mol (-1.31 ± 0.26%), respectively. In contrast, 18 patients with fasting plasma triglyceride > 1.7 mmol/l had mean decreases in HbA1c of -7 ± 1.7 mmol/mol (-0.66 ± 0.16%), -5 ± 1.6 mmol/mol (-0.44 ± 0.18%) and -5 ± 1.7 mmol/mol (-0.42 ± 0.16%), respectively. Pearson's correlation coefficient between fasting plasma triglyceride and decreases in HbA1c at 12 months of treatment was 0.34 (P treatment in patients with high baseline fasting triglycerides, while it progressively improved in patients with low fasting plasma triglycerides. Patients with low fasting plasma triglycerides had a tendency to lose more weight than those with high fasting plasma triglycerides, but this did not achieve statistical significance. The data presented suggest the existence of a triglyceride lipotoxic mechanism that interferes with gastric/neural mediated pathways that can regulate glycaemic control in patients with type 2 diabetes. The data suggest the existence of a triglyceride lipotoxic pathway that interferes with gastric/neural mediated pathways that can regulate glycaemic control. © 2013 The

  15. [Change of paradigm in the surgical treatment of metastatic diseases of bone. Part I. Bony metastases of the extremities and pelvis].

    Science.gov (United States)

    Szendrői, Miklós; Kiss, János; Perlaky, Tamás; Antal, Imre; Szalay, Krisztián; Szendrői, Attila

    2017-10-01

    According to the statistical data of tumor registries the incidence of cancer has increased in the last decade, however the mortality shows only a slight change due to the new and effective multimodal treatments. The aim of our overview article is to present the changes in the survival of the metastatic patients, and to demonstrate which factors influence their prognosis. The improvement of survival resulted in a more active surgical role both in metastases of the bone of the extremities and the pelvis. We present a diagnostic flow chart and current options for the reconstruction of the different regions of the bone and skeleton, and we will discuss their potential advantages, disadvantages and complications. It is evident that apart from the impending and pathological fracture surgery it is not the first choice of treatment but rather a palliative measure. The aim of surgery is to alleviate pain, to regain mobility and improve quality of life. If possible minimal invasive techniques are performed, as they are less demanding and allow fast rehabilitation for the patient, and they are solutions that last for a lifetime. In optimal conditions radical curative surgery can be performed in about 10 to 15 per cent of the cases, and better survival is encouraging. Orv Hetil. 2017; 158(40): 1563-1569.

  16. The Rational Relevance of the Diffuse Paradigms

    Directory of Open Access Journals (Sweden)

    Marin Dinu

    2006-03-01

    Full Text Available Processes like the globalization consistency and learning about society are screened by diffuse concepts such as those taking the last steps of the industrial civilization and hierarchically ordered world through hegemony. This is why the meaning of globalization is given by deviant trends, like globalism, and the knowledge society is taken for the tools promoted by itself, such as the internet. This does not imply only approximations of meaning but rather the vanity of change, preserving the status quo represented by the pre-global world or the adversity principle. Historicism of paradigm cannot be avoided. Evolvement towards something else, announced by globalization is implacable, and the new ordinating principle, the one of competition, opens the opportunity horizon to global world

  17. The Rational Relevance of the Diffuse Paradigms

    Directory of Open Access Journals (Sweden)

    Marin Dinu

    2006-01-01

    Full Text Available Processes like the globalization consistency and learning about society are screened by diffuse concepts such as those taking the last steps of the industrial civilization and hierarchically ordered world through hegemony. This is why the meaning of globalization is given by deviant trends, like globalism, and the knowledge society is taken for the tools promoted by itself, such as the internet. This does not imply only approximations of meaning but rather the vanity of change, preserving the status quo represented by the pre-global world or the adversity principle. Historicism of paradigm cannot be avoided. Evolvement towards something else, announced by globalization is implacable, and the new ordinating principle, the one of competition, opens the opportunity horizon to global world.

  18. Raeder paratrigeminal neuralgia evolving to hemicrania continua.

    Science.gov (United States)

    Porzukowiak, Tina Renae

    2015-04-01

    Raeder paratrigeminal neuralgia is most commonly characterized as deep, boring, nonpulsatile, severe, unilateral facial and head pain in the distribution of the V1 area combined with ipsilateral oculosympathetic palsy and autonomic symptoms. Raeder paratrigeminal neuralgia evolving into hemicrania continua, a rare primary, chronic headache syndrome characterized by unilateral pain and response to indomethacin, has rarely been documented. The purpose of this case report is to contribute to the medical literature a single case of Raeder paratrigeminal neuralgia presenting as multiple cranial nerve palsies that evolved into hemicrania continua that was successfully treated with onabotulinumtoxinA. A 52-year-old white woman presented to the emergency department with the complaint of severe, aching, constant eye pain radiating to the V1 area for 1 week with associated ptosis and photophobia of the left eye. Ocular examination revealed involvement of cranial nerves II, III, V, and VI. Additional symptoms included ipsilateral lacrimation, eyelid edema, and rhinorrhea. Extensive medical work-up showed normal results. Raeder paratrigeminal neuralgia was diagnosed with multiple cranial nerve involvement; the headache component became chronic with periodic exacerbations of autonomic symptoms evolving to a diagnosis of hemicrania continua. The patient was intolerant to traditional indomethacin treatment, and the headache was successfully treated with onabotulinumtoxinA injections. Recognition of ipsilateral signs such as miosis, ptosis, hydrosis, eyelid edema, hyperemia, rhinorrhea, or nasal congestion is useful in the differential diagnosis of painful ophthalmoplegia, particularly in the diagnosis of Raeder paratrigeminal neuralgia and hemicrania continua. This case study illustrates a rare presentation of Raeder paratrigeminal neuralgia evolving into hemicrania continua presenting as a painful ophthalmoplegia with multiple cranial nerve involvement. The example supports the

  19. Treatment paradigms for patients with metastatic non small cell lung cancer (NSCLC, squamous lung cancer: first, second and third-line

    Directory of Open Access Journals (Sweden)

    Abdulaziz eAl Farsi

    2014-06-01

    Full Text Available Historically, the treatment algorithm applied to non small cell lung cancer (NSCLC was the same for all histologic subtypes. However, recent advances in our understanding of the molecular profiles of squamous and non-squamous NSCLC have changed this perspective. Histologic subtype and the presence of specific molecular abnormalities have predictive value for response to and toxicity from therapy, as well as overall survival. For patients with squamous NSCLC, a platinum agent plus gemcitabine, or paclitaxel is recommended as first-line therapy. The role of EGFR monoclonal antibodies is uncertain. Maintenance therapy is not widely recommended, although data exist for the use of erlotinib. The standard recommendation for second-line therapy is docetaxel and erlotinib should be considered as second or third-line therapy. There is ongoing research identifying molecular targets in squamous NSCLC and many agents are in early phase clinical trials. Immunotherapeutic approaches targeting programmed death 1 receptor (PD-1 and its ligand (PD-L1 appear promising.

  20. EVOLVE : a Bridge between Probability, Set Oriented Numerics, and Evolutionary Computation II

    CERN Document Server

    Coello, Carlos; Tantar, Alexandru-Adrian; Tantar, Emilia; Bouvry, Pascal; Moral, Pierre; Legrand, Pierrick; EVOLVE 2012

    2013-01-01

    This book comprises a selection of papers from the EVOLVE 2012 held in Mexico City, Mexico. The aim of the EVOLVE is to build a bridge between probability, set oriented numerics and evolutionary computing, as to identify new common and challenging research aspects. The conference is also intended to foster a growing interest for robust and efficient methods with a sound theoretical background. EVOLVE is intended to unify theory-inspired methods and cutting-edge techniques ensuring performance guarantee factors. By gathering researchers with different backgrounds, a unified view and vocabulary can emerge where the theoretical advancements may echo in different domains. Summarizing, the EVOLVE focuses on challenging aspects arising at the passage from theory to new paradigms and aims to provide a unified view while raising questions related to reliability,  performance guarantees and modeling. The papers of the EVOLVE 2012 make a contribution to this goal. 

  1. The Evolving Resource Metadata Infrastructure

    Science.gov (United States)

    Biemesderfer, Chris

    The search and discovery mechanisms that will facilitate and simplify systematic research on the Internet depend on systematic classifications of resources, as well as on standardized access to such metadata. The principles and technologies that will make this possible are evolving in the work of the Internet Engineering Task Force and the digital library initiatives, among others. The desired outcome is a set of standards, tools, and practices that permits both cataloging and retrieval to be comprehensive and efficient.

  2. Ranking in evolving complex networks

    Science.gov (United States)

    Liao, Hao; Mariani, Manuel Sebastian; Medo, Matúš; Zhang, Yi-Cheng; Zhou, Ming-Yang

    2017-05-01

    Complex networks have emerged as a simple yet powerful framework to represent and analyze a wide range of complex systems. The problem of ranking the nodes and the edges in complex networks is critical for a broad range of real-world problems because it affects how we access online information and products, how success and talent are evaluated in human activities, and how scarce resources are allocated by companies and policymakers, among others. This calls for a deep understanding of how existing ranking algorithms perform, and which are their possible biases that may impair their effectiveness. Many popular ranking algorithms (such as Google's PageRank) are static in nature and, as a consequence, they exhibit important shortcomings when applied to real networks that rapidly evolve in time. At the same time, recent advances in the understanding and modeling of evolving networks have enabled the development of a wide and diverse range of ranking algorithms that take the temporal dimension into account. The aim of this review is to survey the existing ranking algorithms, both static and time-aware, and their applications to evolving networks. We emphasize both the impact of network evolution on well-established static algorithms and the benefits from including the temporal dimension for tasks such as prediction of network traffic, prediction of future links, and identification of significant nodes.

  3. "Act on Threes" Paradigm for Treatment Intensification of Type 2 Diabetes in Managed Care: Results of a Randomized Controlled Study with an Educational Intervention Targeting Improved Glycemic Control.

    Science.gov (United States)

    Bieszk, Nella; Reynolds, Shannon L; Wei, Wenhui; Davis, Cralen; Kamble, Pravin; Uribe, Claudia

    2016-09-01

    Clinical inertia, which has been defined as the recognition of a problem with a patient's management but failing to act, is a concern in type 2 diabetes (T2D) because it places the patient at risk of diabetes-related complications. Despite managed care organizations making significant investment in this area, little is known about the impact of educational programs aimed at aligning patients and their physicians with diabetes guidelines and thus overcoming clinical inertia. To assess the impact of an educational intervention specifically designed to align patients and their physicians with 2012 American Diabetes Association (ADA) guidelines on glycated hemoglobin (A1c) testing frequency and insulin initiation. The "Act on Threes" educational intervention was a 12-month, randomized controlled prospective study that included Medicare Advantage patients aged 18-85 years with T2D, who received ≥ 3 oral antidiabetes drugs (OADs) and/or had A1c not at goal and/or had no recent A1c evaluation over 12 months, as identified through the analysis of administrative claims data (May 1, 2011-April 30, 2013) from the Humana database. Identified patients were randomized 3:1 to receive the Act on Threes educational intervention in conjunction with standard care (intervention group) or standard care alone (control group). For the educational intervention, patients and physicians were simultaneously mailed general and targeted information aimed at aligning them to 3 vital aspects of A1c control: timely measurement of A1c every 3 months; timely treatment intensification to meet A1c goals with treatment intensification every 3 months if A1c is not at goal; and insulin initiation when appropriate, including patients receiving ≥ 3 OADs with A1c not at goal. Control patients were only enrolled if the treating physician was not involved in the care of any patients in the intervention group. The primary outcome measures were A1c testing frequency based on the ADA standard for compliance

  4. Towards reduction of Paradigm coordination models

    NARCIS (Netherlands)

    S. Andova; L.P.J. Groenewegen; E.P. de Vink (Erik Peter); L. Aceto (Luca); M.R. Mousavi

    2011-01-01

    htmlabstractThe coordination modelling language Paradigm addresses collaboration between components in terms of dynamic constraints. Within a Paradigm model, component dynamics are consistently specified at a detailed and a global level of abstraction. To enable automated verification of Paradigm

  5. A nomenclature paradigm for benign midmembranous vocal fold lesions.

    Science.gov (United States)

    Rosen, Clark A; Gartner-Schmidt, Jackie; Hathaway, Bridget; Simpson, C Blake; Postma, Gregory N; Courey, Mark; Sataloff, Robert T

    2012-06-01

    There is a significant lack of uniform agreement regarding nomenclature for benign vocal fold lesions (BVFLs). This confusion results in difficulty for clinicians communicating with their patients and with each other. In addition, BVFL research and comparison of treatment methods are hampered by the lack of a detailed and uniform BVFL nomenclature. Clinical consensus conferences were held to develop an initial BVFL nomenclature paradigm. Perceptual video analysis was performed to validate the stroboscopy component of the paradigm. The culmination of the consensus conferences and the video-perceptual analysis was used to evaluate the BVFL nomenclature paradigm using a retrospective review of patients with BVFL. An initial BVFL nomenclature paradigm was proposed utilizing detailed definitions relating to vocal fold lesion morphology, stroboscopy, response to voice therapy and intraoperative findings. Video-perceptual analysis of stroboscopy demonstrated that the proposed binary stroboscopy system used in the BVFL nomenclature paradigm was valid and widely applicable. Retrospective review of 45 patients with BVFL followed to the conclusion of treatment demonstrated that slight modifications of the initial BVFL nomenclature paradigm were required. With the modified BVFL nomenclature paradigm, 96% of the patients fit into the predicted pattern and definitions of the BVFL nomenclature system. This study has validated a multidimensional BVFL nomenclature paradigm. This vocal fold nomenclature paradigm includes nine distinct vocal fold lesions: vocal fold nodules, vocal fold polyp, pseudocyst, vocal fold cyst (subepithelial or ligament), nonspecific vocal fold lesion, vocal fold fibrous mass (subepithelial or ligament), and reactive lesion. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  6. The evolvability of programmable hardware

    Science.gov (United States)

    Raman, Karthik; Wagner, Andreas

    2011-01-01

    In biological systems, individual phenotypes are typically adopted by multiple genotypes. Examples include protein structure phenotypes, where each structure can be adopted by a myriad individual amino acid sequence genotypes. These genotypes form vast connected ‘neutral networks’ in genotype space. The size of such neutral networks endows biological systems not only with robustness to genetic change, but also with the ability to evolve a vast number of novel phenotypes that occur near any one neutral network. Whether technological systems can be designed to have similar properties is poorly understood. Here we ask this question for a class of programmable electronic circuits that compute digital logic functions. The functional flexibility of such circuits is important in many applications, including applications of evolutionary principles to circuit design. The functions they compute are at the heart of all digital computation. We explore a vast space of 1045 logic circuits (‘genotypes’) and 1019 logic functions (‘phenotypes’). We demonstrate that circuits that compute the same logic function are connected in large neutral networks that span circuit space. Their robustness or fault-tolerance varies very widely. The vicinity of each neutral network contains circuits with a broad range of novel functions. Two circuits computing different functions can usually be converted into one another via few changes in their architecture. These observations show that properties important for the evolvability of biological systems exist in a commercially important class of electronic circuitry. They also point to generic ways to generate fault-tolerant, adaptable and evolvable electronic circuitry. PMID:20534598

  7. The 'E' factor -- evolving endodontics.

    Science.gov (United States)

    Hunter, M J

    2013-03-01

    Endodontics is a constantly developing field, with new instruments, preparation techniques and sealants competing with trusted and traditional approaches to tooth restoration. Thus general dental practitioners must question and understand the significance of these developments before adopting new practices. In view of this, the aim of this article, and the associated presentation at the 2013 British Dental Conference & Exhibition, is to provide an overview of endodontic methods and constantly evolving best practice. The presentation will review current preparation techniques, comparing rotary versus reciprocation, and question current trends in restoration of the endodontically treated tooth.

  8. Negative pressure darwinism: survival of the fittest paradigm.

    Science.gov (United States)

    Miller, Michael; Bybordi, Farhad

    2009-07-01

    The use of negative pressure for wound healing has been based on a set of parameters and devices that until recently were combined into a single paradigm. Despite historical and more recent evidence providing viable alternative considerations, it is only recently that this paradigm and its tenets have come into question. As the understanding of the limits of the current paradigm and specific instances of its benefits and drawbacks are identified, shifts in the paradigm must take place if the therapy is to evolve, develop, and continue to be efficacious. The pertinence of the concept of survival of the fittest is used to explore the need for a paradigm shift in negative pressure wound therapy.

  9. The emerging land management paradigm

    DEFF Research Database (Denmark)

    Enemark, Stig

    paradigm. The model reflects drivers of globalisation and technology development which support establishment of multifunctional information systems incorporating diverse land rights, land use regulations and other useful data. A third major driver, sustainable development, stimulates demands...

  10. The Consumption Paradigm in Marketing

    Directory of Open Access Journals (Sweden)

    Eka Ardianto

    2003-08-01

    Full Text Available This article elaborates consumption paradigm in marketing. In background, this paper reviews different perspectives of consumption: economic perspective and marketing perspective. In ontology, this work describes various issues regarding consumption view. In epistemology, this article demonstrates how marketers especially researches explore the consumption phenomena. In methodology, the article describes experiential marketing –one of applied consumption paradigm in marketing, which could be an alternative choice of marketing practices.

  11. Paradigms, platitudes, opportunists.

    Science.gov (United States)

    Mascolini, M

    1995-11-01

    Research developments and problems in managing opportunistic diseases were addressed at the 1995 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the European Conference on Clinical Aspects and Treatment of HIV Infection. Topics included how HIV develops into AIDS, the use of antiretroviral therapy in HIV infection, viral invasions of lymphoid tissue, and CMV prophylaxis and resistance. Results of research on CMV reduction, MAC reduction, prolonged survival, and the treatment of cryptococcal meningitis are also presented. Final comments address the use of prolonged or painful drug therapy research trials.

  12. Primordial evolvability: Impasses and challenges.

    Science.gov (United States)

    Vasas, Vera; Fernando, Chrisantha; Szilágyi, András; Zachár, István; Santos, Mauro; Szathmáry, Eörs

    2015-09-21

    While it is generally agreed that some kind of replicating non-living compounds were the precursors of life, there is much debate over their possible chemical nature. Metabolism-first approaches propose that mutually catalytic sets of simple organic molecules could be capable of self-replication and rudimentary chemical evolution. In particular, the graded autocatalysis replication domain (GARD) model, depicting assemblies of amphiphilic molecules, has received considerable interest. The system propagates compositional information across generations and is suggested to be a target of natural selection. However, evolutionary simulations indicate that the system lacks selectability (i.e. selection has negligible effect on the equilibrium concentrations). We elaborate on the lessons learnt from the example of the GARD model and, more widely, on the issue of evolvability, and discuss the implications for similar metabolism-first scenarios. We found that simple incorporation-type chemistry based on non-covalent bonds, as assumed in GARD, is unlikely to result in alternative autocatalytic cycles when catalytic interactions are randomly distributed. An even more serious problem stems from the lognormal distribution of catalytic factors, causing inherent kinetic instability of such loops, due to the dominance of efficiently catalyzed components that fail to return catalytic aid. Accordingly, the dynamics of the GARD model is dominated by strongly catalytic, but not auto-catalytic, molecules. Without effective autocatalysis, stable hereditary propagation is not possible. Many repetitions and different scaling of the model come to no rescue. Despite all attempts to show the contrary, the GARD model is not evolvable, in contrast to reflexively autocatalytic networks, complemented by rare uncatalyzed reactions and compartmentation. The latter networks, resting on the creation and breakage of chemical bonds, can generate novel ('mutant') autocatalytic loops from a given set of

  13. Peripartum hysterectomy: an evolving picture.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    Peripartum hysterectomy (PH) is one of the obstetric catastrophes. Evidence is emerging that the role of PH in modern obstetrics is evolving. Improving management of postpartum hemorrhage and newer surgical techniques should decrease PH for uterine atony. Rising levels of repeat elective cesarean deliveries should decrease PH following uterine scar rupture in labor. Increasing cesarean rates, however, have led to an increase in the number of PHs for morbidly adherent placenta. In the case of uterine atony or rupture where PH is required, a subtotal PH is often sufficient. In the case of pathological placental localization involving the cervix, however, a total hysterectomy is required. Furthermore, the involvement of other pelvic structures may prospectively make the diagnosis difficult and the surgery challenging. If resources permit, PH for pathological placental localization merits a multidisciplinary approach. Despite advances in clinical practice, it is likely that peripartum hysterectomy will be more challenging for obstetricians in the future.

  14. Extreme evolved solar systems (EESS)

    Science.gov (United States)

    Gaensicke, Boris

    2017-08-01

    In just 20 years, we went from not knowing if the solar system is a fluke of Nature to realising that it is totally normal for stars to have planets. More remarkably, it is now clear that planet formation is a robust process, as rich multi-planet systems are found around stars more massive and less massive than the Sun. More recently, planetary systems have been identified in increasingly complex architectures, including circumbinary planets, wide binaries with planets orbiting one or both stellar components, and planets in triple stellar systems.We have also learned that many planetary systems will survive the evolution of their host stars into the white dwarf phase. Small bodies are scattered by unseen planets into the gravitational field of the white dwarfs, tidally disrupt, form dust discs, and eventually accrete onto the white dwarf, where they can be spectroscopically detected. HST/COS has played a critical role in the study these evolved planetary systems, demonstrating that overall the bulk composition of the debris is rocky and resembles in composition the inner the solar system, including evidence for water-rich planetesimals. Past observations of planetary systems at white dwarfs have focused on single stars with main-sequence progenitors of 1.5 to 2.5Msun. Here we propose to take the study of evolved planetary systems into the extremes of parameter ranges to answer questions such as: * How efficient is planet formation around 4-10Msun stars? * What are the metallicities of the progenitors of debris-accreting white dwarfs?* What is the fate of circumbinary planets?* Can star-planet interactions generate magnetic fields in the white dwarf host?

  15. An FPGA hardware/software co-design towards evolvable spiking neural networks for robotics application.

    Science.gov (United States)

    Johnston, S P; Prasad, G; Maguire, L; McGinnity, T M

    2010-12-01

    This paper presents an approach that permits the effective hardware realization of a novel Evolvable Spiking Neural Network (ESNN) paradigm on Field Programmable Gate Arrays (FPGAs). The ESNN possesses a hybrid learning algorithm that consists of a Spike Timing Dependent Plasticity (STDP) mechanism fused with a Genetic Algorithm (GA). The design and implementation direction utilizes the latest advancements in FPGA technology to provide a partitioned hardware/software co-design solution. The approach achieves the maximum FPGA flexibility obtainable for the ESNN paradigm. The algorithm was applied as an embedded intelligent system robotic controller to solve an autonomous navigation and obstacle avoidance problem.

  16. EVOLVE : a Bridge between Probability, Set Oriented Numerics and Evolutionary Computation

    CERN Document Server

    Tantar, Alexandru-Adrian; Bouvry, Pascal; Moral, Pierre; Legrand, Pierrick; Coello, Carlos; Schütze, Oliver; EVOLVE 2011

    2013-01-01

    The aim of this book is to provide a strong theoretical support for understanding and analyzing the behavior of evolutionary algorithms, as well as for creating a bridge between probability, set-oriented numerics and evolutionary computation. The volume encloses a collection of contributions that were presented at the EVOLVE 2011 international workshop, held in Luxembourg, May 25-27, 2011, coming from invited speakers and also from selected regular submissions. The aim of EVOLVE is to unify the perspectives offered by probability, set oriented numerics and evolutionary computation. EVOLVE focuses on challenging aspects that arise at the passage from theory to new paradigms and practice, elaborating on the foundations of evolutionary algorithms and theory-inspired methods merged with cutting-edge techniques that ensure performance guarantee factors. EVOLVE is also intended to foster a growing interest for robust and efficient methods with a sound theoretical background. The chapters enclose challenging theoret...

  17. The maturing of the quality improvement paradigm in the SEL

    Science.gov (United States)

    Basili, Victor R.

    1993-01-01

    The Software Engineering Laboratory uses a paradigm for improving the software process and product, called the quality improvement paradigm. This paradigm has evolved over the past 18 years, along with our software development processes and product. Since 1976, when we first began the SEL, we have learned a great deal about improving the software process and product, making a great many mistakes along the way. Quality improvement paradigm, as it is currently defined, can be broken up into six steps: characterize the current project and its environment with respect to the appropriate models and metrics; set the quantifiable goals for successful project performance and improvement; choose the appropriate process model and supporting methods and tools for this project; execute the processes, construct the products, and collect, validate, and analyze the data to provide real-time feedback for corrective action; analyze the data to evaluate the current practices, determine problems, record findings, and make recommendations for future project improvements; and package the experience gained in the form of updated and refined models and other forms of structured knowledge gained from this and prior projects and save it in an experience base to be reused on future projects.

  18. Lessons from the Nonlinear Paradigm: Applications of the Theory of Dissipative Structures in the Social Sciences.

    Science.gov (United States)

    Kiel, L. Douglas

    1991-01-01

    Discusses incorporating the dynamics of complex systems, as presented in the theory of dissipative structures, into models of evolving social systems. Considers the importance of instability and minor and random events and the limits of forecasting, generalization, and control. Concludes that the nonlinear paradigm represents a link between…

  19. Paradigm Shifts in Ophthalmic Diagnostics.

    Science.gov (United States)

    Sebag, J; Sadun, Alfredo A; Pierce, Eric A

    2016-08-01

    Future advances in ophthalmology will see a paradigm shift in diagnostics from a focus on dysfunction and disease to better measures of psychophysical function and health. Practical methods to define genotypes will be increasingly important and non-invasive nanotechnologies are needed to detect molecular changes that predate histopathology. This is not a review nor meant to be comprehensive. Specific topics have been selected to illustrate the principles of important paradigm shifts that will influence the future of ophthalmic diagnostics. It is our impression that future evaluation of vision will go beyond visual acuity to assess ocular health in terms of psychophysical function. The definition of disease will incorporate genotype into what has historically been a phenotype-centric discipline. Non-invasive nanotechnologies will enable a paradigm shift from disease detection on a cellular level to a sub-cellular molecular level. Vision can be evaluated beyond visual acuity by measuring contrast sensitivity, color vision, and macular function, as these provide better insights into the impact of aging and disease. Distortions can be quantified and the psychophysical basis of vision can be better evaluated than in the past by designing tests that assess particular macular cell function(s). Advances in our understanding of the genetic basis of eye diseases will enable better characterization of ocular health and disease. Non-invasive nanotechnologies can assess molecular changes in the lens, vitreous, and macula that predate visible pathology. Oxygen metabolism and circulatory physiology are measurable indices of ocular health that can detect variations of physiology and early disease. This overview of paradigm shifts in ophthalmology suggests that the future will see significant improvements in ophthalmic diagnostics. The selected topics illustrate the principles of these paradigm shifts and should serve as a guide to further research and development. Indeed

  20. CNN a paradigm for complexity

    CERN Document Server

    Chua, Leon O

    1998-01-01

    Revolutionary and original, this treatise presents a new paradigm of EMERGENCE and COMPLEXITY, with applications drawn from numerous disciplines, including artificial life, biology, chemistry, computation, physics, image processing, information science, etc.CNN is an acronym for Cellular Neural Networks when used in the context of brain science, or Cellular Nonlinear Networks, when used in the context of emergence and complexity. A CNN is modeled by cells and interactions: cells are defined as dynamical systems and interactions are defined via coupling laws. The CNN paradigm is a universal Tur

  1. Exploring Paradigms of Crime Reduction

    DEFF Research Database (Denmark)

    Soothill, Keith; Christoffersen, Mogens N.; Hussain, Azhar

    2010-01-01

    Using Danish registers for a 1980 birth cohort of 29,944 males with parental information and following up these cases for 25 years, the study considers four paradigms of crime reduction (parental child rearing, structural factors around adolescence, locality and individual resources). Focusing...... on offenders with first-time convictions for shoplifting (n = 1,989), for burglary (n = 1,324) and for violence (n = 1,901), all four paradigms made a contribution to risk of first-time offending for all three crimes. The counter-factual analysis indicated that a focus on structural issues within a society may...

  2. Understanding the land management paradigm

    DEFF Research Database (Denmark)

    Enemark, Stig

    2006-01-01

    There is a worldwide need to build understanding of the land management paradigm and for institutional development to establish sustainable national concepts. This includes creation and adoption of a policy on land development, and an approach that combines the land administration/cadastre/land r......There is a worldwide need to build understanding of the land management paradigm and for institutional development to establish sustainable national concepts. This includes creation and adoption of a policy on land development, and an approach that combines the land administration...

  3. Explaining (Missing) Regulator Paradigm Shifts

    DEFF Research Database (Denmark)

    Wigger, Angela; Buch-Hansen, Hubert

    2014-01-01

    of competition regulation is heaving into sight. It sets out to explain this from the vantage point of a critical political economy perspective, which identifies the circumstances under which a crisis can result in a regulatory paradigm shift. Contrasting the current situation with the shift in EC/EU competition...... capitalism; the social power configuration underpinning the neoliberal order remains unaltered; no clear counter-project has surfaced; the European Commission has been (and remains) in a position to oppose radical changes; and finally, there are no signs of a wider paradigm shift in the EU's regulatory...

  4. Transmission pricing: paradigms and methodologies

    Energy Technology Data Exchange (ETDEWEB)

    Shirmohammadi, Dariush [Pacific Gas and Electric Co., San Francisco, CA (United States); Vieira Filho, Xisto; Gorenstin, Boris [Centro de Pesquisas de Energia Eletrica (CEPEL), Rio de Janeiro, RJ (Brazil); Pereira, Mario V.P. [Power System Research, Rio de Janeiro, RJ (Brazil)

    1994-12-31

    In this paper we describe the principles of several paradigms and methodologies for pricing transmission services. The paper outlines some of the main characteristics of these paradigms and methodologies such as where they may be used for best results. Due to their popularity, power flow based MW-mile and short run marginal cost pricing methodologies will be covered in some detail. We conclude the paper with examples of the application of these two pricing methodologies for pricing transmission services in Brazil. (author) 25 refs., 2 tabs.

  5. The synthesis paradigm in genetics.

    Science.gov (United States)

    Rice, William R

    2014-02-01

    Experimental genetics with model organisms and mathematically explicit genetic theory are generally considered to be the major paradigms by which progress in genetics is achieved. Here I argue that this view is incomplete and that pivotal advances in genetics--and other fields of biology--are also made by synthesizing disparate threads of extant information rather than generating new information from experiments or formal theory. Because of the explosive expansion of information in numerous "-omics" data banks, and the fragmentation of genetics into numerous subdisciplines, the importance of the synthesis paradigm will likely expand with time.

  6. Enabling a New Planning and Scheduling Paradigm

    Science.gov (United States)

    Jaap, John; Davis, Elizabeth

    2004-01-01

    The Flight Projects Directorate at NASA's Marshall Space Flight Center is developing a new planning and scheduling environment and a new scheduling algorithm to enable a paradigm shift in planning and scheduling concepts. Over the past 33 years Marshall has developed and evolved a paradigm for generating payload timelines for Skylab, Spacelab, various other Shuttle payloads, and the International Space Station. The current paradigm starts by collecting the requirements, called "tasks models," from the scientists and technologists for the tasks that they want to be done. Because of shortcomings in the current modeling schema, some requirements are entered as notes. Next a cadre with knowledge of vehicle and hardware modifies these models to encompass and be compatible with the hardware model; again, notes are added when the modeling schema does not provide a better way to represent the requirements. Finally, another cadre further modifies the models to be compatible with the scheduling engine. This last cadre also submits the models to the scheduling engine or builds the timeline manually to accommodate requirements that are expressed in notes. A future paradigm would provide a scheduling engine that accepts separate science models and hardware models. The modeling schema would have the capability to represent all the requirements without resorting to notes. Furthermore, the scheduling engine would not require that the models be modified to account for the capabilities (limitations) of the scheduling engine. The enabling technology under development at Marshall has three major components. (1) A new modeling schema allows expressing all the requirements of the tasks without resorting to notes or awkward contrivances. The chosen modeling schema is both maximally expressive and easy to use. It utilizes graphics methods to show hierarchies of task constraints and networks of temporal relationships. (2) A new scheduling algorithm automatically schedules the models

  7. CERN internal communication is evolving

    CERN Multimedia

    2016-01-01

    CERN news will now be regularly updated on the CERN People page (see here).      Dear readers, All over the world, communication is becoming increasingly instantaneous, with news published in real time on websites and social networks. In order to keep pace with these changes, CERN's internal communication is evolving too. From now on, you will be informed of what’s happening at CERN more often via the “CERN people” page, which will frequently be updated with news. The Bulletin is following this trend too: twice a month, we will compile the most important articles published on the CERN site, with a brand-new layout. You will receive an e-mail every two weeks as soon as this new form of the Bulletin is available. If you have interesting news or stories to share, tell us about them through the form at: https://communications.web.cern.ch/got-story-cern-website​. You can also find out about news from CERN in real time...

  8. Tibiotalar torsion: bioengineering paradigm.

    Science.gov (United States)

    Michele, A A; Nielsen, P M

    1976-10-01

    1. Medial tibiotalar torsion is the most common disorder peculiar to mankind. 2. The pathogonomic findings are (a) an axial medially rotated and adducted distal third of the shaft of the tibia, (b) the plafond of the tibia with its mortise containing the "track-bound" talus, which is deflected strongly toward the tibial side, (c) an exaggerated midtarsal equinus, (d) ostensible restriction of dorsiflexion of the hindfoot against the tibia, (e) mild separation of the distal tibiofibular articulation, and (f) forward displacement of the gravitational axis to the naviculocunei-form joint. 3. Faulty leg crossing in utero resulting in an abnormal pelvofemoral-tibial design is discussed and its important consequences in the vulnerable 40 per cent of the population are emphasized. 4. The kinesiomechanics of the leg, ankle and foot is reviewed. 5. The radiographic parameters of medial tibiotalar torsion are presented, as well as the multiple facets of the clinical examination. 6. Methods of treatment depending on age and severity of the disorder are recommended. Surgery, detortional casts, and corrective footwear are discussed. Shoes presently available are inadequate for tibiotalar torsion and therefore engineering principles must be applied in the design and construction of all footwear, including sneakers and sportswear. This can be done only if the pathological biomechanics of this group of disorders is recognized. Biplane proximal tibial osteotomy is recommended in refractory cases, especially when tibiotalar torsion is demonstrated. 7. After 30 years of experience, the author finds that results with these patients have been uniformly good to excellent, depending on age and mode of treatment. 8. In medial tibiotalar torsion, the consequent adaptive changes are readily observed, but rarely are they recognized as the inevitable sequelae of medial tibiotalar torsion. 9. Adaptive compensating disorders are identified and their mechanism described. 10. The management of

  9. Paradigm shift: cognitive surgery

    Directory of Open Access Journals (Sweden)

    Kenngott Hannes G.

    2017-06-01

    Full Text Available In the last hundred years surgery has experienced a dramatic increase of scientific knowledge and innovation. The need to consider best available evidence and to apply technical innovations, such as minimally invasive approaches, challenges the surgeon both intellectually and manually. In order to overcome this challenge, computer scientists and surgeons within the interdisciplinary field of “cognitive surgery” explore and innovate new ways of data processing and management. This article gives a general overview of the topic and outlines selected pre-, intra- and postoperative applications. It explores the possibilities of new intelligent devices and software across the entire treatment process of patients ending in the consideration of an “Intelligent Hospital” or “Hospital 4.0”, in which the borders between IT infrastructures, medical devices, medical personnel and patients are bridged by technology. Thereby, the “Hospital 4.0” is an intelligent system, which gives the right information, at the right time, at the right place to the individual stakeholder and thereby helps to decrease complications and improve clinical processes as well as patient outcome.

  10. Beyond expressive writing: evolving models of developmental creative writing.

    Science.gov (United States)

    Nicholls, Sophie

    2009-03-01

    Pennebaker's expressive writing paradigm has helped to introduce the benefits of writing to health care. However, research in expressive writing has been largely dominated by an experimental and quantitative approach that does not take into account critical methodologies and approaches in health psychology, the increasingly complex ways in which creative writing is now being used in health care settings or recent research in the broader field of creative writing and personal development, health and well-being (developmental creative writing). This article contrasts expressive writing theories and methodologies with those evolving in the relatively new field of developmental creative writing. It investigates a number of theoretical and methodological problems with the expressive writing model and argues for a more critical approach to future research.

  11. The evolved athlete a guide for elite sport enhancement

    CERN Document Server

    Ivancevic, Tijana; Gojkovic, Zoran; Greenberg, Ronald; Greenberg, Helen; Jovanovic, Bojan; Lukman, Aleksandar

    2017-01-01

    This handbook provides insights into becoming a better and more evolved athlete. It offers aspiring athletes, regardless of skill level, a better understanding of their bodies and how to unlock the unlimited potential of muscles without injury. It focuses on the “superhero” muscle: the iliopsoas, and also sheds light on Diamond-Corporation’s new technology and elite athleticism, and how these can contribute to a healthier life. Lastly, the authors explore the mindset of success and provide exercises for remaining calm under pressure. This stand-alone book is the sequel to Paradigm Shift for Future Tennis and Enhancing Performance and Reducing Stress in Sport (2014, Springer). This book is written by scientists, whose expertise collectively spans the fields of biomechanics, clinical surgery, current and former elite athleticism, engineering and naturopath doctoral work. Together, they aim to inspire and educate athletes on how to improve their sports performance by using new technologies, world class bio...

  12. [The female paradigm in psychoanalysis].

    Science.gov (United States)

    Rohde-Dachser, C

    1990-01-01

    According to the author, the necessary change to a new psychoanalytic paradigm of femininity can only take place if the patriarchal discourse of psychoanalytic metatheory is systematically deconstructed. Only then can a reconstruction of this discourse occur with a view toward the emancipation of both genders.

  13. A New Paradigm of ISD?

    Science.gov (United States)

    Reigeluth, Charles M., Ed.

    1996-01-01

    Examines changes in the "supersystem" of instructional systems design (ISD) that indicate the need for a paradigm of training and education based on learning instead of sorting students. Emphasizes the necessity of developing initiative, teamwork, thinking skills, and diversity, as well as new learning-focused instructional theories and…

  14. Theological paradigms and conservative Afrikaners

    African Journals Online (AJOL)

    logical paradigm for conservative Afrikaner believers must be critical, legitimising and free of .... thoughts with a belief in the divine source of knowledge. Both aimed at arriving at knowledge which is .... the right-wing Afrikaners with the vision that they are the chosen Israel. These peo ple emphasise the concept of election in ...

  15. The Paradigm of Distributed Creativity

    DEFF Research Database (Denmark)

    Glaveanu, Vlad Petre

    This presentation aims to focus on and develop the notion of distributed creativity from a cultural psychological perspective. It will start by outlining the need for a cultural psychological paradigm of creative expression and argue that this perspective is primarily concerned with what can...

  16. The emerging land management paradigm

    DEFF Research Database (Denmark)

    Enemark, Stig

    2006-01-01

    Manchet: This paper was first presented by Professor Enemark at the RICS Christmas Lecture in December last year. It provides a cogent and detailed reference point for the current state of land management in developed countries, charts a course for the future and looks at how education must chang...... to meet the new paradigm....

  17. Biofabrication: a 21st century manufacturing paradigm.

    Science.gov (United States)

    Mironov, V; Trusk, T; Kasyanov, V; Little, S; Swaja, R; Markwald, R

    2009-06-01

    Biofabrication can be defined as the production of complex living and non-living biological products from raw materials such as living cells, molecules, extracellular matrices, and biomaterials. Cell and developmental biology, biomaterials science, and mechanical engineering are the main disciplines contributing to the emergence of biofabrication technology. The industrial potential of biofabrication technology is far beyond the traditional medically oriented tissue engineering and organ printing and, in the short term, it is essential for developing potentially highly predictive human cell- and tissue-based technologies for drug discovery, drug toxicity, environmental toxicology assays, and complex in vitro models of human development and diseases. In the long term, biofabrication can also contribute to the development of novel biotechnologies for sustainable energy production in the future biofuel industry and dramatically transform traditional animal-based agriculture by inventing 'animal-free' food, leather, and fur products. Thus, the broad spectrum of potential applications and rapidly growing arsenal of biofabrication methods strongly suggests that biofabrication can become a dominant technological platform and new paradigm for 21st century manufacturing. The main objectives of this review are defining biofabrication, outlining the most essential disciplines critical for emergence of this field, analysis of the evolving arsenal of biofabrication technologies and their potential practical applications, as well as a discussion of the common challenges being faced by biofabrication technologies, and the necessary conditions for the development of a global biofabrication research community and commercially successful biofabrication industry.

  18. [Meta-legal paradigms of nanomedicine].

    Science.gov (United States)

    Pérez Alvarez, Salvador

    2012-01-01

    Nanomedicine is the Nanotechnology applied in the field of Medicine. Nanomedicine includes a wide range of technologies applied to devices, materials, medical procedures and treatment modalities are being developed, in some cases, through the convergence of living and nonliving materials. The developments in this scientific field are the prelude of a new era in health where Nanotechnology will provide, in a short period of time, substantial benefits for the general welfare and health of people with serious and incurable diseases using other more traditional medical treatments. This is, in brief, the object of this research that has been focused in the study of the ethical-legal paradigms that should inform the developments and expectations generated by medical applications of Nanotechnology.

  19. Policy paradigms, transnationalism, and domestic politics

    National Research Council Canada - National Science Library

    Skogstad, Grace Darlene

    2011-01-01

    Policy Paradigms, Transnationalism, and Domestic Politics offers a variety of perspectives on the development of policy paradigms -- the ideas that structure thinking about what can and should be done in a policy domain...

  20. Treating Communication Anxiety: Implications of the Communibiological Paradigm.

    Science.gov (United States)

    Kelly, Lynne; Keaten, James A.

    2000-01-01

    Offers a synopsis of M. Beatty and J. McCroskey's 1998 reconceptualization of communication apprehension via the communibiological paradigm. Examines possible treatment implications of this model of communication anxiety for teachers of speech communication, particularly of public speaking. Advances pedagogical strategies, based upon the premise…

  1. The evolving role of tiotropium in asthma

    Directory of Open Access Journals (Sweden)

    McIvor ER

    2017-08-01

    Full Text Available Emma R McIvor,1 R Andrew McIvor2 1Queen’s University, Belfast, UK; 2Department of Medicine, McMaster University, Firestone Institute for Respiratory Health, Hamilton, Ontario, Canada Abstract: Tiotropium is a long-acting muscarinic antagonist (LAMA that exerts its bronchodilatory effect by blocking endogenous acetylcholine receptors in the airways. Its safety and efficacy are well established for the treatment of COPD, and it is now being recognized for its role in improving lung function and control in asthma. This review discusses the evolving role of tiotropium delivered by the Respimat® in patients across the range of asthma severities and ages, and provides an overview of safety and efficacy data. Tiotropium is the only LAMA currently approved for the treatment of asthma, and evidence from a large-scale clinical trial program, including several Phase III studies in adults, has demonstrated that tiotropium improves lung function and asthma control, with a safety profile comparable with that of placebo. Clinical trials in adolescent patients (aged 12–17 years have also shown improvements in lung function and trends toward improved asthma control. Of note, the efficacy and safety profiles are consistent regardless of baseline characteristics and phenotype. Given the large and growing body of evidence, it is likely that as clinical experience with tiotropium increases, this treatment may possibly emerge as the key choice for add-on therapy to inhaled corticosteroids/long-acting β2-agonists, and in patients who do not tolerate long-acting bronchodilators or other medications, in the future. Keywords: tiotropium, anticholinergics, asthma, efficacy

  2. Multiple paradigm research on organisational culture

    OpenAIRE

    Podjed, Dan

    2017-01-01

    The author presents multiple paradigm research into the organisational culture of a birdwatching association, where he conducted his ethnographic research. On top of the functionalist, interpretive, radical structuralist and radical humanist paradigms as presented by Gibson Burrell and Gareth Morgan, he applies the fifth paradigm into the analysis of the organisation. The so-called complexity paradigm, which was formed in 1980's based on findings about complex systems and networks that emerge...

  3. Understanding the land management paradigm

    DEFF Research Database (Denmark)

    Enemark, Stig

    2006-01-01

    structures by identifying an ideal and historically neutral LAS model for: servicing the needs of governments, business and the public; utilising the latest technologies; servicing rights, responsibilities, restrictions and risks in relation to land; and delivering much broader information about sustainable...... frameworks complicated by the tasks they must perform, by national cultural, political and judicial settings, and by technology. This paper facilitates an overall understanding of the land management paradigm. This paper assists sharing LAS among countries with diverse legal systems and institutional...

  4. Cancer research in need of a scientific revolution: Using 'paradigm shift' as a method of investigation.

    Science.gov (United States)

    Wion, Didier; Appaix, Florence; Burruss, Meriwether; Berger, Francois; van der Sanden, Boudewijn

    2015-09-01

    Despite important human and financial resources and considerable accumulation of scientific publications, patents, and clinical trials, cancer research has been slow in achieving a therapeutic revolution similar to the one that occurred in the last century for infectious diseases. It has been proposed that science proceeds not only by accumulating data but also through paradigm shifts. Here, we propose to use the concept of 'paradigm shift' as a method of investigation when dominant paradigms fail to achieve their promises. The first step in using the 'paradigm shift' method in cancer research requires identifying its founding paradigms. In this review, two of these founding paradigms will be discussed: (i) the reification of cancer as a tumour mass and (ii) the translation of the concepts issued from infectious disease in cancer research. We show how these founding paradigms can generate biases that lead to over-diagnosis and over-treatment and also hamper the development of curative cancer therapies. We apply the 'paradigm shift' method to produce perspective reversals consistent with current experimental evidence. The 'paradigm shift' method enlightens the existence of a tumour physiologic-prophylactic-pathologic continuum. It integrates the target/antitarget concept and that cancer is also an extracellular disease. The 'paradigm shift' method has immediate implications for cancer prevention and therapy. It could be a general method of investigation for other diseases awaiting therapy.

  5. DNA evolved to minimize frameshift mutations

    OpenAIRE

    Agoni, Valentina

    2013-01-01

    Point mutations can surely be dangerous but what is worst than to lose the reading frame?! Does DNA evolved a strategy to try to limit frameshift mutations?! Here we investigate if DNA sequences effectively evolved a system to minimize frameshift mutations analyzing the transcripts of proteins with high molecular weights.

  6. Poverty eradication: a new paradigm.

    Science.gov (United States)

    Pethe, V P

    1998-08-01

    This article offers a new paradigm for eradicating poverty in India. It was assumed incorrectly by Mahatma Gandhi that a good society without mass poverty would follow after independence. India copied Western models of development and developed giant factories, big dams, and megacities. Agriculture did not expand the number of jobs for people. The Western paradigm failed in India because of the false assumption of "trickle down" of income to the masses. The targeted programs to the poor did not directly benefit enough of the poor. Mega-industrialization led to reduced employment and higher skill needs. The model failed mainly because it was a proxy and relied on indirect ways of reaching the poor. The models failed to be adapted to conditions in India. The Swadeshi paradigm is a direct model for addressing mass poverty. Poverty is affected by immediate, intermediate, and ultimate determinants. Poverty begets social and economic problems, such as ignorance, ill health, high fertility, unemployment, and crime. In India and developing countries, mass poverty results from under use of human resources; lack of equal opportunities; and an outdated non-egalitarian social structure, an unjust global economic order, human cruelty, and erosion of ethical values. Indians are squandering their precious resources mimicking Western consumerism. Poverty leads to rapid population growth. People become productive assets with universal literacy, compulsory and free education, health services and sanitation, vocational training, and work ethics. India needs people-oriented policies with less emphasis on capital accumulation.

  7. The Learner-Centered Paradigm of Education

    Science.gov (United States)

    Watson, Sunnie Lee; Reigeluth, Charles M.

    2008-01-01

    This article, the third in a series of four installments, begins by discussing the need for paradigm change in education and for a critical systems approach to paradigm change, and examines current progress toward paradigm change. Then it explores what a learner-centered, Information-Age educational system should be like, including the APA…

  8. Recent Advances in Egypt for Treatment of Talar Osteochondral Lesions.

    Science.gov (United States)

    Haleem, Amgad M; AbouSayed, Mostafa M; Gomaa, Mohammed

    2016-06-01

    Treatment of osteochondral defects (OCLs) of the talus is a challenging orthopedic surgery. Treatment of talar OCLs has evolved through the 3 "R" paradigm: reconstruction, repair, and replacement. This article highlights current state-of-the-art techniques and reviews recent advances in the literature about articular cartilage repair using various novel tissue engineering approaches, including various scaffolds, growth factors, and cell niches; which include chondrocytes and culture-expanded bone marrow-derived mesenchymal stem cells. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. The Evolving Classification of Pulmonary Hypertension.

    Science.gov (United States)

    Foshat, Michelle; Boroumand, Nahal

    2017-05-01

    - An explosion of information on pulmonary hypertension has occurred during the past few decades. The perception of this disease has shifted from purely clinical to incorporate new knowledge of the underlying pathology. This transfer has occurred in light of advancements in pathophysiology, histology, and molecular medical diagnostics. - To update readers about the evolving understanding of the etiology and pathogenesis of pulmonary hypertension and to demonstrate how pathology has shaped the current classification. - Information presented at the 5 World Symposia on pulmonary hypertension held since 1973, with the last meeting occurring in 2013, was used in this review. - Pulmonary hypertension represents a heterogeneous group of disorders that are differentiated based on differences in clinical, hemodynamic, and histopathologic features. Early concepts of pulmonary hypertension were largely influenced by pharmacotherapy, hemodynamic function, and clinical presentation of the disease. The initial nomenclature for pulmonary hypertension segregated the clinical classifications from pathologic subtypes. Major restructuring of this disease classification occurred between the first and second symposia, which was the first to unite clinical and pathologic information in the categorization scheme. Additional changes were introduced in subsequent meetings, particularly between the third and fourth World Symposia meetings, when additional pathophysiologic information was gained. Discoveries in molecular diagnostics significantly progressed the understanding of idiopathic pulmonary arterial hypertension. Continued advancements in imaging modalities, mechanistic pathogenicity, and molecular biomarkers will enable physicians to define pulmonary hypertension phenotypes based on the pathobiology and allow for treatment customization.

  10. Evolving Concepts in Atopic Dermatitis.

    Science.gov (United States)

    Sidbury, Robert; Khorsand, Kate

    2017-07-01

    Tremendous advances have been made in the field of atopic dermatitis in the past 5 years. We will explore developments in burden of disease, co-morbidities, pathogenesis, prevention, and management. The tremendous burden moderate to severe atopic dermatitis (AD) places on families from a medical, psychosocial, and financial perspective has been characterized. Epidemiologic studies have identified intriguing new associations beyond the well-characterized "atopic march" of food allergies, asthma, and hay fever. Studies of primary prevention have gained traction including the remarkable impacts of early emollient therapy. Basic advances have simultaneously elucidated the nature of atopic inflammation, setting the stage for an explosion of new potential therapeutic targets. After a fallow period of nearly 15 years without a substantial therapeutic advance, this year has already seen two new FDA-approved treatments for AD. AD has a tremendous impact on quality of life with an underappreciated burden of disease; there are important newly described co-morbidities including ADHD and anemia; new insights into etio-pathogenesis have paved the way for novel topical therapies like crisaborole, and new systemic interventions like dupilumab.

  11. Nonalcoholic Steatohepatitis: An Evolving Diagnosis

    Directory of Open Access Journals (Sweden)

    Brent A Neuschwander-Tetri

    2000-01-01

    Full Text Available Nonalcoholic steatohepatitis (NASH is a histological diagnosis applied to a constellation of liver biopsy findings that develop in the absence of alcohol abuse. Steatosis, a mixed cellular inflammatory infiltrate across the lobule, evidence of hepatocyte injury and fibrosis are the findings that can be seen. This entity is often identified during evaluation of elevated aminotransferases after exclusion of viral, metabolic and other causes of liver disease. Obesity is a major risk factor for NASH. The role of diabetes is less certain, although evidence is accumulating that hyperinsulinism may play an important pathophysiological role. Patients sometimes suffer from right upper quadrant abdominal pain and fatigue; examination may reveal centripetal obesity and hepatomegaly. Although patients are often discovered because of persistent aminotransferase elevations, these enzymes can be normal in NASH. When they are elevated, the alanine aminotransferase level is typically significantly greater than the aspartate aminotransferase level. This can be particularly helpful for excluding occult alcohol abuse. Imaging studies identify hepatic steatosis when the amount of fat in the liver is significant; however, imaging does not distinguish benign steatosis from NASH. Ultimately a liver biopsy is needed to diagnose NASH. The biopsy may be useful for establishing prognosis based on the presence or absence of fibrosis and for excluding other unexpected causes of liver enzyme elevations. Weight loss is the mainstay of treatment for obese patients. About 15% to 40% of NASH patients develop fibrosis; how many of these cases progress to cirrhosis is unknown, but about 1% of liver transplants are performed with a pretransplant diagnosis of NASH.

  12. [Paradigm shift in bancroftian filariasis].

    Science.gov (United States)

    Dreyer, Gerusa; Mattos, Denise; Figueredo-Silva, José; Norões, Joaquim

    2009-01-01

    The way a particular subject is understood changes over time as a result of scientific research. In most cases, these changes are minor, with limited effect on the overall knowledge on the subject. Sometimes, however, revolutionary changes occur and not only modify the understanding of the subject but open perspectives that can trigger new interpretations and new ways for expansion of scientific knowledge. The studies of Gregor Johann Mendel were a good example. They led to discovery of the laws of inheritance which, in turn, have revolutionized biology and provided the foundation for genetics. In certain situations, changes not only alter ways of thinking, but have practical implications, also improving the quality of life for many people. In his book The Structure of Scientific Revolutions, Thomas Kuhn refers to discontinuities in scientific development as a 'change of paradigm', a term now used in a generic manner to describe a profound changes in our reference points. For lymphatic filariasis the old paradigm stated that Wuchereria bancrofti at the adult stage causes lymphatic vessel obstruction, triggering an inevitable immune response in predisposed individuals and leading to elephantiasis. This has been replaced by a new paradigm, which offers hope that W. bancrofti infection does not necessarily predispose to the disfiguring outward manifestation of lymphatic dysfunction. Repeated secondary bacterial infections (erysipela-like) are now recognized as the most important factor for initiation and progression of chronic lymphedema in individuals living in filariasis-endemic areas. Most inhabitants of endemic communities can prevent and minimize the acute bacterial episodes by regular use of soap and water, the simplest form of hygiene already well known to human beings.

  13. Turbomachinery computational fluid dynamics: asymptotes and paradigm shifts.

    Science.gov (United States)

    Dawes, W N

    2007-10-15

    This paper reviews the development of computational fluid dynamics (CFD) specifically for turbomachinery simulations and with a particular focus on application to problems with complex geometry. The review is structured by considering this development as a series of paradigm shifts, followed by asymptotes. The original S1-S2 blade-blade-throughflow model is briefly described, followed by the development of two-dimensional then three-dimensional blade-blade analysis. This in turn evolved from inviscid to viscous analysis and then from steady to unsteady flow simulations. This development trajectory led over a surprisingly small number of years to an accepted approach-a 'CFD orthodoxy'. A very important current area of intense interest and activity in turbomachinery simulation is in accounting for real geometry effects, not just in the secondary air and turbine cooling systems but also associated with the primary path. The requirements here are threefold: capturing and representing these geometries in a computer model; making rapid design changes to these complex geometries; and managing the very large associated computational models on PC clusters. Accordingly, the challenges in the application of the current CFD orthodoxy to complex geometries are described in some detail. The main aim of this paper is to argue that the current CFD orthodoxy is on a new asymptote and is not in fact suited for application to complex geometries and that a paradigm shift must be sought. In particular, the new paradigm must be geometry centric and inherently parallel without serial bottlenecks. The main contribution of this paper is to describe such a potential paradigm shift, inspired by the animation industry, based on a fundamental shift in perspective from explicit to implicit geometry and then illustrate this with a number of applications to turbomachinery.

  14. Industrial ecology: a new paradigm?

    OpenAIRE

    Eik, Arne

    1999-01-01

    The aim of industrial ecology is to design and re-design industrial systems, by using nature as a metaphor and model. In this way far less non-renewable resources will be used and far less emissions and wastes will be released to the natural environment than up to now. Many approaches to industrial ecology are attempted, varying from those looking upon industrial ecology as a method for waste recycling to those who see industrial ecology as a new paradigm in a wider social perspective . By go...

  15. Psychiatry beyond the current paradigm.

    LENUS (Irish Health Repository)

    Bracken, Pat

    2012-12-01

    A series of editorials in this Journal have argued that psychiatry is in the midst of a crisis. The various solutions proposed would all involve a strengthening of psychiatry\\'s identity as essentially \\'applied neuroscience\\'. Although not discounting the importance of the brain sciences and psychopharmacology, we argue that psychiatry needs to move beyond the dominance of the current, technological paradigm. This would be more in keeping with the evidence about how positive outcomes are achieved and could also serve to foster more meaningful collaboration with the growing service user movement.

  16. GRB 110731A within the IGC paradigm

    Directory of Open Access Journals (Sweden)

    Primorac Daria

    2018-01-01

    Full Text Available Bright gamma-ray burst (GRB 110731A was simultaneously observed by Fermi and Swift observatories, with a follow up optical observation which inferred the redshift of z = 2.83. Thus, available data are spanning from optical to high energy (GeV emission. We analyze these data within the induced gravitational collapse (IGC paradigm, recently introduced to explain temporal coincidence of some long GRBs with type Ic supernovae. The case of binary-driven hypcrnova (BdHN assumes a close system, which starts as an evolved core - neutron star binary. After the core-collapse event, the new NS - black hole system is formed, emitting the GRB in the process. We performed the time-resolved and time-integrated analysis of the Fermi data. Preliminary results gave isotropic energy Eiso = 6.05 × 1053 erg and the total P-GRB energy of Ep–GRB = 3.7 × 1052 erg. At transparency point we found a Lorentz factor Γ ~ 2.17 × 103 laboratory radius of 8.33 x 1013 cm, P-GRB observed temperature of 168 keV and a baryon load B = 4.35 × 10-4. Simulated light-curve and prompt emission spectra showed the average circum burst medium density to be n ~ 0.03 particles per cm3. We reproduced the X-ray light-curve within the rest-frame of the source, finding the common late power-law behavior, with α = –1.22. Considering these results, we interpret GRB 110731A as a member of a BdHNe group.

  17. GRB 110731A within the IGC paradigm

    Science.gov (United States)

    Primorac, Daria; Ruffini, Remo; Pisani, Giovanni Battista; Aimuratov, Yerlan; Biancol, Carlo Luciano; Karlica, Mile; Melon Fuksman, Julio David; Moradi, Rahim; Muccino, Marco; Penacchioni, Ana Virginia; Rueda, Jorge Armando; Wang, Yu

    2018-01-01

    Bright gamma-ray burst (GRB) 110731A was simultaneously observed by Fermi and Swift observatories, with a follow up optical observation which inferred the redshift of z = 2.83. Thus, available data are spanning from optical to high energy (GeV) emission. We analyze these data within the induced gravitational collapse (IGC) paradigm, recently introduced to explain temporal coincidence of some long GRBs with type Ic supernovae. The case of binary-driven hypcrnova (BdHN) assumes a close system, which starts as an evolved core - neutron star binary. After the core-collapse event, the new NS - black hole system is formed, emitting the GRB in the process. We performed the time-resolved and time-integrated analysis of the Fermi data. Preliminary results gave isotropic energy Eiso = 6.05 × 1053 erg and the total P-GRB energy of Ep-GRB = 3.7 × 1052 erg. At transparency point we found a Lorentz factor Γ 2.17 × 103 laboratory radius of 8.33 x 1013 cm, P-GRB observed temperature of 168 keV and a baryon load B = 4.35 × 10-4. Simulated light-curve and prompt emission spectra showed the average circum burst medium density to be n 0.03 particles per cm3. We reproduced the X-ray light-curve within the rest-frame of the source, finding the common late power-law behavior, with α = -1.22. Considering these results, we interpret GRB 110731A as a member of a BdHNe group.

  18. Hemicrania continua evolving from cluster headache responsive to valproic acid.

    Science.gov (United States)

    Lambru, Giorgio; Castellini, Paola; Bini, Annamaria; Evangelista, Andrea; Manzoni, Gian Camillo; Torelli, Paola

    2008-10-01

    Hemicrania continua (HC) is a rare type of primary headache characterized by a prompt and enduring response to indomethacin. We describe a patient who suffered from cluster headache evolving into ipsilateral HC, who does not tolerate a long-term indomethacin therapy. The case was complex in terms of diagnosis, associated comorbidity, and choice of treatment; after several trials with different therapeutic regimens, we started the patient on a therapy with valproic acid and obtained an improvement of her HC.

  19. Evolving Concepts in the Management of Retinopathy of Prematurity.

    Science.gov (United States)

    Sternberg, Paul; Durrani, Alia K

    2017-11-03

    The introduction of anti-vascular endothelial growth factor (VEGF) agents has stimulated considerable reexamination of treatment strategies for the management of retinopathy of prematurity (ROP). Herein we summarize and review evolving concepts and provide a personal perspective on clinical management today and future directions of treatment. Literature review. To synthesize the evolving management concepts for diagnosis and treatment of retinopathy of prematurity and to provide interpretation and perspective on current emerging therapies. Although initial treatment strategies focused on ablative therapy for threshold ROP, earlier treatment for type 1 or pre-threshold disease has been found to decrease unfavorable visual and structural outcomes. Vascular endothelial growth factor has emerged as a significant contributor to retinal-vascular diseases in the previous 2 decades. The potential role of anti-VEGF treatment for type 1 ROP has become a focus in recent years, but the protracted recurrence of disease and unknown adverse ocular and systemic effects have caused concern from some clinicians. In addition, the use of telemedicine technologies may provide the ability to screen remote areas with a shortage of ROP providers, thereby reducing the burden of disease. The diagnosis and management of ROP has changed over the past 40 years; the role of anti-VEGF therapy remains to be established in current treatment strategies. Screening for initial disease and progression will likely be impacted by the increasing prevalence of telemedicine and relative shortage of clinicians. Published by Elsevier Inc.

  20. Satcom access in the evolved packet core

    NARCIS (Netherlands)

    Cano, M.D.; Norp, A.H.J.; Popova, M.P.

    2012-01-01

    Satellite communications (Satcom) networks are increasingly integrating with terrestrial communications networks, namely Next Generation Networks (NGN). In the area of NGN the Evolved Packet Core (EPC) is a new network architecture that can support multiple access technologies. When Satcom is

  1. Acquisition: Acquisition of the Evolved SEASPARROW Missile

    National Research Council Canada - National Science Library

    2002-01-01

    .... The Evolved SEASPARROW Missile, a Navy Acquisition Category II program, is an improved version of the RIM-7P SEASPARROW missile that will intercept high-speed maneuvering, anti-ship cruise missiles...

  2. Cyberspace Operations: Influence Upon Evolving War Theory

    Science.gov (United States)

    2011-03-18

    St ra te gy R es ea rc h Pr oj ec t CYBERSPACE OPERATIONS: INFLUENCE UPON EVOLVING WAR THEORY BY COLONEL KRISTIN BAKER United States...DATES COVERED (From - To) 4. TITLE AND SUBTITLE Cyberspace Operations: Influence Upon Evolving War Theory 5a. CONTRACT NUMBER... Leadership 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S

  3. Evolving effective incremental SAT solvers with GP

    OpenAIRE

    Bader, Mohamed; Poli, R.

    2008-01-01

    Hyper-Heuristics could simply be defined as heuristics to choose other heuristics, and it is a way of combining existing heuristics to generate new ones. In a Hyper-Heuristic framework, the framework is used for evolving effective incremental (Inc*) solvers for SAT. We test the evolved heuristics (IncHH) against other known local search heuristics on a variety of benchmark SAT problems.

  4. Hypothesis Formation, Paradigms, and Openness

    Directory of Open Access Journals (Sweden)

    Conrad P. Pritscher

    2008-01-01

    Full Text Available A part of hypothesis formation, while necessary for scientific investigation, is beyond direct observation. Powerful hypothesis formation is more than logical and is facilitated by mind­opening. As Percy Bridgeman, Nobel laureate, said, science is: “Nothing more than doing one's damnedest with one's mind, no holds barred.” This paper suggests more open schooling helps generate more open hypothesizing which helps one do one's damnedest with one's mind. It is hypothesized that a more open process of hypothesis formation may help schools and society forge new ways of living and learning so that more people more often can do their damnedest with their mind. This writing does not offer a new paradigm but rather attempts to elaborate on the notion that new paradigms are difficult to form without openness to what was previously quasi­unthinkable. More on these topics and issues is included in the author's Reopening Einstein's Thought: About What Can't Be Learned From Textbooks ­­to be published by Sense Publishers in June 2008.

  5. Quantifying paradigm change in demography

    Directory of Open Access Journals (Sweden)

    Jakub Bijak

    2014-03-01

    Full Text Available Background: Demography is a uniquely empirical research area amongst the social sciences. We posit that the same principle of empiricism should be applied to studies of the population sciences as a discipline, contributing to greater self-awareness amongst its practitioners. Objective: The paper aims to include measurable data in the study of changes in selected demographic paradigms and perspectives. Methods: The presented analysis is descriptive and is based on a series of simple measures obtained from the free online tool Google Books Ngram Viewer, which includes frequencies of word groupings (n-grams in different collections of books digitised by Google. Results: The tentative findings corroborate the shifts in the demographic paradigms identified in the literature -- from cross-sectional, through longitudinal, to event-history and multilevel approaches. Conclusions: These findings identify a promising area of enquiry into the development of demography as a social science discipline. We postulate that more detailed enquiries in this area in the future could lead to establishing History of Population Thought as a new sub-discipline within population sciences.

  6. Experimental psychopathology paradigms for alcohol use disorders: Applications for translational research.

    Science.gov (United States)

    Bujarski, Spencer; Ray, Lara A

    2016-11-01

    In spite of high prevalence and disease burden, scientific consensus on the etiology and treatment of Alcohol Use Disorder (AUD) has yet to be reached. The development and utilization of experimental psychopathology paradigms in the human laboratory represents a cornerstone of AUD research. In this review, we describe and critically evaluate the major experimental psychopathology paradigms developed for AUD, with an emphasis on their implications, strengths, weaknesses, and methodological considerations. Specifically we review alcohol administration, self-administration, cue-reactivity, and stress-reactivity paradigms. We also provide an introduction to the application of experimental psychopathology methods to translational research including genetics, neuroimaging, pharmacological and behavioral treatment development, and translational science. Through refining and manipulating key phenotypes of interest, these experimental paradigms have the potential to elucidate AUD etiological factors, improve the efficiency of treatment developments, and refine treatment targets thus advancing precision medicine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Anti-CD123 chimeric antigen receptor T-cells (CART): an evolving treatment strategy for hematological malignancies, and a potential ace-in-the-hole against antigen-negative relapse.

    Science.gov (United States)

    Cummins, Katherine D; Gill, Saar

    2017-09-13

    Chimeric antigen receptor-modified T-cells (CART) are a potent and targeted immunotherapy which have induced remissions in some patients with chemotherapy refractory or relapsed (RR) hematologic malignancies. Hundreds of patients have now been treated worldwide with anti-CD19 CART cells, with complete response rates of up to 90%. CART therapy has a unique toxicity profile, and unfortunately not all responses are durable. Treatment failure occurs via two main routes - by loss of the CART cell population, or relapse with antigen loss. Emerging data indicate that targeting an alternative antigen instead of, or as well as CD19, could improve CART cell efficacy and reduce antigen-negative relapse. Other strategies include the addition of other immune-based therapies. This review explores the rationale, pre-clinical data and currently investigative strategies underway for CART therapy targeting the myeloid and lymphoid stem/progenitor antigen CD123.

  8. The detour paradigm in animal cognition.

    Science.gov (United States)

    Kabadayi, Can; Bobrowicz, Katarzyna; Osvath, Mathias

    2018-01-01

    In this paper, we review one of the oldest paradigms used in animal cognition: the detour paradigm. The paradigm presents the subject with a situation where a direct route to the goal is blocked and a detour must be made to reach it. Often being an ecologically valid and a versatile tool, the detour paradigm has been used to study diverse cognitive skills like insight, social learning, inhibitory control and route planning. Due to the relative ease of administrating detour tasks, the paradigm has lately been used in large-scale comparative studies in order to investigate the evolution of inhibitory control. Here we review the detour paradigm and some of its cognitive requirements, we identify various ecological and contextual factors that might affect detour performance, we also discuss developmental and neurological underpinnings of detour behaviors, and we suggest some methodological approaches to make species comparisons more robust.

  9. Evolvability Search: Directly Selecting for Evolvability in order to Study and Produce It

    DEFF Research Database (Denmark)

    Mengistu, Henok; Lehman, Joel Anthony; Clune, Jeff

    2016-01-01

    One hallmark of natural organisms is their significant evolvability, i.e.,their increased potential for further evolution. However, reproducing such evolvability in artificial evolution remains a challenge, which both reduces the performance of evolutionary algorithms and inhibits the study...... of evolvable digital phenotypes. Although some types of selection in evolutionary computation indirectly encourage evolvability, one unexplored possibility is to directly select for evolvability. To do so, we estimate an individual's future potential for diversity by calculating the behavioral diversity of its...... immediate offspring, and select organisms with increased offspring variation. While the technique is computationally expensive, we hypothesized that direct selection would better encourage evolvability than indirect methods. Experiments in two evolutionary robotics domains confirm this hypothesis: in both...

  10. Changing Paradigm of Hemophilia Management: Extended Half-Life Factor Concentrates and Gene Therapy.

    Science.gov (United States)

    Kumar, Riten; Dunn, Amy; Carcao, Manuel

    2016-02-01

    Management of hemophilia has evolved significantly in the last century-from recognition of the causative mechanism in the 1950s to commercially available clotting factor concentrates in the 1960s. Availability of lyophilized concentrates in the 1970s set the stage for home-based therapy, followed by introduction of virally attenuated plasma-derived, and then recombinant factor concentrates in the 1980s and 1990s, respectively. The subsequent years saw a paradigm shift in treatment goals from on-demand therapy to prophylactic factor replacement starting at an early age, to prevent hemarthrosis becoming the standard of care for patients with severe hemophilia. In the developed world, the increasing use of home-based prophylactic regimens has significantly improved the quality of life, and life expectancy of patients with severe hemophilia. Seminal developments in the past 5 years, including the commercial availability of extended half-life factor concentrates and the publication of successful results of gene therapy for patients with hemophilia B, promise to further revolutionize hemophilia care over the next few decades. In this review, we summarize the evolution of management for hemophilia, with a focus on extended half-life factor concentrates and gene therapy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. FuGeIDS: Fuzzy Genetic paradigms in Intrusion Detection Systems

    OpenAIRE

    Borgohain, Rajdeep

    2012-01-01

    With the increase in the number of security threats, Intrusion Detection Systems have evolved as a significant countermeasure against these threats. And as such, the topic of Intrusion Detection Systems has become one of the most prominent research topics in recent years. This paper gives an overview of the Intrusion Detection System and looks at two major machine learning paradigms used in Intrusion Detection System, Genetic Algorithms and Fuzzy Logic and how to apply them for intrusion dete...

  12. Emerging Paradigms in Machine Learning

    CERN Document Server

    Jain, Lakhmi; Howlett, Robert

    2013-01-01

    This  book presents fundamental topics and algorithms that form the core of machine learning (ML) research, as well as emerging paradigms in intelligent system design. The  multidisciplinary nature of machine learning makes it a very fascinating and popular area for research.  The book is aiming at students, practitioners and researchers and captures the diversity and richness of the field of machine learning and intelligent systems.  Several chapters are devoted to computational learning models such as granular computing, rough sets and fuzzy sets An account of applications of well-known learning methods in biometrics, computational stylistics, multi-agent systems, spam classification including an extremely well-written survey on Bayesian networks shed light on the strengths and weaknesses of the methods. Practical studies yielding insight into challenging problems such as learning from incomplete and imbalanced data, pattern recognition of stochastic episodic events and on-line mining of non-stationary ...

  13. The Oral Paradigm and Snapchat

    Directory of Open Access Journals (Sweden)

    Oren Soffer

    2016-09-01

    Full Text Available In this short essay, I argue that the ephemeral nature of emerging instant-messaging applications, such as Snapchat, applies an oral paradigm. While online discourse of computer-mediated communication shares many qualities with oral communication, the case of ephemeral applications is unique, as the oral features are already integrated in the application technology design and as orality is often implemented on highly visual products. Snapchat applies technology that fades visual contents as if they were spoken words fading in the air after utterance. Moreover, Snapchat’s promise to delete all messages from its database after they are viewed echoes a key characteristic of primary oral culture: that is, the inability (and in our case, the obligation not to store knowledge. In this, Snapchat demonstrates counter-logic to the contemporary grammar of new media, which is based on information aggregation.

  14. Datacubes as a Service Paradigm

    Science.gov (United States)

    Rossi, Angelo Pio; Baumann, Peter

    2016-04-01

    Spatio-temporal data sets often can be represented conveniently through datacubes as a common unifying paradigm. Flexible, scalable services can be offered based on the concept of a datacube query language while hiding the technicalities, thereby allowing user-friendly visual data interaction. One of today's most influential initiatives in Big Geo Data is EarthServer which is paving the way for flexible, scalable datacube services based on innovative NewSQL technology (Fig. 1). Researchers from Europe, the US and recently Australia have teamed up to rigorously materialize the datacube paradigm for Earth Observation, ocean, meteorological, and planetary science. EarthServer has established client and server technology for such spatio-temporal datacubes strictly based on the open datacube standards, OGC WCS and WPCS. The underlying scalable array engine, rasdaman, enables direct interaction, including 3-D visualization, what-if scenarios, common EO data processing, and general analytics on regular and irregular grids. Integration of datacube and metadata retrieval, together with advanced visualization based on NASA WorldWind, are geared towards an effective, user-friendly access and analysis. Conversely, EarthServer is significantly shaping the ISO, OGC, and INSPIRE Big Data standards landscape by being specification editor. Phase 1 of EarthServer has advanced scalable array data¬base technology into 100+ TB services; in phase 2, a federation of Petabyte datacubes is being built in Europe and Australia to perform ad-hoc querying and merging. Phase 1 reviewers have attested rasdaman to "significantly transform the way that scientists in different areas of Earth Science will be able to access and use data in a way that hitherto was not possible". Altogether, these large-scale deployments prove that datacubes are a convenient model for presenting users with a simple, consolidated view on the massive amount of data files gathered - "a cube tells more than a million

  15. Evolved atmospheric entry corridor with safety factor

    Science.gov (United States)

    Liang, Zixuan; Ren, Zhang; Li, Qingdong

    2018-02-01

    Atmospheric entry corridors are established in previous research based on the equilibrium glide condition which assumes the flight-path angle to be zero. To get a better understanding of the highly constrained entry flight, an evolved entry corridor that considers the exact flight-path angle is developed in this study. Firstly, the conventional corridor in the altitude vs. velocity plane is extended into a three-dimensional one in the space of altitude, velocity, and flight-path angle. The three-dimensional corridor is generated by a series of constraint boxes. Then, based on a simple mapping method, an evolved two-dimensional entry corridor with safety factor is obtained. The safety factor is defined to describe the flexibility of the flight-path angle for a state within the corridor. Finally, the evolved entry corridor is simulated for the Space Shuttle and the Common Aero Vehicle (CAV) to demonstrate the effectiveness of the corridor generation approach. Compared with the conventional corridor, the evolved corridor is much wider and provides additional information. Therefore, the evolved corridor would benefit more to the entry trajectory design and analysis.

  16. Interactively Evolving Compositional Sound Synthesis Networks

    DEFF Research Database (Denmark)

    Jónsson, Björn Þór; Hoover, Amy K.; Risi, Sebastian

    2015-01-01

    While the success of electronic music often relies on the uniqueness and quality of selected timbres, many musicians struggle with complicated and expensive equipment and techniques to create their desired sounds. Instead, this paper presents a technique for producing novel timbres that are evolved......, CPPNs can theoretically compute any function and can build on those present in traditional synthesizers (e.g. square, sawtooth, triangle, and sine waves functions) to produce completely novel timbres. Evolved with NeuroEvolution of Augmenting Topologies (NEAT), the aim of this paper is to explore...... the space of potential sounds that can be generated through such compositional sound synthesis networks (CSSNs). To study the effect of evolution on subjective appreciation, participants in a listener study ranked evolved timbres by personal preference, resulting in preferences skewed toward the first...

  17. Quantifying evolvability in small biological networks

    Energy Technology Data Exchange (ETDEWEB)

    Nemenman, Ilya [Los Alamos National Laboratory; Mugler, Andrew [COLUMBIA UNIV; Ziv, Etay [COLUMBIA UNIV; Wiggins, Chris H [COLUMBIA UNIV

    2008-01-01

    The authors introduce a quantitative measure of the capacity of a small biological network to evolve. The measure is applied to a stochastic description of the experimental setup of Guet et al. (Science 2002, 296, pp. 1466), treating chemical inducers as functional inputs to biochemical networks and the expression of a reporter gene as the functional output. The authors take an information-theoretic approach, allowing the system to set parameters that optimise signal processing ability, thus enumerating each network's highest-fidelity functions. All networks studied are highly evolvable by the measure, meaning that change in function has little dependence on change in parameters. Moreover, each network's functions are connected by paths in the parameter space along which information is not significantly lowered, meaning a network may continuously change its functionality without completely losing it along the way. This property further underscores the evolvability of the networks.

  18. Evolution of evolvability in gene regulatory networks.

    Directory of Open Access Journals (Sweden)

    Anton Crombach

    Full Text Available Gene regulatory networks are perhaps the most important organizational level in the cell where signals from the cell state and the outside environment are integrated in terms of activation and inhibition of genes. For the last decade, the study of such networks has been fueled by large-scale experiments and renewed attention from the theoretical field. Different models have been proposed to, for instance, investigate expression dynamics, explain the network topology we observe in bacteria and yeast, and for the analysis of evolvability and robustness of such networks. Yet how these gene regulatory networks evolve and become evolvable remains an open question. An individual-oriented evolutionary model is used to shed light on this matter. Each individual has a genome from which its gene regulatory network is derived. Mutations, such as gene duplications and deletions, alter the genome, while the resulting network determines the gene expression pattern and hence fitness. With this protocol we let a population of individuals evolve under Darwinian selection in an environment that changes through time. Our work demonstrates that long-term evolution of complex gene regulatory networks in a changing environment can lead to a striking increase in the efficiency of generating beneficial mutations. We show that the population evolves towards genotype-phenotype mappings that allow for an orchestrated network-wide change in the gene expression pattern, requiring only a few specific gene indels. The genes involved are hubs of the networks, or directly influencing the hubs. Moreover, throughout the evolutionary trajectory the networks maintain their mutational robustness. In other words, evolution in an alternating environment leads to a network that is sensitive to a small class of beneficial mutations, while the majority of mutations remain neutral: an example of evolution of evolvability.

  19. Penicillin and cephalosporin drug allergies: a paradigm shift.

    Science.gov (United States)

    Smith, Robert G

    2008-01-01

    Medication hypersensitivity is a constant variable that podiatric physicians face during their professional day. To avoid potential patient harm, an understanding of penicillin and cephalosporin hypersensitivities as it pertains to podiatric medicine needs to be achieved. To accomplish this, a narrative describing the signs, symptoms, and immunologic mechanisms for the basis of penicillin and cephalosporin drug hypersensitivities is presented. Second, specific medical literature serving as clinical-based evidence to support the prescribing of cephalosporins in patients with documented penicillin allergy is presented. Finally, a review of the medical and legal literature describing health-care provider liability regarding subsequent drug hypersensitivity is presented. The information contained in this review allows for the evolving paradigm that permits the prescribing of selective cephalosporins to patients with a history of penicillin allergy as long as the allergic symptoms were not serious or life-threatening.

  20. How the first biopolymers could have evolved.

    Science.gov (United States)

    Abkevich, V I; Gutin, A M; Shakhnovich, E I

    1996-01-01

    In this work, we discuss a possible origin of the first biopolymers with stable unique structures. We suggest that at the prebiotic stage of evolution, long organic polymers had to be compact to avoid hydrolysis and had to be soluble and thus must not be exceedingly hydrophobic. We present an algorithm that generates such sequences for model proteins. The evolved sequences turn out to have a stable unique structure, into which they quickly fold. This result illustrates the idea that the unique three-dimensional native structures of first biopolymers could have evolved as a side effect of nonspecific physicochemical factors acting at the prebiotic stage of evolution. PMID:8570645

  1. Evolving Intelligent Systems Methodology and Applications

    CERN Document Server

    Angelov, Plamen; Kasabov, Nik

    2010-01-01

    From theory to techniques, the first all-in-one resource for EIS. There is a clear demand in advanced process industries, defense, and Internet and communication (VoIP) applications for intelligent yet adaptive/evolving systems. Evolving Intelligent Systems is the first self- contained volume that covers this newly established concept in its entirety, from a systematic methodology to case studies to industrial applications. Featuring chapters written by leading world experts, it addresses the progress, trends, and major achievements in this emerging research field, with a strong emphasis on th

  2. Listening Fluency Before Speaking: An Alternative Paradigm.

    Science.gov (United States)

    Nord, James, R.

    The foreign language instruction in the United States has followed a paradigm commonly called the "audio-lingual" method for almost twenty years. This paradigm is basically response-oriented and based upon structural linguistics and behavioral psychology. It focuses attention on speaking as the primary skill. It has not lived up to expectations.…

  3. The Failure of Progressive Paradigm Reversal

    Science.gov (United States)

    Guthrie, Gerard

    2017-01-01

    The student-centred, progressive paradigm has not had sustained success in changing teacher-centred, formalistic practices in "developing" country classrooms. Does "Gestalt-switch" and paradigm reversal demonstrate that progressive theory has realigned with formalistic reality, or has it remained axiomatic in the research and…

  4. The New Paradigm Dialogs and Qualitative Inquiry

    Science.gov (United States)

    Denzin, Norman K.

    2008-01-01

    This paper re-engages the paradigm wars of the 1980s, discussing their relevance in the current historical moment. It extends Egon Guba's call for dialogue across paradigm communities. Ten theses and three agenda items are advanced. (Contains 4 notes.)

  5. Feminist Research and Paradigm Shift in Anthropology

    Directory of Open Access Journals (Sweden)

    Terence Rajivan Edward

    2012-12-01

    Full Text Available In her paper ‘An Awkward Relationship: the Case of Feminism and Anthropology’, Marilyn Strathern argues that feminist research cannot produce a paradigm shift in social anthropology. I present an argument for thinking that, on the relevant understanding of paradigm shift, it is possible for this to happen. I then object to Strathern’s arguments against the possibility.

  6. When a paradigm becomes a paradogma

    NARCIS (Netherlands)

    Kirschner, Paul A.

    2018-01-01

    Every science, every scientific discipline, operates under one or more paradigms; a world view that underlies the theories and methodologies of the discipline. Sometimes a discipline’s paradigms complement or supplement each other while at other times they may contradict or even exclude each other.

  7. Preface: evolving rotifers, evolving science: Proceedings of the XIV International Rotifer Symposium

    Czech Academy of Sciences Publication Activity Database

    Devetter, Miloslav; Fontaneto, D.; Jersabek, Ch.D.; Welch, D.B.M.; May, L.; Walsh, E.J.

    2017-01-01

    Roč. 796, č. 1 (2017), s. 1-6 ISSN 0018-8158 Institutional support: RVO:60077344 Keywords : evolving rotifers * 14th International Rotifer Symposium * evolving science Subject RIV: EG - Zoology OBOR OECD: Zoology Impact factor: 2.056, year: 2016

  8. A New Paradigm for Chemical Engineering?

    DEFF Research Database (Denmark)

    Gani, Rafiqul

    businesses has been observed. There is an increasing trend within the chemical industry to focus on products and the sustainable processes that can make them. Do these changes point to a paradigm shift in chemical engineering as a discipline? Historically, two previous paradigm shifts in chemical engineering...... corresponded to major shifts in chemical engineering as a discipline, which affected not only the education of chemical engineers, but also the development of chemical engineering as a discipline. Has the time come for a new paradigm shift that will prepare the current and future chemical engineering graduates...... to tackle the complex problems facing the chemicals based industries and serve the modern society more efficiently? The lecture will review the current status of chemical engineering as a discipline, the proposals for the third paradigm, the need for such a paradigm shift and related educational issues....

  9. An alternate pathophysiologic paradigm of sepsis and septic shock

    Science.gov (United States)

    Kumar, Anand

    2014-01-01

    The advent of modern antimicrobial therapy following the discovery of penicillin during the 1940s yielded remarkable improvements in case fatality rate of serious infections including septic shock. Since then, pathogens have continuously evolved under selective antimicrobial pressure resulting in a lack of significant improvement in clinical effectiveness in the antimicrobial therapy of septic shock despite ever more broad-spectrum and potent drugs. In addition, although substantial effort and money has been expended on the development novel non-antimicrobial therapies of sepsis in the past 30 years, clinical progress in this regard has been limited. This review explores the possibility that the current pathophysiologic paradigm of septic shock fails to appropriately consider the primacy of the microbial burden of infection as the primary driver of septic organ dysfunction. An alternate paradigm is offered that suggests that has substantial implications for optimizing antimicrobial therapy in septic shock. This model of disease progression suggests the key to significant improvement in the outcome of septic shock may lie, in great part, with improvements in delivery of existing antimicrobials and other anti-infectious strategies. Recognition of the role of delays in administration of antimicrobial therapy in the poor outcomes of septic shock is central to this effort. However, therapeutic strategies that improve the degree of antimicrobial cidality likely also have a crucial role. PMID:24184742

  10. Thermal and Evolved-Gas Analyzer Illustration

    Science.gov (United States)

    2008-01-01

    This is a computer-aided drawing of the Thermal and Evolved-Gas Analyzer, or TEGA, on NASA's Phoenix Mars Lander. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  11. Apollo 16 Evolved Lithology Sodic Ferrogabbro

    Science.gov (United States)

    Zeigler, Ryan; Jolliff, B. L.; Korotev, R. L.

    2014-01-01

    Evolved lunar igneous lithologies, often referred to as the alkali suite, are a minor but important component of the lunar crust. These evolved samples are incompatible-element rich samples, and are, not surprisingly, most common in the Apollo sites in (or near) the incompatible-element rich region of the Moon known as the Procellarum KREEP Terrane (PKT). The most commonly occurring lithologies are granites (A12, A14, A15, A17), monzogabbro (A14, A15), alkali anorthosites (A12, A14), and KREEP basalts (A15, A17). The Feldspathic Highlands Terrane is not entirely devoid of evolved lithologies, and rare clasts of alkali gabbronorite and sodic ferrogabbro (SFG) have been identified in Apollo 16 station 11 breccias 67915 and 67016. Curiously, nearly all pristine evolved lithologies have been found as small clasts or soil particles, exceptions being KREEP basalts 15382/6 and granitic sample 12013 (which is itself a breccia). Here we reexamine the petrography and geochemistry of two SFG-like particles found in a survey of Apollo 16 2-4 mm particles from the Cayley Plains 62283,7-15 and 62243,10-3 (hereafter 7-15 and 10-3 respectively). We will compare these to previously reported SFG samples, including recent analyses on the type specimen of SFG from lunar breccia 67915.

  12. Paradigm shifts in corneal transplantation.

    Science.gov (United States)

    Tan, Donald T H; Anshu, Arundhati; Mehta, Jodhbir S

    2009-04-01

    Conventional corneal transplantation, in the form of penetrating keratoplasty (PK), involves full-thickness replacement of the cornea, and is a highly successful procedure. However, the cornea is anatomically a multi-layered structure. Pathology may only affect individual layers of the cornea, hence selective lamellar surgical replacement of only the diseased corneal layers whilst retaining unaffected layers represents a new paradigm shift in the field. Recent advancements in surgical techniques and instrumentation have resulted in several forms of manual, microkeratome and femto-second laser-assisted lamellar transplantation procedures. Anterior lamellar keratoplasty (ALK) aims at replacing only diseased or scarred corneal stroma, whilst retaining the unaffected corneal endothelial layer, thus obviating the risk of endothelial allograft rejection. Posterior lamellar keratoplasty/endothelial keratoplasty (PLK/EK) involves the replacement of the dysfunctional endothelial cell layer only. Whilst significant technical and surgical challenges are involved in performing lamellar micro-dissection of a tissue which is only 0.5 mm thick, the benefits of a more controlled surgical procedure and improved graft survival rates have resulted in a shift away from conventional PK. This review details the current advances in emerging lamellar corneal surgical procedures and highlights the main advantages and disadvantages of these new lamellar corneal procedures.

  13. Dealing with a Paradigm Shift

    Science.gov (United States)

    Pack, Allan I.

    2015-01-01

    Recent changes in policies by insurance companies with respect to mandating home sleep apnea testing rather than in-laboratory studies have a large impact on the financial viability of clinical sleep centers. Coping with this disruptive change requires forward planning. First, it is important to be well positioned with respect to facilities so that these can be quickly downsized to control costs. There is also a need to develop, in advance, an accredited home sleep study program so that centers can respond to the rapidly changing environment. Following the change there is a need to control costs by rapidly downsizing the technology workforce. Technologists can be retrained for other essential roles. Centralizing the precertification process with knowledgeable, well-trained staff and a robust auditing process is an essential component. The approach taken at the University of Pennsylvania to this change is described as is how one can ensure continued financial viability of a comprehensive sleep center program in a major academic medical center. Citation: Pack AI. Dealing with a paradigm shift. J Clin Sleep Med 2015;11(8):925–929. PMID:26094918

  14. Human Amebiasis: Breaking the Paradigm?

    Directory of Open Access Journals (Sweden)

    Oswaldo Partida

    2010-03-01

    Full Text Available For over 30 years it has been established that the Entamoeba histolytica protozoan included two biologically and genetically different species, one with a pathogenic phenotype called E. histolytica and the other with a non-pathogenic phenotype called Entamoeba dispar. Both of these amoebae species can infect humans. E. histolytica has been considered as a potential pathogen that can cause serious damage to the large intestine (colitis, dysentery and other extraintestinal organs, mainly the liver (amebic liver abscess, whereas E. dispar is a species that interacts with humans in a commensal relationship, causing no symptoms or any tissue damage. This paradigm, however, should be reconsidered or re-evaluated. In the present work, we report the detection and genotyping of E. dispar sequences of DNA obtained from patients with amebic liver abscesses, including the genotyping of an isolate obtained from a Brazilian patient with a clinical diagnosis of intestinal amebiasis that was previously characterized as an E. dispar species. The genetic diversity and phylogenetic analysis performed by our group has shown the existence of several different genotypes of E. dispar that can be associated to, or be potentiality responsible for intestinal or liver tissue damage, similar to that observed with E. histolytica.

  15. A handy new design paradigm

    Directory of Open Access Journals (Sweden)

    B. Bergelin

    2011-02-01

    Full Text Available In light of technological advances, researchers have lost sight of robotic grippers/end effectors design intent. In a semi-structured environment the biomimetic approach is impractical due to the high complexity of the mechanism and control algorithms. Current industrial grippers are robust, but lack the flexibility that allows for in hand manipulation. The authors believe that underactuated grippers provide the best approach to allow for in hand manipulation along with being rugged enough for an industrial setting. Thinking of the robotic gripper and the robotic arm as one system (as opposed to two separate subsystems, one is capable of using the degrees of freedom of the robot in conjunction with that of the gripper to provide the desired motion profile without the complexity of running two subsystems. This paper will outline where recent grippers have failed and will introduce a new design paradigm for grippers along with several underactuated gripper ideas.

    This paper was presented at the IFToMM/ASME International Workshop on Underactuated Grasping (UG2010, 19 August 2010, Montréal, Canada.

  16. New Indivisible Planetary Science Paradigm

    CERN Document Server

    Herndon, J Marvin

    2013-01-01

    I present here a new, indivisible planetary science paradigm, a wholly self-consistent vision of the nature of matter in the Solar System, and dynamics and energy sources of planets. Massive-core planets formed by condensing and raining-out from within giant gaseous protoplanets at high pressures and high temperatures. Earth's complete condensation included a 300 Earth-mass gigantic gas/ice shell that compressed the rocky kernel to about 66% of Earth's present diameter. T-Tauri eruptions stripped the gases away from the inner planets and stripped a portion of Mercury's incompletely condensed protoplanet, and transported it to the region between Mars and Jupiter where it fused with in-falling oxidized condensate from the outer regions of the Solar System and formed the parent matter of ordinary chondrite meteorites, the main-Belt asteroids, and veneer for the inner planets, especially Mars. In response to decompression-driven planetary volume increases, cracks form to increase surface area and mountain ranges ...

  17. Health Paradigm Shifts in the 20th Century

    Directory of Open Access Journals (Sweden)

    Jose Miguel DeAngulo

    2015-01-01

    Full Text Available The application of systems theory and the study of complexity to medicine and human health allows for a more comprehensive understanding and a more holistic view of what it means to be human. Such application overcomes the limitations of the traditional, fragmented understanding of phenomena and problems based on the mechanistic or Newtonian worldview. It recognizes that phenomena are interrelated, and that individual parts cannot be understood by only focusing on the analysis of their individual qualities. Rather, the individual parts can only be understood in relation to the whole and by being analyzed in the context of their interaction with the whole. The door is opened to previously unimagined models of thinking.In the 20th Century there have been shifts in the paradigms that have governed medicine and human health in the modern western world. There has been a shift from the focus on specific biological analysis and pathological diagnostics to complex human interactions with the environment and with sociopolitical and economic processes. There are complex models of systems in immunology, in neuroscience, and in genetics, as well as complex ways of understanding interactions as in epidemic modeling, in social media technologies, socioeconomic factors, and artificial intelligence.In this paper we describe three paradigms of the health-disease process that in some degree correspond to the historical development of modern medicine and healthcare over the previous century. The oldest paradigm focused on specific disease mechanisms and treatment. This gave way to paradigms that historically were broader and more inclusive, such as “international health”. The international health paradigm focused primarily on the control of epidemics across national borders and considered government as the only health actor. However, this perspective has come to be seen as excessively reductionist and excluded many critical components essential to a robust

  18. Moving alcohol prevention research forward-Part I: introducing a complex systems paradigm.

    Science.gov (United States)

    Apostolopoulos, Yorghos; Lemke, Michael K; Barry, Adam E; Lich, Kristen Hassmiller

    2018-02-01

    The drinking environment is a complex system consisting of a number of heterogeneous, evolving and interacting components, which exhibit circular causality and emergent properties. These characteristics reduce the efficacy of commonly used research approaches, which typically do not account for the underlying dynamic complexity of alcohol consumption and the interdependent nature of diverse factors influencing misuse over time. We use alcohol misuse among college students in the United States as an example for framing our argument for a complex systems paradigm. A complex systems paradigm, grounded in socio-ecological and complex systems theories and computational modeling and simulation, is introduced. Theoretical, conceptual, methodological and analytical underpinnings of this paradigm are described in the context of college drinking prevention research. The proposed complex systems paradigm can transcend limitations of traditional approaches, thereby fostering new directions in alcohol prevention research. By conceptualizing student alcohol misuse as a complex adaptive system, computational modeling and simulation methodologies and analytical techniques can be used. Moreover, use of participatory model-building approaches to generate simulation models can further increase stakeholder buy-in, understanding and policymaking. A complex systems paradigm for research into alcohol misuse can provide a holistic understanding of the underlying drinking environment and its long-term trajectory, which can elucidate high-leverage preventive interventions. © 2017 Society for the Study of Addiction.

  19. Patient-centred measurement in ophthalmology – a paradigm shift

    Directory of Open Access Journals (Sweden)

    Pesudovs Konrad

    2006-06-01

    Full Text Available Abstract Ophthalmologists and researchers in ophthalmology understand what a rapidly evolving field ophthalmology is, and that to conduct good research it is essential to use the latest and best methods. In outcomes research, one modern initiative has been to conduct holistic measurement of outcomes inclusive of the patient's point of view; patient-centred outcome. This, of course, means including a questionnaire. However, the irony of trying to improve outcomes research by being inclusive of many measures is that the researcher may not be expert in all measures used. Certainly, few people conducting outcomes research in ophthalmology would claim to be questionnaire experts. Most tend to be experts in their ophthalmic subspecialty and probably simply choose a popular questionnaire that appears to fit their needs and think little more about it. Perhaps, unlike our own field, we assume that the field of questionnaire research is relatively stable. This is far from the case. The measurement of patient-centred outcomes with questionnaires is a rapidly evolving field. Indeed, over the last few years a paradigm shift has occurred in patient-centred measurement.

  20. Ostracism Online: A social media ostracism paradigm.

    Science.gov (United States)

    Wolf, Wouter; Levordashka, Ana; Ruff, Johanna R; Kraaijeveld, Steven; Lueckmann, Jan-Matthis; Williams, Kipling D

    2015-06-01

    We describe Ostracism Online, a novel, social media-based ostracism paradigm designed to (1) keep social interaction experimentally controlled, (2) provide researchers with the flexibility to manipulate the properties of the social situation to fit their research purposes, (3) be suitable for online data collection, (4) be convenient for studying subsequent within-group behavior, and (5) be ecologically valid. After collecting data online, we compared the Ostracism Online paradigm with the Cyberball paradigm (Williams & Jarvis Behavior Research Methods, 38, 174-180, 2006) on need-threat and mood questionnaire scores (van Beest & Williams Journal of Personality and Social Psychology 91, 918-928, 2006). We also examined whether ostracized targets of either paradigm would be more likely to conform to their group members than if they had been included. Using a Bayesian analysis of variance to examine the individual effects of the different paradigms and to compare these effects across paradigms, we found analogous effects on need-threat and mood. Perhaps because we examined conformity to the ostracizers (rather than neutral sources), neither paradigm showed effects of ostracism on conformity. We conclude that Ostracism Online is a cost-effective, easy to use, and ecologically valid research tool for studying the psychological and behavioral effects of ostracism.

  1. Antibody-Mediated Rejection: An Evolving Entity in Heart Transplantation

    Directory of Open Access Journals (Sweden)

    Sharon Chih

    2012-01-01

    Full Text Available Antibody-mediated rejection (AMR is gaining increasing recognition as a major complication after heart transplantation, posing a significant risk for allograft failure, cardiac allograft vasculopathy, and poor survival. AMR results from activation of the humoral immune arm and the production of donor-specific antibodies (DSA that bind to the cardiac allograft causing myocardial injury predominantly through complement activation. The diagnosis of AMR has evolved from a clinical diagnosis involving allograft dysfunction and the presence of DSA to a primarily pathologic diagnosis based on histopathology and immunopathology. Treatment for AMR is multifaceted, targeting inhibition of the humoral immune system at different levels with emerging agents including proteasome and complement inhibitors showing particular promise. While there have been significant advances in our current understanding of the pathogenesis, diagnosis, and treatment of AMR, further research is required to determine optimal diagnostic tools, therapeutic agents, and timing of treatment.

  2. The Cognitive Paradigm Ontology: Design and Application

    Science.gov (United States)

    Laird, Angela R.

    2013-01-01

    We present the basic structure of the Cognitive Paradigm Ontology (CogPO) for human behavioral experiments. While the experimental psychology and cognitive neuroscience literature may refer to certain behavioral tasks by name (e.g., the Stroop paradigm or the Sternberg paradigm) or by function (a working memory task, a visual attention task), these paradigms can vary tremendously in the stimuli that are presented to the subject, the response expected from the subject, and the instructions given to the subject. Drawing from the taxonomy developed and used by the BrainMap project (www.brainmap.org) for almost two decades to describe key components of published functional imaging results, we have developed an ontology capable of representing certain characteristics of the cognitive paradigms used in the fMRI and PET literature. The Cognitive Paradigm Ontology is being developed to be compliant with the Basic Formal Ontology (BFO), and to harmonize where possible with larger ontologies such as RadLex, NeuroLex, or the Ontology of Biomedical Investigations (OBI). The key components of CogPO include the representation of experimental conditions focused on the stimuli presented, the instructions given, and the responses requested. The use of alternate and even competitive terminologies can often impede scientific discoveries. Categorization of paradigms according to stimulus, response, and instruction has been shown to allow advanced data retrieval techniques by searching for similarities and contrasts across multiple paradigm levels. The goal of CogPO is to develop, evaluate, and distribute a domain ontology of cognitive paradigms for application and use in the functional neuroimaging community. PMID:21643732

  3. Coronary Restenosis; A Shifting Paradigm

    NARCIS (Netherlands)

    Stella, P.R.|info:eu-repo/dai/nl/304814717

    2009-01-01

    In this thesis, different modalities and treatment options for the treatment and prevention of coronary restenosis are discussed. All studied during the past 10 years in the clinical setting of the coronary catheterization laboratories in Utrecht. At first the initial results using intracoronary

  4. Stroke mimics under the drip-and-ship paradigm.

    Science.gov (United States)

    Mehta, Sonal; Vora, Nirav; Edgell, Randall C; Allam, Hesham; Alawi, Aws; Koehne, Jennifer; Kumar, Abhay; Feen, Eliahu; Cruz-Flores, Salvador; Alshekhlee, Amer

    2014-01-01

    Recent reports suggested better outcomes associated with the drip-and-ship paradigm for acute ischemic stroke (AIS) treated with thrombolysis. We hypothesized that a higher rate of stroke mimics (SM) among AIS treated in nonspecialized stroke centers that are transferred to comprehensive centers is responsible for such outcomes. Consecutive patients treated with thrombolysis according to the admission criteria were reviewed in a single comprehensive stroke center over 1 academic year (July 1, 2011 to June 30, 2012). Information on the basic demographic, hospital complications, psychiatric diagnoses, and discharge disposition was collected. We identified those patients who were treated at a facility and then transferred to the tertiary center (ie, drip-and-ship paradigm). In addition to comparative and adjusted analysis to identify predictors for SM, a stratified analysis by the drip-and-ship status was performed. One hundred twenty patients were treated with thrombolysis for AIS included in this analysis; 20 (16.7%) were discharged with the final diagnosis of SM; 14 of those had conversion syndrome and 6 patients had other syndromes (seizures, migraine, and hypoglycemia). Patients with SM were younger (55.6 ± 15.0 versus 69.4 ± 14.9, P = .0003) and more likely to harbor psychiatric diagnoses (45% versus 9%; P ≤ .0001). Eighteen of 20 SM patients (90%) had the drip-and-ship treatment paradigm compared with 65% of those with AIS (P = .02). None of the SM had hemorrhagic complications, and all were discharged to home. Predictors of SM on adjusted analysis included the drip-and-ship paradigm (odds ratio [OR] 12.8, 95% confidence interval [CI] 1.78, 92.1) and history of any psychiatric illness (OR 12.08; 95% CI 3.14, 46.4). Eighteen of 83 drip-and-ship patients (21.7%) were diagnosed with SM compared with 2 of 37 patients (5.4%) presented directly to the hub hospital (P = .02). The drip-and-ship paradigm and any psychiatric history predict the diagnosis of

  5. PARADIGM OF EDUCATION FOR THE INFORMATION SOCIETY

    Directory of Open Access Journals (Sweden)

    Yuriy M. Bogachkov

    2015-10-01

    Full Text Available Considering total crisis in education in Informational Age, we suggest that to overcome the crisis, it is necessary to promote pedagogical science up from "pre-paradigm stage” to the "paradigm stage". For this purpose it is necessary to separate the "educational science" from "education." “Educational paradigm” in such study will be the subject of the science. The key concepts for the "pedagogical paradigm" should be the concepts of "educational practice", "class of problems" and "educational text". We offer some axioms around these concepts.

  6. The Prerequisites for a Degrowth Paradigm Shift

    DEFF Research Database (Denmark)

    Buch-Hansen, Hubert

    2018-01-01

    What would it take for a degrowth paradigm shift to take place? Drawing on contemporary critical political economy scholarship, this article identifies four prerequisites for socio-economic paradigm shifts: deep crisis, an alternative political project, a comprehensive coalition of social forces...... currently facing humanity. On the other hand, the prospects for a degrowth paradigm shift remain bleak: unlike political projects that became hegemonic in the past, degrowth has neither support from a comprehensive coalition of social forces nor any consent to its agenda among the broader population....

  7. Dynamic Consistency in Process Algebra: From Paradigm to ACP

    NARCIS (Netherlands)

    S. Andova; L.P.J. Groenewegen; E.P. de Vink (Erik Peter)

    2011-01-01

    htmlabstractThe coordination modelling language Paradigm addresses collaboration between components in terms of dynamic constraints. Within a Paradigm model, component dynamics are consistently specified at various levels of abstraction. The operational semantics of Paradigm is given. For a

  8. Evolving wormhole geometries within nonlinear electrodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Arellano, Aaron V B [Facultad de Ciencias, Universidad Autonoma del Estado de Mexico, El Cerrillo, Piedras Blancas, CP 50200, Toluca (Mexico); Lobo, Francisco S N [Centro de Astronomia e Astrofisica da Universidade de Lisboa, Campo Grande, Ed C8 1749-016 Lisbon (Portugal)

    2006-10-21

    In this work, we explore the possibility of evolving (2 + 1) and (3 + 1)-dimensional wormhole spacetimes, conformally related to the respective static geometries, within the context of nonlinear electrodynamics. For (3 + 1)-dimensional spacetime, it is found that the Einstein field equation imposes a contracting wormhole solution and the obedience of the weak energy condition. Nevertheless, in the presence of an electric field, the latter presents a singularity at the throat; however, for a pure magnetic field the solution is regular. For (2 + 1)-dimensional case, it is also found that the physical fields are singular at the throat. Thus, taking into account the principle of finiteness, which states that a satisfactory theory should avoid physical quantities becoming infinite, one may rule out evolving (3 + 1)-dimensional wormhole solutions, in the presence of an electric field, and (2 + 1)-dimensional case coupled to nonlinear electrodynamics.

  9. Continual Learning through Evolvable Neural Turing Machines

    DEFF Research Database (Denmark)

    Lüders, Benno; Schläger, Mikkel; Risi, Sebastian

    2016-01-01

    Continual learning, i.e. the ability to sequentially learn tasks without catastrophic forgetting of previously learned ones, is an important open challenge in machine learning. In this paper we take a step in this direction by showing that the recently proposed Evolving Neural Turing Machine (ENT......) approach is able to perform one-shot learning in a reinforcement learning task without catastrophic forgetting of previously stored associations.......Continual learning, i.e. the ability to sequentially learn tasks without catastrophic forgetting of previously learned ones, is an important open challenge in machine learning. In this paper we take a step in this direction by showing that the recently proposed Evolving Neural Turing Machine (ENTM...

  10. Antibody therapeutics - the evolving patent landscape.

    Science.gov (United States)

    Petering, Jenny; McManamny, Patrick; Honeyman, Jane

    2011-09-01

    The antibody patent landscape has evolved dramatically over the past 30 years, particularly in areas of technology relating to antibody modification to reduce immunogenicity in humans or improve antibody function. In some cases antibody techniques that were developed in the 1980s are still the subject of patent protection in the United States or Canada. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. The evolving epidemiology of inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Shanahan, Fergus

    2009-07-01

    Epidemiologic studies in inflammatory bowel disease (IBD) include assessments of disease burden and evolving patterns of disease presentation. Although it is hoped that sound epidemiologic studies provide aetiological clues, traditional risk factor-based epidemiology has provided limited insights into either Crohn\\'s disease or ulcerative colitis etiopathogenesis. In this update, we will summarize how the changing epidemiology of IBD associated with modernization can be reconciled with current concepts of disease mechanisms and will discuss studies of clinically significant comorbidity in IBD.

  12. Directional Communication in Evolved Multiagent Teams

    Science.gov (United States)

    2013-06-10

    networks. Artificial Life, 15(2):185– 212, 2009. [23] K. O. Stanley and R. Miikkulainen. Evolving neural networks through augmenting topologies ...paper. 2.2 Neuroevolution of Augmenting Topologies The HyperNEAT approach is itself an extension of the original NEAT (Neu- roevolution of Augmenting ...Gauci and K. O. Stanley. Autonomous evolution of topographic regu- larities in artificial neural networks. Neural Computation, 22(7):1860–1898, 2010

  13. The Evolving Leadership Path of Visual Analytics

    Energy Technology Data Exchange (ETDEWEB)

    Kluse, Michael; Peurrung, Anthony J.; Gracio, Deborah K.

    2012-01-02

    This is a requested book chapter for an internationally authored book on visual analytics and related fields, coordianted by a UK university and to be published by Springer in 2012. This chapter is an overview of the leadship strategies that PNNL's Jim Thomas and other stakeholders used to establish visual analytics as a field, and how those strategies may evolve in the future.

  14. Evolvability of Amyloidogenic Proteins in Human Brain

    Science.gov (United States)

    Hashimoto, Makoto; Ho, Gilbert; Sugama, Shuei; Takamatsu, Yoshiki; Shimizu, Yuka; Takenouchi, Takato; Waragai, Masaaki; Masliah, Eliezer

    2018-01-01

     Currently, the physiological roles of amyloidogenic proteins (APs) in human brain, such as amyloid-β and α-synuclein, are elusive. Given that many APs arose by gene duplication and have been resistant against the pressures of natural selection, APs may be associated with some functions that are advantageous for survival of offspring. Nonetheless, evolvability is the sole physiological quality of APs that has been characterized in microorganisms such as yeast. Since yeast and human brain may share similar strategies in coping with diverse range of critical environmental stresses, the objective of this paper was to discuss the potential role of evolvability of APs in aging-associated neurodegenerative disorders, including Alzheimer’s disease and Parkinson’s disease. Given the heterogeneity of APs in terms of structure and cytotoxicity, it is argued that APs might be involved in preconditioning against diverse stresses in human brain. It is further speculated that these stress-related APs, most likely protofibrillar forms, might be transmitted to offspring via the germline, conferring preconditioning against forthcoming stresses. Thus, APs might represent a vehicle for the inheritance of the acquired characteristics against environmental stresses. Curiously, such a characteristic of APs is reminiscent of Charles Darwin’s ‘gemmules’, imagined molecules of heritability described in his pangenesis theory. We propose that evolvability might be a physiological function of APs during the reproductive stage and neurodegenerative diseases could be a by-product effect manifested later in aging. Collectively, our evolvability hypothesis may play a complementary role in the pathophysiology of APs with the conventional amyloid cascade hypothesis. PMID:29439348

  15. Mathematical modeling of bone marrow--peripheral blood dynamics in the disease state based on current emerging paradigms, part I.

    Science.gov (United States)

    Afenya, Evans K; Ouifki, Rachid; Camara, Baba I; Mundle, Suneel D

    2016-04-01

    Stemming from current emerging paradigms related to the cancer stem cell hypothesis, an existing mathematical model is expanded and used to study cell interaction dynamics in the bone marrow and peripheral blood. The proposed mathematical model is described by a system of nonlinear differential equations with delay, to quantify the dynamics in abnormal hematopoiesis. The steady states of the model are analytically and numerically obtained. Some conditions for the local asymptotic stability of such states are investigated. Model analyses suggest that malignancy may be irreversible once it evolves from a nonmalignant state into a malignant one and no intervention takes place. This leads to the proposition that a great deal of emphasis be placed on cancer prevention. Nevertheless, should malignancy arise, treatment programs for its containment or curtailment may have to include a maximum and extensive level of effort to protect normal cells from eventual destruction. Further model analyses and simulations predict that in the untreated disease state, there is an evolution towards a situation in which malignant cells dominate the entire bone marrow - peripheral blood system. Arguments are then advanced regarding requirements for quantitatively understanding cancer stem cell behavior. Among the suggested requirements are, mathematical frameworks for describing the dynamics of cancer initiation and progression, the response to treatment, the evolution of resistance, and malignancy prevention dynamics within the bone marrow - peripheral blood architecture. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. High-order evolving surface finite element method for parabolic problems on evolving surfaces

    OpenAIRE

    Kovács, Balázs

    2016-01-01

    High-order spatial discretisations and full discretisations of parabolic partial differential equations on evolving surfaces are studied. We prove convergence of the high-order evolving surface finite element method, by showing high-order versions of geometric approximation errors and perturbation error estimates and by the careful error analysis of a modified Ritz map. Furthermore, convergence of full discretisations using backward difference formulae and implicit Runge-Kutta methods are als...

  17. Paradigms and Principles Shaping Educational Design Research

    NARCIS (Netherlands)

    McKenney, Susan

    2014-01-01

    McKenney, S. (2013). Paradigms and Principles Shaping Educational Design Research. Invited panel presentation at the annual meeting of the European Association for Research on Learning and Instruction. August 27-31, Munich.

  18. Consumers’ Empowerement for a New Marketing Paradigm

    National Research Council Canada - National Science Library

    Victor Danciu

    2013-01-01

    ...’ power and how more power could work for a new marketing paradigm. There are many unethical marketing techniques which could be found in deceptive product recipes, packaging, promotion, prices and in other...

  19. Levelling in the German Verb Paradigm

    Science.gov (United States)

    Newman, John

    1974-01-01

    Levelling processes in the history of the German verb paradigm from Old High German to the present are discussed. It is asserted that the theory of transformational generative grammar provides a proper framework for the study of linguistic change. (RM)

  20. Beyond desertification: New paradigms for dryland landscapes

    Science.gov (United States)

    The dryland desertification paradigm focuses on losses of ecosystem services accompanying transitions from grasslands to systems dominated by bare ground or woody plants unpalatable for domestic livestock. However, recent studies reveal complex transitions across a range of environmental conditions ...

  1. Theological paradigms and conservative Afrikaners | Robbertze ...

    African Journals Online (AJOL)

    1988) reject foundationalistic theology and recommend a holistic theological ap proach. In this process contextual theology, which emphasises the distinctiveness of individual nations, is accused of being the 'domination paradigm' and is even ...

  2. Engineering paradigms and anthropogenic global change

    Science.gov (United States)

    Bohle, Martin

    2016-04-01

    This essay discusses 'paradigms' as means to conceive anthropogenic global change. Humankind alters earth-systems because of the number of people, the patterns of consumption of resources, and the alterations of environments. This process of anthropogenic global change is a composite consisting of societal (in the 'noosphere') and natural (in the 'bio-geosphere') features. Engineering intercedes these features; e.g. observing stratospheric ozone depletion has led to understanding it as a collateral artefact of a particular set of engineering choices. Beyond any specific use-case, engineering works have a common function; e.g. civil-engineering intersects economic activity and geosphere. People conceive their actions in the noosphere including giving purpose to their engineering. The 'noosphere' is the ensemble of social, cultural or political concepts ('shared subjective mental insights') of people. Among people's concepts are the paradigms how to shape environments, production systems and consumption patterns given their societal preferences. In that context, engineering is a means to implement a given development path. Four paradigms currently are distinguishable how to make anthropogenic global change happening. Among the 'engineering paradigms' for anthropogenic global change, 'adaptation' is a paradigm for a business-as-usual scenario and steady development paths of societies. Applying this paradigm implies to forecast the change to come, to appropriately design engineering works, and to maintain as far as possible the current production and consumption patterns. An alternative would be to adjust incrementally development paths of societies, namely to 'dovetail' anthropogenic and natural fluxes of matter and energy. To apply that paradigm research has to identify 'natural boundaries', how to modify production and consumption patterns, and how to tackle process in the noosphere to render alterations of common development paths acceptable. A further alternative

  3. [Paradigm shift in higher education].

    Science.gov (United States)

    Csóka, Mária

    2009-08-30

    The fast changes that took place in the last quarter of the 20th century made the professionals dealing with pedagogy realize that our school system followed the economical changes in terms of training supply and the matter of education very slowly, if at all; let alone the educational methods. We had to realize that the maintaining of this conservative system is not rational, education has become the most important part of the globalisational competition and the key to the 21st century is learning. Accordingly, the spatial and temporal expenditure of education has become a new trend, namely lifelong learning (LLL). The social needs on education have increased, the expectations of economy and employers have changed: knowledge has become the fund of competitiveness. In this process, universities have got an accentuated role: in addition to being the place of undergraduate training they have become the site of postgraduate courses for the increasing graduate adult masses. Therefore, reform processes have started in a number of European countries in the nineties. The Bologna Declaration signed on 19th June 1999 set a common direction for these reforms, with its signatories aiming to establish a standard European Higher Education Area with harmonized and comparable educational systems by 2010. However, the administrative change itself is not enough to reach the goals; a formal innovation has to be followed by a reform of the contents which means reformation of higher education. In recent years, Hungarian colleges and universities have worked out their educational programs that are suitable for the new structure; it is only the new educational programs that started from 1st September 2006. The author determines the most important parts of the reform of the training system of Semmelweis University Faculty of Health Sciences, which are the following: redrawing of the training philosophy and paradigm, the reform of the training structure of macro level (cognition

  4. New Indivisible Planetary Science Paradigm: Consequence of Questioning Popular Paradigms

    Science.gov (United States)

    Marvin Herndon, J.

    2014-05-01

    Progress in science involves replacing less precise understanding with more precise understanding. In science and in science education one should always question popular ideas; ask "What's wrong with this picture?" Finding limitations, conflicts or circumstances that require special ad hoc consideration sometimes is the key to making important discoveries. For example, from thermodynamic considerations, I found that the 'standard model of solar system formation' leads to insufficiently massive planetary cores. That understanding led me to discover a new indivisible planetary science paradigm. Massive-core planets formed by condensing and raining-out from within giant gaseous protoplanets at high pressures and high temperatures, accumulating heterogeneously on the basis of volatility with liquid core-formation preceding mantle-formation; the interior states of oxidation resemble that of the Abee enstatite chondrite. Core-composition was established during condensation based upon the relative solubilities of elements, including uranium, in liquid iron in equilibrium with an atmosphere of solar composition at high pressures and high temperatures. Uranium settled to the central region and formed planetary nuclear fission reactors, producing heat and planetary magnetic fields. Earth's complete condensation included a ~300 Earth-mass gigantic gas/ice shell that compressed the rocky kernel to about 66% of Earth's present diameter. T-Tauri eruptions, associated with the thermonuclear ignition of the Sun, stripped the gases away from the Earth and the inner planets. The T-Tauri outbursts stripped a portion of Mercury's incompletely condensed protoplanet and transported it to the region between Mars and Jupiter where it fused with in-falling oxidized condensate from the outer regions of the Solar System, forming the parent matter of ordinary chondrite meteorites, the main-Belt asteroids, and veneer for the inner planets, especially Mars. With its massive gas/ice shell

  5. Web applications - New mobile service paradigm

    OpenAIRE

    Ngu, Phuc Huy

    2012-01-01

    The explosion of mobile applications both in number and variety raises the need of shedding light on their architecture, composition and quality. Indeed, it is crucial to understand which mobile application paradigm fits better to what type of application and usage. Such understanding has direct consequences on the user experience, the development cost and sale revenues of mobile apps. In this thesis, we identify four main mobile application paradigms and evaluate them from the viewpoints of ...

  6. Nanomachine : One word for three different paradigms

    OpenAIRE

    Bensaude-Vincent, Bernadette

    2007-01-01

    International audience; Scientists and engineers who extensively use the term “nanomachine” are not always aware of the philosophical implications of this term. The purpose of this paper is to clarify the concept of nanomachine through a distinction between three major paradigms of machine. After a brief presentation of two well-known paradigms - Cartesian mechanistic machines and Von Neumann's complex and uncontrolled machines – we will argue that Drexler's model was mainly Cartesian. But wh...

  7. The Underlying Social Dynamics of Paradigm Shifts.

    Directory of Open Access Journals (Sweden)

    Carlos Rodriguez-Sickert

    Full Text Available We develop here a multi-agent model of the creation of knowledge (scientific progress or technological evolution within a community of researchers devoted to such endeavors. In the proposed model, agents learn in a physical-technological landscape, and weight is attached to both individual search and social influence. We find that the combination of these two forces together with random experimentation can account for both i marginal change, that is, periods of normal science or refinements on the performance of a given technology (and in which the community stays in the neighborhood of the current paradigm; and ii radical change, which takes the form of scientific paradigm shifts (or discontinuities in the structure of performance of a technology that is observed as a swift migration of the knowledge community towards the new and superior paradigm. The efficiency of the search process is heavily dependent on the weight that agents posit on social influence. The occurrence of a paradigm shift becomes more likely when each member of the community attaches a small but positive weight to the experience of his/her peers. For this parameter region, nevertheless, a conservative force is exerted by the representatives of the current paradigm. However, social influence is not strong enough to seriously hamper individual discovery, and can act so as to empower successful individual pioneers who have conquered the new and superior paradigm.

  8. The Underlying Social Dynamics of Paradigm Shifts.

    Science.gov (United States)

    Rodriguez-Sickert, Carlos; Cosmelli, Diego; Claro, Francisco; Fuentes, Miguel Angel

    2015-01-01

    We develop here a multi-agent model of the creation of knowledge (scientific progress or technological evolution) within a community of researchers devoted to such endeavors. In the proposed model, agents learn in a physical-technological landscape, and weight is attached to both individual search and social influence. We find that the combination of these two forces together with random experimentation can account for both i) marginal change, that is, periods of normal science or refinements on the performance of a given technology (and in which the community stays in the neighborhood of the current paradigm); and ii) radical change, which takes the form of scientific paradigm shifts (or discontinuities in the structure of performance of a technology) that is observed as a swift migration of the knowledge community towards the new and superior paradigm. The efficiency of the search process is heavily dependent on the weight that agents posit on social influence. The occurrence of a paradigm shift becomes more likely when each member of the community attaches a small but positive weight to the experience of his/her peers. For this parameter region, nevertheless, a conservative force is exerted by the representatives of the current paradigm. However, social influence is not strong enough to seriously hamper individual discovery, and can act so as to empower successful individual pioneers who have conquered the new and superior paradigm.

  9. Comparison of coronary artery calcification scores and National Cholesterol Education program guidelines for coronary heart disease risk assessment and treatment paradigms in individuals with chronic traumatic spinal cord injury.

    Science.gov (United States)

    Lieberman, Jesse A; Hammond, Flora M; Barringer, Thomas A; Norton, H J; Goff, David C; Bockenek, William L; Scelza, William M

    2011-01-01

    To investigate the risk of coronary heart disease (CHD) in individuals with spinal cord injury (SCI) according to the National Cholesterol Educational Program (NCEP) guidelines and CT coronary artery calcium scores (CCS). Cross-sectional study of consecutive sample of males with SCI presenting to a single site for CHD risk assessment. Males age 45-70 with traumatic SCI (American Spinal Injury Association (ASIA) A, B, and C) injured for at least 10 years with no prior history of clinical CHD. Medical history, blood-pressure, and fasting lipid panel were used to calculate risk for CHD with the use of the Framingham risk score (FRS). Risk and treatment eligibility status was assessed based on NCEP/FRS recommendations and by presence and amount of CCS. Percent agreement (PA) and kappa were calculated between the two algorithms. Spearman correlations were calculated between CCS and FRS and individual risk factors. A total of 38 men were assessed; 18 (47.4%) had CCS > 0. The PA between NCEP/FRS assessment and CCS was 18% with a kappa of -0.03. 11 (28.9%) had CCS > 100 or >75th percentile for their age, sex, and race, which might qualify them for lipid-lowering treatment. Only 26 were placed into the same treatment category by NCEP/FRS and CCS, for a PA of 68% with a kappa of 0.35. In all, 20 (52.6%) were eligible for lipid-lowering treatment by either NCEP/FRS (n=9) or CCS (n = 11). Seven subjects were above the treatment threshold based on CCS, but not NCEP/FRS and five subjects were above the NCEP/FRS threshold, but not CCS. Just four subjects were eligible by both algorithms. CCS only correlated with FRS (r = 0.508, P = 0.001) and age (r = 0.679, P < 0.001).

  10. Evolvability Is an Evolved Ability: The Coding Concept as the Arch-Unit of Natural Selection.

    Science.gov (United States)

    Janković, Srdja; Ćirković, Milan M

    2016-03-01

    Physical processes that characterize living matter are qualitatively distinct in that they involve encoding and transfer of specific types of information. Such information plays an active part in the control of events that are ultimately linked to the capacity of the system to persist and multiply. This algorithmicity of life is a key prerequisite for its Darwinian evolution, driven by natural selection acting upon stochastically arising variations of the encoded information. The concept of evolvability attempts to define the total capacity of a system to evolve new encoded traits under appropriate conditions, i.e., the accessible section of total morphological space. Since this is dependent on previously evolved regulatory networks that govern information flow in the system, evolvability itself may be regarded as an evolved ability. The way information is physically written, read and modified in living cells (the "coding concept") has not changed substantially during the whole history of the Earth's biosphere. This biosphere, be it alone or one of many, is, accordingly, itself a product of natural selection, since the overall evolvability conferred by its coding concept (nucleic acids as information carriers with the "rulebook of meanings" provided by codons, as well as all the subsystems that regulate various conditional information-reading modes) certainly played a key role in enabling this biosphere to survive up to the present, through alterations of planetary conditions, including at least five catastrophic events linked to major mass extinctions. We submit that, whatever the actual prebiotic physical and chemical processes may have been on our home planet, or may, in principle, occur at some time and place in the Universe, a particular coding concept, with its respective potential to give rise to a biosphere, or class of biospheres, of a certain evolvability, may itself be regarded as a unit (indeed the arch-unit) of natural selection.

  11. InSpire to Promote Lung Assessment in Youth: Evolving the Self-Management Paradigms of Young People With Asthma.

    Science.gov (United States)

    Elias, Pierre; Rajan, Nithin O; McArthur, Kara; Dacso, Clifford C

    2013-01-01

    Asthma is the most common chronic disease in childhood, disproportionately affecting urban, minority, and disadvantaged children. Individualized care plans supported by daily lung-function monitoring can reduce morbidity and mortality. However, despite 20 years of interventions to increase adherence, only 50% of US youth accurately follow their care plans, which leads to millions of preventable hospitalizations, emergency room visits, and sick days every year. We present a feasibility study of a novel, user-centered approach to increasing young people's lung-function monitoring and asthma self-care. Promoting Lung Assessment in Youth (PLAY) helps young people become active managers of their asthma through the Web 2.0 principles of participation, cocreation, and information sharing. Specifically, PLAY combines an inexpensive, portable spirometer with the motivational power and convenience of mobile phones and virtual-community gaming. The objective of this study was to develop and pilot test InSpire, a fully functional interface between a handheld spirometer and an interactive game and individualized asthma-care instant-messaging system housed on a mobile phone. InSpire is an application for mobile smartphones that creates a compelling world in which youth collaborate with their physicians on managing their asthma. Drawing from design-theory on global timer mechanics and role playing, we incentivized completing spirometry maneuvers by making them an engaging part of a game young people would want to play. The data can be sent wirelessly to health specialists and return care recommendations to patients in real-time. By making it portable and similar to applications normally desired by the target demographic, InSpire is able to seamlessly incorporate asthma management into their lifestyle. We describe the development process of building and testing the InSpire prototype. To our knowledge, the prototype is a first-of-its kind mobile one-stop shop for asthma management. Feasibility testing in children aged 7 to 14 with asthma assessed likability of the graphical user interface as well as young people's interest in our incentivizing system. Nearly 100% of children surveyed said they would play games like those in PLAY if they involved breathing into a spirometer. Two-thirds said they would prefer PLAY over the spirometer alone, whereas 1/3 would prefer having both. No children said they would prefer the spirometer over PLAY. Previous efforts at home-monitoring of asthma in children have experienced rapid decline in adherence. An inexpensive monitoring technology combined with the computation, interactive communication, and display ability of a mobile phone is a promising approach to sustainable adherence to lung-function monitoring and care plans. An exciting game that redefines the way youth conduct health management by inviting them to collaborate in their health better can be an incentive and a catalyst for more far-reaching goals.

  12. Survivability is more fundamental than evolvability.

    Directory of Open Access Journals (Sweden)

    Michael E Palmer

    Full Text Available For a lineage to survive over long time periods, it must sometimes change. This has given rise to the term evolvability, meaning the tendency to produce adaptive variation. One lineage may be superior to another in terms of its current standing variation, or it may tend to produce more adaptive variation. However, evolutionary outcomes depend on more than standing variation and produced adaptive variation: deleterious variation also matters. Evolvability, as most commonly interpreted, is not predictive of evolutionary outcomes. Here, we define a predictive measure of the evolutionary success of a lineage that we call the k-survivability, defined as the probability that the lineage avoids extinction for k generations. We estimate the k-survivability using multiple experimental replicates. Because we measure evolutionary outcomes, the initial standing variation, the full spectrum of generated variation, and the heritability of that variation are all incorporated. Survivability also accounts for the decreased joint likelihood of extinction of sub-lineages when they 1 disperse in space, or 2 diversify in lifestyle. We illustrate measurement of survivability with in silico models, and suggest that it may also be measured in vivo using multiple longitudinal replicates. The k-survivability is a metric that enables the quantitative study of, for example, the evolution of 1 mutation rates, 2 dispersal mechanisms, 3 the genotype-phenotype map, and 4 sexual reproduction, in temporally and spatially fluctuating environments. Although these disparate phenomena evolve by well-understood microevolutionary rules, they are also subject to the macroevolutionary constraint of long-term survivability.

  13. Present weather and climate: evolving conditions

    Science.gov (United States)

    Hoerling, Martin P; Dettinger, Michael; Wolter, Klaus; Lukas, Jeff; Eischeid, Jon K.; Nemani, Rama; Liebmann, Brant; Kunkel, Kenneth E.

    2013-01-01

    This chapter assesses weather and climate variability and trends in the Southwest, using observed climate and paleoclimate records. It analyzes the last 100 years of climate variability in comparison to the last 1,000 years, and links the important features of evolving climate conditions to river flow variability in four of the region’s major drainage basins. The chapter closes with an assessment of the monitoring and scientific research needed to increase confidence in understanding when climate episodes, events, and phenomena are attributable to human-caused climate change.

  14. f( R) gravity solutions for evolving wormholes

    Science.gov (United States)

    Bhattacharya, Subhra; Chakraborty, Subenoy

    2017-08-01

    The scalar-tensor f( R) theory of gravity is considered in the framework of a simple inhomogeneous space-time model. In this research we use the reconstruction technique to look for possible evolving wormhole solutions within viable f( R) gravity formalism. These f( R) models are then constrained so that they are consistent with existing experimental data. Energy conditions related to the matter threading the wormhole are analyzed graphically and are in general found to obey the null energy conditions (NEC) in regions around the throat, while in the limit f(R)=R, NEC can be violated at large in regions around the throat.

  15. Information theory, evolutionary innovations and evolvability.

    Science.gov (United States)

    Wagner, Andreas

    2017-12-05

    How difficult is it to 'discover' an evolutionary adaptation or innovation? I here suggest that information theory, in combination with high-throughput DNA sequencing, can help answer this question by quantifying a new phenotype's information content. I apply this framework to compute the phenotypic information associated with novel gene regulation and with the ability to use novel carbon sources. The framework can also help quantify how DNA duplications affect evolvability, estimate the complexity of phenotypes and clarify the meaning of 'progress' in Darwinian evolution.This article is part of the themed issue 'Process and pattern in innovations from cells to societies'. © 2017 The Author(s).

  16. Evolving Random Forest for Preference Learning

    DEFF Research Database (Denmark)

    Abou-Zleikha, Mohamed; Shaker, Noor

    2015-01-01

    This paper introduces a novel approach for pairwise preference learning through a combination of an evolutionary method and random forest. Grammatical evolution is used to describe the structure of the trees in the Random Forest (RF) and to handle the process of evolution. Evolved random forests ...... obtained for predicting pairwise self-reports of users for the three emotional states engagement, frustration and challenge show very promising results that are comparable and in some cases superior to those obtained from state-of-the-art methods....

  17. Mesenchymal stromal cells: misconceptions and evolving concepts.

    Science.gov (United States)

    Phinney, Donald G; Sensebé, Luc

    2013-02-01

    Nearly half a century has passed since the publication of the first articles describing plastic-adherent cells from bone marrow, referred to initially as colony-forming unit fibroblasts, then marrow stromal cells, mesenchymal stem cells and most recently multipotent mesenchymal stromal cells (MSCs). As expected, our understanding of the nature and biologic functions of MSCs has undergone major paradigm shifts over this time. Despite significant advances made in deciphering their complex biology and therapeutic potential in both experimental animal models and human clinical trials, numerous misconceptions regarding the nature and function of MSCs have persisted in the field. Continued propagation of these misconceptions in some cases may significantly impede the advancement of MSC-based therapies in clinical medicine. We have identified six prevalent misconceptions about MSCs that we believe affect the field, and we attempt to rectify them based on current available data. Copyright © 2013 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  18. [Toward a new paradigm of education].

    Science.gov (United States)

    Viniegra-Velázquez, Leonardo

    2008-01-01

    This work has as starting point the concept of paradigm proposed by E. Morin: principal categories that guide the intelligibility and logical thinking. The great paradigm of the western hemisphere (prevailing paradigm) is characterized by its effects of disjunction, reduction, simplification, and exclusion. The effects of the paradigm in the medical practice, in the scientific work, and in education are analyzed. The epistemological premises of neopositivism, heir of the prevailing paradigm, and of critical of experience are confronted. It emphasizes the opposite roles that each epistemological tendency gives to the ideas and facts in knowledge. The disjunction between the creation and use of knowledge, typical of the school institution, originates the passive perspective of education. The idea of knowledge as elaboration of the learner in knowledge situation, originates the participative perspective of education. The characteristics of both perspectives of education in relation to the role of theory and practice, the role of the professor and student, and the main purposes are contrasted. It is briefly analyzed how the different educational schools appeared in the XX century do not represent true alternatives to the paradigm, except P. Freire's proposals. The more relevant aspects of the participative perspective of education are emphasized: habit of reflective thinking about the vital experience, exercise of criticism and self-criticism, development of points of view about problem situations of experience and of methodological and practical abilities. Different considerations are made about what the participative perspective of education implies in the pretension to overcome the effects of disjunction, reduction and simplification of the ruling paradigm.

  19. Active training paradigm for motor imagery BCI.

    Science.gov (United States)

    Li, Junhua; Zhang, Liqing

    2012-06-01

    Brain-computer interface (BCI) allows the use of brain activities for people to directly communicate with the external world or to control external devices without participation of any peripheral nerves and muscles. Motor imagery is one of the most popular modes in the research field of brain-computer interface. Although motor imagery BCI has some advantages compared with other modes of BCI, such as asynchronization, it is necessary to require training sessions before using it. The performance of trained BCI system depends on the quality of training samples or the subject engagement. In order to improve training effect and decrease training time, we proposed a new paradigm where subjects participated in training more actively than in the traditional paradigm. In the traditional paradigm, a cue (to indicate what kind of motor imagery should be imagined during the current trial) is given to the subject at the beginning of a trial or during a trial, and this cue is also used as a label for this trial. It is usually assumed that labels for trials are accurate in the traditional paradigm, although subjects may not have performed the required or correct kind of motor imagery, and trials may thus be mislabeled. And then those mislabeled trials give rise to interference during model training. In our proposed paradigm, the subject is required to reconfirm the label and can correct the label when necessary. This active training paradigm may generate better training samples with fewer inconsistent labels because it overcomes mistakes when subject's motor imagination does not match the given cues. The experiments confirm that our proposed paradigm achieves better performance; the improvement is significant according to statistical analysis.

  20. Netgram: Visualizing Communities in Evolving Networks.

    Directory of Open Access Journals (Sweden)

    Raghvendra Mall

    Full Text Available Real-world complex networks are dynamic in nature and change over time. The change is usually observed in the interactions within the network over time. Complex networks exhibit community like structures. A key feature of the dynamics of complex networks is the evolution of communities over time. Several methods have been proposed to detect and track the evolution of these groups over time. However, there is no generic tool which visualizes all the aspects of group evolution in dynamic networks including birth, death, splitting, merging, expansion, shrinkage and continuation of groups. In this paper, we propose Netgram: a tool for visualizing evolution of communities in time-evolving graphs. Netgram maintains evolution of communities over 2 consecutive time-stamps in tables which are used to create a query database using the sql outer-join operation. It uses a line-based visualization technique which adheres to certain design principles and aesthetic guidelines. Netgram uses a greedy solution to order the initial community information provided by the evolutionary clustering technique such that we have fewer line cross-overs in the visualization. This makes it easier to track the progress of individual communities in time evolving graphs. Netgram is a generic toolkit which can be used with any evolutionary community detection algorithm as illustrated in our experiments. We use Netgram for visualization of topic evolution in the NIPS conference over a period of 11 years and observe the emergence and merging of several disciplines in the field of information processing systems.

  1. Evolving MEMS Resonator Designs for Fabrication

    Science.gov (United States)

    Hornby, Gregory S.; Kraus, William F.; Lohn, Jason D.

    2008-01-01

    Because of their small size and high reliability, microelectromechanical (MEMS) devices have the potential to revolution many areas of engineering. As with conventionally-sized engineering design, there is likely to be a demand for the automated design of MEMS devices. This paper describes our current status as we progress toward our ultimate goal of using an evolutionary algorithm and a generative representation to produce designs of a MEMS device and successfully demonstrate its transfer to an actual chip. To produce designs that are likely to transfer to reality, we present two ways to modify evaluation of designs. The first is to add location noise, differences between the actual dimensions of the design and the design blueprint, which is a technique we have used for our work in evolving antennas and robots. The second method is to add prestress to model the warping that occurs during the extreme heat of fabrication. In future we expect to fabricate and test some MEMS resonators that are evolved in this way.

  2. Netgram: Visualizing Communities in Evolving Networks

    Science.gov (United States)

    Mall, Raghvendra; Langone, Rocco; Suykens, Johan A. K.

    2015-01-01

    Real-world complex networks are dynamic in nature and change over time. The change is usually observed in the interactions within the network over time. Complex networks exhibit community like structures. A key feature of the dynamics of complex networks is the evolution of communities over time. Several methods have been proposed to detect and track the evolution of these groups over time. However, there is no generic tool which visualizes all the aspects of group evolution in dynamic networks including birth, death, splitting, merging, expansion, shrinkage and continuation of groups. In this paper, we propose Netgram: a tool for visualizing evolution of communities in time-evolving graphs. Netgram maintains evolution of communities over 2 consecutive time-stamps in tables which are used to create a query database using the sql outer-join operation. It uses a line-based visualization technique which adheres to certain design principles and aesthetic guidelines. Netgram uses a greedy solution to order the initial community information provided by the evolutionary clustering technique such that we have fewer line cross-overs in the visualization. This makes it easier to track the progress of individual communities in time evolving graphs. Netgram is a generic toolkit which can be used with any evolutionary community detection algorithm as illustrated in our experiments. We use Netgram for visualization of topic evolution in the NIPS conference over a period of 11 years and observe the emergence and merging of several disciplines in the field of information processing systems. PMID:26356538

  3. BOOK REVIEW: OPENING SCIENCE, THE EVOLVING GUIDE ...

    Science.gov (United States)

    The way we get our funding, collaborate, do our research, and get the word out has evolved over hundreds of years but we can imagine a more open science world, largely facilitated by the internet. The movement towards this more open way of doing and presenting science is coming, and it is not taking hundreds of years. If you are interested in these trends, and would like to find out more about where this is all headed and what it means to you, consider downloding Opening Science, edited by Sönke Bartling and Sascha Friesike, subtitled The Evolving Guide on How the Internet is Changing Research, Collaboration, and Scholarly Publishing. In 26 chapters by various authors from a range of disciplines the book explores the developing world of open science, starting from the first scientific revolution and bringing us to the next scientific revolution, sometimes referred to as “Science 2.0”. Some of the articles deal with the impact of the changing landscape of how science is done, looking at the impact of open science on Academia, or journal publishing, or medical research. Many of the articles look at the uses, pitfalls, and impact of specific tools, like microblogging (think Twitter), social networking, and reference management. There is lots of discussion and definition of terms you might use or misuse like “altmetrics” and “impact factor”. Science will probably never be completely open, and Twitter will probably never replace the journal article,

  4. ENVIRONMENTALISM AND CLASSIC PARADIGMS OF INTERNATIONAL RELATIONS

    Directory of Open Access Journals (Sweden)

    D. D. Miniaeva

    2014-06-01

    Full Text Available This article examines an environmentalism integration process into Three classical paradigms of international relations theory (Liberalism, Realism and Marxism into Three classical paradigms of international relations theory (Liberalism, Realism and Marxism. The main purpose of this study is to reveal the result of this integration. Methods used in this article include analysis and comparison of "ecological" paradigms on selected parameters (the nature of international relations, actors, targets, tools, processes. Results of research show that the beginning of the XXI century is distinguished by the development of new types of political concepts that explain interaction of elements in modern international relations in the area of environmental protection. The reason of these changes lies in the phenomena of environmentalism integration into Three paradigms of international relations. However, we cannot say that any of the examined paradigms accumulated all features of environmentalism without their modification. Better to say, it's rather similar to adaptation of environmental ideas. Therefore, to understand modern international relations processes, it is necessary to take into account their environmental element. Purchase on Elibrary.ru > Buy nowDOI: http://dx.doi.org/10.12731/2070-7568-2014-3-4

  5. Paradigm formation and paradigm change in the EU’s Stability and Growth Pact

    NARCIS (Netherlands)

    Princen, Sebastiaan; van Esch, Femke

    2016-01-01

    This article analyses whether the European Union’s (EU) Stability and Growth Pact (SGP) has been underpinned by a policy paradigm. In doing so, it seeks to contribute to the debate on the existence and importance of paradigms in policy-making. It uses a causal mapping technique to reconstruct the

  6. International business and the eclectic paradigm

    DEFF Research Database (Denmark)

    The eclectic paradigm has become the dominant theoretical basis in the study of international business, multinational corporations and internationalization since 1980. However, developments such as economic globalization and the subsequent growth of global and alliance capitalism have fundamentally......, finance, evolutionary economics, resource-based theory or strategic management? Can it be utilized to explain new developments in international business and economics? Do these require new ideas and concepts to be integrated within the eclectic paradigm? What are the new challenges to which international...... affected the way in which MNC activities are undertaken and organized. The contributions to this volume evaluate the eclectic paradigm in the global economy and its validity as a theoretical basis to understand these developments. Contributions by leading scholars -including John Dunning, Stephen Gusinger...

  7. [Paradigm errors in the old biomedical science].

    Science.gov (United States)

    Skurvydas, Albertas

    2008-01-01

    The aim of this article was to review the basic drawbacks of the deterministic and reductionistic thinking in biomedical science and to provide ways for dealing with them. The present paradigm of research in biomedical science has not got rid of the errors of the old science yet, i.e. the errors of absolute determinism and reductionism. These errors restrict the view and thinking of scholars engaged in the studies of complex and dynamic phenomena and mechanisms. Recently, discussions on science paradigm aimed at spreading the new science paradigm that of complex dynamic systems as well as chaos theory are in progress all over the world. It is for the nearest future to show which of the two, the old or the new science, will be the winner. We have come to the main conclusion that deterministic and reductionistic thinking applied in improper way can cause substantial damage rather than prove benefits for biomedicine science.

  8. Understanding Mixed Emotions: Paradigms and Measures.

    Science.gov (United States)

    Kreibig, Sylvia D; Gross, James J

    2017-06-01

    In this review, we examine the paradigms and measures available for experimentally studying mixed emotions in the laboratory. For eliciting mixed emotions, we describe a mixed emotions film library that allows for the repeated elicitation of a specific homogeneous mixed emotional state and appropriately matched pure positive, pure negative, and neutral emotional states. For assessing mixed emotions, we consider subjective and objective measures that fall into univariate, bivariate, and multivariate measurement categories. As paradigms and measures for objectively studying mixed emotions are still in their early stages, we conclude by outlining future directions that focus on the reliability, temporal dynamics, and response coherence of mixed emotions paradigms and measures. This research will build a strong foundation for future studies and significantly advance our understanding of mixed emotions.

  9. Evolvability as a Quality Attribute of Software Architectures

    NARCIS (Netherlands)

    Ciraci, S.; van den Broek, P.M.; Duchien, Laurence; D'Hondt, Maja; Mens, Tom

    We review the definition of evolvability as it appears on the literature. In particular, the concept of software evolvability is compared with other system quality attributes, such as adaptability, maintainability and modifiability.

  10. The emperor's tailors: the failure of the medical weight loss paradigm and its causal role in the obesity of America.

    Science.gov (United States)

    Puterbaugh, J S

    2009-06-01

    During the past century, the medical profession has developed a paradigm for the treatment of obesity, which prescribes specific exercise and dietary goals under the umbrella of 'lifestyle change'. It has three components, all of which evolved from origins that had nothing to do with weight control. First, it is individually prescriptive, that is weight loss is considered the responsibility of the individual as contrasted to a societal or group responsibility. Second, it recommends exercise aimed towards structured, or non-functional, activities with a variety of physiological endpoints. Last, dietary goals are defined by calories, exchanges, food groups and various nutritional components. Diets are usually grouped by these goals. This model is unique to America, it is not working and it has also played a causal role in the obesity it is attempting to eliminate. A new model must be developed, which contains an observationally based societal prescription and links activity with functional outcomes and diets, which are food rather than nutritionally based.

  11. Tracking correlated, simultaneously evolving target populations, II

    Science.gov (United States)

    Mahler, Ronald

    2017-05-01

    This paper is the sixth in a series aimed at weakening the independence assumptions that are typically presumed in multitarget tracking. Earlier papers investigated Bayes …lters that propagate the correlations between two evolving multitarget systems. Last year at this conference we attempted to derive PHD …lter-type approximations that account for both spatial correlation and cardinality correlation (i.e., correlation between the target numbers of the two systems). Unfortunately, this approach required heuristic models of both clutter and target appearance in order to incorporate both spatial and cardinality correlation. This paper describes a fully rigorous approach- provided, however, that spatial correlation between the two populations is ignored and only their cardinality correlations are taken into account. We derive the time-update and measurement-update equations for a CPHD …lter describing the evolution of such correlated multitarget populations.

  12. Resiliently evolving supply-demand networks.

    Science.gov (United States)

    Rubido, Nicolás; Grebogi, Celso; Baptista, Murilo S

    2014-01-01

    The ability to design a transport network such that commodities are brought from suppliers to consumers in a steady, optimal, and stable way is of great importance for distribution systems nowadays. In this work, by using the circuit laws of Kirchhoff and Ohm, we provide the exact capacities of the edges that an optimal supply-demand network should have to operate stably under perturbations, i.e., without overloading. The perturbations we consider are the evolution of the connecting topology, the decentralization of hub sources or sinks, and the intermittence of supplier and consumer characteristics. We analyze these conditions and the impact of our results, both on the current United Kingdom power-grid structure and on numerically generated evolving archetypal network topologies.

  13. A local-world evolving hypernetwork model

    Science.gov (United States)

    Yang, Guang-Yong; Liu, Jian-Guo

    2014-01-01

    Complex hypernetworks are ubiquitous in the real system. It is very important to investigate the evolution mechanisms. In this paper, we present a local-world evolving hypernetwork model by taking into account the hyperedge growth and local-world hyperedge preferential attachment mechanisms. At each time step, a newly added hyperedge encircles a new coming node and a number of nodes from a randomly selected local world. The number of the selected nodes from the local world obeys the uniform distribution and its mean value is m. The analytical and simulation results show that the hyperdegree approximately obeys the power-law form and the exponent of hyperdegree distribution is γ = 2 + 1/m. Furthermore, we numerically investigate the node degree, hyperedge degree, clustering coefficient, as well as the average distance, and find that the hypernetwork model shares the scale-free and small-world properties, which shed some light for deeply understanding the evolution mechanism of the real systems.

  14. The Evolving Theory of Evolutionary Radiations.

    Science.gov (United States)

    Simões, M; Breitkreuz, L; Alvarado, M; Baca, S; Cooper, J C; Heins, L; Herzog, K; Lieberman, B S

    2016-01-01

    Evolutionary radiations have intrigued biologists for more than 100 years, and our understanding of the patterns and processes associated with these radiations continues to grow and evolve. Recently it has been recognized that there are many different types of evolutionary radiation beyond the well-studied adaptive radiations. We focus here on multifarious types of evolutionary radiations, paying special attention to the abiotic factors that might trigger diversification in clades. We integrate concepts such as exaptation, species selection, coevolution, and the turnover-pulse hypothesis (TPH) into the theoretical framework of evolutionary radiations. We also discuss other phenomena that are related to, but distinct from, evolutionary radiations that have relevance for evolutionary biology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Epidemic spreading on evolving signed networks

    CERN Document Server

    Saeedian, M; Jafari, G R; Kertesz, J

    2016-01-01

    Most studies of disease spreading consider the underlying social network as obtained without the contagion, though epidemic influences peoples willingness to contact others: A friendly contact may be turned to unfriendly to avoid infection. We study the susceptible-infected (SI) disease spreading model on signed networks, in which each edge is associated with a positive or negative sign representing the friendly or unfriendly relation between its end nodes. In a signed network, according to Heiders theory, edge signs evolve such that finally a state of structural balance is achieved, corresponding to no frustration in physics terms. However, the danger of infection affects the evolution of its edge signs. To describe the coupled problem of the sign evolution and disease spreading, we generalize the notion of structural balance by taking into account the state of the nodes. We introduce an energy function and carry out Monte-Carlo simulations on complete networks to test the energy landscape, where we find loc...

  16. Finch: A System for Evolving Java (Bytecode)

    Science.gov (United States)

    Orlov, Michael; Sipper, Moshe

    The established approach in genetic programming (GP) involves the definition of functions and terminals appropriate to the problem at hand, after which evolution of expressions using these definitions takes place. We have recently developed a system, dubbed FINCH (Fertile Darwinian Bytecode Harvester), to evolutionarily improve actual, extant software, which was not intentionally written for the purpose of serving as a GP representation in particular, nor for evolution in general. This is in contrast to existing work that uses restricted subsets of the Java bytecode instruction set as a representation language for individuals in genetic programming. The ability to evolve Java programs will hopefully lead to a valuable new tool in the software engineer's toolkit.

  17. Radioactive Iodine Therapy of Differentiated Thyroid Carcinoma: Redesigning the Paradigm

    Directory of Open Access Journals (Sweden)

    Stanley J. Goldsmith

    2017-02-01

    Full Text Available Radioactive iodine therapy has evolved over the past 70 years from treatment of known metastatic thyroid carcinoma to include adjuvant use to decrease the incidence of recurrent disease and to ablation of normal remnant tissue following thyroidectomy, even for minimal tumor involvement. Advances in laboratory testing, development of drugs useful in radioiodine treatment, as well as advances in radiation detection and imaging instrumentation, have progressively improved the utility of radioiodine therapy of differentiated thyroid carcinoma. Guidelines have proliferated and they have become more detailed and complex. This trend is likely to continue as the science and technology involved increases in sophistication and efficacy.

  18. Radioactive Iodine Therapy of Differentiated Thyroid Carcinoma: Redesigning the Paradigm.

    Science.gov (United States)

    Goldsmith, Stanley J

    2017-02-09

    Radioactive iodine therapy has evolved over the past 70 years from treatment of known metastatic thyroid carcinoma to include adjuvant use to decrease the incidence of recurrent disease and to ablation of normal remnant tissue following thyroidectomy, even for minimal tumor involvement. Advances in laboratory testing, development of drugs useful in radioiodine treatment, as well as advances in radiation detection and imaging instrumentation, have progressively improved the utility of radioiodine therapy of differentiated thyroid carcinoma. Guidelines have proliferated and they have become more detailed and complex. This trend is likely to continue as the science and technology involved increases in sophistication and efficacy.

  19. RFID security a lightweight paradigm

    CERN Document Server

    Khattab, Ahmed; Amini, Esmaeil; Bayoumi, Magdy

    2017-01-01

    This book provides a comprehensive treatment of security in the widely adopted, Radio Frequency Identification (RFID) technology. The authors present the fundamental principles of RFID cryptography in a manner accessible to a broad range of readers, enabling them to improve their RFID security design. This book also offers the reader a range of interesting topics portraying the current state-of-the-art in RFID technology and how it can be integrated with today’s Internet of Things (IoT) vision. The authors describe a first-of-its-kind, lightweight symmetric authenticated encryption cipher called Redundant Bit Security (RBS), which enables significant, multi-faceted performance improvements compared to existing cryptosystems. This book is a must-read for anyone aiming to overcome the constraints of practical implementation in RFID security technologies.

  20. Cryptic species as a window into the paradigm shift of the species concept.

    Science.gov (United States)

    Fišer, Cene; Robinson, Christopher T; Malard, Florian

    2018-01-15

    The species concept is the cornerstone of biodiversity science, and any paradigm shift in the delimitation of species affects many research fields. Many biologists now are embracing a new "species" paradigm as separately evolving populations using different delimitation criteria. Individual criteria can emerge during different periods of speciation; some may never evolve. As such, a paradigm shift in the species concept relates to this inherent heterogeneity in the speciation process and species category-which is fundamentally overlooked in biodiversity research. Cryptic species fall within this paradigm shift: they are continuously being reported from diverse animal phyla but are poorly considered in current tests of ecological and evolutionary theory. The aim of this review is to integrate cryptic species in biodiversity science. In the first section, we address that the absence of morphological diversification is an evolutionary phenomenon, a "process" counterpart to the long-studied mechanisms of morphological diversification. In the next section regarding taxonomy, we show that molecular delimitation of cryptic species is heavily biased towards distance-based methods. We also stress the importance of formally naming of cryptic species for better integration into research fields that use species as units of analysis. Finally, we show that incorporating cryptic species leads to novel insights regarding biodiversity patterns and processes, including large-scale biodiversity assessments, geographic variation in species distribution and species coexistence. It is time for incorporating multicriteria species approaches aiming to understand speciation across space and taxa, thus allowing integration into biodiversity conservation while accommodating for species uncertainty. © 2018 John Wiley & Sons Ltd.

  1. Paradigms for Realizing Machine Learning Algorithms.

    Science.gov (United States)

    Agneeswaran, Vijay Srinivas; Tonpay, Pranay; Tiwary, Jayati

    2013-12-01

    The article explains the three generations of machine learning algorithms-with all three trying to operate on big data. The first generation tools are SAS, SPSS, etc., while second generation realizations include Mahout and RapidMiner (that work over Hadoop), and the third generation paradigms include Spark and GraphLab, among others. The essence of the article is that for a number of machine learning algorithms, it is important to look beyond the Hadoop's Map-Reduce paradigm in order to make them work on big data. A number of promising contenders have emerged in the third generation that can be exploited to realize deep analytics on big data.

  2. An Enabling Technology for New Planning and Scheduling Paradigms

    Science.gov (United States)

    Jaap, John; Davis, Elizabeth

    2004-01-01

    The Night Projects Directorate at NASA's Marshall Space Flight Center is developing a new planning and scheduling environment and a new scheduling algorithm to enable a paradigm shift in planning and scheduling concepts. Over the past 33 years Marshall has developed and evolved a paradigm for generating payload timelines for Skylab, Spacelab, various other Shuttle payloads, and the International Space Station. The current paradigm starts by collecting the requirements, called ?ask models," from the scientists and technologists for the tasks that are to be scheduled. Because of shortcomings in the current modeling schema, some requirements are entered as notes. Next, a cadre with knowledge of vehicle and hardware modifies these models to encompass and be compatible with the hardware model; again, notes are added when the modeling schema does not provide a better way to represent the requirements. Finally, the models are modified to be compatible with the scheduling engine. Then the models are submitted to the scheduling engine for automatic scheduling or, when requirements are expressed in notes, the timeline is built manually. A future paradigm would provide a scheduling engine that accepts separate science models and hardware models. The modeling schema would have the capability to represent all the requirements without resorting to notes. Furthermore, the scheduling engine would not require that the models be modified to account for the capabilities (limitations) of the scheduling engine. The enabling technology under development at Marshall has three major components: (1) A new modeling schema allows expressing all the requirements of the tasks without resorting to notes or awkward contrivances. The chosen modeling schema is both maximally expressive and easy to use. It utilizes graphical methods to show hierarchies of task constraints and networks of temporal relationships. (2) A new scheduling algorithm automatically schedules the models without the

  3. A new paradigm of cardiovascular risk factor modification

    Directory of Open Access Journals (Sweden)

    Muhammad Firdaus

    2005-07-01

    Full Text Available Muhammad Firdaus1, Jeffery M Asbury2, Dwight W Reynolds21Donald W Reynolds Department of Geriatric Medicine, University of Oklahoma, Oklahoma City, OK, USA; 2Department of Medicine, Cardiovascular Section, University of Oklahoma, Oklahoma City, OK, USAAbstract: Atherosclerotic cardiovascular diseases (CVDs are the leading cause of death and disability in the United States. While multiple studies have demonstrated that modification of atherosclerotic cardiovascular risk factors (CVRFs significantly reduces morbidity and mortality rates, clinical control of CVDs and CVRFs remains poor. By 2010, the American Heart Association seeks to reduce coronary heart disease, stroke, and risk by 25%. To meet this goal, clinical practitioners must establish new treatment paradigms for CVDs and CVRFs. This paper discusses one such treatment model – a comprehensive atherosclerosis program run by physician extenders (under physician supervision, which incorporates evidence-based CVD and CVRF interventions to achieve treatment goals.Keywords: atherosclerosis, cardiovascular risk factors, prevention, modification

  4. Sipuleucel-T (Provenge(®))-Autopsy of an Innovative Paradigm Change in Cancer Treatment: Why a Single-Product Biotech Company Failed to Capitalize on its Breakthrough Invention.

    Science.gov (United States)

    Jarosławski, Szymon; Toumi, Mondher

    2015-10-01

    Approved by the US Food and Drug Administration (FDA) in 2010, sipuleucel-T (Provenge(®)) was the first 'personalized' cancer vaccine for the treatment of prostate cancer in a metastatic, non-symptomatic population of 30,000 men in the USA. Sipuleucel-T is prepared individually for each patient and infused in three sessions over a period of 1 month. However, in 2015, Dendreon, the owner of sipuleucel-T, filed for bankruptcy. This opinion paper reviews the probable reasons this innovative product failed to achieve commercial success. PubMed and internet searches were performed focused on pricing, reimbursement, and market access. We found that sipuleucel-T's FDA approval was delayed by 3 years, reportedly because of the vaccine's new mechanism of action. Sipuleucel-T was cleared by the European Medicines Agency 2 years later, but other national agencies were not approached. It was priced at $US93,000 for a course of treatment, and this high price combined with the company's late securement of reimbursement for the vaccine by the US Centers for Medicare and Medicaid Services (CMS) resulted in another year's delay in accessing the market. Despite a positive recommendation by the National Comprehensive Cancer Network, sipuleucel-T's complex administration, high price, and uncertainty about the reimbursement status deterred doctors from prescribing the product. Furthermore, the vaccine's supply was limited during the first year of launch due to limited manufacturing capacity. In addition, two oral metastatic prostate cancer drugs with similar survival benefits reached the US market 1 and 2 years after sipuleucel-T. Also, even though Dendreon's market capitalization topped $US7.5 billion following the FDA's approval of sipuleucel-T, this value degraded gradually until the firm's bankruptcy 5 years later. We conclude that the bankruptcy of Dendreon was largely due to the delay in securing FDA approval and CMS coverage, as well as the high cost that had to be incurred by

  5. Cancer stem cells: constantly evolving and functionally heterogeneous therapeutic targets.

    Science.gov (United States)

    Yang, Tao; Rycaj, Kiera; Liu, Zhong-Min; Tang, Dean G

    2014-06-01

    Elucidating the origin of and dynamic interrelationship between intratumoral cell subpopulations has clear clinical significance in helping to understand the cellular basis of treatment response, therapeutic resistance, and tumor relapse. Cancer stem cells (CSC), together with clonal evolution driven by genetic alterations, generate cancer cell heterogeneity commonly observed in clinical samples. The 2013 Shanghai International Symposium on Cancer Stem Cells brought together leaders in the field to highlight the most recent progress in phenotyping, characterizing, and targeting CSCs and in elucidating the relationship between the cell-of-origin of cancer and CSCs. Discussions from the symposium emphasize the urgent need in developing novel therapeutics to target the constantly evolving CSCs. ©2014 American Association for Cancer Research.

  6. Image-Based Brachytherapy for the Treatment of Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Harkenrider, Matthew M., E-mail: mharkenrider@lumc.edu; Alite, Fiori; Silva, Scott R.; Small, William

    2015-07-15

    Cervical cancer is a disease that requires considerable multidisciplinary coordination of care and labor in order to maximize tumor control and survival while minimizing treatment-related toxicity. As with external beam radiation therapy, the use of advanced imaging and 3-dimensional treatment planning has generated a paradigm shift in the delivery of brachytherapy for the treatment of cervical cancer. The use of image-based brachytherapy, most commonly with magnetic resonance imaging (MRI), requires additional attention and effort by the treating physician to prescribe dose to the proper volume and account for adjacent organs at risk. This represents a dramatic change from the classic Manchester approach of orthogonal radiographic images and prescribing dose to point A. We reviewed the history and currently evolving data and recommendations for the clinical use of image-based brachytherapy with an emphasis on MRI-based brachytherapy.

  7. Major Development Communication Paradigms and Practices ...

    African Journals Online (AJOL)

    info

    experience change and actually to guide it. An intensified exchange of ideas among all ... process is greatly determined by the communication paradigm and practices adopted by the source (media requesting ... to create awareness and interest that encourages evaluation, trials and rapid adoption of development ideas.

  8. Science Academies' Refresher Course on Paradigms and ...

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 16; Issue 11. Science Academies' Refresher Course on Paradigms and Applications of Pattern Recognition in Image Processing and Computer Vision. Information and Announcements Volume 16 Issue 11 November 2011 pp 1100-1100 ...

  9. ACCOUNTING PARADIGMS WHICH FAVOR HISTORICAL COST

    Directory of Open Access Journals (Sweden)

    Valentin Gabriel CRISTEA

    2014-05-01

    Full Text Available Henning Kirkegaard shows that the evolution of accounting is to shift from one paradigm to another . Business continuity perspective should guide the company into the future , without confine it exclusively in the past. Accounting in its classical form , however, can not be dissociated from the historical cost evaluation .

  10. a postfoundationalist research paradigm of practical theology

    African Journals Online (AJOL)

    2010-07-18

    Jul 18, 2010 ... Park, S-K., 2010, 'A postfoundationalist research paradigm of practical theology ',. HTS Teologiese Studies/. Theological Studies 66(2),. Art. #849, 6 pages. DOI: 10.4102/hts.v66i2. ... Philosophically, the foundationalist views transform the narratives by which we live into the typical grand metanarratives of ...

  11. THE NEW PUBLIC ADMINISTRATION PARADIGM DIRECTIONS

    OpenAIRE

    CHERVYAKOVA OLHA VOLODYMYRIVNA

    2017-01-01

    This article presents aspects of public administration paradigm of using disciplinary matrix, a public management model based on a feedback mechanism in the subject-subject interaction, which is the basis of theoretical and methodological establishment in public administration science (Public administration) in Ukraine.

  12. Empirical Testing of an Affective Learning Paradigm.

    Science.gov (United States)

    Asmus, Edward P., Jr.

    1980-01-01

    This investigation of a college music course examined the effectiveness of a cyclical affective learning paradigm based on the premise that student affect toward a course of instruction will dictate, in part, cognitive performance. Results suggest that teachers would be better advised to concentrate on cognitive instruction than on affect.…

  13. The New Environmental Paradigm Scale: A Reexamination.

    Science.gov (United States)

    Geller, Jack M.; Lasley, Paul

    1985-01-01

    Explains how the New Environmental Paradigm Scale (NEP) is used to examine and measure paradigmatic shifts in the public's orientation toward the physical environment. Study findings across three different populations confirm the dimensionality of a three-factor model. An appendix contains the NEP scale and item numbers. (ML)

  14. Review Article Heart failure - an inflammatory paradigm

    African Journals Online (AJOL)

    1999-02-01

    Feb 1, 1999 ... Heart failure - an inflammatory paradigm. E. Q. KLUG. TABLE I. CYTOKINES MEDIATING MYOCARDIAL. DEPRESSION certain characteristics. In general they mediate cell growth, inflammation, immunity, differentiation and repair. They are small to medium-sized peptides produced by a variety of different ...

  15. Challenging paradigms in estuarine ecology and management

    Science.gov (United States)

    Elliott, M.; Whitfield, A. K.

    2011-10-01

    For many years, estuarine science has been the 'poor relation' in aquatic research - freshwater scientists ignored estuaries as they tended to get confused by salt and tides, and marine scientists were more preoccupied by large open systems. Estuaries were merely regarded by each group as either river mouths or sea inlets respectively. For the past four decades, however, estuaries (and other transitional waters) have been regarded as being ecosystems in their own right. Although often not termed as such, this has led to paradigms being generated to summarise estuarine structure and functioning and which relate to both the natural science and management of these systems. This paper defines, details and affirms these paradigms that can be grouped into those covering firstly the science (definitions, scales, linkages, productivity, tolerances and variability) and secondly the management (pressures, valuation, health and services) of estuaries. The more 'science' orientated paradigms incorporate the development and types of ecotones, the nature of stressed and variable systems (with specific reference to resilience and redundancy), the relationship between generalists and specialists produced by environmental tolerance, the relevance of scale in relation to functioning and connectivity, the sources of production and degree of productivity, the biodiversity-ecosystem functioning and the stress-subsidy debates. The more 'management' targeted paradigms include the development and effects of exogenic unmanaged pressures and endogenic managed pressures, the perception of health and the ability to manage estuaries (related to internal and external influences), and the influence of all of these on the production of ecosystem services and societal benefits.

  16. School on Cloud: Towards a Paradigm Shift

    Science.gov (United States)

    Koutsopoulos, Kostis C.; Kotsanis, Yannis C.

    2014-01-01

    This paper presents the basic concept of the EU Network School on Cloud: Namely, that present conditions require a new teaching and learning paradigm based on the integrated dimension of education, when considering the use of cloud computing. In other words, it is suggested that there is a need for an integrated approach which is simultaneously…

  17. Science Academies' Refresher Course on Paradigms and ...

    Indian Academy of Sciences (India)

    2011-11-30

    Nov 30, 2011 ... ANN. Science Academies' Refresher Course on. Paradigms and Applications of Pattern Recognition in. Image Processing and Computer Vision hosted by School of Information Technology and Science. Dr GR Damodaran College of Science, Coimbatore 641 014. Recognition of patterns is a cognitive task ...

  18. Has the Education Paradigm Begun to Shift?

    Science.gov (United States)

    Chadwick, Clifton B.

    2014-01-01

    The author reviews various elements of what may be considered as evidence that the long-awaited shift in the education paradigm is actually happening. Concepts like student-centered learning, attainment-based evaluation, knowledge-based constructivism, and effort-based intelligence are growing, are being more widely recognized as important, and…

  19. Production planning development and paradigm integration

    OpenAIRE

    Galina Ledneva; Viktor Jludov; Alexander Pesin; Viktor Salganik; Vladimir Shmakov

    2009-01-01

    The paper reviews principles of different concepts of enterprise management including a theory of constrains, a Balanced Scorecard, lean production, Six Sigma. The authors believe that creating some mix or integration of these paradigms can bring extraordinary effect for production management. As example the modified Balanced Scorecard based on constraints and its application on Magnitorsk metallurgical enterprise in Russia is described.

  20. Changing the Paradigm of Air Pollution Monitoring

    Science.gov (United States)

    Historically, approaches for monitoring air pollution generally use expensive, complex, stationary equipment,1,2 which limits who collects data, why data are collected, and how data are accessed. This paradigm is changing with the materialization of lower-cost, easy-to...

  1. Augmenting the ADDIE Paradigm for Instructional Design

    Science.gov (United States)

    Ni, Xiaopeng; Branch, Robert Maribe

    2008-01-01

    The authors discuss topics appropriate for augmenting the ADDIE paradigm for instructional design. The topics selected are based on data from a study of working professionals who successfully completed an instructional design and technology certificate program and who identified related topics that they regarded as beneficial. The participants…

  2. FEDERAL BALANCING IN NIGERIA: A PARADIGM FOR ...

    African Journals Online (AJOL)

    user

    FEDERAL BALANCING IN NIGERIA: A PARADIGM. FOR SUSTAINABLE DEMOCRACY. Bonaventure I. Ozoigbo. Introduction. Federal balancing in Nigeria since she became a federation in 1954 till date is an issue worth discussing. Right from the time of amalgamation of Southern and Northern provinces in 1914, there.

  3. Den postmoderna stadens två paradigm

    DEFF Research Database (Denmark)

    Nielsen, Tom

    2005-01-01

    the attention of politicians, planners and architects today is focused on the individual, not the collective. But the policy of the third way has no counterpart in an urbanism torn between two paradigms. Tom Nielsen paints the picture of what has to urban development since the welfare state...

  4. Paradigm Shift In Career Counselling: Implications For ...

    African Journals Online (AJOL)

    However, many of the respondents were aware of the need for a new approach to career counselling. The implication of this finding to entrepreneurship development is the need to adopt a paradigm shift in career counselling. Retraining of practicing counsellors and new training guides for student counsellors as well as the ...

  5. In search of a new paradigm

    DEFF Research Database (Denmark)

    Poulsen, Lars K.

    2005-01-01

    In this review of research priorities, presented for the European Commission, food allergy is established as a disease with a considerable impact on modern society. Research paradigms have changed from establishing basic symptomatology and diagnostic methods over allergen characterization to a risk...

  6. Redesigning Higher Education: Embracing a New Paradigm

    Science.gov (United States)

    Watson, William R.; Watson, Sunnie Lee

    2014-01-01

    Higher education is under enormous pressure to transform itself and embrace a new paradigm. Operating under an outdated model that no longer aligns with the realities of modern society, institutions of higher education are recognizing the need to drastically remake themselves or possibly cease to exist. This article explores the current landscape…

  7. Diet and Cancer: The Fourth Paradigm

    Science.gov (United States)

    Walter C. Willett, MD, DrPH, an international expert in diet and nutrition, with posts as a Professor of Epidemiology and Nutrition and Chairman of the Department of Nutrition at Harvard School of Public Health and as Professor of Medicine at Harvard Medical School, presented "Diet and Cancer: The Fourth Paradigm".

  8. Counselling Practices: An Emerging Paradigm for New ...

    African Journals Online (AJOL)

    This paper argues that there is an emergence of a new paradigm of professionalism in agriculture as a result of the introduction of several participatory learning approaches. These approaches have necessitated the change from the conventional advisory services in agricultural extension to counselling services where the ...

  9. An Instrumental Paradigm for Ubiquitous Interaction

    DEFF Research Database (Denmark)

    Klokmose, Clemens Nylandsted

    2008-01-01

    will require comprehensive experimental user centred development. Originality/Value -- This research offers a new way of thinking interaction, suited for the dynamism of modern computing. Take away message -- Through a strong foundation in activity theory and ecological psychology a new paradigm for ubiquitous...

  10. Moral Developmental Science between Changing Paradigms

    Science.gov (United States)

    Keller, Monika

    2012-01-01

    This review encompasses a time-span of about 50 years of research on morality and moral development. It discusses Kohlberg's (1984) work as a milestone that constituted the cognitive developmental viewpoint of morality and that dominated research for about three decades. In this paradigm the role of reasoning and deliberation was emphasized as the…

  11. Contextual dependencies in a stimulus equivalence paradigm

    NARCIS (Netherlands)

    Dibbets, P.; Maes, J.H.R.; Vossen, J.M.H.

    2002-01-01

    Two experiments with human subjects assessed contextual dependencies in a stimulus equivalence paradigm. Subjects learned to form two sets of stimuli in a matching-to-sample training procedure. Each set was presented against one of two different background colours, the contextual cues. At test, the

  12. Historical ESWT Paradigms Are Overcome: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Heinz Lohrer

    2016-01-01

    Full Text Available Extracorporeal Shock Wave Therapy (ESWT is a conservative treatment modality with still growing interest in musculoskeletal disorders. This narrative review aims to present an overview covering 20-year development in the field of musculoskeletal ESWT. Eight historical paradigms have been identified and put under question from a current perspective: energy intensity, focus size, anesthesia, imaging, growth plates, acuteness, calcifications, and number of sessions. All paradigms as set in a historical consensus meeting in 1995 are to be revised. First, modern musculoskeletal ESWT is divided into focused and radial technology and the physical differences are about 100-fold with respect to the applied energy. Most lesions to be treated are easy to reach and clinical focusing plays a major role today. Lesion size is no longer a matter of concern. With the exception of nonunion fractures full, regional, or even local anesthesia is not helpful in musculoskeletal indications. Juvenile patients can also effectively be treated without risk of epiphyseal damage. Further research is needed to answer the question about if and which acute injuries can be managed effectively. Treatment parameters like the number of sessions are still relying on empirical data and have to be further elucidated.

  13. The evolving energy budget of accretionary wedges

    Science.gov (United States)

    McBeck, Jessica; Cooke, Michele; Maillot, Bertrand; Souloumiac, Pauline

    2017-04-01

    The energy budget of evolving accretionary systems reveals how deformational processes partition energy as faults slip, topography uplifts, and layer-parallel shortening produces distributed off-fault deformation. The energy budget provides a quantitative framework for evaluating the energetic contribution or consumption of diverse deformation mechanisms. We investigate energy partitioning in evolving accretionary prisms by synthesizing data from physical sand accretion experiments and numerical accretion simulations. We incorporate incremental strain fields and cumulative force measurements from two suites of experiments to design numerical simulations that represent accretionary wedges with stronger and weaker detachment faults. One suite of the physical experiments includes a basal glass bead layer and the other does not. Two physical experiments within each suite implement different boundary conditions (stable base versus moving base configuration). Synthesizing observations from the differing base configurations reduces the influence of sidewall friction because the force vector produced by sidewall friction points in opposite directions depending on whether the base is fixed or moving. With the numerical simulations, we calculate the energy budget at two stages of accretion: at the maximum force preceding the development of the first thrust pair, and at the minimum force following the development of the pair. To identify the appropriate combination of material and fault properties to apply in the simulations, we systematically vary the Young's modulus and the fault static and dynamic friction coefficients in numerical accretion simulations, and identify the set of parameters that minimizes the misfit between the normal force measured on the physical backwall and the numerically simulated force. Following this derivation of the appropriate material and fault properties, we calculate the components of the work budget in the numerical simulations and in the

  14. CHANGES OF PARADIGM IN THE SECRETARIAT PROFESSIONALS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Walkíria Gomes de Almeida

    2010-09-01

    Full Text Available In this unstable market, with continuous changes, it is necessary that professionals increase their skills and prepare themselves for an overwhelming competitiveness, seeking for developmental alternatives. Secretariat professionals evolved and developed over a long trajectory of struggles and achievements, including globalization and technological revolution. Their professional profile has changed over the years and nowadays we observe that they act as co-managers, entrepreneurs, and consultants who work in an operational basis focused on results. The profession has won many victories: profession’s regulation law, code of ethics, establishment of the Secretaries’ National Association, Secretaries’ Labor Union in all Brazilian states, and so forth. However, even after all this evolution, there are companies and managers who do not believe in professional changing paradigms. They believe that secretaries’ work is the same as in past decades. This is the reason why this research sought to investigate which are the desirable skills to the secretariat’s professionals in order to allow them to contribute to the company's results-based management.

  15. Cancer Screening and Genetics: A Tale of Two Paradigms

    Science.gov (United States)

    Hamilton, Jada G.; Edwards, Heather M.; Khoury, Muin J.; Taplin, Stephen H.

    2014-01-01

    The long-standing medical tradition to “first do no harm” is reflected in population-wide evidence-based recommendations for cancer screening tests that focus primarily on reducing morbidity and mortality. The conventional cancer screening process is predicated on finding early-stage disease that can be treated effectively; yet emerging genetic and genomic testing technologies have moved the target earlier in the disease development process to identify a probabilistic predisposition to disease. Genetic risk information can have varying implications for the health and well-being of patients and their relatives, and has raised important questions about the evaluation and value of risk information. This paper explores the paradigms that are being applied to the evaluation of conventional cancer screening tests and emerging genetic and genomic tests of cancer susceptibility, and how these perspectives are shifting and evolving in response to advances in our ability to detect cancer risks. We consider several challenges germane to the evaluation of both categories of tests including defining benefits and harms in terms of personal and clinical utility, addressing healthcare consumers’ information preferences, and managing scientific uncertainty. We encourage research and dialogue aimed at developing a better understanding of the value of all risk information, non-genetic and genetic, to people’s lives. PMID:24706727

  16. Universities in the global knowledge economy: the eclectic paradigm

    Directory of Open Access Journals (Sweden)

    Denys Ilnytskyy

    2015-06-01

    Full Text Available As institutions of knowledge generation and diffusion, in the course of their activities universities should take into account not only the level of an organization or a country but also that of individual knowledge transformation, whereby creating favorable conditions for developing creativity of both graduates and academic staff who form the basis of the intellectual capital of the university and the country. While functioning in the global competitive climate, the national intellectual capital is a factor of socio-economic development and international competitive status of individual countries. During decades the concept of university has been evolving toward determining the operation mode of a university as that of an institution providing mass education, carrying out fundamental and applied researches as well as largely participating in local, national and global development. However, the university operation paradigm remains eclectic. Equal relationships between universities, government and industry in a knowledge-based society are well-defined by the concept of triple helix innovation systems engaging NGOs. World-class universities tend ever more to incorporate the feature of an entrepreneurial university actively competing in the global academic domain.

  17. Biased agonism: An emerging paradigm in GPCR drug discovery.

    Science.gov (United States)

    Rankovic, Zoran; Brust, Tarsis F; Bohn, Laura M

    2016-01-15

    G protein coupled receptors have historically been one of the most druggable classes of cellular proteins. The members of this large receptor gene family couple to primary effectors, G proteins, that have built in mechanisms for regeneration and amplification of signaling with each engagement of receptor and ligand, a kinetic event in itself. In recent years GPCRs, have been found to interact with arrestin proteins to initiate signal propagation in the absence of G protein interactions. This pinnacle observation has changed a previously held notion of the linear spectrum of GPCR efficacy and uncovered a new paradigm in GPCR research and drug discovery that relies on multidimensionality of GPCR signaling. Ligands were found that selectively confer activity in one pathway over another, and this phenomenon has been referred to as 'biased agonism' or 'functional selectivity'. While great strides in the understanding of this phenomenon have been made in recent years, two critical questions still dominate the field: How can we rationally design biased GPCR ligands, and ultimately, which physiological responses are due to G protein versus arrestin interactions? This review will discuss the current understanding of some of the key aspects of biased signaling that are related to these questions, including mechanistic insights in the nature of biased signaling and methods for measuring ligand bias, as well as relevant examples of drug discovery applications and medicinal chemistry strategies that highlight the challenges and opportunities in this rapidly evolving field. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Chronic traumatic encephalopathy: A paradigm in search of evidence?

    Science.gov (United States)

    Castellani, Rudy J

    2015-06-01

    Chronic traumatic encephalopathy (CTE) has been in the medical literature since the 1920s. It is characterized clinically by diverse neuropsychiatric symptoms, and pathologically by variable degrees of phosphorylated tau accumulation in the brain. The evolving paradigm for the pathogenesis of CTE suggests that concussion or subconcussion from athletic participation initiates a cascade of pathologic events, encompassing neuroinflammation and protein templating with trans-synaptic neurotoxicity. The end result is neurologic and neurobehavioral deterioration, often with self-harm. Although these concepts warrant further investigation, the available evidence permits no conclusions as regards the pathogenesis of the reported findings. Investigations into the role of premorbid or co-morbid neurodegenerative diseases has been limited to date, and in-depth genetic analyses have not been performed. The role of concussion or subconcussion if any, whether and how the condition progresses over time, the extent of phosphorylated tau in clinically normal athletes, the role of phosphorylated tau as a toxic species versus an inert disease response, and whether protein templating has any in vivo relevance remain to be elucidated.

  19. Degrowth - Taking Stock and Reviewing an Emerging Academic Paradigm.

    Science.gov (United States)

    Weiss, Martin; Cattaneo, Claudio

    2017-07-01

    Degrowth has evolved within a decade from an activist movement into a multi-disciplinary academic paradigm. However, an overview taking stock of the peer-refereed degrowth literature is yet missing. Here, we review 91 articles that were published between 2006 and 2015. We find that the academic degrowth discourse occupies a small but expanding niche at the intersection of social and applied environmental sciences. The discourse is shaped by authors from high-income, mainly Mediterranean, countries. Until 2012, articles largely constitute conceptual essays endorsed by normative claims. More recently, degrowth has branched out into modelling, empirical assessments, and the study of concrete implementations. Authors tend to agree in that economic growth cannot be sustained ad infinitum on a resource constraint planet and that degrowth requires far reaching societal change. Whether degrowth should be considered as a collectively consented choice or an environmentally-imposed inevitability constitutes a major debate among degrowth thinkers. We argue that the academic discourse could benefit from rigid hypotheses testing through input-output modelling, material flow analysis, life-cycle assessments, or social surveys. By analyzing the potentials for non-market value creation and identifying concrete well-being benefits, the degrowth discourse could receive wider public support and contribute to a paradigmatic change in the social sciences.

  20. Magnetic fields in Planetary Nebulae: paradigms and related MHD frontiers

    Science.gov (United States)

    Blackman, Eric G.

    2009-04-01

    Many, if not all, post AGB stellar systems swiftly transition from a spherical to a powerful aspherical pre-planetary nebula (pPNE) outflow phase before waning into a PNe. The pPNe outflows require engine rotational energy and a mechanism to extract this energy into collimated outflows. Just radiation and rotation are insufficient but a symbiosis between rotation, differential rotation and large scale magnetic fields remains promising. Present observational evidence for magnetic fields in evolved stars is suggestive of dynamically important magnetic fields, but both theory and observation are rife with research opportunity. I discuss how magnetohydrodynamic outflows might arise in pPNe and PNe and distinguish different between approaches that address shaping vs. those that address both launch and shaping. Scenarios involving dynamos in single stars, binary driven dynamos, or accretion engines cannot be ruled out. One appealing paradigm involves accretion onto the primary post-AGB white dwarf core from a low mass companion whose decaying accretion supply rate owers first the pPNe and then the lower luminosity PNe. Determining observational signatures of different MHD engines is a work in progress. Accretion disk theory and large scale dynamos pose many of their own fundamental challenges, some of which I discuss in a broader context.

  1. Streptococcus mutans: a new Gram-positive paradigm?

    Science.gov (United States)

    Quivey, Robert G.; Koo, Hyun; Abranches, Jacqueline

    2013-01-01

    Despite the enormous contributions of the bacterial paradigms Escherichia coli and Bacillus subtilis to basic and applied research, it is well known that no single organism can be a perfect representative of all other species. However, given that some bacteria are difficult, or virtually impossible, to cultivate in the laboratory, that some are recalcitrant to genetic and molecular manipulation, and that others can be extremely dangerous to manipulate, the use of model organisms will continue to play an important role in the development of basic research. In particular, model organisms are very useful for providing a better understanding of the biology of closely related species. Here, we discuss how the lifestyle, the availability of suitable in vitro and in vivo systems, and a thorough understanding of the genetics, biochemistry and physiology of the dental pathogen Streptococcus mutans have greatly advanced our understanding of important areas in the field of bacteriology such as interspecies biofilms, competence development and stress responses. In this article, we provide an argument that places S. mutans, an organism that evolved in close association with the human host, as a novel Gram-positive model organism. PMID:23393147

  2. Bayesian analysis: a new statistical paradigm for new technology.

    Science.gov (United States)

    Grunkemeier, Gary L; Payne, Nicola

    2002-12-01

    Full Bayesian analysis is an alternative statistical paradigm, as opposed to traditionally used methods, usually called frequentist statistics. Bayesian analysis is controversial because it requires assuming a prior distribution, which can be arbitrarily chosen; thus there is a subjective element, which is considered to be a major weakness. However, this could also be considered a strength since it provides a formal way of incorporating prior knowledge. Since it is flexible and permits repeated looks at evolving data, Bayesian analysis is particularly well suited to the evaluation of new medical technology. Bayesian analysis can refer to a range of things: from a simple, noncontroversial formula for inverting probabilities to an alternative approach to the philosophy of science. Its advantages include: (1) providing direct probability statements--which are what most people wrongly assume they are getting from conventional statistics; (2) formally incorporating previous information in statistical inference of a data set, a natural approach which we follow in everyday reasoning; and (3) flexible, adaptive research designs allowing multiple looks at accumulating study data. Its primary disadvantage is the element of subjectivity which some think is not scientific. We discuss and compare frequentist and Bayesian approaches and provide three examples of Bayesian analysis: (1) EKG interpretation, (2) a coin-tossing experiment, and (3) assessing the thromboembolic risk of a new mechanical heart valve.

  3. On the Critical Role of Divergent Selection in Evolvability

    Directory of Open Access Journals (Sweden)

    Joel Lehman

    2016-08-01

    Full Text Available An ambitious goal in evolutionary robotics is to evolve increasingly complex robotic behaviors with minimal human design effort. Reaching this goal requires evolutionary algorithms that can unlock from genetic encodings their latent potential for evolvability. One issue clouding this goal is conceptual confusion about evolvability, which often obscures the aspects of evolvability that are important or desirable. The danger from such confusion is that it may establish unrealistic goals for evolvability that prove unproductive in practice. An important issue separate from conceptual confusion is the common misalignment between selection and evolvability in evolutionary robotics. While more expressive encodings can represent higher-level adaptations (e.g. sexual reproduction or developmental systems that increase long-term evolutionary potential (i.e. evolvability, realizing such potential requires gradients of fitness and evolvability to align. In other words, selection is often a critical factor limiting increasing evolvability. Thus, drawing from a series of recent papers, this article seeks to both (1 clarify and focus the ways in which the term evolvability is used within artificial evolution, and (2 argue for the importance of one type of selection, i.e. divergent selection, for enabling evolvability. The main argument is that there is a fundamental connection between divergent selection and evolvability (on both the individual and population level that does not hold for typical goal-oriented selection. The conclusion is that selection pressure plays a critical role in realizing the potential for evolvability, and that divergent selection in particular provides a principled mechanism for encouraging evolvability in artificial evolution.

  4. Treatment

    National Research Council Canada - National Science Library

    Safaa M. Raghab; Ahmed M. Abd El Meguid; Hala A. Hegazi

    2013-01-01

    ... composed. This paper presents the results of the analyses of leachate treatment from the solid waste landfill located in Borg El Arab landfill in Alexandria using an aerobic treatment process which was applied...

  5. How does cognition evolve? Phylogenetic comparative psychology

    Science.gov (United States)

    Matthews, Luke J.; Hare, Brian A.; Nunn, Charles L.; Anderson, Rindy C.; Aureli, Filippo; Brannon, Elizabeth M.; Call, Josep; Drea, Christine M.; Emery, Nathan J.; Haun, Daniel B. M.; Herrmann, Esther; Jacobs, Lucia F.; Platt, Michael L.; Rosati, Alexandra G.; Sandel, Aaron A.; Schroepfer, Kara K.; Seed, Amanda M.; Tan, Jingzhi; van Schaik, Carel P.; Wobber, Victoria

    2014-01-01

    Now more than ever animal studies have the potential to test hypotheses regarding how cognition evolves. Comparative psychologists have developed new techniques to probe the cognitive mechanisms underlying animal behavior, and they have become increasingly skillful at adapting methodologies to test multiple species. Meanwhile, evolutionary biologists have generated quantitative approaches to investigate the phylogenetic distribution and function of phenotypic traits, including cognition. In particular, phylogenetic methods can quantitatively (1) test whether specific cognitive abilities are correlated with life history (e.g., lifespan), morphology (e.g., brain size), or socio-ecological variables (e.g., social system), (2) measure how strongly phylogenetic relatedness predicts the distribution of cognitive skills across species, and (3) estimate the ancestral state of a given cognitive trait using measures of cognitive performance from extant species. Phylogenetic methods can also be used to guide the selection of species comparisons that offer the strongest tests of a priori predictions of cognitive evolutionary hypotheses (i.e., phylogenetic targeting). Here, we explain how an integration of comparative psychology and evolutionary biology will answer a host of questions regarding the phylogenetic distribution and history of cognitive traits, as well as the evolutionary processes that drove their evolution. PMID:21927850

  6. Approximating centrality in evolving graphs: toward sublinearity

    Science.gov (United States)

    Priest, Benjamin W.; Cybenko, George

    2017-05-01

    The identification of important nodes is a ubiquitous problem in the analysis of social networks. Centrality indices (such as degree centrality, closeness centrality, betweenness centrality, PageRank, and others) are used across many domains to accomplish this task. However, the computation of such indices is expensive on large graphs. Moreover, evolving graphs are becoming increasingly important in many applications. It is therefore desirable to develop on-line algorithms that can approximate centrality measures using memory sublinear in the size of the graph. We discuss the challenges facing the semi-streaming computation of many centrality indices. In particular, we apply recent advances in the streaming and sketching literature to provide a preliminary streaming approximation algorithm for degree centrality utilizing CountSketch and a multi-pass semi-streaming approximation algorithm for closeness centrality leveraging a spanner obtained through iteratively sketching the vertex-edge adjacency matrix. We also discuss possible ways forward for approximating betweenness centrality, as well as spectral measures of centrality. We provide a preliminary result using sketched low-rank approximations to approximate the output of the HITS algorithm.

  7. How does cognition evolve? Phylogenetic comparative psychology.

    Science.gov (United States)

    MacLean, Evan L; Matthews, Luke J; Hare, Brian A; Nunn, Charles L; Anderson, Rindy C; Aureli, Filippo; Brannon, Elizabeth M; Call, Josep; Drea, Christine M; Emery, Nathan J; Haun, Daniel B M; Herrmann, Esther; Jacobs, Lucia F; Platt, Michael L; Rosati, Alexandra G; Sandel, Aaron A; Schroepfer, Kara K; Seed, Amanda M; Tan, Jingzhi; van Schaik, Carel P; Wobber, Victoria

    2012-03-01

    Now more than ever animal studies have the potential to test hypotheses regarding how cognition evolves. Comparative psychologists have developed new techniques to probe the cognitive mechanisms underlying animal behavior, and they have become increasingly skillful at adapting methodologies to test multiple species. Meanwhile, evolutionary biologists have generated quantitative approaches to investigate the phylogenetic distribution and function of phenotypic traits, including cognition. In particular, phylogenetic methods can quantitatively (1) test whether specific cognitive abilities are correlated with life history (e.g., lifespan), morphology (e.g., brain size), or socio-ecological variables (e.g., social system), (2) measure how strongly phylogenetic relatedness predicts the distribution of cognitive skills across species, and (3) estimate the ancestral state of a given cognitive trait using measures of cognitive performance from extant species. Phylogenetic methods can also be used to guide the selection of species comparisons that offer the strongest tests of a priori predictions of cognitive evolutionary hypotheses (i.e., phylogenetic targeting). Here, we explain how an integration of comparative psychology and evolutionary biology will answer a host of questions regarding the phylogenetic distribution and history of cognitive traits, as well as the evolutionary processes that drove their evolution.

  8. On the Discovery of Evolving Truth.

    Science.gov (United States)

    Li, Yaliang; Li, Qi; Gao, Jing; Su, Lu; Zhao, Bo; Fan, Wei; Han, Jiawei

    2015-08-01

    In the era of big data, information regarding the same objects can be collected from increasingly more sources. Unfortunately, there usually exist conflicts among the information coming from different sources. To tackle this challenge, truth discovery, i.e., to integrate multi-source noisy information by estimating the reliability of each source, has emerged as a hot topic. In many real world applications, however, the information may come sequentially, and as a consequence, the truth of objects as well as the reliability of sources may be dynamically evolving. Existing truth discovery methods, unfortunately, cannot handle such scenarios. To address this problem, we investigate the temporal relations among both object truths and source reliability, and propose an incremental truth discovery framework that can dynamically update object truths and source weights upon the arrival of new data. Theoretical analysis is provided to show that the proposed method is guaranteed to converge at a fast rate. The experiments on three real world applications and a set of synthetic data demonstrate the advantages of the proposed method over state-of-the-art truth discovery methods.

  9. Sexual regret: evidence for evolved sex differences.

    Science.gov (United States)

    Galperin, Andrew; Haselton, Martie G; Frederick, David A; Poore, Joshua; von Hippel, William; Buss, David M; Gonzaga, Gian C

    2013-10-01

    Regret and anticipated regret enhance decision quality by helping people avoid making and repeating mistakes. Some of people's most intense regrets concern sexual decisions. We hypothesized evolved sex differences in women's and men's experiences of sexual regret. Because of women's higher obligatory costs of reproduction throughout evolutionary history, we hypothesized that sexual actions, particularly those involving casual sex, would be regretted more intensely by women than by men. In contrast, because missed sexual opportunities historically carried higher reproductive fitness costs for men than for women, we hypothesized that poorly chosen sexual inactions would be regretted more by men than by women. Across three studies (Ns = 200, 395, and 24,230), we tested these hypotheses using free responses, written scenarios, detailed checklists, and Internet sampling to achieve participant diversity, including diversity in sexual orientation. Across all data sources, results supported predicted psychological sex differences and these differences were localized in casual sex contexts. These findings are consistent with the notion that the psychology of sexual regret was shaped by recurrent sex differences in selection pressures operating over deep time.

  10. Extracting evolving pathologies via spectral clustering.

    Science.gov (United States)

    Bernardis, Elena; Pohl, Kilian M; Davatzikos, Christos

    2013-01-01

    A bottleneck in the analysis of longitudinal MR scans with white matter brain lesions is the temporally consistent segmentation of the pathology. We identify pathologies in 3D+t(ime) within a spectral graph clustering framework. Our clustering approach simultaneously segments and tracks the evolving lesions by identifying characteristic image patterns at each time-point and voxel correspondences across time-points. For each 3D image, our method constructs a graph where weights between nodes capture the likeliness of two voxels belonging to the same region. Based on these weights, we then establish rough correspondences between graph nodes at different time-points along estimated pathology evolution directions. We combine the graphs by aligning the weights to a reference time-point, thus integrating temporal information across the 3D images, and formulate the 3D+t segmentation problem as a binary partitioning of this graph. The resulting segmentation is very robust to local intensity fluctuations and yields better results than segmentations generated for each time-point.

  11. Functional Topology of Evolving Urban Drainage Networks

    Science.gov (United States)

    Yang, Soohyun; Paik, Kyungrock; McGrath, Gavan S.; Urich, Christian; Krueger, Elisabeth; Kumar, Praveen; Rao, P. Suresh C.

    2017-11-01

    We investigated the scaling and topology of engineered urban drainage networks (UDNs) in two cities, and further examined UDN evolution over decades. UDN scaling was analyzed using two power law scaling characteristics widely employed for river networks: (1) Hack's law of length (L)-area (A) [L∝Ah] and (2) exceedance probability distribution of upstream contributing area (δ) [P>(A≥δ>)˜aδ-ɛ]. For the smallest UDNs ((A≥δ>) plots for river networks are abruptly truncated, those for UDNs display exponential tempering [P>(A≥δ>)=aδ-ɛexp⁡>(-cδ>)]. The tempering parameter c decreases as the UDNs grow, implying that the distribution evolves in time to resemble those for river networks. However, the power law exponent ɛ for large UDNs tends to be greater than the range reported for river networks. Differences in generative processes and engineering design constraints contribute to observed differences in the evolution of UDNs and river networks, including subnet heterogeneity and nonrandom branching.

  12. Evolving application of biomimetic nanostructured hydroxyapatite

    Directory of Open Access Journals (Sweden)

    Norberto Roveri

    2010-11-01

    Full Text Available Norberto Roveri, Michele IafiscoLaboratory of Environmental and Biological Structural Chemistry (LEBSC, Dipartimento di Chimica ‘G. Ciamician’, Alma Mater Studiorum, Università di Bologna, Bologna, ItalyAbstract: By mimicking Nature, we can design and synthesize inorganic smart materials that are reactive to biological tissues. These smart materials can be utilized to design innovative third-generation biomaterials, which are able to not only optimize their interaction with biological tissues and environment, but also mimic biogenic materials in their functionalities. The biomedical applications involve increasing the biomimetic levels from chemical composition, structural organization, morphology, mechanical behavior, nanostructure, and bulk and surface chemical–physical properties until the surface becomes bioreactive and stimulates cellular materials. The chemical–physical characteristics of biogenic hydroxyapatites from bone and tooth have been described, in order to point out the elective sides, which are important to reproduce the design of a new biomimetic synthetic hydroxyapatite. This review outlines the evolving applications of biomimetic synthetic calcium phosphates, details the main characteristics of bone and tooth, where the calcium phosphates are present, and discusses the chemical–physical characteristics of biomimetic calcium phosphates, methods of synthesizing them, and some of their biomedical applications.Keywords: hydroxyapatite, nanocrystals, biomimetism, biomaterials, drug delivery, remineralization

  13. Evolving application of biomimetic nanostructured hydroxyapatite.

    Science.gov (United States)

    Roveri, Norberto; Iafisco, Michele

    2010-11-09

    By mimicking Nature, we can design and synthesize inorganic smart materials that are reactive to biological tissues. These smart materials can be utilized to design innovative third-generation biomaterials, which are able to not only optimize their interaction with biological tissues and environment, but also mimic biogenic materials in their functionalities. The biomedical applications involve increasing the biomimetic levels from chemical composition, structural organization, morphology, mechanical behavior, nanostructure, and bulk and surface chemical-physical properties until the surface becomes bioreactive and stimulates cellular materials. The chemical-physical characteristics of biogenic hydroxyapatites from bone and tooth have been described, in order to point out the elective sides, which are important to reproduce the design of a new biomimetic synthetic hydroxyapatite. This review outlines the evolving applications of biomimetic synthetic calcium phosphates, details the main characteristics of bone and tooth, where the calcium phosphates are present, and discusses the chemical-physical characteristics of biomimetic calcium phosphates, methods of synthesizing them, and some of their biomedical applications.

  14. Epidemic spreading on evolving signed networks

    Science.gov (United States)

    Saeedian, M.; Azimi-Tafreshi, N.; Jafari, G. R.; Kertesz, J.

    2017-02-01

    Most studies of disease spreading consider the underlying social network as obtained without the contagion, though epidemic influences people's willingness to contact others: A "friendly" contact may be turned to "unfriendly" to avoid infection. We study the susceptible-infected disease-spreading model on signed networks, in which each edge is associated with a positive or negative sign representing the friendly or unfriendly relation between its end nodes. In a signed network, according to Heider's theory, edge signs evolve such that finally a state of structural balance is achieved, corresponding to no frustration in physics terms. However, the danger of infection affects the evolution of its edge signs. To describe the coupled problem of the sign evolution and disease spreading, we generalize the notion of structural balance by taking into account the state of the nodes. We introduce an energy function and carry out Monte Carlo simulations on complete networks to test the energy landscape, where we find local minima corresponding to the so-called jammed states. We study the effect of the ratio of initial friendly to unfriendly connections on the propagation of disease. The steady state can be balanced or a jammed state such that a coexistence occurs between susceptible and infected nodes in the system.

  15. Orbital Decay in Binaries with Evolved Stars

    Science.gov (United States)

    Sun, Meng; Arras, Phil; Weinberg, Nevin N.; Troup, Nicholas; Majewski, Steven R.

    2018-01-01

    Two mechanisms are often invoked to explain tidal friction in binary systems. The ``dynamical tide” is the resonant excitation of internal gravity waves by the tide, and their subsequent damping by nonlinear fluid processes or thermal diffusion. The ``equilibrium tide” refers to non-resonant excitation of fluid motion in the star’s convection zone, with damping by interaction with the turbulent eddies. There have been numerous studies of these processes in main sequence stars, but less so on the subgiant and red giant branches. Motivated by the newly discovered close binary systems in the Apache Point Observatory Galactic Evolution Experiment (APOGEE-1), we have performed calculations of both the dynamical and equilibrium tide processes for stars over a range of mass as the star’s cease core hydrogen burning and evolve to shell burning. Even for stars which had a radiative core on the main sequence, the dynamical tide may have very large amplitude in the newly radiative core in post-main sequence, giving rise to wave breaking. The resulting large dynamical tide dissipation rate is compared to the equilibrium tide, and the range of secondary masses and orbital periods over which rapid orbital decay may occur will be discussed, as well as applications to close APOGEE binaries.

  16. UKAEA'S evolving contract philosophy

    Energy Technology Data Exchange (ETDEWEB)

    Nicol, R. D. [UK Atomic Energy Authority, UKAEA, Harwell, Oxfordshire (United Kingdom)

    2003-07-01

    The United Kingdom Atomic Energy Authority (UKAEA) has gone through fundamental change over the last ten years. At the heart of this change has been UKAEA's relationship with the contracting and supply market. This paper describes the way in which UKAEA actively developed the market to support the decommissioning programme, and how the approach to contracting has evolved as external pressures and demands have changed. UKAEA's pro-active approach to industry has greatly assisted the development of a healthy, competitive market for services supporting decommissioning in the UK. There have been difficult changes and many challenges along the way, and some retrenchment was necessary to meet regulatory requirements. Nevertheless, UKAEA has sustained a high level of competition - now measured in terms of competed spend as a proportion of competable spend - with annual out-turns consistently over 80%. The prime responsibility for market development will pass to the new Nuclear Decommissioning Authority (NDA) in 2005, as the owner, on behalf of the Government, of the UK's civil nuclear liabilities. The preparatory work for the NDA indicates that the principles established by UKAEA will be carried forward. (author)

  17. An evolving model of online bipartite networks

    Science.gov (United States)

    Zhang, Chu-Xu; Zhang, Zi-Ke; Liu, Chuang

    2013-12-01

    Understanding the structure and evolution of online bipartite networks is a significant task since they play a crucial role in various e-commerce services nowadays. Recently, various attempts have been tried to propose different models, resulting in either power-law or exponential degree distributions. However, many empirical results show that the user degree distribution actually follows a shifted power-law distribution, the so-called Mandelbrot’s law, which cannot be fully described by previous models. In this paper, we propose an evolving model, considering two different user behaviors: random and preferential attachment. Extensive empirical results on two real bipartite networks, Delicious and CiteULike, show that the theoretical model can well characterize the structure of real networks for both user and object degree distributions. In addition, we introduce a structural parameter p, to demonstrate that the hybrid user behavior leads to the shifted power-law degree distribution, and the region of power-law tail will increase with the increment of p. The proposed model might shed some lights in understanding the underlying laws governing the structure of real online bipartite networks.

  18. Changing paradigms of anti-VEGF in the Indian scenario

    Directory of Open Access Journals (Sweden)

    P Mahesh Shanmugam

    2014-01-01

    Full Text Available Anti-vascular endothelial growth factors (VEGF agents have revolutionized the treatment of retinal diseases. Use of anti-VEGF agents in the Indian Scenario present some unique challenges considering the absence of compounding pharmacies, poor penetrance of health insurance and limited affordability of the citizens of a developing economy. To study the changing paradigms of anti-VEGF use in the Indian scenario, all articles published by Indian authors, data from web-based surveys amongst Indian vitreo-retinal specialists were reviewed. In the paucity of compounding pharmacies in India, fractionation and injection techniques differ from those of developed countries. Frequent anti-VEGF monotherapy offers the best anatomical and visual results, but economics of scale do not allow the same in the Indian scenario, resulting in PRN dosing and combination of anti-VEGF with laser photocoagulation, being the commonly employed treatment protocols.

  19. Evolving concepts of cardiac valve dynamics: the continuum of development, functional structure, pathobiology, and tissue engineering.

    Science.gov (United States)

    Schoen, Frederick J

    2008-10-28

    Considerable progress has been made in recent years toward elucidating a conceptual framework that integrates the dynamic functional structure, mechanical properties, and pathobiological behavior of the cardiac valves. This communication reviews the evolving paradigm of a continuum of heart valve structure, function, and pathobiology and explores its implications. Specifically, we discuss (1) the interactions of valve biology and biomechanics (eg, correlations of function with structure at the cell, tissue, and organ levels and mechanical considerations, development, endothelial cell and interstitial cell biology, extracellular matrix biology, homeostasis, and adaptation to environmental change); (2) mechanisms of disease (eg, valve cell and matrix pathobiology in congenital anomalies, aortic valve calcification, and mitral valve prolapse); (3) considerations in replacement and repair (eg, cell/matrix biology of tissue valve substitutes and their degeneration and durability of repairs); and (4) the potential for tissue engineering approaches to therapeutic regeneration of the cardiac valves. Opportunities for research and clinical translation are highlighted.

  20. In situ regeneration of bioactive coatings enabled by an evolved Staphylococcus aureus sortase A

    Science.gov (United States)

    Ham, Hyun Ok; Qu, Zheng; Haller, Carolyn A.; Dorr, Brent M.; Dai, Erbin; Kim, Wookhyun; Liu, David R.; Chaikof, Elliot L.

    2016-04-01

    Surface immobilization of bioactive molecules is a central paradigm in the design of implantable devices and biosensors with improved clinical performance capabilities. However, in vivo degradation or denaturation of surface constituents often limits the long-term performance of bioactive films. Here we demonstrate the capacity to repeatedly regenerate a covalently immobilized monomolecular thin film of bioactive molecules through a two-step stripping and recharging cycle. Reversible transpeptidation by a laboratory evolved Staphylococcus aureus sortase A (eSrtA) enabled the rapid immobilization of an anti-thrombogenic film in the presence of whole blood and permitted multiple cycles of film regeneration in vitro that preserved its biological activity. Moreover, eSrtA transpeptidation facilitated surface re-engineering of medical devices in situ after in vivo implantation through removal and restoration film constituents. These studies establish a rapid, orthogonal and reversible biochemical scheme to regenerate selective molecular constituents with the potential to extend the lifetime of bioactive films.

  1. Quantum mechanics in an evolving Hilbert space

    Science.gov (United States)

    Artacho, Emilio; O'Regan, David D.

    2017-03-01

    Many basis sets for electronic structure calculations evolve with varying external parameters, such as moving atoms in dynamic simulations, giving rise to extra derivative terms in the dynamical equations. Here we revisit these derivatives in the context of differential geometry, thereby obtaining a more transparent formalization, and a geometrical perspective for better understanding the resulting equations. The effect of the evolution of the basis set within the spanned Hilbert space separates explicitly from the effect of the turning of the space itself when moving in parameter space, as the tangent space turns when moving in a curved space. New insights are obtained using familiar concepts in that context such as the Riemann curvature. The differential geometry is not strictly that for curved spaces as in general relativity, a more adequate mathematical framework being provided by fiber bundles. The language used here, however, will be restricted to tensors and basic quantum mechanics. The local gauge implied by a smoothly varying basis set readily connects with Berry's formalism for geometric phases. Generalized expressions for the Berry connection and curvature are obtained for a parameter-dependent occupied Hilbert space spanned by nonorthogonal Wannier functions. The formalism is applicable to basis sets made of atomic-like orbitals and also more adaptative moving basis functions (such as in methods using Wannier functions as intermediate or support bases), but should also apply to other situations in which nonorthogonal functions or related projectors should arise. The formalism is applied to the time-dependent quantum evolution of electrons for moving atoms. The geometric insights provided here allow us to propose new finite-difference time integrators, and also better understand those already proposed.

  2. Emergent spacetime in stochastically evolving dimensions

    Energy Technology Data Exchange (ETDEWEB)

    Afshordi, Niayesh [Perimeter Institute for Theoretical Physics, 31 Caroline St. N., Waterloo, ON, N2L 2Y5 (Canada); Department of Physics and Astronomy, University of Waterloo, Waterloo, ON, N2L 3G1 (Canada); HEPCOS, Department of Physics, SUNY at Buffalo, Buffalo, NY 14260-1500 (United States); Stojkovic, Dejan, E-mail: ds77@buffalo.edu [Perimeter Institute for Theoretical Physics, 31 Caroline St. N., Waterloo, ON, N2L 2Y5 (Canada); HEPCOS, Department of Physics, SUNY at Buffalo, Buffalo, NY 14260-1500 (United States)

    2014-12-12

    Changing the dimensionality of the space–time at the smallest and largest distances has manifold theoretical advantages. If the space is lower dimensional in the high energy regime, then there are no ultraviolet divergencies in field theories, it is possible to quantize gravity, and the theory of matter plus gravity is free of divergencies or renormalizable. If the space is higher dimensional at cosmological scales, then some cosmological problems (including the cosmological constant problem) can be attacked from a completely new perspective. In this paper, we construct an explicit model of “evolving dimensions” in which the dimensions open up as the temperature of the universe drops. We adopt the string theory framework in which the dimensions are fields that live on the string worldsheet, and add temperature dependent mass terms for them. At the Big Bang, all the dimensions are very heavy and are not excited. As the universe cools down, dimensions open up one by one. Thus, the dimensionality of the space we live in depends on the energy or temperature that we are probing. In particular, we provide a kinematic Brandenberger–Vafa argument for how a discrete causal set, and eventually a continuum (3+1)-dim spacetime along with Einstein gravity emerges in the Infrared from the worldsheet action. The (3+1)-dim Planck mass and the string scale become directly related, without any compactification. Amongst other predictions, we argue that LHC might be blind to new physics even if it comes at the TeV scale. In contrast, cosmic ray experiments, especially those that can register the very beginning of the shower, and collisions with high multiplicity and density of particles, might be sensitive to the dimensional cross-over.

  3. Emergent spacetime in stochastically evolving dimensions

    Science.gov (United States)

    Afshordi, Niayesh; Stojkovic, Dejan

    2014-12-01

    Changing the dimensionality of the space-time at the smallest and largest distances has manifold theoretical advantages. If the space is lower dimensional in the high energy regime, then there are no ultraviolet divergencies in field theories, it is possible to quantize gravity, and the theory of matter plus gravity is free of divergencies or renormalizable. If the space is higher dimensional at cosmological scales, then some cosmological problems (including the cosmological constant problem) can be attacked from a completely new perspective. In this paper, we construct an explicit model of ;evolving dimensions; in which the dimensions open up as the temperature of the universe drops. We adopt the string theory framework in which the dimensions are fields that live on the string worldsheet, and add temperature dependent mass terms for them. At the Big Bang, all the dimensions are very heavy and are not excited. As the universe cools down, dimensions open up one by one. Thus, the dimensionality of the space we live in depends on the energy or temperature that we are probing. In particular, we provide a kinematic Brandenberger-Vafa argument for how a discrete causal set, and eventually a continuum (3 + 1)-dim spacetime along with Einstein gravity emerges in the Infrared from the worldsheet action. The (3 + 1)-dim Planck mass and the string scale become directly related, without any compactification. Amongst other predictions, we argue that LHC might be blind to new physics even if it comes at the TeV scale. In contrast, cosmic ray experiments, especially those that can register the very beginning of the shower, and collisions with high multiplicity and density of particles, might be sensitive to the dimensional cross-over.

  4. Emergent spacetime in stochastically evolving dimensions

    Directory of Open Access Journals (Sweden)

    Niayesh Afshordi

    2014-12-01

    Full Text Available Changing the dimensionality of the space–time at the smallest and largest distances has manifold theoretical advantages. If the space is lower dimensional in the high energy regime, then there are no ultraviolet divergencies in field theories, it is possible to quantize gravity, and the theory of matter plus gravity is free of divergencies or renormalizable. If the space is higher dimensional at cosmological scales, then some cosmological problems (including the cosmological constant problem can be attacked from a completely new perspective. In this paper, we construct an explicit model of “evolving dimensions” in which the dimensions open up as the temperature of the universe drops. We adopt the string theory framework in which the dimensions are fields that live on the string worldsheet, and add temperature dependent mass terms for them. At the Big Bang, all the dimensions are very heavy and are not excited. As the universe cools down, dimensions open up one by one. Thus, the dimensionality of the space we live in depends on the energy or temperature that we are probing. In particular, we provide a kinematic Brandenberger–Vafa argument for how a discrete causal set, and eventually a continuum (3+1-dim spacetime along with Einstein gravity emerges in the Infrared from the worldsheet action. The (3+1-dim Planck mass and the string scale become directly related, without any compactification. Amongst other predictions, we argue that LHC might be blind to new physics even if it comes at the TeV scale. In contrast, cosmic ray experiments, especially those that can register the very beginning of the shower, and collisions with high multiplicity and density of particles, might be sensitive to the dimensional cross-over.

  5. Evolvable Cryogenics (ECRYO) Pressure Transducer Calibration Test

    Science.gov (United States)

    Diaz, Carlos E., Jr.

    2015-01-01

    This paper provides a summary of the findings of recent activities conducted by Marshall Space Flight Center's (MSFC) In-Space Propulsion Branch and MSFC's Metrology and Calibration Lab to assess the performance of current "state of the art" pressure transducers for use in long duration storage and transfer of cryogenic propellants. A brief historical narrative in this paper describes the Evolvable Cryogenics program and the relevance of these activities to the program. This paper also provides a review of three separate test activities performed throughout this effort, including: (1) the calibration of several pressure transducer designs in a liquid nitrogen cryogenic environmental chamber, (2) the calibration of a pressure transducer in a liquid helium Dewar, and (3) the calibration of several pressure transducers at temperatures ranging from 20 to 70 degrees Kelvin (K) using a "cryostat" environmental chamber. These three separate test activities allowed for study of the sensors along a temperature range from 4 to 300 K. The combined data shows that both the slope and intercept of the sensor's calibration curve vary as a function of temperature. This homogeneous function is contrary to the linearly decreasing relationship assumed at the start of this investigation. Consequently, the data demonstrates the need for lookup tables to change the slope and intercept used by any data acquisition system. This ultimately would allow for more accurate pressure measurements at the desired temperature range. This paper concludes with a review of a request for information (RFI) survey conducted amongst different suppliers to determine the availability of current "state of the art" flight-qualified pressure transducers. The survey identifies requirements that are most difficult for the suppliers to meet, most notably the capability to validate the sensor's performance at temperatures below 70 K.

  6. Ethical Concerns About Emerging Treatment Paradigms for Gender Dysphoria.

    Science.gov (United States)

    Levine, Stephen B

    2017-03-23

    The increasing incidence of requests for medical services to support gender transition for children, adolescents, and adults has consequences for society, governmental institutions, schools, families, health-care professionals, and, of course, patients. The sociological momentum to recognize and accommodate to trans phenomena has posed ethical dilemmas for endocrinologists, mental health professionals, and sexual specialists as they experience within themselves the clash between respect for patient autonomy, beneficence, nonmaleficence, and informed consent. The larger ethical clashes are cultural and therefore political. There is a distinct difference between pronouncements that represent human rights ideals and the reality of clinical observations. Some interpret this clash as a moral issue. This article delves into these tensions and reminds apologists from both passionate camps that clinical science has a rich tradition of resolving controversy through careful follow-up, which is not yet well developed in this arena.

  7. New treatment paradigm of combined raloxifene and conjugated ...

    African Journals Online (AJOL)

    Marwa N. Emam

    2016-07-25

    Jul 25, 2016 ... RLX and estrogen, demonstrating that RLX shows either neu- trality or an estrogen antagonist, blocking the estradiol-induced effects in the uterus. Moreover RLX wasn't associated with, and may even be effective at, preventing endometrial cancer.33. Despite the fact that the vagina is a classic estrogen-.

  8. [Hypertensive crisis: problems of diagnostics and paradigm of the treatment].

    Science.gov (United States)

    Fursov, A N; Potekhin, N P; Chernov, S A; Vereshchagina, A V; Zakharova, E G; Olondar', N N

    2012-07-01

    Analysis of causes of increase of the uncomplicated hypertensive crisis (HC) from 46 to 61% indicates that in the half of cases the cause was only high ABP with minimal clinical symptomatology. To refer all cases of the catadrome of hypertensive disease to hypertensive crisis is inappropriately. It is recommended to use with such concepts as "complicated" and "uncomplicated" HC also term "catadrome of hypertensive disease (instability of ABP)". It allows to except the hyperdiagnosis of HC and to optimize indication for hospital admission. There are recommendations for medical actions in case of complicated and uncomplicated HC and catadrome of hypertensive disease.

  9. Logistic paradigm for industrial solid waste treatment processes

    Directory of Open Access Journals (Sweden)

    Janusz Grabara

    2014-12-01

    Full Text Available Due to the fact that industrial waste are a growing problem, both economic and environmental as their number is increasing every year, it is important to take measures to correctly dealing wi th industrial waste. This article presents the descriptive model of logistics processes concerning the management of industrial waste. In this model the flow of waste begins in the place of production and ends at their disposal. The article presents the concept of logistics model in graphical form together with an analysis of individual processes and their linkages, and opportunities to improve flow of industrial waste streams. Furthermore, the model allows for justification of the relevance of use logistics and its processes for waste management

  10. Web Content Analysis: Expanding the Paradigm

    Science.gov (United States)

    Herring, Susan C.

    Are established methods of content analysis (CA) adequate to analyze web content, or should new methods be devised to address new technological developments? This article addresses this question by contrasting narrow and broad interpretations of the concept of web content analysis. The utility of a broad interpretation that subsumes the narrow one is then illustrated with reference to research on weblogs (blogs), a popular web format in which features of HTML documents and interactive computer-mediated communication converge. The article concludes by proposing an expanded Web Content Analysis (WebCA) paradigm in which insights from paradigms such as discourse analysis and social network analysis are operationalized and implemented within a general content analytic framework.

  11. BMS invariance and the membrane paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Penna, Robert F. [Department of Physics and Kavli Institute for Astrophysics and Space Research,Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States)

    2016-03-04

    The Bondi-van der Burg-Metzner-Sachs (BMS) group is the asymptotic symmetry group of asymptotically flat spacetime. It is infinite dimensional and entails an infinite number of conservation laws. According to the black hole membrane paradigm, null infinity (in asymptotically flat spacetime) and black hole event horizons behave like fluid membranes. The fluid dynamics of the membrane is governed by an infinite set of symmetries and conservation laws. Our main result is to point out that the infinite set of symmetries and conserved charges of the BMS group and the membrane paradigm are the same. This relationship has several consequences. First, it sheds light on the physical interpretation of BMS conservation laws. Second, it generalizes the BMS conservation laws to arbitrary subregions of arbitrary null surfaces. Third, it clarifies the identification of the superrotation subgroup of the BMS group. We briefly comment on the black hole information problem.

  12. The Knowledge Society: A Sustainability Paradigm

    Directory of Open Access Journals (Sweden)

    Naim Hamdija Afgan

    2010-10-01

    Full Text Available This paper defines the knowledge society as a human structured organisation based on contemporary developed knowledge and representing new quality of life support systems. It implies the need for a full understanding of distribution of knowledge, access to information and the capability to transfer information into a knowledge. The understanding of knowledge is the central challenge when defining a knowledge society. From our present perception of knowledge society, it is of interest to emphasize the role of the knowledge society in future development of human society. The life support systems are essential pillars of human society development. In this respect knowledge society represents a new paradigm for future development and it is strongly correlated to sustainable development. For this reason the sustainability paradigm of knowledge society is a potential frame for human society development leading to social cohesion, economic competitiveness and stability, use of resources and economic development, safeguarding biodiversity and the ecosystem.In order to verify the mutual relation between knowledge society and sustainability, we have to introduce the difference between these two terms. The knowledge society is based on the agglomeration of eco-knowledge, env-knowledge and soc-knowledge, it may be evaluated as the complex knowledge of quality of life support systems. We have to introduce metrics which will allow us to present knowledge as the paradigm of the number of indicators for verifying progress made.Sustainability metrics are designed to consolidate measures of economic, environmental and social performance of any system. It can be understood as a pattern for evaluation of the available knowledge about systems and their performance. In particular the decision-making process for the selection of the system under consideration must be based on the available knowledge. The link between knowledge and sustainability makes it possible for

  13. Self-determination and Substantiation of Paradigm

    Directory of Open Access Journals (Sweden)

    E M Akimkin

    2008-09-01

    Full Text Available The article given describes the author's view on theoretical ideas by T.M. Dridze as well as on the derivative social technologies relevant to local self-government. Besides, the article touches upon interactions between scientific community and municipal authority, in particular municipal consulting. The author maintains that prediction social projection based upon ecoanthropocentric paradigm of social cognition and semiosociopsychologic concept of social communication should be interpreted as socially oriented management consulting of municipal development.

  14. What Do Ecological Paradigms Offer to Conservation?

    Directory of Open Access Journals (Sweden)

    Som B. Ale

    2010-01-01

    Full Text Available Ecological theory provides applications to biodiversity management—but often falls short of expectations. One possibility is that heuristic theories of a young science are too immature. Logistic growth predicts a carrying capacity, but fisheries managed with the Lotka-Volterra paradigm continue to collapse. A second issue is that general predictions may not be useful. The theory of island biogeography predicts species richness but does not predict community composition. A third possibility is that the theory itself may not have much to do with nature, or that empirical parameterization is too difficult to know. The metapopulation paradigm is relevant to conservation, but metapopulations might not be common in nature. For instance, empirical parameterization within the metapopulation paradigm is usually infeasible. A challenge is to determine why ecology fails to match needs of managers sometimes but helps at other. Managers may expect too much of paradigmatic blueprints, while ecologists believe them too much. Those who implement biodiversity conservation plans need simple, pragmatic guidelines based on science. Is this possible? What is possible? An eclectic review of theory and practice demonstrate the power and weaknesses of the ideas that guide conservation and attempt to identify reasons for prevailing disappointment.

  15. SAID-SAPS Paradigm: Beliefs and Reality

    Science.gov (United States)

    Mishin, E. V.

    2016-12-01

    Enhanced westward flows are the dominant feature of the plasma convection in the perturbed subauroral geospace. These include latitudinally-narrow "polarization jets" (PJ) or "subauroral ion drifts" (SAID) observed mainly in the premidnight MLT sector and broad flow channels on the duskside. The generic term "sub-auroral polarization streams" (SAPS) was introduced to unite both (narrow and broad) flows, taking for granted that their underlying mechanisms are quite similar, if not the same. The concept of voltage and current generators is believed to explain the SAPS major features. The generator paradigm treats hot, ≥1 keV, plasma sheet (PS) particles as single (test) particles driven by the dawn-to-dusk and co-rotation electric fields and gradient-curvature drift disregarding charge neutrality and concomitant polarization fields, inherent in slow plasma processes. In this approach, the inner boundary of the hot ion trajectories on the duskside extends earthward of that of the PS electrons by some distance increasing toward dusk. However, magnetically conjugate observations in the evening sector reveal that the generator paradigm fails to explain the substorm SAID features and that they are rather explained in terms of a short-circuiting of substorm-injected hot plasma jets over the plasmapause. This report presents multispacecraft magnetically conjugate observations of substorm-enhanced flows on the duskside showing that their features are hardly compatible with the (test particle) generator paradigm. It is suggested that they are causally related to the two-loop system of the westward traveling surge.

  16. Marketing communications: Qualitative and quantitative paradigm

    Directory of Open Access Journals (Sweden)

    Uzelac Nikola

    2005-01-01

    Full Text Available This paper focuses on key issues in relation to the choice of basic language of communication of marketing as a practical and academic field. Principally, marketing managers prefer descriptive way of expression, but they should use the advantages of language of numbers much more. By doing so, they will advance decision-making process - and the communication with finance and top management. In this regard, models offered by academic community could be helpful. This especially pertains to those positive or normative verbal approaches and models in which mathematics and statistical solutions have been embedded, as well as to those which emphasize financial criteria in decision-making. Concerning the process of creation and verification of scientific knowledge, the choice between languages of words and numbers is the part of much wider dimension, because it is inseparable from the decision on basic research orientation. Quantitative paradigm is more appropriate for hypotheses testing, while qualitative paradigm gives greater contribution in their generation. Competition factor could become the key driver of changes by which existing "parallel worlds" of main paradigms would be integrating, for the sake of disciplinary knowledge advancement.

  17. The professional paradigm of qualified psychiatric nurses.

    Science.gov (United States)

    Lindström, U A

    1995-10-01

    The main purpose of this research was to determine the professional paradigm of the qualified psychiatric nurse and the factors influencing the formation of this paradigm. The research was both explorative and descriptive, and both qualitative and quantitative methods were used. The research approach was deductive and based on the theory of paradigm of Törnebohm. The test persons comprised three groups: Swedish-speaking Finns, Swedes and Finns. In each group there were eight students in the final stages of their psychiatric nursing training. A total of 40 questionnaires were distributed to each group. The research revealed four different characteristic types of qualified psychiatric nurses: caring science oriented, partly caring science oriented, general humanist and finally the personality- and experience-oriented. The results also indicate that there is a discrepancy between will and ability within caring. This can partly be interpreted as an expression of the discrepancy between philosophical and ideological impressions and real acts but it may partly indicate a lack of information. Many informants had difficulty naming a theoretical frame of reference for their work and stating aspects of psychiatric caring that would be important to know but on which no information so far exists. Many informants expressed the need for more research and development but did not indicate the subjects.

  18. Perceptual crossing: The simplest online paradigm

    Directory of Open Access Journals (Sweden)

    Malika eAuvray

    2012-06-01

    Full Text Available Researchers in social cognition increasingly realize that many phenomena cannot be understood by investigating offline situations only, focusing on individual mechanisms and an observer perspective. There are processes of dynamic emergence specific to online situations, when two or more persons are engaged in a real-time interaction that are more than just the sum of the individual capacities or behaviours, and these require the study of online social interaction. Auvray et al.’s (2009 perceptual crossing paradigm offers possibly the simplest paradigm for studying such online interactions: two persons, a one-dimensional space, one bit of information, and a yes/no answer. Despite, or maybe because of its simplicity, this study has provoked a lot of resonance in different areas of research, including experimental psychology, computer/robot modelling, philosophy, more recently psychopathology, and even in the field of design. In this article, we review and critically assess this body of literature. We give an overview over work on the perceptual crossing paradigm, both concerning behavioural experiments and computational agent modelling, and review the different contexts in which it has been referred to. We discuss the controversy about the possible constitutive role of perceptual crossing for social cognition and other theoretical contexts in which the research has been cited, offering our own interpretation. We conclude with an outlook on future research possibilities, in particular those that could elucidate the link between online interaction dynamics and individual social cognition.

  19. Nonspecific effects of gap paradigm on swallowing.

    Science.gov (United States)

    Yoneda, Masaki; Saitoh, Kazuya

    2017-02-01

    Analogous to the gap paradigm in experiments for saccadic eye movements with very short reaction times, we hypothesized that the initiation of oropharyngeal swallowing movements guided by visual cues are encouraged under experimental conditions using a similar gap paradigm. A red visual cue indicating to hold a bolus in the mouth and a blue one indicating to swallow the bolus were sequentially provided on a computer display to 11 healthy participants. The gap period between these cues varied from 0 to 800ms. Swallowing kinetics and kinematics were recorded using surface electromyography and a laser displacement sensor, respectively. In comparison with the no-gap paradigm, the delay from the onset of muscle activities to initiation of movement significantly decreased with a 100- (pparadigm of 100-200ms. Wrist flexion was boosted in a similar manner. Thus, the gap effect may be a generalized warning effect. Our findings might provide insights into the contribution of the basal ganglia to volitional swallowing. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Perceptual crossing: the simplest online paradigm

    Science.gov (United States)

    Auvray, Malika; Rohde, Marieke

    2012-01-01

    Researchers in social cognition increasingly realize that many phenomena cannot be understood by investigating offline situations only, focusing on individual mechanisms and an observer perspective. There are processes of dynamic emergence specific to online situations, when two or more persons are engaged in a real-time interaction that are more than just the sum of the individual capacities or behaviors, and these require the study of online social interaction. Auvray et al.'s (2009) perceptual crossing paradigm offers possibly the simplest paradigm for studying such online interactions: two persons, a one-dimensional space, one bit of information, and a yes/no answer. This study has provoked a lot of resonance in different areas of research, including experimental psychology, computer/robot modeling, philosophy, psychopathology, and even in the field of design. In this article, we review and critically assess this body of literature. We give an overview of both behavioral experimental research and simulated agent modeling done using the perceptual crossing paradigm. We discuss different contexts in which work on perceptual crossing has been cited. This includes the controversy about the possible constitutive role of perceptual crossing for social cognition. We conclude with an outlook on future research possibilities, in particular those that could elucidate the link between online interaction dynamics and individual social cognition. PMID:22723776

  1. Toward a Metatheoretical Integration of Developmental Paradigms

    Directory of Open Access Journals (Sweden)

    Mark W. Antley

    2010-07-01

    Full Text Available This paper shows how a partial consilience might be achieved in the field of human development by means of principles from general systems theory. The author concurs with Sameroff (1989 that it is possible to interpret the mechanistic, organisimic, and contextualist paradigms/worldviews (Goldhaber, 2000; Pepper, 1970 in terms of general systems theory. The author selects a major developmentalist from each paradigm and interprets that scholar’s work in terms of systems principles. The following developmentalists were selected: Arnold Sameroff (contextualism, Erik Erickson (organicism, and Albert Bandura (mechanism. The systems principles employed are wholeness and order, self-stabilization, self-reorganization, hierarchical interaction, and dialectical contradiction (Sameroff, 1989. The author addresses the conflicting presuppositions of the major paradigms in order to provide for their theoretical subsuming under systems theory. Finally, the author notes areas of inconsistency that will need to be resolved in the future and calls for further scholarship to translate developmental theory in terms of general systems theory for the benefit of students, scholars, consultants and other practitioners familiar with systems theory.

  2. Biological Robustness: Paradigms, Mechanisms, and Systems Principles

    Directory of Open Access Journals (Sweden)

    James Michael Whitacre

    2012-05-01

    Full Text Available Robustness has been studied through the analysis of data sets, simulations, and a variety of experimental techniques that each have their own limitations but together confirm the ubiquity of biological robustness. Recent trends suggest that different types of perturbation (e.g. mutational, environmental are commonly stabilized by similar mechanisms, and system sensitivities often display a long-tailed distribution with relatively few perturbations representing the majority of sensitivities. Conceptual paradigms from network theory, control theory, complexity science, and natural selection have been used to understand robustness, however each paradigm has a limited scope of applicability and there has been little discussion of the conditions that determine this scope or the relationships between paradigms. Systems properties such as modularity, bow-tie architectures, degeneracy, and other topological features are often positively associated with robust traits, however common underlying mechanisms are rarely mentioned. For instance, many system properties support robustness through functional redundancy or through response diversity with responses regulated by competitive exclusion and cooperative facilitation. Moreover, few studies compare and contrast alternative strategies for achieving robustness such as homeostasis, adaptive plasticity, environment shaping, and environment tracking. These strategies share similarities in their utilization of adaptive and self-organization processes that are not well appreciated yet might be suggestive of reusable building blocks for generating robust behavior.

  3. Orthogonally Evolved AI to Improve Difficulty Adjustment in Video Games

    DEFF Research Database (Denmark)

    Hintze, Arend; Olson, Randal; Lehman, Joel Anthony

    2016-01-01

    (i.e. agents subject to fewer generations of evolution) make for easier opponents, while highly-evolved agents are more challenging to overcome. In this publication we test a new approach for difficulty adjustment in games: orthogonally evolved AI, where the player receives support from collaborating...... opponents. Furthermore, human interaction can modulate (and be informed by) the performance and behavior of collaborating agents. In this way, orthogonally evolved AI both facilitates smoother difficulty adjustment and enables new game experiences....

  4. Linking aims, paradigm and method in nursing research.

    Science.gov (United States)

    Houghton, Catherine; Hunter, Andrew; Meskell, Pauline

    2012-01-01

    To explore the use of paradigms as ontological and philosophical guides for conducting PhD research. A paradigm can help to bridge the aims of a study and the methods to achieve them. However, choosing a paradigm can be challenging for doctoral researchers: there can be ambiguity about which paradigm is suitable for a particular research question and there is a lack of guidance on how to shape the research process for a chosen paradigm. The authors discuss three paradigms used in PhD nursing research: post-positivism, interpretivism and pragmatism. They compare each paradigm in relation to its ontology, epistemology and methodology, and present three examples of PhD nursing research studies to illustrate how research can be conducted using these paradigms in the context of the research aims and methods. The commonalities and differences between the paradigms and their uses are highlighted. Creativity and flexibility are important when deciding on a paradigm. However, consistency and transparency are also needed to ensure the quality and rigour necessary for conducting nursing research. When choosing a suitable paradigm, the researcher should ensure that the ontology, epistemology and methodology of the paradigm are manifest in the methods and research strategies employed.

  5. Paradigm Adherence and Personality Correlates across Mental Health Professions

    Science.gov (United States)

    Rauscher, Laura Anne

    2012-01-01

    Paradigm adherence has been developed as a meta-theoretical approach to organize and to classify the multitude of different theories of counseling and psychotherapy. Four paradigms have been identified in the literature: The Organic-Medical, The Psychological, The Systemic-Relational, and the Social Constructivist paradigms. Only one other study…

  6. Paradigms and theories in water governance: the case of South ...

    African Journals Online (AJOL)

    This paper indicates the influence of paradigms and theories on the development of South Africa's National Water Resource Strategy, Second Edition. Five paradigms exist: positivism, postpositivism, interpretivism/constructivism, critical theories and the participatory paradigm. I use the PULSE3 framework for analysis that I ...

  7. Cranial Stereotactic Radiosurgery: Current Status of the Initial Paradigm Shifter

    Science.gov (United States)

    Sheehan, Jason P.; Yen, Chun-Po; Lee, Cheng-Chia; Loeffler, Jay S.

    2014-01-01

    The concept of stereotactic radiosurgery (SRS) was first described by Lars Leksell in 1951. It was proposed as a noninvasive alternative to open neurosurgical approaches to manage a variety of conditions. In the following decades, SRS emerged as a unique discipline involving a collegial partnership among neurosurgeons, radiation oncologists, and medical physicists. SRS relies on the precisely guided delivery of high-dose ionizing radiation to an intracranial target. The focused convergence of multiple beams yields a potent therapeutic effect on the target and a steep dose fall-off to surrounding structures, thereby minimizing the risk of collateral damage. SRS is typically administered in a single session but can be given in as many as five sessions or fractions. By providing an ablative effect noninvasively, SRS has altered the treatment paradigms for benign and malignant intracranial tumors, functional disorders, and vascular malformations. Literature on extensive intracranial radiosurgery has unequivocally demonstrated the favorable benefit-to-risk profile that SRS affords for appropriately selected patients. In a departure from conventional radiotherapeutic strategies, radiosurgical principles have recently been extended to extracranial indications such as lung, spine, and liver tumors. The paradigm shift resulting from radiosurgery continues to alter the landscape of related fields. PMID:25113762

  8. Anomalies in the dominant sarcoidosis paradigm justify its displacement.

    Science.gov (United States)

    Reich, Jerome M

    2017-04-01

    The prevailing paradigm defines sarcoidosis as a disease of unknown etiology characterized by a systemic noncaseating epithelioid granulomatous response (SGR). This formulation fails to account for the elusiveness of the etiological agent, the nature of the Kveim response, the paradox of cutaneous delayed type hypersensitivity anergy in a setting of intense immune response and the appearance of SGR, indistinguishable from sarcoidosis, in persons with lymphohematogenous and solid neoplasms and a variety of cellular immune deficiencies. Displacing this formulation with an evidence-based alternative in which the SGR is viewed as an etiologically diverse, primitive immunological fallback due to inefficient cellular immune processing eliminates these shortcomings, providing a unifying accounting for the puzzles and violations of expectations associated with the prevailing paradigm. Its clinical import resides in the reported annual three-percent increase in sarcoidosis mortality in the past two decades (Swigris et al., 2011), which may be attributable, in part, to unneeded suppressive treatment. Copyright © 2017 Elsevier GmbH. All rights reserved.

  9. A New Control Paradigm for Stochastic Differential Equations

    Science.gov (United States)

    Schmid, Matthias J. A.

    to scalar systems subject to state-dependent noise and to systems of higher order. The suggested control paradigm is further advanced when a sequential application of MLD control is considered. This technique yields a nominal path corresponding to the minimum total deviation probability on the entire time domain. It is demonstrated that this sequential optimization concept can be unified in a single objective function which is revealed to be the Jacobi field performance index on the entire domain subject to an endpoint deviation. The emerging closed-form term replaces the previously required nested optimization and, thus, results in a highly efficient application-ready control design. This effectively substantiates Minimum Path Deviation (MPD) control. The proposed control paradigm allows the specific problem of stochastic cost control to be addressed as a special case. This new technique is employed within this study for the stochastic cost problem giving rise to Cost Constrained MPD (CCMPD) as well as to Minimum Quadratic Cost Deviation (MQCD) control. An exemplary treatment of a generic scalar nonlinear system subject to quadratic costs is performed for MQCD control to demonstrate the elementary expandability of the new control paradigm. This work concludes with a numerical evaluation of both MPD and CCMPD control for three exemplary benchmark problems. Numerical issues associated with the simulation of SDEs are briefly discussed and illustrated. The numerical examples furnish proof of the successful design. This study is complemented by a thorough review of statistical control methods, stochastic processes, Large Deviations techniques and the Freidlin-Wentzell theory, providing a comprehensive, self-contained account. The presentation of the mathematical tools and concepts is of a unique character, specifically addressing an engineering audience.

  10. Evolving R Coronae Borealis Stars with MESA

    Science.gov (United States)

    Clayton, Geoffrey C.; Lauer, Amber; Chatzopoulos, Emmanouil; Frank, Juhan

    2018-01-01

    being a WD. Solving the mystery of how the RCB stars evolve will lead to a better understanding of other important types of stellar merger events such as Type Ia SNe.

  11. Ventilator-Associated Pneumonia in Critically Ill Children: A New Paradigm.

    Science.gov (United States)

    Mourani, Peter M; Sontag, Marci K

    2017-10-01

    Ventilator-associated pneumonia (VAP) is a serious complication of critical illness. Surveillance definitions have undergone revisions for more objective and consistent reporting. The 1 organism-1 disease paradigm for microbial involvement may not adequately apply to many cases of VAP, in which pathogens are introduced to a pre-existing and often complex microbial community that facilitates or hinders the potential pathogen, consequently determining whether progression to VAP occurs. As omics technology is applied to VAP, a paradigm is emerging incorporating simultaneous assessments of microbial populations and their activity, as well as the host response, to personalize prevention and treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. On the Evolving Nature of Exposure Therapy

    Science.gov (United States)

    Schare, Mitchell L.; Wyatt, Kristin P.

    2013-01-01

    Four articles examining methodological applications of exposure therapy and its limited dissemination were briefly reviewed. Methodological articles included those by Abramowitz et al., Gryczkowski et al., and Weiner and McKay, which addressed couple treatment of obsessive-compulsive disorder (OCD), modification of evidence-based anxiety…

  13. Rationalizing virtual reality based on manufacturing paradigms

    NARCIS (Netherlands)

    Damgrave, Roy Gerhardus Johannes; Lutters, Diederick; Drukker, J. W.

    2014-01-01

    Comparing the evolvement of the manufacturing industry of the last century to the way virtual reality is used nowadays some remarkable similarities come to light. Current virtual reality equipment requires a high level of craftsmanship to achieve the maximum results, and often equipment is specially

  14. Gastrointestinal Tumor Board: An Evolving Experience in Tehran Cancer Institute

    Directory of Open Access Journals (Sweden)

    Peiman Haddad

    2013-04-01

    Full Text Available Gastrointestinal (GI cancers are a significant source of morbidity and mortality in Iran, with stomach adenocarcinoma as the most common cancer in men and the second common cancer in women. Also, some parts of Northern Iran have one of the highest incidences of esophageal cancer in the world. Multi-disciplinary organ-based joint clinics and tumor boards are a well-recognized necessity for modern treatment of cancer and are routinely utilized in developed countries, especially in major academic centres. But this concept is relatively new in developing countries, where cancer treatment centres are burdened by huge loads of patients and have to cope with a suboptimum availability of resources and facilities. Cancer Institute of Tehran University of Medical Sciences is the oldest and the only comprehensive cancer treatment centre in Iran, with a long tradition of a general tumor board for all cancers. But with the requirements of modern oncology, there has been a very welcome attention to sub-specialized organ-based tumor boards and joint clinics here in the past few years. Considering this, we started a multi-disciplinary tumor board for GI cancers in our institute in early 2010 as the first such endeavor here. We hereby review this 2-year evolving experience. The process of establishment of a GI tumor board, participations from different oncology disciplines and related specialties, the cancers presented and discussed in the 2 years of this tumor board, the general intents of treatment for the decisions made and the development of interest in this tumor board among the Tehran oncology community will be reviewed. The GI tumor board of Tehran Cancer Institute started its work in January 2010, with routine weekly sessions. A core group of 2 physicians from each surgical, radiation and medical oncology departments plus one gastroenterologist, GI pathologist and radiologist was formed, but participation from all interested physicians was encouraged. An

  15. Identity of psychology, psychological paradigms and constructivism: Toward a perspective social psychology

    Directory of Open Access Journals (Sweden)

    Janek Musek

    2003-09-01

    Full Text Available Philosophical self-reflexion is a healthy practice of any science including psychology. Nevertheless, psychology has long ago outgrew the age of the search for its own identity. It is however a science sui generis, determined by a radical split into Lockean and Kantian (objective and phenomenological paradigm, each completely legitimate but also completely different in defining the objectives as well as the methods of research. That internal splitting is presented in all psychological disciplines. In social psychology, social constructivism emerged decades ago as a typical disciplinary "paradigm" (although subordinated to both previously mentioned paradigms. The present contribution is aimed to show that social constructivism could be effectively merged with the theoretical frame of cognitivism, dominant theoretical orientation in contemporaneous psychology. On the other hand, social constructivism failed to understand the proper relationship between human nature and human cultural context. Human beings are evolutionary evolved as beings genetically programmed for the construction of the culture and social milieu. Human beings are not products of the culture in the proper sense of meaning. The truth is quite opposite: the culture is a product of human biological equipment. But this is an equipment that predisposes human individual to be a social, cultural being uniquely capable of learning, uniquely capable of receiving the influence of his own products – social environment and culture.

  16. Brachytherapy in the treatment of cervical cancer: a review

    Directory of Open Access Journals (Sweden)

    Banerjee R

    2014-05-01

    Full Text Available Robyn Banerjee,1 Mitchell Kamrava21Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada; 2Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USAAbstract: Dramatic advances have been made in brachytherapy for cervical cancer. Radiation treatment planning has evolved from two-dimensional to three-dimensional, incorporating magnetic resonance imaging and/or computed tomography into the treatment paradigm. This allows for better delineation and coverage of the tumor, as well as improved avoidance of surrounding organs. Consequently, advanced brachytherapy can achieve very high rates of local control with a reduction in morbidity, compared with historic approaches. This review provides an overview of state-of-the-art gynecologic brachytherapy, with a focus on recent advances and their implications for women with cervical cancer.Keywords: cervical cancer, brachytherapy, image-guided brachytherapy

  17. Current Paradigm for Ischemia in Kidney Surgery.

    Science.gov (United States)

    Mir, Maria C; Pavan, Nicola; Parekh, Dipen J

    2016-06-01

    Partial nephrectomy is the accepted standard of care for treatment of patients with small renal masses. The primary goal while performing partial nephrectomy is cancer control with a secondary important goal of maximizing renal function preservation with minimal perioperative morbidity. Recent studies have highlighted the importance of renal parenchymal quality and quantity postoperatively rather than duration of ischemia in determining long-term renal function. We review the available data regarding perioperative renal function optimization with special interest in ischemia during partial nephrectomy, highlighting the controversies and establishing future lines of investigation. We performed a comprehensive literature review for the years 1970 to 2014 via MEDLINE(®), PubMed(®) and the Cochrane Library. Review was consistent with the PRISMA (Preferred Reporting Items for Systemic Reviews and Meta-Analyses) criteria. We used MeSH (Medical Subject Headings) terms for the search including "acute kidney injury/failure," "carcinoma, renal cell/carcinoma of kidney/neoplasm of kidney," "kidney failure, chronic/end-stage kidney disease," "ischemia-reperfusion" and "warm ischemia/cold ischemia." Relevant review articles were included. Abstracts from major urological/surgical conferences were reviewed. All studies included were performed in adults, were written in English and had an abstract available. Our traditional knowledge of renal ischemia is derived from animal studies, ie kidney transplant and retrospective partial nephrectomy series that indicate the risk of renal function impairment for every minute of ischemia. Careful evaluation of historical studies highlights flaws of the use of ischemia duration as a dichotomous marker (25 or 30 minutes) while predicting renal function outcomes. Recent studies have revealed no effect of duration of ischemia on ultimate kidney function in the short or long term. Quality and quantity of parenchyma preserved postoperatively are

  18. Food Addiction: An Evolving Nonlinear Science

    Science.gov (United States)

    Shriner, Richard; Gold, Mark

    2014-01-01

    The purpose of this review is to familiarize readers with the role that addiction plays in the formation and treatment of obesity, type 2 diabetes and disorders of eating. We will outline several useful models that integrate metabolism, addiction, and human relationship adaptations to eating. A special effort will be made to demonstrate how the use of simple and straightforward nonlinear models can and are being used to improve our knowledge and treatment of patients suffering from nutritional pathology. Moving forward, the reader should be able to incorporate some of the findings in this review into their own practice, research, teaching efforts or other interests in the fields of nutrition, diabetes, and/or bariatric (weight) management. PMID:25421535

  19. Food Addiction: An Evolving Nonlinear Science

    Directory of Open Access Journals (Sweden)

    Richard Shriner

    2014-11-01

    Full Text Available The purpose of this review is to familiarize readers with the role that addiction plays in the formation and treatment of obesity, type 2 diabetes and disorders of eating. We will outline several useful models that integrate metabolism, addiction, and human relationship adaptations to eating. A special effort will be made to demonstrate how the use of simple and straightforward nonlinear models can and are being used to improve our knowledge and treatment of patients suffering from nutritional pathology. Moving forward, the reader should be able to incorporate some of the findings in this review into their own practice, research, teaching efforts or other interests in the fields of nutrition, diabetes, and/or bariatric (weight management.

  20. Paradigm Shift in Language Teaching and Language Teacher Education

    Directory of Open Access Journals (Sweden)

    Elaine Ferreira do Vale Borges

    2014-11-01

    Full Text Available In this article, I intend to conduct a short literature review and discussion about paradigm shift in language teaching and language teacher education from Cartesian to the complexity paradigm. For that, I use the Kuhnian notion of scientific revolution to present a short compilation of works related to paradigm shift in different sciences, including psychology, linguistics and, more emphatically, applied linguistics. The main proposal is to show the evolutions of paradigm shift in language and social sciences and its impact on the emergence of the complexity paradigm in language teaching and language teacher education fields.

  1. Loops and autonomy promote evolvability of ecosystem networks.

    Science.gov (United States)

    Luo, Jianxi

    2014-09-29

    The structure of ecological networks, in particular food webs, determines their ability to evolve further, i.e. evolvability. The knowledge about how food web evolvability is determined by the structures of diverse ecological networks can guide human interventions purposefully to either promote or limit evolvability of ecosystems. However, the focus of prior food web studies was on stability and robustness; little is known regarding the impact of ecological network structures on their evolvability. To correlate ecosystem structure and evolvability, we adopt the NK model originally from evolutionary biology to generate and assess the ruggedness of fitness landscapes of a wide spectrum of model food webs with gradual variation in the amount of feeding loops and link density. The variation in network structures is controlled by linkage rewiring. Our results show that more feeding loops and lower trophic link density, i.e. higher autonomy of species, of food webs increase the potential for the ecosystem to generate heritable variations with improved fitness. Our findings allow the prediction of the evolvability of actual food webs according to their network structures, and provide guidance to enhancing or controlling the evolvability of specific ecosystems.

  2. Protein structural modularity and robustness are associated with evolvability.

    Science.gov (United States)

    Rorick, Mary M; Wagner, Günter P

    2011-01-01

    Theory suggests that biological modularity and robustness allow for maintenance of fitness under mutational change, and when this change is adaptive, for evolvability. Empirical demonstrations that these traits promote evolvability in nature remain scant however. This is in part because modularity, robustness, and evolvability are difficult to define and measure in real biological systems. Here, we address whether structural modularity and/or robustness confer evolvability at the level of proteins by looking for associations between indices of protein structural modularity, structural robustness, and evolvability. We propose a novel index for protein structural modularity: the number of regular secondary structure elements (helices and strands) divided by the number of residues in the structure. We index protein evolvability as the proportion of sites with evidence of being under positive selection multiplied by the average rate of adaptive evolution at these sites, and we measure this as an average over a phylogeny of 25 mammalian species. We use contact density as an index of protein designability, and thus, structural robustness. We find that protein evolvability is positively associated with structural modularity as well as structural robustness and that the effect of structural modularity on evolvability is independent of the structural robustness index. We interpret these associations to be the result of reduced constraints on amino acid substitutions in highly modular and robust protein structures, which results in faster adaptation through natural selection.

  3. Adaptation of Escherichia coli to glucose promotes evolvability in lactose.

    Science.gov (United States)

    Phillips, Kelly N; Castillo, Gerardo; Wünsche, Andrea; Cooper, Tim F

    2016-02-01

    The selective history of a population can influence its subsequent evolution, an effect known as historical contingency. We previously observed that five of six replicate populations that were evolved in a glucose-limited environment for 2000 generations, then switched to lactose for 1000 generations, had higher fitness increases in lactose than populations started directly from the ancestor. To test if selection in glucose systematically increased lactose evolvability, we started 12 replay populations--six from a population subsample and six from a single randomly selected clone--from each of the six glucose-evolved founder populations. These replay populations and 18 ancestral populations were evolved for 1000 generations in a lactose-limited environment. We found that replay populations were initially slightly less fit in lactose than the ancestor, but were more evolvable, in that they increased in fitness at a faster rate and to higher levels. This result indicates that evolution in the glucose environment resulted in genetic changes that increased the potential of genotypes to adapt to lactose. Genome sequencing identified four genes--iclR, nadR, spoT, and rbs--that were mutated in most glucose-evolved clones and are candidates for mediating increased evolvability. Our results demonstrate that short-term selective costs during selection in one environment can lead to changes in evolvability that confer longer term benefits. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

  4. A new paradigm (Westphal-Paradigm) to study the neural correlates of panic disorder with agoraphobia.

    Science.gov (United States)

    Wittmann, A; Schlagenhauf, F; John, T; Guhn, A; Rehbein, H; Siegmund, A; Stoy, M; Held, D; Schulz, I; Fehm, L; Fydrich, T; Heinz, A; Bruhn, H; Ströhle, A

    2011-04-01

    Agoraphobia (with and without panic disorder) is a highly prevalent and disabling anxiety disorder. Its neural complexity can be characterized by specific cues in fMRI studies. Therefore, we developed a fMRI paradigm with agoraphobia-specific stimuli. Pictures of potential agoraphobic situations were generated. Twenty-six patients, suffering from panic disorder and agoraphobia, and 22 healthy controls rated the pictures with respect to arousal, valence, and agoraphobia-related anxiety. The 96 pictures, which discriminated best between groups were chosen, split into two parallel sets and supplemented with matched neutral pictures from the International Affective Picture System. Reliability, criterion, and construct validity of the picture set were determined in a second sample (44 patients, 28 controls). The resulting event-related "Westphal-Paradigm" with cued and uncued pictures was tested in a fMRI pilot study with 16 patients. Internal consistency of the sets was very high; parallelism was given. Positive correlations of picture ratings with Mobility Inventory and Hamilton anxiety scores support construct validity. FMRI data revealed activations in areas associated with the fear circuit including amygdala, insula, and hippocampal areas. Psychometric properties of the Westphal-Paradigm meet necessary quality requirements for further scientific use. The paradigm reliably produces behavioral and fMRI patterns in response to agoraphobia-specific stimuli. To our knowledge, it is the first fMRI paradigm with these properties. This paradigm can be used to further characterize the functional neuroanatomy of panic disorder and agoraphobia and might be useful to contribute data to the differentiation of panic disorder and agoraphobia as related, but conceptually different clinical disorders.

  5. Evolving definitions of hope in oncology.

    Science.gov (United States)

    Olver, Ian N

    2012-06-01

    This review updates the literature on hope and oncology following a prior review of studies up until 2009. It particularly focusses on the evolution of the definition of hope in the light of the clinical experience of patients with cancer, their carers and health professionals. Hope creates meaning for patients and is an important coping mechanism. Clinicians are wary of communicating bad news because it may deprive patients of hope, but work with decision aids suggests that this communication can be managed successfully. Hope and optimism negatively correlate with anxiety and depression. Maintaining hope may result in patients with incurable cancer accepting treatments or trials with little chance of benefit. Hope also needs to be maintained by palliative care nurses who harmonize their hopes with the different degrees and constructs of hope around them. Hope interventions can be successful in increasing hope and decreasing psychological distress. More research is required into how to communicate about active anticancer treatment withdrawal and prognosis without depriving patients with cancer of hope, given how important hope is in alleviating psychological distress. The optimal intervention to increase levels of hope needs further investigation.

  6. Auto/ethnography: A Transformative Research Paradigm

    Directory of Open Access Journals (Sweden)

    Sadruddin Bahadur Qutoshi

    2015-12-01

    Full Text Available This paper aims to address the key question, ‘How far autoethnography contributes towards enriching the field of transformative learning?’ Using my lived experiences as a teacher educator/autoethnographer/researcher and contextualizing self/others within a particular socio-pedagogical life courses I build the basis through addressing questions: Why auto/ethnography is one of the most suitable spaces for transformative researchers and to what extent it serves the agenda of envisioning a transformative teacher education. To achieve this objective I use autobiographies, stories, reflections and poems etc. as narratives with multiple logics and genres; pictography as art-based expression; and ethnography as methodological space within multiparadigmatic design space. In so doing autoethnographer has to delve into whole process of research along a continuum of self and beyond within a particular sociocultural context to understand the phenomena at deeper level of consciousness. This transformative paradigm holds a strong basis in the process of research as: re/reading, re/viewing, critically reflecting on self/others, re/writing for meaning making and developing a subjective understanding of phenomena under exploration. This process of research is found to be an innovative way of knowing through ‘interpreting and constructing (Luitel, 2009within Interpretivism, critically thinking and reflecting within Criticalism, and adding both ‘pluralism and playfulness’ (Taylor, 2013 within Postmodernism. In so doing it raises awareness, develops consciousness and improves capacities constantly that ultimately alters our way of seeing and being in the world differently- a paradigm shift in self/others. It is found to be highly rigorous, dialectically eloquent, dialogically rigorous, critically reflective, consciously awakening, and innovative critical discourse that greatly contributes to transform researcher/s. Therefore, it seems illustrious for

  7. Inevitable suicide: a new paradigm in psychiatry.

    Science.gov (United States)

    Sadock, Benjamin J

    2012-05-01

    The author suggests that a new paradigm may be needed which holds that some suicides may be inevitable. The goal of this paradigm would be to diminish the sense of failure and inadequacy felt by many psychiatrists who experience the suicide of a patient and to increase understanding of the unique biopsychosocial profile of those whose suicides appear to be inevitable. The author stresses that this proposed paradigm should not be misconstrued as therapeutic nihilism but rather should serve to stimulate efforts to treat this patient population more effectively. Risk factors that place individuals at high risk for suicide are reviewed, including presence of a mental illness, genetic predisposition, and factors such as a history of abuse, divorce, unemployment, male gender, recent discharge from a psychiatric hospital, prior suicide attempts, alcohol or other substance abuse, a history of panic attacks, and persistent suicidal thoughts, especially if coupled with a plan. The author notes that, in those suicides that appear to have been inevitable, risk factors are not only numerous but at the extreme end of profound pathology. The example of Ernest Hemingway is used to illustrate how such a combination of risk factors may have contributed to his eventual suicide. Psychiatrists, like other doctors, may have to acknowledge that some psychiatric disorders are associated with a high mortality rate as a natural outcome. This could lead to heightened vigilance, a more realistic view of what can and cannot be achieved with therapy, and efforts to improve the quality of life of patients at high risk for suicide with the goal of reducing this risk and prolonging their lives. (Journal of Psychiatric Practice 2012;18:221-224).

  8. The implications of the new paradigm of dental caries.

    Science.gov (United States)

    Kidd, Edwina

    2011-12-01

    The caries process is the ubiquitous, natural metabolism in the biofilm that causes numerous fluctuations in pH. The interaction of this biofilm with the dental tissues may result in a caries lesion. However, lesion formation and progression can be controlled, particularly by disturbing plaque regularly with a fluoride containing toothpaste. This paradigm implies that everyone with teeth is at risk to lesion development. Treatment of caries is principally non-operative, involving plaque control, fluoride and a sensible diet. Operative dentistry repairs un-cleansable cavities and is part of plaque control. A diagnosis is a mental resting place on the way to a treatment decision. The relevant diagnostic features with respect to caries are lesion activity (active lesions require active management) and un-cleansable cavities. When teaching undergraduates, it is important that they are credited for the non-operative treatment of caries as well as for operative dentistry. This is equally important in dental practice where an appropriate skills mix of the dental team is required to deliver dental health cost-effectively. Training more dentists may be an expensive mistake as far as disease control is concerned. It is ironic that dentists make most money from operative care and specialist treatment when disease control could be delivered relatively cheaply. The key to dental health is regular and effective plaque control with a fluoride containing toothpaste, from cradle to grave. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Infrequent dialysis: a new paradigm for hemodialysis initiation.

    Science.gov (United States)

    Rhee, Connie M; Unruh, Mark; Chen, Jing; Kovesdy, Csaba P; Zager, Phillip; Kalantar-Zadeh, Kamyar

    2013-01-01

    Nearly a half-century ago, the thrice-weekly hemodialysis schedule was empirically established as a means to provide an adequate dialysis dose while also treating the greatest number of end-stage renal disease (ESRD) patients using limited resources. Landmark trials of hemodialysis adequacy have historically been anchored to thrice-weekly regimens, but a recent randomized controlled trial demonstrated that frequent hemodialysis (six times per week) confers cardiovascular and survival benefits. Based on these collective data and experience, clinical practice guidelines advise against a less than thrice-weekly treatment schedule in patients without residual renal function, yet provide limited guidance on the optimal treatment frequency when substantial native kidney function is present. Thus, during the transition from Stage 5 chronic kidney disease to ESRD, the current paradigm is to initiate hemodialysis on a "full-dose" thrice-weekly regimen even among patients with substantial residual renal function. However, emerging data suggest that frequent hemodialysis accelerates residual renal function decline, and infrequent regimens may provide better preservation of native kidney function. Given the high mortality rates during the first 6 months of hemodialysis and the survival benefits of preserved native kidney function, initiation with twice-weekly treatment schedules ("infrequent hemodialysis") with an incremental increase in frequency over time may provide an opportunity to optimize patient survival. This review outlines the clinical benefits of post-hemodialysis residual renal function, studies of twice-weekly treatment regimens, and the potential risks and benefits of infrequent hemodialysis. © 2013 Wiley Periodicals, Inc.

  10. Functional cognitive paradigm in research of metaphor

    Directory of Open Access Journals (Sweden)

    Nahnybida Lyubov Serhiyivna

    2017-07-01

    Full Text Available The article reviews traditional and modern lines of research that contribute revelation of many-sided entity of metaphor. Despite numerous efforts of scrutinizing and systematization of metaphors, there is no far and wide integrated theory that could have included ideas of different approaches. The author identifies main, the most effective researches in classifications of metaphors that give the idea of its place and role within the text and discourse. Functional cognitive paradigm is determinant in metaphor studying and revealing its dual nature.

  11. Chua's circuit a paradigm for chaos

    CERN Document Server

    1993-01-01

    For uninitiated researchers, engineers, and scientists interested in a quick entry into the subject of chaos, this book offers a timely collection of 55 carefully selected papers covering almost every aspect of this subject. Because Chua's circuit is endowed with virtually every bifurcation phenomena reported in the extensive literature on chaos, and because it is the only chaotic system which can be easily built by a novice, simulated in a personal computer, and tractable mathematically, it has become a paradigm for chaos, and a vehicle for illustrating this ubiquitous phenomenon. Its supreme

  12. Social Media Guidelines and the News Paradigm

    DEFF Research Database (Denmark)

    Blumell, Lindsey; Hellmueller, Lea; Etter, Michael

    and if these guidelines challenge the news paradigm. While using social media have been a “loop-hole” of sorts to disseminating political information in countries that have strong censorship (the Arab Spring being a premiere example, Eltantawy & Wiest, 2011; Lotan, Graeff, Ananny, Gaffney, & Pearce, 2011), journalists......Social network use continues to increase in the majority of regions around the world, with a global increase of 17.6% in 2012, and another projected 12.6% in 2014 (digital.org, 2014). Social media have also been incorporated into daily routines of American journalists, with 53.8% reporting...

  13. Three paradigms for the analysis of corruption

    Directory of Open Access Journals (Sweden)

    Alberto Vannucci

    2015-10-01

    Full Text Available In the last decades a growing awareness emerged of the relevance of corruption as an hidden factor which may negatively affect political and economic decision-making processes. In spite of a lively scientific debate there is no general consensus on a commonly accepted definition of what corruption is.The A. distinguishes three main paradigms, focusing on different (though not irreconcilable variables.The first is the economic paradigm, which usually takes the principal-agent model of corruption as its founding pillar. In this paradigm corruption is considered the outcome of rational individual choices, and its spread within a certain organization is influenced by the factors defining the structure of expected costs and rewards.A second approach – the cultural paradigm – looks at the differences in cultural traditions, social norms and interiorized values which shape individuals’ moral preferences and consideration of his social and institutional role. These are a leading forces that can push a corrupt public or private agent (not to violate legal norms.A third neo-institutional approach considers also mechanisms which allow the internal regulation of social interactions within corrupt networks, and their effects on individuals’ beliefs and preferences. Though the corrupt agreements cannot be enforced with legal sanctions, several informal, non-written rules, contractual provisos and conventions may regulate the corrupt exchange between agent and corruptor.The A. underlines that corruption is the outcome of a multitude of individual and collective choices which change public opinion towards corruption and its diffusion throughout the state, markets and civil society. There is no univocal recipe to deal with anti-bribery measures, since corruption is a complex and multifaceted phenomenon.Reforms aimed at dismantling systemic corruption have to be finely tuned against its hidden governance structures, i.e. its internal regulation of

  14. An adaptive paradigm for human space settlement

    Science.gov (United States)

    Smith, Cameron M.

    2016-02-01

    Because permanent space settlement will be multigenerational it will have to be viable on ecological timescales so far unfamiliar to those planning space exploration. Long-term viability will require evolutionary and adaptive planning. Adaptations in the natural world provide many lessons for such planning, but implementing these lessons will require a new, evolutionary paradigm for envisioning and carrying out Earth-independent space settlement. I describe some of these adaptive lessons and propose some cognitive shifts required to implement them in a genuinely evolutionary approach to human space settlement.

  15. Trace elements as paradigms of developmental neurotoxicants

    DEFF Research Database (Denmark)

    Grandjean, Philippe; Herz, Katherine T

    2015-01-01

    Trace elements have contributed unique insights into developmental neurotoxicity and serve as paradigms for such adverse effects. Many trace elements are retained in the body for long periods and can be easily measured to assess exposure by inexpensive analytical methods that became available...... neurotoxicants that provide a reference for other substances that may have similar adverse effects. Less evidence is available on manganese, fluoride, and cadmium, but experience from the former trace elements suggest that, with time, adverse effects are likely to be documented at exposures previously thought...

  16. Modeling Patient Treatment With Medical Records: An Abstraction Hierarchy to Understand User Competencies and Needs.

    Science.gov (United States)

    St-Maurice, Justin D; Burns, Catherine M

    2017-07-28

    Health care is a complex sociotechnical system. Patient treatment is evolving and needs to incorporate the use of technology and new patient-centered treatment paradigms. Cognitive work analysis (CWA) is an effective framework for understanding complex systems, and work domain analysis (WDA) is useful for understanding complex ecologies. Although previous applications of CWA have described patient treatment, due to their scope of work patients were previously characterized as biomedical machines, rather than patient actors involved in their own care. An abstraction hierarchy that characterizes patients as beings with complex social values and priorities is needed. This can help better understand treatment in a modern approach to care. The purpose of this study was to perform a WDA to represent the treatment of patients with medical records. The methods to develop this model included the analysis of written texts and collaboration with subject matter experts. Our WDA represents the ecology through its functional purposes, abstract functions, generalized functions, physical functions, and physical forms. Compared with other work domain models, this model is able to articulate the nuanced balance between medical treatment, patient education, and limited health care resources. Concepts in the analysis were similar to the modeling choices of other WDAs but combined them in as a comprehensive, systematic, and contextual overview. The model is helpful to understand user competencies and needs. Future models could be developed to model the patient's domain and enable the exploration of the shared decision-making (SDM) paradigm. Our work domain model links treatment goals, decision-making constraints, and task workflows. This model can be used by system developers who would like to use ecological interface design (EID) to improve systems. Our hierarchy is the first in a future set that could explore new treatment paradigms. Future hierarchies could model the patient as a

  17. Transmissible Tumors: Breaking the Cancer Paradigm

    OpenAIRE

    Ostrander, Elaine A.; Davis, Brian W.; Ostrander, Gary K.

    2015-01-01

    Transmissible tumors are those that have transcended the bounds of their incipient hosts by evolving the ability to infect another individual through direct transfer of cancer cells; thus becoming parasitic cancer clones. Coitus, biting, and scratching are transfer mechanisms for the two primary species studied, the domestic dog (Canis lupus familiaris) and the Tasmanian devil (Sarcophilus harrisii). Canine transmissible venereal tumors (CTVT) are likely thousands of years old, and have succe...

  18. Evolving roles of circadian rhythms in liver homeostasis and pathology

    Science.gov (United States)

    Chen, Lu; Jia, Leijuan; Yuan, Jie; Sun, Mei; Zhang, Wen; Wang, Peipei; Zuo, Jian; Xu, Zhenyu; Luan, Jiajie

    2016-01-01

    Circadian clock in mammals is determined by a core oscillator in the suprachiasmatic nucleus (SCN) of the hypothalamus and synchronized peripheral clocks in other tissues. The coherent timing systems could sustain robust output of circadian rhythms in response to the entrainment controlled environmentally. Disparate approaches have discovered that clock genes and clock-controlled genes (CCGs) exist in nearly all mammalian cell types and are essential for establishing the mechanisms and complexity of internal time-keeping systems. Accumulating evidence demonstrates that the control of homeostasis and pathology in the liver involves intricate loops of transcriptional and post-translational regulation of clock genes expression. This review will focus on the recent advances with great importance concerning clock rhythms linking liver homeostasis and diseases. We particularly highlight what is currently known of the evolving insights into the mechanisms underlying circadian clock. Eventually, findings during recent years in the field might prompt new circadian-related chronotherapeutic strategies for the diagnosis and treatment of liver diseases by coupling these processes PMID:26843619

  19. New and evolving concepts in CT for abdominal vascular imaging.

    Science.gov (United States)

    Fuentes-Orrego, Jorge M; Pinho, Daniella; Kulkarni, Naveen M; Agrawal, Mukta; Ghoshhajra, Brian B; Sahani, Dushyant V

    2014-01-01

    Computed tomographic (CT) angiography has become the standard of care, supplanting invasive angiography for comprehensive initial evaluation of acute and chronic conditions affecting the vascular system in the abdomen and elsewhere. Over the past decade, the capabilities of CT have improved substantially; simultaneously, the expectations of the referring physician and vascular surgeons have also evolved. Increasingly, CT angiography is used as an imaging biomarker for treatment selection and assessment of effectiveness. However, the growing use of CT angiography has also introduced some challenges, as potential radiation-associated and contrast media-induced risks need to be addressed. These concerns can be partly confronted by modifying scanning parameters (applying a low tube voltage) with or without using software-based solutions. Most recently, multienergy technology has endowed CT with new capabilities offering improved CT angiographic image quality and novel plaque characterization while decreasing radiation and iodine dose. In this article, we discuss current and new approaches using both conventional and multienergy CT for studying vascular disease in the abdomen. We propose various approaches to overcoming commonly encountered image quality challenges in CT angiography. In addition, we describe supplemental strategies for improving patient safety that leverage the available technology. ©RSNA, 2014.

  20. NASA's Space Launch System: An Evolving Capability for Exploration An Evolving Capability for Exploration

    Science.gov (United States)

    Creech, Stephen D.; Crumbly, Christopher M.; Robinson, Kimerly F.

    2016-01-01

    A foundational capability for international human deep-space exploration, NASA's Space Launch System (SLS) vehicle represents a new spaceflight infrastructure asset, creating opportunities for mission profiles and space systems that cannot currently be executed. While the primary purpose of SLS, which is making rapid progress towards initial launch readiness in two years, will be to support NASA's Journey to Mars, discussions are already well underway regarding other potential utilization of the vehicle's unique capabilities. In its initial Block 1 configuration, capable of launching 70 metric tons (t) to low Earth orbit (LEO), SLS is capable of propelling the Orion crew vehicle to cislunar space, while also delivering small CubeSat-class spacecraft to deep-space destinations. With the addition of a more powerful upper stage, the Block 1B configuration of SLS will be able to deliver 105 t to LEO and enable more ambitious human missions into the proving ground of space. This configuration offers opportunities for launching co-manifested payloads with the Orion crew vehicle, and a class of secondary payloads, larger than today's CubeSats. Further upgrades to the vehicle, including advanced boosters, will evolve its performance to 130 t in its Block 2 configuration. Both Block 1B and Block 2 also offer the capability to carry 8.4- or 10-m payload fairings, larger than any contemporary launch vehicle. With unmatched mass-lift capability, payload volume, and C3, SLS not only enables spacecraft or mission designs currently impossible with contemporary EELVs, it also offers enhancing benefits, such as reduced risk, operational costs and/or complexity, shorter transit time to destination or launching large systems either monolithically or in fewer components. This paper will discuss both the performance and capabilities of Space Launch System as it evolves, and the current state of SLS utilization planning.

  1. Pancreatic Ductal Adenocarcinoma: Current and Evolving Therapies

    Directory of Open Access Journals (Sweden)

    Aleksandra Adamska

    2017-06-01

    Full Text Available Pancreatic ductal adenocarcinoma (PDAC, which constitutes 90% of pancreatic cancers, is the fourth leading cause of cancer-related deaths in the world. Due to the broad heterogeneity of genetic mutations and dense stromal environment, PDAC belongs to one of the most chemoresistant cancers. Most of the available treatments are palliative, with the objective of relieving disease-related symptoms and prolonging survival. Currently, available therapeutic options are surgery, radiation, chemotherapy, immunotherapy, and use of targeted drugs. However, thus far, therapies targeting cancer-associated molecular pathways have not given satisfactory results; this is due in part to the rapid upregulation of compensatory alternative pathways as well as dense desmoplastic reaction. In this review, we summarize currently available therapies and clinical trials, directed towards a plethora of pathways and components dysregulated during PDAC carcinogenesis. Emerging trends towards targeted therapies as the most promising approach will also be discussed.

  2. Phantom Limb Pain: Mechanisms and Treatment Approaches

    Science.gov (United States)

    Subedi, Bishnu; Grossberg, George T.

    2011-01-01

    The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain. PMID:22110933

  3. Phantom Limb Pain: Mechanisms and Treatment Approaches

    Directory of Open Access Journals (Sweden)

    Bishnu Subedi

    2011-01-01

    Full Text Available The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain.

  4. Novel Drugs of Abuse: A Snapshot of an Evolving Marketplace

    Science.gov (United States)

    Vandrey, Ryan; Johnson, Matthew W.; Johnson, Patrick S.; Khalil, Miral A.

    2014-01-01

    Background & objectives Over the past decade, non-medical use of novel drugs has proliferated worldwide. In most cases these are synthetic drugs first synthesized in academic or pharmaceutical laboratories for research or drug development purposes, but also include naturally occurring substances that do not fit the typical pharmacological or behavioral profile of traditional illicit substances. Perhaps most unique to this generation of new drugs is that they are being sold over the counter and on the Internet as “legal highs” or substitutes for traditional illicit drugs such as cannabis, cocaine, amphetamines, MDMA, and LSD. The purpose of this review is to provide an overview of novel drugs in current use, including the epidemiology of use and toxicologic and pharmacological properties, and to offer some guidelines to clinicians who see patients experiencing adverse effects from these drugs. Method We review the known scientific literature on recently introduced synthetic drug types, synthetic cannabinoids and synthetic cathinones, and the hallucinogen Salvia divinorum. Results These substances comprise part of a rapidly evolving and controversial drug market that has challenged definitions of what is legal and illegal, has benefitted from open commercial sales without regulatory oversight, and is noteworthy for the pace at which new substances are introduced. Conclusions This emerging trend in substance use presents significant and unique public health and criminal justice challenges. At this time, these substances are not detected in routine drug screens and substance-specific treatment for cases of use-related toxicity are not available. Clinicians are encouraged to learn characteristic signs associated with misuse of novel drugs to recognize cases in their practice, and are recommended to use a symptom-specific approach for treatment in each case. PMID:24921061

  5. Tourism development and the degrowth paradigm

    Directory of Open Access Journals (Sweden)

    Andriotis Konstantinos

    2014-01-01

    Full Text Available This paper aims to look at alternatives to the classic models of development by exploring the paradigm of degrowth in a tourism context. Degrowth touted as an alternative to mainstream paradigms of development, aims to ensure a high quality of life for people in a society where work, production and consumption are reduced. As a weapon to the problems accrued by capitalism, degrowth reorients the current unsustainable and inequitable path through the transition to a smaller economy with less production and consumption. By arguing that natural limits to growth of many destinations have already been surpassed and their carrying capacity levels have been reached, degrowth proposes the abandonment of growth which promotes nothing other than a quest for profits on part of the owners of capital and results in disastrous implications for the environment and the humanity. As a philosophical concept and movement, degrowth is revolutionary and anticapitalist directed to sustainable change which results from an interest in locality and place, small and medium-sized enterprises, employment generation and reduction in working hours, ecology and quality of life, decommodification of tourism activity, carbon reduction in transport, changed pattern of production and consumption, and high priority in the travel experience.

  6. Tolerance of sexual harassment: a laboratory paradigm.

    Science.gov (United States)

    Angelone, David J; Mitchell, Damon; Carola, Kara

    2009-12-01

    The present study attempted to develop a laboratory analogue for the study of tolerance for sexual harassment by using an online speed-dating paradigm. In that context, the relation between participants' sexual harassment attitudes, perpetrator attractiveness, perpetrator status, and perceived dating potential of the perpetrator were examined as factors influencing participants' tolerance of sexually harassing behavior. Participants were 128 female college students from a small northeastern public university. Results indicated that attractiveness, high social status, and attitudinal beliefs about sexual harassment were all predictive of tolerance for sexual harassment, providing preliminary support for the validity of this paradigm. In addition, participants' self reported likelihood to date a bogus male dating candidate was also predictive of tolerance for sexual harassment, over and above the aforementioned variables, suggesting that dating potential can play a role in perceptions of sexual harassment. Further, this experiment demonstrated that perceptions of sexual harassment can be assessed using the in vivo measurement of behavior. In addition, using an online environment not only provides a contemporary spin and adds a greater degree of external validity compared to other sexual harassment analogues, it also reduces any risk of potential physical sexual contact for participants.

  7. Paradigm which will change education of adults

    Directory of Open Access Journals (Sweden)

    Petra Javrh

    2009-12-01

    Full Text Available Modern moment more and more denotes realisation that we will have to change the way of life in order to preserve this planet and culture for descendants. We talk about new paradigm relationship to the world and action, which can by its extent compete with other widest and biggest world’s movements under UNESCO, World health organisation and other international organisations. Movement of endeavours for lasting development is defined and encouraged by series of international documents, accepted in last two decades. They are the result of countries’ efforts and politics which acknowledge the necessity of active uniting of powers and resources, to preserve the planet and ensure future for generations to come. Important vision is a holistic development of a person who is becoming an active and responsible citizen, ready to co-influence important decisions. Usefulness and life knowledges, constructive, critical thinking and cooperation are those components which are necessary for making these decisions and will lead to true long-lasting development. Therefore must be visions and values of lasting development also key component of quality education (UNESCO 2004 in the vertical and all others extensions, also in the lifelong dimension. Theorists predict – practitioners are already experiencing this - that education of adult will have to change innovatively in order to follow the requirements of this paradigm.

  8. Consumers’ Empowerement for a New Marketing Paradigm

    Directory of Open Access Journals (Sweden)

    Victor Danciu

    2013-09-01

    Full Text Available The marketing practices of the companies show that not all of them are observing ethical and moral standards and they manipulate the consumers. This paper has as main goal to examine the most usual unethical techniques, the present status of consumers’ power and how more power could work for a new marketing paradigm. There are many unethical marketing techniques which could be found in deceptive product recipes, packaging, promotion, prices and in other areas. Most consumers have no appropriate powers and tools to counteract the manipulation techniques and feel they have fewer rights than the marketers. The current state of empowerment of the consumer show that the European consumers are not in the best position in the market as the Consumer Empowerment Index proves. This matter of facts emphasizes a strong need for a better empowerment of the consumers. The consumer which has more power and wisely use it could improve the balance of power in the market. But the consumers should have a proactive buying behavior in order to get such results. These revolutionary consumers attack the structural roots of the social, economic and political problems which produces a new market ideology as a part of the new tier of transnational institutional ideology. This consumer behavior may have a strong influence toward a new marketing paradigm.

  9. Towards a New Paradigm in Education

    Directory of Open Access Journals (Sweden)

    Garry Jacobs

    2014-05-01

    Full Text Available A new paradigm in human development must be founded upon a new paradigm in education. A human-centered educational system is needed whose aim is the fullest development of the capacities of each individual. Today humanity is on the cusp of a major transition in education, our most powerful instrument for conscious social evolution. Quality education can now be made universally accessible and affordable. Equally important, future education must be made relevant to the rapidly changing needs of society, the increasingly sophisticated demands of the labor market, the growing shortage of attitudes and skills need to promote entrepreneurship and full employment, the values needed for social harmony and problem solving, and the individuality needed for leadership, independent thinking and creativity. The coming revolution in education spurred by the breakthrough in online learning has made all of these goals achievable. New technology can facilitate a shift from the drudgery of passive knowledge transfer and memorization to the exhilaration of active learning that fosters curiosity, discovery and original thinking. It can also help break down the intellectual boundaries between disciplines, making possible a more comprehensive, transdisciplinary, integrated approach to knowledge. A revolution in higher education is upon us.

  10. New paradigms of Game Theory from globalization

    Directory of Open Access Journals (Sweden)

    Francisco Javier Esquivel

    2015-06-01

    Full Text Available Games Theory constitutes a model by means every player tries to predict what they will make the other players in reply to his own actions, and to optimize the result of the above mentioned actions in his benefit knowing that the others are thinking to about the same form. The development of the theory supposed a boom after the World War II, which happened of analyzing exclusively competitive behaviors to considering situations with competitive and cooperative characteristics. Nevertheless, the advance of the humanity and the disappearance of both geopolitical blocks have eliminated the balance of power and have produced the emergence of a world the most based on the exclusive conquest of the power. This has originated the model change and dilemmas, happening from the most cooperative models (Prisoner’s Dilemma or from the models of the Cold War (Dilemma of the Gallina up to reaching the dilemmas of the Leader or of the Hero. This change of paradigm owes to the extension of the globalization, which originates an immeasurable loss of economic, social, political power, of human rights, which they have affected negatively to the poor people. In this paper is studied the change of paradigm caused by the consequences of the globalization and the geopolitical transformations in a monopolar world, analyzing the consequences on the basis of the Theory of Games.

  11. Passage of American shad: paradigms and realities

    Science.gov (United States)

    Haro, Alex; Castro-Santos, Theodore

    2012-01-01

    Despite more than 250 years of development, the passage of American shad Alosa sapidissima at dams and other barriers frequently remains problematic. Few improvements in design based on knowledge of the swimming, schooling, and migratory behaviors of American shad have been incorporated into passage structures. Large-scale technical fishways designed for the passage of adult salmonids on the Columbia River have been presumed to have good performance for American shad but have never been rigorously evaluated for this species. Similar but smaller fishway designs on the East Coast frequently have poor performance. Provision of effective downstream passage for both juvenile and postspawning adult American shad has been given little consideration in most passage projects. Ways to attract and guide American shad to both fishway entrances and downstream bypasses remain marginally understood. The historical development of passage structures for American shad has resulted in assumptions and paradigms about American shad behavior and passage that are frequently unsubstantiated by supporting data or appropriate experimentation. We propose that many of these assumptions and paradigms are either unfounded or invalid and that significant improvements to American shad upstream and downstream passage can be made via a sequential program of behavioral experimentation, application of experimental results to the physical and hydraulic design of new structures, and controlled tests of large-scale prototype structures in the laboratory and field.

  12. Achieving Operability via the Mission System Paradigm

    Science.gov (United States)

    Hammer, Fred J.; Kahr, Joseph R.

    2006-01-01

    In the past, flight and ground systems have been developed largely-independently, with the flight system taking the lead, and dominating the development process. Operability issues have been addressed poorly in planning, requirements, design, I&T, and system-contracting activities. In many cases, as documented in lessons-learned, this has resulted in significant avoidable increases in cost and risk. With complex missions and systems, operability is being recognized as an important end-to-end design issue. Never-the-less, lessons-learned and operability concepts remain, in many cases, poorly understood and sporadically applied. A key to effective application of operability concepts is adopting a 'mission system' paradigm. In this paradigm, flight and ground systems are treated, from an engineering and management perspective, as inter-related elements of a larger mission system. The mission system consists of flight hardware, flight software, telecom services, ground data system, testbeds, flight teams, science teams, flight operations processes, procedures, and facilities. The system is designed in functional layers, which span flight and ground. It is designed in response to project-level requirements, mission design and an operations concept, and is developed incrementally, with early and frequent integration of flight and ground components.

  13. Colloidal paradigm in supercapattery electrode systems

    Science.gov (United States)

    Chen, Kunfeng; Xue, Dongfeng

    2018-01-01

    Among decades of development, electrochemical energy storage systems are now sorely in need of a new design paradigm at the nano size and ion level to satisfy the higher energy and power demands. In this review paper, we introduce a new colloidal electrode paradigm for supercapattery that integrates multiple-scale forms of matter, i.e. ion clusters, colloidal ions, and nanosized materials, into one colloid system, coupled with multiple interactions, i.e. electrostatic, van der Waals forces, and chemical bonding, thus leading to the formation of many redox reactive centers. This colloidal electrode not only keeps the original ionic nature in colloidal materials, but also creates a new attribute of high electroactivity. Colloidal supercapattery is a perfect application example of the novel colloidal electrode, leading to higher specific capacitance than traditional electrode materials. The high electroactivity of the colloidal electrode mainly comes from the contribution of exposed reactive centers, owing to the confinement effect of carbon and a binder matrix. Systematic and thorough research on the colloidal system will significantly promote the development of fundamental science and the progress of advanced energy storage technology.

  14. Metformin in breast cancer - an evolving mystery.

    Science.gov (United States)

    Camacho, Laura; Dasgupta, Atreyi; Jiralerspong, Sao

    2015-06-26

    Metformin, a diabetes drug with well-established side effect and safety profiles, has been widely studied for its anti-tumor activities in a number of cancers, including breast cancer. But its mechanism of action in the clinical arena remains elusive. In a window of opportunity trial of metformin in non-diabetic breast cancer patients, Dowling and colleagues examined both the direct actions of the drug on cancer cells (as mediated by AMP kinase), as well as its indirect actions (as mediated by circulating insulin). The data suggest that short-term administration of metformin in this setting has anti-tumor effects significantly involving the indirect, insulin-dependent pathway. The role of the direct pathway remains to be determined. This study represents an important step forward in establishing one of several possible mechanisms for metformin, information that will be useful in determining candidate biomarkers to evaluate in large clinical trials of metformin, such as the ongoing NCIC CTG MA.32 trial of adjuvant metformin. The potential significance of these data for metformin in the treatment of breast cancer is discussed here.

  15. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

    The main goal of this study is to utilize a natural low cost material “as an accelerator additive to enhance the chemical treatment process using Alum coagulant and the accelerator substances were Perlite and Bentonite. The performance of the chemical treatment was enhanced using the accelerator substances with 90 mg/l Alum as a constant dose. Perlite gave better performance than the Bentonite effluent. The removal ratio for conductivity, turbidity, BOD and COD for Perlite was 86.7%, 87.4%, 89.9% and 92.8% respectively, and for Bentonite was 83.5%, 85.0%, 86.5% and 85.0% respectively at the same concentration of 40 mg/l for each.

  16. Self-Evolvable Systems Machine Learning in Social Media

    CERN Document Server

    Iordache, Octavian

    2012-01-01

    This monograph presents key method to successfully manage the growing  complexity of systems  where conventional engineering and scientific methodologies and technologies based on learning and adaptability come to their limits and new ways are nowadays required. The transition from adaptable to evolvable and finally to self-evolvable systems is highlighted, self-properties such as self-organization, self-configuration, and self-repairing are introduced and challenges and limitations of the self-evolvable engineering systems are evaluated.

  17. Matrotrophy and placentation in invertebrates: a new paradigm.

    Science.gov (United States)

    Ostrovsky, Andrew N; Lidgard, Scott; Gordon, Dennis P; Schwaha, Thomas; Genikhovich, Grigory; Ereskovsky, Alexander V

    2016-08-01

    Matrotrophy, the continuous extra-vitelline supply of nutrients from the parent to the progeny during gestation, is one of the masterpieces of nature, contributing to offspring fitness and often correlated with evolutionary diversification. The most elaborate form of matrotrophy-placentotrophy-is well known for its broad occurrence among vertebrates, but the comparative distribution and structural diversity of matrotrophic expression among invertebrates is wanting. In the first comprehensive analysis of matrotrophy across the animal kingdom, we report that regardless of the degree of expression, it is established or inferred in at least 21 of 34 animal phyla, significantly exceeding previous accounts and changing the old paradigm that these phenomena are infrequent among invertebrates. In 10 phyla, matrotrophy is represented by only one or a few species, whereas in 11 it is either not uncommon or widespread and even pervasive. Among invertebrate phyla, Platyhelminthes, Arthropoda and Bryozoa dominate, with 162, 83 and 53 partly or wholly matrotrophic families, respectively. In comparison, Chordata has more than 220 families that include or consist entirely of matrotrophic species. We analysed the distribution of reproductive patterns among and within invertebrate phyla using recently published molecular phylogenies: matrotrophy has seemingly evolved at least 140 times in all major superclades: Parazoa and Eumetazoa, Radiata and Bilateria, Protostomia and Deuterostomia, Lophotrochozoa and Ecdysozoa. In Cycliophora and some Digenea, it may have evolved twice in the same life cycle. The provisioning of developing young is associated with almost all known types of incubation chambers, with matrotrophic viviparity more widespread (20 phyla) than brooding (10 phyla). In nine phyla, both matrotrophic incubation types are present. Matrotrophy is expressed in five nutritive modes, of which histotrophy and placentotrophy are most prevalent. Oophagy, embryophagy and

  18. Evaluation at half treatment of the response to chemotherapy by PET with {sup 18}F-F.D.G. in the locally evolved cancers of esophagus; Evaluation a mi-traitement de la reponse a la chimioradiotherapie par TEP au 18F-FDG dans les cancers de l'oesophage localement evolues

    Energy Technology Data Exchange (ETDEWEB)

    Moretti, J.L.; Hindie, E.; Teyton, P. [Service de medecine nucleaire, hopital Saint-Louis, Paris, (France); Maylin, C.; Quero, L.; Cuenca, X.; Hennequin, C. [service de cancerologie et radiotherapie, hopital Saint-Louis, Paris, (France)

    2009-05-15

    The evaluation of the response to chemo-radiotherapy in the esophagus cancers could give directions for the therapy decision towards surgery or continuation of chemo-radiotherapy. The conclusions are that the {sup 18}F.D.G. PET-T.D.M. can help the early evaluation of the response to chemo-radiotherapy in the locally evolved esophagus cancers but cannot take the place single-handedly to the endoscopic and radiological evaluation. The three examinations are complementary to the decision of an eventual surgery after chemo-radiotherapy. (N.C.)

  19. Simulation Support: Prototyping the Automation-Based Paradigm

    OpenAIRE

    Balci, Osman; Nance, Richard E.

    1987-01-01

    This paper describes our research efforts in prototyping the automation-based software paradigm to provide automated support for discrete-event simulation model development. The automation-based paradigm has been suggested as the software technology in the 1990's. The technology needed to support this paradigm does not yet exist. However, the benefits to be gained are so significant that, if achieved, it could profoundly change the way that simulation models are developed. We have been workin...

  20. Triple Track: A New Paradigm for Developing Air Force Officers

    Science.gov (United States)

    2017-03-06

    AIR WAR COLLEGE AIR UNIVERSITY TRIPLE TRACK: A NEW PARADIGM FOR DEVELOPING AIR FORCE OFFICERS by Tracy N. Hunter, Lieutenant...their careers in order to possess the skills to effectively integrate capabilities across the joint force.5 The AF needs to alter the paradigm on...same time developing officers who can integrating elements across multiple domains. This new paradigm will encourage a focus on officer