Hathaway, M; Seltman, K
Mayo Clinic has a long international history and has been providing care to international patients since its inception. Despite its history and reputation, however, the marketing staff continues to monitor the international market to gauge the level of awareness, reputation, and attractiveness of Mayo Clinic around the world. Here's a look at how one institution has used word-of-mouth marketing to maintain its global reputation.
Swensen, Stephen J; Dilling, James A; Harper, C Michel; Noseworthy, John H
The authors present Mayo Clinic's Value Creation System, a coherent systems engineering approach to delivering a single high-value practice. There are 4 tightly linked, interdependent phases of the system: alignment, discovery, managed diffusion, and measurement. The methodology is described and examples of the results to date are presented. The Value Creation System has been demonstrated to improve the quality of patient care while reducing costs and increasing productivity.
Wald, John T; Lowery-Schrandt, Sherri; Hayes, David L; Kotsenas, Amy L
By leveraging its experience and expertise as a consultative clinical partner, the Mayo Clinic developed an innovative, scalable care model to accomplish several strategic goals: (1) create and sustain high-value relationships that benefit patients and providers, (2) foster relationships with like-minded partners to act as a strategy against the development of narrow health care networks, and (3) increase national and international brand awareness of Mayo Clinic. The result was the Mayo Clinic Care Network. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Full Text Available Individualized medicine enables better diagnoses and treatment decisions for patients and promotes research in understanding the molecular underpinnings of disease. Linking individual patient’s genomic and molecular information with their clinical phenotypes is crucial to these efforts. To address this need, the Center for Individualized Medicine at Mayo Clinic has implemented a genomic data warehouse and a workflow management system to bring data from institutional electronic health records and genomic sequencing data from both clinical and research bioinformatics sources into the warehouse. The system is the foundation for Mayo Clinic to build a suite of tools and interfaces to support various clinical and research use cases. The genomic data warehouse is positioned to play a key role in enhancing the research capabilities and advancing individualized patient care at Mayo Clinic.
Horton, Iain; Lin, Yaxiong; Reed, Gay; Wiepert, Mathieu; Hart, Steven
Individualized medicine enables better diagnoses and treatment decisions for patients and promotes research in understanding the molecular underpinnings of disease. Linking individual patient's genomic and molecular information with their clinical phenotypes is crucial to these efforts. To address this need, the Center for Individualized Medicine at Mayo Clinic has implemented a genomic data warehouse and a workflow management system to bring data from institutional electronic health records and genomic sequencing data from both clinical and research bioinformatics sources into the warehouse. The system is the foundation for Mayo Clinic to build a suite of tools and interfaces to support various clinical and research use cases. The genomic data warehouse is positioned to play a key role in enhancing the research capabilities and advancing individualized patient care at Mayo Clinic.
Kuchera, Dustin; Rohleder, Thomas R
In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.
Forbes, Glenn S.; Morin, Richard L.; Pavlicek, William
A joint project between Mayo Clinic and IBM to develop a picture archival and communications system has been under development for three years. This project began as a potential solution to a pressing archival problem in magnetic resonance imaging. The project has grown to encompass a much larger sphere of activity including workstations, image retrieval, and report archival. This report focuses on the clinical aspects involved in the design, development, and implementation of such a system. In particular, emphasis is placed on the clinical impact of the system both inside and outside of the radiology department. The primary concerns have centered on fidelity of archival data, ease of use, and diagnostic efficacy. The project to date has been limited to neuroradiology practice. This group consists of nine staff radiologists and fellows. Administrative policy decisions regarding the accessibility and available of digital data in the clinical environment have been much more difficult and complex than originally conceived. Based on the observations thus far, the authors believe the system will become a useful and valuable adjunct to clinical practice of radiology.
Full Text Available Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.
Joglekar, Siddharth B.; Rose, Peter S.; Sim, Franklin; Okuno, Scott; Petersen, Ivy
Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation
Weatherby, R.P.; Dahlin, D.C.; Ivins, J.C.
Postradiation sarcoma of bone is an uncommon but serious sequela of radiation therapy. Seventy-eight Mayo Clinic patients have been treated for sarcomas arising in irradiated bones. They received their initial radiotherapy for a wide variety of nonneoplastic and neoplastic conditions, both benign and malignant. Thirty-five sarcomas arose in bone that was normal at the time of radiotherapy, and 43 arose in irradiated preexisting osseous lesions. The latent period between radiotherapy and diagnosis of sarcoma averaged 14.3 years. Ninety percent of the postradiation sarcomas were either osteosarcomas or fibrosarcomas; chondrosarcoma, malignant (fibrous) histiocytoma, malignant lymphoma, Ewing's tumor, and metastasizing chondroblastoma also occurred. Prompt radical surgery, when feasible, is usually the treatment of choice for the sarcoma. About 30% of patients with sarcomas of the extremities or craniofacial bones survived 5 years without recurrence; there were no disease-free survivors among patients with tumors of the vertebral column, pelvis, or shoulder girdle. The low risk of sarcoma following radiotherapy for the treatment of cancer should not be a contraindication to its use in these patients; however, radiation therapy for benign bone tumors should be reserved for lesions that are not amenable to surgical treatment. An unusual case is also reported herein in which a fibrosarcoma was discovered in the humerus of a patient who had received radiotherapy 55 years previously for a verified osteosarcoma in the same site.
Weatherby, R.P.; Dahlin, D.C.; Ivins, J.C.
Postradiation sarcoma of bone is an uncommon but serious sequela of radiation therapy. Seventy-eight Mayo Clinic patients have been treated for sarcomas arising in irradiated bones. They received their initial radiotherapy for a wide variety of nonneoplastic and neoplastic conditions, both benign and malignant. Thirty-five sarcomas arose in bone that was normal at the time of radiotherapy, and 43 arose in irradiated preexisting osseous lesions. The latent period between radiotherapy and diagnosis of sarcoma averaged 14.3 years. Ninety percent of the postradiation sarcomas were either osteosarcomas or fibrosarcomas; chondrosarcoma, malignant (fibrous) histiocytoma, malignant lymphoma, Ewing's tumor, and metastasizing chondroblastoma also occurred. Prompt radical surgery, when feasible, is usually the treatment of choice for the sarcoma. About 30% of patients with sarcomas of the extremities or craniofacial bones survived 5 years without recurrence; there were no disease-free survivors among patients with tumors of the vertebral column, pelvis, or shoulder girdle. The low risk of sarcoma following radiotherapy for the treatment of cancer should not be a contraindication to its use in these patients; however, radiation therapy for benign bone tumors should be reserved for lesions that are not amenable to surgical treatment. An unusual case is also reported herein in which a fibrosarcoma was discovered in the humerus of a patient who had received radiotherapy 55 years previously for a verified osteosarcoma in the same site
Chute, Christopher G; Beck, Scott A; Fisk, Thomas B; Mohr, David N
Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions.
Coelen, Robert J. S.; Gaspersz, Marcia P.; Labeur, Tim A.; van Vugt, Jeroen L. A.; van Dieren, Susan; Willemssen, François E. J. A.; Nio, Chung Y.; Ijzermans, Jan N. M.; Klümpen, Heinz-Josef; Groot Koerkamp, Bas; van Gulik, Thomas M.
BACKGROUND & AIMS: Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiologic variables, but has not yet been validated. We
Rayan, Tarek; Carlson, Matthew L; Piepgras, David G; Link, Michael J; Van Gompel, Jamie J
Dr Albert L. Rhoton Jr became the focal point of neurosurgery's evolution in understanding the intricate and complex microanatomy of the human brain over the last 4 decades. His pioneering work on cadaveric specimens proved to be a pivotal endeavor in the pursuit to better understand the complex microsurgical anatomy of cranial surgery. This paper details his early career at the Mayo Clinic in Rochester, Minnesota. A comprehensive review and synthesis of data acquired from the institutional historical archives including the Annual Reports to the Executive Committee, the Reports to the Board of Directors, the MAYOVOX Newsletter, the illustration archives of the Mayo Clinic Division of Creative Media, staff biographies, curriculum vitae, personal interviews, as well as full-text journal articles, and book publications was performed. Dr Rhoton was engaged in a busy clinical practice as a young staff at the Mayo Clinic. Records show he focused on tackling complex intracranial pathologies along with numerous basic research and neuroanatomy projects that became a major part of his life's work and passion. He was a great teacher and friend to countless individuals and his work will continue to impact and improve the care provided to neurosurgery patients for generations to come. Copyright © 2017 by the Congress of Neurological Surgeons.
Full Text Available Joshua Faucher,1 Jordan Rosedahl,2 Dawn Finnie,3 Amy Glasgow,3 Paul Takahashi4 1Mayo Medical School, Mayo Clinic College of Medicine, 2Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, 3Center for the Science of Health Care Delivery, 4Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA Background: Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL. Aims: To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods: A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results: MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16. Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21. Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant
McJoynt, Terre A; Hirzallah, Muhanad A; Satele, Daniel V; Pitzen, Jason H; Alberts, Steven R; Rajkumar, S Vincent
Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.
Fottler, Myron D; Erickson, Eric; Rivers, Patrick A
Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions. This article shows how Mayo Clinic uses the popular Balanced Scorecard approach to align its measures of HR performance to the organization's strategic plan.
Curtright, J W; Stolp-Smith, S C; Edell, E S
Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.
Wright, James R
Malcolm B. Dockerty and Lewis B. Woolner, 2 preeminent mid-20th-century surgical pathologists, spent their entire careers at the Mayo Clinic. Both were raised in poverty on potato farms only 49 miles apart in Canada's smallest province (Prince Edward Island); both were educated in 1-room schools and graduated as gold medalists from Prince Edward Island's only college and then from Maritime Canada's only medical school; both then trained at the Mayo Clinic. To explore the lives and accomplishments of these 2 important surgical pathologists. Standard historiographic methods were used to explore primary and secondary historical sources. Both became world-renowned general surgical pathologists, one developing subspecialty expertise in gynecologic pathology and the other in cytopathology, pulmonary pathology, and thyroid/parathyroid pathology. Both were prolific authors with h-indices higher than 40, and between them, they published more than 750 peer-reviewed papers and book chapters. As educators, they trained hundreds of pathology and surgery residents/fellows who disseminated their knowledge around the world. Both were fascinated by poetry from childhood and could quote the classics from memory. One wrote poetry throughout his entire life and even used it to teach pathology and serve as his memoir; the other strongly preferred the classics and in jest called his colleague "a (minor) poet." Both received postretirement honorary doctorates from their alma maters. Dockerty died in 1987; Woolner celebrates his 100th birthday on November 17, 2013. Every pathologist should know of these 2 pioneering surgical pathologists.
Tefferi, Ayalew; Gangat, Naseema; Mudireddy, Mythri; Lasho, Terra L; Finke, Christy; Begna, Kebede H; Elliott, Michelle A; Al-Kali, Aref; Litzow, Mark R; Hook, C Christopher; Wolanskyj, Alexandra P; Hogan, William J; Patnaik, Mrinal M; Pardanani, Animesh; Zblewski, Darci L; He, Rong; Viswanatha, David; Hanson, Curtis A; Ketterling, Rhett P; Tang, Jih-Luh; Chou, Wen-Chien; Lin, Chien-Chin; Tsai, Cheng-Hong; Tien, Hwei-Fang; Hou, Hsin-An
To develop a new risk model for primary myelodysplastic syndromes (MDS) that integrates information on mutations, karyotype, and clinical variables. Patients with World Health Organization-defined primary MDS seen at Mayo Clinic (MC) from December 28, 1994, through December 19, 2017, constituted the core study group. The National Taiwan University Hospital (NTUH) provided the validation cohort. Model performance, compared with the revised International Prognostic Scoring System, was assessed by Akaike information criterion and area under the curve estimates. The study group consisted of 685 molecularly annotated patients from MC (357) and NTUH (328). Multivariate analysis of the MC cohort identified monosomal karyotype (hazard ratio [HR], 5.2; 95% CI, 3.1-8.6), "non-MK abnormalities other than single/double del(5q)" (HR, 1.8; 95% CI, 1.3-2.6), RUNX1 (HR, 2.0; 95% CI, 1.2-3.1) and ASXL1 (HR, 1.7; 95% CI, 1.2-2.3) mutations, absence of SF3B1 mutations (HR, 1.6; 95% CI, 1.1-2.4), age greater than 70 years (HR, 2.2; 95% CI, 1.6-3.1), hemoglobin level less than 8 g/dL in women or less than 9 g/dL in men (HR, 2.3; 95% CI, 1.7-3.1), platelet count less than 75 × 10 9 /L (HR, 1.5; 95% CI, 1.1-2.1), and 10% or more bone marrow blasts (HR, 1.7; 95% CI, 1.1-2.8) as predictors of inferior overall survival. Based on HR-weighted risk scores, a 4-tiered Mayo alliance prognostic model for MDS was devised: low (89 patients), intermediate-1 (104), intermediate-2 (95), and high (69); respective median survivals (5-year overall survival rates) were 85 (73%), 42 (34%), 22 (7%), and 9 months (0%). The Mayo alliance model was subsequently validated by using the external NTUH cohort and, compared with the revised International Prognostic Scoring System, displayed favorable Akaike information criterion (1865 vs 1943) and area under the curve (0.87 vs 0.76) values. We propose a simple and contemporary risk model for MDS that is based on a limited set of genetic and clinical variables
Andreen, Debra L; Dobie, Linda J; Jasperson, Jan C; Lucas, Thomas A; Wubbenhorst, Cathryn L
This article describes the conversion to electronic hospital notes at a large, multi-specialty group practice: Mayo Clinic in Rochester, Minnesota. Because of the size of the institution and the barriers to the adoption of electronic notes, the process was a gradual one that took several years. Making a convincing case for change to institutional leaders and maintaining their support was crucial to success. Equally vital was the careful investigation of user requirements and the development of software features that allowed providers to complete their notes quickly in the fast-paced hospital environment. Care providers discovered the value of having immediate access to legible hospital notes throughout the campus and from remote locations.
Kotsenas, Amy L; Aase, Lee; Arce, Makala; Timimi, Farris K; Dacy, Matthew; Young, Colleen; Wald, John T
Hippocrates' admonition and the medical community's aversion to risk have caused many physicians and institutions to resist participation in modern social media sites such as Facebook (Facebook, Inc, Menlo Park, California, USA), Twitter (Twitter Inc, San Francisco, California, USA), and YouTube (San Mateo, California, USA). However, because Mayo Clinic's founders were champions of analog social networking, it was among the earliest hospitals worldwide to create official accounts on these digital platforms. A proper understanding of the traditional mechanisms of knowledge diffusion in medicine and of the nature of social media sites should help professionals see and embrace the opportunities for positive engagement in social media. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Patel, Alpen B; Bansberg, Stephen F; Adler, Charles H; Lott, David G; Crujido, Lisa
Analyze demographic data collected over a 25-year experience of 718 patients with spasmodic dysphonia (SD) who have been treated with botulinum toxin-A (BoNT-A) and compare our data with previously published studies. Seven hundred eighteen patients with SD were treated with 6621 BoNT-A injections at Mayo Clinic Arizona between 1989 and 2014. All patients were treated by the same physician team. Background demographic data for each patient were recorded. Of 718 patients, 557 patients were female (77.6%). Six hundred sixty of 718 (91.8%) patients had adductor SD (AdSD), and 58 of 718 (8.1%) patients had abductor SD (AbSD). Average age of onset was 51 years. Of 718 patients, 378 (52.6%) had vocal tremor (VT); VT was present in 54.4% of AdSD patients and 32.1% of AbSD patients. Thirty-seven of 718 (5.2%) patients had other dystonias, including cervical dystonia (2.3%), blepharospasm (1.4%), limb dystonia (1.1%), and oromandibular dystonia (0.3%). A positive family history of SD was present in only 6 of 718 patients (0.8%) and of other dystonias in 11 of 718 patients (1.5%). Spasmodic dysphonia is a chronic and potentially disabling focal laryngeal dystonia. The Mayo Clinic Arizona SD experience compares to prior reports and reveals a female preponderance, onset in middle age, infrequent hereditary pattern, high co-occurrence of VT, and low co-occurrence of other dystonias. © The Author(s) 2015.
Malec, James F; Kean, Jacob; Monahan, Patrick O
To determine the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) as measures of response to intervention. Retrospective analysis of existing data. Both distribution- and anchor-based methods were used to triangulate on the MCID and to identify a moderate, that is, more robust, level of change (RCID) for the MPAI-4. These were further evaluated with respect to clinical provider ratings. Data for individuals with acquired brain injury in rehabilitation programs throughout the United States in the OutcomeInfo Database (n = 3087) with 2 MPAI-4 ratings. MPAI-4, Supervision Rating Scale, Clinician Rating of Global Clinical Improvement. Initial analyses suggested 5 T-score points (5T) as the MCID and 9T as the RCID. Eighty-one percent to 87% of clinical raters considered a 5T change and 99% considered a 9T change to indicate meaningful improvement. 5T represents the MCID for the MPAI-4 and 9T, the RCID. Both values are notably less than the Reliable Change Index (RCI). While the RCI indicates change with a high level of statistical confidence, it may be insensitive to change that is considered meaningful by providers and participants as indicated by the MCID.
Tolkachjov, Stanislav N; Hocker, Thomas L; Hochwalt, Phillip C; Camilleri, Michael J; Arpey, Christopher J; Brewer, Jerry D; Otley, Clark C; Roenigk, Randall K; Baum, Christian L
Hidradenocarcinoma (HAC) is a rare malignant adnexal neoplasm with reported metastatic potential and undefined optimal treatment. To review clinical characteristics and outcomes of patients with HAC treated with Mohs micrographic surgery (MMS). The authors performed a retrospective chart review of patients with HAC treated by MMS at Mayo Clinic from 1993 to 2013, recording patient demographics, tumor characteristics, MMS stages to clearance, follow-up, recurrence, metastasis, and mortality. Ten patients underwent MMS for HAC more than 20 years. The average age was 62.8 years, with 6 females and 4 males. Occipital scalp was the most common location (40%), followed by extremities (30%) and face (20%). In 5 of 7 cases (71%), "cyst" was the working clinical diagnosis. The average preoperative lesion area was 3.18 cm, with an average of 1.5 MMS stages required for clearance. Mean postoperative follow-up was 7 years (range, 5-205 months). No tumors treated with MMS recurred, metastasized, or led to disease-related mortality. Mohs micrographic surgery seems to be a useful treatment modality for HAC. This is the largest reported series of HAC treated with MMS with long-term follow-up.
Romak, Jonathan J; Neel, H Bryan; Ekbom, Dale C
The aim of this study was to clarify the nature of laryngeal schwannomas through review of the experience of a single institution during a 104-year period. This is a retrospective case series. The Mayo Clinic, Rochester, Minnesota clinical and surgical pathology database was reviewed for the years 1985-2011. Four cases of laryngeal schwannoma were identified. These cases were pooled with a previously published series of laryngeal schwannomas treated at our institution between 1907 and 1986. The characteristics of all 11 cases were studied, and relevant literature was reviewed. A total of 11 cases of schwannoma of the larynx were identified. The mean age at presentation was 48 years (range 12-73 years). The most common presenting symptoms were dysphonia and dysphagia. The most frequently involved primary site was the false vocal fold (six patients), followed by the aryepiglottic fold (three), epiglottis (two), subglottis (two), ventricle (one), true vocal fold (one) and postcricoid region (one). The mean maximal tumor diameter was 2.5 cm. In all but one case, surgical excision was curative with no recurrence during recorded follow up ranging from 1 to 17 years. Laryngeal schwannomas, although rare, should be considered in the differential diagnosis of laryngeal tumors. They occur most frequently in the false vocal fold and present most commonly with dysphonia and/or dysphagia. Surgical excision is the treatment of choice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Fahy, Caoimhe M R; Torgerson, Rochelle R; Davis, Mark D P
Genital or vulval lichen planus (VLP) may have a disabling effect on a patient's quality of life. Evidence-based management guidelines are lacking for VLP. We sought to review clinical presentation and treatment of patients who received a diagnosis of VLP. The 100 consecutive patients who received a diagnosis of VLP at Mayo Clinic between January 1, 1997, and December 31, 2015, were reviewed retrospectively. Descriptive statistics were used for data analysis. Fisher's exact test and the Wilcoxon rank sum test were used for analysis of categorical and continuous variables, respectively. All statistical tests were 2 sided, with the α level set at .05 for statistical significance. The time to diagnosis for 49% of patients was more than 1 year. Three patients (3%) had vulval dysplasia, including invasive squamous cell carcinoma. Sixty-eight patients (68%) had multisite lichen planus disease. Eleven patients (11%) had disease remission. Dermatology was the lead specialty for 9 of these cases of remission. This was a retrospective, small-cohort study. A low frequency of disease remission was seen in patients with VLP. Patients with lichen planus benefit considerably from dermatology consultation. Further research is warranted to establish high-quality, evidence-based guidelines for multidisciplinary management of this challenging disease. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Narang, Amol K; Haddock, Michael G; Donohue, John H; Schulick, Richard D; Wolfgang, Christopher L; Cameron, John L; Herman, Joseph M; Miller, Robert C; Hsu, Charles C; Bhatia, Sumita; Pawlik, Timothy M; Laheru, Dan; Hruban, Ralph H; Zhou, Jessica; Winter, Jordan M
The role of adjuvant chemoradiation therapy for ampullary carcinoma is unknown. Previous literature suggests that certain populations with high risk factors for recurrence may benefit from adjuvant chemoradiation. We combined the experience of two institutions to better delineate which patients may benefit from adjuvant chemoradiation. Patients who underwent curative surgery for ampullary carcinoma at the Johns Hopkins Hospital (n = 290; 1992-2007) and at the Mayo Clinic (n = 130; 1977-2005) were reviewed. Patients with <60 days of follow-up, metastatic disease at surgery, or insufficient pathologic data were excluded. The final combined study consisted of 186 patients (n = 104 Johns Hopkins, n = 82 Mayo). Most patients received 5-FU based chemoradiation with conformal radiation. Cox proportional hazards models were used for survival analysis. Median overall-survival was 39.9 months with 2- and 5-year survival rates of 62.4% and 39.1%. On univariate analysis, adverse prognostic factors for overall survival included T3/T4 stage disease (RR = 1.86, p = 0.002), node positive status (RR = 3.18, p < 0.001), and poor histological grade (RR = 1.69, p = 0.011). Patients who received adjuvant chemoradiation (n = 66) vs. surgery alone (n = 120) showed a higher rate of T3/T4 stage disease (57.6% vs. 30.8%, P < 0.001), lymph node involvement (72.7% vs. 30.0%, P < 0.001), and close or positive margins (4.6% vs. 0.0%, P = 0.019). Five year survival rates among node negative and node positive patients were 58.7% and 18.4% respectively. When compared with surgery alone, use of adjuvant chemoradiation improved survival among node positive patients (mOS 32.1 vs. 15.7 mos, 5 yr OS: 27.5% vs. 5.9%; RR = 0.47, P = 0.004). After adjusting for adverse prognostic factors on multivariate analysis, patients treated with adjuvant chemoradiation demonstrated a significant survival benefit (RR = 0.40, P < 0.001). Disease relapse occurred in 37.1% of all patients, most commonly metastatic
Richter, Michael D; Pinkston, Olga; Kottschade, Lisa A; Finnes, Heidi D; Markovic, Svetomir N; Thanarajasingam, Uma
To determine the risk of rheumatic disease flare and adverse effects in patients with preexisting rheumatic disease who were receiving immune checkpoint inhibitor (ICI) therapy. A retrospective medical record review was performed to identify all patients who received ICI therapy at Mayo Clinic in Rochester, Minnesota between 2011 and 2016 (~700 patients). Those with a preexisting rheumatic disease were identified using specific diagnostic codes. Sixteen patients were identified (81% female, median age 68.5 years). The most common rheumatic diseases were rheumatoid arthritis (n = 5), polymyalgia rheumatica (n = 5), Sjögren's syndrome (n = 2), and systemic lupus erythematosus (n = 2). Seven patients were receiving immunosuppressive therapy or glucocorticoids for their rheumatic disease at the time of initiation of the ICI. The primary malignancies were melanoma (n = 10), pulmonary (n = 4), or hematologic (n = 2). In most cases, ICIs were offered only after failure of several other therapies. Immune-related adverse effects (IRAEs) occurred in 6 patients, and all were treated successfully with glucocorticoids and discontinuation of the ICI therapy. There were no significant differences in time from cancer diagnosis to immunotherapy, duration of immunotherapy, age, or sex between the patients with and those without IRAEs. To our knowledge, this represents the largest single-center cohort of patients with rheumatic diseases who were exposed to modern cancer immunotherapy. Only a minority of these patients experienced a flare of their preexisting rheumatic disease or any other IRAE. © 2017, American College of Rheumatology.
Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S
Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.
Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael
Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
LaRusso, Nicholas; Farrugia, Gianrico
The Only Innovation Guide You Will Ever Need--from the Award-Winning Minds at Mayo Clinic. A lot of businesspeople talk about innovation, but few companies have achieved the level of truly transformative innovation as brilliantly--or as famously--as the legendary Mayo Clinic. Introducing Think Big, Start Small, Move Fast, the first innovation guide based on the proven, decade-long program that’s made Mayo Clinic one of the most respected and successful organizations in the world. This essential must-have guide shows you how to: Inspire and ignite trailblazing innovation in your workplace Design a new business model that’s creative, collaborative, and sustainable Apply the traditional scientific method to the latest innovations in "design thinking" Build a customized toolkit of the best practices, project portfolios, and strategies Increase your innovation capacity--and watch how quickly you succeed These field-tested techniques grew out of the health care industry but are designed ...
Gamez, Mauricio E; Jeans, Elizabeth; Hinni, Michael L; Moore, Eric; Young, Geoffrey; Ma, Daniel; McGee, Lisa; Buras, Matthew R; Patel, Samir H
Sarcomatoid carcinoma is a rare variant of squamous cell carcinoma of the head and neck. No consensus exists on its management. Our aim was to present our outcomes. Retrospective study. Median follow-up 45 months. There were 38 patients with pathologically confirmed sarcomatoid carcinoma of the larynx treated at the Mayo Clinic from 1990 to 2014. Statistical analysis of overall survival (OS), progression-free survival (PFS), and local control (LC) were conducted using the Kaplan-Meier method. The majority of patients were elderly males (92%) with a smoking history (74%) presenting with early-stage disease (71%). Surgery alone was the primary treatment in 27 patients (71%). Nine patients (25%) were treated with adjuvant radiation due to initial stage or high-risk pathologic features. Median radiation dose to the primary/surgical bed was 65 Gy (range, 60.3-75.0 Gy). A total of 15 patients (39%) had tumor recurrence, majority being local (n = 12). Sixty percent (n = 9) had multiple local recurrences. Five-year OS, PFS, and LC were 63%, 46%, and 72%, respectively. Subgroup analysis by stage I versus higher stages (II-IV) showed an OS of 80% versus 43% (P = .030), PFS of 65% versus 18% (P = .003), and LC of 84% versus 57% (P = .039). Sarcomatoid carcinoma of the larynx is rare, and frequently presents at an early stage in older men with history of smoking. Based on our outcomes and patterns of failure, it appears early-stage tumors are treated appropriately with single-modality therapy, whereas more advanced tumors require multimodality therapy. Validation in a larger cohort is warranted. 4. Laryngoscope, 128:373-377, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
M. A. C. Onuigbo
Full Text Available Despite decades of research, a full understanding of chronic kidney disease (CKD-end stage renal disease (ESRD progression remains elusive. The common consensus is a predictable, linear, progressive and time-dependent decline of CKD to ESRD. Acute kidney injury (AKI on CKD is usually assumed to be transient, with recovery as the expected outcome. AKI-ESRD association in current nephrology literature is blamed on the so-called "residual confounding." We had previously described a relationship between AKI events and rapid onset yet irreversible ESRD happening in a continuum in a high-risk CKD cohort. However, the contribution of the syndrome of rapid onset-ESRD (SORO-ESRD to incident United States ESRD population remained conjectural. In this retrospective analysis, we analyzed serum creatinine trajectories of the last 100 consecutive ESRD patients in 4 Mayo Clinic chronic hemodialysis units to determine the incidence of SORO-ESRD. Excluding 9 patients, 31 (34% patients, including two renal transplant recipients, had SORO-ESRD: 18 males and 13 females age 72 (range 50-92 years. Precipitating AKI followed pneumonia (8, acutely decompensated heart failure (7, pyelonephritis (4, post-operative (5, sepsis (3, contrast-induced nephropathy (2, and others (2. Time to dialysis was shortest following surgical procedures. Concurrent renin angiotensin aldosterone system blockade was higher with SORO-ESRD - 23% versus 5%, P = 0.0113. In conclusion, SORO-ESRD is not uncommon among the incident general US ESRD population. The implications for ESRD care planning, AV-fistula-first programs, general CKD care and any associations with renal ageing/senescence warrant further study.
Nassar, Aziza; Visscher, Daniel W.; Degnim, Amy C.; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene; Radisky, Derek C.; Vachon, Celine M.; Kraft, Ruth A.; Hartmann, Lynn C.; Ghosh, Karthik
Purpose To examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. Methods The study included women aged 18 to 85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed vs expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression (nonproliferative disease, proliferative disease without atypia [PDWA], or atypical hyperplasia). Results Fibroadenoma was identified in 2,136 women (noncomplex, 1,835 [85.9%]; complex, 301 [14.1%]). SIR for noncomplex fibroadenoma was 1.49 (95% CI, 1.26–1.74); for complex fibroadenoma, it was 2.27 (95% CI, 1.63–3.10) (test for heterogeneity in SIR, P=.02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (eg, incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Conclusions Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics. PMID:26264469
Nassar, Aziza; Visscher, Daniel W; Degnim, Amy C; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene; Radisky, Derek C; Vachon, Celine M; Kraft, Ruth A; Hartmann, Lynn C; Ghosh, Karthik
The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed versus expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression [nonproliferative disease, proliferative disease without atypia (PDWA), or atypical hyperplasia]. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (e.g., incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics.
Grant, Clive S; Thompson, Geoffrey; Farley, David; van Heerden, Jon
Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (HPT) has equal cure and recurrence rates as standard cervical exploration. Changes in the management of primary HPT have occurred since introducing MIP including localization, anesthesia, intraoperative parathyroid hormone monitoring, and indications for parathyroidectomy. Cohort analysis of 1361 consecutive patients with primary HPT operated on at the Mayo Clinic, Rochester, Minn, from June 1998 through March 2004. Mean follow-up, 25 months. Tertiary referral center. One thousand three hundred sixty-one patients operated on for primary HPT, excluding 160 patients who were reoperated on. Standard cervical exploration MIP. Cure, recurrence, localization, anesthesia, hospitalization, intraoperative parathyroid hormone level monitoring, contraindications to MIP, surgical indications, assessment of osteoporosis and osteopenia, postoperative patient assessment of general patient health, and operative satisfaction. Cure of primary HPT for both conventional exploration and MIP was 97%; only 1 patient who underwent MIP had a potential recurrence. Imaging sensitivity and positive predictive values were as follows: sestamibi scintigraphy, 86% and 93%; ultrasonography, 61% and 87%, respectively. Usage of general vs local anesthesia with intravenous sedation was 46% and 49%, respectively, in patients w ho underwent MIP; 46% were dismissed as outpatients, 49% had single-night stays. The accuracy of intraoperative parathyroid hormone level monitoring was as follows: 98% (8% had true-negative results); the frequency of multiple gland disease was 13%. Accounting for causes precluding MIP, an estimated 60% to 70% of all patients would be eligible for MIP. By preoperative assessment, 79% had osteoporosis-osteopenia; 58% with postoperative bone mineral density measurements were improved. More than 85% were satisfied with the results of their operation. With high-quality localization and intraoperative
Kashani, Kianoush B; Ramar, Kannan; Farmer, J Christopher; Lim, Kaiser G; Moreno-Franco, Pablo; Morgenthaler, Timothy I; Dankbar, Gene C; Hale, Curt W
The Accreditation Council for Graduate Medical Education emphasizes quality improvement (QI) education in residency/fellowship training programs. The Mayo Clinic Combined Critical Care Fellowship (CCF) program conducted a pilot QI education program to incorporate QI training as a required curriculum for the 2010-2011 academic year. CCF collaborated with the Mayo Quality Academy to customize and teach the existing Mayo Quality Fellows curriculum to the CCF fellows with the help of two quality coaches over five months starting July 2010. All fellows were to achieve Bronze and Silver certification prior to graduation. Silver required passing four written exams and submitting a health care QI project. Five projects were selected on the basis of the Impact-Effort Prioritization matrix, and DMAIC (Define, Measure, Analyze, Improve, and Control) methodology was used to complete the projects. The primary outcome was to assess learners' satisfaction, knowledge, and skill transfer. All 20 fellows were Bronze certified, and 14 (70%) were Silver certified by the time of graduation. All five QI projects were completed and showed positive impacts on patient safety and care. Surveys showed improved learner satisfaction. Graduates felt the QI training improved their QI skills and employment and career advancement. The QI curriculum had appropriate content and teaching pace and did not significantly displace other important clinical core curriculum topics. The pilot was successfully implemented in the CCF program and now is in the fourth academic year as an established and integral part of the fellowship core curriculum.
Alhurani, Rabe E.; Vassilaki, Maria; Aakre, Jeremiah; Mielke, Michelle M.; Kremers, Walter K.; Machulda, Mary M.; Geda, Yonas E.; Knopman, David S.; Peterson, Ronald C.; Roberts, Rosebud O.
IMPORTANCE Unintentional weight loss has been associated with risk of dementia. Since mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI. OBJECTIVE To investigate the association of change in weight and BMI with risk of MCI. DESIGN, SETTING, AND PARTICIPANTS A population-based, prospective study of participants aged 70 years and older from the Mayo Clinic Study of Aging. Maximum weight and height in midlife (aged 40 to 65 years old) were retrospectively ascertained from the medical records of participants using a medical records linkage system. MAIN OUTCOMES MEASURES Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and body mass index with risk of MCI was investigated using proportional hazards models. RESULTS Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI. The mean (standard deviation) rate of weight change per decade from midlife to study entry was greater for individuals who developed incident MCI vs. those who remained cognitively normal (−2.0 (5.1) vs. −1.2 (4.9) kg; p = 0.006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR] 95% confidence interval [CI], 1.04 [1.02, 1.06], p weight loss of 5 kg/decade corresponds to a 24% increase in risk of MCI (HR=1.24). Higher decline in BMI per decade was also associated with incident MCI (HR, 1.08, 95% CI = [1.03, 1.13], p = 0.003). CONCLUSIONS AND RELEVANCE These findings suggest that declining weight from midlife to late-life is a marker for MCI and may help identify persons at increased risk for MCI. PMID:26831542
Miller, Robert C.; Iott, Matthew J.; Corsini, Michele M.
Purpose: To present an overview of Phase III trials in adjuvant therapy for pancreatic cancer and review outcomes at the Mayo Clinic after adjuvant radiochemotherapy (RT/CT) for resected pancreatic cancer. Methods and Materials: A literature review and a retrospective review of 472 patients who underwent an R0 resection for T1-3N0-1M0 invasive carcinoma of the pancreas from 1975 to 2005 at the Mayo Clinic, Rochester, MN. Patients with metastatic or unresectable disease at the time of surgery, positive surgical margins, or indolent tumors and those treated with intraoperative radiotherapy were excluded from the analysis. Median radiotherapy dose was 50.4Gy in 28 fractions, with 98% of patients receiving concurrent 5-fluorouracil- based chemotherapy. Results: Median follow-up was 2.7 years. Median overall survival (OS) was 1.8 years. Median OS after adjuvant RT/CT was 2.1 vs. 1.6 years for surgery alone (p = 0.001). The 2-y OS was 50% vs. 39%, and 5-y was 28% vs. 17% for patients receiving RT/CT vs. surgery alone. Univariate and multivariate analysis revealed that adverse prognostic factors were positive lymph nodes (risk ratio [RR] 1.3, p < 0.001) and high histologic grade (RR 1.2, p < 0.001). T3 tumor status was found significant on univariate analysis only (RR 1.1, p = 0.07). Conclusions: Results from recent clinical trials support the use of adjuvant chemotherapy in resected pancreatic cancer. The role of radiochemotherapy in adjuvant treatment of pancreatic cancer remains a topic of debate. Results from the Mayo Clinic suggest improved outcomes after the administration of adjuvant radiochemotherapy after a complete resection of invasive pancreatic malignancies.
Oddson, Bruce; Rumney, Peter; Johnson, Patricia; Thomas-Stonell, Nancy
The Mayo-Portland Adaptability Inventory (MPAI; designed to be administered by clinicians) is a popular measure of disability following head injury in adults. Its acceptability, validity, and reliability were assessed for use with children. There were 335 children and adolescents (215 males, 120 females) aged between 1 and 19 years at injury (median age 9y 8mo [SD 5y]) in our sample. The test was acceptable to respondents, rapidly and easily administered, and required only small modifications. It demonstrated validity against client and parent reports of major symptoms. It demonstrated test-retest reliability within the limitations of our data and excellent interrater accord. Consequently, the MPAI is recommended for paediatric use for evaluating rehabilitation needs and therapy outcome.
Murrey, G J; Hale, F M; Williams, J D
To determine if the Mayo-Portland Adaptability Inventory (MPAI) demonstrates clinical utility in differentiating between persons with severe TBI and frontal lobe damage/anosognosia and persons with mild TBI and no frontal lobe damage. Forty-three persons with TBI and documented frontal lobe damage (mean age = 34; mean time since injury = 5.2 years) and 69 persons with mild TBI and no frontal lobe damage (mean age = 34.3; mean time since injury = 4.8 4.8 years). MPAI. Total inventory and select sub-category difference scores were significantly greater in the frontal lobe group than in the non-frontal lobe group. However, as expected, there was no significant difference between the two groups on the mobility sub-category difference scores. The MPAI appears to be potentially clinically useful in assessing for frontal lobe damage and associated anosognosia in patients with TBI.
Full Text Available David T Eton,1,2 Timothy J Beebe,1,2 Philip T Hagen,3 Michele Y Halyard,4 Victor M Montori,1,5 James M Naessens,1,2 Jeff A Sloan,6 Carrie A Thompson,7 Douglas L Wood1,81Division of Heath Care Policy and Research, Department of Health Sciences Research, 2Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 3Department of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN, 4Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, 5Knowledge and Evaluation Research Unit, 6Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, 7Division of Hematology, Department of Medicine, 8Center for Innovation, Mayo Clinic, Rochester, MN, USAAbstract: Patient-reported outcomes (PROs capture how patients perceive their health and their health care; their use in clinical research is longstanding. Today, however, PROs increasingly are being used to inform the care of individual patients, and document the performance of health care entities. We recently wrote and internally distributed an institutional position statement titled "Harmonizing and Consolidating the Measurement of Patient-Reported Outcomes at Mayo Clinic: A Position Statement for the Center for the Science of Health Care Delivery". The statement is meant to educate clinicians, clinical teams, and institutional administrators about the merits of using PROs in a systematic manner for clinical care and quality measurement throughout the institution. The present article summarizes the most important messages from the statement, describing PROs and their use, identifying practical considerations for implementing them in routine practice, elucidating potential barriers to their use, and formulating strategies to overcome these barriers. The lessons learned from our experience – including pitfalls, challenges, and successes – may inform other health care institutions that are interested in
Falls in the elderly are a significant public health problem. Previous studies have shown that most falls are multifactorial and an efficacious way of reducing the risk of falling is provided by a falls clinic.
Smoot Dustin L
Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.
Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A
Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the
National Oceanic and Atmospheric Administration, Department of Commerce — The Light Detection and Ranging (LiDAR) dataset is a survey of Suwannee River G12PD00242 1.0 Meter LiDAR Survey Area 4, Classified Point Cloud, in north-central...
Wennberg, Alexandra M V; Hagen, Clinton E; Machulda, Mary M; Hollman, John H; Roberts, Rosebud O; Knopman, David S; Petersen, Ronald C; Mielke, Michelle M
Levels of insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, and their ratio in the blood may be useful for monitoring those at risk of cognitive and functional decline. However, the association between IGF measures and functional and cognitive outcomes has been mixed, and the associations may vary by sex. The present study investigated the cross-sectional, sex-specific associations between serum measures total IGF-1, IGFBP-3, and the IGF-1/IGFBP-3 ratio, gait speed, and cognition in 1320 cognitively unimpaired participants aged 50-95 years enrolled in the Mayo Clinic Study of Aging. We used multivariable linear regression models to determine the association between IGF measures and gait speed or cognitive test performance by sex. IGF measures were not associated with cognitive or functional performance among men. Among women, higher levels of log total IGF-1 and IGFBP-3 were associated with better performance in attention, visuospatial, and global cognitive domains, independent of the gait speed. These findings suggest that among women, IGF measures are associated with cognition, and these associations are independent of function. Copyright © 2018 Elsevier Inc. All rights reserved.
The Prevalence of Cardiovascular Disease Risk Factors and the Framingham Risk Score in Patients Undergoing Percutaneous Intervention Over the Last 17 Years by Gender: Time-trend Analysis From the Mayo Clinic PCI Registry
Full Text Available Objectives: This study aims to investigate trends of cardiovascular disease (CVD risk factor profiles over 17 years in percutaneous coronary intervention (PCI patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for β-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.
Persons, Kenneth R.; Gehring, Dale G.; Pavicic, Mark J.; Ding, Yingjai
The Mayo Clinic and IBM (at Rochester, Minnesota) have jointly developed a picture archiving system for use with Mayo's MRI and Neuro CT imaging modalities. The communications backbone of the PACS is a portion of the Mayo institutional network: a series of 4-Mbps token rings interconnected by bridges and fiber optic extensions. The performance characteristics of this system are important to understand because they affect the response time a PACS user can expect, and the response time for non-PACS users competing for resources on the institutional network. The performance characteristics of each component and the average load levels of the network were measured for various load distributions. These data were used to quantify the response characteristics of the existing system and to tune a model developed by North Dakota State University Department of Computer Science for predicting response times of more complex topologies.
Ahmad, Harris A; Gottlieb, Klaus; Hussain, Fez
Despite its importance and potential impact in clinical trials, central reading continues to be an under-represented topic in the literature about inflammatory bowel disease (IBD) clinical trials. Although several IBD studies have incorporated central reading to date, none have fully detailed the specific methodology with which the reads were conducted. Here we outline key principles for designing an efficient central reading paradigm for an ulcerative colitis (UC) study that addresses regulatory, operational and clinical expectations. As a step towards standardization of read methodology for the growing number of multicenter phase 3 clinical trials in IBD, we have applied these principles to the design of an optimal read methodology that we call the '2 + 1 paradigm.' The 2 + 1 paradigm involves the use of both site and central readers, validated scoring criteria and multiple measures for blinding readers, all of which contribute to reducing bias and generating a reliable endoscopic subscore that reflects endoscopic disease severity. The paradigm can be utilized while maintaining a practical workflow compatible with an operationally feasible clinical trial. The 2 + 1 paradigm represents a logical approach to endoscopic assessment in IBD clinical trials, one that should be considered attractive to prospective sponsors, contract research organizations, key opinion leaders and regulatory authorities and be ready for implementation and further evaluation. © The Author(s) 2015. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.
Duncan C. Lutes; Robert E. Keane
The Fuel Load method (FL) is used to sample dead and down woody debris, determine depth of the duff/ litter profile, estimate the proportion of litter in the profile, and estimate total vegetative cover and dead vegetative cover. Down woody debris (DWD) is sampled using the planar intercept technique based on the methodology developed by Brown (1974). Pieces of dead...
Morr Verenzuela, Claudia S; Davis, Mark D P; Bruce, Alison J; Torgerson, Rochelle R
Burning mouth syndrome (BMS) is a disorder characterized by chronic mouth pain in the absence of objective clinical abnormalities. Vitamin or mineral deficiencies may have a role in BMS, but data regarding the prevalence and relevance of hematinic deficiencies are conflicting. We aimed to determine the frequency of specific laboratory abnormalities in patients with BMS. We retrospectively reviewed the results of screening blood tests in patients with BMS at our institution between January 2003 and December 2013. Among 659 patients with BMS, the most common decreased values or deficiencies were vitamin D 3 (15%), vitamin B 2 (15%), vitamin B 6 (5.7%), zinc (5.7%), vitamin B 1 (5.3%), thyrotropin (TSH) (3.2%), vitamin B 12 (0.8%), and folic acid (0.7%). Laboratory values for fasting blood glucose and TSH were increased in 23.7% and 5.2%, respectively. In patients with symptoms of BMS, our results suggest it is reasonable to screen for fasting blood glucose, vitamin D (D 2 and D 3 ), vitamin B 6 , zinc, vitamin B 1 , and TSH. Deficiencies of vitamin B 12 and folic acid were rare (<1% abnormal). © 2017 The International Society of Dermatology.
This color infrared photo of the Orlando, FL area (28.5N,81.5W) shows the extensive citrus tree orchards as neat bright red field patterns. The extensive road and highway network in the central Florida region is clearly visible. Also, the recent urban growth caused by the opening of the Disney World amusement complex just southwest of Orlando is clearly evident. This view spans the width of the state from Tampa Bay to the Atlantic coast.
Smith, Steven C.; Gronseth, Darren L.
In order for research programs at academic medical centers and universities to survive and thrive in the increasingly challenging economic, political and regulatory environment, successful transformation is extremely important. Transformation and quality management techniques are increasingly well established in medical practice organizations. In…
Mahoney, Kevin T.; Baker, David B.
Compares the simultaneous emergence of Mayo's nonauthoritarian interviewing approach and Rogers' nondirective counseling approach. Examines the influence of Piaget on Mayo and reviews the Hawthorne studies. Concludes that differences in the approaches outweigh similarities. (Contains 21 references.) (SK)
Hamed, Razan; Tariah, Hashem Abu; Malkawi, Somaya; Holm, Margo B.
The Mayo-Portland Adaptability Inventory 4 (MPAI-4) is a valid and reliable assessment tool to detect clinical impairments in patients with acquired brain injury. The tool is widely used by rehabilitation therapists worldwide, given its good psychometric properties and its availability in several languages. The purpose of this study was to…
L. Shi (Lu); H. Tian (Haijun); W.J. McCarthy (William); B. Berman (Barbara); S. Wu (Shinyi); R. Boer (Rob)
textabstractBackground: The Mayo Lung Project (MLP), a randomized controlled clinical trial of lung cancer screening conducted between 1971 and 1986 among male smokers aged 45 or above, demonstrated an increase in lung cancer survival since the time of diagnosis, but no reduction in lung cancer
Kottke, T. E.; Little Finger, L.; Trapp, M. A.; Panser, L. A.; Novotny, P. J.
OBJECTIVE: To determine the response of participants to the Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project. DESIGN: We describe a 3-month demonstration project of medical education and clinical consultations conducted by means of satellite transmission. Postparticipation questionnaires and a postproject survey were used to assess the success of the activity. MATERIAL AND METHODS: Patients and employees at the Pine Ridge Indian Health Service Hospital in southwestern South Dakota and employees at Mayo Clinic Rochester participated in a telemedicine project, after which they completed exit surveys and a postproject questionnaire to ascertain the acceptability of this mode of health care. RESULTS: Almost all Pine Ridge and Mayo Clinic participants viewed the project as beneficial. The educational sessions received favorable evaluations, and almost two-thirds of the patients who completed evaluations thought the consultation had contributed to their medical care. More than 90% of the respondents from Pine Ridge and more than 85% of the respondents from Mayo Clinic Rochester said that they would recommend participation in this project to others. More than 90% of respondents from Pine Ridge and 80% of Mayo respondents agreed with the statement that the project should continue. CONCLUSION: These data suggest that a program of clinical consultation services, professional education, and patient education available by telemedicine might be viewed as beneficial.
This article presents an interview with Peter Mayo, author and expert in the field of sociology of adult education, on his major influences in this area, his books, and his views on the role of radical adult education and radical scholarship in the future. In the interview, Peter Mayo states that his initial view of adult education was quite a…
Full Text Available The article is focused on a specific case study of ‘motherist movement’ in Argentina during the last military rule (1976-1983: the Grandmothers of Plaza de Mayo. Blurring the boundaries between public and private realm, these old women, without a previous, soundly-based political conscience, were able to set up a transnational human rights movement, well known all over the world, while looking for their abducted grandchildren. A crucial issue, still, is: how far did this group go in terms of advocating womens’ rights? Could we really find a correspondence, as Jelin puts it, between ‘women for human rights’ and ‘women for women’s rights’? The answer, as the Argentinean case shows, seems to be not so straightforward.
Gönen, Ipek Kuru
Reading in FL possesses certain challenges for FL readers such as difficulty in inferring underlying messages in texts and dealing with unfamiliar cultural load. All these challenges may be associated with FL learners' reading proficiency and their use of FL reading strategies especially while reading academic materials. This study aims at…
Orlando Moreno Martínez
Full Text Available El presente artículo tiene como propósito analizar los sucesos ocurridos en la ciudad de Bogotá durante el paro estudiantil de mayo de 1938, programado para oponerse a algunas medidas de modernización y secularización educativa impuestas por el gobierno liberal del presidente Alfonso López Pumarejo. Específicamente, los estudiantes se levantaron contra el examen de revisión que se aplicaba al terminar la secundaria y el curso preparatorio que era un requisito para poder ingresar a la universidad. El escrito aborda la problemática suscitada por la reforma educativa, el desencadenamiento de la protesta estudiantil, las acciones desarrolladas por los estudiantes en la capital de la República, el impacto del movimiento en otras partes del país y las tendencias ideológicas que apoyaron el paro de estudiantes. A propósito de este último punto, si bien fue evidente el respaldo de la oposición conservadora, muchos estudiantes universitarios y de secundaria lucharon con convicción por lo que consideraron en su momento una arbitrariedad por parte del gobierno liberal.
...This action amends Class D airspace at Opa Locka Airport, Miami, FL; and Hollywood, FL, by correcting the geographic coordinates of the airport to aid in the navigation of our National Airspace System.
Specialized consultant in radiological safety to the Reforma peripheral clinic, PEMEX. - I. - May-June of 2003; Asesoria especializada en seguridad radiologica a la clinica periferica Reforma, PEMEX.- I.- Mayo-Junio de 2003
Torres P, A.; Garcia A, J.; Rodriguez A, F
The Reforma peripheral clinic, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the clinic can conserve its respective sanitary license.(Author)
... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Rock Island, FL to Cape San Blas, FL. 80.805 Section 80.805 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Eighth District § 80.805 Rock Island, FL...
Liborio Sánchez Avella
Full Text Available El 6 de mayo de 1981 cumplió el Hospital de La Misericordia 75 años de haber iniciado sus labores. La idea de crear el Hospital se venía gestando desde comienzos de 1890. Obtuvo la Personería Jurídica el 23 de julio de 1897y el 25 de julio del mismo año colocó la primera piedra el Presidente de la República Miguel Antonio Caro. José Ignacio Barberi, su fundador, dejó un escrito en el cual relataba la historia de este Hospital. El mejor homenaje que se le puede hacer al Hospital y a José Ignacio Barberi, es transcribir las palabras que él dejó inéditas en 1940.
Das mechanische Verhalten von Flüssigkeiten und Gasen ist dadurch gekennzeichnet, dass sie keine statische Schubfestigkeit besitzen, andernfalls würden sie nicht beginnen, zu fließen. In ruhenden Flüssigkeiten und Gasen können daher keine Schubspannungen bestehen:
Full Text Available Identify the role and effectiveness of flânerie as a tool of interpretation, understanding the contribution that the flâneur can bring to the analysis of the urban landscape, meaning of course the latter term not only natural or artificial backgrounds that characterize the city but also the figures that the inhabit daily. A sort of diary about the treatment of the flâneur covers its origins, its characteristics prevalent, its proximity/distance from other urban figures and its usefulness in teaching.
Marisa R Buchakjian
Full Text Available Genetic mouse models of soft tissue sarcoma provide critical insights into disease pathophysiology, which are oftentimes unable to be extracted from human tumor samples or xenograft models. In this study we describe a mouse model of soft tissue sarcoma mediated by adenoviral-Cre recombinase injection into Trp53fl/fl/Ptenfl/fl lox-stop-lox luciferase mice. Injection of adenovirus expressing Cre recombinase, either subcutaneously or intramuscularly in two experimental groups, results in viral infection and gene recombination with 100% penetrance within the first 24 hours following injection. Luciferase expression measured by real-time bioluminescence imaging increases over time, with an initial robust increase following viral injection, followed by a steady rise over the next several weeks as primary tumors develop and grow. Intramuscular injections were more commonly associated with evidence of systemic viral distribution than subcutaneous injections. All mice developed soft tissue sarcomas at the primary injection site, with histological examination identifying 93% of tumors as invasive pleomorphic sarcomas based on microscopic morphology and immunohistochemical expression of sarcoma markers. A lymphocytic infiltrate was present in 64% of the sarcomas in this immunocompetent model and 71% of tumors expressed PD-L1. This is the first report of a viral-Cre mediated Trp53/Pten mouse model of undifferentiated pleomorphic sarcoma. The bioluminescence imaging feature, along with high penetrance of the model and its immunological characteristics, makes it suited for pre-clinical studies of soft tissue sarcoma.
National Oceanic and Atmospheric Administration, Department of Commerce — Airborne terrestrial LiDAR was collected for St. Johns County, FL. System Parameters/Flight Plan. The LiDAR system acquisition parameters were developed based on a...
National Oceanic and Atmospheric Administration, Department of Commerce — Martin County FL QL2 Lidar Acquisition and Processing Production Task Task Order No. G14PS00574 Woolpert Order No. 76001 Contractor: Woolpert, Inc. This task is for...
Widmer, R Jay; Engler, Nicole B; Geske, Jeffrey B; Klarich, Kyle W; Timimi, Farris K
With more than 300 million monthly active users, Twitter is a powerful social media tool in healthcare, yet the characterization of an academic healthcare Twitter account remains poor to date. We assessed basic gender and geographic data on the account's "followers," as well as categorization of each tweet based on content type. We analyzed the impressions, engagements, retweets, favorites, replies, hashtag clicks, and detail expansions using both Sprinklr and Twitter Analytics. Over a period of 12 months, the account amassed 1,235 followers, with 54 percent being male and 68 percent residing in the United States. Of the 1,635 tweets sent out over the life of the account, we report more than 382,464 impressions, 6,023 engagements, 1,255 retweets, 776 favorites, and 1,654 embedded media clicks in this period. When broken down by tweet category, publication tweets garnered the highest engagement with an estimated mean number of clicks per tweet of 8.2 ± 81.9. Original content had higher total engagement per tweet than retweeted material (2.8 ± 9.2 vs. 0.2 ± 0.9 engagements per tweet; p < 0.0001). Tweets regarding internal, national, and continuing medical education events had similar engagement. Herein is the first publication within the medical literature describing a "case series" of cardiovascular tweets over 12 months. We highlight a rapidly emerging group of interactive followers, a successful means by which to disseminate and engage in breaking topics throughout the cardiovascular field, and the importance of combining physician-led knowledge with intermittent marketing messages.
Bhatia, Sumita; Miller, Robert C.; Haddock, Michael G.; Donohue, John H.; Krishnan, Sunil
Purpose: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. Methods and Materials: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. Results: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p = 0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p = 0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. Conclusions: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed
Gold, Douglas G.; Miller, Robert C.; Haddock, Michael G.; Gunderson, Leonard L.; Quevedo, Fernando; Donohue, John H.; Bhatia, Sumita; Nagorney, David M.
Purpose: To analyze the effect of adjuvant chemoradiotherapy on gallbladder carcinoma. Methods and Materials: We retrospectively reviewed the records from consecutive patients who underwent R0 resection of gallbladder carcinoma between January 1, 1985, and December 31, 2004. Patients had either Stage I (T1-T2N0M0) or Stage II (T3N0M0 or T1-T3N1M0) disease. Patients undergoing adjuvant therapy received 5-fluorouracil chemotherapy concurrently with radiotherapy (median dosage, 50.4 Gy in 28 fractions). Adverse prognostic factors and the effect of adjuvant treatment on overall survival (OS) were evaluated. Results: A total of 73 patients were included in the analysis; of these, 25 received adjuvant chemoradiotherapy. On univariate analysis, no adverse prognostic factors for OS reached statistical significance, but trends were noted for Stage N1 vs. N0 (p = .06), Nx vs. N0 (p = .09), Stage T3 vs. T1-T2 (p = .06), and histologic findings other than adenocarcinoma (p = .13). The median OS for patients receiving adjuvant chemoradiotherapy vs. surgery alone was 4.8 years and 4.2 years, respectively (log-rank test, p = .56). However, a significantly greater percentage of patients receiving adjuvant chemoradiotherapy had Stage II disease (p <.001). In the multivariate Cox model, increasing T and N category and histologic findings other than adenocarcinoma were significant predictors of decreased OS. Additionally, adjuvant chemoradiotherapy was a significant predictor of improved OS after adjusting for these prognostic factors (hazard ratio for death, 0.3; 95% confidence interval, 0.13-0.69; p = .004). Conclusion: After adjusting for the stage parameters and histologic findings, our data suggest that adjuvant chemoradiotherapy might improve OS for patients with gallbladder cancer.
Laws, E.R.; Abay, E.O.; Forbes, G.S.; Grado, G.L.; Bruckman, J.E.; Scott, M.
The typical pineal tumor occurs in an adolescent boy with subacute increased intracranial pressure and Parinaud's syndrome. Diagnosis is confirmed by CT scanning, and long-term survival usually following shunting and radiation therapy. Direct surgical methods for successful treatment of suitable pineal tumors have evolved and may be utilized with relatively low risk in appropriate cases
Reeves, Emer P
The pathogenesis of lung disease in cystic fibrosis is characterised by decreased airway surface liquid volume and subsequent failure of normal mucociliary clearance. Mucus within the cystic fibrosis airways is enriched in negatively charged matrices composed of DNA released from colonizing bacteria or inflammatory cells, as well as F-actin and elevated concentrations of anionic glycosaminoglycans. Therapies acting against airway mucus in cystic fibrosis include aerosolized hypertonic saline. It has been shown that hypertonic saline possesses mucolytic properties and aids mucociliary clearance by restoring the liquid layer lining the airways. However, recent clinical and bench-top studies are beginning to broaden our view on the beneficial effects of hypertonic saline, which now extend to include anti-infective as well as anti-inflammatory properties. This review aims to discuss the described therapeutic benefits of hypertonic saline and specifically to identify novel models of hypertonic saline action independent of airway hydration.
Miranda Bojórquez, Erasmo; Vergara Villegas, Osslan Osiris; Cruz Sánchez, Vianey Guadalupe; García-Alcaraz, Jorge Luis; Favela Vara, Jesús
This paper presents the results of a study applied to undergraduates in order to know how the cultural dimensions affect their perceptions of the acceptance and use of new technologies in a student-centered learning environment. A total of 85 undergraduate students from the Autonomous Indigenous University of Mexico (UAIM) participated in the study. Each student was asked to use a mobile augmented reality (MAR) application designed to learn Mayo language (language spoken in Northwestern Mexic...
By Carolynne Keenan, Guest Writer In the 1990s, when Joseph Mayo, D.V.M, ran out of gas leading coworkers home from a meeting in Bethesda, he pulled over to the side of the road on I-270 and waited for help. He didn’t have to wait long; within a few minutes a passing motorist took pity on the group of scientists and offered them a lift back to Fort Detrick.
Validation of the Omron HEM-7320-LA, upper arm blood pressure monitor with Intelli Wrap Technology Cuff HEM-FL1 for self-measurement and clinic use according to the European Society of Hypertension International Protocol revision 2010 in the Mexican population.
Grover-Páez, Fernando; Cardona-Muñoz, Ernesto G; Cardona-Müller, David; Guzmán-Saldívar, Víctor H; Rodríguez-De la Cerda, Mariana; Jiménez-Cázarez, Mayra B; Totsuka-Sutto, Sylvia E; Alanis-Sánchez, Guillermo A; Ramos-Becerra, Carlos G
The aim of this study was to determine the accuracy of the Omron HEM-7320-LA with Intelli Wrap technology cuff HEM-FL1 for self-measurement and clinic blood pressure (BP) measurement according to the European Society of Hypertension International Protocol revision 2010. The evaluation was performed in 39 individuals. The mean age of the participants was 47.9±14 years; systolic BP was 145.2±24.3 mmHg (range: 97-190), diastolic BP was 90.9±12.9 mmHg (range: 68-120), and arm circumference was 30.8±4 cm (range: 25-38.5). The device successfully fulfilled the established criteria of the validation protocol. The device overestimated systolic BP by 0.6±5.7 mmHg and diastolic BP by 2.2±5.1 mmHg. The specially designed cuff HEM-FL1 to cover a broad range of arm circumferences and self-placement fulfilled the requirements of the International Protocol.
...-0070; Airspace Docket No. 10-ASO-43] Amendment of Class E Airspace; Cocoa, FL AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule. SUMMARY: This action amends Class E Airspace at Cocoa, FL, as the... Island Airport, Cocoa, FL (75 FR 21266) Docket No. FAA-2011-0070. Interested parties were invited to...
We report the draft genome sequence of the type strain Mycobacterium chimaera Fl-0169T, a member of the Mycobacterium avium complex (MAC). M. chimaera Fl-0169T was isolated from a patient in Italy and is highly similar to strains of M. chimaera isolated in Ireland, though Fl-016...
Christopher P. Irwin
Full Text Available New intravital optical imaging technologies have revolutionized our understanding of mammalian biology and continue to evolve rapidly. However, there are only a limited number of imaging probes available to date. In this study, we investigated in mouse models of glioblastoma whether a fluorescent small molecule inhibitor of the DNA repair enzyme PARP1, PARPi-FL, can be used as an imaging agent to detect glioblastomas in vivo. We demonstrated that PARPi-FL has appropriate biophysical properties, low toxicity at concentrations used for imaging, high stability in vivo, and accumulates selectively in glioblastomas due to high PARP1 expression. Importantly, subcutaneous and orthotopic glioblastoma xenografts were imaged with high contrast clearly defining tumor tissue from normal surrounding tissue. This research represents a step toward exploring and developing PARPi-FL as an optical intraoperative imaging agent for PARP1 in the clinic.
McGarry, A.T.; Fennell, S.G.; Mackin, G.M.; Madden, J.S.; O'Colmain, M.
This report presents the results of the final phase of the National Radon Survey carried out by the Radiological Protection Institute of Ireland. The counties included in this phase are Galway and Mayo. The average radon concentrations for the houses measured in these counties were 112 Bq/m 3 and 100 Bq/m 3 , respectively. The measurement data were grouped on the basis of the 10 km grid squares of the Irish National Grid System and used to predict the percentage of dwellings in each grid square which exceeds the Reference Level of 200 Bq/m 3 . Grid squares where this percentage is predicted to be 10% or higher are designated High Radon Areas. The health effects of exposure to high radon levels are discussed and recommendations are made regarding both new and existing dwellings. (author)
Erasmo Miranda Bojórquez
Full Text Available This paper presents the results of a study applied to undergraduates in order to know how the cultural dimensions affect their perceptions of the acceptance and use of new technologies in a student-centered learning environment. A total of 85 undergraduate students from the Autonomous Indigenous University of Mexico (UAIM participated in the study. Each student was asked to use a mobile augmented reality (MAR application designed to learn Mayo language (language spoken in Northwestern Mexico. Afterwards, the students responded to a survey with items concerning the use and technology acceptance and about cultural dimensions of individualism and uncertainty avoidance. Structural equation modeling (SEM was used to analyze the data collected from students. Results provide evidence that the individualism contributes positively to perceived ease of use of the MAR app, and uncertainty avoidance has no impact. The findings showed that the MAR system could be easily used if it includes a natural way to promote collaborative work. In addition, to gain the trust of students, the uncertainty avoidance needs to be reduced by enriching the help information offered for app use.
...-0503; Airspace Docket No. 11-ASO-19] Amendment of Class E Airspace; Orlando, FL AGENCY: Federal... Orlando, FL, as new Standard Instrument Approach Procedures have been developed at Orlando Executive... coordinates of Orlando Executive Airport, Orlando International Airport, and Kissimmee Municipal Airport...
PARE koordinaator tutvustab tuntud inimkapitali ideoloogi Andrew Mayo raamatut "Ettevõtte inimväärtus". Raamatu autori hinnangul on tänapäeva organisatsioonides juhtimise olulisim ülesanne inimese juhtimine varana. Lisa: Konverents
Malec, James F; Kragness, Miriam; Evans, Randall W; Finlay, Karen L; Kent, Ann; Lezak, Muriel D
To evaluate the internal consistency of the Mayo-Portland Adaptability Inventory (MPAI), further refine the instrument, and provide reference data based on a large, geographically diverse sample of persons with acquired brain injury (ABI). 386 persons, most with moderate to severe ABI. Outpatient, community-based, and residential rehabilitation facilities for persons with ABI located in the United States: West, Midwest, and Southeast. Rasch, item cluster, principal components, and traditional psychometric analyses for internal consistency of MPAI data and subscales. With rescoring of rating scales for 4 items, a 29-item version of the MPAI showed satisfactory internal consistency by Rasch (Person Reliability=.88; Item Reliability=.99) and traditional psychometric indicators (Cronbach's alpha=.89). Three rationally derived subscales for Ability, Activity, and Participation demonstrated psychometric properties that were equivalent to subscales derived empirically through item cluster and factor analyses. For the 3 subscales, Person Reliability ranged from.78 to.79; Item Reliability, from.98 to.99; and Cronbach's alpha, from.76 to.83. Subscales correlated moderately (Pearson r =.49-.65) with each other and strongly with the overall scale (Pearson r=.82-.86). Outcome after ABI is represented by the unitary dimension described by the MPAI. MPAI subscales further define regions of this dimension that may be useful for evaluation of clinical cases and program evaluation.
Bohac, D L; Malec, J F; Moessner, A M
Principal-components (PC) factor analysis of the Mayo-Portland Adaptability Inventory (MPAI) was conducted using a sample of outpatients (n = 189) with acquired brain injury (ABI) to evaluate whether outcome after ABI is multifactorial or unifactorial in nature. An eight-factor model was derived which explained 64-4% of the total variance. The eight factors were interpreted as representing Activities of Daily Living, Social Initiation, Cognition, Impaired-Self-awareness/Distress, Social Skills/ Support, Independence, Visuoperceptual, and Psychiatric, respectively. Validation of the Cognition factor was supported when factor scores were correlated with various neuropsychological measures. In addition, 117 patient self-rating total scores were used to evaluate the Impaired Self-awareness/Distress factor. An inverse relationship was observed, supporting this factor's ability to capture the two-dimensional phenomena of diminished self-awareness or enhanced emotional distress. A new subscale structure is suggested, that may allow greater clinical utility in understanding how ABI manifests in patients, and may provide clinicians with a better structure for implementing treatment strategies to address specific areas of impairment and disability for specific patients. Additionally, more precise measurement of treatment outcomes may be afforded by this reorganization.
Full Text Available Abstract Background The Mayo Lung Project (MLP, a randomized controlled clinical trial of lung cancer screening conducted between 1971 and 1986 among male smokers aged 45 or above, demonstrated an increase in lung cancer survival since the time of diagnosis, but no reduction in lung cancer mortality. Whether this result necessarily indicates a lack of mortality benefit for screening remains controversial. A number of hypotheses have been proposed to explain the observed outcome, including over-diagnosis, screening sensitivity, and population heterogeneity (initial difference in lung cancer risks between the two trial arms. This study is intended to provide model-based testing for some of these important arguments. Method Using a micro-simulation model, the MISCAN-lung model, we explore the possible influence of screening sensitivity, systematic error, over-diagnosis and population heterogeneity. Results Calibrating screening sensitivity, systematic error, or over-diagnosis does not noticeably improve the fit of the model, whereas calibrating population heterogeneity helps the model predict lung cancer incidence better. Conclusions Our conclusion is that the hypothesized imperfection in screening sensitivity, systematic error, and over-diagnosis do not in themselves explain the observed trial results. Model fit improvement achieved by accounting for population heterogeneity suggests a higher risk of cancer incidence in the intervention group as compared with the control group.
National Oceanic and Atmospheric Administration, Department of Commerce — These data sets contain raw and processed data, including collection location (bay) date, individual data for all trout collected, including FL, TL, whole weight,...
National Oceanic and Atmospheric Administration, Department of Commerce — Martin County FL QL2 Lidar Acquisition and Processing Production Task Task Order No. G14PS00574 Woolpert Order No. 76001 Contractor: Woolpert, Inc. This task is for...
...] Television Broadcasting Services; Panama City, FL AGENCY: Federal Communications Commission. ACTION: Proposed rule. SUMMARY: The Commission has before it a petition for rulemaking filed by Gray Television Licensee... 73 Television, Television broadcasting. Federal Communications Commission. Barbara A. Kreisman, Chief...
This page presents radiation air monitoring and air filter analysis data for Orlando, FL from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.
, the molecular targeting features of FL118 plus its superior antitumor activity warrant its further development toward clinical trials.
Malec, James F; Kean, Jacob; Altman, Irwin M; Swick, Shannon
(1) To evaluate the measurement reliability and construct validity of the Mayo-Portland Adaptability Inventory, 4th revision (MPAI-4) in a sample consisting exclusively of patients with cerebrovascular accident (CVA) using single parameter (Rasch) item-response methods; (2) to examine the differential item functioning (DIF) by sex within the CVA population; and (3) to examine DIF and differential test functioning (DTF) across traumatic brain injury (TBI) and CVA samples. Retrospective psychometric analysis of rating scale data. Home- and community-based brain injury rehabilitation program. Individuals post-CVA (n=861) and individuals with TBI (n=603). Not applicable. MPAI-4. Item data on admission to community-based rehabilitation were submitted to Rasch, DIF, and DTF analyses. The final calibration in the CVA sample revealed satisfactory reliability/separation for persons (.91/3.16) and items (1.00/23.64). DIF showed that items for pain, anger, audition, and memory were associated with higher levels of disability for CVA than TBI patients; whereas, self-care, mobility, and use of hands indicated greater overall disability for TBI patients. DTF analyses showed a high degree of association between the 2 sets of items (R=.92; R(2)=.85) and, at most, a 3.7 point difference in raw scores. The MPAI-4 demonstrates satisfactory psychometric properties for use with individuals with CVA applying for interdisciplinary posthospital rehabilitation. DIF reveals clinically meaningful differences between CVA and TBI groups that should be considered in results at the item and subscale level. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Uuest heliplaadist "Penderecki: Konzert für Flöte und Kammerorchester; Eespere: Konzert für Flöte und Kammerorchester; Bartok: Suite paysanne hongroise für Flöte und Streichorchester. Estonian National Symphony Orchestra / Arvo Volmer". Signum/Note 1 CD X72-00 (WD:54'30")DDD
... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 11169-029] Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and Soliciting Comments and Motions To Intervene On November 20, 2012, Mayo Hydropower, LLC (transferor) and Avalon Hydropower...
Ángel Vera Noriega
Full Text Available En el artículo se describen las características de las prácticas de crianza en una comunidad mayo y se realiza un análisis documental del Modelo de Educación Inicial no Escolarizada del CONAFE. Ello con la finalidad de contrastar los resultados de la práctica de crianza con las competencias esperadas de los padres y niños que asisten al programa y con base en ello, identificar la eficacia de la implementación del programa para la reproducción social en la etnia mayo. Participaron cincuenta madres y niños de la comunidad indígena mayo "El Júpare" ubicada en el municipio de Huatabampo, al sur de Sonora. Los instrumentos utilizados fueron Índice de Estrés Parental (Abidin, 1990, Interacción Padre-Hijo-Madre (Peña, 2004, Estimulación del Niño en el Hogar (Caldwell y Bradley, 1967 y Escala del Desarrollo Integral del niño (Atkin, 1987. En la evaluación del desarrollo, 54% de los niños presentan un desarrollo normal, 26% rrollo en riesgo y en 20% se detectan problemas. El programa de Educación Inicial no Escolarizado requiere de modificaciones sustantivas para responder a las prácticas de crianza que se desarrollan en la etnia mayo.
Mansell, Robin; Berdou, Evangelia
Despite the growing amount of research on Free/Libre/Open Source Software (FL/OSS) development, there is little insight into how structural factors associated with institutions influence the patterns of software developer activity in this area. This article examines some of the dynamics of the development of this type of software and the extent to which these dynamics are associated with features of the gift economy as is frequently suggested in the literature. Drawing on an empirical analysis of contributors to the GNOME FL/OSS project, we suggest that greater attention should be given to the emergence of a mixed economy in which features of the exchange economy come to the fore with implications for the power relationships among those contributing to FL/OSS.
Gilbert, B K; Mitchell, M P; Bengali, A R; Khandheria, B K
To describe the development of telemedicine capabilities-application of remote consultation and diagnostic techniques-and to evaluate the feasibility and practicality of such clinical outreach to rural and underserved communities with limited telecommunications infrastructures. In 1992, Mayo Foundation (Rochester, Minn, Jacksonville, Fla, and Scottsdale, Ariz), the National Aeronautics and Space Administration, and the Defense Advanced Research Projects Agency collaborated to create a complex network of fiberoptic landlines, video recording systems, satellite terminals, and specially developed data translators linking Mayo sites with other locations in the continental United States on an on-demand basis. The purpose was to transmit data via the asynchronous transfer mode (ATM) digital communications protocol over the Advanced Communications Technology Satellite. The links were intended to provide a conduit for transmission of data for patient-specific consultations between physicians, evaluation of medical imagery, and medical education for clinical staffs at remote sites. Low-data-rate (LDR) experiments went live late in 1993. Mayo Clinic Rochester successfully provided medical consultation and services to 2 small regional medical facilities. High-data-rate (HDR) experiments included studies of remote digital echocardiography, store-and-forward telemedicine, cardiac catheterization, and teleconsultation for congenital heart disease. These studies combined landline data transmission with use of the satellite. The complexity of the routing paths and network components, immaturity of available software, and inexperience with existing telecommunications caused significant study delays. These experiments demonstrated that next-generation satellite technology can provide batch and real-time imagery for telemedicine. The first-generation of the ATM and satellite network technology used in these experiments created several technical problems and inconveniences that should
Kean, Jacob; Malec, James F; Cooper, Douglas B; Bowles, Amy O
To investigate the psychometric properties of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) obtained by self-report in a large sample of active duty military personnel with traumatic brain injury (TBI). Consecutive cohort who completed the MPAI-4 as a part of a larger battery of clinical outcome measures at the time of intake to an outpatient brain injury clinic. Medical center. Consecutively referred sample of active duty military personnel (N=404) who suffered predominantly mild (n=355), but also moderate (n=37) and severe (n=12), TBI. Not applicable. MPAI-4 RESULTS: Initial factor analysis suggested 2 salient dimensions. In subsequent analysis, the ratio of the first and second eigenvalues (6.84:1) and parallel analysis indicated sufficient unidimensionality in 26 retained items. Iterative Rasch analysis resulted in the rescaling of the measure and the removal of 5 additional items for poor fit. The items of the final 21-item Mayo-Portland Adaptability Inventory-military were locally independent, demonstrated monotonically increasing responses, adequately fit the item response model, and permitted the identification of nearly 5 statistically distinct levels of disability in the study population. Slight mistargeting of the population resulted in the global outcome, as measured by the Mayo-Portland Adaptability Inventory-military, tending to be less reflective of very mild levels of disability. These data collected in a relatively large sample of active duty service members with TBI provide insight into the ability of patients to self-report functional impairment and the distinct effects of military deployment on outcome, providing important guidance for the meaningful measurement of outcome in this population. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
... Operation Regulation; Snake Creek, Islamorada, FL AGENCY: Coast Guard, DHS. ACTION: Notice of temporary... deviation from the regulation governing the operation of Snake Creek Bridge, mile 0.5, across Snake Creek... schedule of Snake Creek Bridge in Islamorada, Florida. This deviation will result in the bridge opening...
The use of videogames in the foreign language (FL) classroom seems to be gradually increasing nowadays. TICs are making the lives of educators easier and their teaching methods more effective; these positive experiences make that researchers in this field are constantly introducing and developing new teaching methods and electronic applications.…
Dannebrog. Kongehuset. Flæskesteg. Folkeskolen. Fodbold og øl. En lang række symboler og fortællinger kendetegner danskhed, men det er en myte, at danskerne er en homogen gruppe, fortæller professor Richard Jenkins....
...] Television Broadcasting Services; Panama City, FL AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: The Commission grants a petition for rulemaking filed by Gray Television Licensee, LLC... the Congressional review Act, see 5 U.S.C. 801(a)(1)(A). List of Subjects in 47 CFR Part 73 Television...
Dewhirst, Chad A; Hung, Joseph C
The purpose of this project was the development of a device that improves the design of our current capping block, the Mayo recapper. The major challenges for design and improvement included creating a device that is simple to use and can be applied throughout our department. We wanted a recapper device that increased safety and minimized the potential for needlesticks. Simplicity was another important factor, along with versatility and low cost. A new recapper, called EZ-Cap, was developed, and a comparison study was conducted to evaluate the pros and cons of the EZ-Cap recapper and the Mayo recapper. Nuclear medicine technologists (n = 10) in our department used each device when administering patient injections. At the conclusion of their patient injection rotation, they recorded on a survey sheet the pros and cons of each device. The results of this survey were used to evaluate the effectiveness, comfort level during use, and safety of each recapping device. We used a 2-level scoring system to help determine which device was more favorable. The first level focused on comfort and convenience and was given a score of +1 or -1. The second level focused on safety and was given a score of +2 or -2. Because we believed that safety was a high priority for our capping blocks, this level received a higher score than the first level. The Mayo recapper was the device preferred by 9 of 10 technologists surveyed. The EZ-Cap recapper had several technical issues that made it difficult to use and that could potentially lead to safety concerns. According to our scoring system, the Mayo recapper received a score of +9 for its pros and -4 for its cons. By comparison, the EZ-Cap recapper received a score of +7 for its pros and -16 for its cons. Our results show that the Mayo recapper was the device of choice because its pros outweighed its cons. However, we will continually improve the effectiveness of the Mayo recapper to prevent needlesticks.
Hurley, Deirdre A
BACKGROUND: Chronic low back pain (CLBP) is a persistent disabling condition with rising significant healthcare, social and economic costs. Current research supports the use of exercise-based treatment approaches that encourage people with CLBP to assume a physically active role in their recovery. While international clinical guidelines and systematic reviews for CLBP support supervised group exercise as an attractive first-line option for treating large numbers of CLBP patients at low cost, barriers to their delivery include space and time restrictions in healthcare settings and poor patient attendance. The European Clinical Guidelines have identified the need for research in the use of brief\\/minimal contact self-activation interventions that encourage participation in physical activity for CLBP. Walking may be an ideally suited form of individualized exercise prescription as it is easy to do, requires no special skills or facilities, and is achievable by virtually all ages with little risk of injury, but its effectiveness for LBP is unproven. METHODS AND DESIGN: This study will be an assessor-blinded randomized controlled trial that will investigate the difference in clinical effectiveness and costs of an individualized walking programme and a supervised general exercise programme compared to usual physiotherapy, which will act as the control group, in people with chronic low back pain. A sample of 246 patients will be recruited in Dublin, Ireland through acute general hospital outpatient physiotherapy departments that provide treatment for people with CLBP. Patients will be randomly allocated to one of the three groups in a concealed manner. The main outcomes will be functional disability, pain, quality of life, fear avoidance, back beliefs, physical activity, satisfaction and costs, which will be evaluated at baseline, and 3, 6 and 12 months [follow-up by pre-paid postage]. Qualitative telephone interviews and focus groups will be embedded in the research
... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Release of Airport Property: Orlando Executive Airport, Orlando, FL AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Request for... 12.4 acres at the Orlando Executive Airport, Orlando, FL from the conditions, release certain...
Lack of sleep has well established effects on physiological, cognitive and behavioural functionality. Sleep deprivation can adversely affect clinical performance as severely as alcohol according to some sources. Sleep deficiency may be due to loss of one night’s sleep or repeated interruptions of sleep. Chronic sleep degrades the ability to recognise one’s ability to recognise the impairments induced by sleep loss. The problem of sleep deprivation has vexed acute medical practice for decades. Improvement has been painfully slow. The problem is that all 168 hours throughout every week of every year have to be covered and there are a finite number of doctors to shoulder the burden. There are many strongly held views about how best to provide night-time and week-end care. Constructive innovations are thin on the ground. The biggest gap is between administration and doctors with financial considerations being the limiting factor. It is, however, generally accepted on all sides that sleep loss and fatigue can have adverse effects on both patients and doctors.
...-0099; Airspace Docket No. 12-ASO-11] Amendment of Class D Airspace; Cocoa Beach, FL AGENCY: Federal... Class D airspace at Cape Canaveral Skid Strip, Cocoa Beach, FL, by correcting the geographic coordinates... of Cape Canaveral Skid Strip, Cocoa Beach, FL. Also, the geographic coordinates for the airport need...
...-0099; Airspace Docket No. 12-ASO-11] Amendment of Class D Airspace; Cocoa Beach, FL AGENCY: Federal... Federal Register on April 11, 2012 that amends Class D airspace at Cocoa Beach, FL. DATES: Effective 0901...), amends Class D airspace at Cape Canaveral Skid Strip, Cocoa Beach, FL. A typographical error was made in...
...-AA09 Drawbridge Operation Regulations; Gulf Intracoastal Waterway, Venice, FL AGENCY: Coast Guard, DHS... that governs the Hatchett Creek (US-41) Twin Bridges, Gulf Intracoastal Waterway mile 56.9, Venice, FL... mile 56.9 at Venice, FL as listed in Sec. 117.287(b), provides the draw of the Hatchett Creek (US-41...
Kean, Jacob; Malec, James F; Altman, Irwin M; Swick, Shannon
The precise measurement of patient outcomes depends upon clearly articulated constructs and refined clinical assessment instruments that work equally well for all subgroups within a population. This is a challenging task in those with acquired brain injury (ABI) because of the marked heterogeneity of the disorder and subsequent outcomes. Although essential, the iterative process of instrument refinement is often neglected. This present study was undertaken to examine validity, reliability, dimensionality and item estimate invariance of the Mayo-Portland Adaptability Inventory - 4 (MPAI-4), an outcome measure for persons with ABI. The sampled population included 603 persons with traumatic ABI participating in a home- and community-based rehabilitation program. Results indicated that the MPAI-4 is a valid, reliable measure of outcome following traumatic ABI, which measures a broad but unitary core construct of outcome after ABI. Further, the MPAI-4 is composed of items that are unbiased toward selected subgroups except where differences could be expected [e.g., more chronic traumatic brain injury (TBI) patients are better able to negotiate demands of transportation than more acute TBI patients]. We address the trade-offs between strict unidimensionality and clinical applicability in measuring outcome, and illustrate the advantages and disadvantages of applying single-parameter measurement models to broad constructs.
Rutenberg, Tal Frenkel; Warshevski, Yaniv; Gold, Aviram; Shasha, Nadav; Snir, Nimrod; Chechik, Ofir; Dolkart, Oleg; Eilig, Dynai; Herman, Amir; Rath, Ehud; Kramer, Moti; Drexler, Michael
The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013. All patients underwent clinical assessment, radiological evaluation for the presence and development of radiolucent lines, and functional assessment (numerical analog scale, Harris hip score, and Short Form-12 questionnaire). Ninety-five hips (79 patients) were available for analysis. The patients' mean age was 43 years (range, 18-64 years), and the mean follow-up was 97 months (range, 26.9-166 months). The postoperative clinical assessments and functional assessments revealed significant improvements. Sixteen patients (20.3%) had 18 orthopedic complications, the most common of which were an intraoperative femoral fracture and implant dislocation requiring revision surgeries in 10 hips (10.5%). Radiological analysis revealed evidence of femoral remodeling in 64 (67.4%) implants, spot welds (neocortex) in 35 (36.8%), and osteolysis in 3 (3.2%). These results suggest that the conservative hip femoral implant has an unacceptable complication rate for non-elderly patients. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.
Die Bemerkung über die Probleme eines allgemeingültigen Ansatzes, die wir zu Anfang von Kap. 1 machten, gilt in noch höherem Maße für die Mechanik von strömenden Flüssigkeiten; dort erreicht man sogar ziemlich rasch die Grenze der Leistungsfähigkeit der heutigen Mathematik, d. h. wir können zwar - ausgehend von den Newtonschen Gesetzen (Bd. I/3) - eine Differentialgleichung für die Strömung von Flüssigkeiten aufstellen, die sog. Navier-Stokes-Gleichung, es sind aber keine allgemein anwendbaren Lösungsverfahren für diese Gleichung bekannt. Ein Blick in die Natur und auf die vielfältigen Strömungsphänomene zeigt, dass diese Tatsache nicht verwunderlich ist.
...-AA00 Safety Zone; Pensacola Bay; Pensacola, FL AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a temporary safety zone for a portion of Pensacola Bay including...[deg]17'20.31'' W, 30[deg]20'41.51'' N 087[deg]15'01.15'' W, and 30[deg]20'11.76'' N 087[deg]15'01.18...
Malec, James F
To determine the internal consistency, reliability and comparability of the Mayo-Portland Adaptability Inventory (MPAI-4) and sub-scales completed by people with acquired brain injury (ABI), family and significant others (SO) and rehabilitation staff. 134 people with ABI consecutively seen for outpatient rehabilitation evaluation. MPAI-4 protocols based on independent ratings by the people with ABI undergoing evaluation, SO and rehabilitation staff were submitted to Rasch Facets analysis to determine the internal consistency of the overall measure and sub-scales (Ability, Adjustment and Participation indices) for each rater group and for a composite measure based on all rater groups. Rater agreement for individual items was also examined. Rasch indicators of internal consistency were entirely within acceptable limits for 3-rater composite full scale and sub-scale measures; these indicators were generally within acceptable limits for measures based on a single rater group. Item agreement was generally acceptable; disagreements suggested various sources of bias for specific rater groups. The MPAI-4 possesses satisfactory internal consistency regardless of rating source. A composite measure based on ratings made independently by people with ABI, SO and staff may serve as a 'gold standard' for research purposes. In the clinical setting, assessment of varying perspectives and biases may not only best represent outcome as evaluated by all parties involved but be essential to developing effective rehabilitation plans.
Khurmi, Narjeet; Patel, Perene; Koushik, Sarang; Daniels, Thomas; Kraus, Molly
Understanding the goals of targeted radiation therapy in pediatrics is critical to developing high quality and safe anesthetic plans in this patient population. An ideal anesthetic plan includes allaying anxiety and achieving optimal immobilization, while ensuring rapid and efficient recovery. We conducted a retrospective chart review of children receiving anesthesia for radiation oncology procedures from 1/1/2014 to 7/31/2016. No anesthetics were excluded from the analysis. The electronic anesthesia records were analyzed for perianesthetic complications along with efficiency data. To compare our results to past and current data, we identified relevant medical literature covering a period from 1984-2017. A total of 997 anesthetic procedures were delivered in 58 unique patients. The vast majority of anesthetics were single-agent anesthesia with propofol. The average duration of radiation treatment was 13.24 min. The average duration of anesthesia was 37.81 min, and the average duration to meet discharge criteria in the recovery room was 29.50 min. There were seven instances of perianesthetic complications (0.7%) and no complications noted for the 80 CT simulations. Two of the seven complications occurred in patients receiving total body irradiation. The 5-year survival rate for pediatric cancers has improved greatly in part due to more effective and targeted radiation therapy. Providing an anesthetic with minimal complications is critical for successful daily radiation treatment. The results of our data analysis corroborate other contemporary studies showing minimal risk to patients undergoing radiation therapy under general anesthesia with propofol. Our data reveal that single-agent anesthesia with propofol administered by a dedicated anesthesia team is safe and efficient and should be considered for patients requiring multiple radiation treatments under anesthesia.
Siwani, Rizwan; Tombers, Nicole M; Rieck, Kevin L; Cofer, Shelagh A
To review and compare the epidemiology and treatment of mandibular fractures in subgroups of a pediatric population. We conducted a retrospective review of pediatric patients (age, ≤18 years) with mandibular fractures treated at our institution from January 1996 through November 2011. We identified 122 patients (93 [76%] male) with 216 mandibular fractures. The prevalent mechanisms of injury were motor vehicle accidents (n=52 [43%]), sports injuries (n=24 [20%]), and assault (n=13 [11%]). The most common fracture sites were subcondylar, parasymphyseal, angle, and body. Two patients (2%) were treated conservatively by observation only, 67 (55%) underwent maxillomandibular fixation alone, 41 (34%) underwent maxillomandibular fixation with plate fixation, and 7 (5.7%) underwent plate fixation only. The average duration of maxillomandibular fixation was 26 days (range, 7-49 days). Complications occurred in 11 patients (9.0%) over a mean follow-up of 92 days (range, 21-702 days). Fifty patients (41.0%) had comorbid conditions or a history of mental illness at the time of injury, including attention deficit hyperactivity disorder (n=11 [9%]), mental disorders other than attention deficit hyperactivity disorder (n=23 [19%]), and asthma (n=17 [14%]). Twenty-six patients (21%) had a history of substance use, the most common being tobacco (n=18 [15%]), alcohol (n=13 [11%]), and marijuana (n=11 [9%]). Treatment approach and outcomes were affected by age and fracture characteristics. In addition, a marked proportion of this cohort had preexisting mental disorders and history of substance use, which may have implications on treatment approach. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Shiva P. Ponamgi
Conclusions: We describe the largest reported case series of catheter-based intervention for PV stenosis in FM. Although catheter-based therapy improved hemodynamics, short-term vascular patency, and patient symptoms, the rate of life-threatening complications, restenosis, and mortality associated with these interventions was found to be high. Despite these associated risks, catheter-based intervention is the only palliative option available to improve quality of life in severely symptomatic patients with PV stenosis and FM. Patients with PV stenosis and FM (especially those with bilateral disease have an overall poor prognosis in spite of undergoing these interventions due to the progressive and recalcitrant nature of the disease. This underscores the need for further innovative approaches to manage this disease.
Gold, Douglas G.; Miller, Robert C.; Petersen, Ivy A.; Osborn, Thomas G.
Purpose: To determine the frequency of acute and chronic adverse effects in patients with scleroderma who receive radiotherapy for treatment of cancer. Methods and Materials: Records were reviewed of 20 patients with scleroderma who received radiotherapy. Acute and chronic toxic effects attributable to radiotherapy were analyzed, and freedom from radiation-related toxicity was calculated. Results: Of the 20 patients, 15 had acute toxic effects, with Grade 3 or higher toxicity for 3 patients. Seven patients had self-limited Grade 1 or 2 radiation dermatitis, and no patient had Grade 3 or higher radiation dermatitis. Thirteen patients had chronic toxic effects, with Grade 3 or higher chronic toxicity for 3 patients. The median estimated time to any grade chronic toxicity was 0.4 years, and the median estimated time to Grade 3 or higher chronic toxicity has not been reached. Conclusions: The results suggest that although some patients with scleroderma treated with radiation experience considerable toxic effects, the occurrence of Grade 3 or higher toxicity may be less than previously anticipated
Miller, Robert C.; Lachance, Daniel H.; Lucchinetti, Claudia F.; Keegan, B. Mark; Gavrilova, Ralitza H.; Brown, Paul D.; Weinshenker, Brian G.; Rodriguez, Moses
Purpose: The aim of this study was a retrospective assessment of neurotoxicity in patients with multiple sclerosis (MS) receiving external beam radiotherapy (EBRT) to the brain. Methods and Materials: We studied 15 consecutively treated patients with MS who received brain EBRT. Neurologic toxicity was assessed with the Common Toxicity Criteria v.3.0. Results: Median follow-up for the 5 living patients was 6.0 years (range, 3.3-27.4 years). No exacerbation of MS occurred in any patient during EBRT. Five patients had Grade 4 neurologic toxicity and 1 had possible Grade 5 toxicity. Kaplan-Meier estimated risk of neurotoxicity greater than Grade 4 at 5 years was 57% (95% confidence interval, 27%-82%). Toxicity occurred at 37.5 to 54.0 Gy at a median of 1.0 year (range, 0.2-4.3 years) after EBRT. Univariate analysis showed an association between opposed-field irradiation of the temporal lobes, central white matter, and brainstem and increased risk of neurotoxicity (p < 0.04). Three of 6 cases of toxicity occurred in patients treated before 1986. Conclusions: External beam radiotherapy of the brain in patients with MS may be associated with an increased risk of neurotoxicity compared with patients without demyelinating illnesses. However, this risk is associated with treatment techniques that may not be comparable to modern, conformal radiotherapy
While many different proposals have been put forward outlining a post-Cold War security identity for the United States, most do not characterize an American role in terms of either excessive activism...
Christodoulidis, Georgios; Kundoor, Vishwa; Kaluski, Edo
BACKGROUND Various physical and emotional factors have been previously described as triggers for stress induced cardiomyopathy. However, acute myocardial infarction as a trigger has never been reported. CASE REPORT We describe four patients who presented with an acute myocardial infarction, in whom the initial echocardiography revealed wall motion abnormalities extending beyond the coronary distribution of the infarct artery. Of the four patients identified, the mean age was 59 years; three patients were women and two patients had underlying psychiatric history. Electrocardiogram revealed ST elevation in the anterior leads in three patients; QTc was prolonged in all cases. All patients had ≤ moderately elevated troponin. Single culprit lesion was found uniformly in the proximal or mid left anterior descending artery. Initial echocardiography revealed severely reduced ejection fraction with relative sparing of the basal segments, whereas early repeat echocardiography revealed significant improvement in the left ventricular function in all patients. CONCLUSIONS This is the first case series demonstrating that acute myocardial infarction can trigger stress induced cardiomyopathy. Extensive reversible wall motion abnormalities, beyond the ones expected from angiography, accompanied by modest elevation in troponin and marked QTc prolongation, suggest superimposed stress induced cardiomyopathy.
Stubbs, James R; Zielinski, Martin D; Jenkins, Donald
AABB Standards specify that ABO group-specific whole blood is the only acceptable choice for whole blood transfusions. Although universal donor group O stored whole blood (SWB) was used extensively by the military during the wars of the mid-twentieth century, its use has fallen out of favor and has never been used to great extent in the civilian trauma population. Interest in the use of whole blood has been renewed, particularly in light of its potential value in far-forward military and other austere environments. Evidence of preserved platelet function in SWB has heightened enthusiasm for a "one stop shop" resuscitation product providing volume, oxygen carrying capacity, and hemostatic effects. Experience with universal donor group O SWB is required to ascertain whether its use will be an advance in trauma care. Described here is the process of establishing a universal donor group O SWB at a civilian trauma center in the United States. © 2016 AABB.
Pinn, Melva E.; Gold, Douglas G. M.; Petersen, Ivy A.; Osborn, Thomas G.; Brown, Paul D.; Miller, Robert C.
Purpose: To determine the acute and chronic toxic effects of radiotherapy in patients with systemic lupus erythematosus (SLE). Methods and Materials: Medical records of 21 consecutive patients with SLE, who had received 34 courses of external beam radiotherapy and one low-dose-rate prostate implant, were retrospectively reviewed. Patients with discoid lupus erythematosus were excluded. Results: Median survival was 2.3 years and median follow-up 5.6 years. Eight (42%) of 19 patients evaluable for acute toxicity during radiotherapy experienced acute toxicity of Grade 1 or greater, and 4 (21%) had acute toxicity of Grade 3 or greater. The 5- and 10-year incidence of chronic toxicity of Grade 1 or greater was 45% (95% confidence interval [CI], 22-72%) and 56% (95% CI, 28-81%), respectively. The 5- and 10-year incidence of chronic toxicity of Grade 3 or greater was 28% (95% CI, 18-60%) and 40% (95% CI, 16-72%), respectively. Univariate analysis showed that chronic toxicity of Grade 1 or greater correlated with SLE renal involvement (p < 0.006) and possibly with the presence of five or more American Rheumatism Association criteria (p < 0.053). Chronic toxicity of Grade 3 or greater correlated with an absence of photosensitivity (p < 0.02), absence of arthritis (p < 0.03), and presence of a malar rash (p < 0.04). Conclusions: The risk of acute and chronic toxicity in patients with SLE who received radiotherapy was moderate but was not prohibitive of the use of radiotherapy. Patients with more advanced SLE may be at increased risk for chronic toxicity
Creagan, Edward T; Bauer, Brent A; Thomley, Barbara S; Borg, Jessica M
The animal-human bond refers to an emotional, almost existential, relationship between animals and people. From the time of antiquity, domestic animals were an important source of economic vitality, but with the changing cultural landscape, the companion animal has become a faithful friend. Overwhelming anecdotal evidence supports the healing power of this relationship. We summarize the emerging literature on the neurobiochemical and cardiovascular benefits of companion pet ownership. We address the peer-reviewed data from myriad journal articles assessing the impact of the companion animal on the quality and often the length of life of select patients. Copyright © 2015 Elsevier Ltd. All rights reserved.
...-1146; Airspace Docket No. 10-ASO-25] RIN 2120-AA66 Amendment of Restricted Areas R-2907A and R-2907B, Lake George, FL; and R-2910, Pinecastle, FL AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... commenters objected to the proposed establishment of two new restricted areas, R-2907B (located between R...
Valverde Gómez, José Antonio, 1926-2003
Salida de campo a Etang de Fournelet, seguramente cerca a la reserva natural de La Camarga, en el delta del río Ródano (Provenza), el 1 de mayo de 1954, de la que se anotaron observaciones sobre las siguientes aves: Actitis hypoleucos (Andarríos chico, llamado Actynioides hypoleucus por el autor), Circus aeruginosus (Aguilucho lagunero occidental), Himantopus himantopus (Cigüeñuela común), Motacilla flava (Lavandera boyera), Saxicola rubetra (Tarabilla norteña), Sylvia conspicillata (Curruca ...
Coronado-Aceves, Enrique Wenceslao; Sánchez-Escalante, José Jesús; López-Cervantes, Jaime; Robles-Zepeda, Ramón Enrique; Velázquez, Carlos; Sánchez-Machado, Dalia Isabel; Garibay-Escobar, Adriana
Tuberculosis (TB) is an infectious disease mainly caused by Mycobacterium tuberculosis (Mtb), which generates 9 million new cases worldwide each year. The Mayo ethnicity of southern Sonora, Mexico is more than 2000 years old, and the Mayos possess extensive knowledge of traditional medicine. To evaluate the antimycobacterial activity levels of extracts of medicinal plants used by the Mayos against Mtb and Mycobacterium smegmatis (Msm) in the treatment of TB, respiratory diseases and related symptoms. A total of 34 plant species were collected, and 191 extracts were created with n-hexane, dichloromethane, ethyl acetate (EtOAc), methanol and water. Their minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined against Mtb H37Rv using the microplate alamar blue assay (MABA) and against Msm using the resazurin microplate assay (REMA) at 6 and 2 days of exposure, respectively, and at concentrations of 250-1.9µg/mL (n-hexane extracts) and 1000-7.81µg/mL (extracts obtained with dichloromethane, EtOAc, methanol and water). Rhynchosia precatoria (Willd.) DC. (n-hexane root extract), Euphorbia albomarginata Torr. and A. Gray. (EtOAc shoot extract) and Helianthus annuus L. (n-hexane stem extract) were the most active plants against Mtb H37Rv, with MICs of 15.6, 250, 250µg/mL and MBCs of 31.25, 250, 250µg/mL, respectively. R. precatoria (root) was the only active plant against Msm, with MIC and MBC values of ≥250µg/mL. None of the aqueous extracts were active. This study validates the medicinal use of certain plants used by the Mayo people in the treatment of TB and related symptoms. R. precatoria, E. albomarginata and H. annuus are promising plant sources of active compounds that act against Mtb H37Rv. To our knowledge, this is the first time that their antimycobacterial activity has been reported. Crude extracts obtained with n-hexane, EtOAc and dichloromethane were the most active against Mtb H37Rv. Copyright © 2016
Gutiérrez González, Acela Elena
Al movimiento feminista lo podemos dividir en dos etapas. La primera corresponde a su lucha por la igualdad de derechos civiles que concluye en los países europeos y Norteamérica con la finalización de la segunda guerra mundial. La segunda etapa es política. En Latinoamérica surge con el nacimiento de la revolución cubana. En los países europeos, como consecuencia de la Primavera de Praga, el Mayo Francés y la oposición de los jóvenes norteamericanos a intervenir militarmente en la autodeterm...
Chudhary, M.K.; Younis, M.; Bukhari, M.H.
The World Health Organization cites tobacco use as one of the biggest public health threats the world has ever faced. Tobacco is the number one preventable cause of disability and death. Tobacco has many negative health effects which many of the smokers know them well. In Pakistan tobacco use is common in general public and the health professionals don't lack behind this habit. To study the smoking trends amongst young doctors of Mayo Hospital. Questionnaire based descriptive study. This study was conducted at the Institute of Chest Medicine, Mayo Hospital - A tertiary care hospital affiliated with King Edward Medical University, Lahore. Out of 250 doctors, 180 (72%) were males and 70 (28%) were female. Amongst 180 male doctors 97 (53.88%) were smokers and 83 (46.21%) were non smokers. Amongst 70 female doctors 8 (11.43%) were smokers and 62 (88.57%) were non smokers. Smoking is common among male young doctors but it is less common in female doctors. (author)
Extreme Hochwasser verursachen enorme Schäden in Flusslandschaften. Flussgemeinschaften müssen künftig den Flüssen mehr Raum geben, um Hochwasser in der Fläche zurückzuhalten, statt in der Höhe (der Deiche) zu bekämpfen. Die Idee „den Flüssen mehr Raum geben“ beschreibt eigentlich etwas
Severina Álvarez González
Full Text Available Nowadays the university educational system finds itself in a process of changes affecting the pedagogical scope. Bids are on new methodologies whose emphasis is made on open knowledge construction, cooperative learning and new resources and didactic tools: the use of ICT in the classroom. This paper shows the experience of a language classroom when implanting a didactic proposal including the use of ICT to provide cooperative learning among the students at the University of Oviedo. In order to value the results obtained by the experience in the FL teaching process, the students were asked to fill in a survey to express their experiences and teachers were asked to daily write their class planning, issues, motivations etc.
Patricia Marion Y. Lopez
Full Text Available The paper reflects on the meanings of the Flores de Mayo ritual as performed in a town on the southeastern coast of Cebu through the examination of Mary as a “semantically open” symbol. The essay illustrates how ideas about Mary are constructed through the discourse of the Church and are in turn, reinforced through a Church-instituted and regulated ritual. An analysis of selected elements of the ritual however, reveals that the symbol of Mary has the potential to hold “other” kinds of meanings that slip in between “official” and “unofficial” discourses, highlighting how Mary continues to be a negotiated field between church authorities and the popular faithful.
José Felix Patiño Restrepo
Full Text Available
Brillante, generoso, noble, escritor prolífico, un completo caballero, Fernando Serpa Flórez fue el prototipo del médico intelectual, humanista y humanitario. Su vocación por la salud pública lo llevó a ocupar altos cargos en el ramo: Secretario General del Ministerio de Salud, Secretario de Salud de Bogotá, Director del Instituto Nacional de Salud, Director del Ministerio de Salud y Ministro Encargado de Salud. Como Asesor de la Organización Mundial de la Salud, trabajó en Afganistán en el programa de erradicación de la viruela.
Fue médico, jefe de Ecopetrol. Desde su elevada posición como Magistrado del Tribunal Nacional de Etica Médica, y con el ejemplo de su vida personal, como uno de los miembros más distinguidos de la Academia Nacional de Medicina, Fernando Serpa Flórez ocupa un lugar de particular distinción en la historia
contemporánea de la medicina colombiana.
Tuve el privilegio de su amistad por más de medio siglo, como condiscípulo en la Facultad de Medicina de la Universidad Nacional y luego a través de los años compartiendo afectos e intereses. Me acompaño con talento, lealtad y dedicación como Director del Ministerio cuando ocupé el cargo de Ministro en el Gobierno del eximio Presidente Guillermo León Valencia. Para quienes lo conocimos de cerca, este vástago de
una brillante familia de médicos, sobrevivirá en nuestra memoria y en sus obras...
...-0070; Airspace Docket No. 10-ASO-43] Proposed Amendment of Class E Airspace; Cocoa, FL AGENCY: Federal... proposes to amend Class E Airspace at Cocoa, FL, as the Merritt Island Non-Directional Beacon (NDB) has... surface to support new standard instrument approach procedures developed at Merritt Island Airport, Cocoa...
...-0503; Airspace Docket No. 11-ASO-19] Proposed Amendment of Class E Airspace; Orlando, FL AGENCY... action proposes to amend Class E Airspace at Orlando, FL, as new Standard Instrument Approach Procedures have been developed at Orlando Executive Airport. This action would enhance the safety and airspace...
... received without jeopardizing the safety or security of people, places or vessels. 7. Unfunded Mandates... waters of Biscayne Bay, Miami, FL between Bayfront Park and the Intercontinental-Miami Hotel encompassed... Area. All waters of Biscayne Bay, Miami, FL between Bayfront Park and the Intercontinental-Miami Hotel...
van Dam, GM; Gips, CH; Reisman, Y; Maas, KW; Purmer, IM; Huizenga, [No Value; Verbaan, BW
BACKGROUND/AIMS: One of the prognostic methods for survival in primary biliary cirrhosis (PBC) is the Mayo model, with a time-scale limited to 7 years. The aim of our study was to assess how major clinical events, signs, several severity assessment methods and Mayo survival probabilities fit in with
Minssen, Timo; Nilsson, David
On 20 March 2012, the US Supreme Court handed down its much awaited patent eligibility- ruling in the dispute between Prometheus Laboratories Inc (“Prometheus”), acting as plaintiffs, and Mayo Medical Laboratories (“Mayo”), as alleged infringers of Prometheus’ licensed patents. This case review w...
Síndrome de Hopkins no diagnóstico diferencial das paralisias flácidas na infância: aspectos clínicos e neurofisiológicos. Relato de caso Hopkins' syndrome in the differential diagnosis of flaccid paralysis in children: clinical and neurophysiological features. Case report
Daniel B. Nora
Full Text Available INTRODUÇÃO: A síndrome de Hopkins (SH é caracterizada por monoplegia ou diplegia, decorrente de lesão no corno anterior da medula, que se segue a um ataque agudo de asma, ocorre geralmente em crianças e sua etiologia ainda não está definida. Há 34 casos descritos no mundo, sendo este o primeiro relato na América do Sul e durante o primeiro ano de vida. CASO: Criança internada aos 4 meses de idade com quadro de sibilância e insuficiência respiratória. Cerca de 3 dias após melhora do quadro respiratório, observou-se perda de força nos membros inferiores. Teve alta hospitalar com regressão do quadro respiratório mantendo a paraparesia. Reinternada aos 9 meses de idade por novo quadro de broncoespasmo, demonstrando paralisia flácida assimétrica (E>D e atrofia nos membros inferiores. EXAME NEUROLÓGICO: força e reflexos miotáticos normais nos membros superiores, arreflexia miotática nos membros inferiores e sensibilidade preservada. Exames de líquor, ressonância magnética de coluna lombossacra e potencial evocado somatossensitivo dos membros inferiores: normais. BIÓPSIA MUSCULAR: Grupamento de fibras. A eletroneuromiografia demonstrou sinais de lesão do neurônio motor do corno anterior da medula nos metâmeros lombossacros. CONCLUSÃO: A Síndrome de Hopkins, apesar de rara, deve ser lembrada no diagnóstico diferencial de paralisias flácidas, quando houver concomitância com asma.INTRODUCTION: Hopkins syndrome is a motor neuron disease which leads to a flaccid paralysis affecting one or more limbs resembling poliomyelites. It follows an asthmatic attack and the prognosis is poor. All the 34 related cases occured after 13 months of age and there is no report in South America. Our objective is to describe a case of Hopkins Syndrome in Brazil affecting a patient younger than 1 year. CASE: Male 4 months-old infant, started presenting wheezing that turned into respiratory failure which required mecanical ventilation. Three
Yokoyama, Katsushi; Nogami, Hideki; Kabasawa, Mamiko; Ebihara, Sonomi; Shimowasa, Ai; Hashimoto, Keiko; Kawashima, Tsuyoshi; Ishijima, Sanae A.; Suzuki, Masashi
The DNA-binding mode of archaeal feast/famine-regulatory proteins (FFRPs), i.e. paralogs of the Esherichia coli leucine-responsive regulatory protein (Lrp), was studied. Using the method of systematic evolution of ligands by exponential enrichment (SELEX), optimal DNA duplexes for interacting with TvFL3, FL10, FL11 and Ss-LrpB were identified as TACGA[AAT/ATT]TCGTA, GTTCGA[AAT/ATT]TCGAAC, CCGAAA[AAT/ATT]TTTCGG and TTGCAA[AAT/ATT]TTGCAA, respectively, all fitting into the form abcdeWWWedcba. Here W is A or T, and e.g. a and a are bases complementary to each other. Apparent equilibrium binding constants of the FFRPs and various DNA duplexes were determined, thereby confirming the DNA-binding specificities of the FFRPs. It is likely that these FFRPs recognize DNA in essentially the same way, since their DNA-binding specificities were all explained by the same pattern of relationship between amino-acid positions and base positions to form chemical interactions. As predicted from this relationship, when Gly36 of TvFL3 was replaced by Thr, the b base in the optimal DNA duplex changed from A to T, and, when Thr36 of FL10 was replaced by Ser, the b base changed from T to G/A. DNA-binding characteristics of other archaeal FFRPs, Ptr1, Ptr2, Ss-Lrp and LysM, are also consistent with the relationship. PMID:19468044
Boer, Y.A. de; Ende, C.H.M. van den; Eygendaal, D.; Jolie, I.M.M.; Hazes, J.M.W.; Rozing, P.M.
OBJECTIVES: (1) To investigate the measurement characteristics of the Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment instruments, utilizing methodological criteria including feasibility, reliability, validity, and discriminative ability; and (2) to develop an efficient and
Riaz, N.; Warriach, R.A.
The oro-facial region including the oral cavity, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla. We report results from a retrospective study spanning five years on the frequency, clinical presentation, sites and character of orofacial tumors seen in the main referral hospital of Pakistan. Patients and Methods: Records of consecutive patients of all age and sex seen by the author's team at the Department of Oral and Maxillofacial Surgery, Mayo Hospital with tumours affecting the oro-facial region from January 2005 to December 2009 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 237 patients with oro-facial swellings were retrieved from the registry. The complete data set was obtained for 189 patients, comprising 108 (57.9%) males and 81 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), and ulceration (29%). The tumors were found in the mandible 67 (35%), buccal mucosa 33 (17%), floor of the mouth 22 (11%) and tongue 29 (15%). The remainder making up almost 20% was found in the palate, submandibular region, pre auricular region and lips. Ninety three (49.2%) of the patients presented with lesions that were classified as malignant of which 64 (69%) were diagnosed as squamous cell carcinoma (SCC). seventy (37.0%) had benign odontogenic tumors and twenty six (13.7%) had non-odontogenic tumor - like lesions. Sixty - four (69%) of malignant tumors were squamous cell carcinoma; sixty four (86.4%) of the benign odontogenic tumors were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged
Javed, T.; Bibi, A.
Major outbreak of measles took place in Punjab recently (2013), leading on to increase in hospitalized cases of measles in children wards, with unacceptably high morbidity and mortality. The aim of this study was to find out morbidity and mortality pattern of hospitalized cases of measles and associated factors. Design: Prospective case series conducted at Pediatric Department Mayo Hospital, Lahore for 7 months, i.e. from 1st Jan to 31st Jul 2013 Methods:A total of 628 cases of measles were admitted in the children ward, Unit II, Mayo Hospital, Lahore from Jan-Jul 2013. The diagnosis was assigned using WHO criteria. Cases were admitted through emergency on 24 hour basis and managed in HDU and Measles isolation section. Chest X-Ray and blood complete examination was done in all cases. Complications were noted and managed along with eye consultations where necessary. Data was recorded in a predesigned proforma and entered in computer. Results: 628 admitted cases were enrolled, with comparable sex distribution, having mean age 30.8+-26.25 months and mean weight 9.69+-4.14 Kg. Eighty three percent cases were below 6 years of age (33% <1 year), 71% cases were under weight and 68% were wasted (WHO classification). Sixty six percent cases had not received measles vaccination, 144 (23%) cases had received a single dose and 71 cases (12.2%) had received two doses before admission. Majority of cases belonged to Lahore city and its peri-urban areas (83%). Pneumonia (80%), diarrhea (37%), and encephalitis (7.7%) were common complications. Eye complications (corneal ulcers, keratitis, perforation and blindness) were seen in 7.3% cases. Being under weight, H/O improper measles immunization, presence of anemia, pneumonia and encephalitis were statistically significant risk factors for mortality. The case fatality rate was 8.76%. Conclusion:Recent Measles outbreak further highlights the importance of strengthening the need for routine and mass vaccination for all children. In a
Akkelies van Ness
Full Text Available The aim of this research is to show how the spatial features of urban environments affect women and men’s behaviour pattern. The paper’s first part reveals the concept flâneuse in the relationship with the flâneur. Then the spatial parameters of built environments are discussed. As the results from this inquiry show, correlations between the spatial configurative structures and how men and women use urban space were found on the one hand. In spatially integrated streets, an equal number of women and men were found. The more segregated the streets tend to be the more they were dominated by men. On the other hand, as soon as the shops were closed, men dominated the streets. Women are using the street as corridor and not as a destination itself. When women are using the squares in the evening or at night, they are usually accompanied by others. The use of space syntax showed that liveliness could be predicted by the structure of the city. Not only do the crowd provide the flâneuse a valid excuse to wander around the streets, a sense of security, but it’s also a component of flânerie: to see and to be seen. Namely, for the flâneuse liveliness is one of the conditions to stroll around. Hence, knowledge provided from research seems to be essential for designing urban environment attractive for women as well for men.
Elahi, S.; Khan, M.; Rasool, S.; Khalid, A.; Tasneem, A.
To know level of iodine intake in women residing in Lahore and correlate it with pattern of thyroid diseases found in women referred to Centre for Nuclear Medicine (CENUM), Mayo Hospital. Iodine intake status was determined by urinary iodine (UI) excretion by Sandell-Kolthoff reaction. Thyroid related hormones (FT4, FT3 and TSH) were measured by radioimmunoassay. In 110 non-pregnant euthyroid women (age 20-36 year) average iodine intake was 66.3 +- 14.4 mu g/L (range: 30-98 mu g/dL). All women were iodine deficient (UI 22.0 pmol/L and TSH greater or equal to 0.1mIU/L) was detected in 580(10.8%) women and hypothyroidism (FT4 0.4mIU/L) was found in 271(5.1%) women. Thus incidence of hyperthyroidism was almost double than that of hypothyroidism. Low iodine intake is manifested as increased incidence of hyperthyroidism. (author)
Lexell, Jan; Malec, James F; Jacobsson, Lars J
To examine the contents of the Mayo-Portland Adaptability Inventory (MPAI-4) by mapping it to the International Classification of Functioning, Disability and Health (ICF). Each of the 30 scoreable items in the MPAI-4 was mapped to the most precise ICF categories. All 30 items could be mapped to components and categories in the ICF. A total of 88 meaningful concepts were identified. There were, on average, 2.9 meaningful concepts per item, and 65% of all concepts could be mapped. Items in the Ability and Adjustment subscales mapped to categories in both the Body Functions and Activity/Participation components of the ICF, whereas all except 1 in the Participation subscale were to categories in the Activity/Participation component. The items could also be mapped to 34 (13%) of the 258 Environmental Factors in the ICF. This mapping provides better definition through more concrete examples (as listed in the ICF) of the types of body functions, activities, and participation indicators that are represented by the 30 scoreable MPAI-4 items. This may assist users throughout the world in understanding the intent of each item, and support further development and the possibility to report results in the form of an ICF categorical profile, making it universally interpretable.
Malec, James F
To evaluate the internal consistency, interrater agreement, concurrent validity, and floor and ceiling effects of the 8-item Participation Index (M2PI) of the Mayo-Portland Adaptability Inventory (MPAI). M2PI data derived from MPAIs completed independently by the people with acquired brain injury undergoing evaluation, their significant others, and rehabilitation staff were submitted to Rasch Facets analysis to determine the internal consistency of each independent rater group and of composite measures that combined rater groups. Correlations with the full-scale MPAI were examined to assess concurrent validity, as was interrater agreement. Outpatient rehabilitation in academic physical medicine and rehabilitation department. People with acquired brain injury (N=134) consecutively seen for evaluation, significant others, and evaluating staff. Not applicable. The MPAI and M2PI. The M2PI showed satisfactory internal consistency, concurrent validity, interrater agreement, and minimal floor and ceiling effects, although evidence of rater bias was also apparent. Composite indices showed more desirable psychometric properties than ratings by individual rater groups. The M2PI, particularly in composite indices and with attention to rater biases, provides an outcome measure with satisfactory psychometric qualities and the potential to represent the varying perspectives of people with acquired brain injury, significant others, and rehabilitation staff.
Bubach, Débora; Catán, Soledad Perez; Di Fonzo, Carla; Dopchiz, Laura
Several pollutants, which include metals, are present in the Antarctic atmosphere, snow, marine and terrestrial organisms. This work reports the elements incorporated by Usnea sp thalli in Potter Peninsula, 25 de Mayo (King George) Island, South Shetlands, Antarctica. Geological origin was analyzed as possible sources of elements. For this purpose, correlations were done using a geochemical tracer, principal component analysis and enrichment factors were computed. Lithophile elements from particulate matter were present in most of the sampling sites. Bromine, Se and Hg showed the highest enrichment factors suggesting other sources than the particulate matter. Mercury values found in Usnea sp were in the same range as those reported for Deception Island (South Shetlands) and remote areas from the Patagonia Andes. - Highlights: • Hg enrichment factor was higher in ASPA than in human settlements area. • The elemental composition in Usnea sp from Antarctica reflected the human influence. • Bromine, Ca, Sr, Se, Fe, Hg and K contents indicated origins natural and anthropic. • The data will be considered as baselines for Potter Peninsula, King George Island. - This study provides recent element contents in Usnea sp from Potter Peninsula, South Shetland Islands, Antarctica. Some of them are the first concentration reported by Argentina.
Alma Angelina Haro Martínez
Full Text Available en este trabajo se presentan los resultados de la valora-ción económica de los servicios ambientales, para la cuencabaja del río Mayo, en Sonora, en el noroeste de México,donde las actividades económicas han impactado severa-mente y sustituido los ecosistemas naturales en la mayorparte del territorio. La metodología utilizada consistió en ladelimitación de los servicios en función de su distribuciónespacial y, en algunos casos, se usaron componentes de losecosistemas como proxy. Se compararon nueve servicios,que abarcan los cuatro grupos de funciones ecosistémicas(regulación, soporte, provisión y cultural. Los cálculos sebasaron en valores estimados de mercado por servicio y porunidad de área. Esto generó nueve mapas individuales y unodonde se integra el valor total por unidad de área.
Rovati, José I; Pajot, Hipólito F; Ruberto, Lucas; Mac Cormack, Walter; Figueroa, Lucía I C
Antarctica offers a range of extreme climatic conditions, such as low temperatures, high solar radiation and low nutrient availability, and constitutes one of the harshest environments on Earth. Despite that, it has been successfully colonized by ’cold-loving’ fungi, which play a key role in decomposition cycles in cold ecosystems. However, knowledge about the ecological role of yeasts in nutrient or organic matter recycling/mineralization remains highly fragmentary. The aim of this work was to study the yeast microbiota in samples collected on 25 de Mayo/King George Island regarding the scope of their ability to degrade polyphenolic substrates such as lignin and azo dyes. Sixty-one yeast isolates were obtained from 37 samples, including soil, rocks, wood and bones. Molecular analyses based on rDNA sequences revealed that 35 yeasts could be identified at the species level and could be classified in the genera Leucosporidiella, Rhodotorula, Cryptococcus, Bullera and Candida. Cryptococcus victoriae was by far the most ubiquitous species. In total, 33% of the yeast isolates examined showed significant activity for dye decolorization, 25% for laccase activity and 38% for ligninolytic activity. Eleven yeasts did not show positive activity in any of the assays performed and no isolates showed positive activity across all tested substrates. A high diversity of yeasts were isolated in this work, possibly including undescribed species and conspicuous Antarctic yeasts, most of them belonging to oligotrophic, slow-growing and metabolically diverse basidiomycetous genera.
Ghani, U; Niaz, Z; Cheema, T M; Abaidullah, S; Salman, S; Latif, F [King Edward Medical University, Mayo Hospital, Lahore (Pakistan). Dept. of Diabetic Mellitus
Introduction: The metabolic syndrome is a cluster of metabolic abnormalities including abdominal obesity, glucose intolerance, hypertension and dyslipidemia. Diabetic retinopathy is common sequel of diabetes. Objective: To determine the frequency of retinopathy in patients of type 2 diabetes metabolic syndrome. Study Design; Descriptive study. This study was conducted in diabetic clinic of Mayo Hospital, Lahore, from January 17, 2007 to July 16,2007. Methods; Three hundred and sixty patients fulfilling the inclusion criteria were selected for this study and divided into two groups. (Diabetes and with metabolic syndrome) Demographic data of each patient including age, sex, height and weight were collected. Each patient was interviewed about the duration, treatment and complications of diabetes. Data were analyzed by SPSS. P value was calculated by Chi Square test. Results; In group I, the mean height was 1.60 +- 0.08 meters, mean weight was 68.82 +- 7.36 kilograms and mean BMI was 26.38 +- 1.10 kg/m2 and In group II, the mean height was 1.56 +- 0.12 meters, mean weight was 81.58 +- 9.85 kilograms and mean BMI was 33.80 +- 3.61 kg/m/sup 2/. In group I micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 12.22% patients. In group II, micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 25% patients (p 0.0028). In group I, there were 10.56% patients in which cotton wool spots were found and in group II there were 11.67% patients in which cotton wool spots were found (p 0.0358). In group I, there were 2.78% patients in which new blood vessel formation were found and in group II there were 4.44% patients in which new blood vessel formation was found (p 0.625). Conclusion; It is concluded from this study that frequency of retinopathy is high in patients with metabolic syndrome as compared to patients without metabolic syndrome. (author)
Ghani, U.; Niaz, Z.; Cheema, T.M.; Abaidullah, S.; Salman, S.; Latif, F.
Introduction: The metabolic syndrome is a cluster of metabolic abnormalities including abdominal obesity, glucose intolerance, hypertension and dyslipidemia. Diabetic retinopathy is common sequel of diabetes. Objective: To determine the frequency of retinopathy in patients of type 2 diabetes metabolic syndrome. Study Design; Descriptive study. This study was conducted in diabetic clinic of Mayo Hospital, Lahore, from January 17, 2007 to July 16,2007. Methods; Three hundred and sixty patients fulfilling the inclusion criteria were selected for this study and divided into two groups. (Diabetes and with metabolic syndrome) Demographic data of each patient including age, sex, height and weight were collected. Each patient was interviewed about the duration, treatment and complications of diabetes. Data were analyzed by SPSS. P value was calculated by Chi Square test. Results; In group I, the mean height was 1.60 +- 0.08 meters, mean weight was 68.82 +- 7.36 kilograms and mean BMI was 26.38 +- 1.10 kg/m2 and In group II, the mean height was 1.56 +- 0.12 meters, mean weight was 81.58 +- 9.85 kilograms and mean BMI was 33.80 +- 3.61 kg/m/sup 2/. In group I micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 12.22% patients. In group II, micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 25% patients (p 0.0028). In group I, there were 10.56% patients in which cotton wool spots were found and in group II there were 11.67% patients in which cotton wool spots were found (p 0.0358). In group I, there were 2.78% patients in which new blood vessel formation were found and in group II there were 4.44% patients in which new blood vessel formation was found (p 0.625). Conclusion; It is concluded from this study that frequency of retinopathy is high in patients with metabolic syndrome as compared to patients without metabolic syndrome. (author)
National Oceanic and Atmospheric Administration, Department of Commerce — In the summer of 2008, the Northwest Florida Water Management District collected lidar data over a portion of Walton County, FL (Eglin Air force Base) to support...
U.S. Environmental Protection Agency — The EnviroAtlas Tampa, FL Meter-Scale Urban Land Cover (MULC) data was generated from USDA NAIP (National Agricultural Imagery Program) four band (red, green, blue...
Ziel dieser Arbeit war es, ein besseres physikalisches Verständnis der Struktur-Eigenschaftsbeziehungen in smektischen Flüssigkristallen vom de Vries-Typ zu erarbeiten und damit eine Basis für rationale Synthesestrategien dieser wissenschaftlich wie technologisch interessanten Materialklasse zu schaffen. Im Sinne dieser Zielvorstellung wurden drei Aspekte bearbeitet: Der Mechanismus der Phasenumwandlung SmA - SmC vom de Vries-Typ, das rationale Design smektischer Flüssigkristalle vom de Vries...
... 46 Shipping 1 2010-10-01 2010-10-01 false St. Simons Island, GA to Little Talbot Island, FL. 7.85... BOUNDARY LINES Atlantic Coast § 7.85 St. Simons Island, GA to Little Talbot Island, FL. (a) A line drawn from latitude 31°04.1′ N. longitude 81°16.7′ W. (St. Simons Lighted Whistle Buoy “ST S”) to latitude 30...
McElhiney, Judith; Lohse, Matthew R; Arora, Amindra S; Peloquin, Joanna M; Geno, Debra M; Kuntz, Melissa M; Enders, Felicity B; Fredericksen, Mary; Abdalla, Adil A; Khan, Yulia; Talley, Nicholas J; Diehl, Nancy N; Beebe, Timothy J; Harris, Ann M; Farrugia, Gianrico; Graner, Darlene E; Murray, Joseph A; Locke, G Richard; Grothe, Rayna M; Crowell, Michael D; Francis, Dawn L; Grudell, April M B; Dabade, Tushar; Ramirez, Angelica; Alkhatib, MhdMaan; Alexander, Jeffrey A; Kimber, Jessica; Prasad, Ganapathy; Zinsmeister, Alan R; Romero, Yvonne
The aim of this study was to develop the Mayo Dysphagia Questionnaire-30 Day (MDQ-30), a tool to measure esophageal dysphagia, by adapting items from validated instruments for use in clinical trials, and assess its feasibility, reproducibility, and concurrent validity. Outpatients referred to endoscopy for dysphagia or seen in a specialty clinic were recruited. Feasibility testing was done to identify problematic items. Reproducibility was measured by test-retest format. Concurrent validity reflects agreement between information gathered in a structured interview versus the patients' written responses. The MDQ-30, a 28-item instrument, took 10 min (range = 5-30 min) to complete. Four hundred thirty-one outpatients [210 (49%) men; mean age = 61 years] participated. Overall, most concurrent validity kappa values for dysphagia were very good to excellent with a median of 0.78 (min 0.28, max 0.95). The majority of reproducibility kappa values for dysphagia were moderate to excellent with a median kappa value of 0.66 (min 0.07, max 1.0). Overall, concurrent validity and reproducibility kappa values for gastroesophageal reflux disease (GERD) symptoms were 0.81 (95% CI = 0.72, 0.91) and 0.66 (95% CI = 0.55, 0.77), respectively. Individual item percent agreement was generally very good to excellent. Internal consistency was excellent. We conclude that the MDQ-30 is an easy-to-complete tool to evaluate reliably dysphagia symptoms over the last 30 days.
Shiomi, T.; Sato, K.
A new method (viral suicide method) for the isolation of uv-sensitive mutants is described. Colonies of mutagenized human FL cells were infected with uv-irradiated Herpes simplex viruses and surviving ones which seemed to be deficient in host cell reactivation (HCR) were examined for their uv sensitivity. Nineteen of 238 clones examined were sensitive to uv irradiation at the time of the isolation. After recloning, four of these clones have been studied and two (UVS-1 and UVS-2) of them are stable in their uv sensitivity for 4 months in culture. uv sensitivity of UVS-1, UVS-2, and the parental FL cells are as follows: the extrapolation numbers (n) are 2.2, 2.1, and 1.8 and mean lethal doses (DO) are 2.9, 3.7, and 7.8 J/m 2 for UVS-1, UVS-2, and the parental FL cells, respectively. They are no more sensitive than FL cells to x-irradiation. The ability of HCR in UVS-2 cells is apparently lower than that in FL cells, whereas UVS-1 cells are the same as FL cells in the ability
Valentín Galván García
Full Text Available Los movimientos de detracción a la psiquiatría clásica no nacieron hasta la década de los años 60. Las reflexiones comunes de sociólogos, filósofos, políticos, psiquiatras y enfermos mentales coincidieron en un severo replanteamiento del saber psiquiátrico y de las prácticas propugnadas. El término propuesto en 1967 por David Cooper fue el estandarte de estos nuevos planteamientos. Con anterioridad al movimiento psiquiátrico, en 1961, se publicaron dos textos fundamentales: Internados de Erving Goffman y la Historia de la locura de Michel Foucault. Ambas obras, hasta entonces, conocidas exclusivamente en el ámbito académico, por lo que sus enfoques y problemáticas tuvieron escasa repercusión hasta los acontecimientos de Mayo del 68, los cuales propiciaron unas condiciones más favorables para su discurso.________________________ABSTRACT:The movements back to the classical psychiatry weren’t born until the 60 ths decade. The common thoughts of sociologists, philosophers, politicians, psychiatrists and mentally sick people joined together a strict reconsideration of the phychiatric knowledge and the proposed training. The word “antipsychiatry” proposed in 1967 by David Cooper was the flagship of these new thoughts. Before the psychiatric movement, in 1961, two main books were published: Asylums by Erving Goffman and History of mandess by Michel Foucault. Both books, until then, were known exclusively in the academic field, for its focus and problems had little repercussion until the May 68 events, which encouraged more favourable conditions for its speech.
Malik, A.K.; Chaudhry, A.; Karamat, A.; Arif, N.; Cheema, M.A.; Rauf, A.
Objectives: To observe the frequency of cigarette smoking in doctors and paramedics and study various variables associated with it. Methods: An anonymous questionnaire was given to randomly selected 250 Doctors and 250 Paramedics at Mayo Hospital in 2009. Information about demographic characteristics, smoking status in family, number of cigarettes smoked per day, influence for starting smoking, reason for continuation of smoking and use of nicotine replacement therapy was obtained. Results: A total of 234 questionnaires from doctors and 207 from paramedics were received back (88.2% response rate). There were 280 males (163 Doctors; 117 Paramedics) and 161 females (71 Doctors; 90 Paramedics). Eighty seven (37.18%) Doctors and 74 (35.74%) Paramedics were smokers with 82 (50.31%) male doctors and 5 (7.04%) females. Similar results were obtained in Paramedics 72 (61.53%) males and 2 (2.22%) females. Of the smokers, majority started smoking between 11-20 years age with 39 (44.83%) Doctors and 48 (64.86%) Paramedics. Twenty three (26.44%) Doctors and 31 (41.89%) Paramedics smoked 11-20 cigarettes per day. Smoking was initiated due to the influence of friends by 48 (55.17%) Doctors and 56 (75.68%) Paramedics. Most smokers, 29 (33.33%) Doctors and 33 (44.59%) Paramedics found use of cigarette smoking as 'Relaxing'. Addiction was the main reason for difficulty in quitting cigarette smoking as reported by 33 (37.93%) Doctors and 31 (41.89%) Paramedics. Of the smokers, 61(70.11%) doctors and 50 (32.43%) paramedics had no intention to quit smoking in the next 6 months. Conclusion: A significant number of doctors and paramedics, especially males, in Pakistan smoke cigarettes, which requires proper attention. (author)
Julio César Duarte Ruiz
Full Text Available En México se presentan prácticamente todos los grandes tipos de vegetación que existen en el mundo y su distribución a menudo es compleja. El objetivo del trabajo consistió en realizar un listado de la flora silvestre ribereña del Río Mayo, localizado en el sur del estado de Sonora, para conocer su composición. La recolección de especímenes se realizó mediante la técnica de intercepción o línea de Canfield (1941, en 15 sitios con dos repeticiones sumando 30 transectos. Se encontraron un total de 40 familias, 79 géneros y 99 especies. Las familias mejor representadas fueron: Leguminoseae, Cactaceae, Gramineae, Compositae, Chenopodiaceae, Salicaceae, Solanaceae, Euphorbiaceae, Amaranthaceae y Asteraceae. La dominante fue Leguminoseae con vegetación de bosque espinoso compuesta por Acacia cymbispina, Acacia farnesiana, Parkinsonia aculeata y Prosopis juliflora. Resulta perceptible la pérdida de flora debido al cambio de uso de suelo. Especies representativas de la zona riparia como Populus fremontii y Salix bonplandiana están desapareciendo por alteración del ecosistema. Poblaciones de mangle como Rhizophora mangle y Conocarpus erectus están disminuidas. El área estudiada es rica en especies a pesar de la perturbación. La diversidad varía de acuerdo al gradiente altitudinal y el número de especies guarda relación con los géneros y familias recolectadas. La agricultura, acuicultura, ganadería, la industria pesquera y la urbanización, son los giros que causan mayor afectación en los ecosistemas
Wang, Xia; An, Qiang; Zhao, Bin; Guo, Jin Song; Huang, Yuan Sheng; Tian, Meng
Enterobacter sp. strain FL was newly isolated from activated sludge and exhibited significant capability of auto-aggregation as well as aerobic denitrification. The removal efficiencies of NO 3 - -N, total nitrogen (TN), and TOC by strain FL in batch culture reached 94.6, 63.9, and 72.5% in 24 h, respectively. The production of N 2 O and N 2 in the presence of oxygen demonstrated the occurrence of aerobic denitrification. The auto-aggregation index of strain FL reached 54.3%, suggesting a high tendency that the cells would agglomerate into aggregates. The production of extracellular polymeric substances (EPSs), which were mainly composed of proteins followed by polysaccharides, was considered to be related to the cell aggregation according to Fourier transform infrared (FT-IR) and confocal laser scanning microscopy (CLSM). The proteins in EPS were evenly and tightly combined to cells and altered the protein secondary structures of cell surface from random coils to β-sheets and three-turn helices. The alteration of protein secondary structures of cell surface caused by the proteins in EPS might play a dominant role in the auto-aggregation of strain FL. To further assess the feasibility of strain FL for synthetic wastewater treatment, a sequencing batch reactor (SBR), solely inoculated with strain FL, was conducted. During the 16 running cycles, the removal efficiency of NO 3 - -N was 90.2-99.7% and the auto-aggregation index was stabilized at 35.0-41.5%. The EPS promoted the biomass of strain FL to aggregate in the SBR.
OʼRourke, Justin; Critchfield, Edan; Soble, Jason; Bain, Kathleen; Fullen, Chrystal; Eapen, Blessen
To examine the utility of the Mayo-Portland Adaptability Inventory-4th Edition Participation Index (M2PI) as a self-report measure of functional outcome following mild traumatic brain injury (mTBI) in US Military veterans. Department of Veterans Affairs Polytrauma Rehabilitation Center specialty hospital. On hundred thirty-nine veterans with a history of self-reported mTBI. Retrospective cross-sectional examination of data collected from regular clinical visits. M2PI, Neurobehavioral Symptoms Inventory with embedded validity measures, Posttraumatic Stress Disorder Checklist-Military Version. Forty-one percent of the sample provided symptom reports that exceeded established cut scores on embedded symptom validity tests. Invalid responders had higher levels of unemployment and endorsed significantly greater functional impairment, posttraumatic stress symptoms, and postconcussive complaints. For valid responders, regression analyses revealed that self-reported functioning was primarily related to posttraumatic stress complaints, followed by postconcussive cognitive complaints. For invalid responders, posttraumatic stress complaints also predicted self-reported functioning. Caution is recommended when utilizing the M2PI to measure functional outcome following mTBI in military veterans, particularly in the absence of symptom validity tests.
Edwin Javier Barrios-Gómez
Full Text Available Se estudió el efecto del déficit hídrico del suelo y temperatura alta del aire en las relaciones hídricas y temperatura del dosel del cultivo (Tc, rendimiento de semilla (RS y sus componentes en 8 variedades de frijol del tipo "Flor de Mayo" (FM y una variedad criolla. Se realizaron 3 experimentos de campo; Montecillo en riego (MR con la aplicación de agua de la siembra a la madurez, Montecillo en secano (MS con la lluvia como fuente única de humedad y Celaya en secano (CS con lluvia y 2 riegos suplementarios en floración. Se utilizó una dosis de fertilización de 80 kg.ha-1 de nitrógeno y 40 kg.ha-1 de fósforo. En MR el potencial hídrico foliar ( =-0,33 Mpa, osmótico ( =-1,26 Mpa y de turgencia y (P=0,93 Mpa fue más alto que en CS ( =-0,77, =-1,36 y P=0,59 Mpa y MS ( =-1,22, =-1,57 y P=0,35 Mpa; MS, con mayor deficiencia hídrica del suelo, tuvo mayor reducción en y , y mayor grado de ajuste osmótico (AO=0,70 Mpa. El AO estuvo positiva y significativamente asociado con RS y biomasa aérea final (BMAF en los 2 ambientes de secano. La Tc en MR (26,7°C fue más baja que en CS (30,8°C y MS (36,6°C; el estrés por calor se agudizó con el descenso en el contenido hídrico de las plantas en el ambiente más seco (MS; Tc se relacionó negativa y significativamente con y en MS. La alta Tc también tuvo efecto significativo en la producción de BMAF y RS y sus componentes; la alta Tc redujo el RS, BMAF, número de vainas normales.m-2 (VN.m-2 y peso de 100 semillas (P100S en 12,5, 10,7, 10,2 y 3,4% por cada ºC (-1 ºC de aumento en la Tc, respectivamente.
Omer, N. H.
The study undertook the pollution problem in Mayo area, south of the Green Belt. This is considered to have come about as a result of legal and illegal planning and the re-planning of the squatter settlements, plus the area that lies in the vicinity of the sanitary drainage pool. The study identified the factors and causes of the pollutants.The study also studied the effects of these pollutants on health. The objectives of the study were to identify the factors of environmental pollution in the area, the role of the people in the environmental pollution, the negative consequences of this pollution on people in the area, the attempts of the local authorities in fighting the area's pollution and improving the habitat. The study depended on some scientific approaches such as the historic method and the descriptive statistics method. Information was collected from primary and secondary sources. The researcher depended on field work such as direct observation, personal interviews and filling questionnaire which were prepared for data allocation. The study concluded that the environmental pollution is an out come of many factors that inter link with each other. One of the most important factors is the low economic level of the people, and its effects on the poor and deteriorating living environment and the planning of the area placing it near the sources of environmental pollution at the green belt. In addition to the negative role played by the areas inhabitants in relation to getting rid of environmental pollutants of the area, which has in turn led to the outbreak of environmental diseases that reside in the area, specially malaria and diarrhea. The researcher views that one of the most important recommendations that this study has come out of with is the general planning that takes into consideration the health, economic natural and environmental aspects. These are necessities that will participate in the decline and end of the spreading of these pollutants and what
Full Text Available En la segunda mitad de la década de los cincuenta la dictadura franquista atravesaba un período de crisis, ante la gravedad de la situación socio-económica que atravesaba el país, es en este contexto en el que el Partido Comunista de España decidió convocar una jornada de movilización contra la dictadura, a la que denominó Jornada de Reconciliación Nacional, para el 5 de mayo de 1958, pese a estar precedida de un período de fuertes protestas sociales los resultados de la misma fueron muy modestos, en este hecho influyeron el propio aislamiento en que se encontraban los comunistas dentro de la oposición antifranquista, como el miedo a la represión, mientras el franquismo continuaría recibiendo el apoyo de las instituciones políticas y grupos sociales sobre las que se asentaba asi como sus apoyos exteriores, lo que le permitiría imponer sus propias soluciones y sobrevivir hasta la muerte del dictador.In the second half of the fifties, the Franco dictatorship was going through a period of crisis given the gravity of the socioeconomic situation that the country was facing. It is in this context that the Spanish Communist Party decided to call mobilization day against dictatorship, which he called National Reconciliation Day, for the 5th of May 1958. Although it was preceded by a period of strong social protest, the results of it were very modest.In this event influenced the isolation itself in which the Communists were inside the anti-Franco opposition, as the fear of repression. While the Franco´s regime would continue receiving the support of political institutions and social groups on which was laid down as well as their external supports, which would enable it to impose its own solutions and survive until the dictator’s death.
Webber, Tawnya M; Allen, Andrew C; Ma, Wai Kit; Molloy, Rhett G; Kettelkamp, Charisse N; Dow, Caitlin A; Gage, Matthew J
The p53 tumor suppressor protein is a critical checkpoint in prevention of tumor formation, and the function of p53 is dependent on proper formation of the active tetramer. In vitro studies have shown that p53 binds DNA most efficiently as a tetramer, though inactive p53 is predicted to be monomeric in vivo. We demonstrate that FlAsH binding can be used to distinguish between oligomeric states of p53, providing a potential tool to explore p53 oligomerization in vivo. The FlAsH tetra-cysteine binding motif has been incorporated along the dimer and tetramer interfaces in the p53 tetramerization domain to create reporters for the dimeric and tetrameric states of p53, though the geometry of the four cysteines is critical for efficient FlAsH binding. Furthermore, we demonstrate that FlAsH binding can be used to monitor tetramer formation in real-time. These results demonstrate the potential for using FlAsH fluorescence to monitor protein-protein interactions in vivo.
In dieser Arbeit wurde ein neuartiges Verfahren zur Produktion von 2,2-Dimethoxypropan (DMP) aus Aceton und Methanol unter Verwendung von Brønsted-aciden ionischen Flüssigkeiten (BAILs) als Katalysator in einer flüssig-flüssig Zweiphasenreaktion entwickelt. Darüber hinaus wurde die Anwendung des neuartigen Zweiphasenprozesses in der Herstellung von Ketalen aus höhermolekularen linearen Ketonen, insbesondere 2-Butanon, und Methanol demonstriert. Im Unterschied zu bisher publizierten Verfahren ...
Jeffrey M. Banister
Full Text Available Northwest Mexico’s irrigation landscape, known today as El Distrito de Riego 038, or El Valle del Mayo, issues from historical struggles to build an official order out of a diverse world of signs, symbols, processes, places, and peoples. It is the ancestral home of the Yoreme (Mayo, an indigenous group for whom colonisation and agricultural development have meant the loss of autonomy and of the seasonal mobility required to subsist in an arid land. It is also the birthplace of President Álvaro Obregón, a one-time chickpea farmer who transformed late-19th century irrigation praxis into the laws and institutions of 20th century water management. Reshaping territory for the ends of centralising ('federalising' water resources has always proved exceedingly difficult in the Mayo. But this was particularly so in the beginning of the federalisation process, a time of aggressive modernisation under the direction of President Porfirio Díaz (1876-1910. Research on Mexican hydraulic politics and policy, with some important exceptions, has tended to focus on the scale and scope of centralisation. Scholars have paid less attention to the moments and places where water escapes officials’ otherwise ironclad grasp. This paper explores water governance (and state formation more broadly in the late 19th century, on the eve of Mexico’s 1910 Revolution, as an ongoing, ever-inchoate series of territorial claims and projects. Understanding the weaknesses and incompleteness of such projects offers critical insight into post-revolutionary and/or contemporary hydraulic politics.
El Proyecto de Extensión Universitaria "Madres y Abuelas de Plaza de Mayo" fue realizado por el Taller de Producción Audiovisual I de la Facultad de Periodismo y Comunicación Social de la Universidad Nacional de La Plata. Su objetivo fue relevar y compilar relatos audiovisuales de las madres y abuelas víctimas del terrorismo de Estado en la Argentina para socializar sus experiencias de vida, fomentar la participación política y el compromiso de la comunidad universitaria. El present...
Maria Fernanda Garbero de Aragão Ponzio
O contexto da Argentina da década de setenta é o cenário de personagens e narrativas que emergem do medo e permanecem, até os dias atuais, em posições de resistência e enfrentamento. Nessa paisagem marcada pela opressão do Estado militar, nascem as Madres de Plaza de Mayo, originadas pela tragédia do desaparecimento forçado de seus filhos. Investidas pela maternidade, elas rompem com a esfera privada para desestabilizar a esfera pública e questionar a memória de um país maculad...
Dubón Méndez, Nancy; Altamirano González, Marjorie del Socorro; Alemán Rivera, Teresa de Jesús
Streptococos del grupo B (SGB) es una de las principales causas de muertes neonatales en todo el mundo y esta directamente relacionada con la colonización materna al momento del parto. Se realizó un estudio descriptivo de corte transversal que incluyó un total de 120 mujeres embarazadas atendidas en el Centro de Salud 1ro. de mayo-León, con el objetivo de identificar la frecuencia de streptococo del grupo B, debido a que la identificación de esta bacteria influye positivamente en la prevenció...
Full Text Available This study examines whether learners’ capacity to use a foreign language (FL successfully in the global world is developed in the FL classroom in Polish high schools. The article reports results of the quantitative research which aimed at assessing whether and to what extent homogeneous FL classes in Poland are conducive to developing learners’ intercultural (IC sensitivity and competence. The results obtained from the two study samples, namely learners and teachers, are contradictory: In the students’ opinion, IC teaching/learning plays a marginal role, whereas the teacher respondents claim they practice IC teaching moderately. Thus, to be able to get a broader picture of IC teaching/learning in Poland the current research should be complemented by a separate qualitative study, that is, lesson observations and interviews with teachers and students. Only then could more valid conclusions be drawn.
Aaron, F. D.; Alexa, C.; Andreev, V.; Antunovic, B.; Aplin, S.; Asmone, A.; Astvatsatourov, A.; Bacchetta, A.; Backovic, S.; Baghdasaryan, A.; Baranov, P.; Barrelet, E.; Bartel, W.; Beckingham, M.; Begzsuren, K.; Behnke, O.; Belousov, A.; Berger, N.; Bizot, J. C.; Boenig, M.-O.; Boudry, V.; Bozovic-Jelisavcic, I.; Bracinik, J.; Brandt, G.; Brinkmann, M.; Brisson, V.; Bruncko, D.; Bunyatyan, A.; Buschhorn, G.; Bystritskaya, L.; Campbell, A. J.; Cantun Avila, K. B.; Cassol-Brunner, F.; Cerny, K.; Cerny, V.; Chekelian, V.; Cholewa, A.; Contreras, J. G.; Coughlan, J. A.; Cozzika, G.; Cvach, J.; Dainton, J. B.; Daum, K.; Deák, M.; de Boer, Y.; Delcourt, B.; Del Degan, M.; Delvax, J.; De Roeck, A.; De Wolf, E. A.; Diaconu, C.; Dodonov, V.; Dossanov, A.; Dubak, A.; Eckerlin, G.; Efremenko, V.; Egli, S.; Eliseev, A.; Elsen, E.; Essenov, S.; Falkiewicz, A.; Faulkner, P. J. W.; Favart, L.; Fedotov, A.; Felst, R.; Feltesse, J.; Ferencei, J.; Finke, L.; Fleischer, M.; Fomenko, A.; Gabathuler, E.; Gayler, J.; Ghazaryan, S.; Glazov, A.; Glushkov, I.; Goerlich, L.; Goettlich, M.; Gogitidze, N.; Gouzevitch, M.; Grab, C.; Greenshaw, T.; Grell, B. R.; Grindhammer, G.; Habib, S.; Haidt, D.; Hansson, M.; Helebrant, C.; Henderson, R. C. W.; Henschel, H.; Herrera, G.; Hildebrandt, M.; Hiller, K. H.; Hoffmann, D.; Horisberger, R.; Hovhannisyan, A.; Hreus, T.; Jacquet, M.; Janssen, M. E.; Janssen, X.; Jemanov, V.; Jönsson, L.; Johnson, D. P.; Jung, A. W.; Jung, H.; Kapichine, M.; Katzy, J.; Kenyon, I. R.; Kiesling, C.; Klein, M.; Kleinwort, C.; Klimkovich, T.; Kluge, T.; Knutsson, A.; Kogler, R.; Korbel, V.; Kostka, P.; Kraemer, M.; Krastev, K.; Kretzschmar, J.; Kropivnitskaya, A.; Krüger, K.; Kutak, K.; Landon, M. P. J.; Lange, W.; Laštovička-Medin, G.; Laycock, P.; Lebedev, A.; Leibenguth, G.; Lendermann, V.; Levonian, S.; Li, G.; Lipka, K.; Liptaj, A.; List, B.; List, J.; Loktionova, N.; Lopez-Fernandez, R.; Lubimov, V.; Lucaci-Timoce, A.-I.; Lytkin, L.; Makankine, A.; Malinovski, E.; Marage, P.; Marti, Ll.; Martyn, H.-U.; Maxfield, S. J.; Mehta, A.; Meier, K.; Meyer, A. B.; Meyer, H.; Meyer, H.; Meyer, J.; Michels, V.; Mikocki, S.; Milcewicz-Mika, I.; Moreau, F.; Morozov, A.; Morris, J. V.; Mozer, M. U.; Mudrinic, M.; Müller, K.; Murín, P.; Nankov, K.; Naroska, B.; Naumann, Th.; Newman, P. R.; Niebuhr, C.; Nikiforov, A.; Nowak, G.; Nowak, K.; Nozicka, M.; Olivier, B.; Olsson, J. E.; Osman, S.; Ozerov, D.; Palichik, V.; Panagoulias, I.; Pandurovic, M.; Papadopoulou, Th.; Pascaud, C.; Patel, G. D.; Pejchal, O.; Peng, H.; Perez, E.; Petrukhin, A.; Picuric, I.; Piec, S.; Pitzl, D.; Plačakytė, R.; Polifka, R.; Povh, B.; Preda, T.; Radescu, V.; Rahmat, A. J.; Raicevic, N.; Raspiareza, A.; Ravdandorj, T.; Reimer, P.; Rizvi, E.; Robmann, P.; Roland, B.; Roosen, R.; Rostovtsev, A.; Rotaru, M.; Ruiz Tabasco, J. E.; Rurikova, Z.; Rusakov, S.; Salek, D.; Salvaire, F.; Sankey, D. P. C.; Sauter, M.; Sauvan, E.; Schmidt, S.; Schmitt, S.; Schmitz, C.; Schoeffel, L.; Schöning, A.; Schultz-Coulon, H.-C.; Sefkow, F.; Shaw-West, R. N.; Sheviakov, I.; Shtarkov, L. N.; Shushkevich, S.; Sloan, T.; Smiljanic, I.; Smirnov, P.; Soloviev, Y.; Sopicki, P.; South, D.; Spaskov, V.; Specka, A.; Staykova, Z.; Steder, M.; Stella, B.; Straumann, U.; Sunar, D.; Sykora, T.; Tchoulakov, V.; Thompson, G.; Thompson, P. D.; Toll, T.; Tomasz, F.; Tran, T. H.; Traynor, D.; Trinh, T. N.; Truöl, P.; Tsakov, I.; Tseepeldorj, B.; Tsurin, I.; Turnau, J.; Tzamariudaki, E.; Urban, K.; Valkárová, A.; Vallée, C.; Van Mechelen, P.; Vargas Trevino, A.; Vazdik, Y.; Vinokurova, S.; Volchinski, V.; Wegener, D.; Wessels, M.; Wissing, Ch.; Wünsch, E.; Yeganov, V.; Žáček, J.; Zálešák, J.; Zhang, Z.; Zhelezov, A.; Zhokin, A.; Zhu, Y. C.; Zimmermann, T.; Zohrabyan, H.; Zomer, F.; H1 Collaboration
A first measurement is reported of the longitudinal proton structure function FL (x ,Q2) at the ep collider HERA. It is based on inclusive deep inelastic e+ p scattering cross section measurements with a positron beam energy of 27.5 GeV and proton beam energies of 920, 575 and 460 GeV. Employing the energy dependence of the cross section, FL is measured in a range of squared four-momentum transfers 12 ⩽Q2 ⩽ 90 GeV2 and low Bjorken x 0.00024 ⩽ x ⩽ 0.0036. The FL values agree with higher order QCD calculations based on parton densities obtained using cross section data previously measured at HERA.
Webber, Tawnya M.; Allen, Andrew C.; Ma, Wai Kit; Molloy, Rhett G.; Kettelkamp, Charisse N.; Dow, Caitlin A.; Gage, Matthew J.
The p53 tumor suppressor protein is a critical checkpoint in prevention of tumor formation, and the function of p53 is dependent on proper formation of the active tetramer. In vitro studies have shown that p53 binds DNA most efficiently as a tetramer, though inactive p53 is predicted to be monomeric in vivo. We demonstrate that FlAsH binding can be used to distinguish between oligomeric states of p53, providing a potential tool to explore p53 oligomerization in vivo. The FlAsH tetra-cysteine ...
Lucía Rivas Lara
Full Text Available El 1° de Mayo, cuyo origen estuvo en la aspiración obrera a la jornada de ocho horas, se celebró por primera vez en Estados Unidos en 1886, después de muchos años de lucha de los trabajadores en los diversos países por el acortamiento de las jornadas, dado que hasta entonces habían sido de 12 a 16 horas según los lugares. Pero este 1° de mayo de 1886 tuvo un nacimiento espontáneo entre los trabajadores anarquistas norteamericanos, merced a la decisión de un congreso de la Federación Americana del Trabajo (AFL, sin perspectiva de continuidad ni trascendencia más allá de sus fronteras. No obstante, en el marco de su país tuvo un notable éxito consiguiendo con él muchos trabajadores la jornada de ocho horas, y sirviendo de precedente.
When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.
Nickerson, Terry P; Zielinski, Martin D; Jenkins, Donald H; Schiller, Henry J
Although uncommon, Morel-Lavallée lesions (also called closed degloving injuries) are associated with considerable morbidity in trauma patients. There is lack of consensus regarding proper management of these lesions. Management options include nonoperative therapies, along with percutaneous and operative techniques. We sought to define the factors associated with failure of percutaneous aspiration to better identify patients requiring immediate operative management. We retrospectively searched our prospectively collected database for patient records containing the terms Morel-Lavallée, closed degloving injury, or posttraumatic seroma from February 2, 2004, through December 23, 2011. Treatment methods included compression wraps or observation (nonoperative management), percutaneous aspiration, or operative management with incision/drainage or formal debridement of skin and soft tissues that resulted in wound vacuum-assisted closure placement and/or split-thickness skin graft (operative management). The treatment groups were compared using univariate analysis and χ testing. We identified 79 patients with 87 Morel-Lavallée lesions in the setting of trauma. Most were caused by motor vehicle collisions (25%). No difference was observed between the treatment groups in sex, body mass index, anticoagulation treatment, diabetes mellitus, smoking history, or alcohol use. The percutaneous aspiration group had higher rates of recurrence (56% vs. 19% and 15% in nonoperative and operative groups, respectively). The percentage of patients who had aspiration of more than 50 mL of fluid was higher for lesions that recurred than for lesions that resolved (83% vs. 33%, p = 0.02). Aspiration of more than 50 mL of fluid from Morel-Lavallée lesions was much more common among lesions that recurred (83%) than among those that resolved (33%). We therefore recommend that aspiration of more than 50 mL of fluid from a Morel-Lavallée lesion prompts operative intervention. We have now adopted this as a practice management guideline. Therapeutic/care management study, level III.
Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K
Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.
... GENERAL SERVICES ADMINISTRATION [Wildlife Order 187; 4-D-FL-1218] Public Buildings Service; Key Largo Beacon Annex Site; Key Largo, FL; Transfer of Property Pursuant to section 2 of Public Law 537, 80th Congress, approved May 19, 1948 (16 U.S.C. 667c), notice is hereby given that: 1. The General...
...-0803; Airspace Docket No. 13-ASO-20] RIN 2120-AA66 Change of Using Agency for Restricted Areas R-2916, FL and R- 7105, PR AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule. SUMMARY: This action updates the name of the using agencies for Restricted Areas R-2916, FL and R-7105, PR, at...
... 1625-AA00 Safety Zone; Cocoa Beach Air Show, Atlantic Ocean, Cocoa Beach, FL AGENCY: Coast Guard, DHS... waters of the Atlantic Ocean located east of Cocoa Beach, Florida during the Cocoa Beach Air Show. The Cocoa Beach Air Show will include aircraft engaging in aerobatic maneuvers. The event is scheduled to...
... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Olde Cypress Community Bank, Clewiston, FL... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Olde Cypress Community Bank, Clewiston, Florida...
... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Bayside Savings Bank, Port St. Joe, FL... section 5(d)(2) of the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Bayside Savings Bank, Port St. Joe, Florida...
... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Turnberry Bank, Aventura, FL; Notice of... the Home Owners' Loan Act, the Office of Thrift Supervision has duly appointed the Federal Deposit Insurance Corporation as sole Receiver for Turnberry Bank, Aventura, Florida (OTS No. 08087), on July 16...
... and Danger Zones at Eglin Air Force Base, FL AGENCY: U.S. Army Corps of Engineers, Department of... within the Eglin Air Force Base (AFB) facilities and along the Eglin AFB facility shoreline in Florida... have the permission of the Commander, 96 Air Base Wing, Eglin AFB or his/her authorized representative...
...-AA08 Special Local Regulations; Palm Beach World Championship, Atlantic Ocean; Jupiter, FL AGENCY... offshore of Jupiter, Florida during the Palm Beach World Championship, a high speed power boat race. The... Atlantic Ocean, just offshore of Jupiter, Florida. The high speed power boat race event will include...
Oct 20, 2008 ... origin. It is therefore important that forensic science community shares information on the occurrence of these variants and reduces complications during STR typing. In this study, we report 5 variant alleles at AmpFlSTR SGM. Plus loci in a sample population of Bangladesh. MATERIALS AND METHODS.
..., Federal Aviation Administration, Orlando Airports District Office, 5950 Hazeltine National Drive, Suite 400, Orlando, FL 32822, 407-812-6331. SUPPLEMENTARY INFORMATION: This notice announces that the FAA... airport operator may submit to the FAA Noise Exposure Maps which meet applicable regulations and which...
... Aviation Administration, Orlando Airports District Office, 5950 Hazeltine National Drive Citadel International Building, Suite 400, Orlando, FL 32822, 407-812-6331. SUPPLEMENTARY INFORMATION: This notice... Abatement Act (the Act), an airport operator may submit to the FAA Noise Exposure Maps which meet applicable...
... INFORMATION CONTACT: Allan Nagy, Federal Aviation Administration, Orlando Airports District Office, 5950 Hazeltine National Drive Citadel International Building, Suite 400, Orlando, FL 32822, 407-812-6331... Maps which meet applicable regulations and which depict non-compatible land uses as of the date of...
...-AA08 Special Local Regulations; Boca Raton Holiday Boat Parade, Intracoastal Waterway, Boca Raton, FL... Raton Holiday Boat Parade on Saturday, December 17, 2011. The marine parade will consist of... through Friday, except Federal holidays. FOR FURTHER INFORMATION CONTACT: If you have questions on this...
... under Executive Order 13045, Protection of Children from Environmental Health Risks and Safety Risks. This rule is not an economically significant rule and does not create an environmental risk to health...-AA00 Safety Zone; 12th Annual Saltwater Classic; Port Canaveral Harbor; Port Canaveral, FL AGENCY...
... Environmental Health Risks and Safety Risks. This rule is not an economically significant rule and does not create an environmental risk to health or risk to safety that may disproportionately affect children...-AA87 Security Zone; 2012 Fleet Week, Port Everglades, Fort Lauderdale, FL AGENCY: Coast Guard, DHS...
Obel, G.; Farinha, P.; Lam, W.
American patients with transformed FL. Methods: High-resolution BAC-array comparative genomic hybridisation (CGH) was used to detect genomic imbalances. Gene expression profiling was performed using cDNA microarrays (Affymetrix). Results: Of 9 biopsy pairs identified so far, analysis results of the first 4...
...: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed rulemaking (NPRM). SUMMARY: This action proposes to amend Class E Airspace in the Tallahassee, FL area. Tallahassee Commercial Airport has... in developing reasoned regulatory decisions on the proposal. Comments are specifically invited on the...
...-AA08 Special Local Regulation; New River Raft Race, New River; Fort Lauderdale, FL AGENCY: Coast Guard... on the New River in Fort Lauderdale, Florida during the Rotary Club of Fort Lauderdale New River Raft... States during the Rotary Club of Fort Lauderdale New River Raft Race. On March 23, 2013, Fort Lauderdale...
... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety/Security Zone: St. Johns... OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY REGULATED NAVIGATION AREAS AND LIMITED... § 165.720 Safety/Security Zone: St. Johns River, Jacksonville, FL. (a) Location. The water and the land...
... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R4-R-2011-N053; 40136-1265-0000-S3] St... conservation plan and environmental assessment (Draft CCP/EA) for St. Johns National Wildlife Refuge (NWR) in... Complex, P.O. Box 2683, Titusville, FL 32781, or via e-mail at [email protected] , or St. Johns CCP...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9767-6; CERCLA-04-2012-3780] Ellman Battery Superfund Site; Orlando, Orange County, FL; Notice of Settlement AGENCY: Environmental Protection Agency (EPA). ACTION... Action at the Ellman Battery Superfund Site located in Orlando, Orange County, Florida. DATES: The Agency...
... Airspace Services, Federal Aviation Administration, 800 Independence Avenue SW., Washington, DC 20591...; then south along Interstate 75 to the 10-mile arc of the Sarasota, FL, Class C airspace area; then counterclockwise along the Sarasota Class C airspace area 10-mile arc to the 30-mile radius of the Point of Origin...
Gottschalk, Sanne; Gottlieb, Caroline Trebbien; Vestergaard, Martin
antimicrobials. In the present study, the analogue FL9, based on the amphibian AMP fallaxin, was studied to elucidate its mode of action and antibacterial activity against the human pathogen Staphylococcus aureus. Our data showed that FL9 may have a dual mode of action against S. aureus. At concentrations around...... and at alkaline pH, while it was compromised by acidic pH and exposure to serum. Furthermore, at subinhibitory concentrations of FL9, S. aureus responded by increasing the expression of two major virulence factor genes, namely the regulatory rnaIII and hla, encoding α-haemolysin. In addition, the S. aureus...... the MIC, FL9 bound DNA, inhibited DNA synthesis and induced the SOS DNA damage response, whereas at concentrations above the MIC the interaction between S. aureus and FL9 led to membrane disruption. The antibacterial activity of the peptide was maintained over a wide range of NaCl and MgCl2 concentrations...
Eefectividad de los colutorios de clorhexidina más flúor en niños de 6 años con alto riesgo de caries Effectiveness of the clorhexidine plus fluoride collutoriums in 6 year-old children with high risk of dental caries
Ana Caridad López Vantour
Full Text Available Se efectuó un estudio cuasiexperimental en 27 escolares de 6 años con alto riesgo de caries, pertenecientes a la Escuela Primaria "Miguel Ángel Oramas Alfonso" de Santiago de Cuba, desde octubre del 2009 hasta mayo del 2012, con vistas a determinar la efectividad de los colutorios de clorhexidina más flúor en estos niños. La casuística quedó distribuida en 2 grupos: estudio (A y control (B, seleccionados a través de un muestreo aleatorio simple; los primeros tratados con clorhexidina más flúor, durante 15 días continuos, por 4 meses y los segundos con flúor solamente, por igual periodo. Se demostró la efectividad de los citados colutorios con resultados significativos, puesto que en el grupo A existió una disminución proporcional de las caries (66,6 %, no aparecieron nuevas y 76,9 % de sus integrantes lograron una higiene bucal eficiente.A quasi-experimental study was carried out in 27 school children who were 6 years-old with high cavity risk, belonging to "Miguel Ángel Oramas Alfonso" Primary School in Santiago de Cuba, from October, 2009 to May, 2012, aimed at determining the effectiveness of clorhexidine plus fluoride collutoriums in these children. The case material was distributed in 2 groups: study group (A and control group (B, selected through a simple random sampling; the first group was treated with clorhexidine plus fluorine, during 15 continuous days, for 4 months and the second one with fluoride only, during an equal period. The effectiveness of the mentioned collutoriums was demonstrated with significant results, since in group A proportional decrease of the caries existed (66.6%, there were no new ones and 76.9 % of its members achieved an efficient oral hygiene.
Munro, R; Lysons, R; Venables, C; Horigan, M; Jeffrey, M; Dawson, M
In an experiment on bovine immunodeficiency-like virus (BIV), the virological and serological aspects of which were reported in an earlier paper, three groups (A, B and C) of three calves were inoculated subcutaneously with a recently isolated strain (FL112). For group B and group C, the virus was suspended in milk, and for group C (controls) the viral suspension was subjected to pasteurization before inoculation. The calves were killed for necropsy 12 months later. Clinical assessment revealed subtle ataxia in two group A calves, which took the form of an intermittent "shifting" (from one leg to another) lameness, and palpable enlargement of the pre-scapular lymph nodes in one group B animal. At necropsy, haemal lymph nodes (0.1 to 0.5 cm in diameter), occurring singly, were observed in all animals. However, in groups A and B (but not C), enlarged haemal lymph nodes (< or = 2 cm in diameter) were also seen, occurring singly and in chains; and in one group A animal they occurred in grape-like clusters. In groups A and B (but not C), histopathological examination revealed generalized hyperplastic changes in lymph nodes, especially the haemal lymph nodes. This finding was particularly striking in the two clinically ataxic animals from group A, which also showed a non-suppurative meningo-encephalitis; the latter was possibly the cause of the subtle clinical signs. This study supports previous findings on lymphadenopathy resulting from experimental infection with BIV.
Diaz, Julia Inés; Fusaro, Bruno; Longarzo, Lucrecia; Coria, Néstor Rubén; Vidal, Virginia; Jerez, Silvia; Ortiz, Juana; Barbosa, Andrés
The aim of this work is to contribute to the knowledge of gastrointestinal parasites of the Gentoo penguin (Pygoscelis papua) from 25 de Mayo/King George Island (South Shetlands, Antarctica). Gastrointestinal tracts of 37 fresh dead individuals (21 chicks, 10 juveniles, and 6 adults) were collected from December 2006 to February 2012 and examined for macroparasites. Four adult parasite species were found: one Cestoda species (Parorchites zederi), two Nematoda species (Stegophorus macronectes and Tetrameres wetzeli), and one Acanthocephalan (Corynosoma shackletoni). Two species of immature acanthocephalans, Corynosoma hamanni and Corynosoma bullosum, were found in a single host. This is the first record of Tetrameres wetzeli in Gentoo penguins. The low parasite richness observed could be related to the stenophagic and pelagic diet of this host species which feeds almost exclusively on krill.
Acosta Reginfo, N.; Ramirez Quijada, R.
In order to implement a model of quality control program, the General Hospital Dos de Mayo was selected, since it manages a specialized radiology service - defined according to the OMS criteria - This radiology service attends nearly 60 % of total patients of the Hospital. This program intends to be a model for application to another hospitals havings similar characteritics, since any formal quality control program has been implemented in neither private nor public hospitals in the country. The model, while allowing to make measurements of main parameters, also allows to verify that radiation doses to patients, radiation workers and public trend to a level as low as reasonably achievable, and also to yield images with enough diagnostic quality, and to induce work environment with shared responsibility and commitment
Pulido Madrigal, L.; Gonzalez Meraz, J.
a soil salinity survey was carried out in the Rio Mayo irrigation district (ID) in 1996, using satellite imagery along with and EM-38 electromagnetic (EM) device. Data from Landsat TM imagery were calibrated with field data, according to the Plant Indicator methodology. This methodology yielded a partial salinity map of the ID, but including only those areas where indicator crops were cultivated. The remaining non-mapped areas were surveyed with an EM-38 electromagnetic device, generating a second partial salinity map. Both partial maps were integrated to get a complete soil salinity map of the ID. In 2001, another soil salinity survey was carried out using solely the EM device. The results of both methodologies were analyzed, resulting in less affected areas in 2001 compared too those obtained in 1996. (Author) 4 refs.
...-1146; Airspace Docket No. 10-ASO-25] Proposed Amendment of Restricted Areas R-2907A and R-2907B, Lake George, FL; and R-2910, Pinecastle, FL AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice... limits of restricted areas R-2907A and R-2907B, Lake George, FL; and restricted area R-2910, Pinecastle...
Stouge, Svend; Harper, David A. T.; Sevastopulo, George D.
The Middle Ordovician Rosroe Formation consists of some 1350m of coarse, mainly siliciclastic to volcaniclastic sedimentary rocks, deposited in a submarine fan environment, and is restricted to the southern limb of the South Mayo Trough, western Ireland. Discrete allochthonous blocks, reaching 5m...
Liu, Lanlan; Han, Jizhong; Li, Haoran; Liu, Mengmeng; Zeng, Bin
The insulin resistance models of mouse liver epithelial and rat myoblasts cells were induced by three kinds of inducers: dexamethasone, high insulin and high glucose. The purpose is to select the optimal insulin resistance model, to provide a simple and reliable TR cell model for the study of the pathogenesis of TR and the improvement of TR drugs and functional foods. The MTT method is used for toxicity screening of three compounds, selecting security and suitable concentration. We performed a Glucose oxidase peroxidase (GOD-POD) method involving FL83B and L6 cell with dexamethasone, high insulin and high glucose-induced insulin resistance. Results suggested that FL83B cells with dexamethasone-induced (0.25uM) were established insulin resistance and L6 cells with high-glucose (30mM) and dexamethasone-induced (0.25uM) were established insulin resistance.
Duryea, Elaine L; Casey, Brian M; McIntire, Donald D; Twickler, Diane M
To determine if sonographic variables, including fetal femur length to abdominal circumference (FL/AC) ratio, are associated with shoulder dystocia in women with gestational diabetes. This was a retrospective cohort study of women with gestational diabetes who delivered singleton infants at Parkland Hospital from 1997 to 2015. Diagnosis and treatment of gestational diabetes were uniform including sonography at 32-36 weeks. Biometric calculations were evaluated for correlation with shoulder dystocia. During the study period, 6952 women with gestational diabetes underwent a sonogram at a mean gestation of 34.8 ± 1.8 weeks. Of 4183 vaginal deliveries, 66 experienced shoulder dystocia (16/1000). The FL/AC was associated with shoulder dystocia (p dystocia in women with gestational diabetes. Additionally, it is a simple ratio that is independent of the reference used and remains stable, unlike age-adjusted AC and HC/AC ratio.
In den vergangenen Jahren haben Parlamente, Regierungen und Gerichte unterschiedliche Personen und Personengruppen rehabilitiert. Der vorliegende Beitrag bietet einen Überblick über die jüngst in der Schweiz ausgesprochenen Rehabilitierungen, ordnet diese rechtsdogmatisch ein und zeigt weiter die Funktionen und Grenzen der Rehabilitierung als Form staatlicher ,Vergangenheitsbewältigung‘ auf. Der Beitrag schliesst mit der Erkenntnis, dass Flüchtlingshelfer, Spanienkämpfer, administrativ Versor...
P. A. Mason
Full Text Available We present new broad band optical photometry of two magnetic cataclysmic variable stars, the asynchronous polar BY Camelopardalis and the short period polar FL Ceti. Observations were obtained at the 2.1-m Otto Struve Telescope of McDonald Observatory with 3s and 1s integration times respectively. In an attempt to understand the observed complex changes in accretion flow geometry observed in BY Cam, we performed full 3D MHD simulations assuming a variety of white dwarf magnetic field structures. We investigate fields with increasing complexity including both aligned and non-aligned dipole plus quadrupole field components. We compare model predictions with photometry at various phases of the beat cycle and find that synthetic light curves derived from a multipolar field structure are broadly consistent with optical photometry. FL Ceti is observed to have two very small accretion regions at the foot-points of the white dwarf’s magnetic field. Both accretion regions are visible at the same time in the high state and are about 100 degrees apart. MHD modeling using a dipole plus quadrupole field structure yields quite similar accretion regions as those observed in FL Ceti. We conclude that accretion flows calculated from MHD modeling of multi-polar magnetic fields produce synthetic light curves consistent with photometry of these magnetic cataclysmic variables.
Fredslund, Stine Frisk; Mogensen, Helle Smidt; Morling, Niels
Validation of the AmpFlSTR« SEfiler Plus(TM) PCR Amplification kit with 29 and 30 PCR cycles for forensic STR analysis demonstrated that the kit had fewer artefacts than the AmpFlSTR« SGM Plus(TM) kit (28 PCR cycles). The SEfiler Plus kit was more sensitive and devoid of colour artefacts, but sho......, but showed more stutters, drop-ins, drop-outs and allelic imbalances...
Dorota Najgebauer-Lejko; Małgorzata Tabaszewska; Tadeusz Grega
Background. Vegetables, apart from having high nutritional value, also contain considerable amounts of dietary fi bre and other components, which may affect physico-chemical properties of fermented milks, e.g. viscosity, texture, susceptibility to syneresis, fl avour profi le etc. The present work was established to study the effect of selected vegetables addition on the rheological, textural, microbiological and fl avour profi le parameters of yoghurts. Material and methods. The vegetabl...
...This action amends the legal descriptions of Jet Routes J-45 and J-79, and VHF omnidirectional range (VOR) Federal airways V-3, V-51, V-159, V-225, V-295 and V-537, in the vicinity of Vero Beach, FL. The FAA is taking this action because the name of the Vero Beach, FL, VOR Tactical Air Navigation (VORTAC) facility, which is included in the descriptions of the above routes, is being changed to the Treasure VORTAC.
The experimental gingivitis study of Löe et al.1 demonstrated a cause and effect relationship between plaque accumulation and gingival inflammation, and helped to establish plaque\\/biofilm as the primary risk factor for gingivitis. When healthy individuals withdrew oral hygiene efforts, gingival inflammation ensued within 21 days in all subjects. Once effective plaque removal was recommenced, clinical gingival health was quickly re-established – indicating that plaque-associated inflammation is modifiable by plaque control. As current consensus confirms that gingivitis and periodontitis may be viewed as a continuum of disease,2 the rationale for achieving effective plaque control is clear.
The Object Management Group (OMG) Platform Technology Committee (PTC) ratified its support for a new asynchronous messaging service for CORBA at OMG's recent Technical Committee Meeting in Orlando, FL. The meeting, held from 8 - 12 June, saw the PTC send the Messaging Service out for a final vote among the OMG membership. The Messaging Service, which will integrate Message Oriented Middleware (MOM) with CORBA, will give CORBA a true asynchronous messaging capability - something of great interest to users and developers. Formal adoption of the specification will most likely occur by the end of the year. The Messaging Service The Messaging Service, when adopted, will be the world's first standard for Message Oriented Middleware and will give CORBA a true asynchronous messaging capability. Asynchronous messaging allows developers to build simpler, richer client environments. With asynchronous messaging there is less need for multi-threaded clients because the Asynchronous Method Invocation is non-blocking, meaning the client thread can continue work while the application waits for a reply. David Curtis, Director of Platform Technology for OMG, said: `This messaging service is one of the more valuable additions to CORBA. It enhances CORBA's existing asynchronous messaging capabilities which is a feature of many popular message oriented middleware products. This service will allow better integration between ORBs and MOM products. This enhanced messaging capability will only make CORBA more valuable for builders of distributed object systems.' The Messaging Service is one of sixteen technologies currently being worked on by the PTC. Additionally, seventeen Revision Task Forces (RTFs) are working on keeping OMG specifications up to date. The purpose of these Revision Task Forces is to take input from the implementors of OMG specifications and clarify or make necessary changes based on the implementor's input. The RTFs also ensure that the specifications remain up to date
Sloan, Jeff A.; Frost, Marlene H.; Berzon, Rick; Dueck, Amylou; Guyatt, Gordon; Moinpour, Carol; Sprangers, Mirjam; Ferrans, Carol; Cella, David
BACKGROUND: A series of six manuscripts with an introduction appeared in the Mayo Clinic Proceedings, based upon the collective effort of 30 individuals with an interest and expertise in assessing the clinical significance of quality of life (QOL) assessments. The series of manuscripts described the
Morin, Richard L.; Forbes, Glenn S.; Gehring, Dale G.; Salutz, James R.; Pavlicek, William
This joint project began in 1988 and was motivated by the need to develop an alternative to the archival process in place at that time (magnetic tape) for magnetic resonance imaging and neurological computed tomography. In addition, this project was felt to be an important step in gaining the necessary clinical experience for the future implementation of various aspects of electronic imaging. The initial phase of the project was conceived and developed to prove the concept, test the fundamental components, and produce performance measurements for future work. The key functions of this phase centered on attachment of imaging equipment (GE Signa) and archival processes using a non-dedicated (institutionally supplied) local area network (LAN). Attachment of imaging equipment to the LAN was performed using commercially available devices (Ethernet, PS/2, Token Ring). Image data were converted to ACR/NEMA format with retention of the vendor specific header information. Performance measurements were encouraging and led to the design of following projects. The second phase has recently been concluded. The major features of this phase have been to greatly expand the network, put the network into clinical use, establish an efficient and useful viewing station, include diagnostic reports in the archive data, provide wide area network (WAN) capability via ISDN, and establish two-way real-time video between remote sites. This phase has heightened both departmental and institutional thought regarding various issues raised by electronic imaging. Much discussion regarding both present as well as future archival processes has occurred. The use of institutional LAN resources has proven to be adequate for the archival function examined thus far. Experiments to date have shown that use of dedicated resources will be necessary for retrieval activities at even a basic level. This report presents an overview of the background present status and future directions of the project.
Malec, James F; Parrot, Devan; Altman, Irwin M; Swick, Shannon
The objective of the study was to develop statistical formulas to predict levels of community participation on discharge from post-hospital brain injury rehabilitation using retrospective data analysis. Data were collected from seven geographically distinct programmes in a home- and community-based brain injury rehabilitation provider network. Participants were 642 individuals with post-traumatic brain injury. Interventions consisted of home- and community-based brain injury rehabilitation. The main outcome measure was the Mayo-Portland Adaptability Inventory (MPAI-4) Participation Index. Linear discriminant models using admission MPAI-4 Participation Index score and log chronicity correctly predicted excellent (no to minimal participation limitations), very good (very mild participation limitations), good (mild participation limitations), and limited (significant participation limitations) outcome levels at discharge. Predicting broad outcome categories for post-hospital rehabilitation programmes based on admission assessment data appears feasible and valid. Equations to provide patients and families with probability statements on admission about expected levels of outcome are provided. It is unknown to what degree these prediction equations can be reliably applied and valid in other settings.
McGilloway, Emer; Mitchell, James; Dharm-Datta, Shreshth; Roberts, Andrew; Tilley, Haydn; Etherington, John
The aim of this study was to identify the most appropriate rehabilitation outcome measure for use in a young adult population with acquired brain injury. A 2-year prospective study of patients admitted to a UK military neuro-rehabilitation unit with acquired brain injury to compare the appropriateness of the Functional Independence Measure/Functional Assessment Measure (FIM+FAM) vs the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) in assessing outcomes. Patients were assessed at admission, discharge and at 4-month follow-up using FIM+FAM and MPAI-4. The FIM+FAM total motor score showed a marked ceiling affect, 42% of patients scored the maximum on admission rising to 80% at discharge. The MPAI-4 did not show significant ceiling effects. The other sub-scales of FIM+FAM and MPAI-4 were generally comparable, no more than 17% achieved ceiling at follow-up. This is the first comparative study of FIM+FAM and MPAI-4 in a young adult military population following acquired brain injury. All patients showed improvements in both outcome measures following intensive inpatient rehabilitation. However, the MPAI-4 did not show ceiling effects in motor scores. This measure was, therefore, found to be more appropriate in the cohort.
Full Text Available La emergencia de enterobacterias productoras de carbapenemasas de tipo Nueva Delhi Metalo beta-lactamasas (NDM, representan, hoy en día, un verdadero problema de salud pública mundial. La presencia de este mecanismo de resistencia limita o anula las opciones terapéuticas para combatir a estas bacterias. En Latinoamérica, las cifras son cada vez más elevadas, pues se reportan en Guatemala, Colombia, Chile, Argentina, entre otros. Perú no ha descrito, hasta la fecha, la presencia de este patrón de resistencia; sin embargo, desde hace varios años se presume de su existencia. Se describen nueve casos de Klebsiella pneumoniae NDM, como agentes infecciosos o colonizantes, en pacientes críticamente enfermos, en su mayoría con patología neuroquirúrgica, del Hospital Nacional Dos de Mayo, en Lima - Perú. Los pacientes de la serie descrita a continuación, representan los primeros reportes de Klebsiella pneumoniae NDM en el Perú.
Anna Ribera Carb\\u00F3
Full Text Available De entre las tradiciones inventadas por los trabajadores del mundo, la más exitosa es, sin duda, la del Primero de Mayo que sirvió para cohesionar a grupos obreros de distinta denominación ideológica y a crear entre ellos conciencia de clase como ninguna otra. En México la conmemoración empezó a realizarse de manera tardía. Fue en 1913 cuando se organizó en la ciudad de México la primera manifestación masiva a partir de la iniciativa de la Casa del Obrero Mundial fundada un año antes y vinculada al pensamiento anarcosindicalista. Fue justamente con esta manifestación que la clase obrera empezó a construir su propio espacio en la capital del país y convirtió a la Casa del Obrero Mundial en un elemento fundamental del entramado político de la Revolución Mexicana.
Full Text Available RESUMEN: El presente artículo hace un repaso por el surgimiento y consolidación de Madres de Plaza de Mayo como movimiento social que inició sus actividades cuestionando la lucha antisubversiva emprendida por la dictadura militar argentina. Plantea además como este movimiento ha sufrido una radicalización de su discurso en la época de la transición a la democracia, cuando se desarrolla el enjuiciamiento de las Juntas Militares, y a partir de ese momento deciden enfrentarse al "sistema burgués". El discurso de Madres de Plaza de Mayo es inicialmente ético y moral para posteriormente adquirir matices de izquierda.ABSTRACT: This article analyzes the emergence and consolidation of the "Madres de Plaza de Mayo" as a social movement which initiated its action questioning the repressive policies led by the Argentine military dictatorship. It shows how the "Madres" undertook a radicalization of its discourse during the democratic transition, as the military "Juntas" were tried by Argentine courts. At this moment, the "Madres" dcided to struggle against the "bourgeois system." The discourse of the Madres was initially ethical and moral, and it became later left wing oriented.
Gottschalk, Sanne; Gottlieb, Caroline T; Vestergaard, Martin; Hansen, Paul R; Gram, Lone; Ingmer, Hanne; Thomsen, Line E
The rapid rise in antibiotic-resistant pathogens is causing increased health concerns, and consequently there is an urgent need for novel antimicrobial agents. Antimicrobial peptides (AMPs), which have been isolated from a wide range of organisms, represent a very promising class of novel antimicrobials. In the present study, the analogue FL9, based on the amphibian AMP fallaxin, was studied to elucidate its mode of action and antibacterial activity against the human pathogen Staphylococcus aureus. Our data showed that FL9 may have a dual mode of action against S. aureus. At concentrations around the MIC, FL9 bound DNA, inhibited DNA synthesis and induced the SOS DNA damage response, whereas at concentrations above the MIC the interaction between S. aureus and FL9 led to membrane disruption. The antibacterial activity of the peptide was maintained over a wide range of NaCl and MgCl(2) concentrations and at alkaline pH, while it was compromised by acidic pH and exposure to serum. Furthermore, at subinhibitory concentrations of FL9, S. aureus responded by increasing the expression of two major virulence factor genes, namely the regulatory rnaIII and hla, encoding α-haemolysin. In addition, the S. aureus-encoded natural tolerance mechanisms included peptide cleavage and the addition of positive charge to the cell surface, both of which minimized the antimicrobial activity of FL9. Our results add new information about FL9 and its effect on S. aureus, which may aid in the future development of analogues with improved therapeutic potential.
Xu, Ya-Ming; Bashyal, Bharat P; Liu, Mangping X; Espinosa-Artiles, Patricia; U'Ren, Jana M; Arnold, A Elizabeth; Gunatilaka, A A Leslie
Two new metabolites, 6-oxo-12-norcytochalasin D (1) and 4,5-di-isobutyl-2(1H)-pyrimidinone (2), together with seven known metabolites, cytochalasins D (3), Q (4), and N (5), 12-hydroxyzygosporin G (6), heptelidic acid chlorohydrin (7), (+)-heptelidic acid (8), and trichoderonic acid A (9), were isolated from Xylariaceae sp. FL0390, a fungal endophyte inhabiting Spanish moss, Tillandsia usneoides. Metabolite 1 is the first example of a 12-norcytochalasin. All metabolites, except 2 and 9, showed cytotoxic activity in a panel of five human tumor cell lines with IC50S of 0.2-5.0 μM.
Névio de Campos
Full Text Available Este artigo objetiva discutir alguns aspectos da trajetória de Flávio Suplicy de Lacerda, enfatizando sua genealogia familiar (capital social e o capital cultural herdado e adquirido como trunfos utilizados para ocupar a reitoria da Universidade do Paraná, e as funções de Secretário do Estado paranaense, e de Ministro da Educação no governo militar de Castelo Branco. A hipótese afirma que o espírito de família e a herança cultural, se constituíram em estratégias utilizadas por Flávio de Lacerda para assumir funções de destaque no cenário cultural e político do Paraná e do Brasil, e foi discutida à luz dos conceitos de trajetória, estratégia, espírito de família e capital cultural herdado e adquirido, a partir de dados biográficos e autobiográficos. Esses dados foram tomados como produção de uma memória ou/e uma representação que buscava sacralizar essa personagem. As descrições biográficas, por sua vez, foram cruzadas com os contextos social e cultural, permitindo pôr em jogo o aparato teórico e o objeto empírico. Esta análise permite afirmar que as estruturas estruturadas se converteram em estruturas estruturantes na trajetória de Flávio de Lacerda, isto é, esse intelectual, ao interiorizar as estruturas estruturadas, incorporou o senso prático como sentido de jogo, como estratégia para ingressar no campo intelectual, assim como para ampliar seus espaços de ação nesse próprio campo. Em síntese, ao tomar os dados como tentativa de sacralização da trajetória de Flávio de Lacerda e convertê-los em produtos do processo dos contextos social e cultural, este artigo contribui ao entendimento da complexa relação entre o indivíduo e a sociedade, isto é, evidencia que os trunfos sociais e culturais funcionam como poderosas estratégias para assumir papeis de liderança nos campos político e cultural.
Mandianes Castro, Manuel
En las novelas de W. F. Flórez, como en la vida real de las aldeas gallegas, el espacio tiene muchos niveles: "lareira", aldea, parroquia, ciudad, Castilla, América, "fraga" y el subterráneo maravilloso, y el tiempo tiene cualidades: olor, sabor. Una lectura atenta de estas dos novelas demuestra que la oralidad forma parte importante de la narración; que el autor es, por lo mismo, en buena medida, un auténtico trasmisor de la tradición y que, por lo tanto, los etnólogos y antropólogos han de ...
AbstractBackgroundPeripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF) is a common, painful injury. The provision of effective analgesia to this cohort is challenging but an important determinant of their functional outcome. We investigated the analgesic efficacy of continuous femoral nerve block (CFNB) in patients with FNF.MethodsFollowing institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1) or a femoral perineural catheter (Group 2). Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score) at 30 min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10). The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later.ResultsOf 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7) vs 27.5(14.2) h, P = 0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4) vs 31(28), P = 0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30 min up to 54 hours [e.g at 6 h 30.7(23.4) vs 67.0(32.0), P = 0
Qureshi, N.S.; Hanif, A.; Akhtar, B.; Bhatti, T.A.; Lutfullah; Iqbal, M.; Khaled, Z.N.; Bakhshi, I.M.; Khan, B.Z.
Coronary artery disease (CAD) is very common in the South Asian sub-continent, yet there is relatively little published research available from these countries. Although we have a very active Cardiology Department in Mayo Hospital, Lahore, there is a parallel need for documentation of the data generated and its analysis for research and publication. This study was carried out to gain an insight into the nature of the risk factors and presentation of CAD in patients coming to our setup. Objectives: The objective was to study the relation of CAD with anthropometric (BMI, waist circumference, waist . to . height ratio) and demographical (age and gender) factors. Methodology: This study was carried out in the Department of Cardiology, Mayo Hospital, Lahore, for a duration of 17 months. We collected the required information (such as name, gender, and family history, demographical data and anthropometric measurements) on a prescribed proforma, managed and then analyzed accordingly. Results: In this study there were 302 (80.5%) males and 73 (19.5%) females. The number of males was significantly higher (p-value 0.000), but the frequency of different diagnoses was statistically the same in both males and females, i.e. p-value = 0.062. According to the WHO recommended criteria for the BMI of South Asian populations, there were 9(2.4%) people who were under weight, among these 7 (77.8%) were males and 2 (22.2%) were females patients. Out of 302 males, 7(2.3%) were under weight, 36 (11.9%) were of normal weight, 115 (38.1%) were overweight and the rest of 144 (47.7%) were obese. Among 73 females, 2 (2.7%) were under weight, 8 (11%) had normal weight, 15 (20.5%) were overweight and 48 (65.8%) were obese. The proportion of obesity was more in females in this study, p-value (0.000). The mean waist circumference of all patients was 95.57 +- 17.14 cm with a range of 53 - 190 cm. The waist circumference was statistically higher in males than females, p-value = 0.000. In 7 under
Chen, Zhen-Yong; Guo, Xiao-Jiang; Chen, Zhong-Xu; Chen, Wei-Ying; Wang, Ji-Rui
The binding sites of transcription factors (TFs) in upstream DNA regions are called transcription factor binding sites (TFBSs). TFBSs are important elements for regulating gene expression. To date, there have been few studies on the profiles of TFBSs in plants. In total, 4,873 sequences with 5' upstream regions from 8530 wheat fl-cDNA sequences were used to predict TFBSs. We found 4572 TFBSs for the MADS TF family, which was twice as many as for bHLH (1951), B3 (1951), HB superfamily (1914), ERF (1820), and AP2/ERF (1725) TFs, and was approximately four times higher than the remaining TFBS types. The percentage of TFBSs and TF members showed a distinct distribution in different tissues. Overall, the distribution of TFBSs in the upstream regions of wheat fl-cDNA sequences had significant difference. Meanwhile, high frequencies of some types of TFBSs were found in specific regions in the upstream sequences. Both TFs and fl-cDNA with TFBSs predicted in the same tissues exhibited specific distribution preferences for regulating gene expression. The tissue-specific analysis of TFs and fl-cDNA with TFBSs provides useful information for functional research, and can be used to identify relationships between tissue-specific TFs and fl-cDNA with TFBSs. Moreover, the positional distribution of TFBSs indicates that some types of wheat TFBS have different positional distribution preferences in the upstream regions of genes.
Taguchi, Yuzuru; Hohsfield, Lindsay A.; Hollister, Jason R.
The FlAsH/tetracysteine (FlAsH/TC) tag is a powerful tool for fluorescent labeling of proteins. However, even small tags such as FlAsH/TC could alter the behavior of the tagged proteins, especially if the insertion occurs at internal sites. Defining the influence of FlAsH/TC on nearby protein-protein interactions might aid in selecting appropriate positions for internal TC insertions and allow the exploitation of serial FlAsH/TC insertions (TC-scanning) as a probe to characterize sites of protein-protein interaction. To explore this application in the context of substrate-protease interactions, we analyzed the effect of FlAsH/TC insertions on proteolysis of cellular prion protein (PrPsen) in in vitro reactions and generation of the C1 metabolic fragment of PrPsen in live neuroblastoma cells. The influence of FlAsH/TC insertion was evaluated by TC-scanning across the cleavage sites of each protease. The results showed that FlAsH/TC inhibited protease cleavage only within limited ranges of the cleavage sites that varied from about 1 to 6 residues-wide depending on the protease, providing an estimate of the PrP residues interacting with each protease. TC-scanning was also used to probe a different type of protein-protein interaction, the conformational conversion of FlAsH-PrPsen to the prion disease-associated isoform, PrPres. PrP constructs with FlAsH/TC insertions at residues 90–96 but not 97–101 were converted to FlAsH-PrPres, identifying a boundary separating loosely versus compactly folded regions of PrPres. Our observations demonstrate that TC-scanning with the FlAsH/TC tag can be a versatile method for probing protein-protein interactions and folding processes. PMID:23943295
Coleman, Bradley M.; Nisbet, Rebecca M.; Han, Sen; Cappai, Roberto; Hatters, Danny M.; Hill, Andrew F.
Prion diseases are associated with the misfolding of the host-encoded cellular prion protein (PrP C ) into a disease associated form (PrP Sc ). Recombinant PrP can be refolded into either an α-helical rich conformation (α-PrP) resembling PrP C or a β-sheet rich, protease resistant form similar to PrP Sc . Here, we generated tetracysteine tagged recombinant PrP, folded this into α- or β-PrP and determined the levels of FlAsH fluorescence. Insertion of the tetracysteine tag at three different sites within the 91-111 epitope readily distinguished β-PrP from α-PrP upon FlAsH labeling. Labelling of tetracysteine tagged PrP in the α-helical form showed minimal fluorescence, whereas labeling of tagged PrP in the β-sheet form showed high fluorescence indicating that this region is exposed upon conversion. This highlights a region of PrP that can be implicated in the development of diagnostics and is a novel, protease free mechanism for distinguishing PrP Sc from PrP C . This technique may also be applied to any protein that undergoes conformational change and/or misfolding such as those involved in other neurodegenerative disorders including Alzheimer's, Huntington's and Parkinson's diseases.
Full Text Available Meine ersten Gedanken sind persönlicher Art. Sie erzählen eine Geschichte darüber, wie wir, die neuen Deutschen, offenbar niemals deutsch genug sein können. Und zwar nicht, weil wir uns der „Integration verweigern“ (wiewohl wir natürlich unsere individuelle historische, kulturelle, religiöse oder ethnische Identität nicht assimilieren können, selbst wenn es wir wollten. Sondern weil uns ebendiese Integration – das selbstverständliche, fraglose, unkommentierte Deutsch-Sein – verweigert wird. Nicht nur die Schönheit, sondern auch die Fremdheit liegt offenbar im Auge des Betrachters. Der zweite Gedanke widmet sich dem Begriff der Flüchtlingskrise, der die öffentliche Diskussion seit einiger Zeit beherrscht und anders beschaffen ist als die vertrauten Krisen-Rhetoriken der vergangenen Jahrzehnte. Die „Flüchtlingskrise“ bezeichnet eine Identitätskrise, der mit dem Instrumentarium der „Werte“ beigekommen werden soll. Am Beispiel der Debatte um die deutsche Leitkultur und deren mutmaßliche Kernwerte möchte ich abschließend dafür plädieren, das notwendig identitätsbezogene Konzept der Werte aus einer (zukünftigen Ethik der Integration herauszuhalten.
Fiona Kumari Campbell
Full Text Available Cosmopolitanism, desire and the contracting of social relationships are enduring themes in both philosophy and social theory. In this paper I seek to explore these themes in order to ascertain what they might mean to disabled people and the ethos of ableism more generally. Modern Westernized life has since the Industrial Revolution been sited in cities fostering the growth of urban culture and an ethos of cosmopolitanism (Agamben, 2009; Beck, 2002; Cheah, 2006. The cosmopolitan outlook has become the signifier of that which is developed, advanced and civilized in society. The liberal project of the melting pot, of social tolerance is cast against the backdrop of city life (Brown, 2006. The paper will first examine the trope of cosmopolitanism and disability including the place of ‘spaces’ for marginal peoples. Second, it will provide a perspective on the disabled flâneur (Campbell, 2009; Simmel, 1908; Young, 2005 who ambivalently claims ‘outsider-insidedness’ and finally the paper moves to consider the significant question of social inclusion and the government of aversion through the deployment of discourses of tolerance. Keywords: cosmopolitanism; social inclusion, community, flâneur, tolerance; biopolitics; disability
van den Brand, Michiel; van der Velden, Walter J F M; Diets, Illja J; Ector, Geneviève I C G; de Haan, Anton F J; Stevens, Wendy B C; Hebeda, Konnie M; Groenen, Patricia J T A; van Krieken, Han J M
Nodal marginal zone lymphoma (NMZL) is a rare type of B-cell non-Hodgkin lymphoma. This study assessed the clinical features of 56 patients with NMZL in comparison to 46 patients with follicular lymphoma (FL). Patients with NMZL and FL had a largely similar clinical presentation, but patients with FL had a higher disease stage at presentation, more frequent abdominal lymphadenopathy and bone marrow involvement, and showed more common transformation into diffuse large B-cell lymphoma (DLBCL) during the course of disease. Overall survival and event-free survival were similar for patients with NMZL and FL, but factors associated with worse prognosis differed between the two groups. Transformation into DLBCL was associated with a significantly poorer outcome in both groups, but the phenotypes were different: DLBCL arising in FL was mainly of germinal center B-cell phenotype, whereas DLBCL arising in NMZL was mainly of non-germinal center B-cell phenotype.
Boletín Cultural y Bibliográfico Banco de la República
Full Text Available Don Isidoro Laverde Amaya desempeñó en el campo de la inteligencia todos los oficios imaginables, desde el relato histórico hasta la crítica literaria, pasando por la poesía, la biografía, el teatro, el cuento y el periodismo.
Full Text Available This essay examines the critical character of Friedrich Schlegel’s Romantic irony, following its considerations and appropriations by Walter Benjamin, Harold Bloom and Paul de Man. Likewise, it shows a parallelism of this critical attitude of irony with three Romantic literary figures: the aesthete, the dandy and the flâneur. The aesthete, the dandy and the flâneur, joined by a prophetic faith in art, make of irony a profession moving between creation and destruction. Appropriation in the poststructuralist context allows us to perceive in irony such a radical incomprehension, developing an aesthetic pattern operating between creation and annihilation.
Cattelani, R; Corsini, D; Posteraro, L; Agosti, M; Saccavini, M
The assessment of major obstacles to community integration which may result from an acquired brain injury (ABI) is needed for rational planning and effective management of ABI patients' social adjustment. Currently, such a generally acceptable measure is not available for the Italian population. This paper reports the translation process, the internal consistency, and the inter-rater reliability data for the Italian version of the Mayo-Portland Adaptability Inventory-4 (MPAI-4), a useful measure with highly developed and well documented psychometric properties. The MPAI-4 is specifically designed to assess socially relevant aspects of physical status and cognitive-behavioural competence following ABI. It is a 29-item inventory which is divided into three subdomains (Abilities, Adjustment, and Participation indices) covering a reasonably representative range Twenty ABI patients with at least one-year discharge from the rehabilitation facilities were submitted to the Italian MPAI-4. They were independently rated by two different rehabilitation professionals and a family member/significant other serving as informant (SO). Internal consistency was assessed by calculating the Cronbach's alpha values. Inter-rater agreement for individual items was statistically examined by determining the interclass correlation coefficient (ICC). In addition to the 8% of perfectly correspondent sentences, a clear prevalence (75.5%) of minor semantic variations and formal variations with no semantic value at the sentence-to-sentence matching was found. Full-scale Cronbach's alpha was 0.951 and 0.947 for the two professionals (rater #1 and rater #2, respectively), and was 0.957 for the family member serving as informant (rater #3). Full-Scale ICC (2.1) between professionals and SOs was 0.804 (CI=95%; lower-upper bound=0.688-0.901). The Italian MPAI-4 shares many psychometric features with the original English version, demonstrates both good internal consistency and good inter
Full Text Available Objetivo: Evaluar la evolución y letalidad de los pacientes portadores de endocarditis infecciosa, así como la presencia de complicaciones y la influencia de estas sobre la mortalidad. Diseño: Estudio longitudinal no concurrente. Lugar: Servicio de cardiología del Hospital 2 de Mayo, hospital universitario. Pacientes: Pacientes con diagnóstico de endocarditis infecciosa. Intervenciones: Se revisó las historias clínicas de los pacientes con diagnóstico de endocarditis infecciosa atendidos entre junio de 1999 y junio de 2005. Se evaluó los criterios clínicos, de laboratorio y ecocardiográficos (criterios de Duke empleados en el diagnóstico. Para el análisis estadístico, se realizó el análisis descriptivo y comparativo con el empleo de las pruebas de Fisher y t de Student y la comparación de las curvas de Kaplan Meier, para evaluar la supervivencia a través de la prueba de rango logarítmico. Principales medidas de resultados: Evaluación de supervivencia: Complicaciones y mortalidad en pacientes en endocarditis infecciosa. Resultados: Se estudió 75 pacientes, la edad promedio fue 42,1±20,4 años, 66,7% del sexo masculino. El 93,3% tenía cardiopatía de base. La presentación clínica incluyó insuficiencia cardiaca congestiva (73,3%, encefalopatía (17,3% y fenómenos embólicos (50,6%. Se evaluó la evolución de los parámetros de laboratorio, evidenciándose deterioro de la función renal. El ecocardiograma evidenció presencia de vegetaciones en 97,3% y complicaciones, como rotura valvar (8%, abscesos valvares (4%. Durante la evolución, se sometió a cirugía a 14,7%. La letalidad general fue 14,7%, la cual estuvo influenciada por el número de complicaciones, en particular las complicaciones sépticas y renales, que impactaron de igual manera en la probabilidad de supervivencia de estos pacientes. Conclusiones: Se registró una letalidad general de 14,7%. La probabilidad de supervivencia se vio afectada
Aaron, F.D.; Andreev, V.
A first measurement is reported of the longitudinal proton structure function F L (x,Q 2 ) at the ep collider HERA. It is based on inclusive deep inelastic e + p scattering cross section measurements with a positron beam energy of 27.5 GeV and proton beam energies of 920, 575 and 460 GeV. Employing the energy dependence of the cross section, F L is measured in a range of squared four-momentum transfers 12≤Q 2 ≤90 GeV 2 and low Bjorken x 0.00024≤x≤0.0036. The FL values agree with higher order QCD calculations based on parton densities obtained using cross section data previously measured at HERA. (orig.)
Émile Cardoso Andrade
Full Text Available Extensão do curta-metragem homônimo escrito por Gustavo Taretto em 2004 e filmado em 2005, Medianeras é uma reflexão simples e espirituosa sobre a falta de sincronia do destino das pessoas e sobre o impacto da tecnologia no dia a dia delas. Narrar a experiência solitária e anônima dentro da cidade é uma tradição da sociedade industrial que não se perdeu com a explosão e popularização da rede mundial de computadores a partir da década de 1990. Mas, agora, estamos diante do flâneur digital.
Kobetz, Erin; Menard, Janelle; Kish, Jonathan; Bishop, Ian; Hazan, Gabrielle; Nicolas, Guerda
In January 2010, a massive earthquake struck Haiti resulting in unprecedented damage. Little attention, however, has focused on the earthquake's mental health impact in the Haitian diaspora community. As part of an established community-based participatory research initiative in Little Haiti, the predominately Haitian neighborhood in Miami, FL, USA, community health workers conducted surveys with neighborhood residents about earthquake-related losses, coping strategies, and depressive/traumatic symptomology. Findings reveal the earthquake strongly impacted the diaspora community and highlights prominent coping strategies. Following the earthquake, only a small percentage of participants self-reported engaging in any negative health behaviors. Instead, a majority relied on their social networks for support. This study contributes to the discourse on designing culturally-responsive mental health initiatives for the Haitian diaspora and the ability of existing community-academic partnerships to rapidly adapt to community needs.
Park, S. H.; Kim, K. R.; Kim, D. H.; Cho, S. W.
The developmental need for a localized severe accident analysis code is on the rise, and KAERI is developing a severe accident code MIDAS, based on MELCOR. The existing data saving method uses pointer variables for a fix-sized storage management, and it deteriorates the readability, maintainability and portability of the code. But new features in FORTRAN90 such as a dynamic allocation have been used for the restructuring. The restructuring of the data saving and transferring method of the existing code makes it easy to understand the code. Before an entire restructuring of the code, a restructuring template for a simple package was developed and tested. The target for the restructuring was the FL package which is responsible for modeling the thermal-hydraulic behavior of a liquid water, water vapor, and gases in MELCOR with the CVH package. The verification was done through comparing the results before and after the restructuring
Tzanos, C.P.; Pedersen, D.R.
The RVACS test 2F-L was analyzed to support the validation of COMMIX. This test is characterized by a power input of 50 kW, natural convection in the sodium pool, forced RVACS air circulation and a heat up period of 8 hours. At the beginning of the experiment the sodium pool was isothermal. After 7.5 hours the system reached near steady state with a temperature difference between the bottom and top of the pool of 96 degree C. The COMMIX predictions for the sodium pool temperatures and the air outlet temperatures were in good agreement with measurements. The maximum difference between predictions and measurements was ∼12 degree C. 4 refs., 5 figs
Full Text Available Los beneficios de la utilización de Flúor en la salud dental han sido convencionalmente aceptados, sinembargo en la actualidad nuevas investigaciones en salud humana revelan la urgencia por evitar la ingestión de Fluor al punto de inclusive modificar programas de salud e implementar nuevas investigaciones. Los gobiernos como Canadá, Estados Unidos Chile, Países Europeos y Asiáticos que han invertido cifras millonarias en Fluorización pública; ahora deben modificar sus programas e investigar daños causados. Por este motivo la dotación de agua deberá seguir estas directrices.
Liu Huigang; Zhao Meirong; Zhang Cong; Ma Yun; Liu Weiping
Synthetic pyrethroids (SPs) are used in preference to organochlorines and organophosphates due to their high efficiency, low toxicity to mammals, and ready biodegradability. Previous studies reported that enantioselective toxicity of SPs occurs in aquatic toxicity. Several studies have indicated that SPs could lead to oxidative damage in humans or animals which was associated with their toxic effects. Little is known about the differences in the effects of chronic toxicity induced by individual stereoisomers of chiral SPs. The present study was therefore undertaken to evaluate the enantioselectivity in cytotoxicity, genotoxicity caused by bifenthrin (BF) on human amnion epithelial (FL) cell lines and pesticidal activity on target organism. The cell proliferation and cytoflow analysis indicated that 1S-cis-BF presented more toxic effects than 1R-cis-BF above the concentration of 7.5 mg L -1 (p > 0.05). FL cells incubated with 1S-cis-BF exhibited a dose-dependent accumulation of intracellular reactive oxygen species (ROS). In the comet assay, the number of cells with damaged DNA incubated with 1S-cis-BF was more than that with 1R-cis-BF (p 50 values of enantiomer to the target pest on Pieris rapae L. show that 1R-cis-BF was 300 times more active than 1S-cis-BF. These results indicate that the enantioselective toxicity and activity of BF between non-target organism and target organism was reversal. These implications together suggest that assessment of the environmental safety and new pesticides development with chiral centers should consider enantioselectivity
El-Heliebi, Amin; Hille, Claudia; Laxman, Navya; Svedlund, Jessica; Haudum, Christoph; Ercan, Erkan; Kroneis, Thomas; Chen, Shukun; Smolle, Maria; Rossmann, Christopher; Krzywkowski, Tomasz; Ahlford, Annika; Darai, Evangelia; von Amsberg, Gunhild; Alsdorf, Winfried; König, Frank; Löhr, Matthias; de Kruijff, Inge; Riethdorf, Sabine; Gorges, Tobias M; Pantel, Klaus; Bauernhofer, Thomas; Nilsson, Mats; Sedlmayr, Peter
Liquid biopsies can be used in castration-resistant prostate cancer (CRPC) to detect androgen receptor splice variant 7 (AR-V7), a splicing product of the androgen receptor. Patients with AR-V7-positive circulating tumor cells (CTCs) have greater benefit of taxane chemotherapy compared with novel hormonal therapies, indicating a treatment-selection biomarker. Likewise, in those with pancreatic cancer (PaCa), KRAS mutations act as prognostic biomarkers. Thus, there is an urgent need for technology investigating the expression and mutation status of CTCs. Here, we report an approach that adds AR-V7 or KRAS status to CTC enumeration, compatible with multiple CTC-isolation platforms. We studied 3 independent CTC-isolation devices (CellCollector, Parsortix, CellSearch) for the evaluation of AR-V7 or KRAS status of CTCs with in situ padlock probe technology. Padlock probes allow highly specific detection and visualization of transcripts on a cellular level. We applied padlock probes for detecting AR-V7, androgen receptor full length (AR-FL), and prostate-specific antigen (PSA) in CRPC and KRAS wild-type (wt) and mutant (mut) transcripts in PaCa in CTCs from 46 patients. In situ analysis showed that 71% (22 of 31) of CRPC patients had detectable AR-V7 expression ranging from low to high expression [1-76 rolling circle products (RCPs)/CTC]. In PaCa patients, 40% (6 of 15) had KRAS mut expressing CTCs with 1 to 8 RCPs/CTC. In situ padlock probe analysis revealed CTCs with no detectable cytokeratin expression but positivity for AR-V7 or KRAS mut transcripts. Padlock probe technology enables quantification of AR-V7, AR-FL, PSA, and KRAS mut/wt transcripts in CTCs. The technology is easily applicable in routine laboratories and compatible with multiple CTC-isolation devices. © 2017 American Association for Clinical Chemistry.
Vite Gutiérrez, Flor Yessenia
Objetivo: Conocer la incidencia de anemia ferropénica y factores asociados en la gestación en el distrito de Rapayan, Ancash, Perú. Material y método: estudio prospectivo, analítico y longitudinal en 39 gestantes del distrito de Rapayán, provincia de Huari, departamento de Ancash, Perú durante el periodo comprendido entre mayo 2010 y marzo del 2011. Se procedió a tomar muestras de sangre del total de la muestra n= 39 gestantes, durante los tres trimestres con el fin de controlar los niveles d...
...-AA00 Safety Zone; Second Annual Space Coast Super Boat Grand Prix, Atlantic Ocean, Cocoa Beach, FL... temporary safety zone on the waters of the Atlantic Ocean east of Cocoa Beach, Florida during the Second... Atlantic Ocean east of Cocoa Beach, Florida. Approximately 30 high-speed power boats will be participating...
Kissling, Elizabeth M.; O'Donnell, Mary E.
This study describes how oral language was assessed in an advanced-level college foreign language (FL) conversation course. Learners used the American Council on the Teaching of Foreign Languages Proficiency Guidelines to guide self-analyses of their oral production at intervals throughout the course. The intent was to provide opportunities for…
... Zone; Festival of States 2012 Night Parade Fireworks Display, Tampa Bay, St. Petersburg, FL AGENCY... safety zone on the waters of Tampa Bay in St. Petersburg, Florida during Festival of States 2012 Night... Thursday, March 22, 2012, the Festival of States 2012 Night Parade Fireworks Display is scheduled to take...
... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [B-51-2012] Foreign-Trade Zone 32--Miami, FL... Foreign-Trade Zones (FTZ) Board (the Board) by the Greater Miami Foreign-Trade Zone, Inc., grantee of FTZ 32, requesting authority to reorganize the zone under the alternative site framework (ASF) adopted by...
...-AA08 Special Local Regulation; Emerald Coast Super Boat Grand Prix; Saint Andrew Bay; Panama City, FL... navigable waters during the Emerald Coast Super Boat Grand Prix high speed boat races. Entry into... needed to safeguard persons and vessels from safety hazards associated with the Emerald Coast Super Boat...
Pigeau, Nora; Barnes de Carlotto, Estela; Lovazzano, Eduardo; Velazco, Luis; Cuadra, Estela de la; Cardoso, Miriam
Informe de Radio Universidad Nacional de La Plata sobre el hallazgo de la nieta número 115, recuperada por Abuelas de Plaza de Mayo: Ana Libertad Baratti de la Cuadra. El 22 de agosto de 2014 la ciudad de La Plata y el país entero celebró el encuentro de la nieta de la co-fundadora y primera presidenta de la Asociación Abuelas de Plaza de Mayo, Alicia “Licha” Zubasnabar de De la Cuadra: apareció Ana Libertad Baratti de la Cuadra. Héctor Carlos Baratti y de Elena de la Cuadra fueron se...
Jeffrey M. Banister
Full Text Available El actual distrito de riego 038 o valle del Mayo, que forma parte del espacio de riego del noroeste de México, surge de luchas históricas por construir un orden oficial en un mundo diverso de signos, símbolos, procesos, lugares y personas. Es el hogar ancestral de los yoremes (mayos, un grupo indígena para el que la colonización y el desarrollo agrícola han significado la pérdida de autonomía y de la movilidad estacional que requieren para subsistir en un terreno árido. Es el lugar donde nació el presidente Álvaro Obregón, otrora productor de garbanzo, que transformó las prácticas de riego de fines del siglo xix en las leyes e instituciones para la administración del agua del siglo xx. Reconfigurar el territorio con el fin de centralizar ("federalizar" los recursos hídricos ha probado ser excesivamente difícil en la zona del Mayo, pero esto fue así en particular al inicio del proceso de federalización, una época de modernización dinámica bajo la dirección del presidente Porfirio Díaz (1876-1910. La investigación sobre la política hidráulica de México, con algunas importantes excepciones, ha tendido a enfocarse en la centraliza- ción. Los estudiosos le han prestado menor atención a los momentos y lugares en los que el agua escapa al control de las autoridades. Este trabajo explora la importancia de la administración del agua (y más ampliamente la formación del Estado a finales del siglo xix, en vísperas de la Revolución Mexicana de 1910, como una serie continua, siempre incipiente de derechos y proyectos relativos a las tierras. Entender las debilidades e incompetencias de dichos proyectos ofrece un discernimiento crucial acerca de la política hidráulica posrevolucionaria o contemporánea.
manifestaciones, cómo los sectores populares nativos podían influir sobre la marcha de la economía y de la política, muchas veces para su propio beneficio. En este intento, las muchedumbres nativas de Lima de principios del siglo XX desarrollaron una cotidiana lucha que tenía como escenario el mercado de trabajo que, a veces, llegaba a niveles altos de violencia como en las asonadas de mayo de 1909 en el que, como se apreciará en el artículo que sigue, los trabajadores chinos fueron blanco de las agresiones de una multitud que consideraba que los orientales desplazaban a nacionales y además contribuían a la depreciación del salario. THE MAY 1909 RIOTS. IMMIGRANTS AND NATIONALS IN THE LABOUR MARKET OF LIMA AT THE BEGINNING OF THE 20TH CENTURY. This article is part of a larger study that seeks to contribute to our understanding of a crucial period of peruvian history, 1890-1920. The study of urban riots allows us to analyze how a society that was going through the first stages of a modernization process, produced a form of lower-class protest characterized by the destruction of property, the lack of a permanent form of organization, certain manifestations of racial outrage, and above all, notions of legitimacy sanctioned by tradition. In addition, the study of urban riots allows us to understand how lower classes could influence economic and political developments, often for their own benefit. In this attempt, the native masses of early 20th century Lima carried on a daily struggle whose scenario was the labor market witch, on occasion, was characterized by high levels of violence, such as the May 1909 riots. As the article details, Chinese people were the target of the crowds fury, due to the belief that Chinese workers were displacing locals from their jobs and were a factor in the overall decline in salary rates.
Kurata, Shinya; Kanagawa, Takahiro; Yamada, Kazutaka; Torimura, Masaki; Yokomaku, Toyokazu; Kamagata, Yoichi; Kurane, Ryuichiro
We have developed a simple method for the quantitative detection of specific DNA or RNA molecules based on the finding that BODIPY® FL fluorescence was quenched by its interaction with a uniquely positioned guanine. This approach makes use of an oligonucleotide probe or primer containing a BODIPY® FL-modified cytosine at its 5′-end. When such a probe was hybridized with a target DNA, its fluorescence was quenched by the guanine in the target, complementary to the modified cytosine, and the quench rate was proportional to the amount of target DNA. This widely applicable technique will be used directly with larger samples or in conjunction with the polymerase chain reaction to quantify small DNA samples. PMID:11239011
Malec, J F; Moessner, A M; Kragness, M; Lezak, M D
Evaluate the psychometric properties of the Mayo-Portland Adaptability Inventory (MPAI). Rating scale (Rasch) analysis of MPAI and principal component analysis of residuals; the predictive validity of the MPAI measures and raw scores was assessed in a sample from a day rehabilitation program. Outpatient brain injury rehabilitation. 305 persons with brain injury. A 22-item scale reflecting severity of sequelae of brain injury that contained a mix of indicators of impairment, activity, and participation was identified. Scores and measures for MPAI scales were strongly correlated and their predictive validities were comparable. Impairment, activity, and participation define a single dimension of brain injury sequelae. The MPAI shows promise as a measure of this construct.
Exon 3-deleted/full-length growth hormone receptor polymorphism genotype frequencies in Spanish short small-for-gestational-age (SGA) children and adolescents (n = 247) and in an adult control population (n = 289) show increased fl/fl in short SGA.
Audí, Laura; Esteban, Cristina; Carrascosa, Antonio; Espadero, Rosa; Pérez-Arroyo, Annalisa; Arjona, Rosa; Clemente, María; Wollmann, Hartmut; Fryklund, Linda; Parodi, Luis A
A polymorphism in the human GH receptor gene (d3/fl-GHR) resulting in genomic deletion of exon 3 has been associated with the degree of height increase in response to GH therapy. The objective of the study was to evaluate the frequencies of d3/fl-GHR polymorphism genotypes in control and short small-for-gestational-age (SGA) populations. An adult control population with heights normally distributed (ACPNH) between -2 and +2 sd score (SDS) and a short non-GH-deficient SGA child population were selected. Thirty Spanish hospitals participated in the selection of the short non-GH-deficient SGA children in the setting of a controlled, randomized trial, and one of these hospitals selected the ACPNH. CONTROLS AND PATIENTS: Two hundred eighty-nine adult subjects of both sexes constituted the ACPNH and 247 children and adolescents of both sexes the short SGA patients. Heights and weights were recorded in the ACPNH, and auxologic and biochemical data were recorded at each hospital for the SGA patients; d3/fl-GHR genotypes were determined and data analyzed in a single hospital. In short SGA patients, d3/fl-GHR genotype frequencies were significantly different from those in ACPNH, with a higher frequency of fl/fl genotype (P or=-2 SDS, n = 60). Our data showed significant differences in the frequency distribution of the d3/fl-GHR genotypes between a normally distributed adult height population and short SGA children, with the biologically less active fl/fl genotype being almost twice as frequent in SGA patients. These data suggest that the d3/fl-GHR polymorphism might be considered among the factors that contribute to the phenotypic expression of growth.
Rita S. Villena
Full Text Available A utilização de flúor sistêmico deve ser controlada em termos de risco/benefício, pois enquanto a subdosagem não trouxer benefício anticárie, a sobredosagem estará associada com fluorose dental. Assim, uma das preocupações é o consumo de águas minerais, o qual tem aumentado nos últimos anos. Deste modo, foi realizado estudo com o objetivo de analisar a concentração de flúor em águas minerais comercializadas no Brasil. Foram analisadas 104 marcas comerciais, de diferentes regiões do País. Utilizou-se eletrodo específico Orion 96-09 e analisador de íons Orion EA 940, previamente calibrados com soluções padrões de flúor. Foram observadas concentrações de flúor variando de 0,0 a 4,4 ppm. Constataram-se: 1 Concentrações significativas de flúor não relatadas pelo produtor; 2 Concentrações de flúor sem significado preventivo anti-cárie, embora o produtor destaque na embalagem "Água Mineral Fluoretada"; 3 Concentrações de flúor capazes de provocar fluorose dental severa, embora o produtor não faça nenhuma referência que o mesmo existe. Conclui-se ser necessário um Sistema de Vigilância Sanitária para o controle de flúor nas águas minerais oferecidas à população brasileira, quer seja em termos de benefício como de risco.
Zhang Yong; Zhang Linsheng; Zhang Hongbing; Guo Chaohua; Tong Shiwu
Objective: To observe the effect of CD34 cord blood stem cell transfected by plasmid vector plRES2-FL-IL-3 on the mouse after irradiation and to investigate its mechanisms. Methods: In the co-expressed group (12 mice), CD 34 + cord blood stem cells were transfected by plasmid vector pIRES2-FL-IL-3.5 x lO 5 cells were injected intravenously in the mouse. The hemogram changes in mice were detected 2, 4 and 6 weeks after radiation. At 6 weeks after irradiation, the expression of the CD 34 in spleen was detected by immumofluorescence method. The mRNA level and the activity of IL-3 and FL were detected by RT-PCR and Western blot. Other 3 groups were CD 34 + cell group (CD 34 group), pIRES2-IL-3 group(IL 3 group) and pIRES2-FL group(FL group), and there were 12 mice in each group. Results: The survival rate of CD 34 group, IL3 group and FL group at the 6th week were 25.0% (3/12), 50.0% (6/12) and 50.0% (6/12), respectively. It was 91.7% (11/12) in the co-expressed group, which was higher than those in the other groups. The expression of the CD 34 of spleen in the co-expressed group was higher than those of the other groups. The mRNA level and the activity of IL-3 and FL of spleen in the co-expressed group were higher than those in the other groups too. Conclusions: The CD 34 '+ cord blood stem cells transfected by plasmid vector pIRES2-FL-IL-3 have hemogenesis promotion effect on the mice after irradiation, which was related with the aggregation, proliferation of stem cells and the high expression of the interest proteins.. (authors)
When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists. PMID:23634159
Curtis, Kelly K.; Ross, Helen J.; Garrett, Ashley L.; Jizba, Theresa A.; Patel, Ajay B.; Patel, Samir H.; Wong, William W.; Halyard, Michele Y.; Ko, Stephen J.; Kosiorek, Heidi E.; Foote, Robert L.
We reviewed outcomes of patients with loco-regionally recurrent (LRR) or new primary (NP) squamous cell carcinoma of the head and neck (SCCHN) treated at our institution with reirradiation (RRT). Patients received definitive RRT (DRRT) or post-operative RRT following salvage surgery (PRRT) from 2003 to 2011. Measured survival outcomes included loco-regional relapse free survival (LRFS) and overall survival (OS). Among 81 patients (PRRT, 42; DRRT, 39), median PRRT and DRRT doses were 60 Gy (12–70 Gy) and 69.6 Gy (48–76.8 Gy). The majority of patients received IMRT-based RRT (n = 77, 95 %). With median follow-up of 78.1 months (95 % CI, 56–96.8 months), 2-year OS was 53 % with PRRT and 48 % with DRRT (p = 0.12); 23 % of patients were alive at last follow-up. LRFS at 2 years was 60 %, and did not differ significantly between PRRT and DRRT groups. A trend toward inferior LRFS was noted among patients receiving chemotherapy with RRT versus RRT alone (p = 0.06). Late serious toxicities were uncommon, including osteoradionecrosis (2 patients) and carotid artery bleeding (1 patient, non-fatal). OS of PRRT- and DRRT-treated patients in this series appears superior to the published literature. We used IMRT for the majority of patients, in contrast to several series and trials previously reported, which may account in part for this difference. Future studies should seek to improve outcomes among patients with LRR/NP SCCHN via alternative therapeutic modalities such as proton radiotherapy and by incorporating novel systemic agents
Adriana Silva de CARVALHO
Full Text Available Atualmente no mercado odontológico existem diversos tipos de materiais restauradores que liberam flúor com o objetivo de diminuir ou eliminar as cáries recorrentes. Considerando-se a diferença de composição desses materiais, foi avaliada sua capacidade de liberação de flúor. Foram avaliados os materiais restauradores: Chelon-fil (ESPE, Vitremer (3M, Variglass (Dentsply, Dyract (Dentsply e Tetric (Vivadent. Confeccionaram-se seis amostras cilíndricas (área = 1,65 cm2 de cada material, as quais foram imersas individualmente em 2,0 ml de água deionizada, que foi trocada diariamente durante 15 dias. A liberação de flúor foi determinada após adição de volume igual de tampão TISAB II às soluções. Para a análise da concentração de flúor foi utilizado um eletrodo específico para flúor Orion 96-09, acoplado a um analisador de íons Orion EA-940. Todos os materiais seguiram o mesmo padrão de liberação de flúor. As maiores médias de flúor liberado dentro de cada material foram encontradas no 1º dia, decrescendo bruscamente no 2º e 3º dias, e a quantidade de flúor liberado apresentou um decréscimo com o passar dos dias até atingir um nível quase constante. A liberação média de flúor durante o período de avaliação (média e desvio padrão em µg F/cm2 foi: CHE = 7,62 ± 0,76A, VIT = 5,91 ± 0,79B, VAR = 2,72 ± 0,25C, DYR = 1,50 ± 0,17 D, TET = 0,136 ± 0,016 E. Médias seguidas por letras distintas diferem entre si ao nível de significância de 5% (Tukey. Os resultados mostraram que a composição dos materiais restauradores influencia de maneira significativa sua liberação de flúor.Nowadays there are several types of restorative materials with fluoride release properties. Thus, the purpose of this study was to analyze the fluoride release from the following restorative materials, considering their different compositions. The materials used were: Chelon Fil-ESPE (CHE, Vitremer-3M (VIT, Variglass
Commentary on: "Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): A multicentre, randomised, double-blind, phase 3 trial." Kwon ED, Drake CG, Scher HI, Fizazi K, Bossi A, van den Eertwegh AJ, Krainer M, Houede N, Santos R, Mahammedi H, Ng S, Maio M, Franke FA, Sundar S, Agarwal N, Bergman AM, Ciuleanu TE, Korbenfeld E, Sengeløv L, Hansen S, Logothetis C, Beer TM, McHenry MB, Gagnier P, Liu D, Gerritsen WR, CA184-043 Investigators. Departments of Urology and Immunology and Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Rochester, MN, USA, Electronic address: email@example.com; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and Brady Urological Institute, Baltimore, MD, USA; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA; Institut Gustave Roussy, University of Paris-Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France; VU University Medical Centre, Amsterdam, Netherlands; Vienna General Hospital, Medical University Vienna, Vienna, Austria; Institut Bergonié, Bordeaux, France; CHU Caremeau, Nimes, France; Centro Médico Austral, Buenos Aires, Argentina; Centre Jean Perrin, Clermont-Ferrand, France; St John of God Hospital, Subiaco, WA, Australia; University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy; Hospital de Caridade de Ijuí, Ijuí, Brazil; Nottingham University Hospital, Nottingham, UK; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA; Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Institute of Oncology Ion Chiricuta and University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania; Hospital Británico de Buenos Aires, Buenos Aires, Argentina; Herlev Hospital, Herlev, Denmark; Odense University Hospital, Odense, Denmark; University of Texas MD Anderson Cancer Center, Houston,
Ipilimumab is a fully human monoclonal antibody that binds cytotoxic T-lymphocyte antigen 4 to enhance antitumour immunity. Our aim was to assess the use of ipilimumab after radiotherapy in patients with metastatic castration-resistant prostate cancer that progressed after docetaxel chemotherapy. We did a multicentre, randomised, double-blind, phase 3 trial in which men with at least one bone metastasis from castration-resistant prostate cancer that had progressed after docetaxel treatment were randomly assigned in a 1:1 ratio to receive bone-directed radiotherapy (8Gy in one fraction) followed by either ipilimumab 10mg/kg or placebo every 3 weeks for up to four doses. Non-progressing patients could continue to receive ipilimumab at 10mg/kg or placebo as maintenance therapy every 3 months until disease progression, unacceptable toxic effect, or death. Patients were randomly assigned to either treatment group via a minimisation algorithm, and stratified by Eastern Cooperative Oncology Group performance status, alkaline phosphatase concentration, haemoglobin concentration, and investigator site. Patients and investigators were masked to treatment allocation. The primary endpoint was overall survival, assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00861614. From May 26, 2009, to Feb 15, 2012, 799 patients were randomly assigned (399 to ipilimumab and 400 to placebo), all of whom were included in the intention-to-treat analysis. Median overall survival was 11.2 months (95% CI: 9.5-12.7) with ipilimumab and 10.0 months (8.3-11.0) with placebo (hazard ratio [HR] = 0.85, 0.72-1.00; P = 0.053). However, the assessment of the proportional hazards assumption showed that it was violated (P = 0.0031). A piecewise hazard model showed that the HR changed over time: the HR for 0-5 months was 1.46 (95% CI: 1.10-1.95), for 5-12 months was 0.65 (0.50-0.85), and beyond 12 months was 0.60 (0.43-0.86). The most common grade 3
Rimena Ramos Domingues
Full Text Available A emissão de fluoretos à atmosfera oriunda da produção de superfosfatos e de cerâmica tem causado preocupação pelo efeito tóxico às plantas, contudo são poucos os estudos desenvolvidos acerca do problema com espécie de interesse econômico agrícola. Desenvolveu-se o estudo para avaliar o efeito do flúor (F atmosférico em plantas de capim-colonião e de cultivares de milho, utilizando como referência espécies bioindicadoras do tipo sensível e tolerante. As plantas foram expostas à contaminação pelo F atmosférico por curtos períodos durante 32 dias em sistema de nebulização com 0,16 mol L-1 de ácido fluorídrico no ambiente interno de uma câmara (~0,20 mmol m-3 de F, havendo um controle não exposto, com quatro repetições. A exposição das plantas ao F causou aumento da concentração do elemento nas folhas até 60 mg kg-1 para o capim-colonião, e entre 100 mg kg-1 nas folhas novas e 170 mg kg-1 nas folhas velhas para quatro cultivares de milho, o que demonstrou o efeito cumulativo do elemento no ambiente. Sintomas visuais da toxicidade foram observados nas plantas e se caracterizaram pela ocorrência de cloroses e necroses na lâmina foliar. O capim-colonião é uma espécie bastante sensível ao poluente no ar. As cultivares de milho DKB 390 e Ômega 8315 também são mais sensíveis ao F quando comparadas às AG7088 e 2B707. Os teores de clorofila a nas plantas foram mais afetados pelo F em relação aos teores de clorofila b.
Corcoran, Alina A.; Wolny, Jennifer; Leone, Erin; Ivey, James; Murasko, Susan
In the past four decades, consistent and coordinated management actions led to the recovery of Tampa Bay, FL (USA) - an estuary that was declared dead in the 1970s. An exception to this success story is Old Tampa Bay, the northernmost subestuary of the system. Compared to the other bay segments, Old Tampa Bay is characterized by poorer water quality and spring and summer blooms of cyanobacteria, picoplankton, diatoms, and the saxitoxin-producing dinoflagellate Pyrodinium bahamense. Together, these blooms contribute to light attenuation and lagging recovery of seagrass beds. Yet, studies of phytoplankton dynamics within Old Tampa Bay have been limited - both in number and in their spatiotemporal resolution. In this study, we used field sampling and continuous monitoring to (1) characterize temporal and spatial variability in phytoplankton biomass and community composition and (2) identify key drivers of the different phytoplankton blooms in Old Tampa Bay. Overall, temporal variability in phytoplankton biomass (using chlorophyll a as a proxy) and community composition surpassed spatial variability of these parameters. We found a base community of small diatoms and flagellates, as well as certain dinoflagellates, that persisted year round in the system. Seasonally, freshwater runoff stimulated phytoplankton growth, specifically that of chlorophytes, cyanobacteria and other dinoflagellates - consistent with predictions based on ecological theory. On shorter time scales, salinity, visibility, and freshwater inflows were important predictors of phytoplankton biomass. With respect to P. bahamense, environmental drivers including salinity, temperature and dissolved nutrient concentrations explained ∼24% of the variability in cell abundance, indicating missing explanatory parameters in our study for this taxon, such as cyst density and location of cyst beds. Spatially, we found differences in community trajectories across north-south and west-east gradients, with the
Kean, Jacob; Malec, James F.; Altman, Irwin M.; Swick, Shannon
The precise measurement of patient outcomes depends upon clearly articulated constructs and refined clinical assessment instruments that work equally well for all subgroups within a population. This is a challenging task in those with acquired brain injury (ABI) because of the marked heterogeneity of the disorder and subsequent outcomes. Alhough essential, the iterative process of instrument refinement is often neglected. This present study was undertaken to examine validity, reliability, dim...
Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline
Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p resuscitation durations compared to that of the other groups (p resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Elizabeth A Vanner,1 Michael W Stewart21Department of Preventive Medicine, Pathology and Bioinformatics, Stony Brook University, Stony Brook, NY, USA; 2Department of Ophthalmology, Mayo Clinic College of Medicine, Jacksonville, FL, USAPurpose/design: We aimed to perform a systematic review and meta-analysis comparing the risk difference of clinical outcomes for same-day (SD vs delayed (DEL pars plana vitrectomy (PPV.Methods: We searched MEDLINE (English; January 1, 1985 to July 16, 2013 and article reference lists, for patients with crystalline retained lens fragments and discussion of SD-PPV vs DEL-PPV. For the meta-analysis, articles needed the number of patients receiving SD-PPV and DEL-PPV, and the number, in each group, who experienced one or more of the outcomes: not good visual acuity (VA (<20/40, bad VA (≤20/200, retinal detachment, increased intraocular pressure/glaucoma, intraocular infection/inflammation, cystoid macular edema, and corneal edema.Results: Of 304 articles identified, 23 provided data for the meta-analysis. Results were mixed, indicating 1 neither vitrectomy time produced better outcomes in all studies (not good VA risk difference =10.3% [positive numbers favored SD-PPV; negative numbers favored DEL-PPV], 95% confidence interval [CI] = [-0.4% to 21.0%], P=0.059; and bad VA risk difference =-0.3%, 95% CI = [-10.7% to 10.1%], P=0.953; 2 better outcomes with immediate SD-PPV compared with all DEL-PPV (not good VA risk difference =16.2%, 95% CI = [0.8% to 31.5%], P=0.039; and bad VA risk difference =8.5%; 95% CI = [0.8% to 16.2%], P=0.030; and 3 immediate SD-PPV and prompt DEL-PPV (3 to 14 days after cataract surgery had no significant differences and so may produce similar outcomes (not good VA risk differences range = [-19.9% to 6.5%], 95% CI = [-59.9% to 36.4%]; and bad VA risk differences range = [-6.9% to 7.4%], 95% CI = [-33.1% to 31.8%].Conclusion: Perhaps SD-PPV should be limited to facilities at which a
Atrubin, David; Wiese, Michael; Snider, Rebecca; Workman, Kiley; McDougle, Warren
Objective To describe disease and illness surveillance utilized during the 2012 Republican National Convention (RNC) held August 26–30, 2012 in Tampa, FL. Introduction While the Tampa Bay Area has previously hosted other high profile events that required heightened disease surveillance (e.g., two Super Bowls), the 2012 RNC marked the first national special security event (NSSE) held in Florida. The Hillsborough County Health Department (HCHD), in conjunction with the Pinellas County Health Department (PinCHD) coordinated disease surveillance activities during this time frame. This presentation will focus of the disease surveillance efforts of the Hillsborough County Health Department during the 2012 RNC. In addition to the surveillance systems that are used routinely, the HCHD Epidemiology Program implemented additional systems designed to rapidly detect individual cases and outbreaks of public health importance. The short duration of RNC, coupled with the large number of visitors to our area, provided additional surveillance challenges. Tropical Storm Isaac, which threatened Tampa in the days leading up to RNC, and an overwhelming law enforcement presence likely dissuaded many protestors from coming to Tampa. As a result, a tiny fraction of the number of protestors that were expected actually showed up. Methods Our normal daily analysis of the emergency department (ED) data using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) was expanded to look in detail at ED volumes and chief complaints of those patients who live outside of a 5-county Tampa Bay area. This analysis used patient zip code to determine place of residence. Additionally, ESSENCE queries were utilized to look for heat, tear gas, and RNC related exposures. The ESSENCE system also receives Poison Control data every 15 minutes. Expanded analyses of the Poison Control data were conducted as well. Two Disaster Medical Assistance Teams (DMATs) were
Full Text Available Vor dem Hintergrund der Flüchtlingsdebatte in Deutschland 2015 wird in diesem Beitrag danach gefragt, welche (Massen-Kommunikationskanäle Flüchtlinge vor, während und nach der Flucht nutzen, um sich über migrationsrelevante Themen zu informieren und sich darüber mit anderen Migrationswilligen auszutauschen. Dabei wird nicht nur die Frage nach der subjektiven Bewertung der genutzten Quellen gestellt, sondern auch untersucht, ob die Flüchtlinge eine informierte Entscheidung in den verschiedenen Phasen der Migration treffen. Auf Basis des Uses-and-Gratifications-Ansatzes und der Handlungstheorie (symbolischer Interaktionismus wurden zwischen November 2015 und Februar 2016 vier Fokusgruppen und 36 Tiefeninterviews mit syrischen und irakischen Flüchtlingen durchgeführt. Die Ergebnisse verdeutlichen, dass sich die befragten Flüchtlinge vor und während der Flucht gut informiert fühlten, da persönliche Kontakte und soziale Medien die Informationsbedürfnisse weitgehend befriedigen konnten. Informationsdefizite zeigten sich vor allem nach der Ankunft in Deutschland.
Manuelita Barrios Rodríguez
Full Text Available En 1998 sucedió la masacre del 16 de mayo en Barrancabermeja, que significó el ingreso de los grupos paramilitares al territorio y el incremento de la violencia. Como respuesta, las organizaciones sociales presentes en la ciudad realizaron diversas acciones colectivas, que trascendieron este hecho a un tema de interés nacional e internacional. El presente artículo es el resultado de una investigación triangular que utilizó técnicas cuantitativas y cualitativas de recolección de información. El análisis se realizó desde el enfoque del mesoanálisis, a través del cual se estudió la definición de la masacre como un problema público, y su inserción dentro del ciclo de política pública, que fue visibilizado por la acción colectiva y los medios de comunicación, generando un efecto búmeran.
Juan Carlos Castilla
Full Text Available La reconciliación es uno de los retos de la consolidación de la paz. El ejercicio de la soberanía por parte de las instituciones locales, puede originar diferencias con las organizaciones internacionales durante la transformación del conflicto. El desafío es coordinar estrategias y medidas en el tiempo. El proceso de reconciliación comenzó en Malí con un gobierno de transición. Durante el año 2014, el gobierno ha tratado de impulsar el proceso, en un contexto en el que se han reproducido los enfrentamientos tribales, se han dado nuevos choques entre el MNLA y las Fuerzas Armadas malíes, y dónde sigue influyendo la actividad terrorista yihadista. IBK se refirió a aspectos fundamentales para el futuro inmediato del proceso tras los acontecimientos de mayo en Kidal. Tras estos acontecimientos, las negociaciones de paz se desarrollan con la mediación argelina. La complementariedad entre la justicia nacional y la internacional será una de las claves, lo que a su vez puede interrelacionar con la potencial re-integración futura de excombatientes.
Soto Bonilla, Gerardo
Full Text Available Uno de los eventos volcánicos importantes del siglo XX en Costa Rica fue el ocurrido el 8 de mayo del año 1991 en el Volcán Rincón de la Vieja. A continuación, se muestra la información recopilada en la serie Hoy hace. concerniente a la emergencia suscitada en esa ocasión. Se incluye una relación de las principales observaciones reportadas con respecto al Volcán desde el año 1765 hasta el año 1998. El documento explica el mecanismo de la erupción principal y enlista las actividades posteriores que se dieron One of the important volcanic events of the 20th Century in Costa Rica was the one of May 8, 1991 at the Rincón de la Vieja Volcano. Following, it shows the information collected in the series Today in History (Hoy hace related to the emergency generated at that moment. It includes a relation to the main observations reported in regards to the Volcano from the year 1765 to the year 1998. The document explains the mechanism of the main eruption and lists the posterior activities
Daglio, Yasmin; Sacristán, Hernán; Ansaldo, Martín; Rodríguez, María C.
Biofilms were allowed to develop on ceramic tiles placed in closed containers on the shore of Potter Cove, 25 de Mayo (King George) Island. Water pumping from the cove inside the containers extended for 25 days. Diatoms were the dominant microalgae in these biofilms, which were removed from a set of tiles to a) characterize the extracellular mucilage, b) carry out floristic determination and c) perform grazing experiments with the limpet Nacella concinna. Biofilms mucilaginous matrix consisted of proteins and carbohydrates. Room temperature aqueous extraction of the freeze-dried material rendered a fraction enriched in the storage glucan chrysolaminarin, its identity confirmed by methylation structural analyses. Hot water extracted products showed greater heterogeneity in monosaccharide composition, including glucose, mannose, galactose, fucose, xylose and rhamnose. Diatom identification revealed that Pseudogomphonema kamtschaticum was the dominant species followed by several Navicula species, Nitzschia pellucida and Synedra kerguelensis. Photographical survey of colonized tiles placed in glass flasks together with a specimen of Nacella concinna exhibited between 5 and 30% removal of the biofilms coverage after 24 h of exposure to the limpet, suggesting that EPS and chrysolaminarin constitute a C-source for the gastropod.
Full Text Available El presente artículo se propone rastrear a grandes rasgos la relación ―especial‖ entre el estado nacional argentino y, a partir de 1958, la provincia de Chubut por una parte y los colonos galeses que se establecieron en Chubut desde 1865 y sus descendientes por otra, a través del análisis de la posición de la colectividad galesa del Chubut en dos momentos históricos destacados: el Centenario y el Bicentenario de la Revolución de Mayo (1810. Al corresponderse el perfil de los galeses con la idea de poblaciones "civilizadas" que las autoridades pretendían impulsar en desmedro de los legítimos pobladores originales, estas políticas dieron lugar a una fuerte identificación histórica de la Provincia de Chubut con la llamada "gesta galesa". Se generó asimismo una peculiar dinámica triangular de las relaciones estatales, cuya evolución a través del tiempo ha desembocado en la actual promoción de la identidad chubutense como el resultado de la fusión de las culturas de los tehuelches originarios y los colonos galeses.
Yuan, Gangjun; Chen, Xin; Liu, Zhuowei; Wei, Wensu; Shu, Qinghai; Abou-Hamdan, Hussein; Jiang, Lijuan; Li, Xiangdong; Chen, Rixin; Désaubry, Laurent; Zhou, Fangjian; Xie, Dan
Prohibitin 1 (PHB) is a potential target for the treatment of urothelial carcinoma of the bladder (UCB). FL3 is a newly synthesized agent that inhibits cancer cell proliferation by targeting the PHB protein; however, the effect of FL3 in UCB cells remains unexplored. FL3 was identified to be a potent inhibitor of UCB cell viability using CCK-8 (cell counting kit-8) assay. Then a series of in vitro and in vivo experiments were conducted to further demonstrate the inhibitory effect of FL3 on UCB cell proliferation and to determine the underlying mechanisms. FL3 inhibited UCB cell proliferation and growth both in vitro and in vivo. By targeting the PHB protein, FL3 inhibited the interaction of Akt and PHB as well as Akt-mediated PHB phosphorylation, which consequently decreases the localization of PHB in the mitochondria. In addition, FL3 treatment resulted in cell cycle arrest in the G2/M phase, and this inhibitory effect of FL3 could be mimicked by knockdown of PHB. Through the microarray analysis of mRNA expression after FL3 treatment and knockdown of PHB, we found that the mRNA expression of the growth arrest and DNA damage-inducible alpha (GADD45α) gene were significantly upregulated. When knocked down the expression of GADD45α, the inhibitory effect of FL3 on cell cycle was rescued, suggesting that FL3-induced cell cycle inhibition is GADD45α dependent. Our data provide that FL3 inhibits the interaction of Akt and PHB, which in turn activates the GADD45α-dependent cell cycle inhibition in the G2/M phase.
Grec,Roberto Henrique da Costa; Moura,Patrícia Garcia de; Pessan,Juliano Pelim; Ramires,Irene; Costa,Beatriz; Buzalaf,Marília Afonso Rabelo
O objetivo do estudo foi avaliar a concentração de flúor na água engarrafada comercializada, comparando-a aos valores impressos no rótulo da embalagem. Foram coletadas 229 amostras de água das 35 marcas disponíveis em diversos supermercados, mercearias e lanchonetes de grande circulação nas diferentes regiões do município de São Paulo, em 2006. A concentração de flúor foi determinada por análise em duplicata, utilizando o eletrodo íon-específico. A concentração de flúor variou entre 0,01 e 2,...
Ambulatory Gynaecology allows a “see-and-treat” approach to managing gynaecological conditions, providing a more streamlined, integrated care pathway than the traditional gynaecology clinic and inpatient care model. This study was designed to assess patient satisfaction and acceptability of Ambulatory Gynaecology services in Mayo University Hospital, Castlebar, Ireland. It also provided for feedback from patients as to how the service might be improved. \\r\
Ramires, Irene; Grec, Roberto Henrique da Costa; Cattan, Lourenço; Moura, Patrícia Gomes de; Lauris, José Roberto Pereira; Buzalaf, Marília Afonso Rabelo
OBJETIVO: Considerando a água como importante fonte de ingestão de flúor, o aumento da prevalência de fluorose dentária e do consumo de água mineral, o estudo realizado teve como objetivo avaliar o consumo de água mineral e sua concentração de flúor. MÉTODOS: A pesquisa foi realizada nos bairros do município de Bauru, SP. Foram visitadas mil residências que compunham uma amostra estratificada, obtida por conglomerados. Cada conglomerado correspondia a um quarteirão. Para efeito de sorteio os ...
Full Text Available In alginate-assimilating bacteria, alginate is depolymerized to unsaturated monosaccharide by the actions of endolytic and exolytic alginate lyases (EC 22.214.171.124 and EC 126.96.36.199. The monosaccharide is non-enzymatically converted to 4-deoxy-l-ery thro-5-hexoseulose uronic acid (DEH, then reduced to 2-keto-3-deoxy-d-gluconate (KDG by a specific reductase, and metabolized through the Entner–Doudoroff pathway. Recently, the NADPH-dependent reductase A1-R that belongs to short-chain dehydrogenases/reductases (SDR superfamily was identified as the DEH-reductase in Sphingomonas sp. A1. We have subsequently noticed that an SDR-like enzyme gene, flred, occurred in the genome of an alginolytic bacterium Flavobacterium sp. strain UMI-01. In the present study, we report on the deduced amino-acid sequence of flred and DEH-reducing activity of recombinant FlRed. The deduced amino-acid sequence of flred comprised 254 residues and showed 34% amino-acid identities to that of A1-R from Sphingomonas sp. A1 and 80%–88% to those of SDR-like enzymes from several alginolytic bacteria. Common sequence motifs of SDR-superfamily enzymes, e.g., the catalytic tetrad Asn-Lys-Tyr-Ser and the cofactor-binding sequence Thr-Gly-x-x-x-Gly-x-Gly in Rossmann fold, were completely conserved in FlRed. On the other hand, an Arg residue that determined the NADPH-specificity of Sphingomonas A1-R was replaced by Glu in FlRed. Thus, we investigated cofactor-preference of FlRed using a recombinant enzyme. As a result, the recombinant FlRed (recFlRed was found to show high specificity to NADH. recFlRed exhibited practically no activity toward variety of aldehyde, ketone, keto ester, keto acid and aldose substrates except for DEH. On the basis of these results, we conclude that FlRed is the NADH-dependent DEH-specific SDR of Flavobacterium sp. strain UMI-01.
. Although archaeobotanical records of oil plants are in most cases found in small numbers, they are often abundant at excavations in southern Scandinavia. This paper presents a diachronic review of plant records of fl ax (Linum usitatissimum L.) and hemp (Cannabis sativa L.), both known for the dual use...... as to whether corn spurrey had been a cultivar or if the seeds had been collected from wild populations. KEYWORDS: Archaeobotany, oil-rich seeds, fl ax, hemp, gold of pleasure, corn spurrey, southern Scandinavia...
Eicher, Vicki; Murphy, Mary Pat; Murphy, Thomas F; Malec, James F
To compare progress in 4 types of post-inpatient rehabilitation brain injury programs. Quasiexperimental observational cohort study. Community and residential. Individuals (N=604) with acquired brain injury. Four program types within the Pennsylvania Association of Rehabilitation Facilities were compared: intensive outpatient and community-based rehabilitation (IRC; n=235), intensive residential rehabilitation (IRR; n=78), long-term residential supported living (SLR; n=246), and long-term community-based supported living (SLC; n=45). With the use of a commercial web-based data management system developed with federal grant support, progress was examined on 2 consecutive assessments. Mayo-Portland Adaptability Inventory (MPAI-4). Program types differed in participant age (F=10.69, PMPAI-4 score (F=6.89, PMPAI-4 score and chronicity were significantly associated with the second MPAI-4 rating. On average, SLR participants were 9.1 years postinjury compared with 5.1 years for IRR, 6.0 years for IRC, and 6.8 years for SLC programs. IRR participants were more severely disabled per MPAI-4 total score on admission than the other groups. Controlling for these variables, program types varied significantly on second MPAI-4 total score (F=5.14, P=.002). Both the IRR and IRC programs resulted in significant functional improvement across assessments. In contrast, both the SLR and SLC programs demonstrated relatively stable MPAI-4 scores. Results are consistent with stated goals of the programs; that is, intensive programs resulted in functional improvements, whereas supported living programs produced stable functioning. Further studies using data from this large, multiprovider measurement collaboration will potentially provide the foundation for developing outcome expectations for various types of postacute brain injury programs. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Paim, Crislaine Pires Padilha; Goldmeier, Silvia
Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom's taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. The development of the game called "Playing with Tweezers" was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. The "digital" nursing student needs engagement, stimulation, reality, and entertainment, not just readings. "Playing with Tweezers" is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we cannot forget that skill training in an educational game does not
Frederico Spada Silva
Full Text Available Pathé-Baby (1926 marca a estreia editorial de António de Alcântara Machado (1901-1935. Também publicadas (em parte no Jornal do Comércio, de São Paulo, estas crônicas de sua viagem à Europa, em 1925, são aqui analisadas a partir de sua estreita ligação com a estética futurista, enfocando seu intenso e inovador diálogo entre literatura, cidade, cinema e artes plásticas, em que se destacam o ritmo alucinante (flashes, a busca pelo novo (o moderno e as ironias às cidades-museus do Velho Mundo visitadas pelo cronista-flâneur.
Gentry, R V
Accompanying disproof of the F-L expansion paradigm eliminates the basis for expansion redshifts, which in turn eliminates the basis for the Cosmological Principle. The universe is not the same everywhere. Instead the spherical symmetry of the cosmos demanded by the Hubble redshift relation proves the universe is isotropic about a nearby universal Center. This is the foundation of the relatively new Cosmic Center Universe (CCU) model, which accounts for, explains, or predicts: (i) The Hubble redshift relation, (ii) a CBR redshift relation that fits all current CBR measurements, (iii) the recently discovered velocity dipole distribution of radiogalaxies, (iv) the well-known time dilation of SNeIa light curves, (v) the Sunyaev-Zeldovich thermal effect, (vi) Olber's paradox, (vii) SN dimming for z 1 an enhanced brightness that fits SN 1997ff measurements, (ix) the existence of extreme redshift (z > 10) objects which, when observed, will further distinguish it from the big bang. The CCU model also plausibly expl...
Devault, Kenneth R
Mayo Clinic recently presented an outstanding education meeting in Orlando, FL, USA. This meeting is one of several education meetings coordinated by the gastroenterology and hepatology divisions from Mayo Clinic held throughout the year in multiple locations in the USA. The focus of this 3-day meeting was to provide an update on advances in all areas of gastroenterology with an emphasis on the management of difficult cases. A total of 23 podium presentations, 17 breakout sessions and a Fellow's poster program were presented. In addition, there was a specific program directed at nurses involved in the care of gastroenterology patients. Highlights from selected presentations are included in this report.
Biermann, Mark L.; Biermann, Lois A. A.
Discusses descriptions of the way in which an optical system controls the quantity of light that reaches a point on the image plane, a basic feature of optical imaging systems such as cameras, telescopes, and microscopes. (JRH)
María Teresa BARBADILLO
Full Text Available Publicamos aquí un texto inédito de Wenceslao Fernández Flórez contenido en 23 cuartillas escritas de su puño y letra, que me fueron confiadas generosamente por sus sobrinos Wenceslao y Antonio Fernández Flórez. El manuscrito no lleva fecha alguna, y el sobre que lo contenía sólo reproduce el título, con la indicación «Charla radiofónica». Don Antonio Fernández Flórez tiene idea de que data de 1934 ó 35, posiblemente del mes de octubre. No obstante, ni en la prensa de esos años, ni en los archivos del Servicio de Documentación escrita de Radio Nacional de España —en donde nos atendieron con suma amabilidad— queda constancia de esta intervención de Fernández Flórez a través de las ondas.
Lim, K B; Jeevan, N H; Jaya, P; Othman, M I; Lee, Y H
Allele frequencies for the nine STRs genetic loci included in the AmpFlSTR Profiler kit were obtained from samples of unrelated individuals comprising 139-156 Malays, 149-153 Chinese and 132-135 Indians, residing in Malaysia.
Full Text Available Development of a novel and effective vaccine against Mycobacterium tuberculosis (M.tb is a challenging for preventing TB infection. In this study, a novel nanoparticle-based recombinant DNA vaccine was developed, which contains Esat-6 three T cell epitopes (Esat-6/3e and fms-like tyrosine kinase 3 ligand (FL genes (termed Esat-6/3e-FL, and was enveloped with chitosan (CS nanoparticles (nano-chitosan. The immunologic and protective efficacy of the nano-chitosan-based DNA vaccine (termed nano-Esat-6/3e-FL was assessed in C57BL/6 mice after intramuscular prime vaccination with the plasmids DNA and nasal boost with the Esat-6/3e peptides. The results showed that the immunized mice remarkably elicited enhanced T cell responses and protection against M.tb H37Rv challenge. These findings indicate that the nano-chitosan can significantly elevate the immunologic and protective effects of the DNA vaccine, and the nano-Esat-6/3e-FL is a useful vaccine for preventing M.tb infection in mice.
Full Text Available OBJETIVO: Considerando a água como importante fonte de ingestão de flúor, o aumento da prevalência de fluorose dentária e do consumo de água mineral, o estudo realizado teve como objetivo avaliar o consumo de água mineral e sua concentração de flúor. MÉTODOS: A pesquisa foi realizada nos bairros do município de Bauru, SP. Foram visitadas mil residências que compunham uma amostra estratificada, obtida por conglomerados. Cada conglomerado correspondia a um quarteirão. Para efeito de sorteio os quarteirões foram numerados dentro das 17 regiões estabelecidas no plano diretor do município. Para coleta das amostras de água mineral foram usados frascos plásticos de 50 ml, previamente identificados. Na análise de flúor utilizou-se eletrodo íon sensível (Orion 9609 após tamponamento com TISAB II. Informações a respeito do consumo de água mineral foram obtidas com a aplicação de um questionário. RESULTADOS: Constatou-se que cerca de 29,7% da população do município consome água mineral. Nas 260 amostras analisadas, das 29 diferentes águas, a concentração de flúor variou de 0,045 a 1,515 mg/l. Em uma das águas, constava no rótulo o valor de 0,220 mg/l, mas na análise constatou-se 1,515 mg/l de flúor. Além disso, algumas águas não traziam especificado a concentração de flúor; e, na análise constataram-se valores variando entre 0,049 e 0,924 mg/l. CONCLUSÕES: Os resultados mostraram uma grande variação na concentração de flúor e reforçam a importância do controle dessas águas por parte da vigilância sanitária.
Vanessa Eid da Silva Cardoso
Full Text Available Breakfast cereals and snacks are foodstuffs highly appreciated by children, and the possibility that they contain substantial amounts of fluoride, associated with their widespread consume, may make them important contributors to the total daily fluoride intake. The aim of this study was to analyze the fluoride content on several breakfast cereals (A and snacks (B purchased in Brazil. The analysis were made after HMDS-facilitated diffusion (Taves using the ion-specific electrode (9609. Mean fluoride concentrations ± SD (range, unit mg F/g were: A= 0.76 ± 0.60 (0.08-1.86, n=15 and B= 0.32 ± 0.09 (0.22-0.55, n=18. Our results suggest that the total amount of fluoride available in some products may contribute to the total daily fluoride intake. The product labels should provide information on their fluoride content to prevent fluorosis at the age of risk.Cereais matinais e salgadinhos são guloseimas altamente apreciadas pelas crianças, e a possibilidade de conterem quantidades substanciais de flúor, associada ao seu indiscriminado consumo, pode torná-los importantes contribuintes para a ingestão diária total de flúor. O objetivo deste estudo foi analisar o conteúdo de flúor em diversos cereais matinais (A e salgadinhos (B adquiridos no Brasil. As análises foram feitas após difusão facilitada por HMDS (Taves, usando o eletrodo íon específico (9609. As concentrações médias de flúor ± SD (amplitude, unidade mg F/g foram: A= 0,76 ± 0,60 (0,08-1,86, n=15 e B= 0,32 ± 0,09 (0,22-0,55, n=18. Nossos resultados sugerem que a quantidade de flúor presente em alguns produtos pode contribuir com a ingestão diária total de flúor. Os rótulos dos produtos deveriam informar seu conteúdo de flúor para prevenir fluorose no período de risco.
Rogério Lacerda dos Santos
Full Text Available OBJECTIVES: The objective of the authors was to evaluate fluoride release of 3 glass ionomer cements with immediate protection of fluoride varnish (Cavitine, SS White, divided into 3 groups: Group M (Meron, VOCO, Group V (Vidrion C, SS White and Group KC (Ketac-Cem, 3M ESPE. METHODS: Fluoride release was measured during 60 days by means of an ion-selective electrode connected to an ion analyzer. After 4 weeks, the test specimens were exposed to a solution of 0.221% sodium fluoride (1000 ppm of fluoride. RESULTS: Results showed that the cements reached a maximum peak of fluoride release in a period of 24 h. There was a statistically significant difference between the amount of fluoride released after the applications of fluoride among the groups from the 31st to 60th day (p> 0.05. CONCLUSION: The Vidrion C and Meron cements showed better performance to uptake and release fluoride when compared with Ketac-Cem cement.OBJETIVO: o objetivo desse estudo foi avaliar a liberação de flúor dos seguintes três cimentos de ionômero de vidro, com proteção imediata de verniz fluoretado (Cavitine, S. S. White: Meron / VOCO (Grupo M; Vidrion C / S. S. White (Grupo V; e Ketac Cem / 3M ESPE (Grupo KC. MÉTODOS: a liberação de flúor foi medida durante 60 dias, através de eletrodo íon seletivo conectado a um analisador de íons. Após quatro semanas, os corpos de prova foram expostos a uma solução de fluoreto de sódio a 0,221% (1.000ppm de flúor. RESULTADOS: os resultados evidenciaram que os cimentos atingiram o pico máximo de liberação de flúor com 24h após a presa inicial. Houve diferença estatisticamente significativa entre os grupos, quanto à quantidade de flúor liberado após as aplicações de flúor, do 31º ao 60° dia (p > 0,05. CONCLUSÃO: os cimentos Meron e Vidrion apresentaram maior capacidade de captação e liberação de flúor, em comparação ao cimento Ketac Cem.
Toro, Leonor; Pla, Myrna
Designed as a resource for teachers, this booklet, written in Spanish, contains brief information on seven May events: La Semana de la Educacion (first Friday in May), Harry S. Truman (May 8), Dia de las Madres (second Sunday in May), Luis Llorens Torres (May 14), La Cruz Roja (May 21), John F. Kennedy (May 29), and El Dia De Conmemoracion (May…
Guo, Qiang; Meng, Lin; Humphreys, Mike W; Scullion, John; Mur, Luis A J
Heavy metal ATPase 3 (HMA3), a P 1B2 -ATPase, is a key tonoplast transporter involved in mediating the vacuolar sequestration of cadmium (Cd) to detoxify the intake of this element by plants. HMA3 expression in response to Cd stress has not been previously examined in the grass hybrid species Festulolium loliaceum (Huds.) P. Fourn. In this study, FlHMA3 isolated from F. loliaceum was found to comprise 833 amino acid residues with 77% homology to the rice OsHMA3. Transient expression of FlHMA3 fused to enhanced green fluorescent protein in Arabidopsis protoplasts suggested its localization to vacuolar membranes. Quantitative real-time RT-PCR analysis of F. loliaceum revealed that FlHMA3 is expressed predominantly within roots and up-regulated by excess Cd. Over the 168 h treatment, Cd content of F. loliaceum roots was significantly higher than that of shoots, regardless of external CdCl 2 concentrations. A significant positive correlation was found between FlHMA3 expression and Cd accumulation in roots of F. loliaceum seedlings subjected to 10-100 mg L -1 CdCl 2 for 168 h or, in a separate experiment, to 25 or 100 mg L -1 CdCl 2 for the same duration. These findings provide evidence that FlHMA3 encodes a vacuolar P 1B2 -ATPase that may play an important role in Cd 2+ sequestration into root cell vacuoles, thereby limiting the entry of Cd 2+ into the cytoplasm and reducing Cd 2+ toxicity. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Full Text Available Most of the substances used as fluorescent probes to study drug transport and the effect of efflux blockers in multidrug resistant cells have many drawbacks, such as toxicity, unspecific background, accumulation in mitochondria. New fluorescent compounds, among which Bodipy‐FL‐verapamil (BV, have been therefore proposed as more useful tools. The uptake of BV has been evaluated by cytofluorimetry and fluorescence microscopy using cell lines that overexpress P‐glycoprotein (P388/ADR and LLC‐PK1/ADR or MRP (multidrug resistance‐related protein (PANC‐1 and clinical specimens from patients. The effect of specific inhibitors for P‐glycoprotein (verapamil and vinblastine or MRP (MK571 and probenecid has been also studied. BV intracellular concentrations were significantly lower in the two P‐glycoprotein overexpressing cell lines in comparison with the parental lines. In addition, verapamil and vinblastine increased the intracellular concentrations of the dye; MK571 and probenecid, two MRP inhibitors, increased BV levels in PANC‐1 cells, that express this protein. These findings were confirmed in clinical specimens from patients. Fluorescence microscopy revealed a faint fluorescence emission in P‐glycoprotein or MRP expressing cell lines; however, treatment with specific inhibitors significantly increased the fluorescence. BV is a useful tool for studying multidrug resistance proteins with different techniques such as cytofluorimetry and fluorescence microscopy, but does not discriminate between P‐glycoprotein and MRP. In comparison with other classic fluorescent probes, the assay with this dye is extremely rapid, simple, not toxic for cells, devoid of fluorescent background, and can be useful in the clinical settings.
Nordstrom, Robert J.; Almutairi, Adah; Hillman, Elizabeth M.C.
The editors introduce the Biomedical Optics Express feature issue, “Bio-Optics in Clinical Applications, Nanotechnology, and Drug Discovery,” which combines three technical areas from the 2010 Optical Society of America (OSA), Biomedical Optics (BIOMED) Topical Meeting held on 11–14 April in Miami, FL and includes contributions from conference attendees.
Ana Maria Mauad
Full Text Available O artigo tem como proposta analisar a relação entre a fotografia de imprensa e a escrita da história contemporânea. Apóia-se nos estudos sobre a história da memória do fotojornalismo brasileiro, orientados pela metodologia da história oral e do uso da fotografia na análise historiográfica. O foco central incide sobre a trajetória do fotógrafo gaúcho Flávio Damm e sua primeira reportagem de impacto, publicada na Revista do Globo, em 1948, sobre o retorno de Getúlio Vargas à cena política após o Estado Novo. Discute-se, a partir deste estudo de caso, as relações entre as palavras e as imagens na elaboração das chamadas fontes de memória, a produção do acontecimento pela mídia e sua repercussão na memória contemporânea, e por fim, a capacidade narrativa da imagem fotográfica e sua relação com a escrita da história renovada pela introdução de fontes não tradicionais - orais e visuais.The article discusses the relationship between press photographs and the writing of contemporary history. Based upon the studies about history of the Brazilian memory, photojournalism, this work is methodologically oriented by oral history researches and the uses of photography in history. The central focus relied on the analysis of the Brazilian photographer Flávio Damm, and his first impact reportage, published at Revista do Globo, in 1948, about the return of Getulio Vargas to the political scene after the Estado Novo. From this case study the article analyses the relationship between words and images, and its contribution on the building of the so-called sources of memory; the impact of the media on the contemporary memory; and finally, the capacity of the photography image in narrating and building a historical writing, renewed by the uses of non-traditional sources - oral and visual.
Catán, Soledad Perez; Bubach, Debora; Di Fonzo, Carla; Dopchiz, Laura; Arribére, Maria; Ansaldo, Martin
We report the contents of elements in feathers of Chinstrap penguin (Pygoscelis antarcticus), which had not been informed up to now, such as silver and bromine and others listed as hazardous by the United States Environmental Protection Agency as arsenic, cobalt, chromium, and mercury. Analyses of the element concentrations in feathers, adult and chicken, from Barton Peninsulas at 25 de Mayo (King George) Island, South Shetlands, were made by Instrumental Neutron Activation Analysis. Samarium, lanthanum a, thorium, and uranium concentrations in Chinstrap penguin feathers were below 0.1 mg/kg. This suggests that the elements in feather do not come from atmospheric particles surface deposition. Arsenic (0.120 ± 0.050 mg/kg) and cobalt (0.030 ± 0.020 mg/kg) concentrations were lower than the reports for other colony of Chinstrap penguins, and essential elements as iron (26 ± 12 mg/kg), zinc (78.0 ± 5.3 mg/kg), and chromium (0.51 ± 0.27 mg/kg) were in the same range while Se (2.90 ± 0.65 mg/kg) content were the lowest reported. Mercury (0.43 ± 0.21 mg/kg), chromium (0.210 ± 0.060 mg/kg), and silver (0.083 ± 0.003 mg/kg) in chicks tended to be lower than in adults. Iron, cobalt, and arsenic concentrations in feathers found in this study were the lowest compared to measurements were in several penguin species in Antarctica. These results confirm to feathers like effective indicators for the trace elements incorporated in the penguins and it provide a data set which can adds to the baseline for bioindication studies using feathers.
Yvonne Torres de Yon
Full Text Available Objetivo: Identificar el virus influenza y otros agentes etiológicos relacionados con la presentación de síndrome febril en los departamentos de Piura, Tumbes, Lambayeque y La Libertad, en mayo de 2001. Material y Métodos: Estudio descriptivo, transversal. Incluye pacientes febriles que acudieron a los puestos de salud centinelas y que presentaban fiebre mayor de 38°C y gota gruesa negativa. Se obtuvieron dos muestras de sangre con un intervalo de 15-45 días. Se registró la sintomatología asociada a fiebre, y se determinó la presencia de anticuerpos mediante pruebas serológicas para dengue, influenza, sarampión y rubéola, además de pruebas para aislamiento y tipificación viral. Resultados: Se registraron 174 pacientes, 58,6% de ellos mujeres, siendo el grupo etáreo más frecuente de menores de 16 años (32,2%. Además de la fiebre se informaron como síntomas más frecuentes el dolor de cabeza (90,1% y dolor de huesos (81,9%. En 89 pacientes (51,1% se pudo obtener muestras de sueros pareados, los cuales fueron incluidos en el estudio serológico; 62 pacientes (69,6% presentaron serología positiva para dengue, 53 (59,5% para influenza y sólo uno (1,1% para rubéola. Conclusiones: El diagnóstico diferencial de pacientes sintomáticos febriles en los departamentos de la costa norte del Perú, luego de descartarse malaria, debe incluir además entre otras etiologías al virus influenza. Un diagnóstico diferencial adecuado permitirá un tratamiento precoz y efectivo. Se hace necesario implementar la vigilancia epidemiológica para mejorar el diagnóstico diferencial en sintomáticos febriles, que incluya a influenza.
Oficina Nacional de Evaluación de Recursos Naturales
Determina a nivel de semidetalle, el potencial y grado de utilización de los recursos suelos y forestales, así como el uso actual de la tierra de la cuenca alta del río Mayo, sector río Túmbaro - río Avisado, situada en el Norte del departamento de San Martín. El estudio, fue ejecutado en un sector con potencial agropecuario y comprendió una profundización del conocimiento de los recursos relacionados con estas actividades, con el fin de establecer y reordenar asentamientos humanos, formular ...
Espinoza Díaz, Cristóbal Ignacio; Astudillo González, Odalis; Cabrera Medina, Henry
La parasitosis intestinal es responsable de una morbilidad considerable en el mundo entero, se presenta frecuentemente con síntomas no específicos y altas tasas de prevalencia. Objetivo: Establecer la prevalencia y factores asociados de enteroparásitos en los niños en edad escolar de la Unidad Educativa “Eudófilo Álvarez” comunidad de Cumbatza, cantón Sucúa en el período de Mayo- Octubre de 2014, previo a un Análisis Situacional de Salud realizado. Materiales y métodos: Se realizó un e...
Camacuari Cárdenas, Feliman Salome
Determina los factores que intervienen en la aplicación de medidas de bioseguridad del profesional de enfermería del Servicio de Centro Quirúrgico (SCQ) del Hospital Nacional Dos de Mayo (HNDM). Estudio de tipo cuantitativo, método descriptivo de corte transversal. La población en estudio está constituida por 30 profesionales de enfermería que laboran en el SCQ. La técnica utilizada es la encuesta y el instrumento un cuestionario estructurado. Se llega a la conclusión que los factores desfavo...
ändlichen Burma die effektivste Schutzmaßnahme. Die Befriedigung der Schutzbedürfnisse und der humanitären Notlage von Flüchtlingen bleibt so untrennbar mit dem Engagement der „täglichen Politik“ der ländlichen Bevölkerung verbunden. Der Artikel versucht, konventionelle Auffassungen des Flüchtlingsschutzes zu hinterfragen, die auf staatliche Neutralität setzen und die tägliche Politik außen vor lassen.
Zhu, Hong-Ji; Sun, Li-Fan; Zhang, Yan-Fei; Zhang, Xiao-Li; Qiao, Jian-Jun
To develop high-efficient biofertilizer, an environmental stress-tolerant phosphate-solubilizing microorganism (PSM) was isolated from agricultural wastes compost, and then applied to spent mushroom substrate (SMS). The isolate FL7 was identified as Pichia farinose with resistance against multiple environmental stresses, including 5-45°C temperature, 3-10 pH range, 0-23% (w/v) NaCl and 0-6M ammonium ion. Under the optimized cultivation condition, 852.8 mg/l total organic acids can be produced and pH can be reduced to 3.8 after 60 h, meanwhile, the soluble phosphate content reached 816.16 mg/l. The P. farinose was used to convert SMS to a phosphate biofertilizer through a semi-solid fermentation (SSF) process. After fermentation of 10 days, cell density can be increased to 5.6 × 10(8)CFU/g in biomass and pH in this medium can be decreased to 4.0. SMS biofertilizer produced by P. farinose significantly improved the growth of soybean in pot experiments, demonstrating a tremendous potential in agricultural application. Copyright Â© 2012 Elsevier Ltd. All rights reserved.
Burkett-Cadena, Nathan D; Bingham, Andrea M; Hunt, Brenda; Morse, Gary; Unnasch, Thomas R
Winter ecology of putative vectors of eastern equine encephalomyelitis virus (EEEV) in northern Florida was investigated at field locations with evidence of historic EEEV winter transmission. Light traps and resting shelters were used to sample the mosquito community in the vicinity of eight sentinel flocks throughout the winter period (November-April) of 2013 and 2014 in Walton County, FL. Overall mosquito activity was relatively low, although mosquitoes were captured during each week of the study period. Mosquito activity was linked to morning temperature, and females were captured when ambient morning temperatures were quite low (1-5°C). Anopheles crucians Wiedemann, Culex erraticus (Dyar and Knab), Culex territans Walker, and Culiseta melanura (Coquillett) were the most commonly collected mosquito species (of 20 total species). Analysis of blood-engorged mosquitoes revealed a number of mosquito species feeding upon chickens, other birds, amphibians, and domestic and wild mammals. Cs. melanura fed primarily upon chickens and songbirds (Passeriformes), suggesting that this mosquito species is the likely winter vector of EEEV to sentinel chickens in northern Florida. Both resident and nonresident songbird species were fed upon, constituting 63.9 and 36.1% of total songbird meals, respectively. Our results suggest important roles for Cs. melanura and songbird hosts for the winter transmission of EEEV in northern Florida. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Imanaka, Takahiro; Sato, Izumi; Tanaka, Shiro; Kawakami, Koji
Placebo effect is one of the methodological difficulties in dry eye clinical trials. If we could elucidate the tendencies of the placebo response and find predictors, we could reduce the placebo response in clinical trials for dry eye. In this study, we investigated the predictive factors for the placebo effect in dry eye clinical trials. A total of 205 patients with dry eye assigned to the placebo arms of three placebo-controlled randomised clinical trials were analysed by simple and multivariable regression analysis. The corneal fluorescein (FL) staining score and dry eye symptoms were studied at week 4. The variables of interest included gender, age, complications of Sjögren's syndrome, Schirmer's test I value, tear break-up time and conjunctival hyperaemia score. We also conducted a stratified analysis according to the patients' age. Among all the studied endpoints, the baseline scores were significantly related to the corresponding placebo response. In addition, for the FL score and the dryness score, age was a significant predictor of the placebo response (p=0.04 and p<0.0001, respectively). Stratified analysis by age showed that patients more than 40 years of age are more likely to have a stronger placebo response in the FL and dryness scores. The baseline scores and age were predictive factors of the placebo response in frequently used endpoints, such as FL score or dryness symptoms. These patient characteristics can be controlled by study design, and our findings enable the design of more efficient placebo-controlled studies with good statistical power. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Kageyama, Shinji; Shinmura, Kazuya; Yamamoto, Hiroko; Goto, Masanori; Suzuki, Koichi; Tanioka, Fumihiko; Tsuneyoshi, Toshihiro; Sugimura, Haruhiko
The PCR-based DNA fingerprinting method called the methylation-sensitive amplified fragment length polymorphism (MS-AFLP) analysis is used for genome-wide scanning of methylation status. In this study, we developed a method of fluorescence-labeled MS-AFLP (FL-MS-AFLP) analysis by applying a fluorescence-labeled primer and fluorescence-detecting electrophoresis apparatus to the existing method of MS-AFLP analysis. The FL-MS-AFLP analysis enables quantitative evaluation of more than 350 random CpG loci per run. It was shown to allow evaluation of the differences in methylation level of blood DNA of gastric cancer patients and evaluation of hypermethylation and hypomethylation in DNA from gastric cancer tissue in comparison with adjacent non-cancerous tissue.
Menezes,Léa Maria Bezerra de; Sousa,Maria da Luz Rosário de; Rodrigues,Lidiany Karla Azevedo; Cury,Jaime Aparecido
A percepção da fluorose dental e seu impacto em escolares de Piracicaba, SP, Brasil, expostos ao uso de flúor pela água e dentifrício, foram avaliados. O problema foi encontrado em 72% das crianças, mas o grau de alteração decorrente não provocou nenhum impacto na satisfação das crianças com seus dentes. Embora a fluorose dental, devido à ingestão de flúor pela água e ao uso de dentifrício fluoretado, não tenha comprometido a estética da amostra populacional avaliada, estudo mais abrangente d...
In der vorliegenden Arbeit wurde die Regenerierung fester Katalysatoren für die Isobutan/Buten-Alkylierung durch hydrierende Behandlung in flüssiger Phase untersucht. Als Katalysatoren dienten edelmetallhaltige Zeolithe des Typs La-X (FAU). Die Alkylierungs- und Regenerierungsexperimente wurden in einer Apparatur mit kontinuierlich betriebenem Rührkesselreaktor und Analytikeinheit mit On-line-Probenahmevorrichtung durchgeführt. Zunächst wurde der Aufbau der Koksdeposite in Abhängigkeit von...
Montejo Gurruchaga, Lucía
Full Text Available Dario Fernández-Flórez begins in 1944 with Zarabanda a narrative style of intellectual eroticism and inmoral atmosphere which attracted no attention. Six years later he published Lola, espejo oscuro the recollections of a high prostitute. The novel was an scandal and an immediate success. Although the topic and its treatment were odd at the time because the strict moral values which mantained Franco´s regime were ignored, the novel was published with no cuts at all. Censorship was deaf to all the voices that warned of its dangers. This had an explanation: Darío Fernández-Flórez held an important post in the Propaganda National Service. After his dismissal censors were less lenient.Darío Fernández-Flórez inicia en 1944 con Zarabanda una narrativa de erotismo intelectualizado y ambiente amoral que no tuvo ningún eco. Seis años después publicará Lola, espejo oscuro, las memorias de una prostituta de alto copete. La novela suscitó un gran escándalo y su éxito fue inmediato. Aunque el tema y su tratamiento eran inusitados en aquellos momentos porque la obra daba al traste con los estrictos valores morales que sustentaban el régimen franquista, la novela fue publicada sin recortes; la censura hizo oídos sordos a todas las voces que alertaban de su peligro. Este hecho tiene una explicación: Darío Fernández-Flórez ocupaba un cargo importante en el Servicio Nacional de Propaganda. Tras su cese, los censores serán menos benevolentes.
Lim, Wonbong; Park, Sang H; Kim, Bora; Kang, Sin W; Lee, Jung W; Moon, Young L
Lateral epicondylitis (LE) is difficult to manage and can result in significant patient morbidity. Currently, the clinical use of platelet-rich plasma (PRP) for painful tendons has received attention, but its efficacy remains controversial. This study aimed to investigate the clinical effects of PRP and its biological components. A total of 156 patients with LE were randomly divided into group 1, treated with a single injection of 2-ml autologous PRP, and group 2, treated with a control received only physical therapy without injection. Both groups used a tennis elbow strap and performed stretching and strengthening exercises during 24 weeks' follow-up. Pain and functional improvements were assessed using the visual analog scale (VAS), Modified Mayo Clinic Performance Index for the elbow, and magnetic resonance imaging (MRI). White blood cell count, platelet count, and levels of platelet-derived growth factor-AB (PDGF-AB), PDGF-BB, transforming growth factor-β (TGF-β), vascular endothelial growth factor, epithelial growth factor, and interleukin-1 β in PRP were measured and investigated for statistical correlation with the clinical score. At 24 weeks, all pain and functional variables, including VAS score, Mayo Clinic performance scores, and MRI grade, improved significantly in group 1 (p < 0.05). PDGF-AB, PDGF-BB, and TGF-β levels were more significantly increased in PRP than in whole blood. TGF-β level significantly correlated with Mayo Clinic performance score and MRI grade improvement. Thus, TGF-β level in PRP is considered to play a pivotal role in tendon healing. These results may contribute to identifying the best protocol for PRP application in tendinopathies. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:913-920, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Sindagi, S. C.; Sandhu, B. S.
With the increased load on highways, today there is a need to develop alternate ways to transport goods within the sovereignty. The use of ships to transport goods has always been the primary method of transporting goods across the seas but it can also be used to transport goods within the country. This way we can reduce the load on highways which at this point of time serve as the primary method of transportation. Worldwide very few ferries are in operation which transports 100-150 Trailers between two ports. Catching on this opportunity for design, construction and operation of vessels, a survey for possible routes in United States of America which will transport 150 Trailers has been conducted by various authorities and organizations. The challenge here is to determine the parameters of the vessel and design a fleet of vessels that could carry trailers along with their tractors within the least possible time and in with least possible freight between Jacksonville, FL and Bridgeport, CT of United States of America. The primary aim of the work presented here is to propose a design with fleet in such a way that each day 150 trailers could be loaded and unloaded at each of the two mentioned ports. An analysis of the route between the ports brought out various primary parameters like the distance, weather, different load lines to be encountered and also several size constraints that the vessel needs to adhere to, in order to ply smoothly on this route. The vessel is designed as per the Guidelines for ships operating in international waters. The economic analysis of the project was performed spanning over 20 years and the best freight was found out which would be most profitable for the company as well as be a good value for money for the customers.
Full Text Available In the late 1970s, the Federal Republic of Germany witnessed a period of committed public outreach for Vietnamese refugees. While West Germany had not accepted significant numbers of non-European refugees before then, now tens of thousands of ›Boat People‹ rescued from the sea or flown out of camps found shelter as ›quota refugees‹. This article analyses the role civil society groups and political parties, media, and bureaucracy played in this. It shows that it was initially increasing public and international pressure that persuaded the social-liberal administration to accept refugees from Indochina, and that the concurrence of civic and state action subsequently reinforced the decision. Public pressure was created in large part by media campaigns and initiatives by Christian Democrats, who took a decisive stand in favour of taking in the refugees. A critical factor here was that the ›Boat People‹ were connected discursively with German post-war history. The article shows how refugee admission methods and new forms of humanitarian aid developed, both of which can be interpreted as civic and bureaucratic change. Rising xenophobia in the early 1980s eventually curbed this support. * * * In der Bundesrepublik entfaltete sich Ende der 1970er-Jahre eine engagierte Hilfe für Flüchtlinge aus Vietnam. Während Westdeutschland bis dahin kaum außereuropäische Flüchtlinge aufgenommen hatte, fanden nun mehrere zehntausend »Boat People« Schutz als »Kontingentflüchtlinge«, die im Meer gerettet und aus Lagern eingeflogen wurden. Der Aufsatz analysiert, welche Rolle dabei zivilgesellschaftliche Gruppen, politische Parteien, Medien und Bürokratie spielten. Anfangs bewegte vor allem öffentlicher und internationaler Druck die sozialliberale Regierung zur Aufnahme der Indochina-Flüchtlinge; später ergänzten sich zivilgesellschaftliches und staatliches Handeln aber wechselseitig. Der öffentliche Druck entstand insbesondere durch mediale
Carvalho, Diego Z; Townley, Ryan A; Burkle, Christopher M; Rabinstein, Alejandro A; Wijdicks, Eelco F M
Postsedation neuroexcitation is sometimes attributed to intravenous injection of the sedative-hypnotic drug propofol. The movements associated with these events have strongly suggested convulsive activity, but they rarely have been comprehensively evaluated. We present video recordings of 3 healthy young patients who underwent elective surgery under conscious sedation and emerged from sedation with transient but repetitive violent motor activity and impaired consciousness. These manifestations required considerable mobilization of multiple health care workers to protect the patient from inflicting harm. All patients received propofol, and all fully recovered without adverse sequelae. We postulate that these movements are propofol related. Importantly, we found no evidence of seizures clinically or electrographically. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Full Text Available Ketosis of lactating cows is among the most common metabolic diseases in modern dairy farms. The economic importance of the disease is caused by the reduced milk yield and body weight loss, poor feed conversion, lower conception rates, culling and increased mortality of affected animals. In the present study, a total of 47 high-yielding dairy cows up to 45 days in milk (DIM are included. All animals were submitted to physical examination wich included checking the rectal body temperature, heart rate, respiratory and rumen contraction rates, and inspection of visible mucous coats. The body condition was scored, and blood β-hydroxybutyrate (BHBA concentrations were assayed. The cows were divided into 3 groups: first group (control (n=24 with blood β-hydroxybutyrate level 2.6 mmol/l (clinical ketosis. Whole blood samples were obtained and analyzed for Red Blood Cell (RBC, 1012/l, Hemoglobin (HGB, g/l, Hematocrit (HCT, %, Mean Corpuscular Volume (MCV, fl, Mean Corpuscular Hemoglobin (MCH, pg, Mean Corpuscular Hemoglobin Concentration (MCHC, g/l, White Blood Cell (WBC, 109/l, Lymphocytes (LYM, 109/l, Monocytes (MON, 109/l, Granulocytes (GRA, 109/l, Red Blood Distribution Width (RDW, %, Red Blood Cell Distribution Width Absolute (RDWa, fl, Platelets (PLT, 109/l and Mean Platelet Volume (MPV, fl. In this study, deviations in the clinical parameters in the control group and in those with subclinical ketosis were not identified. The cows from the third group (clinical ketosis exhibited hypotonia, anorexia and body weight loss vs. control group. Hematological analysis showed leukocytosis and lymphocytosis in cows with subclinical ketosis vs. control group. In cows with clinical ketosis WBC counts decreased (leukopenia, while hemoglobin content and hematocrit values are higher vs. control group. Blood BHBA values are higher in both groups of ketotic cows vs. the control group. The other analyzed parameters (RBC, MCH, MCHC, MCV, RDW, RDWa, MON, GRA, PLT
Croghan, Ivana T; Viker, Steven D; Limper, Andrew H; Evans, Tamara K; Cornell, Alissa R; Ebbert, Jon O; Gertz, Morie A
Research, clinical care, and education are the three cornerstones of academic health centers in the United States. The research climate has always been riddled with ebbs and flows, depending on funding availability. During a time of reduced funding, the number and scope of research studies have been reduced, and in some instances, a field of study has been eliminated. Recent reductions in the research funding landscape have led institutions to explore new ways to continue supporting research. Mayo Clinic in Rochester, MN has developed a clinical trial unit within the Department of Medicine, which provides shared resources for many researchers and serves as a solution for training and mentoring new investigators and study teams. By building on existing infrastructure and providing supplemental resources to existing research, the Department of Medicine clinical trial unit has evolved into an effective mechanism for conducting research. This article discusses the creation of a central unit to provide research support in clinical trials and presents the advantages, disadvantages, and required building blocks for such a unit. Copyright © 2015 Mayo Clinic. Published by Elsevier Inc. All rights reserved.
Evidence for Nb-Ta Occurrences in the Syn-Tectonic Pan-African Mayo Salah Leucogranite (Northern Cameroon: Constraints from Nb-Ta Oxide Mineralogy, Geochemistry and U-Pb LA-ICP-MS Geochronology on Columbite and Monazite
Periclex Martial Fosso Tchunte
Full Text Available The Mayo Salah pluton, which is located in the North-Cameroon domain of Central African Bold Belt (CAFB, is emplaced as a laccolith in volcano-sedimentary schists of Poli series, and displays features of Rare-metal Granite (RMG. It is made of two main rock groups: (1 the metaluminous barren muscovite granite (MsG and (2 the Nb-Ta bearing peraluminous leucogranite (MsL which expresses four subtypes. The evolved Rare-element MsL is subalkaline, slightly peraluminous (ASI = 1.01–1.21, and it displays flat REE chondrite-normalized patterns with a strong negative Eu anomaly (Eu/Eu* = 0.02–0.20. It belongs to the peraluminous low phosphorus Rare-element Granites and L-type igneous rocks, as shown by the relatively low Zr/Hf (4.8–14 and Nb/Ta (1.4–9.0 ratios and the positive slope of the Zr-Hf-Nb-Ta profile in spider diagrams. The rare-element-bearing mineral is represented by columbite-group minerals (CGM and other Nb-Ta-oxides (Nb-rutile and pyrochlore supergroup minerals. The CGM is classified as Mn-columbite, with Ta# and Mn# ratios increasing from core to rim. Two stages of mineralization are identified; the earliest stage (CGM-I consists in scattered tabular or prismatic euhedral grains that were related to magmatic fractionation. The latest stage (CGM-II is expressed as a Ta-rich Mn hydrothermal CGM episode represented as rims and/overgrowths around and/or as veinlet crosscutting CGM-I or in cleavage planes of muscovite. The U-Pb dating of columbite and monazite of the Mayo Salah leucogranite indicates a late-Neoproterozoic magmatic-hydrothermal mineralization event from 603.2 ± 5.3 to 581.6 ± 7.2 Ma, as consistent with both late D2 to D3 events that were recorded in the CAFB in Cameroon, and the associated continental collision environment. The Nb-Ta mineralization of the Mayo Salah pluton provides evidence for the presence of RMG in Northern Cameroon of CAFB, and its temporal association with the youngest period of metallogenic epoch
Federal Emergency Management Agency, Department of Homeland Security — Recent developments in digital terrain and geospatial database management technology make it possible to protect this investment for existing and future projects to...
Federal Emergency Management Agency, Department of Homeland Security — Hydrology data include spatial datasets and data tables necessary for documenting the hydrologic procedures for estimating flood discharges for a flood insurance...
This book is built on recipes written in an easy-to-follow manner accompanied by diagrams and crucial insights and knowledge on what they mean in the real world. This book is ideal for musicians and producers who want to take their music creation skills to the next level, learn tips and tricks, and understand the key elements and nuances in building inspirational music. It's good to have some knowledge about music production, but if you have creativity and a good pair of ears, you are already ahead of the curve and well on your way.
Federal Emergency Management Agency, Department of Homeland Security — Recent developments in digital terrain and geospatial database management technology make it possible to protect this investment for existing and future projects to...
Federal Emergency Management Agency, Department of Homeland Security — Hydrology data include spatial datasets and data tables necessary for documenting the hydrologic procedures for estimating flood discharges for a flood insurance...
Federal Emergency Management Agency, Department of Homeland Security — Recent developments in digital terrain and geospatial database management technology make it possible to protect this investment for existing and future projects to...
de Oliveira Machado, Evelyn; Lima, Carlos Henrique Azeredo; Ogino, Liana Lumi; Kasuki, Leandro; Gadelha, Mônica R
Acromegaly is associated with significant morbidity and increased mortality, but has a variable severity phenotype. The presence of the exon 3-deleted isoform of the growth hormone receptor (d3-GHR) may influence the disease phenotype and treatment outcomes, including the frequency of biochemical discordance after medical treatment. The objective of this study was to analyze the influence of the d3-GHR isoform on clinical and biochemical characteristics and in the treatment outcomes of Brazilian multiethnic acromegaly patients. We retrospectively analyzed our acromegaly outpatient clinic databank and collected demographic, clinical, biochemical and treatment outcome data from those patients who agreed to participate in the study. A blood sample was collected from all patients, the DNA was extracted and the GHR isoforms were evaluated by PCR, with the full length (fl)-GHR represented by a 935-bp fragment and the d3-GHR represented by a 532-bp fragment. A total of 121 patients were included. Fifty-six patients (46.3 %) were full-length homozygous (fl/fl), 48 (39.7 %) were heterozygous (fl/d3) and 17 (14.0 %) were d3-GHR homozygous (d3/d3). There was no difference between patients homozygous for the fl isoform and those harboring at least one d3-GHR allele in the demographic, clinical and biochemical data or in the treatment outcomes, including somatostatin receptor ligands (SRL) monotherapy, combination therapy with SRL and cabergoline and pegvisomant treatment. There was also no difference between the groups for the frequency of GH and IGF-I discordance after medical treatment. GHR exon 3 genotyping appears to have no clinical significance, at least in Brazilian acromegaly patients.
Narayanan, Raja; Stewart,Michael; Das,Taraprasad; Chhablani,Jay; Jalali,Subhadra; Ali,Mohammad Hasnat; Panchal,Bhavik
Raja Narayanan,1 Bhavik Panchal,1 Michael W Stewart,2 Taraprasad Das,1 Jay Chhablani,1 Subhadra Jalali,1 Mohd Hasnat Ali3 On behalf of MARVEL study group 1Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, L V Prasad Eye Institute, Hyderabad, India; 2Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA; 3Department of Biostatistics, L V Prasad Eye Institute, Hyderabad, India Purpose: The purpose of this study was to prospectively study the efficacy of grid laser combined ...
Miriam Elizabeth Kriger
Puede volverse una memoria fuerte o débil según la coyuntura y el papel que le otorguen el Estado y la sociedad. Se presentan aquí narrativas biográficas de tres miembros de la asociación Abuelas de Plaza de Mayo, surgidas de entrevistas presenciales semiestructuradas y en profundidad realizadas ad hoc, en las cuales se ponen en juego estas memorias en diferentes registros. Se muestran fragmentos selectos para establecer las modalidades de reconocimiento de sus hijos desaparecidos y las tensiones entre su identidad juvenil y su condición militante.
Ward, N. D.; Osborne, T.; Dye, T.; Julian, P.
The last several years have been marked by a high incidence of Atlantic tropical cyclones making landfall as powerful hurricanes or tropical storms. For example, in 2016 Hurricane Matthew devastated parts of the Caribbean and the southeastern United States. In 2017, this region was further battered by hurricanes Irma and Maria. Here, we present water quality data collected in the intracoastal waterway near the Whitney Lab for Marine Bioscience during hurricanes Matthew and Irma, a region that experienced flooding during both storms. YSI Exo 2 sondes were deployed to measure pH, salinity, temperature, dissolved O2, fluorescent dissolved organic matter (fDOM), turbidity, and Chlorophyll-a (Chl-a) on a 15 minute interval. The Hurricane Matthew sonde deployment failed as soon as the storm hit, but revealed an interesting phenomenon leading up to the storm that was also observed during Irma. Salinity in the intracoastal waterway (off the Whitney Lab dock) typically varies from purely marine to 15-20 psu throughout the tidal cycle. However, several days before both storms approached the Florida coast (i.e. when they were near the Caribbean), the salinity signal became purely marine, overriding any tidal signal. Anecdotally, storm drains were already filled up to street level prior to the storm hitting, poising the region for immense flooding and storm surge. The opposite effect was observed after Irma moved past FL. Water became much fresher than normal for several days and it took almost a week to return to "normal" salinity tidal cycles. As both storms hit, turbidity increased by an order of magnitude for a several hour period. fDOM and O2 behaved similar to salinity during and after Irma, showing a mostly marine signal (e.g. higher O2, lower fDOM) in the lead up, and brief switch to more freshwater influence the week after the storm. Chl-a peaked several days after the storm, presumably due to mobilization of nutrient rich flood and waste waters and subsequent algae
Torres Linares, Mayly Pastora
Psychology in Ecuador is undergoing a process of change and transformation, both socially and educationally, based on the analysis carried out by the Government and its decision to modify the academic structure at the country’s universities. These changes are based on an analysis of the pedagogical model which is used for the teaching of Psychology in this country. With regard to clinical psychology, the need to broaden the knowledge of psychologists and clinical psyc...
Bolea, E; Jiménez-Lamana, J; Laborda, F; Abad-Álvaro, I; Bladé, C; Arola, L; Castillo, J R
A methodology based on Asymmetric Flow Field-Flow Fractionation (AsFlFFF) coupled with UV-Vis absorption spectrometry and ICP mass spectrometry (ICPMS) has been developed and applied to the study of silver nanoparticles (AgNPs) and dissolved species of silver in culture media and cells used in cytotoxicity tests. The effect of a nano-silver based product (protein stabilized silver nanoparticles ca. 15 nm average diameter) on human hepatoma (HepG2) cell viability has been studied. UV-Vis absorption spectrometry provided information about the nature (organic vs. nanoparticle) of the eluted species, whereas the silver was monitored by ICPMS. A shift towards larger hydrodynamic diameters was observed in the AgNPs after a 24 hour incubation period in the culture medium, which suggests a "protein corona" effect. Silver(I) associated with proteins present in the culture medium has also been detected, as a consequence of the oxidation process experimented by the AgNPs. However, the Ag(I) released into the culture medium did not justify the toxicity levels observed. AgNPs associated with the cultured HepG2 cells were also identified by AsFlFFF, after applying a solubilisation process based on the use of tetramethylammonium hydroxide (TMAH) and Triton X-100. These results have been confirmed by transmission electronic microscopy (TEM) analysis of the fractions collected from the AsFlFFF. The effect of AgNPs on HepG2 cells has been compared to that caused by silver(I) as AgNO3 under the same conditions. The determination of the total content of silver in the cells confirms that a much larger mass of silver as AgNPs with respect to AgNO3 (16 to 1) is needed to observe a similar toxicity.
Kang, Dong Young; Kim, Won-Suk; Heo, In Sook; Park, Young Hun; Lee, Seungho
Hyaluronic acid (HA) was extracted in a relatively large scale from rooster comb using a method similar to that reported previously. The extraction method was modified to simplify and to reduce time and cost in order to accommodate a large-scale extraction. Five hundred grams of frozen rooster combs yielded about 500 mg of dried HA. Extracted HA was characterized using asymmetrical flow field-flow fractionation (AsFlFFF) coupled online to a multiangle light scattering detector and a refractive index detector to determine the molecular size, molecular weight (MW) distribution, and molecular conformation of HA. For characterization of HA, AsFlFFF was operated by a simplified two-step procedure, instead of the conventional three-step procedure, where the first two steps (sample loading and focusing) were combined into one to avoid the adsorption of viscous HA onto the channel membrane. The simplified two-step AsFlFFF yielded reasonably good separations of HA molecules based on their MWs. The weight average MW (M(w) ) and the average root-mean-square (RMS) radius of HA extracted from rooster comb were 1.20×10(6) and 94.7 nm, respectively. When the sample solution was filtered through a 0.45 μm disposable syringe filter, they were reduced down to 3.8×10(5) and 50.1 nm, respectively. Copyright © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Wu, Jiaqiang; Hu, Jinlong; Zhao, Shumiao; He, Mingxiong; Hu, Guoquan; Ge, Xiangyang; Peng, Nan
Yeasts are good candidates to utilize the hydrolysates of lignocellulose, the most abundant bioresource, for bioproducts. This study aimed to evaluate the efficiencies of single-cell protein (SCP) and xylitol production by a novel yeast strain, Candida intermedia FL023, from lignocellulosic hydrolysates and xylose. This strain efficiently assimilated hexose, pentose, and cellubiose for cell mass production with the crude protein content of 484.2 g kg -1 dry cell mass. SCP was produced by strain FL023 using corncob hydrolysate and urea as the carbon and nitrogen sources with the dry cell mass productivity 0.86 g L -1 h -1 and the yield of 0.40 g g -1 sugar. SCP was also produced using NaOH-pretreated Miscanthus sinensis straw and corn steep liquor as the carbon and nitrogen sources through simultaneous saccharification and fermentation with the dry cell productivity of 0.23 g L -1 h -1 and yield of 0.17 g g -1 straw. C. intermedia FL023 was tolerant to 0.5 g L -1 furfural, acetic acid, and syringaldehyde in xylitol fermentation and produced 45.7 g L -1 xylitol from xylose with the productivity of 0.38 g L -1 h -1 and the yield of 0.57 g g -1 xylose. This study provides feasible methods for feed and food additive production from the abundant lignocellulosic bioresources.
Kotsiou, Eleni; Okosun, Jessica; Besley, Caroline; Iqbal, Sameena; Matthews, Janet; Fitzgibbon, Jude; Gribben, John G; Davies, Jeffrey K
Donor T-cell immune responses can eradicate lymphomas after allogeneic hematopoietic stem cell transplantation (AHSCT), but can also damage healthy tissues resulting in harmful graft-versus-host disease (GVHD). Next-generation sequencing has recently identified many new genetic lesions in follicular lymphoma (FL). One such gene, tumor necrosis factor receptor superfamily 14 (TNFRSF14), abnormal in 40% of FL patients, encodes the herpes virus entry mediator (HVEM) which limits T-cell activation via ligation of the B- and T-lymphocyte attenuator. As lymphoma B cells can act as antigen-presenting cells, we hypothesized that TNFRSF14 aberrations that reduce HVEM expression could alter the capacity of FL B cells to stimulate allogeneic T-cell responses and impact the outcome of AHSCT. In an in vitro model of alloreactivity, human lymphoma B cells with TNFRSF14 aberrations had reduced HVEM expression and greater alloantigen-presenting capacity than wild-type lymphoma B cells. The increased immune-stimulatory capacity of lymphoma B cells with TNFRSF14 aberrations had clinical relevance, associating with higher incidence of acute GVHD in patients undergoing AHSCT. FL patients with TNFRSF14 aberrations may benefit from more aggressive immunosuppression to reduce harmful GVHD after transplantation. Importantly, this study is the first to demonstrate the impact of an acquired genetic lesion on the capacity of tumor cells to stimulate allogeneic T-cell immune responses which may have wider consequences for adoptive immunotherapy strategies. © 2016 by The American Society of Hematology.
Sánchez de la Fuente, Lorena
La disartria flácida es un trastorno motor del habla caracterizado por anomalías en la articulación. Numerosos autores y especialistas se han centrado en la sintomatología general y el tratamiento farmacológico recibido por los pacientes estudiados, pero ninguno de estos estudios incluye el tratamiento logopédico en ninguno de dichos pacientes. Objetivo: Este estudio tiene como objetivo dar atención a la necesidad del tratamiento logopédico en pacientes con disartria, así como la necesidad...
Lima Ynara Bosco de Oliveira
Full Text Available OBJETIVO: Determinar a dose total de flúor proporcionada por dieta (líquidos e sólidos e escovação com dentifrícios fluoretados a crianças na idade crítica para o desenvolvimento da fluorose dental em uma região de água fluoretada. MÉTODOS: Para realização de um estudo-piloto, foram selecionadas 39 crianças (20 a 30 meses de idade de uma creche de Piracicaba, SP, Brasil. Elas bebiam água fluoretada de abastecimento e comiam alimentos preparados com ela. Foi feita a coleta da dieta-duplicada e dos produtos da escovação por dois dias seguidos, em quatro períodos do ano. A concentração de flúor nas amostras foi determinada utilizando-se eletrodo específico. Foi realizada análise de variância (Anova com nível de 5% de significância. RESULTADOS: A dose total média encontrada foi de 0,090 mg F/dia/kg, tendo a dieta contribuído com 45%, e o dentifrício, com 55%. CONCLUSÕES: Aceitando-se o limite de 0,07 mg F/kg para exposição sistêmica ao flúor, conclui-se que as crianças estão expostas a uma dose total de risco em termos de fluorose dental clinicamente aceitável. Entre as várias medidas de precaução que poderiam ser tomadas para diminuir a ingestão de flúor, a redução da quantidade de dentifrício utilizada para escovar os dentes foi considerada a mais apropriada, contemplando risco/benefício para a saúde pública.
Gladshtejn, V.I.; Sheshenev, M.F.
Results are given of prolonged tests of the metal of industrial casts with various fluidity limits. It has been shown experimentally that a quite satisfactory crack resistance is characteristic of a metal with a fluidity limit in the range 30-50 kgf/mm 2 . Metallographic studies have been conducted. Upon variation of the structure and properties of the 15Kh1M1FL steel during operation, the rate of growth of small cracks (up to 2.0 mm) decreases almost by 3 orders of ten (from 1.4x10 -4 to 2.0x10 -7 mm/hour). Subsequent structural changes during prolonged operation (over 50000 hours) result in a gradual increase in the rate of crack growth. At the same time resistance towards appearance of the impermissible high rate of the crack growth, Ksub(10sup(-3)), diminishes monotonically with the operation time. The metal of industrial 15Kh1M1FL steel casts has good crack resistance (Ksub(10sup(-3)) =30-70 kgf/mmsup(3/2) and Vsub(ef) =) kgf/mm 2 ) and a satisfactory local plasticity (critical opening being no more than 0.20 mm for 10 3 hours)
Wang, Jianhao; Zhu, Zhilan; Qiu, Lin; Wang, Jianpeng; Wang, Xiang; Xiao, Qicai; Xia, Jiang; Liu, Li; Liu, Xiaoqian; Feng, Wei; Wang, Jinmei; Miao, Peng; Gao, Liqian
Small molecules with free thiol groups always show high binding affinity to quantum dots (QDs). However, it is still highly challenging to detect the binding capacity between thiol-containing molecules and QDs inside a capillary. To conquer this limitation, a capillary electrophoresis with fluorescence detection (CE-FL) based assay was proposed and established to investigate the binding capacity between QDs and a poly-thiolated peptide (ATTO 590-DDSSGGCCPGCC, ATTO-C4). Interestingly, the results showed that interval time had a great influence on QDs and ATTO-C4 self-assembly, which can be attributed to longer interval time benefitting the binding of QDs to ATTO-C4. The stability assays on ATTO-C4-QD assembly indicated that high concentration of imidazole or GSH had a high capability of competing with the bound ATTO-C4, evidenced by dramatically dropping of S 625 /S 565 ratio from 0.78 to 0.30 or 0.29. Therefore, all these results above suggested that this novel CE-FL based detection assay could be successfully applied to the binding studies between QDs and thiol-containing biomolecules.
García Hoyos, Felisa
INTRODUCCIÓN: La utilización tópica de fluoruros es probablemente la medida más extendida para la prevención de la caries dental. Se ha demostrado que parte del flúor administrado tópicamente pasa a vías sistémicas, bien por tragado del mismo o por absorción en la mucosa oral. El flúor que es digerido circulará por el torrente sanguineo y será eliminado fundamentalmene por la orina. Este flúor sistémico es muy poco eficaz como elemento preventivo de la caries. OBJETIVOS: Este estudio pretend...
Robert Sambursky Coastal Eye Institute, Cornea and Comprehensive Ophthalmology, Bradenton, FL, USA Background: The presence of clinically significant inflammation has been confirmed in the tears of 40%–65% of patients with symptoms of dry eye. Ocular surface inflammation may lead to tear film instability, epithelial cell irregularities, and permeability, resulting in chronic symptomatic pain and fluctuating vision as well as negative surgical outcomes.Patients and methods: A retro...
Yasmine Mendes Pupo
Full Text Available Objetivo Avaliar a liberação e a capacidade de recarga de flúor de diferentes cimentos de ionômero de vidro, durante a simulação de desafio cariogênico. Material e método Foram confeccionados 12 corpos de prova para cada grupo experimental, com cimentos de ionômero de vidro convencionais – Maxxion R (FGM, Ketac Molar EasyMix (3M ESPE; cimento de ionômero de vidro modificado por resina – Vitrebond (3M ESPE, e resina composta, Filtek™ Z350XT (3M ESPE, como controle negativo. Os corpos de prova foram imersos alternadamente em sistema de ciclagem de pH, permanecendo 6 horas na solução de desmineralização e 18 horas na de remineralização, sendo mantidos em estufa a 37°C. Liberação de flúor foi verificada 1, 2, 7 e 14 dias antes e após a recarga com flúor, com eletrodo específico acoplado ao aparelho analisador de pH/fluoretos, calibrado a cada medição com soluções de fluoreto de sódio a 1 e 10 ppm, preparadas com TISAB II. Para leitura, foi adicionado 0,5 mL da amostra a igual volume de TISAB II. Recarga foi realizada com flúor neutro 2% por 4 minutos nas amostras, lavadas e imersas novamente nas soluções do sistema de ciclagem de pH. Os dados foram submetidos à análise de variância e ao teste de Tukey (α=0,05. Resultado A liberação inicial de fluoreto (μgF/cm2 foi de 45,36; 37,49, e 26,35 para Maxxion R, Vitrebond e Ketac Molar EasyMix, respectivamente. Diferenças estatísticas significativas entre os materiais foram verificadas antes e após a recarga (p=0,001. Após a aplicação tópica de flúor, os cimentos de ionômero de vidro apresentaram capacidade de recarga de flúor. Conclusão Cimentos de ionômero de vidro avaliados foram capazes de liberar flúor em soluções de ciclagem de pH e podem recarregar flúor através da aplicação tópica.
Jon O Ebbert
Full Text Available Jon O Ebbert, Kirk D Wyatt, Ali Zirakzadeh, Michael V Burke, JT HaysMayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USAAbstract: Chronic obstructive pulmonary disease (COPD is a costly and deadly disease afflicting an estimated 210 million people and accounting for 5% of all global deaths. Exposure to cigarette smoke is the greatest risk factor for COPD in the developed world. Smoking cessation improves respiratory symptoms and lung function and reduces mortality among patients with COPD. Cigarette smokers with COPD and other co-morbid conditions such as cardiovascular disease and psychiatric illnesses should receive comprehensive tobacco treatment interventions incorporating efficacious pharmacotherapies. Varenicline, an α4β2 nicotinic acetylcholine receptor partial agonist, is the newest and most effective drug currently available to promote smoking cessation. In conjunction with behavioral interventions and clinical monitoring for potential side effects, varenicline offers great hope for reducing smoking-attributable death and disability.Keywords: smoking cessation, chronic obstructive pulmonary disease, varenicline
Kapoor, Prashant; Ansell, Stephen M; Fonseca, Rafael; Chanan-Khan, Asher; Kyle, Robert A; Kumar, Shaji K; Mikhael, Joseph R; Witzig, Thomas E; Mauermann, Michelle; Dispenzieri, Angela; Ailawadhi, Sikander; Stewart, A Keith; Lacy, Martha Q; Thompson, Carrie A; Buadi, Francis K; Dingli, David; Morice, William G; Go, Ronald S; Jevremovic, Dragan; Sher, Taimur; King, Rebecca L; Braggio, Esteban; Novak, Ann; Roy, Vivek; Ketterling, Rhett P; Greipp, Patricia T; Grogan, Martha; Micallef, Ivana N; Bergsagel, P Leif; Colgan, Joseph P; Leung, Nelson; Gonsalves, Wilson I; Lin, Yi; Inwards, David J; Hayman, Suzanne R; Nowakowski, Grzegorz S; Johnston, Patrick B; Russell, Steven J; Markovic, Svetomir N; Zeldenrust, Steven R; Hwa, Yi L; Lust, John A; Porrata, Luis F; Habermann, Thomas M; Rajkumar, S Vincent; Gertz, Morie A; Reeder, Craig B
Waldenström macroglobulinemia (WM), an IgM-associated lymphoplasmacytic lymphoma, has witnessed several practice-altering advances in recent years. With availability of a wider array of therapies, the management strategies have become increasingly complex. Our multidisciplinary team appraised studies published or presented up to December 2015 to provide consensus recommendations for a risk-adapted approach to WM, using a grading system. Waldenström macroglobulinemia remains a rare, incurable cancer, with a heterogeneous disease course. The major classes of effective agents in WM include monoclonal antibodies, alkylating agents, purine analogs, proteasome inhibitors, immunomodulatory drugs, and mammalian target of rapamycin inhibitors. However, the highest-quality evidence from rigorously conducted randomized clinical trials remains scant. Recognizing the paucity of data, we advocate participation in clinical trials, if available, at every stage of WM. Specific indications exist for initiation of therapy. Outside clinical trials, based on the synthesis of available evidence, we recommend bendamustine-rituximab as primary therapy for bulky disease, profound hematologic compromise, or constitutional symptoms attributable to WM. Dexamethasone-rituximab-cyclophosphamide is an alternative, particularly for nonbulky WM. Routine rituximab maintenance should be avoided. Plasma exchange should be promptly initiated before cytoreduction for hyperviscosity-related symptoms. Stem cell harvest for future use may be considered in first remission for patients 70 years or younger who are potential candidates for autologous stem cell transplantation. At relapse, retreatment with the original therapy is reasonable in patients with prior durable responses (time to next therapy ≥3 years) and good tolerability to previous regimen. Ibrutinib is efficacious in patients with relapsed or refractory disease harboring MYD88 L265P mutation. In the absence of neuropathy, a bortezomib
Case, Jonathan L.; LaCasse, Katherine M.; Dembek, Scott R.; Santos, Pablo; Lapenta, William M.
Over the past few years,studies at the Short-term Prediction Research and Transition (SPoRT) Center have suggested that the use of Moderate Resolution Imaging Spectroradiometer (MODIS) composite sea-surface temperature (SST) products in regional weather forecast models can have a significant positive impact on short-term numerical weather prediction in coastal regions. The recent paper by LaCasse et al. (2007, Monthly Weather Review) highlights lower atmospheric differences in regional numerical simulations over the Florida offshore waters using 2-km SST composites derived from the MODIS instrument aboard the polar-orbiting Aqua and Terra Earth Observing System satellites. To help quantify the value of this impact on NWS Weather Forecast Offices (WFOs), the SPoRT Center and the NWS WFO at Miami, FL (MIA) are collaborating on a project to investigate the impact of using the high-resolution MODIS SST fields within the Weather Research and Forecasting (WRF) prediction system. The scientific hypothesis being tested is: More accurate specification of the lower-boundary forcing within WRF will result in improved land/sea fluxes and hence, more accurate evolution of coastal mesoscale circulations and the associated sensible weather elements. The NWS MIA is currently running the WRF system in real-time to support daily forecast operations, using the National Centers for Environmental Prediction Nonhydrostatic Mesoscale Model dynamical core within the NWS Science and Training Resource Center's Environmental Modeling System (EMS) software; The EMS is a standalone modeling system capable of downloading the necessary daily datasets, and initializing, running and displaying WRF forecasts in the NWS Advanced Weather Interactive Processing System (AWIPS) with little intervention required by forecasters. Twenty-seven hour forecasts are run daily with start times of 0300,0900, 1500, and 2100 UTC on a domain with 4-km grid spacing covering the southern half of Florida and the far
Daniel Araki Ribeiro
Full Text Available Fluoride has been widely used in dentistry because it is a specific and effective caries prophylactic agent. However, excess fluoride may represent a hazard to human health, especially by causing injury to genetic material. Genotoxicity tests represent an important part of cancer research to assess the risk of potential carcinogens. In the current study, the potential DNA damage associated with exposure to fluoride was assessed by the single cell gel (comet assay in vitro. Chinese hamster ovary cells were exposed to sodium fluoride (NaF at final concentration ranging from 7 to 100 µg/ml for 3 h, at 37°C. The results pointed out that NaF in all concentrations tested did not contribute to DNA damage as depicted by the mean tail moment and tail intensity. These findings are clinically important since they represent an important contribution to a correct evaluation of the potential health risk associated with the exposure to dental agents.O flúor tem sido amplamente usado na Odontologia, pois é um agente profilático efetivo e específico contra a cárie dentária. Entretanto, o flúor em excesso pode representar perigos à saúde humana, especialmente por causar agressão ao material genético. Testes de genotoxicidade representam uma importante parte da pesquisa do câncer para a avaliação de risco de possíveis carcinógenos. Neste presente estudo, danos ao DNA associados à exposição ao flúor foram avaliados pelo teste de células individualizadas em gel de agarose (teste do cometa in vitro. Células de ovário de hamster chinês foram expostas ao fluoreto de sódio (NaF nas concentrações finais de 7 a 100 µg/ml, durante 3 h, a 37°C. Os resultados mostraram que o NaF não contribuiu para os danos no DNA em todas as concentrações testadas, conforme demonstrado pelas médias do momento da cauda e da intensidade da cauda dos cometas. Esses achados são clinicamente importantes, uma vez que representam uma importante contribui
Seyed Ahmad Raeissadat
Full Text Available Background. Autologous whole blood and platelet-rich plasma (PRP have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS, modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05. At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05. Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.
Ecological validity of the screening module and the Daily Living tests of the Neuropsychological Assessment Battery using the Mayo-Portland Adaptability Inventory-4 in postacute brain injury rehabilitation.
Zgaljardic, Dennis J; Yancy, Sybil; Temple, Richard O; Watford, Monica F; Miller, Rebekah
The assessment of ecological validity of neuropsychological measures is an area of growing interest, particularly in the postacute brain injury rehabilitation (PABIR) setting, as there is an increasing demand for clinicians to address functional and real-world outcomes. In the current study, we assessed the predictive value of the Screening module and the Daily Living tests of the Neuropsychological Assessment Battery (NAB) using clinician ratings from the Mayo-Portland Adaptability Inventory-4 (MPAI-4) in patients with moderate to severe traumatic brain injury. Forty-seven individuals were each administered the NAB Screening module (NAB-SM) and the NAB Daily Living (NAB-DL) tests following admission to a residential PABIR program. MPAI-4 ratings were also obtained at admission. Linear regression analysis was used to examine the association between these functional and neuropsychological assessment measures. We replicated prior work (Temple at al., 2009) and expanded evidence for the ecological validity of the NAB-SM. Furthermore, our findings support the ecological validity of the NAB-DL Bill Payment, Judgment, and Map Reading tests with regards to functional skills and real-world activities. The current study supports prior work from our lab assessing the predictive value of the NAB-SM, as well as provides evidence for the ecological validity for select NAB-DL tests in patients with moderate to severe traumatic brain injury admitted to a residential PABIR program.
Staged residential post-acute rehabilitation for adults following acquired brain injury: A comparison of functional gains rated on the UK Functional Assessment Measure (UK FIM+FAM) and the Mayo-Portland Adaptability Inventory (MPAI-4).
Jackson, Diana; Seaman, Karla; Sharp, Kristylee; Singer, Rachel; Wagland, Janet; Turner-Stokes, Lynne
To compare the UK Functional Assessment Measure (UK FIM+FAM) and Mayo-Portland Adaptability Inventory (MPAI-4) as measures of functional change in patients with brain injury receiving a staged residential post-acute community-based rehabilitation programme. Longitudinal cohort study of consecutive admissions (N = 42) over 3 years. Patients were assessed at admission and discharge/annual review. We examined groups according to stage of independence on admission: Maximum support (stages 1 and 2: N = 17); moderate/maximum self-care/household support (stage 3: N = 15); minimal self-care and moderate household/community support (stages 4-6: N = 10). Median (IQR) age: 50 (37-56) years. Male:female ratio: (71%:29%). Aetiology: stroke (50%), traumatic (36%) and other brain injuries (14%). Both tools demonstrated significant gains in overall scores and all subscales (p MPAI-4 was more sensitive to changes in adjustment and participation for clients admitted in the later stages (4-6). The UK FIM+FAM and MPAI-4 provide complementary evaluation across functional tasks ranging from self-care to participation. This study supports their use for longitudinal outcome evaluation in community residential rehabilitation services that take patients at different stages of recovery.
Immediate postoperative tracheal extubation in a liver transplant recipient with encephalopathy and the Mayo end-stage liver disease score of 41: A CARE-compliant case report revealed meaningful challenge in recovery after surgery (ERAS) for liver transplantation.
Li, Jianbo; Wang, Chengdi; Chen, Nan; Song, Jiulin; Sun, Yan; Yao, Qin; Yan, Lunan; Yang, Jiayin
Immediate postoperative tracheal extubation (IPTE) is one of the most important subject in recovery after surgery (ERAS) for liver transplantation. However, the criteria for IPTE is not uniform at present. We reported a successful IPTE in a liver transplant recipient with encephalopathy and a high Mayo end-stage liver disease (MELD) score of 41, which beyond the so-called criteria reported in the literature. The patient was 48-year-old man, admitted in September 2016 for end-stage liver cirrhosis secondary to hepatitis B. End-stage liver cirrhosis secondary to hepatitis B with encephalopathy and a high MELD score of 41. He was involved in our ERAS project and was extubated at the end of the liver transplantation in the operating room. As a result, the patient was not reintubated and had an excellent postoperative recovery, staying in intensive care unit (ICU) for just 2 days and discharged home on day 10. We believed IPTE in liver transplant recipients with severe liver dysfunction is a meaningful challenge in ERAS for liver transplantation. Our case and literature review suggest 3 things: IPTE in liver transplantation is generally feasible and safe; the encephalopathy or high MELD score should not be the only limiting factor; and a more systematic predicting system for IPTE in liver transplantation should be addressed in future studies. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
Analice de Lima Palombini
Full Text Available Com base na experiência do acompanhamento terapêutico como uma clínica sem muros, imersa na cidade, o artigo centra-se no tema da cidade nas suas relações com a subjetividade. Valendo-se das elaborações de Benjamin sobre a flânerie e a idéia da amizade como política, presente em Foucault e Derrida, o texto assinala a importância, para a consecução dessa clínica, de se tomar em consideração a cidade como polis, aberta ao encontro com a diferença e, portanto, território de conflitos e negociação. Assim, a cidade como polis é a utopia que a clínica do acompanhamento terapêutico busca ativar.
Rizk, S.A.; Mikhaiel, A.A.
Full grown pupae of the Angoumois grain moth, Sitotroga cerealella were irradiated with 75 and 175 Gy or gamma irradiation .The sterility percent was increased by increasing of' gamma irradiation dose. Also, the sterility percent increased in F 1 males than in parents. Gamma irradiation caused a decrease in size or the ova doles and number of oocytes. The effects of gamma rays on the DNA patterns of adult male parents and Fl males showed alterations among the controls, the treated parents and Ft individuals. Exposure to radiation caused very frequently the appearance of some extra bands and the deficiency of others in the RAPD-PCR amplification patterns of the irradiated insects. However, the similarity in DNA patterns between some normal and treated samples was interpreted by assuming, that the radiation induced damage was in regions of' the genome other than at the loci under study
Aaron, F D; Andreev, V; Backovic, S; Baghdasaryan, A; Baghdasaryan, S; Barrelet, E; Bartel, W; Behrend, O; Belov, P; Begzsuren, K; Belousov, A; Bizot, J C; Boudry, V; Bozovic-Jelisavcic, I; Bracinik, J; Brandt, G; Brinkmann, M; Brisson, V; Britzger, D; Bruncko, D; Bunyatyan, A; Buschhorn, G; Bylinkin, A; Bystritskaya, L; Campbell, A J; Cantun Avila, K B; Ceccopieri, F; Cerny, K; Cerny, V; Chekelian, V; Cholewa, A; Contreras, J G; Coughlan, J A; Cvach, J; Dainton, J B; Daum, K; Delcourt, B; Delvax, J; De Wolf, E A; Diaconu, C; Dobre, M; Dodonov, V; Dossanov, A; Dubak, A; Eckerlin, G; Egli, S; Eliseev, A; Elsen, E; Favart, L; Fedotov, A; Felst, R; Feltesse, J; Ferencei, J; Fischer, D J; Fleischer, M; Fomenko, A; Gabathuler, E; Gayler, J; Ghazaryan, S; Glazov, A; Goerlich, L; Gogitidze, N; Gouzevitch, M; Grab, C; Grebenyuk, A; Greenshaw, T; Grell, B R; Grindhammer, G; Habib, S; Haidt, D; Helebrant, C; Henderson, R C.W; Hennekemper, E; Henschel, H; Herbst, M; Herrera, G; Hildebrandt, M; Hiller, K H; Hoffmann, D; Horisberger, R; Hreus, T; Huber, F; Jacquet, M; Janssen, X; Jonsson, L; Jung, A W; Jung, H; Kapichine, M; Katzy, J; Kenyon, I R; Kiesling, C; Klein, M; Kleinwort, C; Kluge, T; Knutsson, A; Kogler, R; Kostka, P; Kraemer, M; Kretzschmar, J; Kruger, K; Kutak, K; Landon, M P.J; Lange, W; Lastovicka-Medin, G; Laycock, P; Lebedev, A; Lendermann, V; Levonian, S; Lipka, K; List, B; List, J; Loktionova, N; Lopez-Fernandez, R; Lubimov, V; Makankine, A; Malinovski, E; Marage, P; Martyn, H U; Maxfield, S J; Mehta, A; Meyer, A B; Meyer, H; Meyer, J; Mikocki, S; Milcewicz-Mika, I; Moreau, F; Morozov, A; Morris, J V; Mozer, M U; Mudrinic, M; Muller, K; Naumann, Th; Newman, P R; Niebuhr, C; Nikiforov, A; Nikitin, D; Nowak, G; Nowak, K; Olsson, J E; Osman, S; Ozerov, D; Pahl, P; Palichik, V; Panagoulias, I; Pandurovic, M; Papadopoulou, Th; Pascaud, C; Patel, G D; Perez, E; Petrukhin, A; Picuric, I; Piec, S; Pirumov, H; Pitzl, D; Placakyte, R; Pokorny, B; Polifka, R; Povh, B; Radescu, V; Raicevic, N; Ravdandorj, T; Reimer, P; Rizvi, E; Robmann, P; Roosen, R; Rostovtsev, A; Rotaru, M; Ruiz Tabasco, J E; Rusakov, S; Salek, D; Sankey, D P.C; Sauter, M; Sauvan, E; Schmitt, S; Schoeffel, L; Schoning, A; Schultz-Coulon, H C; Sefkow, F; Shtarkov, L N; Shushkevich, S; Sloan, T; Smiljanic, I; Soloviev, Y; Sopicki, P; South, D; Spaskov, V; Specka, A; Staykova, Z; Steder, M; Stella, B; Stoicea, G; Straumann, U; Sykora, T; Thompson, P D; Toll, T; Tran, T H; Traynor, D; Truol, P; Tsakov, I; Tseepeldorj, B; Tsurin, I; Turnau, J; Urban, K; Valkarova, A; Vallee, C; Van Mechelen, P; Vargas, A; Vazdik, Y; von den Driesch, M; Wegener, D; Wunsch, E; Zacek, J; Zalesak, J; Zhang, Z; Zhokin, A; Zohrabyan, H; Zomer, F
A measurement is presented of the inclusive neutral current e\\pm p scattering cross section using data collected by the H1 experiment at HERA during the years 2003 to 2007 with proton beam energies Ep of 920, 575, and 460 GeV. The kinematic range of the measurement covers low absolute four-momentum transfers squared, 1.5 GeV2 < Q2 < 120 GeV2, small values of Bjorken x, 2.9 \\cdot 10-5 < x < 0.01, and extends to high inelasticity up to y = 0.85. The structure function FL is measured by combining the new results with previously published H1 data at Ep = 920 GeV and Ep = 820 GeV. The new measurements are used to test several phenomenological and QCD models applicable in this low Q2 and low x kinematic domain.
Brandão Ioneide Maria Gomes; Valsecki Junior Aylton
Está comprovado que indivíduos de todas as idades podem ser beneficiados pelos efeitos tópicos e sistêmicos da fluoretação da água de consumo. Entretanto, o aumento no consumo de água mineral comercial, em substituição ou em adição à água de abastecimento público, pode trazer implicações para a suplementação segura deste íon. Partindo-se disto, em 1995 analisamos a concentração de íon flúor presente em 31 marcas comerciais de água mineral na região de Araraquara, estado de São Paulo, Brasil. ...
Levenberg, N.E.; German, S.I.; Fomina, O.P.; Netesa, E.M.; Tsaryuk, A.K.; Kornienko, T.A.
Heat affected zone (HAZ) structure of thick-walled, nature joints of 15Kh1M1FL steel for block structure of power reactors and 25Kh2NMFA and 20KhN2MFA steels for rotors - is investigated. Multi-layer arc welding is performed under conditions being created for standard components of turbines. Thermokinetics diagrams of austenite decomposition are built, phase composition and character of the structure forming at HAZ in the process of welding with preheating are studied. It is shown that at HAZ in joints of the steels under consideration in the process of welding with preheating is formed a structure of a grained bainite which is uniform in its structure and phase composition. Small volumes of round and elongated forms consisting of martensite and residual austenite are distributed in α-solid solution of the bainite. The bainite of the HAZ in welded joints possesses high hardness and great stability in the process of tempering
Evelyn Lopez Leite
Full Text Available OBJETIVO: Este estudo avaliou a absorção de íons flúor em cimentos de ionômero de vidro de manipulação mecânica e manual, por uma única aplicação tópica de flúor. METODOLOGIA: Os cimentos de ionômeros de vidro (CIVs Riva Self Cure® (RSC-SDI e Ketac Molar Easymix® (KME- 3M-ESPE foram testados com um material controle (RC-resina composta ICE-SDI, após preparo de dez corpos de prova de cada um (n = 30. Esses corpos foram pesados e armazenados em água deionizada para as aferições da liberação de flúor (eletrodo específico, Orion 9606-BN em dois períodos: antes (PI: 1, 2, 7 e 14 dias e após aplicação tópica de flúor (PII: 16, 17, 18, 20, 22, 24, 26, 28 e 30 dias. No 15.º dia, cinco espécimes de cada material (n = 15 foram submetidos à aplicação tópica de fluoreto de sódio neutro a 2% ou de gel placebo de Natrosol (n = 15. RESULTADO: A maior liberação de íons flúor para ambos os CIVs ocorreu no primeiro dia do PI (KME = 13,44 ± 6,05; RSC = 6,88 ± 0,62 e a quantidade liberada foi semelhante no PII (KME = 6,22 ± 0,80; RSC = 6,67 ± 1,63. A comparação entre os períodos mostrou diferença significante somente para o KME, com maior liberação de flúor no PI (p 0,05. A análise de variância e o teste de Tukey (p < 0,05 não indicaram diferenças significantes entre os materiais antes e após a recarga. CONCLUSÃO: Os CIVs de manipulação mecânica ou manual possuem habilidade semelhante para captar íons flúor, quando submetidos a uma única aplicação tópica de fluoreto de sódio a 2%.
Knopman, David S.; Jack, Clifford R.; Lundt, Emily S.; Weigand, Stephen D.; Vemuri, Prashanthi; Lowe, Val J.; Kantarci, Kejal; Gunter, Jeffrey L.; Senjem, Matthew L.; Mielke, Michelle M.; Machulda, Mary M.; Roberts, Rosebud O.; Boeve, Bradley F.; Jones, David T.; Petersen, Ronald C.
The availability of antemortem biomarkers for Alzheimer’s Disease (AD) enables monitoring the evolution of neurodegenerative processes in real time. Pittsburgh compound B (PIB) positron emission tomography (PET) was used to select participants in the Mayo Clinic Study of Aging and the Mayo Alzheimer’s Disease Research Center with elevated β-amyloid, designated as “A+,” and hippocampal volume and 18fluorodeoxyglucose (FDG) positron emission tomography were used to characterize participants as having evidence of neurodegeneration (“N+”) at the baseline evaluation. There were 145 clinically normal (CN) A+ individuals, 62 persons with mild cognitive impairment (MCI) who were A+ and 20 with A+ AD dementia. Over a period of 1–6 years, MCI A+N+ individuals showed declines in medial temporal, lateral temporal, lateral parietal, and to a lesser extent, medial parietal regions for both FDG standardized uptake value ratio (SUVR) and grey matter (GM) volume that exceeded declines seen in the CN A+N+ group. The AD dementia group showed declines in the same regions on FDG SUVR and GM volume with rates that exceeded that in MCI A+N+. Expansion of regional involvement and faster rate of neurodegeneration characterizes progression in the AD pathway. PMID:27460147
Knopman, David S; Jack, Clifford R; Lundt, Emily S; Weigand, Stephen D; Vemuri, Prashanthi; Lowe, Val J; Kantarci, Kejal; Gunter, Jeffrey L; Senjem, Matthew L; Mielke, Michelle M; Machulda, Mary M; Roberts, Rosebud O; Boeve, Bradley F; Jones, David T; Petersen, Ronald C
The availability of antemortem biomarkers for Alzheimer's disease (AD) enables monitoring the evolution of neurodegenerative processes in real time. Pittsburgh compound B (PIB) positron emission tomography (PET) was used to select participants in the Mayo Clinic Study of Aging and the Mayo Alzheimer's Disease Research Center with elevated β-amyloid, designated as "A+," and hippocampal volume and (18)fluorodeoxyglucose (FDG) positron emission tomography were used to characterize participants as having evidence of neurodegeneration ("N+") at the baseline evaluation. There were 145 clinically normal (CN) A+ individuals, 62 persons with mild cognitive impairment (MCI) who were A+ and 20 with A+ AD dementia. Over a period of 1-6 years, MCI A+N+ individuals showed declines in medial temporal, lateral temporal, lateral parietal, and to a lesser extent, medial parietal regions for both FDG standardized uptake value ratio and gray matter volume that exceeded declines seen in the CN A+N+ group. The AD dementia group showed declines in the same regions on FDG standardized uptake value ratio and gray matter volume with rates that exceeded that in MCI A+N+. Expansion of regional involvement and faster rate of neurodegeneration characterizes progression in the AD pathway. Copyright © 2016 Elsevier Inc. All rights reserved.
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Full Text Available Conventional X-ray-based cystography uses radio-opaque materials, but this method uses harmful ionizing radiation and is not sensitive. In this study, we demonstrate nonionizing and noninvasive photoacoustic (PA and fluorescence (FL cystography using clinically relevant indocyanine green (ICG in vivo. After transurethral injection of ICG into rats through a catheter, their bladders were photoacoustically and fluorescently visualized. A deeply positioned bladder below the skin surface (i.e., ~1.5–5 mm was clearly visible in the PA and FL image using a laser pulse energy of less than 2 mJ/cm2 (1/15 of the safety limit. Then, the in vivo imaging results were validated through in situ studies. Our results suggest that dual modal cystography can provide a nonionizing and noninvasive imaging tool for bladder mapping.
This was a particularly comprehensive gathering of investigators and clinicians interested in the field of allergy, asthma and immunology. The meeting presented information ranging from basic immunological research to the clinical trials of drugs already available for treatment in the US today. There were 984 original oral and poster presentations and over 100 symposia, seminars and workshops. The plenary sessions involved sections on allergic inflammation, immune modulation, chemokine receptors, the origins of asthma, the diagnosis and management of food and drug reactions, the environmental influences on allergic diseases, and dermatological diseases. There were approximately 500 faculty members who presented new data or participated in lectures, seminars or workshops.
Full Text Available AIM: To compare and analyze the clinical efficacy of different artificial tears for patients with xerophthalmia after phacoemulsification. METHODS: Retrospective analysis on the clinical data of 150 cases(150 eyestreated by phacoemulsification in our hospital from March 2014 to April 2017. And according to the artificial tears used, they were divided into Group A(control groupand B(application of sodium hyaluronate eye drops, Group C(used carbomer gel eye drops,50 cases 50 eyes in every group. We compared and analyzed the BUT, FL, SⅠt findings, OSDI scores preoperatively and 1wk, 1 and 3mo postoperatively, and visual acuity before and 3mo after operation in the three groups. RESULTS: There were no differences in BUT, FL, SⅠt and OSDI scores between the three groups before and at 1wk after the operation(P>0.05. At 1mo after operation, the levels of BUT and SⅠt in Group B and Group C were higher than those in Group A, and the scores of OSDI and FL were lower than those in Group A(PP>0.05. After 3mo, the levels of BUT and SⅠt in the Group B and Group C were higher than that in the Group A, and the FL level and OSDI score were lower than those in the Group A(PPPP>0.05. CONCLUSION: different types of artificial tear can improve the symptoms of dry eyes in patients age-related cataract after phacoemulsification, in which carbomer eye drops or lipid containing artificial tears improve postoperative dry eye symptoms and signs, and will not affect the recovery of visual acuity.
The Mayo Kebbi massif located in southwestern Chad between the Congo craton in the South, the West African craton in the west and the Sahara meta-craton to the east exposes a segment of Neo-proterozoic juvenile crust accreted in the Central African orogenic belt during the Pan African orogeny. It consists of two greenstone belts (Zalbi and Goueygoudoum) separated by the May Kebbi calc-alkaline batholith complexes and intruded by calc-alkaline high-K granitic plutons. The whole is covered by Phanerozoic sedimentary formations. The greenstone belts contain sulphide zones hosted mainly by meta-plutonic rocks (granodiorites) and meta-basalts and meta-volcaniclastics. The mineralization comprises pyrite, pyrrhotite, arsenopyrite, chalcopyrite, pentlandite, pentlandite silver, pentlandite cobaltiferous, sphalerite, cobaltite. These sulphides are disseminated, aggregated in form of layers or are filling veins and cracks. The greenstones also contain quartz veins with calcite and chlorite comprising a mineralization made of pyrite, chalcopyrite, galena and gold. Gold is present both as native crystals and as electrum. The high-K calc-alkaline Zabili granitic pluton hosts uranium mineralization related to a superposition of: (1) ductile deformation and metasomatic alteration implying the interaction between magmatic minerals with a Na-rich fluid, of potential magmatic origin, coeval to the main deposition of uranium oxides, followed by (2) brittle deformation and deposition of secondary hydrated uranium silicates involving a Na-Ca-rich fluid. We propose that these uranium mineralizations represent the extreme expression of crustal differentiation as a result of Pan-African reworking of a Neo-proterozoic juvenile crustal segment. (author) [fr
Thomas E Bartlett
Full Text Available We introduce a novel per-gene measure of intra-gene DNA methylation variability (IGV based on the Illumina Infinium HumanMethylation450 platform, which is prognostic independently of well-known predictors of clinical outcome. Using IGV, we derive a robust gene-panel prognostic signature for ovarian cancer (OC, n = 221, which validates in two independent data sets from Mayo Clinic (n = 198 and TCGA (n = 358, with significance of p = 0.004 in both sets. The OC prognostic signature gene-panel is comprised of four gene groups, which represent distinct biological processes. We show the IGV measurements of these gene groups are most likely a reflection of a mixture of intra-tumour heterogeneity and transcription factor (TF binding/activity. IGV can be used to predict clinical outcome in patients individually, providing a surrogate read-out of hard-to-measure disease processes.
Bartlett, Thomas E; Jones, Allison; Goode, Ellen L; Fridley, Brooke L; Cunningham, Julie M; Berns, Els M J J; Wik, Elisabeth; Salvesen, Helga B; Davidson, Ben; Trope, Claes G; Lambrechts, Sandrina; Vergote, Ignace; Widschwendter, Martin
We introduce a novel per-gene measure of intra-gene DNA methylation variability (IGV) based on the Illumina Infinium HumanMethylation450 platform, which is prognostic independently of well-known predictors of clinical outcome. Using IGV, we derive a robust gene-panel prognostic signature for ovarian cancer (OC, n = 221), which validates in two independent data sets from Mayo Clinic (n = 198) and TCGA (n = 358), with significance of p = 0.004 in both sets. The OC prognostic signature gene-panel is comprised of four gene groups, which represent distinct biological processes. We show the IGV measurements of these gene groups are most likely a reflection of a mixture of intra-tumour heterogeneity and transcription factor (TF) binding/activity. IGV can be used to predict clinical outcome in patients individually, providing a surrogate read-out of hard-to-measure disease processes.
Santos, Rogério Lacerda dos
Full Text Available Objetivo: O objetivo deste estudo foi comparar a liberação de flúor de cimentos de ionômero de vidro (CIV utilizados para cimentação ortodôntica, antes e após recarga de flúor. Metodologia: Foram avaliados três CIV: Meron (VOCO, Vidrion C (SS WHITE e Ketac-Cem (3M ESPE. A liberação de flúor foi medida através de eletrodo íon seletivo conectado a um analisador de íons após 1 h e 1, 3, 7, 14, 21 e 28 dias. Para avaliação da recarga de flúor e capacidade de retenção de flúor, os espécimes foram expostos a uma solução de fluoreto de sódio a 0,221 % (1000 ppm de flúor por 5 min nos dias 28, 30, 31 e 32 para medição após 24 h. Os dados foram analisados por ANOVA e teste de Kruskal-Wallis ao nível de significância de 0,05. Resultados: O padrão de liberação de flúor foi similar para os diferentes CIV avaliados, sendo que todos os materiais apresentaram uma maior liberação de flúor no primeiro dia e um decréscimo rápido até o sétimo dia. A exposição à solução fluoretada proporcionou maior liberação de flúor pelos materiais, mas sem atingir os mesmos níveis do primeiro dia. Conclusão: Os cimentos Meron e Vidrion C apresentaram maior liberação de flúor comparado ao cimento Ketac-Cem, tanto antes quanto após a recarga de flúor. O uso de solução com flúor permite elevar a quantidade de captação e liberação de flúor pelos CIVs
Tarquini, Simone; de'Michieli Vitturi, Mattia; Jensen, Esther H.; Barsotti, Sara; Pedersen, Gro B. M.; Coppola, Diego
The 2014-2015 fissure eruption in Holuhraun started when a new code (named F-L) was being developed. The availability of several digital Elevation Models of the area inundated by the lava and the availability of continuously updated maps of the flow (collected in the field and through remote sensing imagery) provided an excellent opportunity for testing and calibrating the new code against an evolving flow field. Remote sensing data also provided a constrain on the effusion rate. Existing numerical codes for the simulation of lava flow emplacement are based either on the solution of some simplification of the physical governing equations of this phenomenon (the so-called "deterministic codes" - e.g. Hidaka et al. 2005; Crisci et al. 2010), or, instead, on the evidence that lava flows tend to follow the steepest descent path from the vent downhill (the so-called "probabilistic codes" - e.g. Favalli et al. 2005). F-L is a new code for the simulation of lava flows, which rests on an approach similar to the one introduced by Glaze and Baloga (2013), and can be ascribed to the "probabilistic family" of lava flow simulation codes. Nevertheless, in contrast with other probabilistic codes (e.g. Favalli et al. 2005), this code explicitly tackles not only the direction of expansion of the growing flow and the area covered, but also the volume of the emplaced lava over time, and hence the supply rate. As a result, this approach bridges the stochastic point of view of a plain probabilistic code with one of the most critical among the input parameters considered by deterministic codes, which is the effusion rate during the course of an eruption. As such, a similar code, in principle, can tackle several aspects which were previously not addressed within the probabilistic approach, which are: (i) the 3D morphology of the flow field (i.e. thickness), (ii) the implications of the effusion rate in the growth of the flow field, and (iii) the evolution of the lava coverage over time
Mozaffari Niapour, S.A.KH.; Danyali, S.; Sharifian, M.B.B.; Feyzi, M.R.
Highlights: → Employing the BLDC motor in water pumping systems. → Utilizing the ZSI as a single-stage power converter in the PV water pumping systems based on BLDC motor. → Improvement of the conventional IC MPPT method with the fuzzy logic control scheme to save more energy from the PV array. → Taking the advantages of the DTC drive of the BLDC motor. → Optimizing the water pumping system speed response characteristic by PSO. - Abstract: This paper discusses operation performance of a water pumping system consist of a brushless dc (BLDC) motor coupled a centrifugal pump and accompanying a Z-source inverter (ZSI) fed by a photovoltaic (PV) array, to be improved. Despite conventional double-stage power converters, this paper proposes utilizing a single-stage ZSI to extract the maximum power of the PV array and supply the BLDC motor simultaneously. Utilizing the ZSI provides some inherent advantages such as high efficiency and low cost, which is very promising for PV systems due to its novel voltage buck/boost capability. In addition, in order to precisely perform the maximum power point tracking (MPPT) of the PV array the fuzzy logic-incremental conductance (FL-IC) MPPT scheme is proposed. The proposed FL-IC MPPT scheme provides enough modification to the conventional IC method to enjoy an appropriate variable step size MPPT control signal for the ZSI. Moreover, direct torque control (DTC) is found more effective in comparison with hysteresis current control with current shaping to drive the BLDC motor, because it benefits from faster torque response, reduced torque ripple, less sensitivity to parameters variations, and simple implementation. In the mean time, due to the frequently variations of the PV power generation; delivered mechanical power to the centrifugal pump is variable. Thus, the BLDC motor should be driven with variable reference speed. In order to improve the speed transient response of the BLDC motor and enhance the energy saving aspect of
«God save us from more revolutions»: the Aranjuez Mutiny and the Dos de Mayo uprising in the light of Count Fernán Núñez’s widow | «Dios nos libre de más revoluciones»: el Motín de Aranjuez y el Dos de Mayo vistos por la condesa viuda de Fernán Núñez
Antonio Calvo Maturana
Full Text Available This essay’s objective is to analyse a direct and unpublished testimony of the two biggest Spanish historical events of 1808: the Mutiny of Aranjuez and Dos de Mayo Uprising. With this purpose we present to the public a collection of letters written by Maria Esclavitud Sarmiento, Countess of Fernan Nuñez, and found in the French National Archives of Paris. In this lady’s correspondence we can appreciate the fears, the hopes and the speculations lived and suffered by the people from Madrid during this period. Thanks to this source we have access to the impressions of an eyewitness (a woman, something even more interesting and unusual who was in constant relation with the current situation, gathering news and rumours, sometimes already obsolete in the next letter because of the frenetic political situation. By her contacts with well-informed people (such as her son, the count of Fernan Nuñez, or members of government like Pedro Cevallos or Eusebio Bardaji, the widow countess offers interesting information about the most important figures and events of this year: Ferdinand VII (his rise to the throne and the preparation for his trip to Bayonne, Napoleon (his arrival to Spain and his recognition, or not, of the new king, Manuel Godoy (his imprisonment and his delivery to French authorities, Charles IV (the renounce of his claim and his posterior regret and Marie Louise of Parme (many rumours related to her dark legend. | El objetivo de este trabajo es ofrecer al lector un testimonio directo e inédito de lo acontecido en Madrid durante los dos grandes hitos históricos españoles de 1808: el Motín de Aranjuez y el Dos de Mayo. Para ello utilizaremos principalmente unas cartas de María Esclavitud Sarmiento, condesa viuda de Fernán Núñez, encontradas en los Archivos Nacionales de París. Esta dama de la alta nobleza reflejó en su correspondencia los miedos, esperanzas y especulaciones que asaltaron a la sociedad madrileña del momento. De
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Alkali-soluble fluoride deposition on enamel after professional application of topical fluoride in vitro Formação de flúor fracamente ligado ao esmalte após a aplicação tópica profissional de flúor in vitro
Mitsue Fujimaki Hayacibara
Full Text Available Since the efficacy of topical fluoride products is related to the fluoride (F availability and its reactivity with enamel, this study was conducted. The F concentration of the following materials was verified: I- acidulated phosphate fluoride (APF gel (1.23% F, II- APF foam (1.23% F and III- Varnish (2.26% F. Forty blocks of bovine enamel were divided into 4 groups and treated according to the materials described, being one of them used as control. Loosely bound fluoride (''CaF2'' was determined on enamel after extraction with 1.0M KOH and analyzed by ion-selective electrode. Total F concentration found in gel was 12,642, in foam 12,755 and in varnish 23,183 mg F/g. All products formed statistically higher amounts of ''CaF2'' on enamel compared to the control group (p 0.05. Thus, ''CaF2'' formation was not proportional to the total F content in the products, suggesting that the pH and the vehicle used are more important.Considerando que a eficácia dos produtos para aplicação tópica profissional de flúor (géis, espumas e vernizes está relacionada com a reatividade do flúor (F com o esmalte e sendo esta dependente da disponibilidade do F em cada produto, este estudo foi conduzido. A concentração de F nos seguintes produtos foi estudada: I - Flúor Fosfato Acidulado (FFA gel (1,23% F, II - FFA espuma (1,23% F e III- Verniz fluoretado (2,26% F. Foram confeccionados 40 blocos de esmalte bovino, tratados de acordo com os grupos descritos, sendo um deles utilizado como controle. O F fracamente ligado (''CaF2'' ao esmalte foi determinado após a extração com 1.0 M KOH e analisado em eletrodo específico. A concentração de F encontrada no gel foi de 12.642, na espuma 12.755 e no verniz 23.183 mg F/g. Todos os produtos formaram uma quantidade significantemente maior de ''CaF2'' na superfície do esmalte, comparado ao grupo controle (p 0,05. Assim, a formação de ''CaF2'' na superfície do esmalte não foi proporcional ao conteúdo de F nos
de Jong, Marin J; Huibregtse, Roxanne; Masclee, Ad A M; Jonkers, Daisy M A E; Pierik, Marie J
Mucosal inflammation must be carefully monitored to improve the long-term outcomes of patients with inflammatory bowel diseases (IBD). Patient-reported outcome measures (PROMs) are used increasingly to monitor disease activity in clinical practice and as endpoints in clinical trials. We performed a systematic review to provide an overview of the available PROMs on IBD activity and to evaluate their diagnostic value. A systematic search of the PubMed, Medline, Cochrane library, and Embase databases using defined keywords, identified 973 articles. These were screened by 2 independent reviewers, and 37 articles on development or validation of PROMs to assess IBD activity were identified for further analysis. Based on the recommendations of the Food and Drug Administration (FDA), the following measurement properties were evaluated: content, construct, and criterion validity; reliability; and responsiveness to change. In addition, data on ease of use in clinical practice were collected. Seventeen articles presenting 20 different PROMs were included the final analysis, although none met all the FDA-recommended criteria. Only 2 PROMs (patient-reported Harvey Bradshaw Index and Simple Clinical Colitis Activity Index scores) reported patient involvement during its development. Only 6 PROMs (patient-reported global assessment, patient assessment of disease activity, mobile health index for Crohn's disease, mobile health index for ulcerative colitis, patient-reported outcome derived from the Mayo score, and the 6-point Mayo score) were validated as markers of IBD activity, using findings from endoscopy as the reference standard; these PROMs identified patients with mucosal inflammation with area under the curve values of 0.63-0.82. The mobile health index for CD and UC scores had the best measurement properties for use in clinical practice and in clinical trials. In a systematic review, we identified more than 20 PROMS that have been developed and tested for their ability to
Faut-il attendre 100 ans pour vivre l'égalité pleine et entière entre les femmes et les hommes ? L'égalité femmes - hommes est un sujet Humain, d'hier, d'aujourd'hui et de demain. Les inégalités persistent, des solutions existent ! Quel que soit votre sexe, votre âge, votre statut, votre métier, votre culture... vous pouvez devenir acteur de ce changement. Valérie Pascal et Catherine Sexton vous invitent à : Réfléchir autrement sur les enjeux de l'égalité femmes - hommes. Ce livre vous donne un panorama sur l'évolution des droits des femmes et des lois en matière d'égalité. Il vous fait découvrir les multiples visions sur le genre, principalement sociales et scientifiques, et apporte des clés pour agir sur les stéréotypes inconscients, facteurs de sexisme. Agir pleinement : quatre leviers peuvent être activés simultanément : Les solutions légales et citoyennes. La gouvernance et la culture d'entreprise. Le développement de l'intelligence individuelle. Le renforcement de l'intellige...
Chan, G.L.Y.; Hewitt, K.A.; Pate, B.D.; Schofield, P.; Adam, M.J.; Ruth, T.J.
A batch-contact alumina-extraction method has been used to separate [ 18 F]-L-6-fluorodopa (FD) from its principal metabolite, 3-O-methyl-[ 18 F]-6 fluorodopa (3-OMe-FD), in arterial blood plasma samples collected from subjects pretreated with carbidopa during positron emission tomography (PET) scans. The time course of the metabolite-corrected blood plasma activity is then used as an input function for kinetic analysis of striatal FD uptake. Results obtained from using the batch-contact alumina-extraction method were compared with those from high performance liquid chromatography, and also with those from a chromatographic alumina cartridge technique. In 60 human subjects including normal healthy volunteers and patients diagnoses as having a movement disorder, arterial blood plasma samples were collected after FD injection during a two-hour PET scan and analyzed by the batch-contact alumina-extraction method. The activity ratio (metabolites/FD) increased linearly with time for all subjects. However, there was a wide variation in the slope of the plot of the activity ratio versus time among the subjects. No significant linear or curved relationship was observed between the slope and the age of the subject. Separation of FD from its metabolites is therefore, necessary for each PET-FD study conducted
Mc Hugh, N
We describe the case of a 20-year-old rower presenting with an uncommon condition of Proliferative Myositis (PM) affecting the Latissimus Dorsi (LD). PM is a rare, benign tumour infrequently developing in the upper back. Its rapid growth and firm consistency may mistake it for sarcoma at presentation. Therefore, careful multidisciplinary work-up is crucial, and should involve appropriate radiological and histopathological investigations. Here, we propose the aetiology of LD PM to be persistent myotrauma induced by repetitive rowing motions. Symptoms and rate of progression ultimately determine the management which includes surveillance and\\/or conservative resection. There have been no documented cases of recurrence or malignant transformation.
Arrhythmogenic Right Ventricular Cardiomyopathy; Cardiomyopathies; Heart Diseases; Cardiovascular Diseases; Sudden Cardiac Arrest; Sudden Cardiac Death; Arrhythmogenic Right Ventricular Dysplasia; Arrhythmogenic Ventricular Cardiomyopathy; Familial Dilated Cardiomyopathy; Cardiovascular Abnormalities
Agustín Rodríguez Garavito
Full Text Available En el documento se presentan las reseñas de los siguientes títulos: -Cayetano Betancur. Manual del ciudadano. Brevarios Colombianos. Ediciones del Banco de la República. -Alberto Duarte French. Guía practica del derecho de familia. Editorial Temis. Librería. 1978. -Abel Naranjo Villegas. Generaciones colombianas. Brevarios Colombianos. Ediciones Banco de la República. Artes Gráficas Centro Don Bosco. -Flor Alba Uribe Marin. Historia de la pequeña Nubia y su Mercenaria virginidad. Ediciones Tercer mundo. Bogotá, Colombia. -Abelardo Forero Benavides. El siglo XIX. Galería de sombras. Nariño, Bolívar, Santander, Obando, Mosquera, Nuñez. Fundación Centenario del Banco de Colombia. 1978. Impreso por Litoformas de Colombia. -Luis Duque Gómez. Introducción al pasado aborigen. Brevarios Colombianos. Banco de la República. Talleres Editorial Retina. Bogotá. Colombia. -Dibujos de Sergio Trujillo Magnenat. Texto de Germán Rubiano Caballero. Biblioteca Fundación Centenario del Banco de Colombia. -Mauro Torres. Tensión en la Unidad familiar. Padres e hijos. Edición Tercer Mundo. Bogotá, Colombia. -Ciro Medina. Antología. Editado por el Banco de América Latina. Impreso por Publicaciones Cultural Ltda. Bogotá, Colombia.
Agustín Rodríguez Garavito
Full Text Available -DIARIO. Por Hernando Téllez. -DIAS DE BELLO EN CARACAS. Por Héctor Parra Márquez- Italigráfica. Caracas. -CON LOS POBRES DE AMÉRICA. Pensamiento político de Tomic, Montoro, Cornejo, Caldera y Frei. -ACTUALIDADES "ECOPETROL". Publicaciones de Relaciones de ECOPETROL. -REMINISCENCIAS DE SANTAFE Y BOGOTÄ. Por José María Cordovez Moure, Biblioteca Shering. Bogotá. Colombia. -EL ESTADO FUERTE. Por Alfonso López Michelsen, Ediciones Populibro. -LA EDUCACIÓN EN COLOMBIA. Por Alejandro Bernal Escobar, Andrés Benoit, Bertha Corredor e Isaac Wust. Oficina Internacional de Investigaciones Sociales de FERE-Lovaina-Bélgica. -LA PICUA SE VA. Por Lucy Barco de Valderrama. Ediciones Lerner.
Agustín Rodríguez Garavito
Full Text Available El documento presenta las reseñas de los siguientes títutlos: Huellas -Por Luis Ernesto Puyana. Bucaramanga, Colombia. Panorama del Folklore Venezolano. Biblioteca de Cultura Universitaria - Caracas. Vitral de Bruma. Helvia de Bodmer. Editorial Antares. Bogotá. Una introducción al arte. F. Gil Tovar. La Mala Hora. Gabriel García Márquez. Premio Literario ESSO. 1961. Camus el Justo. C. Hourdin. Editorial Estela. Barcelona, España. Don Antonio Nariño. Fernando Galvis Salazar. -Drama en once cuadros. Bogotá, Colombia.
The Seminole Serpent Warrior At Miramar, FL, Shows Settlement Locations Enabled Environmental Monitoring Reminiscent Of the Four-corners Kokopelli-like EMF Phenomena, and Related to Earthquakes, Tornados and Hurricanes.
Balam Matagamon, Chan; Pawa Matagamon, Sagamo
Certain Native Americans of the past seem to have correctly deduced that significant survival information for their tradition-respecting cultures resided in EMF-based phenomena that they were monitoring. This is based upon their myths and the place or cult-hero names they bequeathed us. The sites we have located in FL have been detectable by us visually, usually by faint blue light, or by the elicitation of pin-like prickings, by somewhat intense nervous-system response, by EMF interactions with aural electrochemical systems that can elicit tinitus, and other ways. In the northeast, Cautantowit served as a harbinger of Indian summer, and appears to be another alter ego of the EMF. The Miami, FL Tequesta site along the river clearly correlates with tornado, earthquake and hurricane locations. Sites like the Mohave Deserts giant man may have had similar significance.
Renato Massaharu Hassunuma
A fluorose dentária resulta da toxicidade do flúor durante a odontogênese. Vários modelos experimentais têm sido utilizados para tentar explicar a patogênese do flúor no esmalte, mas durante o período fetal e pós-natal inicial, pouco se conhece a respeito da sua ação. Por isso, no atual trabalho, foram utilizadas ratas que receberam 0, 7 ou 100ppm de fluoreto de sódio na água de beber, no período a partir de uma semana antes do acasalamento, durante toda gestação e durante o aleitamento. As h...
Leyda Menéndez, Ana María
El objetivo de este estudio es evaluar la capacidad de remineralización de lesiones incipientes de caries presentes en dientes permanentes de niños con edades comprendidas entre los 6 y los 15 años mediante una crema a base de complejos de fosfopéptidos de la caseína y calciofosfato amorfos, una crema a base de complejos de fosfopéptidos de la caseína y calciofosfato amorfos más flúor, barniz de flúor y barniz de clorhexidina, utilizando como métodos diagnósticos, un láser de fluorescencia (D...
Knoop hardness of enamel and shear bond strength of brackets bonded with composite resin with and without fluoride Dureza Knoop do esmalte e resistência ao cisalhamento de braquetes colados com resina composta com e sem flúor
Silvia Amélia Scudeler Vedovello
Full Text Available OBJECTIVE: The aim of this study was to evaluate the Knoop hardness of enamel, shear bond strength and failure pattern (adhesive, bracket/resin interface or mixed after bonding and debonding brackets, using resin composite with fluoride (Ortho Lite Cure, Ortho Source® and without fluoride (Orthobond, Morelli®. METHODS: Fragments (6 mm x 6 mm of 40 bovine incisor crowns were embedded in acrylic self-polymerizing resin. The Knoop hardness measurements were performed before and after bonding metal brackets. The specimens were divided into two groups, according to composite resin: with fluoride (Ortho Lite Cure, Ortho Source® and without fluoride (Orthobond, Morelli®. After bonding, the specimens were submitted to demineralization and remineralization cycling for 14 days. Shear bond strength testing was performed in a universal test machine (EMIC, at 5 mm/min crosshead speed. RESULTS: There was no significant difference in shear bond strength between Groups I and II. After demineralization and remineralization procedures (DE/RE, the specimens bonded with Ortho Lite Cure showed higher Knoop hardness than Orthobond. For both groups there was predominance of failure at bracket/resin interface. CONCLUSION: specimens bonded with fluoride resin composite showed higher microhardness after DE/RE cycling than those bonded with resin composite without fluoride, although no difference in shear bond strength was found.OBJETIVO: o propósito deste estudo foi avaliar a dureza Knoop do esmalte, resistência ao cisalhamento e padrão de falha (adesiva; interface braquete/resina; e mista após a colagem e descolagem de braquetes, utilizando uma resina composta com flúor (Ortho Lite Cure, Ortho Source® e uma sem flúor (Orthobond, Morelli®. MÉTODOS: fragmentos (6mm x 6mm de 40 coroas de incisivos bovinos foram embutidos em resina acrílica autopolimerizável. A dureza Knoop foi avaliada antes e após a colagem dos braquetes metálicos. Os corpos de prova
Efetividade de uma técnica educativa na aquisição de conhecimentos por pais sobre uso racional do flúor = Effectiveness of an educative techinique on knowledge acquisition on ratinal use of fluorine by parents
Martins, Carolina de Castro
Full Text Available O objetivo do presente estudo foi testar o conhecimento sobre uso racional de flúor adquirido através de grupo de discussão (GD. Um grupo de 47 pais de crianças pré-escolares constituiu a amostra após a assinatura de um termo de consentimento livre e esclarecido. Este estudo foi aprovado por um Comitê de ética em Pesquisa. Para averiguação do nível de conhecimento inicial sobre o tema proposto, os participantes responderam a um questionário com 14 perguntas abertas e fechadas. Seis meses após esta etapa, foi realizado um GD sobre o uso racional de flúor. O GD proposto abordou a metodologia pedagógica problematizadora e contou com a participação ativa dos pais e de três cirurgiões dentistas. Neste momento foram apresentadas afirmações sobre a utilização do flúor pela população, a partir das quais a discussão era deflagrada. Alguns dias após, os pais responderam novamente o questionário inicial. Os dados foram submetidos aos testes estatístico Qui-quadrado e exato de Fisher através do programa SPSS. Houve diferença estatisticamente significante entre praticamente todas as respostas no primeiro e segundo questionários (p < 0,005, sendo que no segundo, houve um maior número de respostas corretas. A técnica educativa avaliada mostrou-se efetiva na incorporação de novos conhecimentos sobre o uso racional de flúor pelos pais, evidenciando a eficácia da metodologia empregada
Full Text Available O objetivo deste estudo foi analisar in situ a efetividade de um dentifrício contendo monofluorfosfato (MFP e sistema abrasivo fosfodicálcio diidratado (DCPD, quando comparado com dentifrício placebo. O estudo foi do tipo cross-over com oito voluntários em duas etapas de 45 dias. Os voluntários utilizaram dispositivo intra-oral palatino de resina acrílica contendo 4 blocos de esmalte com lesão de cárie artificial. Após cada etapa, foi analisada a incorporação de flúor (flúor total em ppm F e microdureza (em Knoop dos blocos de esmalte dental. Os resultados obtidos (média ± E.P. das áreas integradas sob as curvas demonstraram que a concentração de flúor incorporado no esmalte tratado com dentifrício MFP/DCPD foi significativamente maior que no placebo (4.508,55 ± 965,82 e 1.485,51 ± 191,72, respectivamente e os dados de microdureza demonstraram que o dentifrício MFP/DCPD foi capaz de remineralizar o esmalte dental em 34%, enquanto no placebo observou-se perda de 14% de mineral. Assim, os dados obtidos deste estudo demonstraram que o dentifrício MFP/DCPD foi efetivo não apenas na incorporação de flúor no esmalte, mas também na capacidade de remineralizar a lesão de cárie, quando comparado com o placebo.
Pardanani, A; Guglielmelli, P; Lasho, T L; Pancrazzi, A; Finke, C M; Vannucchi, A M; Tefferi, A
MPL and JAK2V617F mutation analysis was performed in 603 patients with primary myelofibrosis (PMF) seen at the Mayo Clinic, USA (n=329) or University of Florence, Italy (n=274). Mutant MPL was detected in 49 (8.1%) patients and JAK2V617F in 350 (58%); 4 patients showed both mutations. MPLW515L/K was the commonest mutation; 2 patients showed novel mutations (L513ins and Q516-P518insAAAA). The US and Italy patient cohorts were separately analyzed for comparison of survival and clinical features between MPL-mutated, JAK2-mutated and JAK2/MPL-unmutated cases. JAK2/MPL-unmutated patients were significantly younger than their JAK2-mutated counterparts, in both patient cohorts (PMPL was associated with older age (PMPL has narrow and inconsistent phenotypic effect in PMF and does not influence overall or leukemia-free survival.
Zhu, Yezi; Sharp, Adam; Anderson, Courtney M; Silberstein, John L; Taylor, Maritza; Lu, Changxue; Zhao, Pei; De Marzo, Angelo M; Antonarakis, Emmanuel S; Wang, Mindy; Wu, Xingyong; Luo, Yuling; Su, Nan; Nava Rodrigues, Daniel; Figueiredo, Ines; Welti, Jonathan; Park, Emily; Ma, Xiao-Jun; Coleman, Ilsa; Morrissey, Colm; Plymate, Stephen R; Nelson, Peter S; de Bono, Johann S; Luo, Jun
Androgen receptor splice variant 7 (AR-V7) has been implicated in resistance to abiraterone and enzalutamide treatment in men with metastatic castration-resistant prostate cancer (mCRPC). Tissue- or cell-based in situ detection of AR-V7, however, has been limited by lack of specificity. To address current limitations in precision measurement of AR-V7 by developing a novel junction-specific AR-V7 RNA in situ hybridization (RISH) assay compatible with automated quantification. We designed a RISH method to visualize single splice junctions in cells and tissue. Using the validated assay for junction-specific detection of the full-length AR (AR-FL) and AR-V7, we generated quantitative data, blinded to clinical data, for 63 prostate tumor biopsies. We evaluated clinical correlates of AR-FL/AR-V7 measurements, including association with prostate-specific antigen progression-free survival (PSA-PFS) and clinical and radiographic progression-free survival (PFS), in a subset of patients starting treatment with abiraterone or enzalutamide following biopsy. Quantitative AR-FL/AR-V7 data were generated from 56 of the 63 (88.9%) biopsy specimens examined, of which 44 were mCRPC biopsies. Positive AR-V7 signals were detected in 34.1% (15/44) mCRPC specimens, all of which also co-expressed AR-FL. The median AR-V7/AR-FL ratio was 11.9% (range 2.7-30.3%). Positive detection of AR-V7 was correlated with indicators of high disease burden at baseline. Among the 25 CRPC biopsies collected before treatment with abiraterone or enzalutamide, positive AR-V7 detection, but not higher AR-FL, was significantly associated with shorter PSA-PFS (hazard ratio 2.789, 95% confidence interval 1.12-6.95; p=0.0081). We report for the first time a RISH method for highly specific and quantifiable detection of splice junctions, allowing further characterization of AR-V7 and its clinical significance. Higher AR-V7 levels detected and quantified using a novel method were associated with poorer response to
Comment on “The role of interbasin groundwater transfers in geologically complex terranes, demonstrated by the Great Basin in the western United States”: report published in Hydrogeology Journal (2014) 22:807–828, by Stephen T. Nelson and Alan L. Mayo
Masbruch, Melissa D.; Brooks, Lynette E.; Heilweil, Victor M.; Sweetkind, Donald S.
The subject article (Nelson and Mayo 2014) presents an overview of previous reports of interbasin flow in the Great Basin of the western United States. This Comment is presented by authors of a cited study (comprising chapters in one large report) on the Great Basin carbonate and alluvial aquifer system (GBCAAS; Heilweil and Brooks 2011; Masbruch et al. 2011; Sweetkind et al. 2011a, b), who agree that water budget imbalances alone are not enough to accurately quantify interbasin flow; however, it is proposed that statements made in the subject article about the GBCAAS report are inaccurate. The Comment authors appreciate the opportunity to clarify some statements made about the work.
Relación del sentimiento de soledad y el estado de salud de los adultos mayores que acuden al Centro Médico Tierra Nueva, mediante la aplicación del cuestionario Sf 36 y escala este , periodo febrero-mayo del 2015”.
Cantuña Tapuyo, Cristina De Los Ángeles
Antecedentes: Estudios revelan correlación de la soledad en el deterioro de salud. La presente investigación, tiene como objetivo general, analizar la relación del sentimiento de soledad y el estado de salud de los adultos mayores que acuden al Centro Médico Tierra Nueva, en los meses de Febrero a Mayo del 2015. Metodología: Es un estudio de tipo transversal analítico. Se estudió 165 adultos mayores, con la aplicación de la escala ESTE y cuestionario SF 36. Para el análisis de los datos se...
Seguimiento domiciliario a la madre adolescente y su recién nacido durante el puerperio. Hospital de Engativá ESE II nivel. Marzo – Mayo de 2009 / Household monitoring to the teen mother and her newborn during the postpartum period. Engativá hospital E.S.E II level March - May 2009
Rocha Velásquez , Vivian Gisell; Puentes López, Miguel Antonio
El trabajo: “SEGUIMIENTO DOMICILIARIO A LA MADRE ADOLESCENTE Y SU RECIÉN NACIDO DURANTE EL PUERPERIO. HOSPITAL DE ENGATIVÁ ESE II NIVEL. MARZO – MAYO DE 2009”, es una estrategia del cuidado de enfermería, para identificar y evaluar riesgos y signos de alarma permitiendo planear y ejecutar intervenciones en el hogar apoyando a madres adolescentes en la recuperación de su salud, el aprendizaje en la crianza de sus hijos con el apoyo de la familia, identificando los riesgos tempranamente que pue...
Co-operation Agreement. The Text of the Agreement of 25 May 1998 between the International Atomic Energy Agency and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials; Acuerdo de Cooperacion. Texto del Acuerdo de 25 de Mayo de 1998 entre el Organismo Internacional de Energia Atomica y la Agencia Brasileno-Argentina de Contabilidad y Control de Materiales Nucleares
The text of the Co-operation Agreement between the International Atomic Energy Agency and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials is reproduced herein for the information of all Members. The Agreement entered into force on 25 May 1998, pursuant to Article 8 [Spanish] El texto del Acuerdo de Cooperacion entre el Organismo Internacional de Energia Atomica y la Agencia Brasileno-Argentina de Contabilidad y Control de Materiales Nucleares se reproduce en el presente documento para informacion de todos los Miembros. El Acuerdo entro en vigor el 25 de mayo de 1998 en conformidad con lo dispuesto en el articulo 8.
Full Text Available Background. Previous studies have shown that Parkinson’s disease (PD patients who have REM behavior disorder (PD with RBD might be a PD subtype since they have different symptom clusters and disease trajectories from PD without RBD. Objective. To study the prevalence of PD with pRBD and to compare the clinical characteristics with PD without pRBD. The feasibility of clinical interview of items adopted from the Mayo Sleep Questionnaire was also to be determined. Methods. A total of 140 Parkinson's patients visiting neurological clinics during January to December 2016 were enrolled in this study. “Probable RBD (pRBD” was defined as present when the patient answered “yes” to a question adapted from the first Mayo Sleep Questionnaire (MSQ. The demographic data, motor symptoms, and nonmotor symptoms were obtained. Results. The prevalence of pRBD among this study’s PD patients was 48.5% (68 out of the total of 140. The median onset of RBD before PD diagnosis was 5 years (range: 0–11 years. By comparison of PD with pRBD and PD without pRBD, this study showed significant difference in the levodopa equivalent dose (742 mg/day versus 566 mg/day; p<0.01, prevalence of symptomatic orthostatic hypotension (35.3% versus 8.3%; p<0.01. The multivariable analysis found that pRBD is independently associated with orthostatic hypotension (OR = 5.02, p<0.01. Conclusion. The findings regarding prevalence and main clinical features of PD with pRBD in this study were similar to those of a previous study of PD with polysomnogram- (PSG- proven RBD. This study hypothesized that interviewing by adopted MSQ may be a cost-effective tool for screening RBD. Further studies with direct comparison are needed.
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M. A. Kartashov
Full Text Available Propionic acid bacteria, including Propionibacterium acidipropionici, are widely used in the chemical industry to produce propionic acid and also for food and feed preservation. However, the efficiency of the industrial production of these bacteria is limited by their sensitivity to high concentrations of propionic acid excreted into the cultivation medium. Therefore, the development of new biotechnological processes and strains able to overcome this limitation and to improve the profitability of the microbiological production remains a relevant problem. A new P. acidipropionici FL-48 strain characterized by an increased resistance to 10 g/L of propionic acid (the number of viable cells after 24-h cultivation reached 1.05 × 106 was developed by a two-step induced mutagenesis using UV and diethyl sulphate from the P. acidipropionici VKPM B-5723 strain. The mutant strain exceeded the parental strain in the biomass accumulation rate and the amount of produced propionic and acetic acids by 35%, 20%, and 16%, respectively. The stability of such important characteristics as the biomass accumulation rate and the viability on media containing heightened concentrations of propionic acid was confirmed by three sequential monoclonal subculturings on a medium supplemented with 10 g/L of propionic acid. The optimization of the cultivation technology made it possible to determine the optimum seed inoculum dose (10% of the fermentation medium volume and the best pH level for the active growth stage (6.1 ± 0.1. The scaling up of the fermentation to a 100-L bioreactor under observance of optimum cultivation conditions demonstrated a high biomass growth rate with a sufficient reproducability; after 20 h of fermentation, the number of viable cells in the culture broth exceeded 1 × 1010 CFU/mL. The new strain could be interesting as the component of silage and haylage biopreservatives and also could be used as an efficient producer of propionic acid.
Full Text Available There is a substantial literature that critiques the role that international aid plays in lending support to oppressive and contested regimes. But few investigators have asked the inverse question: what happens when aid is withdrawn? Following government oppression in 1988, international aid to Burma decreased significantly, providing a case study enabling this question to be addressed. Using Burma as an example, this article asks: if the presence of aid has been shown to support oppressive and contested regimes, what is the impact when aid is withdrawn? The article reviews critiques of development and humanitarian aid and identifies three specific regime-reinforcing phenomena. It demonstrates that these have not diminished following the overall decrease of aid to Burma. The paper then addresses the related relationship between aid flows and refugee flows, and concludes with implications of the research. Es gibt mittlerweile eine ganze Reihe von Literatur, in der die Rolle von internationaler Hilfe zur Unterstützung von Unrechtsregimen kritisch diskutiert wird. Es gibt bislang aber nur wenige Untersuchungen, in denen die Frage anders herum gestellt wird. Was passiert, wenn Hilfsgelder zurückgehalten werden? Seit der Unterdrückung im Jahr 1988 ist die internationale Hilfe an Burma/ Myanmar deutlich zurückgegangen. Dieser Artikel fragt für das Fallbeispiel Burma: Welche Wirkungen hat es, wenn Hilfsgelder zurückgehalten werden? Der Artikel beleuchtet die Debatten zur humanitären Hilfe und Entwicklung und identifiziert drei besondere Regime stützende Effekte. Der Artikel zeigt, dass diese im Fall Burma nicht eingetreten sind, als Hilfe zurückgezogen wurde. Der Artikel diskutiert außerdem die Beziehung zwischen Hilfsgeldern und Flüchtlingsströmen und versucht, Folgerungen aus der Forschung zu entwickeln.
Introduction Previous observations implicate Indian hedgehog (Ihh) signaling in osteoarthritis (OA) development because it regulates chondrocyte hypertrophy and matrix metallopeptidase 13 (MMP-13) expression. However, there is no direct genetic evidence for the role of Ihh in OA, because mice with cartilage or other tissue-specific deletion of the Ihh gene die shortly after birth. We evaluated the role of Ihh in vivo via a Cre-loxP-mediated approach to circumvent the early death caused by Ihh deficiency. Methods To evaluate the role of Ihh in OA development, Ihh was specifically deleted in murine cartilage using an Ihh conditional deletion construct (Col2a1-CreERT2; Ihhfl/fl). The extent of cartilage degradation and OA progression after Ihh deletion was assessed by histological analysis, immunohistochemistry, real-time PCR and in vivo fluorescence molecular tomography (FMT) 2 months after OA was induced by partial medial meniscectomy. The effect of Ihh signaling on cartilage was compared between Ihh-deleted mice and their control littermates. Results Only mild OA changes were observed in Ihh-deleted mice, while control mice displayed significantly more cartilage damage. Typical OA markers such as type X collagen and MMP-13 were decreased in Ihh-deleted mice. In vivo FMT demonstrated decreased cathepsins and MMP activity in knee joints of animals with deletion of Ihh. Conclusions These findings support the protective role of Ihh deletion in surgically induced OA. Thus, our findings suggest the potential to develop new therapeutic strategies that can prevent and treat OA by inhibiting Ihh signaling in chondrocytes. PMID:24428864
Tucker, Valerie C; Kirkham, Amanda J; Hopwood, Andrew J
We describe the forensic validation of Promega's PowerPlex® European Standard Investigator 16 (ESI 16) multiplex kit and compare results generated with the AmpFlSTR® SGM Plus® (SGM+) multiplex. ESI 16 combines the loci contained within the SGM+ multiplex with five additional loci: D2S441, D10S1248, D22S1045, D1S1656, and D12S391. A relative reduction in amplicon size of the SGM+ loci facilitates an increased robustness and amplification success of these amplicons with degraded DNA samples. Tests performed herein supplement ESI 16 data published previously with sensitivity, profile quality, mock casework, inhibitor and mixture study data collected in our laboratories in alignment with our internal technical and quality guidelines and those issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), the DNA Advisory Board (DAB) and the DNA working group (DNAWG) of the European Network of Forensic Science Institutes (ENFSI). Full profiles were routinely generated from a fully heterozygous single source DNA template using 62.5 pg for ESI 16 and 500 pg for SGM+. This increase in sensitivity has a consequent effect on mixture analyses and the detection of minor mixture components. The improved PCR chemistry confers enhanced tolerance to high levels of laboratory prepared inhibitors compared with SGM+ results. In summary, our results demonstrate that the ESI 16 multiplex kit is more robust and sensitive compared with SGM+ and will be a suitable replacement system for the analysis of forensic DNA samples providing compliance with the European standard set of STR loci.
Full Text Available Con su énfasis en la contaminación entre las disciplinas, así como en el papel que otorgan a la integración de los sentidos humanos en la percepción del espacio, las investigaciones contemporáneas sobre las “atmósferas” habitadas tienen un antecedente apenas señalado por la historiografía: la arquitectura fin-de-siècle. En la Francia de finales del siglo XIX la sinestesia se convierte en un tema de moda que, procedente de la recién fundada estética psicológica, pronto desbordará sus primitivos límites para alcanzar la arquitectura; en Alemania, por su parte, la noción romántica de la Gesamtkunstwerk encontrará en el teatro de Wagner un nuevo campo donde las artes colaborarán para producir sorprendes ambientes oníricos. En paralelo, la percepción sinestésica se transformará en el leitmotiv de las instalaciones concebidas para el disfrute multisensorial de los miembros de una incipiente cultura de masas, y dará pie a arquitecturas tan lúdicas como técnicamente sofisticadas: las construcciones para ferias internacionales. Los ambientes sinestésicos para flâneurs, wagnerianos y hombres-masa serán, así, el germen de los pabellones electroacústicos de Le Corbusier, Iannis Xenakis o Charles y Ray Eames, y de las experiencias de integración ambiental entre las artes propias de Jean Labatut, Charles Moore y, en general, buena parte de las vanguardias de las décadas de 1950 y 1960.
Kinetic and Structural Characterization of a Heterohexamer 4-Oxalocrotonate Tautomerase from Chloroflexus aurantiacus J-10-fl: Implications for Functional and Structural Diversity in the Tautomerase Superfamily
Burks, Elizabeth A.; Fleming, Christopher D.; Mesecar, Andrew D.; Whitman, Christian P.; Pegan, Scott D.
4-Oxalocrotonate tautomerase (4-OT) isozymes play prominent roles in the bacterial utilization of aromatic hydrocarbons as sole carbon sources. These enzymes catalyze the conversion of 2-hydroxy-2,4-hexadienedioate (or 2-hydroxymuconate) to 2-oxo-3-hexenedioate, where Pro-1 functions as a general base and shuttles a proton from the 2-hydroxyl group of the substrate to the C-5 position of the product. 4-OT, a homohexamer from Pseudomonas putida mt-2, is the most extensively studied 4-OT isozyme and the founding member of the tautomerase superfamily. A search of five thermophilic bacterial genomes identified a coded amino acid sequence in each that had been annotated as a tautomerase-like protein but lacked Pro-1. However, a nearby sequence has Pro-1, but the sequence is not annotated as a tautomerase-like protein. To characterize this group of proteins, two genes from Chloroflexus aurantiacus J-10-fl were cloned, and the corresponding proteins were expressed. Kinetic, biochemical, and X-ray structural analyses show that the two expressed proteins form a functional heterohexamer 4-OT (hh4-OT), composed of three αβ dimers. Like the P. putida enzyme, hh4-OT requires the amino-terminal proline and two arginines for the conversion of 2-hydroxymuconate to the product, implicating an analogous mechanism. In contrast to 4-OT, hh4-OT does not exhibit the low-level activity of another tautomerase superfamily member, the heterohexamer trans-3-chloroacrylic acid dehalogenase (CaaD). Characterization of hh4-OT enables functional assignment of the related enzymes, highlights the diverse ways the β-α-β building block can be assembled into an active enzyme, and provides further insight into the molecular basis of the low-level CaaD activity in 4-OT.
Naustvoll, L-J; Gustad, E; Dahl, E
The accumulation of phycotoxins in bivalve mussels associated with mussels feeding on toxic phytoplankton is a well-known phenomenon in Norway. Regular monitoring for 25 years has revealed that accumulation of Diarrhetic Shellfish poisoning (DSP) toxins in mussels is the main phycotoxin problem along the Norwegian coast. The aim of this study was to evaluate possible trends over time of Dinophysis spp. and DSP as well as possible correlation between abundance of Dinophysis spp. and toxin accumulation in mussels, as based on intensive and regular monitoring at the southern coast of Norway at Flødevigen Bay. The main source organism causing a risk of DSP in Norway is Dinophysis acuta. However, it cannot be excluded that other Dinophysis spp., e.g. D. acuminata and D. norvegica, may contribute to the total accumulation of toxins. The variability in the occurrence of these species is high at both short- and long-term; between days and between years. There are, however, some important overall patterns in the occurrence of the species during the last decades. Dinophysis acuminata and D. norvegica have mainly been abundant from March to December, whereas D. acuta has typically occurred in late summer and autumn (August-December). For all three species we have observed a narrowing of the peak season since 2002 at the same time as they have become less abundant. Coincident with these changes, the problem of the accumulation of DSP toxins in mussels along the southern coast of Norway has declined significantly, but it is still mainly restricted to the autumn. Why the cell concentration of Dinophysis spp. has declined after 2002 is not obvious, but this has occurred in a period with relatively high summer temperatures. The relatively simultaneous changes in physical, chemical and biological factors of the pelagic ecosystem along the southern coast of Norway indicate that complicated ecological interactions may be involved.
Bartlett, Thomas E.; Jones, Allison; Goode, Ellen L.; Fridley, Brooke L.; Cunningham, Julie M.; Berns, Els M. J. J.; Wik, Elisabeth; Salvesen, Helga B.; Davidson, Ben; Trope, Claes G.; Lambrechts, Sandrina; Vergote, Ignace; Widschwendter, Martin
We introduce a novel per-gene measure of intra-gene DNA methylation variability (IGV) based on the Illumina Infinium HumanMethylation450 platform, which is prognostic independently of well-known predictors of clinical outcome. Using IGV, we derive a robust gene-panel prognostic signature for ovarian cancer (OC, n = 221), which validates in two independent data sets from Mayo Clinic (n = 198) and TCGA (n = 358), with significance of p = 0.004 in both sets. The OC prognostic signature gene-panel is comprised of four gene groups, which represent distinct biological processes. We show the IGV measurements of these gene groups are most likely a reflection of a mixture of intra-tumour heterogeneity and transcription factor (TF) binding/activity. IGV can be used to predict clinical outcome in patients individually, providing a surrogate read-out of hard-to-measure disease processes. PMID:26629914
Full Text Available ... resources to the strategies and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, you may get tests or treatments in a hospital, clinic, or doctor's office. In some ways, taking part in a clinical trial is different ...
Full Text Available ... need to travel or stay in hospitals to take part in clinical trials. For example, the National Institutes of Health Clinical Center in ... Maryland, runs clinical trials. Many other clinical trials take place in medical centers and ... trial can have many benefits. For example, you may gain access to new treatments before ...
Full Text Available ... Health Topics / About Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, ... tool for advancing medical knowledge and patient care. Clinical research is done only if doctors don't know ...
Full Text Available ... about your health or fill out forms about how you feel. Some people will need to travel or stay in hospitals to take part in clinical trials. For example, the National Institutes of Health Clinical Center in Bethesda, Maryland, runs clinical trials. Many other clinical trials take place ...
Full Text Available ... of clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a key ... Enterprise NHLBI has a strong tradition of supporting clinical trials that have not only shaped medical practice around the world, but have improved the health ...
Full Text Available ... child to enroll. Also, children aged 7 and older often must agree (assent) to take part in clinical trials. Clinical trials for children have the same scientific safeguards as clinical trials for adults. For more information, go to "How Do Clinical ...
Full Text Available ... part in a clinical trial is your decision. Talk with your doctor about all of your treatment options. Together, you can make the ... more about, or taking part in, clinical trials, talk with your doctor. He or she may know about ... clinical trials. NIH Clinical Research Studies ...
Federal Emergency Management Agency, Department of Homeland Security — Survey data includes spatial datasets and data tables necessary to digitally represent data collected in the survey phase of the study. (Source: FEMA Guidelines and...
Federal Emergency Management Agency, Department of Homeland Security — Terrain data, as defined in FEMA Guidelines and Specifications, Appendix N: Data Capture Standards, describes the digital topographic data that was used to create...
Federal Emergency Management Agency, Department of Homeland Security — Terrain data, as defined in FEMA Guidelines and Specifications, Appendix N: Data Capture Standards, describes the digital topographic data that was used to create...
Federal Emergency Management Agency, Department of Homeland Security — Terrain data, as defined in FEMA Guidelines and Specifications, Appendix N: Data Capture Standards, describes the digital topographic data that was used to create...
Federal Emergency Management Agency, Department of Homeland Security — Hydrology data include spatial datasets and data tables necessary for documenting the hydrologic procedures for estimating flood discharges for a flood insurance...
Federal Emergency Management Agency, Department of Homeland Security — Survey data includes spatial datasets and data tables necessary to digitally represent data collected in the survey phase of the study. (Source: FEMA Guidelines and...
Federal Emergency Management Agency, Department of Homeland Security — FEMA Framework Basemap datasets comprise six of the seven FGDC themes of geospatial data that are used by most GIS applications (Note: the seventh framework theme,...
Federal Emergency Management Agency, Department of Homeland Security — FEMA Framework Basemap datasets comprise six of the seven FGDC themes of geospatial data that are used by most GIS applications (Note: the seventh framework theme,...
Federal Emergency Management Agency, Department of Homeland Security — FEMA Framework Basemap datasets comprise six of the seven FGDC themes of geospatial data that are used by most GIS applications (Note: the seventh framework theme,...
Federal Emergency Management Agency, Department of Homeland Security — Survey data includes spatial datasets and data tables necessary to digitally represent data collected in the survey phase of the study. (Source: FEMA Guidelines and...
National Oceanic and Atmospheric Administration, Department of Commerce — Juvenile spotted seatrout and other sportfish are being monitored annually over a 6-mo period in Florida Bay to assess their abundance over time relative to...
Federal Emergency Management Agency, Department of Homeland Security — The 8-bit 3-Band (Red, Green, Blue) one-foot orthophotos were flown with a Z/I Intergraph DMC airborne digital sensor. The flight season was from December 15, 2008...
Full Text Available Abstract Background Identification of negation in electronic health records is essential if we are to understand the computable meaning of the records: Our objective is to compare the accuracy of an automated mechanism for assignment of Negation to clinical concepts within a compositional expression with Human Assigned Negation. Also to perform a failure analysis to identify the causes of poorly identified negation (i.e. Missed Conceptual Representation, Inaccurate Conceptual Representation, Missed Negation, Inaccurate identification of Negation. Methods 41 Clinical Documents (Medical Evaluations; sometimes outside of Mayo these are referred to as History and Physical Examinations were parsed using the Mayo Vocabulary Server Parsing Engine. SNOMED-CT™ was used to provide concept coverage for the clinical concepts in the record. These records resulted in identification of Concepts and textual clues to Negation. These records were reviewed by an independent medical terminologist, and the results were tallied in a spreadsheet. Where questions on the review arose Internal Medicine Faculty were employed to make a final determination. Results SNOMED-CT was used to provide concept coverage of the 14,792 Concepts in 41 Health Records from John's Hopkins University. Of these, 1,823 Concepts were identified as negative by Human review. The sensitivity (Recall of the assignment of negation was 97.2% (p Conclusion Automated assignment of negation to concepts identified in health records based on review of the text is feasible and practical. Lexical assignment of negation is a good test of true Negativity as judged by the high sensitivity, specificity and positive likelihood ratio of the test. SNOMED-CT had overall coverage of 88.7% of the concepts being negated.
Lopez-Chiriboga, A Sebastian; Komorowski, Lars; Kümpfel, Tania; Probst, Christian; Hinson, Shannon R; Pittock, Sean J; McKeon, Andrew
To describe retrospectively the clinical associations of immunoglobulin G (IgG) targeting metabotropic glutamate receptor 1 (mGluR1-IgG). Specimens of 9 patients evaluated on a service basis in the Mayo Clinic Neuroimmunology Laboratory by tissue-based immunofluorescence assay (IFA) yielded a robust, synaptic immunostaining pattern consistent with mGluR1-IgG (serum, 9; CSF, 2 available). Transfected HEK293 cell-based assay (CBA) confirmed mGluR1 specificity in all 11 specimens. A further 2 patients were detected in Germany primarily by CBA. The median symptom onset age for the 11 patients was 58 years (range 33-81 years); 6 were male. All 9 Mayo Clinic patients had subacute onset of cerebellar ataxia, 4 had dysgeusia, 1 had psychiatric symptoms, and 1 had cognitive impairment. All were evaluated for malignancy, but only 1 was affected (cutaneous T-cell lymphoma). One developed ataxia post-herpes zoster infection. Head MRIs were generally atrophic or normal-appearing, and CSF was inflammatory in just 1 of 5 tested, though mGluR1-IgG was detected in both specimens submitted. Five patients improved (attributable to immunotherapy in 4, spontaneously in 1), 3 stabilized (attributable to immunotherapy in 2, cancer therapy in 1), and 1 progressively declined (untreated). The 2 German patients had ataxia, but fulfilled multiple sclerosis diagnostic criteria (1 relapsing-remitting, 1 progressive). However, both had histories of hematologic malignancy (acute lymphocytic leukemia and mantle cell lymphoma), and had mGluR1-IgG detected in serum by CBA (weakly positive on tissue-based IFA). mGluR1 autoimmunity represents a treatable form of cerebellar ataxia. Dysgeusia may be a diagnostic clue. Paraneoplastic, parainfectious, or idiopathic causes may occur. © 2016 American Academy of Neurology.
Maria Francisca Thereza Borro Bijella
Full Text Available There is a relationship between the use of fluoride, the reduction of dental caries and the increase of dental fluorosis. The purpose of this study was to analyze the fluoride kinetics in saliva after using the HappydentTM chewing gum, which contains 3.38 mg of fluoride as monofluorophosphate. Fifteen 7-9-year-old volunteers were instructed to chew the gum TridentTM (control and HappydentTM on different days. Total saliva was collected for 3 minutes, at 0, 3, 6, 9, 15, 30 and 45 minutes after starting chewing. Salivary fluoride was analyzed with a fluoride-specific electrode (Orion 96-09 after acid hydrolysis. The data were analyzed by two-way analysis of variance and by Tukey’s post hoc test (p Há uma relação entre o uso de fluoretos, a redução na cárie e o aumento da fluorose dentária. O objetivo deste estudo foi analisar a cinética do flúor na saliva após o uso da goma de mascar Happydent®, que contém 3,38 mg de flúor como monofluorfosfato. A saliva foi coletada de 15 voluntários entre 7 e 9 anos de idade, durante 3 minutos nos intervalos de 0, 3, 6, 9, 15, 30 e 45 minutos. Inicialmente, a coleta foi realizada com o Trident® (controle e, após 24 h, a coleta foi repetida com a goma de mascar Happydent®. O flúor foi analisado com um eletrodo íon-específico (Orion 96-09 após a realização da hidrólise ácida. Os dados foram analisados através da análise de variância a dois critérios e pelo teste de Tukey (p < 0,05. A quantidade média ± dp (mg de flúor liberado na saliva foi 0,276 ± 0,126 e 0,024 ± 0,014 para o Happydent® e o Trident®, respectivamente. A quantidade de flúor nas amostras de saliva após o uso do Happydent® foi significativamente maior do que após o uso do Trident® em todos os tempos experimentais, com exceção dos períodos de 30 e 45 minutos. A alta quantidade de flúor na saliva após o uso do Happydent® poderia ser eficiente na prevenção da cárie dentária, o que deveria ser avaliado
Full Text Available ... medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a key research tool for ... other for moderate persistent asthma. The results provided important treatment information for doctors and patients. The results ...
Full Text Available ... protocol affect the trial's results. Comparison Groups In most clinical trials, researchers use comparison groups. This means ... study before you agree to take part. Randomization Most clinical trials that have comparison groups use randomization. ...
Full Text Available ... Entire Site NHLBI Entire Site Health Topics News & Resources Intramural Research ... or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research ...
Full Text Available ... sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include Government Agencies, ... and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers (including the NHLBI) usually ...
Full Text Available ... decisionmaking. The purpose of clinical trials is research, so the studies follow strict scientific standards. These standards ... otherwise. The purpose of clinical trials is research, so the studies follow strict scientific standards. These standards ...
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Fava, Giovanni A.; Tomba, Elena; Bech, Per
of its most representative expressions and reference to current challenges of clinical research, with particular reference to clinimetrics. The domains of clinical pharmacopsychology encompass the clinical benefits of psychotropic drugs, the characteristics that predict responsiveness to treatment...... effects, (b) treatment-induced unwanted side effects, and (c) the patient's own personal experience of a change in terms of well-being and/or quality of life. Clinical pharmacopsychology offers a unifying framework for the understanding of clinical phenomena in medical and psychiatric settings. Research......The aim of this critical review was to outline emerging trends and perspectives of clinical pharmacopsychology, an area of clinical psychology that is concerned with the psychological effects of medications. The historical development of clinical pharmacopsychology is outlined, with discussion...
Full Text Available ... medical strategy, treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials ... medical strategy, treatment, or device is safe and effective for humans. These studies also may show which ...
Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... care providers might be part of your treatment team. They will monitor your health closely. You may ...
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Full Text Available ... to main content U.S. Department of Health & Human ... of people. Clinical trials produce the best data available for health care decisionmaking. The purpose of clinical trials is research, ...
Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... include factors such as a patient's age and gender, the type and stage of disease, and whether ...
Full Text Available ... needed. For safety purposes, clinical trials start with small groups of patients to find out whether a ... phase I clinical trials test new treatments in small groups of people for safety and side effects. ...
Full Text Available ... to-kol). This plan explains how the trial will work. The trial is led by a principal ... for the clinical trial. The protocol outlines what will be done during the clinical trial and why. ...
Full Text Available ... more information about eligibility criteria, go to "How Do Clinical Trials Work?" Some trials enroll people who ... for adults. For more information, go to "How Do Clinical Trials Protect Participants?" For more information about ...
Full Text Available ... organizations also sponsor clinical trials. Examples include Government Agencies, such as the U.S. Departments of Defense and ... to Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be ...
Full Text Available ... risks that outweigh any possible benefits. Clinical Trial Phases Clinical trials of new medicines or medical devices are done in phases. These phases have different purposes and help researchers ...
Full Text Available ... go to the NHLBI's Children and Clinical Studies Web page. Children and Clinical Studies Learn more about ... Protections The U.S. Department of Health and Human Services’ (HHS’) Office for Human Research Protections (OHRP) oversees ...
Full Text Available ... clinical trials. An IRB is an independent committee created by the institution that sponsors a clinical trial. ... have not only shaped medical practice around the world, but have improved the health of millions of ...
Full Text Available ... and Centers sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include ... U.S. Departments of Defense and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers ( ...
Full Text Available ... at the smallest dose and for the shortest time possible. Clinical trials, like the two described above, ... in a clinical trial, find out ahead of time about costs and coverage. You should learn about ...
Full Text Available ... Clinical trials produce the best data available for health care decisionmaking. The purpose of clinical trials is research, ... and advance medical care. They also can help health care decisionmakers direct resources to the strategies and treatments ...
Full Text Available ... whether a new approach causes any harm. In later phases of clinical trials, researchers learn more about ... other National Institutes of Health (NIH) Institutes and Centers sponsor clinical trials. Many other groups, companies, and ...
Full Text Available ... are research studies that explore whether a medical strategy, treatment, or device is safe and effective for ... a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, ...
Full Text Available ... Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often ... rights that help protect them. Scientific Oversight Institutional Review Board Institutional review boards (IRBs) help provide scientific ...
Full Text Available ... treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research ... are required to have an IRB. Office for Human Research Protections The U.S. Department of Health and ...
Full Text Available ... best data available for health care decisionmaking. The purpose of clinical trials is research, so the studies ... Thus, research in humans is needed. For safety purposes, clinical trials start with small groups of patients ...
Full Text Available ... Children and Clinical Studies Program has been successfully developed and evaluated to fill an important gap in ... Possible Benefits Taking part in a clinical trial can have many benefits. For example, you may gain ...
Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... study? How might this trial affect my daily life? Will I have to be in the hospital? ...
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Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... from a study at any time, for any reason. Also, during the trial, you have the right ...
Full Text Available ... Some companies and groups sponsor clinical trials that test the safety of products, such as medicines, and how well they work. The U.S. Food and Drug Administration (FDA) oversees these clinical trials. ...
Full Text Available ... What to Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might ... enroll in a clinical trial, a doctor or nurse will give you an informed consent form that ...
Full Text Available ... and doctors' offices around the country. Benefits and Risks Possible Benefits Taking part in a clinical trial ... volunteer because they want to help others. Possible Risks Clinical trials do have risks and some downsides, ...
Full Text Available ... you may get tests or treatments in a hospital, clinic, or doctor's office. In some ways, taking ... people will need to travel or stay in hospitals to take part in clinical trials. For example, ...
Full Text Available ... providers don't always cover all patient care costs for clinical trials. If you're thinking about ... clinical trial, find out ahead of time about costs and coverage. You should learn about the risks ...
Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... your doctor about all of your treatment options. Together, you can make the best choice for you. ...
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Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...