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Sample records for higher treatment rates

  1. Higher rate of compensation after surgical treatment versus conservative treatment for acute Achilles tendon rupture

    DEFF Research Database (Denmark)

    Sveen, Thor-Magnus; Troelsen, Anders; Barfod, Kristoffer Weisskirchner

    2015-01-01

    in the period from 1992 to 2010 in the DPIA database were identified and patient records were reviewed manually. RESULTS: The compensation awarded for the 18-year period totalled 18,147,202 DKK with 41% of patient claims being recognised. Out of 180 surgically treated patients, 79 received a total compensation...... of 14,051,377 DKK, median 47,637 (range: 5,000-3,577,043). Of 114 non-surgically treated patients, 40 received 3,715,224 DKK in compensation, with a median amount of 35,788 DKK (range: 5,000-830,073). CONCLUSION: Compensation after surgical treatment was 3.8 times higher than compensation after non......-surgical treatment. It is noteworthy that 34.5% of patients had an overlooked diagnosis which underlines the importance of a correct primary diagnosis. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  2. Higher contamination rate than usual. Treatment and disinfection of water in hot whirlpool systems

    Energy Technology Data Exchange (ETDEWEB)

    Herschman, W

    1985-10-01

    Hot whirlpools must meet the hygienic standards set in the Federal Law Concerning Prevention of Epidemics of 18 Dec 1979. The low water volume of whirlpool systems and the extraordinary contamination rate in uninterrupted operation require a specific water treatment and disinfestation technology to make up for the poor buffer capacity of the low water volume. (orig./BWI).

  3. Interferon-free treatment for patients with chronic hepatitis C and autoimmune liver disease: higher SVR rates with special precautions for deterioration of autoimmune hepatitis.

    Science.gov (United States)

    Kanda, Tatsuo; Yasui, Shin; Nakamura, Masato; Nakamoto, Shingo; Takahashi, Koji; Wu, Shuang; Sasaki, Reina; Haga, Yuki; Ogasawara, Sadahisa; Saito, Tomoko; Kobayashi, Kazufumi; Kiyono, Soichiro; Ooka, Yoshihiko; Suzuki, Eiichiro; Chiba, Tetsuhiro; Maruyama, Hitoshi; Imazeki, Fumio; Moriyama, Mitsuhiko; Kato, Naoya

    2018-02-20

    Interferon-free treatment can achieve higher sustained virological response (SVR) rates, even in patients in whom hepatitis C virus (HCV) could not be eradicated in the interferon treatment era. Immune restoration in the liver is occasionally associated with HCV infection. We examined the safety and effects of interferon-free regimens on HCV patients with autoimmune liver diseases. All 7 HCV patients with autoimmune hepatitis (AIH) completed treatment and achieved SVR. Three patients took prednisolone (PSL) at baseline, and 3 did not take PSL during interferon-free treatment. In one HCV patient with AIH and cirrhosis, PSL were not administered at baseline, but she needed to take 40 mg/day PSL at week 8 for liver dysfunction. She also complained back pain and was diagnosed with vasospastic angina by coronary angiography at week 11. However, she completed interferon-free treatment. All 5 HCV patients with primary biliary cholangitis (PBC) completed treatment and achieved SVR. Three of these HCV patients with PBC were treated with UDCA during interferon-free treatment. Interferon-free regimens could result in higher SVR rates in HCV patients with autoimmune liver diseases. As interferon-free treatment for HCV may have an effect on hepatic immunity and activity of the autoimmune liver diseases, careful attention should be paid to unexpected adverse events in their treatments. Total 12 patients with HCV and autoimmune liver diseases [7 AIH and PBC], who were treated with interferon-free regimens, were retrospectively analyzed.

  4. Leflunomide is associated with a higher flare rate compared to methotrexate in the treatment of chronic uveitis in juvenile idiopathic arthritis.

    Science.gov (United States)

    Bichler, J; Benseler, S M; Krumrey-Langkammerer, M; Haas, J-P; Hügle, B

    2015-01-01

    Chronic anterior uveitis is a serious complication of juvenile idiopathic arthritis (JIA); disease flares are highly associated with loss of vision. Leflunomide (LEF) is used successfully for JIA joint disease but its effectiveness in uveitis has not been determined. The aim of this study was to determine whether LEF improves flare rates of uveitis in JIA patients compared to preceding methotrexate (MTX) therapy. A single-centre retrospective study of consecutive children with JIA and chronic anterior uveitis was performed. All children initially received MTX and were then switched to LEF. Demographic, clinical, and laboratory data, dose and duration of MTX and LEF therapy, concomitant medications and rate of anterior uveitis flares, as determined by an expert ophthalmologist, were obtained. Flare rates were compared using a generalized linear mixed model with a negative binomial distribution. A total of 15 children were included (80% females, all antinuclear antibody positive). The median duration of MTX therapy was 51 (range 26-167) months; LEF was given for a median of 12 (range 4-47) months. Anti-tumour necrosis factor (anti-TNF-α) co-medication was given to four children while on MTX. By contrast, LEF was combined with anti-TNF-α treatment in six children. On MTX, JIA patients showed a uveitis flare rate of 0.0247 flares/month, while LEF treatment was associated with a significantly higher flare rate of 0.0607 flares/month (p = 0.008). Children with JIA had significantly more uveitis flares on LEF compared to MTX despite receiving anti-TNF-α co-medication more frequently. Therefore, LEF may need to be considered less effective in controlling chronic anterior uveitis.

  5. Long-Term Results of Fixed High-Dose I-131 Treatment for Toxic Nodular Goiter: Higher Euthyroidism Rates in Geriatric Patients

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    Gül Ege Aktaş

    2015-10-01

    Full Text Available Objective: Geriatric patient population has special importance due to particular challenges. In addition to the increase in incidence of toxic nodular goiter (TNG with age, it has a high incidence in the regions of low-medium iodine intake such as in our country. The aim of this study was to evaluate the overall outcome of high fixed dose radioiodine (RAI therapy, and investigate the particular differences in the geriatric patient population. Methods: One hundred and three TNG patients treated with high dose I-131 (370-740 MBq were retrospectively reviewed. The baseline characteristics; age, gender, scintigraphic patterns and thyroid function tests before and after treatment, as well as follow-up, duration of antithyroid drug (ATD medication and achievement of euthyroid or hypothyroid state were evaluated. The patient population was divided into two groups as those=>65 years and those who were younger, in order to assess the effect of age. Results: Treatment success was 90% with single dose RAI therapy. Hyperthyroidism was treated in 7±7, 2 months after RAI administration. At the end of the first year, overall hypothyroidism rate was 30% and euthyroid state was achieved in 70% of patients. Age was found to be the only statistically significant variable effecting outcome. A higher ratio of euthyroidism was achieved in the geriatric patient population. Conclusion: High fixed dose I-131 treatment should be preferred in geriatric TNG patients in order to treat persistent hyperthyroidism rapidly. The result of this study suggests that high fixed dose RAI therapy is a successful modality in treating TNG, and high rates of euthyroidism can be achieved in geriatric patients.

  6. Familial prostate cancer has a more aggressive course than sporadic prostate cancer after treatment for localized disease, mainly due to a higher rate of distant metastases

    International Nuclear Information System (INIS)

    Kupelian, Patrick A.; Klein, Eric A.; Suh, John H; Kupelian, Varant A.

    1997-01-01

    with negative and positive family history were 83% and 72% percent, respectively (p=0.013). The 5-year locRFS rates for patients with negative and positive family history were 91% and 87% percent, respectively (p=0.45). The 5-year dRFS rates for patients with negative and positive family history were 91% and 84%, respectively (p=0.032). Table 1 displays the statistical significance in crude (univariate) and adjusted (multivariate) analysis of all factors analyzed with respect to outcomes of interest. After adjusting for potential confounders, family history of prostate cancer remained strongly associated with biochemical failure. For RP patients, even in the presence of pathologic parameters, family history remained a strong independent predictor of biochemical, clinical, and distant failure (data not shown). Conclusion: Our findings suggest that familial prostate cancer may have a more aggressive course after treatment than non-familial prostate cancer, and that clinical and/or pathological parameters may not adequately predict this course. Familial prostate cancer seems associated with a higher rate of distant metastases. Further studies need to be performed to confirm these findings

  7. Treatment Results of Postoperative Radiotherapy on Squamous Cell Carcinoma of the Oral Cavity: Coexistence of Multiple Minor Risk Factors Results in Higher Recurrence Rates

    International Nuclear Information System (INIS)

    Fan, Kang-Hsing; Wang, Hung-Ming; Kang, Chung-Jan

    2010-01-01

    Purpose: The aim of this study was to investigate the treatment results of postoperative radiotherapy (PORT) on squamous cell carcinoma of the oral cavity (OSCC). Materials and Methods: This study included 302 OSCC patients who were treated by radical surgery and PORT. Indications for PORT include Stage III or IV OSCC according to the 2002 criteria of the American Joint Committee on Cancer, the presence of perineural invasion or lymphatic invasion, the depth of tumor invasion, or a close surgical margin. Patients with major risk factors, such as multiple nodal metastases, a positive surgical margin, or extracapsular spreading, were excluded. The prescribed dose of PORT ranged from 59.4 to 66.6Gy (median, 63Gy). Results: The 3-year overall and recurrence-free survival rates were 73% and 70%, respectively. Univariate analysis revealed that differentiation, perineural invasion, lymphatic invasion, bone invasion, location (hard palate and retromolar trigone), invasion depths ≥10mm, and margin distances ≤4mm were significant prognostic factors. The presence of multiple significant factors of univariate analysis correlated with disease recurrence. The 3-year recurrence-free survival rates were 82%, 76%, and 45% for patients with no risk factors, one or two risk factors, and three or more risk factors, respectively. After multivariate analysis, the number of risk factors and lymphatic invasion were significant prognostic factors. Conclusion: PORT may be an adequate adjuvant therapy for OSCC patients with one or two risk factors of recurrence. The presence of multiple risk factors and lymphatic invasion correlated with poor prognosis, and more aggressive treatment may need to be considered.

  8. Autotrophic and heterotrophic nitrification-anoxic denitrification dominated the anoxic/oxic sewage treatment process during optimization for higher loading rate and energy savings.

    Science.gov (United States)

    Zhang, Xueyu; Zheng, Shaokui; Zhang, Hangyu; Duan, Shoupeng

    2018-04-30

    This study clarified the dominant nitrogen (N)-transformation pathway and the key ammonia-oxidizing microbial species at three loading levels during optimization of the anoxic/oxic (A/O) process for sewage treatment. Comprehensive N-transformation activity analysis showed that ammonia oxidization was performed predominantly by aerobic chemolithotrophic and heterotrophic ammonia oxidization, whereas N 2 production was performed primarily by anoxic denitrification in the anoxic unit. The abundances of ammonia-oxidizing bacteria (AOB), nitrite-oxidizing bacteria, and anaerobic AOB in activated sludge reflected their activities on the basis of high-throughput sequencing data. AOB amoA gene clone libraries revealed that the predominant AOB species in sludge samples shifted from Nitrosomonas europaea (61% at the normal loading level) to Nitrosomonas oligotropha (58% and 81% at the two higher loading levels). Following isolation and sequencing, the predominant culturable heterotrophic AOB in sludge shifted from Agrobacterium tumefaciens (42% at the normal loading level) to Acinetobacter johnsonii (52% at the highest loading level). Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Treatment of moderate acute malnutrition with ready-to-use supplementary food results in higher overall recovery rates compared with a corn-soya blend in children in southern Ethiopia: an operations research trial.

    Science.gov (United States)

    Karakochuk, Crystal; van den Briel, Tina; Stephens, Derek; Zlotkin, Stanley

    2012-10-01

    Moderate and severe acute malnutrition affects 13% of children malnutrition affects fewer children but is associated with higher rates of mortality and morbidity. Supplementary feeding programs aim to treat moderate acute malnutrition and prevent the deterioration to severe acute malnutrition. The aim was to compare recovery rates of children with moderate acute malnutrition in supplementary feeding programs by using the newly recommended ration of ready-to-use supplementary food (RUSF) and the more conventional ration of corn-soya blend (CSB) in Ethiopia. A total of 1125 children aged 6-60 mo with moderate acute malnutrition received 16 wk of CSB or RUSF. Children were randomly assigned to receive one or the other food. The daily rations were purposely based on the conventional treatment rations distributed at the time of the study in Ethiopia: 300 g CSB and 32 g vegetable oil in the control group (1413 kcal) and 92 g RUSF in the intervention group (500 kcal). The higher ration size of CSB was provided because of expected food sharing. The HR for children in the CSB group was 0.85 (95% CI: 0.73, 0.99), which indicated that they had 15% lower recovery (P = 0.039). Recovery rates of children at the end of the 16-wk treatment period trended higher in the RUSF group (73%) than in the CSB group (67%) (P = 0.056). In comparison with CSB, the treatment of moderate acute malnutrition with RUSF resulted in higher recovery rates in children, despite the large ration size and higher energy content of the conventional CSB ration.

  10. An estimation of the effect of 100% Compliance with Diabetes Treatment: Can we reduce cost of illness with higher compliance rates?

    Directory of Open Access Journals (Sweden)

    Guvenc Kockaya

    2011-01-01

    Full Text Available Introduction: The current study was designed to estimate the direct cost of noncompliance of diabetes patients to the US health system. Understanding these expenses can inform screening and education budget policy regarding expenditure levels that can be calculated to be cost-beneficial. Materials and Method: The study was conducted in three parts. First, a computer search of National Institutes of Health websites and professional society websites for organizations with members that treat diabetes, and a PubMed search were performed to obtain the numbers required for calculations. Second, formulas were developed to estimate the risk of non-compliance and undiagnosed diabetes. Third, risk calculations were performed using the information obtained in part one and the formulas developed in part two. Results: Direct risk reduction for diabetes-related kidney disease, stroke, heart disease, and amputation were estimated for 100% compliance with diabetes treatment. Risk, case and yearly cost reduction calculated for a 100% compliance with diabetes treatment were 13.6%, 0.9 million and US$ 9.3 billion, respectively. Conclusion: Society, insurers, policy makers and other stakeholders could invest up to these amounts in screening, education and prevention efforts in an effort to reduce these costly and traumatic sequelae of noncompliant diabetes patients.   Type: Original Research

  11. Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men.

    Science.gov (United States)

    Aliyu, Muktar H; Blevins, Meridith; Megazzini, Karen M; Parrish, Deidra D; Audet, Carolyn M; Chan, Naomi; Odoh, Chisom; Gebi, Usman I; Muhammad, Mukhtar Y; Shepherd, Bryan E; Wester, C William; Vermund, Sten H

    2015-11-01

    We examined antiretroviral therapy (ART) initiation and retention by sex and pregnancy status in rural Nigeria. We studied HIV-infected ART-naïve patients aged ≥15 years entering care from June 2009 to September 2013. We calculated the probability of early ART initiation and cumulative incidence of loss to follow-up (LTFU) during the first year of ART, and examined the association between LTFU and sex/pregnancy using Cox regression. The cohort included 3813 ART-naïve HIV-infected adults (2594 women [68.0%], 273 [11.8%] of them pregnant). The proportion of pregnant clients initiating ART within 90 days of enrollment (78.0%, 213/273) was higher than among non-pregnant women (54.3%,1261/2321) or men (53.0%, 650/1219), both pPregnant women initiated ART sooner than non-pregnant women and men (median [IQR] days from enrollment to ART initiation for pregnant women=7 days [0-21] vs 14 days [7-49] for non-pregnant women and 14 days [7-42] for men; pPregnant women with HIV in rural Nigeria were more likely to initiate ART but were no more likely to be retained in care. Our findings underscore the importance of effective retention strategies across all patient groups, regardless of sex and pregnancy status. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Endovascular treatment of basilar and ICA termination aneurysms: effects of the use of HydroCoils on treatment stability in a subgroup of patients prone to a higher recurrence rate

    International Nuclear Information System (INIS)

    Geyik, Serdar; Yavuz, Kivilcim; Cekirge, Saruhan; Saatci, Isil

    2007-01-01

    The aim of this study was to evaluate the stability of occlusion of terminal bifurcation aneurysms after embolization with hydrogel-coated coils. Of 35 bifurcation aneurysms, 34 were treated with hydrogel-coated coils in combination with platinum coils, and 1 was treated with hydrogel-coated coils only. Aneurysms were located at the basilar tip in 17 patients, and the internal carotid artery (ICA) bifurcation in 18 patients. The patient population consisted of 20 women and 15 men with ages ranging from 21 to 65 years. The aneurysm was found in 16 patients on presentation for subarachnoid hemorrhage, and in 19 patients the finding was incidental. Of the 35 aneurysms, 25 were small, 9 were large and 1 was giant. The giant aneurysm was located at the basilar tip and showed partial thrombosis. All except two basilar tip aneurysms were treated with balloon assistance. The remaining two basilar tip aneurysms were embolized with the assistance of an aneurysmal neck bridge device. The mean percentage occluded aneurysm volume for all devices was in the range 34-100%. Follow-up angiograms were obtained at 1 year in 6 patients, 2 years in 11 patients, and 3 years in 18 patients. Angiograms obtained immediately after embolization demonstrated a Raymond class 1 occlusion in 29 patients (82.9%) and a Raymond class 2 occlusion in 6 patients (17.1%). In four of these six patients follow-up angiograms demonstrated regrowth with resultant Raymond class 3 occlusion. In the other two patients, Raymond class 2 occlusion remained stable on follow-up angiograms. In patients who had a Raymond class 1 occlusion on the angiogram obtained immediately after embolization, no regrowth was seen on the follow-up angiograms. The overall recanalization rate was 11.4% (three large, one giant) at 6 months. Retreatment was not considered in three of these patients and they were to be followed; the other patient was retreated. Our initial procedural data demonstrate that higher volumetric occlusion was

  13. Endovascular treatment of basilar and ICA termination aneurysms: effects of the use of HydroCoils on treatment stability in a subgroup of patients prone to a higher recurrence rate

    Energy Technology Data Exchange (ETDEWEB)

    Geyik, Serdar; Yavuz, Kivilcim; Cekirge, Saruhan; Saatci, Isil [Hacettepe University Hospital, Interventional Neuroradiology Unit, Radiology Department, Ankara (Turkey)

    2007-12-15

    The aim of this study was to evaluate the stability of occlusion of terminal bifurcation aneurysms after embolization with hydrogel-coated coils. Of 35 bifurcation aneurysms, 34 were treated with hydrogel-coated coils in combination with platinum coils, and 1 was treated with hydrogel-coated coils only. Aneurysms were located at the basilar tip in 17 patients, and the internal carotid artery (ICA) bifurcation in 18 patients. The patient population consisted of 20 women and 15 men with ages ranging from 21 to 65 years. The aneurysm was found in 16 patients on presentation for subarachnoid hemorrhage, and in 19 patients the finding was incidental. Of the 35 aneurysms, 25 were small, 9 were large and 1 was giant. The giant aneurysm was located at the basilar tip and showed partial thrombosis. All except two basilar tip aneurysms were treated with balloon assistance. The remaining two basilar tip aneurysms were embolized with the assistance of an aneurysmal neck bridge device. The mean percentage occluded aneurysm volume for all devices was in the range 34-100%. Follow-up angiograms were obtained at 1 year in 6 patients, 2 years in 11 patients, and 3 years in 18 patients. Angiograms obtained immediately after embolization demonstrated a Raymond class 1 occlusion in 29 patients (82.9%) and a Raymond class 2 occlusion in 6 patients (17.1%). In four of these six patients follow-up angiograms demonstrated regrowth with resultant Raymond class 3 occlusion. In the other two patients, Raymond class 2 occlusion remained stable on follow-up angiograms. In patients who had a Raymond class 1 occlusion on the angiogram obtained immediately after embolization, no regrowth was seen on the follow-up angiograms. The overall recanalization rate was 11.4% (three large, one giant) at 6 months. Retreatment was not considered in three of these patients and they were to be followed; the other patient was retreated. Our initial procedural data demonstrate that higher volumetric occlusion was

  14. Rich or poor: Who should pay higher tax rates?

    Science.gov (United States)

    Murilo Castro de Oliveira, Paulo

    2017-08-01

    A dynamic agent model is introduced with an annual random wealth multiplicative process followed by taxes paid according to a linear wealth-dependent tax rate. If poor agents pay higher tax rates than rich agents, eventually all wealth becomes concentrated in the hands of a single agent. By contrast, if poor agents are subject to lower tax rates, the economic collective process continues forever.

  15. Estimating diversification rates for higher taxa: BAMM can give problematic estimates of rates and rate shifts.

    Science.gov (United States)

    Meyer, Andreas L S; Wiens, John J

    2018-01-01

    Estimates of diversification rates are invaluable for many macroevolutionary studies. Recently, an approach called BAMM (Bayesian Analysis of Macro-evolutionary Mixtures) has become widely used for estimating diversification rates and rate shifts. At the same time, several articles have concluded that estimates of net diversification rates from the method-of-moments (MS) estimators are inaccurate. Yet, no studies have compared the ability of these two methods to accurately estimate clade diversification rates. Here, we use simulations to compare their performance. We found that BAMM yielded relatively weak relationships between true and estimated diversification rates. This occurred because BAMM underestimated the number of rates shifts across each tree, and assigned high rates to small clades with low rates. Errors in both speciation and extinction rates contributed to these errors, showing that using BAMM to estimate only speciation rates is also problematic. In contrast, the MS estimators (particularly using stem group ages), yielded stronger relationships between true and estimated diversification rates, by roughly twofold. Furthermore, the MS approach remained relatively accurate when diversification rates were heterogeneous within clades, despite the widespread assumption that it requires constant rates within clades. Overall, we caution that BAMM may be problematic for estimating diversification rates and rate shifts. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

  16. Higher rates of sex evolve in spatially heterogeneous environments.

    Science.gov (United States)

    Becks, Lutz; Agrawal, Aneil F

    2010-11-04

    The evolution and maintenance of sexual reproduction has puzzled biologists for decades. Although this field is rich in hypotheses, experimental evidence is scarce. Some important experiments have demonstrated differences in evolutionary rates between sexual and asexual populations; other experiments have documented evolutionary changes in phenomena related to genetic mixing, such as recombination and selfing. However, direct experiments of the evolution of sex within populations are extremely rare (but see ref. 12). Here we use the rotifer, Brachionus calyciflorus, which is capable of both sexual and asexual reproduction, to test recent theory predicting that there is more opportunity for sex to evolve in spatially heterogeneous environments. Replicated experimental populations of rotifers were maintained in homogeneous environments, composed of either high- or low-quality food habitats, or in heterogeneous environments that consisted of a mix of the two habitats. For populations maintained in either type of homogeneous environment, the rate of sex evolves rapidly towards zero. In contrast, higher rates of sex evolve in populations experiencing spatially heterogeneous environments. The data indicate that the higher level of sex observed under heterogeneity is not due to sex being less costly or selection against sex being less efficient; rather sex is sufficiently advantageous in heterogeneous environments to overwhelm its inherent costs. Counter to some alternative theories for the evolution of sex, there is no evidence that genetic drift plays any part in the evolution of sex in these populations.

  17. Enabling Higher Data Rates for Planetary Science Missions

    Science.gov (United States)

    Deutsch, L. J.; Townes, S. A.; Lazio, J.; Bell, D. J.; Chahat, N. E.; Kovalik, J. M.; Kuperman, I.; Sauder, J.; Liebrecht, P. E.

    2017-12-01

    The data rate from deep space spacecraft has increased by more than 10 orders of magnitude since the first lunar missions in the 1960s. The demand for increased data rates has stemmed from the increasing sophistication of the science questions being addressed and the concomitant increase in the complexity of the missions themselves (from fly-by to orbit to land and rove). Projections for the next few decades suggest the demand for data rates for deep space missions will continue to increase by approximately one order of magnitude every decade, driven by these same factors. Achieving higher data rates requires a partnership between the spacecraft and the ground system. We describe a series of technology developments for flight telecommunications systems, both at radio frequency (RF) and optical, to enable spacecraft to transmit and receive larger data volumes. These technology developments include deployable high gain antennas for small spacecraft, re-programmable software-defined radios, and optical communication packages designed for CubeSat form factors. The intent is that these developments would provide enhancements in capability for both spacecraft-Earth and spacecraft-spacecraft telecommunications. We also describe the future planning for NASA's Deep Space Network (DSN), which remains the prime conduit for data from all planetary science missions. Through a combination of new antennas and backends being installed over the next five years and incorporation of optical communications, the DSN aims to ensure that the historical improvements in data rates and volumes will continue for many decades. Part of this research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration.

  18. Reduction Rates for Higher Americium Oxidation States in Nitric Acid

    Energy Technology Data Exchange (ETDEWEB)

    Grimes, Travis Shane [Idaho National Lab. (INL), Idaho Falls, ID (United States); Mincher, Bruce Jay [Idaho National Lab. (INL), Idaho Falls, ID (United States); Schmitt, Nicholas C [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-30

    The stability of hexavalent americium was measured using multiple americium concentrations and nitric acid concentrations after contact with the strong oxidant sodium bismuthate. Contrary to our hypotheses Am(VI) was not reduced faster at higher americium concentrations, and the reduction was only zero-order at short time scales. Attempts to model the reduction kinetics using zero order kinetic models showed Am(VI) reduction in nitric acid is more complex than the autoreduction processes reported by others in perchloric acid. The classical zero-order reduction of Am(VI) was found here only for short times on the order of a few hours. We did show that the rate of Am(V) production was less than the rate of Am(VI) reduction, indicating that some Am(VI) undergoes two electron-reduction to Am(IV). We also monitored the Am(VI) reduction in contact with the organic diluent dodecane. A direct comparison of these results with those in the absence of the organic diluent showed the reduction rates for Am(VI) were not statistically different for both systems. Additional americium oxidations conducted in the presence of Ce(IV)/Ce(III) ions showed that Am(VI) is reduced without the typical growth of Am(V) observed in the systems sans Ce ion. This was an interesting result which suggests a potential new reduction/oxidation pathway for Am in the presence of Ce; however, these results were very preliminary, and will require additional experiments to understand the mechanism by which this occurs. Overall, these studies have shown that hexavalent americium is fundamentally stable enough in nitric acid to run a separations process. However, the complicated nature of the reduction pathways based on the system components is far from being rigorously understood.

  19. Social motivation in prospective memory: higher importance ratings and reported performance rates for social tasks.

    Science.gov (United States)

    Penningroth, Suzanna L; Scott, Walter D; Freuen, Margaret

    2011-03-01

    Few studies have addressed social motivation in prospective memory (PM). In a pilot study and two main studies, we examined whether social PM tasks possess a motivational advantage over nonsocial PM tasks. In the pilot study and Study 1, participants listed their real-life important and less important PM tasks. Independent raters categorized the PM tasks as social or nonsocial. Results from both studies showed a higher proportion of tasks rated as social when important tasks were requested than when less important tasks were requested. In Study 1, participants also reported whether they had remembered to perform each PM task. Reported performance rates were higher for tasks rated as social than for those rated as nonsocial. Finally, in Study 2, participants rated the importance of two hypothetical PM tasks, one social and one nonsocial. The social PM task was rated higher in importance. Overall, these findings suggest that social PM tasks are viewed as more important than nonsocial PM tasks and they are more likely to be performed. We propose that consideration of the social relevance of PM will lead to a more complete and ecologically valid theoretical description of PM performance. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  20. Graduation Rates and the Higher Education Demographic Evolution

    Science.gov (United States)

    Hunsaker, B. Tom; Thomas, Douglas E.

    2013-01-01

    In his 1918 orienting work, The Higher Learning in America, Veblen highlights two primary aims of the higher education institution: (a) scientific and scholarly inquiry, and (b) the instruction of students (Veblen, 1918). As of 2006, this overarching mission remained intact. In contemporary literature, a common measure of the efficacy of the…

  1. ESTIMATING RETURN RATE OF HIGHER EDUCATION FUND IN RUSSIA

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    Semenikhina V. A.

    2014-06-01

    Full Text Available Currently, the Russian government pays great attention to the field of higher and postgraduate education. But in the Russian scientific literature there are gaps related to the effectiveness of the overall evaluation of the higher education sector. The article dwells upon the problem of interregional income spread of the Russian population. Empirical estimator of difference influence accounting for human capital accumulated in Russian regions on wage levels and maximum increase of total wage levels and population income for 2001-2011 is carried out. Higher education, exceeding the influence of accumulated volume of the main funds, has a great influence on income spread in Russian regions. Besides, increase of higher education fund in Russian regions contributes to the population’s wage increase and growth in income, but at the same time it decreases legal wages. Results of the study extend knowledge of the economics of education of the Russian Federation.

  2. Emotional Competence and Drop-Out Rates in Higher Education

    Science.gov (United States)

    Kingston, Emma

    2008-01-01

    Purpose: The purpose of this paper is to compare the emotional competence of first year undergraduates enrolled on a high or low drop-out rate (HDR and LDR, respectively) course, at a newly established university within the UK. Design/methodology/approach: A mixed methods approach using both quantitative and qualitative data collection methods was…

  3. High dose rate endobronchial brachytherapy - treatment technique

    International Nuclear Information System (INIS)

    Carvalho, Heloisa de Andrade; Aisen, Salim; Haddad, Cecilia Maria Kalil; Nadalin, Wladimir; Pedreira Junior, Wilson Leite; Chavantes, Maria Cristina

    1998-01-01

    High dose rate endobronchial brachytherapy is efficient in symptom relief due to obstructive endobronchial malignancies. However, it's role in survival improvement for patients with lung cancer is not yet established. The use of this treatment in increasing, specially in the developing countries. The purpose of this paper is to present the treatment technique used in the Radiotherapy Department of the Hospital da Clinicas, University of Sao Paulo, based on an experience of 60 cases treated with 180 procedures. Some practical suggestions and rules adopted in the Department are described. The severe complications rate is 6.7%, demonstrating an adequate patient selection associated with the technique utilized. (author)

  4. Student Ratings of Instruction in Turkish Higher Education

    Directory of Open Access Journals (Sweden)

    Nehir Sert

    2013-05-01

    Full Text Available The end-of-term student evaluations have a twofold purpose: to provide information for administrators to make personnel decisions, and to help instructors to improve the quality of their teaching. The aim of this study is to investigate the ‘utility’ of the Student Ratings of Instruction (SRI. To that end, the concerns of the administrators, instructors and students regarding the use of the SRI in formative and summative evaluations are questioned. This study also investigates possible variables associated with the SRI: 1 what are the differences in ratings among the below-average, average and the above-average students? and 2 what is the correlation between the students’ grades and ratings? The participants of the study consisted of 5 administrators, 17 instructors and 292 students from the faculty of education of a foundation university in Ankara. A triangulation of quantitative and qualitative methods was adopted. In the first phase, causal comparative and correlation research methods were implemented. In the second phase, qualitative data were collected through semi-structured interviews. The results revealed that there was no significant difference in the SRI among the below-average, average and above-average students. The correlation between the student grades and the SRI was significant at a low level. The SRI were reportedly utilised to make teaching more effective and to make decisions when employing part-time personnel only. The permanent personnel were not affected by the SRI. Suggestions have been put forward to verify the usefulness of SRI.

  5. http://z.umn.edu/INNOVATIONS 2011, Vol. 2, No. 2, Article 45 INNOVATIONS in pharmacy 1 An estimation of the effect of 100% Compliance with Diabetes Treatment: Can we reduce cost of illness with higher compliance rates?

    Directory of Open Access Journals (Sweden)

    Güvenç Koçkaya, MD

    2011-01-01

    Full Text Available Introduction: The current study was designed to estimate the direct cost of noncompliance of diabetes patients to the US health system. Understanding these expenses can inform screening and education budget policy regarding expenditure levels that can be calculated to be cost-beneficial.Materials and Method: The study was conducted in three parts. First, a computer search of National Institutes of Health websites and professional society websites for organizations with members that treat diabetes, and a PubMed search were performed to obtain the numbers required for calculations. Second, formulas were developed to estimate the risk of non-compliance and undiagnosed diabetes. Third, risk calculations were performed using the information obtained in part one and the formulas developed in part two.Results: Direct risk reduction for diabetes-related kidney disease, stroke, heart disease, and amputation were estimated for 100% compliance with diabetes treatment. Risk, case and yearly cost reduction calculated for a 100% compliance with diabetes treatment were 13.6%, 0.9 million and US$ 9.3 billion, respectively.Conclusion: Society, insurers, policy makers and other stakeholders could invest up to these amounts in screening, education and prevention efforts in an effort to reduce these costly and traumatic sequelae of noncompliant diabetes patients.

  6. Expensive Brains: “Brainy” Rodents have Higher Metabolic Rate

    Science.gov (United States)

    Sobrero, Raúl; May-Collado, Laura J.; Agnarsson, Ingi; Hernández, Cristián E.

    2011-01-01

    Brains are the centers of the nervous system of animals, controlling the organ systems of the body and coordinating responses to changes in the ecological and social environment. The evolution of traits that correlate with cognitive ability, such as relative brain size is thus of broad interest. Brain mass relative to body mass (BM) varies among mammals, and diverse factors have been proposed to explain this variation. A recent study provided evidence that energetics play an important role in brain evolution (Isler and van Schaik, 2006). Using composite phylogenies and data drawn from multiple sources, these authors showed that basal metabolic rate (BMR) correlates with brain mass across mammals. However, no such relationship was found within rodents. Here we re-examined the relationship between BMR and brain mass within Rodentia using a novel species-level phylogeny. Our results are sensitive to parameter evaluation; in particular how species mass is estimated. We detect no pattern when applying an approach used by previous studies, where each species BM is represented by two different numbers, one being the individual that happened to be used for BMR estimates of that species. However, this approach may compromise the analysis. When using a single value of BM for each species, whether representing a single individual, or available species mean, our findings provide evidence that brain mass (independent of BM) and BMR are correlated. These findings are thus consistent with the hypothesis that large brains evolve when the payoff for increased brain mass is greater than the energetic cost they incur. PMID:21811456

  7. Success rate of overfilled root canal treatment

    International Nuclear Information System (INIS)

    Yousuf, W.; Sheikh, A.

    2015-01-01

    Traditionally, poor obturation has been considered the primary cause of root canal treatment failures The purpose of this study was to assess the success rate of overfilled root canal treatment cases in order to decide whether a definitive restoration can be placed immediately following treatment in an overfilled case or whether the patient needs to be kept on a follow up prior to the placement of a definitive restoration. Methods: A total of 1242 patients periapical radiographs (1748 teeth) were assessed, out of which 397 teeth (in 285 patients) were found to be overfilled. Out of these 285 patients, 111 (128 cases) agreed to participate in this cross sectional study and were recalled for clinical and radiographic examination. Success was evaluated clinically by absence of symptoms (pain, swelling, tenderness to percussion and sinus tract) and radiograhically by the decrease in size of periapical lesion or no change in size. Increase in size of periapical lesion was deemed to be a failure. Results: Our findings revealed that despite overfill, the treatment was successful in 115 cases and failure was noted in 13 cases showing an overall success rate of 89.8% and failure rate of 10.2%. Out of 13 cases of failure, all 13 showed an increase in periapical lesion size, out of which 10 were accompanied with pain. Conclusion: Based on the results obtained in our study, we have determined that there is no need to delay placement of a permanent restoration on overfilled teeth (ruling out the presence of other procedural errors) nor is there any need to pursue any further surgical or non-surgical endodontic treatment. However we would suggest that patients should be kept on follow-up after placement of permanent restoration. (author)

  8. Low dose rate and high dose rate intracavitary treatment for cervical cancer

    International Nuclear Information System (INIS)

    Hareyama, Masato; Oouchi, Atsushi; Shidou, Mitsuo

    1997-01-01

    From 1984 through 1993, 144 previous untreated patients with carcinoma of uterine cervix were treated with either low dose rate 137 Cs therapy (LDR) or high dose rate 60 Co therapy (HDR). The local failure rates for more than 2-years for the primary lesions were 11.8% (8 of 63 patients) for LDR and 18.0% (11 of 61 patients). Rectal complication rates were significantly lower for HDR versus LDR (14.3% VS. 32.8%. p<0.01). Also, bladder complication rates were significantly lower for HDR versus LDR (0% VS. 10.4%, p<0.005). Treatment results in term of local control were equivalent for HDR and LDR treatment. However, the incidence of complications was higher for the LDR group than for the HDR group. (author)

  9. HIGH-RATE ANAEROBIC TREATMENT OF ALCOHOLIC WASTEWATERS

    Directory of Open Access Journals (Sweden)

    Florencio L.

    1997-01-01

    Full Text Available Modern high-rate anaerobic wastewater treatment processes are rapidly becoming popular for industrial wastewater treatment. However, until recently stable process conditions could not be guaranteed for alcoholic wastewaters containing higher concentrations of methanol. Although methanol can be directly converted into methane by methanogens, under specific conditions it can also be converted into acetate and butyrate by acetogens. The accumulation of volatile fatty acids can lead to reactor instability in a weakly buffered reactor. Since this process was insufficiently understood, the application of high-rate anaerobic reactors was highly questionable. This research investigated the environmental factors that are of importance in the predominance of methylotrophic methanogens over acetogens in a natural mixed culture during anaerobic wastewater treatment in upflow anaerobic sludge bed reactors. Technological and microbiological aspects were investigated. Additionally, the route by which methanol is converted into methane is also presented

  10. Brachytherapy treatment with high dose rate

    International Nuclear Information System (INIS)

    Santana Rodriguez, Sergio Marcelino; Rodriguez Rodriguez, Lissi Lisbet; Ciscal Chiclana, Onelio Alberto

    2009-01-01

    Retrospectively analyze results and prognostic factors of cervical cancer patients treated with radio concomitant cisplatin-based chemotherapy, radiation therapy combined modality. Methods: From January 2003 to December 2007, 198 patients with invasive cervical cancer were treated at the Oncology Department of Hospital Robau Celestino Hernandez (brachytherapy performed at INOR). The most common age group was 31 to 40 years. The histology in squamous cell carcinoma accounted for 84.3% of cases. The treatment consisted of external pelvic irradiation and vaginal brachytherapy, high dose rate. Concomitant chemotherapy consisted of cisplatin 40 mg/m2 weekly with a maximum of 70 mg for 5 weeks. Results: 66.2% of patients completed 5 cycles of chemotherapy. The median overall survival was 39 months, overall survival, disease-free survival and survival free of locoregional recurrence at 5 years of 78%, 76% and 78.6% respectively .. We found that clinical stage, histological type (adenocarcinoma worst outcome) were statistically related to level of response. Conclusions: Treatment with external pelvic radiation, brachytherapy and concurrent weekly cisplatin in patients with stage IIIB cervical cancer is feasible in the Chilean public health system, well tolerated and results comparable to international literature. (Author)

  11. [Awareness rate, treatment rate and control rate of dyslipidemia in Chinese adults, 2010].

    Science.gov (United States)

    Li, Jian-hong; Wang, Li-min; Mi, Sheng-quan; Zhang, Mei; Li, Yi-chong; Jiang, Yong; Xu, Yu; Dai, Meng; Wang, Lin-hong

    2012-08-01

    To explore the awareness, treatment and control rates of dyslipidemia among Chinese adults aged over 18 in 2010, and to analyze the prevalent features. 97 409 subjects aged over 18 were recruited from 162 monitoring sites around 31 provinces in China mainland in 2010, applying multi-stage stratified cluster random sampling method. Information about subjects' history of dyslipidemia, treatment and control were collected by face-to-face interview; and each subject's fasting venous blood was drawn in the morning before having food, to test total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). In total, 51 818 cases of dyslipidemia ever or now, including 2235 subjects who once suffered from dyslipidemia but had their blood lipid controlled to normal, were screened out. And the awareness, treatment and control rates were calculated by complex weighting. The awareness rate of dyslipidemia among Chinese adults was 10.93%, while the stratified rates were 6.00%, 16.75% and 18.74% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 1293.02, P China, respectively (χ² = 117.04, P China, respectively (χ² = 50.71, P control rate of dyslipidemia was 3.53% among total subjects, while whose stratified rates were 1.64%, 5.49% and 6.94% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 554.12, P China, respectively (χ² = 91.45, P control rates of dyslipidemia have been comparatively low among Chinese adults, especially among the population who were young, or who were from rural area or western China.

  12. Optimizing rate of nitrogen application for higher growth and yield of wheat (triticum aestivum l.) cultivars

    International Nuclear Information System (INIS)

    Maqsood, M.; Shehzad, M.A.; Asim, A.; Ahmad, W.

    2012-01-01

    In order to optimize the nitrogen rates in three wheat (Triticum aestivum L.) cultivars for obtaining higher grain yield, a split plot experiment based on Randomized Complete Block Design with three replicates was conducted in the research field of University of Agriculture, Faisalabad during Rabi season 2006-07. Among treatments nitrogen levels (N0= 0, N/sub 1/= 50, N2= 100, N3= 150 kg ha/sup -1/) in main while wheat cultivars (V1= Punjnad-I, V/sub 2/= Fareed-2006, V3=Uqab-2000) were allocated in sub plots during the course of growing season. Traits as plant height, fertile tillers, spike length, spikelets spike-1, grains spike-1, 1000-grain weight, straw yield, grain yield and harvest index (HI) were significantly (P=0.05) affected by treatment combinations. Maximum grain yield was obtained by V3 (Uqab-2000) cultivar when treated with N3 (150 kg ha/sup -1/) fertilizer level. Also, results showed that with increasing nitrogen rates, wheat yield increases significantly up to a level of significance (P=0.05). Increasing nitrogen levels led to significantly increase in plant height (101.81 cm), spike bearing tillers (495.77), grains spike/sup -1/ (61.45), straw yield (8.60 t ha/sup -1/) and harvest index (36.17%) of V3 (Uqab-2000). In all traits except germination count, V3 (Uqab-2000) was found to be superior. (author)

  13. Estimating the effect of treatment rate changes when treatment benefits are heterogeneous: antibiotics and otitis media.

    Science.gov (United States)

    Park, Tae-Ryong; Brooks, John M; Chrischilles, Elizabeth A; Bergus, George

    2008-01-01

    Contrast methods to assess the health effects of a treatment rate change when treatment benefits are heterogeneous across patients. Antibiotic prescribing for children with otitis media (OM) in Iowa Medicaid is the empirical example. Instrumental variable (IV) and linear probability model (LPM) are used to estimate the effect of antibiotic treatments on cure probabilities for children with OM in Iowa Medicaid. Local area physician supply per capita is the instrument in the IV models. Estimates are contrasted in terms of their ability to make inferences for patients whose treatment choices may be affected by a change in population treatment rates. The instrument was positively related to the probability of being prescribed an antibiotic. LPM estimates showed a positive effect of antibiotics on OM patient cure probability while IV estimates showed no relationship between antibiotics and patient cure probability. Linear probability model estimation yields the average effects of the treatment on patients that were treated. IV estimation yields the average effects for patients whose treatment choices were affected by the instrument. As antibiotic treatment effects are heterogeneous across OM patients, our estimates from these approaches are aligned with clinical evidence and theory. The average estimate for treated patients (higher severity) from the LPM model is greater than estimates for patients whose treatment choices are affected by the instrument (lower severity) from the IV models. Based on our IV estimates it appears that lowering antibiotic use in OM patients in Iowa Medicaid did not result in lost cures.

  14. United States private schools have higher rates of exemptions to school immunization requirements than public schools.

    Science.gov (United States)

    Shaw, Jana; Tserenpuntsag, Boldtsetseg; McNutt, Louise-Anne; Halsey, Neal

    2014-07-01

    To compare medical, religious, and personal belief immunization exemption rates between private and public schools in US. Exemption rates were calculated using the Centers for Disease Control and Prevention School Immunization Assessment Surveys for the 2009-2010 school year excluding states with incomplete survey data. Standardized exemption rates weighted on enrollments in public and private schools were calculated. Differences in exemption rates between public and private schools were tested using Wilcoxon signed rank test. The overall state exemption rate was higher in US private than public schools, 4.25% (SD 4.27) vs 1.91% (1.67), P = .0001 and private schools had higher exemption rates for all types of exemptions; medical 0.58% (0.71) vs 0.34% (0.34) respectively (P = .0004), religious 2.09% (3.14) vs 0.83% (1.05) respectively (P = .0001), and personal belief 6.10% (4.12) vs 2.79% (1.57), respectively (P = .006). Overall exemption rates were significantly higher in states that allowed personal belief exemptions. Exemption rates were significantly higher in US private than in public schools. Children attending private schools may be at higher risk of vaccine-preventable diseases than public school children. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Thermocyclic treatment of Be for higher stability of mechanical properties

    International Nuclear Information System (INIS)

    Neklyudov, I.M.; Papirov, I.I.; Stoev, P.I.

    2004-01-01

    The paper reports the results from studies of the effects of upper temperature and speed of thermocyclic treatment (TCT), a combined action of thermal treatment and TCT on the acoustic emission of two batches of hot-pressed beryllium having different mechanical properties. It is demonstrated that the upper temperature of treatment exerts a substantial effect on the mechanical and acoustic characteristics of hot-pressed beryllium. At an upper TCT temperature of 500degC, the materials under study exhibit the minimum activity of acoustic emission and a small total number of pulses detected. Acoustic spectra of beryllium samples were measured after the samples were subjected to the TCT with different velocity values of the process. It has been established that the treatment preceding the TCT (ageing at 650degC for 5 hours) had little effect on the mechanical and acoustic parameters of beryllium, while the treatment following the TCT (600degC, 1 hour) led to dislocation pinning and thus reduced the dislocation mobility. It has been demonstrated that the acoustic parameters can be used for choosing the optimum temperature of the TCT process, for estimating the degree of dislocation mobility and for controlling the quality of thermal treatment performed.(author)

  16. Removal of boron(III) by N-methylglucamine-type cellulose derivatives with higher adsorption rate

    International Nuclear Information System (INIS)

    Inukai, Yoshinari; Tanaka, Yoshiharu; Matsuda, Toshio; Mihara, Nobutake; Yamada, Kouji; Nambu, Nobuyoshi; Itoh, Osamu; Doi, Takao; Kaida, Yasuhiko; Yasuda, Seiji

    2004-01-01

    To obtain adsorbents for boron(III) derived from a natural polymer, two forms (powder and fiber) of N-methylglucamine-type cellulose derivatives were newly synthesized. After the graft polymerization of two forms of cellulose with vinyl monomer having epoxy groups, the N-methylglucamine-type cellulose derivatives were obtained by the reaction of the grafted cellulose with N-methylglucamine. The adsorption capacities of the cellulose derivatives for boron(III) were the same levels as that of a commercially available N-methylglucamine-type polystyrene resin. However, the cellulose derivatives adsorbed boron(III) more quickly than the polystyrene resin. The adsorption and desorption of boron(III) with a column method using the cellulose fiber were achieved at a higher flow rate than that using the polystyrene resin. In addition, the boron(III), adsorbed on the cellulose fiber column, was quantitatively recovered with dilute hydrochloric acid in 20- and 200-fold increased concentrations. Consequently, it was found that the cellulose derivatives were superior to the polystyrene resin as adsorbents for boron(III) for treatment of a large quantity of wastewater

  17. A higher chest compression rate may be necessary for metronome-guided cardiopulmonary resuscitation.

    Science.gov (United States)

    Chung, Tae Nyoung; Kim, Sun Wook; You, Je Sung; Cho, Young Soon; Chung, Sung Phil; Park, Incheol

    2012-01-01

    Metronome guidance is a simple and economical feedback system for guiding cardiopulmonary resuscitation (CPR). However, a recent study showed that metronome guidance reduced the depth of chest compression. The results of previous studies suggest that a higher chest compression rate is associated with a better CPR outcome as compared with a lower chest compression rate, irrespective of metronome use. Based on this finding, we hypothesized that a lower chest compression rate promotes a reduction in chest compression depth in the recent study rather than metronome use itself. One minute of chest compression-only CPR was performed following the metronome sound played at 1 of 4 different rates: 80, 100, 120, and 140 ticks/min. Average compression depths (ACDs) and duty cycles were compared using repeated measures analysis of variance, and the values in the absence and presence of metronome guidance were compared. Both the ACD and duty cycle increased when the metronome rate increased (P = .017, metronome rates of 80 and 100 ticks/min were significantly lower than those for the procedures without metronome guidance. The ACD and duty cyle for chest compression increase as the metronome rate increases during metronome-guided CPR. A higher rate of chest compression is necessary for metronome-guided CPR to prevent suboptimal quality of chest compression. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Vastus Lateralis Motor Unit Firing Rate Is Higher in Women With Patellofemoral Pain.

    Science.gov (United States)

    Gallina, Alessio; Hunt, Michael A; Hodges, Paul W; Garland, S Jayne

    2018-05-01

    To compare neural drive, determined from motor unit firing rate, in the vastus medialis and lateralis in women with and without patellofemoral pain. Cross-sectional study. University research laboratory. Women (N=56) 19 to 35 years of age, including 36 with patellofemoral pain and 20 controls. Not applicable. Participants sustained an isometric knee extension contraction at 10% of their maximal voluntary effort for 70 seconds. Motor units (N=414) were identified using high-density surface electromyography. Average firing rate was calculated between 5 and 35 seconds after recruitment for each motor unit. Initial firing rate was the inverse of the first 3 motor unit interspike intervals. In control participants, vastus medialis motor units discharged at higher rates than vastus lateralis motor units (P=.001). This was not observed in women with patellofemoral pain (P=.78) because of a higher discharge rate of vastus lateralis compared with control participants (P=.002). No between-group differences were observed for vastus medialis (P=.93). Similar results were obtained for the initial motor unit firing rate. These findings suggest that women with patellofemoral pain have a higher neural drive to vastus lateralis but not vastus medialis, which may be a contributor of the altered patellar kinematics observed in some studies. The different neural drive may be an adaptation to patellofemoral pain, possibly to compensate for decreased quadriceps force production, or a precursor of patellofemoral pain. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Does the Economic Crisis Have an Influence on the Higher Education Dropout Rate?

    Science.gov (United States)

    Leão Fernandes, Graça; Chagas Lopes, Margarida

    2016-01-01

    This research aims to identify the effects of the economic crisis on higher education (HE) dropout rates at Lisbon School of Economics and Management (ISEG)--Universidade de Lisboa, after having controlled for individual characteristics, family background, High School and HE trajectories. Our main hypothesis is that the economic crisis induces…

  20. Will ageing lead to a higher real exchange rate for the Netherlands?

    NARCIS (Netherlands)

    van Ewijk, C.; Volkerink, M.

    2012-01-01

    Long term projections for the Netherlands indicate that demand for nontradables—e.g. health care services—will increase relative to supply due to population ageing. If this leads to higher future real exchanges rates this will erode the return of the savings currently made to prepare for ageing.

  1. Will ageing lead to a higher real exchange rate for the Netherlands?

    NARCIS (Netherlands)

    van Ewijk, C.; Volkerink, M.

    2011-01-01

    Long-term projections for the Netherlands indicate that demand for nontradables - e.g. health care services - will increase relative to supply due to population ageing. If this leads to higher future real exchanges rates this will erode the return of the savings currently made to prepare for ageing.

  2. Why do younger women have higher breast cancer recurrence rates after breast-conserving surgery?

    International Nuclear Information System (INIS)

    Nishimura, Reiki; Matsuda, Masakazu; Miyayama, Haruhiko; Okazaki, Shinji; Kai, Chiharu; Ozaki, N.

    2003-01-01

    Preventing breast cancer recurrence after breast-conserving surgery is an important issue. The main factors contributing to such recurrence are positive margins, absence of radiotherapy and young age. To investigate the clinical significance of age in breast-conserving surgery, we examined the relationship between clinicopathological findings or outcome and age, especially young age. The cases were divided into three groups by age; 35 years old or less, 36-50y.o. and 51y.o. or higher. Between April 1989 and March 2003, 743 patients were treated with breast-conserving surgery. There were 49 patients aged 35 years old or less (6.6%). Younger age significantly correlated with positive surgical margin, lymph node metastases, higher proliferative activity, negative estrogen receptor (ER) or progesterone receptor (PgR), larger tumor size, and shorter nipple-tumor distances. Although younger patients had a higher recurrence rate irrespective of radiotherapy, margin status had an impact on recurrence rate. Thus, the reason young age was a significant factor for breast recurrence after breast-conserving surgery was that young patients frequently had numerous risk factors such as positive margin, higher proliferative activity, positive nodes, negative ER/PgR and larger tumor. However, negative surgical margins could reduce recurrence rates even in young women. These results suggest that more suitable criteria and strategies may be needed for young patients with breast cancer. (author)

  3. Heroin and cocaine abusers have higher discount rates for delayed rewards than alcoholics or non-drug-using controls.

    Science.gov (United States)

    Kirby, Kris N; Petry, Nancy M

    2004-04-01

    To test a prediction of the discounting model of impulsiveness that discount rates would be positively associated with addiction. The delay-discount rate refers to the rate of reduction in the present value of a future reward as the delay to that reward increases. We estimated participants' discount rates on the basis of their pattern of choices between smaller immediate rewards ($11-80) and larger, delayed rewards ($25-85; at delays from 1 week to 6 months) in a questionnaire format. Participants had a one-in-six chance of winning a reward that they chose on one randomly selected trial. Heroin (n = 27), cocaine (n = 41) and alcohol (n = 33) abusers and non-drug-using controls (n = 44) were recruited from advertisements. They were tested in a drug abuse research clinic at a medical school. On average, the cocaine and heroin groups had higher rates than controls (both P rates for heroin abusers (P = 0.03), but not for cocaine or alcohol abusers (both P > 0.50). These data suggest that discount rates vary with the preferred drug of abuse, and that high discount rates should be considered in the development of substance abuse prevention and treatment efforts.

  4. Treatment of the prostate cancer with high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Martinez, Alvaro; Torres Silva, Felipe

    2002-01-01

    The prostate cancer treatment in early stages is controversial. The high dose rate brachytherapy has been used like monotherapy or boost with external beam radiotherapy in advanced disease. This paper describes the technique and the advantages over other modalities

  5. Calm Merino ewes have a higher ovulation rate and more multiple pregnancies than nervous ewes.

    Science.gov (United States)

    van Lier, E; Hart, K W; Viñoles, C; Paganoni, B; Blache, D

    2017-07-01

    In 1990, two selection lines of Merino sheep were established for low and high behavioural reactivity (calm and nervous temperament) at the University of Western Australia. Breeding records consistently showed that calm ewes weaned 10% to 19% more lambs than the nervous ewes. We hypothesise that calm ewes could have a higher ovulation rate than nervous ewes and/or calm ewes could have a lower rate of embryo mortality than nervous ewes. We tested these hypotheses by comparing the ovulation rate and the rate of embryo mortality between the calm and nervous lines before and after synchronisation and artificial insemination. Merino ewes from the temperament selection lines (calm, n=100; nervous, n=100) were synchronised (early breeding season) for artificial insemination (day 0) (intravaginal sponges containing fluogestone acetate and eCG immediately after sponge withdrawal). On day-17 and 11 ovarian cyclicity and corpora lutea, and on days 30 and 74 pregnancies and embryos/foetuses were determined by ultrasound. Progesterone, insulin and leptin concentrations were determined in blood plasma samples from days 5, 12 and 17. Ovarian cyclicity before and after oestrus synchronisation did not differ between the lines, but ovulation rate did (day-17: calm 1.63; nervous 1.26; Pewes was higher than on day-17. Loss of embryos by day 30 was high (calm: 71/150; nervous: 68/130); but nervous ewes had a lower proportion (15/47) of multiple pregnancies compared with calm ewes (30/46; Pewes had higher insulin (32.0 pmol/l±1.17 SEM; P=0.013) and lower leptin (1.18 μg/l±0.04 SEM; P=0.002) concentrations than calm ewes (insulin: 27.8 pmol/l±1.17 SEM; leptin: 1.35 μg/l±0.04 SEM). The differences in reproductive outcomes between the calm and nervous ewes were mainly due to a higher ovulation rate in calm ewes. We suggest that reproduction in nervous ewes is compromised by factors leading up to ovulation and conception, or the uterine environment during early pregnancy, that reflect

  6. Treatments that generate higher number of adverse drug reactions and their symptoms

    Directory of Open Access Journals (Sweden)

    Lucía Fernández-López

    2015-12-01

    Full Text Available Objectives: Adverse drug reactions (ADRs are an important cause of morbidity and mortality worldwide and generate high health costs. Therefore, the aims of this study were to determine the treatments which produce more ADRs in general population and the main symptoms they generate. Methods: An observational, cross-sectional study consisting in performing a self-rated questionnaire was carried out. 510 patients were asked about the treatments, illnesses and ADRs, they had suffered from. Results: 26.7% of patients had suffered from some ADR. Classifying patients according to the type of prescribed treatment and studying the number of ADR that they had, we obtained significant differences (p ≤ 0.05 for treatments against arthrosis, anemia and nervous disorders (anxiety, depression, insomnia. Moreover, determining absolute frequencies of these ADRs appearance in each treatment, higher frequencies were again for drugs against arthrosis (22.6% of patients treated for arthrosis suffered some ADR, anemia (14.28%, nerve disorders (13.44% and also asthma (16%. Regarding the symptoms produced by ADRs, the most frequent were gastrointestinal (60% of patients who suffered an ADR, had gastrointestinal symptoms and nervous alterations (dizziness, headache, sleep disturbances etc (24.6%. Conclusion: Therapeutic groups which produce more commonly ADRs are those for arthrosis, anemia, nervous disorders and asthma. In addition, symptoms which are generated more frequently are gastrointestinal and nervous problems. This is in accordance with the usual side effects of mentioned treatments. Health professionals should be informed about it, so that they would be more alert about a possible emergence of an ADR in these treatments. They also could provide enough information to empower patients and thus, they probably could detect ADR events. This would facilitate ADR detection and would avoid serious consequences generated to both patients' health and health economics.

  7. Splenectomy is associated with higher infection and pneumonia rates among trauma laparotomy patients.

    Science.gov (United States)

    Fair, Kelly A; Connelly, Christopher R; Hart, Kyle D; Schreiber, Martin A; Watters, Jennifer M

    2017-05-01

    Splenectomy increases lifetime risk of thromboembolism (VTE) and is associated with long-term infectious complications, primarily, overwhelming post-splenectomy infection (OPSI). Our objective was to evaluate risk of VTE and infection at index hospitalization post-splenectomy. Retrospective review of all patients who received a laparotomy in the NTDB. Propensity score matching for splenectomy was performed, based on ISS, abdominal abbreviated injury score >3, GCS, sex and mechanism. Major complications, VTE, and infection rates were compared. Multiple logistic regression models were utilized to evaluate splenectomy-associated complications. 93,221 laparotomies were performed and 17% underwent splenectomy. Multiple logistic regression models did not demonstrate an association between splenectomy and major complications (OR 0.96, 95% CI 0.91-1.03, p = 0.25) or VTE (OR 1.05, 95% CI 0.96-1.14, p = 0.33). Splenectomy was independently associated with infection (OR 1.07, 95% CI 1.00-1.14, p = 0.045). Subgroup analysis of patients with infection demonstrated that splenectomy was most strongly associated with pneumonia (OR 1.41, 95% CI 1.26-1.57, p Splenectomy is not associated with higher overall complication or VTE rates during index hospitalization. However, splenectomy is associated with a higher rate of pneumonia. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. With age a lower individual breathing reserve is associated with a higher maximal heart rate.

    Science.gov (United States)

    Burtscher, Martin; Gatterer, Hannes; Faulhaber, Martin; Burtscher, Johannes

    2018-01-01

    Maximal heart rate (HRmax) is linearly declining with increasing age. Regular exercise training is supposed to partly prevent this decline, whereas sex and habitual physical activity do not. High exercise capacity is associated with a high cardiac output (HR x stroke volume) and high ventilatory requirements. Due to the close cardiorespiratory coupling, we hypothesized that the individual ventilatory response to maximal exercise might be associated with the age-related HRmax. Retrospective analyses have been conducted on the results of 129 consecutively performed routine cardiopulmonary exercise tests. The study sample comprised healthy subjects of both sexes of a broad range of age (20-86 years). Maximal values of power output, minute ventilation, oxygen uptake and heart rate were assessed by the use of incremental cycle spiroergometry. Linear multivariate regression analysis revealed that in addition to age the individual breathing reserve at maximal exercise was independently predictive for HRmax. A lower breathing reserve due to a high ventilatory demand and/or a low ventilatory capacity, which is more pronounced at a higher age, was associated with higher HRmax. Age explained the observed variance in HRmax by 72% and was improved to 83% when the variable "breathing reserve" was entered. The presented findings indicate an independent association between the breathing reserve at maximal exercise and maximal heart rate, i.e. a low individual breathing reserve is associated with a higher age-related HRmax. A deeper understanding of this association has to be investigated in a more physiological scenario. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Higher Magnitude Cash Payments Improve Research Follow-up Rates Without Increasing Drug Use or Perceived Coercion

    Science.gov (United States)

    Festinger, David S.; Marlowe, Douglas B.; Dugosh, Karen L.; Croft, Jason R.; Arabia, Patricia L.

    2008-01-01

    In a prior study (Festinger et al., 2005) we found that neither the mode (cash vs. gift card) nor magnitude ($10, $40, or $70) of research follow-up payments increased rates of new drug use or perceptions of coercion. However, higher payments and payments in cash were associated with better follow-up attendance, reduced tracking efforts, and improved participant satisfaction with the study. The present study extended those findings to higher payment magnitudes. Participants from an urban outpatient substance abuse treatment program were randomly assigned to receive $70, $100, $130, or $160 in either cash or a gift card for completing a follow-up assessment at 6 months post-admission (n ≅ 50 per cell). Apart from the payment incentives, all participants received a standardized, minimal platform of follow-up efforts. Findings revealed that neither the magnitude nor mode of payment had a significant effect on new drug use or perceived coercion. Consistent with our previous findings, higher payments and cash payments resulted in significantly higher follow-up rates and fewer tracking calls. In addition participants receiving cash vs. gift cards were more likely to use their payments for essential, non-luxury purchases. Follow-up rates for participants receiving cash payments of $100, $130, and $160 approached or exceeded the FDA required minimum of 70% for studies to be considered in evaluations of new medications. This suggests that the use of higher magnitude payments and cash payments may be effective strategies for obtaining more representative follow-up samples without increasing new drug use or perceptions of coercion. PMID:18395365

  10. New system for higher recovery rate of water borne Cryptosporidium oocysts and Giardia cysts

    DEFF Research Database (Denmark)

    Al-Sabi, Mohammad Nafi Solaiman; Gad, Jens; Klinting, Mette

    2012-01-01

    Background: The two most common water borne pathogenic protozoa, Cryptosporidium and Giardia, cause diarrhea worldwide. Detecting these parasites in water samples depends on effective parasite recovery from the water matrix. The reported low recovery rates of the currently used filter methods...... motivate the development of systems with higher recovery rates. Materials and methods: Five replicates of IMS purified Cryptosporidium oocysts and Giardia cysts (N=2x103) were injected into a specially coated filter unit with a carefully chosen pore size. Following filtration, sonication was performed...... were 85% were recorded when the filter was sonicated. Sonication usually affects parasite viability but could be tuned into a useful tool for enhanced backwash collection of parasites using a specially constructed filter unit and a sonication protocol. The filtration...

  11. Why the EU-15 Maintains Higher CIT Rates than the New Member States?

    Directory of Open Access Journals (Sweden)

    Karpowicz Andrzej

    2014-11-01

    Full Text Available The European Union is not a homogenous area. This lack of homogeneity extends to taxes, which vary across jurisdictions. On average, Western Europe imposes significantly higher taxes on capital than New Member States, which joined the Community in 2004 and 2007. Often this fact is simply taken for granted. However, there are several arguments that can explain this variance. Although several of these arguments are well known and have been researched, they have not been assessed in combination, or used in a comparative analysis of corporate income tax (CIT rates between EU member states. Because of interest in harmonizing CIT throughout the EU, the roots of divergent CIT is of particular and timely value. Therefore, this article we attempts to demonstrate the differences in CIT rates in the EU-15 and New Member States. In so doing the general characteristics of these country grouping is identified, and then discussed in the context of the taxation theory.

  12. Higher order constraints on the Higgs production rate from fixed-target DIS data

    International Nuclear Information System (INIS)

    Alekhin, S.; Bluemlein, J.; Moch, S.

    2011-01-01

    The constraints of fixed-target DIS data in fits of parton distributions including QCD corrections to next-to-next-to leading order are studied. We point out a potential problem in the analysis of the NMC data which can lead to inconsistencies in the extracted value for α s (M Z ) and the gluon distribution at higher orders in QCD. The implications for predictions of rates for Standard Model Higgs boson production at hadron colliders are investigated. We conclude that the current range of excluded Higgs boson masses at the Tevatron appears to be much too large. (orig.)

  13. Strain rate effects in nuclear steels at room and higher temperatures

    Energy Technology Data Exchange (ETDEWEB)

    Solomos, G. E-mail: george.solomos@jrc.it; Albertini, C.; Labibes, K.; Pizzinato, V.; Viaccoz, B

    2004-04-01

    An investigation of strain rate, temperature and size effects in three nuclear steels has been conducted. The materials are: ferritic steel 20MnMoNi55 (vessel head), austenitic steel X6CrNiNb1810 (upper internal structure), and ferritic steel 26NiCrMo146 (bolting). Smooth cylindrical tensile specimens of three sizes have been tested at strain rates from 0.001 to 300 s{sup -1}, at room and elevated temperatures (400-600 deg. C). Full stress-strain diagrams have been obtained, and additional parameters have been calculated based on them. The results demonstrate a clear influence of temperature, which amounts into reducing substantially mechanical strengths with respect to RT conditions. The effect of strain rate is also shown. It is observed that at RT the strain rate effect causes up shifting of the flow stress curves, whereas at the higher temperatures a mild downshifting of the flow curves is manifested. Size effect tendencies have also been observed. Some implications when assessing the pressure vessel structural integrity under severe accident conditions are considered.

  14. Influence of homogenization treatment on physicochemical properties and enzymatic hydrolysis rate of pure cellulose fibers.

    Science.gov (United States)

    Jacquet, N; Vanderghem, C; Danthine, S; Blecker, C; Paquot, M

    2013-02-01

    The aim of this study is to compare the effect of different homogenization treatments on the physicochemical properties and the hydrolysis rate of a pure bleached cellulose. Results obtained show that homogenization treatments improve the enzymatic hydrolysis rate of the cellulose fibers by 25 to 100 %, depending of the homogenization treatment applied. Characterization of the samples showed also that homogenization had an impact on some physicochemical properties of the cellulose. For moderate treatment intensities (pressure below 500 b and degree of homogenization below 25), an increase of water retention values (WRV) that correlated to the increase of the hydrolysis rate was highlighted. Result also showed that the overall crystallinity of the cellulose properties appeared not to be impacted by the homogenization treatment. For higher treatment intensities, homogenized cellulose samples developed a stable tridimentional network that contributes to decrease cellulase mobility and slowdown the hydrolysis process.

  15. Higher Growth Rate of Branch Duct Intraductal Papillary Mucinous Neoplasms Associates With Worrisome Features.

    Science.gov (United States)

    Kolb, Jennifer M; Argiriadi, Pamela; Lee, Karen; Liu, Xiaoyu; Bagiella, Emilia; Lucas, Aimee L; Kim, Michelle Kang; Kumta, Nikhil A; Nagula, Satish; Sarpel, Umut; DiMaio, Christopher J

    2018-03-11

    or invasive cancers. BD-IPMNs that developed worrisome features were associated with a significantly higher rate of growth than lesions with low-risk features. Low risk BD-IPMNs that grow more than 2.5 mm/year might require surveillance. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. Starting with a higher dose of inhaled corticosteroids in primary care asthma treatment

    NARCIS (Netherlands)

    van der Molen, T; Meyboom-de Jong, B; Mulder, HH; Postma, DS

    New British guidelines on the treatment of asthma (9) advocate starting with a higher dose of inhaled corticosteroids in newly detected asthma patients. We investigated whether initiating inhaled steroid treatment with a higher dose is clinically more effective than a lower dose in steroid naive

  17. Higher dose rate Gamma Knife radiosurgery may provide earlier and longer-lasting pain relief for patients with trigeminal neuralgia.

    Science.gov (United States)

    Lee, John Y K; Sandhu, Sukhmeet; Miller, Denise; Solberg, Timothy; Dorsey, Jay F; Alonso-Basanta, Michelle

    2015-10-01

    Gamma Knife radiosurgery (GKRS) utilizes cobalt-60 as its radiation source, and thus dose rate varies as the fixed source decays over its half-life of approximately 5.26 years. This natural decay results in increasing treatment times when delivering the same cumulative dose. It is also possible, however, that the biological effective dose may change based on this dose rate even if the total dose is kept constant. Because patients are generally treated in a uniform manner, radiosurgery for trigeminal neuralgia (TN) represents a clinical model whereby biological efficacy can be tested. The authors hypothesized that higher dose rates would result in earlier and more complete pain relief but only if measured with a sensitive pain assessment tool. One hundred thirty-three patients were treated with the Gamma Knife Model 4C unit at a single center by a single neurosurgeon during a single cobalt life cycle from January 2006 to May 2012. All patients were treated with 80 Gy with a single 4-mm isocenter without blocking. Using an output factor of 0.87, dose rates ranged from 1.28 to 2.95 Gy/min. The Brief Pain Inventory (BPI)-Facial was administered before the procedure and at the first follow-up office visit 1 month from the procedure (mean 1.3 months). Phone calls were made to evaluate patients after their procedures as part of a retrospective study. Univariate and multivariate linear regression was performed on several independent variables, including sex, age in deciles, diagnosis, follow-up duration, prior surgery, and dose rate. In the short-term analysis (mean 1.3 months), patients' self-reported pain intensity at its worst was significantly correlated with dose rate on multivariate analysis (p = 0.028). Similarly, patients' self-reported interference with activities of daily living was closely correlated with dose rate on multivariate analysis (p = 0.067). A 1 Gy/min decrease in dose rate resulted in a 17% decrease in pain intensity at its worst and a 22% decrease

  18. Failure Rate of Pediatric Dental Treatment under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Effat Khodadadi

    2018-06-01

    Full Text Available Aim: To assess the failure rates of various pediatric dental treatments performed under general anesthesia (GA after six months to five years of follow-up. Design: This multicenter retrospective cohort study was performed on patients treated by five pedodontists in two private hospitals located in northern Iran during 2010–2013 and comprised 155 patients. The patients were recalled and clinically examined. During the clinical examination of the primary teeth, oral hygiene, dmft index, and failure of previous treatments was evaluated. The data were analyzed using the Chi square and regression analyses with a significance level of 0.05. Results: 114 patients (74 males and 40 females, mean age: 37.17 ± 10.75 months with 1155 primary teeth treated under GA participated in the follow-up. The overall failure rate was 6.59%. The failure rates of pulpectomy, pulopotomy, fissure sealant, stainless steel crown (SSC, amalgam, and composite fillings were 2.90%, 3.03%, 4.83%, 5.26%, 5.33%, and 9.63%, respectively. Among the confounding factors, only gender had a significant effect on the anterior composite failure rate (p = 0.029 and age had a significant effect on the failure rate of fissure sealant therapy (p = 0.015 and SSC (p = 0.018. Conclusion: The overall rate of treatment failure in pediatric patients, treated under GA, was 6.59%.

  19. The motivation paradox: higher psychosocial problem levels in severely mentally ill patients are associated with less motivation for treatment.

    Science.gov (United States)

    Mulder, Cornelis L; Jochems, E; Kortrijk, H E

    2014-04-01

    Lack of motivation for treatment makes a subgroup of patients with severe mental illness (SMI) difficult to engage in psychiatric treatment. Such difficult-to-engage patients may also be the most in need of treatment. We hypothesized that the level of psychosocial problems would be inversely related to motivation for treatment. Cross-sectional study in two independent samples. The first sample (n = 294) included SMI patients who participated in a randomized controlled trial and were assessed using the Health of the Nation Outcome Scales (HoNOS) and self-rated and clinician-rated motivation-for-treatment scales. The second sample (n = 1,170) included SMI patients who were treated in Assertive Outreach Teams and were routinely assessed with the HoNOS and a motivation-for-treatment scale. In both samples, patients also self-rated their quality of life. In both samples, patients with HoNOS scores of 16 and higher had lower motivation scores on all motivation scales than patients with lower HoNOS scores, and also a lower quality of life. A motivation paradox seems inherent to this association between higher psychosocial problems levels, less motivation for treatment, and lower quality of life. Such a paradox has clinical relevance, as it may provide an ethical basis for outreach services which aim to engage marginally motivated SMI patients with severe psychosocial problems into mental health care.

  20. Rabies Vaccination: Higher Failure Rates in Imported Dogs than in those Vaccinated in Italy.

    Science.gov (United States)

    Rota Nodari, E; Alonso, S; Mancin, M; De Nardi, M; Hudson-Cooke, S; Veggiato, C; Cattoli, G; De Benedictis, P

    2017-03-01

    The current European Union (EU) legislation decrees that pets entering the EU from a rabies-infected third country have to obtain a satisfactory virus-neutralizing antibody level, while those moving within the EU require only rabies vaccination as the risk of moving a rabid pet within the EU is considered negligible. A number of factors driving individual variations in dog vaccine response have been previously reported, including a high rate of vaccine failure in puppies, especially those subject to commercial transport. A total of 21 001 observations collected from dogs (2006-2012) vaccinated in compliance with the current EU regulations were statistically analysed to assess the effect of different risk factors related to rabies vaccine efficacy. Within this framework, we were able to compare the vaccination failure rate in a group of dogs entering the Italian border from EU and non-EU countries to those vaccinated in Italy prior to international travel. Our analysis identified that cross-breeds and two breed categories showed high vaccine success rates, while Beagles and Boxers were the least likely to show a successful response to vaccination (88.82% and 90.32%, respectively). Our analysis revealed diverse performances among the commercially available vaccines, in terms of serological peak windows, and marked differences according to geographical area. Of note, we found a higher vaccine failure rate in imported dogs (13.15%) than in those vaccinated in Italy (5.89%). Our findings suggest that the choice of vaccine may influence the likelihood of an animal achieving a protective serological level and that time from vaccination to sampling should be considered when interpreting serological results. A higher vaccine failure in imported compared to Italian dogs highlights the key role that border controls still have in assessing the full compliance of pet movements with EU legislation to minimize the risk of rabies being reintroduced into a disease-free area.

  1. Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings.

    Science.gov (United States)

    Siddiqi, Arjumand; Jones, Marcella K; Erwin, Paul Campbell

    2015-04-01

    As the struggle continues to explain the relatively high rates of infant mortality (IMR) exhibited in the United States, a renewed emphasis is being placed on the role of possible 'contextual' determinants. Cross-sectional and short time-series studies have found that higher income inequality is associated with higher IMR at the state level. Yet, descriptively, the longer-term trends in income inequality and in IMR seem to call such results into question. To assess whether, over the period 1990-2007, state-level income inequality is associated with state-level IMR; to examine whether the overall effect of income inequality on IMR over this period varies by state; to test whether the association between income inequality and IMR varies across this time period. IMR data--number of deaths per 1000 live births in a given state and year--were obtained from the U.S. Centers for Disease Control Wonder database. Income inequality was measured using the Gini coefficient, which varies from zero (complete equality) to 100 (complete inequality). Covariates included state-level poverty rate, median income, and proportion of high school graduates. Fixed and random effects regressions were conducted to test hypotheses. Fixed effects models suggested that, overall, during the period 1990-2007, income inequality was inversely associated with IMR (β = -0.07, SE (0.01)). Random effects models suggested that when the relationship was allowed to vary at the state-level, it remained inverse (β = -0.05, SE (0.01)). However, an interaction between income inequality and time suggested that, as time increased, the effect of income inequality had an increasingly positive association with total IMR (β = 0.009, SE (0.002)). The influence of state income inequality on IMR is dependent on time, which may proxy for time-dependent aspects of societal context. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Higher resting heart rate variability predicts skill in expressing some emotions.

    Science.gov (United States)

    Tuck, Natalie L; Grant, Rosemary C I; Sollers, John J; Booth, Roger J; Consedine, Nathan S

    2016-12-01

    Vagally mediated heart rate variability (vmHRV) is a measure of cardiac vagal tone, and is widely viewed as a physiological index of the capacity to regulate emotions. However, studies have not directly tested whether vmHRV is associated with the ability to facially express emotions. In extending prior work, the current report tested links between resting vmHRV and the objectively assessed ability to facially express emotions, hypothesizing that higher vmHRV would predict greater expressive skill. Eighty healthy women completed self-reported measures, before attending a laboratory session in which vmHRV and the ability to express six emotions in the face were assessed. A repeated measures analysis of variance revealed a marginal main effect for vmHRV on skill overall; individuals with higher resting vmHRV were only better able to deliberately facially express anger and interest. Findings suggest that differences in resting vmHRV are associated with the objectively assessed ability to facially express some, but not all, emotions, with potential implications for health and well-being. © 2016 Society for Psychophysiological Research.

  3. Invasive acacias experience higher ant seed removal rates at the invasion edges

    Directory of Open Access Journals (Sweden)

    D. Montesinos

    2012-06-01

    Full Text Available Seed dispersal is a key process for the invasion of new areas by exotic species. Introduced plants often take advantage of native generalist dispersers. Australian acacias are primarily dispersed by ants in their native range and produce seeds bearing a protein and lipid rich reward for ant mutualists (elaiosome. Nevertheless, the role of myrmecochory in the expansion of Australian acacias in European invaded areas is still not clear. We selected one European population of Acacia dealbata and another of A. longifolia and offered elaiosome-bearing and elaiosome-removed seeds to local ant communities. For each species, seeds were offered both in high-density acacia stands and in low-density invasion edges. For both acacia species, seed removal was significantly higher at the low-density edges. For A. longifolia, manual elimination of elaiosomes reduced the chance of seed removal by 80% in the low-density edges, whereas it made no difference on the high-density stands. For A. dealbata, the absence of elaiosome reduced seed removal rate by 52%, independently of the acacia density. Our data suggests that invasive acacias have found effective ant seed dispersers in Europe and that the importance of such dispersers is higher at the invasion edges.

  4. Effect of additives for higher removal rate in lithium niobate chemical mechanical planarization

    International Nuclear Information System (INIS)

    Jeong, Sukhoon; Lee, Hyunseop; Cho, Hanchul; Lee, Sangjik; Kim, Hyoungjae; Kim, Sungryul; Park, Jaehong; Jeong, Haedo

    2010-01-01

    High roughness and a greater number of defects were created by lithium niobate (LN; LiNbO 3 ) processes such as traditional grinding and mechanical polishing (MP), should be decreased for manufacturing LN device. Therefore, an alternative process for gaining defect-free and smooth surface is needed. Chemical mechanical planarization (CMP) is suitable method in the LN process because it uses a combination approach consisting of chemical and mechanical effects. First of all, we investigated the LN CMP process using commercial slurry by changing various process conditions such as down pressure and relative velocity. However, the LN CMP process time using commercial slurry was long to gain a smooth surface because of lower material removal rate (MRR). So, to improve the material removal rate (MRR), the effects of additives such as oxidizer (hydrogen peroxide; H 2 O 2 ) and complexing agent (citric acid; C 6 H 8 O 7 ) in a potassium hydroxide (KOH) based slurry, were investigated. The manufactured slurry consisting of H 2 O 2 -citric acid in the KOH based slurry shows that the MRR of the H 2 O 2 at 2 wt% and the citric acid at 0.06 M was higher than the MRR for other conditions.

  5. Predicting chromium (VI) adsorption rate in the treatment of liquid ...

    African Journals Online (AJOL)

    The adsorption rate of chromium (VI) on commercial activated carbon during the treatment of the flocculation effluent of liquid-phase oil-based drill-cuttings has been investigated in terms of contact time and initial chromium (VI) ion concentration. Homogenizing 1 g of the activated carbon with 100 ml of the flocculation ...

  6. Performance of slow rate systems for treatment of domestic wastewater.

    Science.gov (United States)

    Tzanakakis, V E; Paranychianakis, N V; Angelakis, A N

    2007-01-01

    The performance of slow rate (SR) systems in terms of treatment efficiency, environmental and health risks, and land sustainability was investigated over a three-year period in a rural community close to Iraklio, Greece. Four plant species (Acacia cyanophylla, Eucalyptus camandulensis, Populus nigra and Arundo donax) were used in order to investigate the role of vegetation in the treatment of wastewater and in biomass production. Wastewater effluent was pre-treated in a septic tank before its application to land. Applied hydraulic loading rates were based on crop water requirements which were determined separately for each plant species. The evaluation of treatment performance was accomplished by measuring COD, TKN, NH3-N, NO3-N, total and reactive P, TC and FC in soil solution samples taken at different depths (15, 30 and 60 cm). SR systems showed great potential for COD, TKN and NH4-N removal which reached 89, 90 and 94%, respectively at a depth of 15 cm. An outstanding removal was also observed for TC and FC which reached 99.99%. The concentration of both P and NO3-N in soil solution increased with the passage of time, but it was lower in winter. Despite the differences in the application rates among the SR systems planted with different plant species, the treatment efficiency was not affected. Moreover, increasing the soil depth from 15 to 60 cm had no effect on the treatment efficiency of the SR systems.

  7. Higher Rates of DZ Twinning in a Twenty-First Century Birth Cohort.

    Science.gov (United States)

    Rhea, Sally Ann; Corley, Robin P; Heath, Andrew C; Iacono, William G; Neale, Michael C; Hewitt, John K

    2017-09-01

    The Colorado Twin Registry is a population based registry initiated in 1984 with the involvement of the Colorado Department of Health, Division of Vital Statistics. Recruitment includes birth cohorts several years prior to 1984 and all subsequent years. As part of a recent evaluation of Colorado birth records for the years 2006 through 2008 we became aware of a shifting trend in the proportion of MZ and DZ twins in the Colorado population. Historically (Bulmer 1970 The biology of twinning in man, Clarendon, Oxford) we have expected a 1/3, 1/3, 1/3 ratio of MZ, same-sex DZ and opposite sex DZ twins in Caucasian populations. An excess of MZ pairs in most studies was assumed to be due to selection bias. Somewhat more recently, Hur et al.(1995 Behav Genet 25, 337-340) provided evidence that the DZ twinning rate was falling and that therefore selection bias was not the reason for higher MZ enrollment in most twin studies. They suggested that twin researchers might consider strategies to over-enroll DZ pairs to maximize statistical power. In contrast, we now find that of the 3217 twin births in Colorado from 2006 to 2008 with identified sex information the MZ rate is estimated at only 22%, and we have corroborating reports from other states of similar estimates. These were calculated applying Weinberg's rule which assumes an equal birth rate for same sex and opposite sex DZ pairs so that the proportion of MZ in a sample is the proportion of same sex (MM + FF) minus the proportion of opposite-sex (MF, FM). We explore factors, such as an increase in the proportion of non-Caucasian parents and an increase in average maternal age, which may contribute to this shift.

  8. Pharmacogenetic analysis of opioid dependence treatment dose and dropout rate.

    Science.gov (United States)

    Crist, Richard C; Li, James; Doyle, Glenn A; Gilbert, Alex; Dechairo, Bryan M; Berrettini, Wade H

    2018-01-01

    Currently, no pharmacogenetic tests for selecting an opioid-dependence pharmacotherapy have been approved by the US Food and Drug Administration. Determine the effects of variants in 11 genes on dropout rate and dose in patients receiving methadone or buprenorphine/naloxone (ClinicalTrials.gov Identifier: NCT00315341). Variants in six pharmacokinetic genes (CYP1A2, CYP2B6, CYP2C19, CYP2C9, CYP2D6, CYP3A4) and five pharmacodynamic genes (HTR2A, OPRM1, ADRA2A, COMT, SLC6A4) were genotyped in samples from a 24-week, randomized, open-label trial of methadone and buprenorphine/naloxone for the treatment of opioid dependence (n = 764; 68.7% male). Genotypes were then used to determine the metabolism phenotype for each pharmacokinetic gene. Phenotypes or genotypes for each gene were analyzed for association with dropout rate and mean dose. Genotype for 5-HTTLPR in the SLC6A4 gene was nominally associated with dropout rate when the methadone and buprenorphine/naloxone groups were combined. When the most significant variants associated with dropout rate were analyzed using pairwise analyses, SLC6A4 (5-HTTLPR) and COMT (Val158Met; rs4860) had nominally significant associations with dropout rate in methadone patients. None of the genes analyzed in the study was associated with mean dose of methadone or buprenorphine/naloxone. This study suggests that functional polymorphisms related to synaptic dopamine or serotonin levels may predict dropout rates during methadone treatment. Patients with the S/S genotype at 5-HTTLPR in SLC6A4 or the Val/Val genotype at Val158Met in COMT may require additional treatment to improve their chances of completing addiction treatment. Replication in other methadone patient populations will be necessary to ensure the validity of these findings.

  9. Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis.

    Directory of Open Access Journals (Sweden)

    Michael A Ruderman

    Full Text Available This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004.Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees.Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs with 95% confidence intervals (CIs were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis.Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05-4.17, drug violations (HR 2.44 95% CI: 2.00-2.98, non-violent violations (HR 2.14 95% CI: 1.73-2.64, violent and serious violations (HR 1.88 95% CI: 1.45-2.43, and technical violations (HR 1.86 95% CI: 1.37-2.53.Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted.

  10. Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis.

    Science.gov (United States)

    Ruderman, Michael A; Wilson, Deirdra F; Reid, Savanna

    2015-01-01

    This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004). Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees. Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis. Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05-4.17), drug violations (HR 2.44 95% CI: 2.00-2.98), non-violent violations (HR 2.14 95% CI: 1.73-2.64), violent and serious violations (HR 1.88 95% CI: 1.45-2.43), and technical violations (HR 1.86 95% CI: 1.37-2.53). Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted.

  11. Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis

    Science.gov (United States)

    Ruderman, Michael A.; Wilson, Deirdra F.; Reid, Savanna

    2015-01-01

    Objective This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004). Background Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees. Methods Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis. Results Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05–4.17), drug violations (HR 2.44 95% CI: 2.00–2.98), non-violent violations (HR 2.14 95% CI: 1.73–2.64), violent and serious violations (HR 1.88 95% CI: 1.45–2.43), and technical violations (HR 1.86 95% CI: 1.37–2.53). Conclusions Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted. PMID:26492490

  12. Modified Mitchell osteotomy alone does not have higher rate of residual metatarsalgia than combined first and lesser metatarsal osteotomy

    Directory of Open Access Journals (Sweden)

    Shu-Jung Chen

    2015-04-01

    Full Text Available Transfer metatarsalgia (TM is a common forefoot disorder secondary to hallux valgus (HV. Some authors suggest that a combined lesser metatarsal osteotomy while undergoing HV surgery improves metatarsalgia, whereas others concluded that isolated HV corrective osteotomy can improve symptomatic metatarsalgia. The main purpose of this retrospective study was to compare clinical outcomes in patients with and without combined lesser metatarsal osteotomy while receiving HV correction surgery. We retrospectively reviewed the patients who underwent osteotomy for HV correction between January 2000 and December 2010. All patients underwent HV correction with modified Mitchell osteotomy. Clinical evaluations including the American Orthopaedic Foot and Ankle Society score and residual metatarsalgia were assessed, and radiographic measurements were carried out. Sixty-five patients (83 feet meeting the selection criteria were enrolled. Thirty feet receiving a combined lesser metatarsal osteotomy were classified as the combined surgery (CS group, and the others were classified as the control (CN group (53 feet. The overall rate of persistent symptomatic metatarsalgia was 19.28% after operative treatment. There were six feet with residual metatarsalgia in the CS group, and 10 feet in the CN group. There was no significant difference in the rate of persistent symptoms between the two groups (p = 0.9. According to this result, modified Mitchell osteotomy alone did not have a higher rate of residual metatarsalgia than CS. We also found that the average recovery rate of TM was about 80.7% and those patients whose preoperative HV angle was > 30° had the higher risk of residual metatarsalgia after surgery.

  13. Higher Education Support Services and Graduation Rates of Structured Education Program Students

    Science.gov (United States)

    Hepner, Seth

    2017-01-01

    The 1st-year retention rate of the Structured Education Program (SEP) is 90%, yet the 6-year graduation rate of SEP students is 29%. The gap between SEP 1st-year retention and graduation rates is the problem that this study addressed. The low graduation rate of SEP students is an important issue because graduation rates are used to measure the…

  14. Increased Total Anesthetic Time Leads to Higher Rates of Surgical Site Infections in Spinal Fusions.

    Science.gov (United States)

    Puffer, Ross C; Murphy, Meghan; Maloney, Patrick; Kor, Daryl; Nassr, Ahmad; Freedman, Brett; Fogelson, Jeremy; Bydon, Mohamad

    2017-06-01

    A retrospective review of a consecutive series of spinal fusions comparing patient and procedural characteristics of patients who developed surgical site infections (SSIs) after spinal fusion. It is known that increased surgical time (incision to closure) is associated with a higher rate of postoperative SSIs. We sought to determine whether increased total anesthetic time (intubation to extubation) is a factor in the development of SSIs as well. In spine surgery for deformity and degenerative disease, SSI has been associated with operative time, revealing a nearly 10-fold increase in SSI rates in prolonged surgery. Surgical time is associated with infections in other surgical disciplines as well. No studies have reported whether total anesthetic time (intubation to extubation) has an association with SSIs. Surgical records were searched in a retrospective fashion to identify all spine fusion procedures performed between January 2010 and July 2012. All SSIs during that timeframe were recorded and compared with the list of cases performed between 2010 and 2012 in a case-control design. There were 20 (1.7%) SSIs in this fusion cohort. On univariate analyses of operative factors, there was a significant association between total anesthetic time (Infection 7.6 ± 0.5 hrs vs. no infection -6.0 ± 0.1 hrs, P operative time (infection 5.5 ± 0.4 hrs vs. no infection - 4.4 ± 0.06 hrs, P infections, whereas level of pathology and emergent surgery were not significant. On multivariate logistic analysis, BMI and total anesthetic time remained independent predictors of SSI whereas ASA status and operative time did not. Increasing BMI and total anesthetic time were independent predictors of SSIs in this cohort of over 1000 consecutive spinal fusions. 3.

  15. [High complication rate after surgical treatment of ankle fractures].

    Science.gov (United States)

    Bjørslev, Naja; Ebskov, Lars; Lind, Marianne; Mersø, Camilla

    2014-08-04

    The purpose of this study was to determine the quality and re-operation rate of the surgical treatment of ankle fractures at a large university hospital. X-rays and patient records of 137 patients surgically treated for ankle fractures were analyzed for: 1) correct classification according to Lauge-Hansen, 2) if congruity of the ankle joint was achieved, 3) selection and placement of the hardware, and 4) the surgeon's level of education. Totally 32 of 137 did not receive an optimal treatment, 11 were re-operated. There was no clear correlation between incorrect operation and the surgeon's level of education.

  16. Improvement of mutation rate and reduction of somatic effects by double treatment of chemical mutagens in barley

    International Nuclear Information System (INIS)

    Koo, B.C.; Maluszynski, M.

    1996-01-01

    Mutation techniques inducing more useful mutations and reducing somatic effects need to be improved for crop breeding. Seeds of barley varieties; Dema, Grosso were treated with two types of mutagens; 1) chemical treatment: single treatment or double treatment of two mutagens (N-nitroso-N-methylurea ; MNH, Sodium Azide; NaN 3 ) 2) gamma ray irradiation treatment. After treatment, half of seeds were used for germination test and half of seeds were sown to the field. With the higher dose of mutagen both chemical and gamma ray were plants treated, the higher rate of growth reduction rate was in M 1 seedling. In chemical treatment, germination rate of seeds, growth rate of coleoptile and root in double treatment of chemical mutagens were better than single treatments, especially in same dose. Growth inhibition rate of plant in double treatment of 1.0 mM MNH (0.5 mM MNH + 0.5 mM MNH), for example, were less than one of plants of single treatment of 1.0 mM MNH in pot and petri dish test. Growth reduction rate of culm and fertility rate in M 1 plants double treated in same dose of single treatment were also less than single one. With the higher dose of mutagen both chemical and gamma ray were plants treated, the higher frequency of chlorophyll mutants was in M 2 seedling. The rate of chlorophyll mutants in double treatment of chemical mutagens were higher than single treatment. Double treatment methods can be a improved method for induction of new good mutants, which were induced more useful mutations and reduced harmful somatic effects

  17. Continuous fermentation and in-situ reed separation of butyric acid for higher sugar consumption rate and productivity

    DEFF Research Database (Denmark)

    Baroi, George Nabin; Skiadas, Ioannis; Westermann, Peter

    that disconnection of the REED system resulted to much lower (48 and 83% for glucose and xylose, respectively) sugars consumption rates and consequently lower butyric acid production rates. It was also noticeable that continuous operation, even without the REED system, resulted to higher glucose consumption rates...

  18. Pulsed dose rate and fractionated high dose rate brachytherapy: choice of brachytherapy schedules to replace low dose rate treatments

    International Nuclear Information System (INIS)

    Visser, Andries G.; Aardweg, Gerard J.M.J. van den; Levendag, Peter C.

    1996-01-01

    Purpose: Pulsed dose rate (PDR) brachytherapy is a new type of afterloading brachytherapy (BT) in which a continuous low dose rate (LDR) treatment is simulated by a series of 'pulses,' i.e., fractions of short duration (less than 0.5 h) with intervals between fractions of 1 to a few hours. At the Dr. Daniel den Hoed Cancer Center, the term 'PDR brachytherapy' is used for treatment schedules with a large number of fractions (at least four per day), while the term 'fractionated high dose rate (HDR) brachytherapy' is used for treatment schedules with just one or two brachytherapy fractions per day. Both treatments can be applied as alternatives for LDR BT. This article deals with the choice between PDR and fractionated HDR schedules and proposes possible fractionation schedules. Methods and Materials: To calculate HDR and PDR fractionation schedules with the intention of being equivalent to LDR BT, the linear-quadratic (LQ) model has been used in an incomplete repair formulation as given by Brenner and Hall, and by Thames. In contrast to earlier applications of this model, both the total physical dose and the overall time were not kept identical for LDR and HDR/PDR schedules. A range of possible PDR treatment schedules is presented, both for booster applications (in combination with external radiotherapy (ERT) and for BT applications as a single treatment. Because the knowledge of both α/β values and the half time for repair of sublethal damage (T (1(2)) ), which are required for these calculations, is quite limited, calculations regarding the equivalence of LDR and PDR treatments have been performed for a wide range of values of α/β and T (1(2)) . The results are presented graphically as PDR/LDR dose ratios and as ratios of the PDR/LDR tumor control probabilities. Results: If the condition that total physical dose and overall time of a PDR treatment must be exactly identical to the values for the corresponding LDR treatment regimen is not applied, there appears

  19. Does adding metformin to clomifene citrate lead to higher pregnancy rates in a subset of women with polycystic ovary syndrome?

    OpenAIRE

    Moll, E.; Korevaar, J.C.; Bossuyt, P.M.M.; van der Veen, F.

    2008-01-01

    BACKGROUND An RCT among newly diagnosed, therapy naive women with polycystic ovary syndrome (PCOS) showed no significant differences in ovulation rate, ongoing pregnancy rate or spontaneous abortion rate in favour of clomifene citrate plus metformin compared with clomifene citrate. We wanted to assess whether there are specific subgroups of women with PCOS in whom clomifene citrate plus metformin leads to higher pregnancy rates. METHODS Subgroup analysis based on clinical and biochemical para...

  20. Treatment philosophy and retreatment rates following piezoelectric lithotripsy.

    Science.gov (United States)

    Fegan, J; Camp, L A; Wilson, W T; Miller, G L; Preminger, G M

    1993-01-01

    Second generation lithotriptors offer the advantage of anesthesia-free fragmentation of renal and ureteral calculi but they frequently require multiple treatments to attain a stone-free status. However, excessive single lithotripsy sessions or multiple treatments may be associated with significant damage to the kidney. For some clinicians a common treatment philosophy involves evaluation of serial plain abdominal films every 24 hours after lithotripsy and immediate retreatment of all patients with incomplete fragmentation. To avoid unnecessary retreatments and, thus, minimize potential renal damage, we prospectively evaluated 100 patients undergoing lithotripsy on a Wolf Piezolith 2300 device. Patients were routinely treated with 4,000 shocks at 1,100 bar. Serial plain abdominal films were obtained at 1 day and 2 weeks after lithotripsy. The need for retreatment was determined by the plain abdominal film results. Additional therapy was considered necessary if there was no stone fragmentation or if residual fragments measured greater than 4 mm. Of the patients whose plain abdominal film at 24 hours indicated the need for a repeat treatment 43% were stone-free on the 2-week film. Thus, these patients were spared an unnecessary treatment by allowing adequate time for the stone fragments to pass spontaneously. Our data suggest that repeat treatments on second generation lithotriptors should not be performed within 24 hours. Rather, the patient should be reevaluated at least 1 to 2 weeks later to avoid unnecessary retreatment with the attendant potential for renal injury. In addition, when comparing the retreatment rates of various lithotriptors, one should also consider the treatment philosophy used at the particular institution and the timing of the radiographic studies used to determine the stone-free status.

  1. Higher USA State Resident Neuroticism Is Associated With Lower State Volunteering Rates.

    Science.gov (United States)

    McCann, Stewart J H

    2017-12-01

    Highly neurotic persons have dispositional characteristics that tend to precipitate social anxiety that discourages formal volunteering. With the 50 American states as analytical units, Study 1 found that state resident neuroticism correlated highly ( r = -.55) with state volunteering rates and accounted for another 26.8% of the volunteering rate variance with selected state demographics controlled. Study 2 replicated Study 1 during another period and extended the association to college student, senior, secular, and religious volunteering rates. Study 3 showed state resident percentages engaged in other social behaviors involving more familiarity and fewer demands than formal volunteering related to state volunteering rates but not to neuroticism. In Study 4, state resident neuroticism largely accounted statistically for relations between state volunteering rates and state population density, collectivism, social capital, Republican preference, and well-being. This research is the first to show that state resident neuroticism is a potent predictor of state volunteering rates.

  2. Predicting higher education graduation rates from institutional characteristics and resource allocation

    Directory of Open Access Journals (Sweden)

    Florence A. Hamrick

    2004-05-01

    Full Text Available This study incorporated institutional characteristics (e.g., Carnegie type, selectivity and resource allocations (e.g., instructional expenditures, student affairs expenditures into a statistical model to predict undergraduate graduation rates. Instructional expenditures, library expenditures, and a number of institutional classification variables were significant predictors of graduation rates. Based on these results, recommendations as well as warranted cautions are included about allocating academic financial resources to optimize graduation rates

  3. Do Astronauts have a Higher Rate of Orthopedic Shoulder Conditions than a Cohort of Working Professionals?

    Science.gov (United States)

    Laughlin, Mitzi S.; Murray, Jocelyn D.; Young, Millenia; Wear, Mary L.; Tarver, W. J.; Van Baalen, Mary

    2016-01-01

    Occupational surveillance of astronaut shoulder injuries began with operational concerns at the Neutral Buoyancy Laboratory (NBL) during Extra Vehicular Activity (EVA) training. NASA has implemented several occupational health initiatives during the past 20 years to decrease the number and severity of injuries, but the individual success rate is unknown. Orthopedic shoulder injury and surgery rates were calculated, but classifying the rates as normal, high or low was highly dependent on the comparison group. The purpose of this study was to identify a population of working professionals and compare orthopedic shoulder consultation and surgery rates.

  4. Predicting higher education graduation rates from institutional characteristics and resource allocation

    OpenAIRE

    Florence A. Hamrick; John H. Schuh; Mack C. Shelley

    2004-01-01

    This study incorporated institutional characteristics (e.g., Carnegie type, selectivity) and resource allocations (e.g., instructional expenditures, student affairs expenditures) into a statistical model to predict undergraduate graduation rates. Instructional expenditures, library expenditures, and a number of institutional classification variables were significant predictors of graduation rates. Based on these results, recommendations as well as warranted cautions are included about allocat...

  5. Results of a pilot scale melter test to attain higher production rates

    International Nuclear Information System (INIS)

    Elliott, M.L.; Perez, J.M. Jr.; Chapman, C.C.

    1991-01-01

    A pilot-scale melter test was completed as part of the effort to enhance glass production rates. The experiment was designed to evaluate the effects of bulk glass temperature and feed oxide loading. The maximum glass production rate obtained, 86 kg/hr-m 2 , was over 200% better than the previous record for the melter used

  6. Heroin addicts have higher discount rates for delayed rewards than non-drug-using controls.

    Science.gov (United States)

    Kirby, K N; Petry, N M; Bickel, W K

    1999-03-01

    Fifty-six heroin addicts and 60 age-matched controls were offered choices between monetary rewards ($11-$80) available immediately and larger rewards ($25-$85) available after delays ranging from 1 week to 6 months. Participants had a 1-in-6 chance of winning a reward that they chose on one randomly selected trial. Delay-discounting rates were estimated from the pattern of participants' choices. The discounting model of impulsiveness (Ainslie, 1975) implies that delay-discounting rates are positively correlated with impulsiveness. On average, heroin addicts' discount rates were twice those of controls (p = .004), and discount rates were positively correlated with impulsivity as measured by self-report questionnaires (p discounting rate as a measure of impulsiveness, a characteristic associated with substance abuse.

  7. The method of treatment cessation and recurrence rate of amblyopia.

    Science.gov (United States)

    Walsh, Leah A; Hahn, Erik K; LaRoche, G Robert

    2009-09-01

    To date, much of the research regarding amblyopia has been focused on which therapeutic modality is the most efficacious in amblyopia management. Unfortunately, there is a lack of research into which method of treatment cessation is the most appropriate once therapy has been completed. The purpose of this study is to investigate if the cessation method affects the recurrence rate of amblyopia. This study was a prospective randomized clinical trial of 20 subjects who were wearing full-time occlusion and were at the end point of their therapy. The subjects were randomized into one of two groups: abrupt cessation or therapy tapering. All subjects were followed for 3 consecutive 4-week intervals, for a total of 12 weeks, to assess the short-term recurrence rate of amblyopia. Subjects who were in the tapered group had their occlusion reduced from full-time occlusion (all waking hours minus one) to 50% of waking hours at study enrollment (i.e., from 12 hours/day to 6 hours per day); occlusion was reduced by an additional 50% at the first 4-week study visit (i.e., from 6 hours/day to 3 hours), with occlusion being discontinued completely at the week 8 visit. All subjects who were in the abrupt cessation group had their full-time occlusion discontinued completely at the start of the study (i.e., from 12 hours/day to none). Additional assessments were also conducted at week 26 and week 52 post-therapy cessation to determine the longer term amblyopia regression rate. For the purposes of this study, recurrence was defined as a 0.2 (10 letters) or more logarithm of the minimum angle of resolution (logMAR) loss of visual acuity. A recurrence of amblyopia occurred in 4 of 17 (24%; CI 9%-47%) participants completing the study by the week 52 study end point. There were 2 subjects from each treatment group who demonstrated a study protocol-defined recurrence. There was a 24% risk of amblyopia recurrence if therapy was discontinued abruptly or tapered in 8 weeks. In this small

  8. Are Interpersonal Violence Rates Higher Among Young Women in College Compared With Those Never Attending College?

    Science.gov (United States)

    Coker, Ann L; Follingstad, Diane R; Bush, Heather M; Fisher, Bonnie S

    2016-05-01

    Estimates of sexual violence and partner violence rates among young women are generated primarily from college samples. Few studies have data to compare rates among similar-aged women attending college with those who never attended college. This study aims to estimate rates of partner violence by type (sexual, physical, and psychological) and severity (mild, moderate, severe), sexual harassment, and knowing or suspecting that someone put a drug in a drink (drugged drink) among a national sample of 959 young women aged 18 to 24 in an intimate relationship in the past 12 months who were either currently in college (college;n= 272) or never attended college (non-college;n= 687). After adjusting for demographic differences between these two groups, no significant differences were found in rates of sexual partner violence (28.4% non-college, 23.5% college), physical partner violence (27.9% non-college, 26.3% college), psychological partner violence (Mscore: 6.10 non-college, 5.59 college), sexual harassment (15.5% non-college, 14.1% college), or drugged drink (8.5% non-college, 7.8% college). Finding high rates of interpersonal violence among young women who are and are not currently attending college indicates the need to target all young adults with violence prevention interventions in educational, workplace, and other community-based settings. © The Author(s) 2015.

  9. Higher speciation and lower extinction rates influence mammal diversity gradients in Asia.

    Science.gov (United States)

    Tamma, Krishnapriya; Ramakrishnan, Uma

    2015-02-04

    Little is known about the patterns and correlates of mammal diversity gradients in Asia. In this study, we examine patterns of species distributions and phylogenetic diversity in Asia and investigate if the observed diversity patterns are associated with differences in diversification rates between the tropical and non-tropical regions. We used species distribution maps and phylogenetic trees to generate species and phylogenetic diversity measures for 1° × 1° cells across mainland Asia. We constructed lineage-through-time plots and estimated diversification shift-times to examine the temporal patterns of diversifications across orders. Finally, we tested if the observed gradients in Asia could be associated with geographical differences in diversification rates across the tropical and non-tropical biomes. We estimated speciation, extinction and dispersal rates across these two regions for mammals, both globally and for Asian mammals. Our results demonstrate strong latitudinal and longitudinal gradients of species and phylogenetic diversity with Southeast Asia and the Himalayas showing highest diversity. Importantly, our results demonstrate that differences in diversification (speciation, extinction and dispersal) rates between the tropical and the non-tropical biomes influence the observed diversity gradients globally and in Asia. For the first time, we demonstrate that Asian tropics act as both cradles and museums of mammalian diversity. Temporal and spatial variation in diversification rates across different lineages of mammals is an important correlate of species diversity gradients observed in Asia.

  10. Vigorous physical activity predicts higher heart rate variability among younger adults.

    Science.gov (United States)

    May, Richard; McBerty, Victoria; Zaky, Adam; Gianotti, Melino

    2017-06-14

    Baseline heart rate variability (HRV) is linked to prospective cardiovascular health. We tested intensity and duration of weekly physical activity as predictors of heart rate variability in young adults. Time and frequency domain indices of HRV were calculated based on 5-min resting electrocardiograms collected from 82 undergraduate students. Hours per week of both moderate and vigorous activity were estimated using the International Physical Activity Questionnaire. In regression analyses, hours of vigorous physical activity, but not moderate activity, significantly predicted greater time domain and frequency domain indices of heart rate variability. Adjusted for weekly frequency, greater daily duration of vigorous activity failed to predict HRV indices. Future studies should test direct measurements of vigorous activity patterns as predictors of autonomic function in young adulthood.

  11. Reducing Error Rates for Iris Image using higher Contrast in Normalization process

    Science.gov (United States)

    Aminu Ghali, Abdulrahman; Jamel, Sapiee; Abubakar Pindar, Zahraddeen; Hasssan Disina, Abdulkadir; Mat Daris, Mustafa

    2017-08-01

    Iris recognition system is the most secured, and faster means of identification and authentication. However, iris recognition system suffers a setback from blurring, low contrast and illumination due to low quality image which compromises the accuracy of the system. The acceptance or rejection rates of verified user depend solely on the quality of the image. In many cases, iris recognition system with low image contrast could falsely accept or reject user. Therefore this paper adopts Histogram Equalization Technique to address the problem of False Rejection Rate (FRR) and False Acceptance Rate (FAR) by enhancing the contrast of the iris image. A histogram equalization technique enhances the image quality and neutralizes the low contrast of the image at normalization stage. The experimental result shows that Histogram Equalization Technique has reduced FRR and FAR compared to the existing techniques.

  12. Mechanisms promoting higher growth rate in arctic than in temperate shorebirds

    NARCIS (Netherlands)

    Schekkerman, H.; Tulp, I.Y.M.; Piersma, T.; Visser, G.H.

    2003-01-01

    We compared prefledging growth, energy expenditure, and time budgets in the arctic-breeding red knot (Calidris canutus) to those in temperate shorebirds, to investigate how arctic chicks achieve a high growth rate despite energetic difficulties associated with precocial development in a cold

  13. Mechanisms promoting higher growth rate in arctic than in temperate shorebirds

    NARCIS (Netherlands)

    Schekkerman, H; Tulp, Ingrid; Piersma, T.; Visser, G.H.

    We compared prefledging growth, energy expenditure, and time budgets in the arctic-breeding red knot (Calidris canutus) to those in temperate shorebirds, to investigate how arctic chicks achieve a high growth rate despite energetic difficulties associated with precocial development in a cold

  14. Honest signaling in trust interactions: smiles rated as genuine induce trust and signal higher earning opportunities

    OpenAIRE

    Centorrino, S.; Djemai, E.; Hopfensitz, A.; Milinski, M.; Seabright, P.

    2015-01-01

    We test the hypothesis that smiles perceived as honest serve as a signal that has evolved to induce cooperation in situations requiring mutual trust. Potential trustees (84 participants from Toulouse, France) made two video clips averaging around 15 seconds for viewing by potential senders before the latter decided whether to ‘send’ or ‘keep’ a lower stake (4 euros) or higher stake (8 euros). Senders (198 participants from Lyon, France) made trust decisions with respect to the recorded clips....

  15. Surgical site infection and transfusion rates are higher in underweight total knee arthroplasty patients

    Directory of Open Access Journals (Sweden)

    Jorge Manrique, MD

    2017-03-01

    Conclusions: Our study demonstrates that UW TKA patients have a higher likelihood of developing SSI and requiring blood transfusions. The specific reasons are unclear, but we conjecture that it may be related to decreased wound healing capabilities and low preoperative hemoglobin. Investigation of local tissue coverage and hematologic status may be beneficial in this patient population to prevent SSI. Based on the results of this study, a prospective evaluation of these factors should be undertaken.

  16. MATHEMATICAL MODELING OF HEATING RATE PRODUCT AT HIGH HEAT TREATMENT

    Directory of Open Access Journals (Sweden)

    M. M. Akhmedova

    2014-01-01

    Full Text Available Methods of computing and mathematical modeling are all widely used in the study of various heat exchange processes that provide the ability to study the dynamics of the processes, as well as to conduct a reasonable search for the optimal technological parameters of heat treatment.This work is devoted to the identification of correlations among the factors that have the greatest effect on the rate of heating of the product at hightemperature heat sterilization in a stream of hot air, which are chosen as the temperature difference (between the most and least warming up points and speed cans during heat sterilization.As a result of the experimental data warming of the central and peripheral layers compote of apples in a 3 liter pot at high-temperature heat treatment in a stream of hot air obtained by the regression equation in the form of a seconddegree polynomial, taking into account the effects of pair interaction of these parameters. 

  17. Chemotherapy-Induced Fatigue Correlates With Higher Fatigue Scores Before Treatment.

    Science.gov (United States)

    Araújo, José Klerton Luz; Giglio, Adriana Del; Munhoz, Bruna Antenusse; Fonseca, Fernando Luiz Affonso; Cruz, Felipe Melo; Giglio, Auro Del

    2017-06-01

    Cancer chemotherapy can induce fatigue in about 20% to 30% of patients. So far, there is very little information as to the predictors of chemotherapy-induced fatigue (CIF). We evaluated potential predictors of CIF in a sample of patients with cancer with several types of solid tumors scheduled to receive chemotherapy according to institutional protocols. Before their first and second chemotherapy cycles, patients answered to the Brief Fatigue Inventory (BFI), Chalder, Mini Nutritional Assessment (MNA), Stress thermometer, and HADS questionnaires as well as provided blood samples for inflammatory markers. We evaluated 52 patients, 37 (71%) were female and mean age was 53 years. The most common tumors were breast cancer 21 (40%) and gastrointestinal tumors 12 (23%). Although 14 (25.2%) patients had an increase in their fatigue BFI scores equal or above 3 points from baseline, we observed no significant overall differences between BFI scores before and after chemotherapy. The only 2 factors associated with an increase of 3 points in the BFI scores after chemotherapy were race and higher baseline BFI levels. By multivariate analysis, overall BFI and Chalder scores after chemotherapy also correlated significantly with their respective baseline scores before treatment. HADS scores before treatment correlated with overall BFI scores postchemotherapy, whereas MNA scores before chemotherapy and female sex correlated with higher Chalder scores after treatment. We conclude that fatigue induced by chemotherapy is common and consistently associated with higher fatigue scores before treatment. Screening for fatigue before chemotherapy may help to identify patients who are prone to develop CIF.

  18. Accuracy of rate coding: When shorter time window and higher spontaneous activity help

    Czech Academy of Sciences Publication Activity Database

    Leváková, Marie; Tamborrino, M.; Košťál, Lubomír; Lánský, Petr

    2017-01-01

    Roč. 95, č. 2 (2017), č. článku 022310. ISSN 2470-0045 R&D Projects: GA ČR(CZ) GA15-08066S; GA MŠk(CZ) 7AMB17AT048 Institutional support: RVO:67985823 Keywords : rate coding * observation window * spontaneous activity * Fisher information * perfect integrate- and -fire model * Wiener process Subject RIV: BB - Applied Statistics, Operational Research OBOR OECD: Biology (theoretical, mathematical, thermal, cryobiology, biological rhythm), Evolutionary biology Impact factor: 2.366, year: 2016

  19. Comparison of higher order spectra in heart rate signals during two techniques of meditation: Chi and Kundalini meditation.

    Science.gov (United States)

    Goshvarpour, Ateke; Goshvarpour, Atefeh

    2013-02-01

    The human heartbeat is one of the important examples of complex physiologic fluctuations. For the first time in this study higher order spectra of heart rate signals during meditation have explored. Specifically, the aim of this study was to analysis and compares the contribution of quadratic phase coupling of human heart rate variability during two forms of meditation: (1) Chinese Chi (or Qigong) meditation and (2) Kundalini Yoga meditation. For this purpose, Bispectrum was estimated by using biased, parametric and the direct (FFT) method. The results show that the mean Bispectrum magnitude of heart rate signals increased during Kundalini Yoga meditation, but it decreased significantly during Chi meditation. However, in both meditation techniques phase-coupled harmonics are shifted to the higher frequencies during meditation. In addition, it has shown that not only there are significant differences between rest and meditation states, but also heart rate patterns appear to be influenced by different types of meditation.

  20. Religious affiliation and psychiatric morbidity in Brazil: higher rates among evangelicals and spiritists.

    Science.gov (United States)

    Dalgalarrondo, Paulo; Marín-León, Leticia; Botega, Neury José; Berti De Azevedo Barros, Marilisa; Bosco De Oliveira, Helenice

    2008-11-01

    To verify the association between the prevalence of mental symptoms and excessive alcohol intake with religious affiliation, church attendance and personal religiosity. A household survey of 515 adults randomly sampled included the WHO SUPRE-MISS questionnaire, SRQ-20 and AUDIT. Weighted prevalences were estimated and logistic analyses were performed. Minor psychiatric morbidity was greater among Spiritists and Protestants/ Evangelicals than in Catholics and in the ;no-religion' group. The latter had a greater frequency of abusive alcohol drinking pattern and Protestants/Evangelicals showed lower drinking patterns. Although belonging to Protestant/Evangelical churches in Brazil may inhibit alcohol involvement it seems to be associated to a higher frequency of depressive symptoms. Processes of seeking relief in new religious affiliations among sub-groups with previous minor psychiatric symptoms may probably occur in the Brazilian society.

  1. Weaker gun state laws are associated with higher rates of suicide secondary to firearms.

    Science.gov (United States)

    Alban, Rodrigo F; Nuño, Miriam; Ko, Ara; Barmparas, Galinos; Lewis, Azaria V; Margulies, Daniel R

    2018-01-01

    Firearm-related suicides comprise over two-thirds of gun-related violence in the United States, and gun laws and policies remain under scrutiny, with many advocating for revision of the regulatory map for lawful gun ownership, aiming at restricting access and distribution of these weapons. However, the quantitative relationship between how strict gun laws are and the incidence of firearm violence with their associated mortality is largely unknown. We therefore, sought to explore the impact of firearm law patterns among states on the incidence and outcomes of firearm-related suicide attempts, utilizing established objective criteria. The National Inpatient Sample for the years 1998-2011 was queried for all firearm-related suicides. Discharge facilities were stratified into five categories (A, B, C, D, and F, with A representing states with the most strict and F representing states with the least strict laws) based on the Brady Campaign to prevent Gun Violence that assigns scorecards for every state. The primary outcomes were suicide attempts and in-hospital mortality per 100,000 populations by Brady state grade. During the 14-year study period, 34,994 subjects met inclusion criteria. The mean age was 42.0 years and 80.1% were male. A handgun was utilized by 51.8% of patients. The overall mortality was 33.3%. Overall, 22.0% had reported psychoses and 19.3% reported depression. After adjusting for confounding factors and using group A as reference, there were higher adjusted odds for suicide attempts for patients admitted in group C, D, and F category states (1.73, 2.09, and 1.65, respectively, all P gun laws, and these injuries tend to be associated with a higher mortality. Efforts aimed at nationwide standardization of firearm state laws are warranted, particularly for young adults and suicide-prone populations. III. Trauma Outcomes study. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Lead Burden as a Factor for Higher Complication Rate in Patients With Implantable Cardiac Devices

    Directory of Open Access Journals (Sweden)

    Christopher Kolibash

    2015-01-01

    Full Text Available Purpose: Lead revisions have increased over the last decade. Patients who do not undergo lead extraction face an increased lead burden. Consequences of increased lead burden have not been fully defined. We sought to characterize the complication rate and outcomes in patients with sterile redundant leads. Methods: We retrospectively reviewed 242 consecutive patients [mean age 74 ± 12 years; 66.9% male] who underwent lead revision that resulted in an abandoned lead from January 2005 to June 2010. Patients were placed in a cohort based on number of leads after last recorded procedure (Group A: ≤2 [n=58]; Group B: 3-4 [n=168]; Group C: ≥5 [n=16]. Prespecified inhospital and long-term follow-up events were compared. Mortality rates were obtained from Social Security Death Index. Median follow-up was 2 years. Results: Baseline age, gender and race demographics were similar among the three groups. Increasing lead burden was associated with more adverse periprocedural events (A: 3.4%, B: 10.1%, C: 25.0%; P=0.031 and long-term device-related events (A: 1.7%, B: 13.0%, C: 18.8%; P=0.031. Device-related readmissions increased in frequency as lead burden increased (A: 3.5%, B: 18.5%, C: 37.5%; P=0.002. Combined periprocedural and late events also increased with more redundant leads (A: 5.2%, B: 23.2%, C: 44.0%; P=0.001. Total major events were infrequent (3.3%. There was no procedure-related mortality. Long-term all-cause mortality was not significantly different (A: 17.2%, B: 23.8%, C: 25.0%; P=0.567. Conclusions: Greater lead burden was associated with increased number of periprocedural and long-term minor events. It did not significantly impact major events or mortality.

  3. Vitamin C supplementation improve the sputum conversion culture rate in pulmonary tuberculosis treatment while rifampicin susceptible

    Science.gov (United States)

    Susanto, L.; Siregar, Y.; Kusumawati, L.

    2018-03-01

    The failure of first-line tuberculosis treatment greatly affects multiple drug-resistant tuberculosis. In vitro study of vitamin C induces the death of M. tuberculosis bacteria and accelerates healing of tuberculosis, so the multiple drug-resistant tuberculosis can be avoided. This research aimed to identify the effect of vitamin C as a supportive treatment on the sputum conversion rate. The randomizedand double group with a parallel design by matching pair method was used to collect samples. The first group was treated with standard tuberculosis treatment, and the other was given vitamin C supplementation. Vitamin C plasma level analyzation was performed before and after two months of treatment. Sputum conversion was evaluated every week for eight weeks. The comparison of vitamin C plasma level in pre and post-treatment group was significant (p=0.03) but not in the other group. There was no significant difference in vitamin C plasma level between two groups (p=0.21). The proportion of sputum conversion rate in both group in the first week was 0% vs. 9.6% (p=0.83) and the last week of study was 83.9% vs. 100% (p=0.02). In conclusion, vitamin C supplementation has effects in improving the healing process of tuberculosis patients as indicated by higher in sputum conversion rate.

  4. TEN-YEAR RECURRENCE RATES IN YOUNG WOMEN WITH BREAST CANCER BY LOCOREGIONAL TREATMENT APPROACH

    Science.gov (United States)

    Beadle, Beth M.; Woodward, Wendy A.; Tucker, Susan L.; Outlaw, Elesyia D.; Allen, Pamela K.; Oh, Julia L.; Strom, Eric A.; Perkins, George H.; Tereffe, Welela; Yu, Tse-Kuan; Meric-Bernstam, Funda; Litton, Jennifer K.; Buchholz, Thomas A.

    2011-01-01

    Purpose Young women with breast cancer have higher locoregional recurrence (LRR) rates than older patients. The goal of this study is to determine the impact of locoregional treatment strategy, breast-conserving therapy (BCT), mastectomy alone (M), or mastectomy with adjuvant radiation (MXRT), on LRR for patients 35 years or younger. Methods and Materials Data for 668 breast cancers in 652 young patients with breast cancer were retrospectively reviewed; 197 patients were treated with BCT, 237 with M, and 234 with MXRT. Results Median follow-up for all living patients was 114 months. In the entire cohort, 10-year actuarial LRR rates varied by locoregional treatment: 19.8% for BCT, 24.1% for M, and 15.1% for MXRT (p = 0.05). In patients with Stage II disease, 10-year actuarial LRR rates by locoregional treatment strategy were 17.7% for BCT, 22.8% for M, and 5.7% for MXRT (p = 0.02). On multivariate analysis, M (hazard ratio, 4.45) and Grade III disease (hazard ratio, 2.24) predicted for increased LRR. In patients with Stage I disease, there was no difference in LRR rates based on locoregional treatment (18.0% for BCT, 19.8% for M; p = 0.56), but chemotherapy use had a statistically significant LRR benefit (13.5% for chemotherapy, 27.9% for none; p = 0.04). Conclusions Young women have high rates of LRR after breast cancer treatment. For patients with Stage II disease, the best locoregional control rates were achieved with MXRT. For patients with Stage I disease, similar outcomes were achieved with BCT and mastectomy; however, chemotherapy provided a significant benefit to either approach. PMID:18707822

  5. Ten-Year Recurrence Rates in Young Women With Breast Cancer by Locoregional Treatment Approach

    International Nuclear Information System (INIS)

    Beadle, Beth M.; Woodward, Wendy A.; Tucker, Susan L.; Outlaw, Elesyia D.; Allen, Pamela K.; Oh, Julia L.; Strom, Eric A.; Perkins, George H.; Tereffe, Welela; Yu, T.-K.; Meric-Bernstam, Funda; Litton, Jennifer K.; Buchholz, Thomas A.

    2009-01-01

    Purpose: Young women with breast cancer have higher locoregional recurrence (LRR) rates than older patients. The goal of this study is to determine the impact of locoregional treatment strategy, breast-conserving therapy (BCT), mastectomy alone (M), or mastectomy with adjuvant radiation (MXRT), on LRR for patients 35 years or younger. Methods and Materials: Data for 668 breast cancers in 652 young patients with breast cancer were retrospectively reviewed; 197 patients were treated with BCT, 237 with M, and 234 with MXRT. Results: Median follow-up for all living patients was 114 months. In the entire cohort, 10-year actuarial LRR rates varied by locoregional treatment: 19.8% for BCT, 24.1% for M, and 15.1% for MXRT (p = 0.05). In patients with Stage II disease, 10-year actuarial LRR rates by locoregional treatment strategy were 17.7% for BCT, 22.8% for M, and 5.7% for MXRT (p = 0.02). On multivariate analysis, M (hazard ratio, 4.45) and Grade III disease (hazard ratio, 2.24) predicted for increased LRR. In patients with Stage I disease, there was no difference in LRR rates based on locoregional treatment (18.0% for BCT, 19.8% for M; p = 0.56), but chemotherapy use had a statistically significant LRR benefit (13.5% for chemotherapy, 27.9% for none; p = 0.04). Conclusions: Young women have high rates of LRR after breast cancer treatment. For patients with Stage II disease, the best locoregional control rates were achieved with MXRT. For patients with Stage I disease, similar outcomes were achieved with BCT and mastectomy; however, chemotherapy provided a significant benefit to either approach

  6. An integrated approach for a higher success rate in mergers and acquisitions

    Directory of Open Access Journals (Sweden)

    Andrej Bertoncelj

    2007-05-01

    Full Text Available The paper outlines the importance of balanced management of hard and soft key success factors, combining the economic logic of corporate performance and human capital through an integrated approach to mergers and acquisitions. The study, based on a questionnaire and interviews, suggests that the achievement level ofmergers and acquisitions’ objectives of acquiring companies in Slovenia should be comparable to findings of similar studies; namely, the objectives that drove the deal were met only half the time. The results indicate that five hard success factors – a professional target search and due diligence, a realistic assessment of synergies, theright mix of financial sources, a detailed post-acquisition integration plan already prepared in the pre-deal phase and its speedy implementation – and five soft success factors – a new “combined” organizational culture, a competent management team, innovative employees, efficient and consistent communication and a creative business environment – are becoming increasingly relevant. Even though they differ in their importance for individual companies in the sample, they are all considered essential to increasing the success rate of corporate combinations

  7. Sex-role reversal of a monogamous pipefish without higher potential reproductive rate in females.

    Science.gov (United States)

    Sogabe, Atsushi; Yanagisawa, Yasunobu

    2007-12-07

    In monogamous animals, males are usually the predominant competitors for mates. However, a strictly monogamous pipefish Corythoichthys haematopterus exceptionally exhibits a reversed sex role. To understand why its sex role is reversed, we measured the adult sex ratio and the potential reproductive rate (PRR), two principal factors influencing the operational sex ratio (OSR), in a natural population of southern Japan. The adult sex ratio was biased towards females throughout the breeding season, but the PRR, which increased with water temperature, did not show sexual difference. We found that an alternative index of the OSR (Sf/Sm: sex ratio of 'time in') calculated from the monthly data was consistently biased towards females. The female-biased OSR associated with sex-role reversal has been reported in some polyandrous or promiscuous pipefish, but factors biasing the OSR differed between these pipefish and C. haematopterus. We concluded that the similar PRR between the sexes in C. haematopterus does not confer reproductive benefit of polygamous mating on either sex, resulting in strict monogamous mating, and its female-biased adult sex ratio promotes female-female competition for a mate, resulting in sex-role reversal.

  8. Lower serotonin level and higher rate of fibromyalgia syndrome with advancing pregnancy.

    Science.gov (United States)

    Atasever, Melahat; Namlı Kalem, Muberra; Sönmez, Çiğdem; Seval, Mehmet Murat; Yüce, Tuncay; Sahin Aker, Seda; Koç, Acar; Genc, Hakan

    2017-09-01

    The aim of the study is to investigate the relationship between changes in serotonin levels during pregnancy and fibromyalgia syndrome (FS) and the relationships between FS and the physical/psychological state, biochemical and hormonal parameters, which may be related to the musculoskeletal system. This study is a prospective case-control study conducted with 277 pregnant women at the obstetric unit of Ankara University Faculty of Medicine, in the period between January and June 2015. FS was determined based on the presence or absence of the 2010 ACR diagnostic criteria and all the volunteers were asked to answer the questionnaires as Fibromyalgia Impact Criteria (FIQ), Widespread Pain Index (WPI), Symptom Severity Scale (SS), Beck Depression Inventory and Visual Analog Scale (VAS). Biochemical and hormonal markers (glucose, TSH, T4, Ca (calcium), P (phosphate), PTH (parathyroid hormone) and serotonin levels) relating to muscle and bone metabolism were measured. In the presence of fibromyalgia, the physical and psychological parameters are negatively affected (p serotonin levels may contribute to the development of fibromyalgia but this was not statistically significant. The Beck Depression Inventory scale statistically showed that increasing scores also increase the risk of fibromyalgia (p serotonin levels in women with FS are lower than the control group and that serotonin levels reduce as pregnancy progresses. Anxiety and depression in pregnant women with FS are higher than the control group. The presence of depression increases the likelihood of developing FS at a statistically significant level. Serotonin impairment also increases the chance of developing FS, but this correlation has not been shown to be statistically significant.

  9. Biodegradation testing of chemicals with high Henry’s constants – separating mass and effective concentration reveals higher rate constants

    DEFF Research Database (Denmark)

    Birch, Heidi; Andersen, Henrik Rasmus; Comber, Mike

    Microextraction (HS-SPME) was applied directly on the test systems to measure substrate depletion by biodegradation relative to abiotic controls. HS-SPME was also applied to determine air to water partitioning ratios. Water phase biodegradation rate constants, kwater, were up to 72 times higher than test system...

  10. Higher dosage nicotine patches increase one-year smoking cessation rates : results from the European CEASE trial

    NARCIS (Netherlands)

    Tonnesen, P; Paoletti, P; Gustavsson, G; Russell, MA; Saracci, R; Gulsvik, A; Rijcken, B

    The Collaborative European Anti-Smoking Evaluation (CEASE) was a European multicentre, randomized, double-blind placebo controlled smoking cessation study, The objectives were to determine whether higher dosage and longer duration of nicotine patch therapy would increase the success rate. Thirty-six

  11. Understanding the Effect of Response Rate and Class Size Interaction on Students Evaluation of Teaching in a Higher Education

    Science.gov (United States)

    Al Kuwaiti, Ahmed; AlQuraan, Mahmoud; Subbarayalu, Arun Vijay

    2016-01-01

    Objective: This study aims to investigate the interaction between response rate and class size and its effects on students' evaluation of instructors and the courses offered at a higher education Institution in Saudi Arabia. Study Design: A retrospective study design was chosen. Methods: One thousand four hundred and forty four different courses…

  12. Children Receiving Free or Reduced-Price School Lunch Have Higher Food Insufficiency Rates in Summer.

    Science.gov (United States)

    Huang, Jin; Barnidge, Ellen; Kim, Youngmi

    2015-09-01

    In 2012, 20% of households in the United States with children lacked consistent access to adequate food. Food insufficiency has significant implications for children, including poor physical and mental health outcomes, behavior problems, and low educational achievements. The National School Lunch Program (NSLP) is one policy solution to reduce food insufficiency among children from low-income families. The objective of this project was to evaluate the association between NSLP participation and household food insufficiency by examining trajectories of food insufficiency over 10 calendar months. The calendar months included both nonsummer months when school is in session and summer months when school is out of session. The study used the data from the Survey of Income and Program Participation and conducted linear growth curve analyses in the multilevel modeling context. Comparisons were made between the trajectories of food insufficiencies among recipients of free or reduced-price lunch and their counterparts who are eligible but choose not to participate in the program. Heads of households that included children receiving free or reduced-price lunch (n = 6867) were more likely to be female, black, unmarried, and unemployed, and have a lower educational attainment than those whose children were eligible but did not receive free or reduced-price lunch (n = 11,396). For households participating in the NSLP, the food insufficiency rate was consistent from January to May at ∼4%, and then increased in June and July to >5%. Meanwhile, food insufficiency among eligible nonrecipients was constant throughout the year at nearly 2%. The NSLP protects households from food insufficiency. Policies should be instituted to make enrollment easier for households. © 2015 American Society for Nutrition.

  13. Informatics technology mimics ecology: dense, mutualistic collaboration networks are associated with higher publication rates.

    Directory of Open Access Journals (Sweden)

    Marco D Sorani

    Full Text Available Information technology (IT adoption enables biomedical research. Publications are an accepted measure of research output, and network models can describe the collaborative nature of publication. In particular, ecological networks can serve as analogies for publication and technology adoption. We constructed network models of adoption of bioinformatics programming languages and health IT (HIT from the literature.We selected seven programming languages and four types of HIT. We performed PubMed searches to identify publications since 2001. We calculated summary statistics and analyzed spatiotemporal relationships. Then, we assessed ecological models of specialization, cooperativity, competition, evolution, biodiversity, and stability associated with publications.Adoption of HIT has been variable, while scripting languages have experienced rapid adoption. Hospital systems had the largest HIT research corpus, while Perl had the largest language corpus. Scripting languages represented the largest connected network components. The relationship between edges and nodes was linear, though Bioconductor had more edges than expected and Perl had fewer. Spatiotemporal relationships were weak. Most languages shared a bioinformatics specialization and appeared mutualistic or competitive. HIT specializations varied. Specialization was highest for Bioconductor and radiology systems. Specialization and cooperativity were positively correlated among languages but negatively correlated among HIT. Rates of language evolution were similar. Biodiversity among languages grew in the first half of the decade and stabilized, while diversity among HIT was variable but flat. Compared with publications in 2001, correlation with publications one year later was positive while correlation after ten years was weak and negative.Adoption of new technologies can be unpredictable. Spatiotemporal relationships facilitate adoption but are not sufficient. As with ecosystems, dense

  14. Informatics technology mimics ecology: dense, mutualistic collaboration networks are associated with higher publication rates.

    Science.gov (United States)

    Sorani, Marco D

    2012-01-01

    Information technology (IT) adoption enables biomedical research. Publications are an accepted measure of research output, and network models can describe the collaborative nature of publication. In particular, ecological networks can serve as analogies for publication and technology adoption. We constructed network models of adoption of bioinformatics programming languages and health IT (HIT) from the literature.We selected seven programming languages and four types of HIT. We performed PubMed searches to identify publications since 2001. We calculated summary statistics and analyzed spatiotemporal relationships. Then, we assessed ecological models of specialization, cooperativity, competition, evolution, biodiversity, and stability associated with publications.Adoption of HIT has been variable, while scripting languages have experienced rapid adoption. Hospital systems had the largest HIT research corpus, while Perl had the largest language corpus. Scripting languages represented the largest connected network components. The relationship between edges and nodes was linear, though Bioconductor had more edges than expected and Perl had fewer. Spatiotemporal relationships were weak. Most languages shared a bioinformatics specialization and appeared mutualistic or competitive. HIT specializations varied. Specialization was highest for Bioconductor and radiology systems. Specialization and cooperativity were positively correlated among languages but negatively correlated among HIT. Rates of language evolution were similar. Biodiversity among languages grew in the first half of the decade and stabilized, while diversity among HIT was variable but flat. Compared with publications in 2001, correlation with publications one year later was positive while correlation after ten years was weak and negative.Adoption of new technologies can be unpredictable. Spatiotemporal relationships facilitate adoption but are not sufficient. As with ecosystems, dense, mutualistic

  15. Prevalence, Treatment, and Control Rates of Conventional and Ambulatory Hypertension Across 10 Populations in 3 Continents.

    Science.gov (United States)

    Melgarejo, Jesus D; Maestre, Gladys E; Thijs, Lutgarde; Asayama, Kei; Boggia, José; Casiglia, Edoardo; Hansen, Tine W; Imai, Yutaka; Jacobs, Lotte; Jeppesen, Jørgen; Kawecka-Jaszcz, Kalina; Kuznetsova, Tatiana; Li, Yan; Malyutina, Sofia; Nikitin, Yuri; Ohkubo, Takayoshi; Stolarz-Skrzypek, Katarzyna; Wang, Ji-Guang; Staessen, Jan A

    2017-07-01

    Hypertension is a major global health problem, but prevalence rates vary widely among regions. To determine prevalence, treatment, and control rates of hypertension, we measured conventional blood pressure (BP) and 24-hour ambulatory BP in 6546 subjects, aged 40 to 79 years, recruited from 10 community-dwelling cohorts on 3 continents. We determined how between-cohort differences in risk factors and socioeconomic factors influence hypertension rates. The overall prevalence was 49.3% (range between cohorts, 40.0%-86.8%) for conventional hypertension (conventional BP ≥140/90 mm Hg) and 48.7% (35.2%-66.5%) for ambulatory hypertension (ambulatory BP ≥130/80 mm Hg). Treatment and control rates for conventional hypertension were 48.0% (33.5%-74.1%) and 38.6% (10.1%-55.3%) respectively. The corresponding rates for ambulatory hypertension were 48.6% (30.5%-71.9%) and 45.6% (18.6%-64.2%). Among 1677 untreated subjects with conventional hypertension, 35.7% had white coat hypertension (23.5%-56.2%). Masked hypertension (conventional BP hypertension rates. Higher social and economic development, measured by the Human Development Index, was associated with lower rates of conventional and ambulatory hypertension. In conclusion, high rates of hypertension in all cohorts examined demonstrate the need for improvements in prevention, treatment, and control. Strategies for the management of hypertension should continue to not only focus on preventable and modifiable risk factors but also consider societal issues. © 2017 American Heart Association, Inc.

  16. Influence of Rice Seeding Rate on Efficacies of Neonicotinoid and Anthranilic Diamide Seed Treatments against Rice Water Weevil

    Directory of Open Access Journals (Sweden)

    Jason Hamm

    2014-12-01

    Full Text Available Rice in the U.S. is frequently seeded at low rates and treated before sowing with neonicotinoid or anthranilic diamide insecticides to target the rice water weevil. A previous study of the influence of seeding rate on rice water weevil densities showed an inverse relationship between seeding rates and immature weevil densities. This study investigated interactive effects of seeding rate and seed treatment on weevil densities and rice yields; in particular, experiments were designed to determine whether seed treatments were less effective at low seeding rates. Four experiments were conducted over three years by varying seeding rates of rice treated at constant per seed rates of insecticide. Larval suppression by chlorantraniliprole was superior to thiamethoxam or clothianidin, and infestations at low seeding rates were up to 47% higher than at high seeding rates. Little evidence was found for the hypothesis that seed treatments are less effective at low seeding rates; in only one of four experiments was the reduction in weevil densities by thiamethoxam greater at high than at low seeding rates. However, suppression of larvae by neonicotinoid seed treatments in plots seeded at low rates was generally poor, and caution must be exercised when using the neonicotioids at low seeding rates.

  17. Concerns and perceptions immediately following Superstorm Sandy: ratings for property damage were higher than for health issues.

    Science.gov (United States)

    Burger, Joanna; Gochfeld, Michael

    Governmental officials, health and safety professionals, early responders, and the public are interested in the perceptions and concerns of people faced with a crisis, especially during and immediately after a disaster strikes. Reliable information can lead to increased individual and community preparedness for upcoming crises. The objective of this research was to evaluate concerns of coastal and central New Jersey residents within the first 100 days of Superstorm Sandy's landfall. Respondents living in central New Jersey and Jersey shore communities were differentially impacted by the storm, with shore residents having higher evacuation rates (47% vs. 13%), more flood waters in their homes, longer power outages (average 23 vs. 6 days), and longer periods without Internet (29 vs. 6 days). Ratings of concerns varied both among and within categories as a function of location (central vs. coastal New Jersey), stressor level (ranging from 1 to 3 for combinations of power outages, high winds, and flooding), and demographics. Respondents were most concerned about property damage, health, inconveniences, ecological services, and nuclear power plants in that order. Respondents from the shore gave higher ratings to the concerns within each major category, compared to those from central Jersey. Four findings have implications for understanding future risk, recovery, and resiliency: (1) respondents with the highest stressor level (level 3) were more concerned about water damage than others, (2) respondents with flood damage were more concerned about water drainage and mold than others, (3) respondents with the highest stressor levels rated all ecological services higher than others, and (4) shore respondents rated all ecological services higher than central Jersey residents. These data provide information to design future preparedness plans, improve resiliency for future severe weather events, and reduce public health risk.

  18. Changes in Body Compositions and Basal Metabolic Rates during Treatment of Graves’ Disease

    Directory of Open Access Journals (Sweden)

    Min Joo Kim

    2018-01-01

    Full Text Available Objectives. Because thyroid hormone is an important determinant of body weight and basal metabolic rate, we investigated the changes in the basal metabolic rate and body composition sequentially after treatment for Graves’ disease. Methods. A prospective cohort study was performed with six women newly diagnosed with Graves’ disease. During a 52-week treatment of methimazole, body composition, resting respiratory expenditure (REE, and handgrip strength were measured consecutively. Results. After methimazole treatment, body weight was initially increased (0–8 weeks, subsequently plateaued (8–24 weeks, and gradually decreased in the later period (24–52 weeks despite the decreased food intake. The measured REE was 40% higher than the predicted REE at baseline, and it gradually decreased after treatment. REE positively correlated with thyroid hormone levels, peripheral deiodinase activity, and thyroid’s secretory capacity. Body compositional analyses showed that the fat mass increased during an earlier period (4–12 weeks, while the lean mass increased significantly during the later period (26–52 weeks. Consistent with the lean mass changes, muscle strength also significantly increased during the later period. Conclusions. Treatment of Graves’ disease increased body weight and fat mass transiently with decreased REE. However, long-term compositional changes moved in a beneficial direction increasing lean mass and reinforcing muscle strength, following decreasing fat percentages.

  19. Score of Inattention Subscale of ADHD Rating Scale-IV is Significantly Higher for AD/HD than PDD.

    OpenAIRE

    Fujibayashi, Hiromi; Kitayama, Shinji; Matsuo, Masafumi

    2010-01-01

    Attention-deficit/hyperactivity disorder (AD/HD) and pervasive developmental disorder (PDD) must be differentiated because the respective treatments are different. However, they are difficult to distinguish because they often show similar symptoms. At our hospital, we have the rearer of a patient answer both the ADHD Rating Scale-IV (ADHD-RS) and the Autism Spectrum Screening Questionnaire (ASSQ), and use the results as an aid for the diagnosis of AD/HD or PDD. These results were compared wit...

  20. Mechanism and accounting treatment of interest rate swap

    OpenAIRE

    Prošić Danica

    2015-01-01

    Interest rate swap is a derivative which is today routinely used in the financial sector worldwide. As opposed to that, the swap market in Serbia is reduced to basic versions of interest rate swaps only, and is limited to the major users and providers of services in the financial market. Banks in Serbia have been introducing and promoting interest rate swaps as one of their services rather slowly, which can be deduced from various information on interest rate swaps and non-innovative offers o...

  1. Definitive radiotherapy for primary vaginal cancer. Correlation between treatment patterns and recurrence rate

    International Nuclear Information System (INIS)

    Kanayama, Naoyuki; Isohashi, Fumiaki; Yoshioka, Yasuo

    2015-01-01

    The purpose of this study was to determine the outcomes and optimal practice patterns of definitive radiotherapy for primary vaginal cancer. Between 1993 and 2012, 49 patients were treated with definitive radiotherapy for primary vaginal cancer in three hospitals. Of these, 15 patients (31%) had clinically positive regional lymph node metastasis. A total of 34 patients (70%) received external beam radiotherapy with high-dose-rate brachytherapy (interstitial or intracavitary), and 8 (16%) (with small superficial Stage I tumors) were treated with local radiotherapy. The median follow-up was 33 months (range: 1–169 months). The 3-year overall survival (OS), disease-free survival (DFS), and loco-regional control (LRC) rates were 83%, 59% and 71%, respectively. In multivariate analysis, the histological type (P = 0.044) was significant risk factors for LRC. In Federation of Gynecology and Obstetrics (FIGO) Stage I cases, 3 of 8 patients (38%) who did not undergo prophylactic lymph node irradiation had lymph node recurrence, compared with 2 of 12 patients (17%) who underwent prophylactic pelvic irradiation. For Stage III–IV tumors, the local recurrence rate was 50% and the lymph node recurrence rate was 40%. Patients with FIGO Stage I/II or clinical Stage N1 had a higher recurrence rate with treatment using a single modality compared with the recurrence rate using combined modalities. In conclusion, our treatment outcomes for vaginal cancer were acceptable, but external beam radiotherapy with brachytherapy (interstitial or intracavitary) was needed regardless of FIGO stage. Improvement of treatment outcomes in cases of FIGO Stage III or IV remains a significant challenge. (author)

  2. Theoretical and computational study of the energy dependence of the muon transfer rate from hydrogen to higher-Z gases

    Energy Technology Data Exchange (ETDEWEB)

    Bakalov, Dimitar, E-mail: dbakalov@inrne.bas.bg [Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, Tsarigradsko chaussée 72, Sofia 1784 (Bulgaria); Adamczak, Andrzej [Institute of Nuclear Physics, Polish Academy of Sciences, ul. Radzikowskiego 152, 31-342 Krakow (Poland); Stoilov, Mihail [Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, Tsarigradsko chaussée 72, Sofia 1784 (Bulgaria); Vacchi, Andrea [Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Via A. Valerio 2, 34127 Trieste (Italy)

    2015-01-23

    The recent PSI Lamb shift experiment and the controversy about proton size revived the interest in measuring the hyperfine splitting in muonic hydrogen as an alternative possibility for comparing ordinary and muonic hydrogen spectroscopy data on proton electromagnetic structure. This measurement critically depends on the energy dependence of the muon transfer rate to heavier gases in the epithermal range. The available data provide only qualitative information, and the theoretical predictions have not been verified. We propose a new method by measurements of the transfer rate in thermalized target at different temperatures, estimate its accuracy and investigate the optimal experimental conditions. - Highlights: • Method for measuring the energy dependence of muon transfer rate to higher-Z gases. • Thermalization and depolarization of muonic hydrogen studied by Monte Carlo method. • Optimal experimental conditions determined by Monte Carlo simulations. • Mathematical model and for estimating the uncertainty of the experimental results.

  3. Higher Prevalence and Awareness, but Lower Control Rate of Hypertension in Patients with Diabetes than General Population: The Fifth Korean National Health and Nutrition Examination Survey in 2011

    Directory of Open Access Journals (Sweden)

    Seung-Hyun Ko

    2014-02-01

    Full Text Available BackgroundWe investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data.MethodsUsing data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM], 242 newly diagnosed with DM (new-DM, and 474 previously diagnosed with DM (known-DM, we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication and control rate of hypertension (blood pressure [BP] <130/80 mm Hg.ResultsThe prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively compared with non-DM adults (26.2%. Compared to non-DM, awareness (85.7%, P<0.001 and treatment (97.0%, P=0.020 rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%, compared to non-DM (35.1%, P<0.001 and known-DM (33.3%, P=0.004. Control rate among treated subjects was also lower in new-DM (25.2%, compared to non-DM (68.4%, P<0.0001 and known-DM (39.9%, P<0.0001.ConclusionHigher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients.

  4. Mechanism and accounting treatment of interest rate swap

    Directory of Open Access Journals (Sweden)

    Prošić Danica

    2015-01-01

    Full Text Available Interest rate swap is a derivative which is today routinely used in the financial sector worldwide. As opposed to that, the swap market in Serbia is reduced to basic versions of interest rate swaps only, and is limited to the major users and providers of services in the financial market. Banks in Serbia have been introducing and promoting interest rate swaps as one of their services rather slowly, which can be deduced from various information on interest rate swaps and non-innovative offers of these instruments. On the other hand, companies are unable to recognize interest rate swaps as instruments of hedge against the negative effects of interest rate fluctuations, and a way to gain competitive edge in relation to other market participants. One of the obstacles for using interest rate swaps is unwillingness of companies to get informed and educated, and to enter new transactions. The volume of conducted swap transactions depends on the level of understanding on the part of their participants. Expansion of knowledge helps bridge the gap between theory and practice, thereby encouraging a more intensive implementation of interest rate swaps in the future.

  5. Brief Report: Remission Rates With Tofacitinib Treatment in Rheumatoid Arthritis: A Comparison of Various Remission Criteria.

    Science.gov (United States)

    Smolen, Josef S; Aletaha, Daniel; Gruben, David; Zwillich, Samuel H; Krishnaswami, Sriram; Mebus, Charles

    2017-04-01

    Tofacitinib is an oral JAK inhibitor that is used for the treatment of rheumatoid arthritis (RA). In previous clinical trials of tofacitinib, a Disease Activity Score in 28 joints (DAS28)-based analysis was used to assess outcomes. In this study, remission rates according to various remission criteria were evaluated across 5 phase III randomized controlled studies. In all 5 studies, tofacitinib was administered at a dosage of 5 mg twice daily or 10 mg twice daily, either as monotherapy or with background methotrexate or other conventional synthetic disease-modifying antirheumatic drugs. One of the studies included adalimumab 40 mg once every 2 weeks. In addition to the 4-variable DAS28 using the erythrocyte sedimentation rate (DAS28-4[ESR]), a primary efficacy variable used in the phase III studies, disease activity was assessed post hoc by the 4-variable DAS28 using the C-reactive protein level (DAS28-4[CRP]), the Clinical Disease Activity Index (CDAI), the Simplified Disease Activity Index (SDAI), and Boolean-based assessment. A total of 3,306 patients were analyzed (1,213 of these patients received tofacitinib 5 mg twice daily, 1,212 received tofacitinib 10 mg twice daily, 679 received placebo, and 202 received adalimumab 40 mg every 2 weeks). Remission rates varied according to the criteria used, with higher rates in the active-treatment groups for the DAS28-4(CRP) than for other scores. At month 3, remission rates with tofacitinib 5 mg twice daily were 18-22% using the DAS28-4(CRP), 5-10% using the DAS28-4(ESR), 4-7% using the SDAI, 5-6% using the CDAI, and 2-7% using the Boolean-based method. In contrast, the remission rates with placebo varied from 0% to 7%, with small differences between the DAS28-4(ESR) and the DAS28-4(CRP). Although tofacitinib at dosages of 5 mg twice daily and 10 mg twice daily was effective compared with placebo in achieving disease remission, regardless of the disease activity measure, remission rates were substantially higher when

  6. Effect of oxygen treatment on heart rate after abdominal surgery

    DEFF Research Database (Denmark)

    Rosenberg-Adamsen, S; Lie, C; Bernhard, A

    1999-01-01

    BACKGROUND: Cardiac complications are common during the postoperative period and may be associated with hypoxemia and tachycardia. Preliminary studies in high-risk patients after operation have shown a possible beneficial effect of oxygen therapy on arterial oxygen saturation and heart rate....... METHODS: The authors studied the effect of oxygen therapy on arterial oxygen saturation and heart rate in 100 consecutive unselected patients randomly and double blindly allocated to receive air or oxygen therapy between the first and fourth day after major abdominal surgery. RESULTS: The median arterial...... oxygen saturation rate increased significantly from 96% to 99% (P heart rate decreased significantly from 85 beats/min to 81 beats/min (P heart rate occurred...

  7. [Effect of high magnesium ion concentration on the electron transport rate and proton exchange in thylakoid membranes in higher plants].

    Science.gov (United States)

    Ignat'ev, A R; Khorobrykh, S A; Ivanov, B N

    2001-01-01

    The effects of magnesium ion concentration on the rate of electron transport in isolated pea thylakoids were investigated in the pH range from 4.0 up to 8.0. In the absence of magnesium ions in the medium and in the presence of 5 mM MgCl2 in the experiments not only without added artificial acceptors but also with ferricyanide or methylviologen as an acceptor, this rate had a well-expressed maximum at pH 5.0. It was shown that, after depression to minimal values at pH 5.5-6.5, it gradually rose with increasing pH. An increase in magnesium ion concentration up to 20 mM essentially affected the electron transfer rate: it decreased somewhat at pH 4.0-5.0 but increased at higher pH values. At this magnesium ion concentration, the maximum rate was at pH 6.0-6.5 and the minimum, at pH 7.0. Subsequent rise upon increasing pH to 8.0 was expressed more sharply. The influence of high magnesium ion concentration on the rate of electron transport was not observed in the presence of gramicidin D. It was found that without uncoupler, the changes in the electron transfer rate under the influence of magnesium ions correlated to the changes in the first-order rate constant of the proton efflux from thylakoids. It is supposed that the change in the ability of thylakoids to keep protons by the action of magnesium ions is the result of electrostatic interactions of these ions with the charges on the external surface of membranes. A possible role of regulation of the electron transport rate by magnesium ions in vivo is discussed.

  8. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012

    Science.gov (United States)

    Sengul, Sule; Akpolat, Tekin; Erdem, Yunus; Derici, Ulver; Arici, Mustafa; Sindel, Sukru; Karatan, Oktay; Turgan, Cetin; Hasanoglu, Enver; Caglar, Sali; Erturk, Sehsuvar

    2016-01-01

    Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in

  9. Does adding metformin to clomifene citrate lead to higher pregnancy rates in a subset of women with polycystic ovary syndrome?

    Science.gov (United States)

    Moll, E; Korevaar, J C; Bossuyt, P M M; van der Veen, F

    2008-08-01

    An RCT among newly diagnosed, therapy naive women with polycystic ovary syndrome (PCOS) showed no significant differences in ovulation rate, ongoing pregnancy rate or spontaneous abortion rate in favour of clomifene citrate plus metformin compared with clomifene citrate. We wanted to assess whether there are specific subgroups of women with PCOS in whom clomifene citrate plus metformin leads to higher pregnancy rates. Subgroup analysis based on clinical and biochemical parameters of 111 women randomized to clomifene citrate plus metformin compared with 114 women randomized to clomifene citrate plus placebo. The data for age, BMI, waist-hip ratio (WHR) and plasma testosterone were available in all women, 2 h glucose in 80% of women and homeostatic model assessment for assessing insulin sensitivity (HOMA) in 50% of women. Of the women who were allocated to the metformin group, 44 women (40%) reached an ongoing pregnancy. In the placebo group, 52 women (46%) reached an ongoing pregnancy. There was a significantly different chance of an ongoing pregnancy for metformin versus placebo between subgroups based on age and WHR (P = 0.014). There was a positive effect of metformin versus placebo on pregnancy rate in older women (>or=28 years) with a high WHR, a negative effect of metformin versus placebo in young women (Metformin may be an effective addition to clomifene citrate in infertile women with PCOS, especially in older and viscerally obese patients.

  10. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Yasser Helmy Mohamed

    2016-01-01

    Full Text Available Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV after primary rhegmatogenous retinal detachment (RRD. Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA. The primary outcome measures were anatomical (primary and final and functional success (visual acuity better than 6/60. Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7±11.2 years. The single-operation reattachment rate (primary anatomical success was 89.8%. The final anatomical success rate was 100% after 2–6 operations (mean = 3.14±1.03. Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P=0.002 and the presence of multiple tears (P=0.01. Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.

  11. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment.

    Science.gov (United States)

    Mohamed, Yasser Helmy; Ono, Kozue; Kinoshita, Hirofumi; Uematsu, Masafumi; Tsuiki, Eiko; Fujikawa, Azusa; Kitaoka, Takashi

    2016-01-01

    Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA). The primary outcome measures were anatomical (primary and final) and functional success (visual acuity better than 6/60). Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7 ± 11.2 years. The single-operation reattachment rate (primary anatomical success) was 89.8%. The final anatomical success rate was 100% after 2-6 operations (mean = 3.14 ± 1.03). Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P = 0.002) and the presence of multiple tears (P = 0.01). Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.

  12. Planning for rate base treatment of large power plants

    International Nuclear Information System (INIS)

    Faruki, C.J.

    1986-01-01

    This paper addresses two related areas of planning for inclusion in rate base of large generating stations. First, the paper discusses the range of options available as to how the plant is to go into rate base, e.g., phase-in plans. In this connection the process of generating the entire range of options that may be available is described and examined. Second, the paper examines innovative ways of using procedures (e.g., accounting proceedings, settlement procedures, cost caps, and other ideas short of a full-blown rate case) and the resources available in the ratemaking arena, to obtain, in the least painful way possible, the necessary ratemaking orders. The thesis is that there must be better alternatives to the many proceedings that have either begun as, or seem to be leading to, endless retrospective examinations of multiple questions (from load forecasting to construction management to continuation-of-construction decisions) under the label of prudence inquiries

  13. Treatment of fluctuations of startup rates for core subcriticality monitoring

    International Nuclear Information System (INIS)

    Mol, Antonio Carlos de Abreu; Martinez, Aquilino Senra

    1996-01-01

    In this paper it is presented a method to eliminate the variations in the source and intermediate range count rate, which are used for the on-line and real time monitoring of the critical safety function Subcriticality. The method may be applied to a safety parameters display system, because it is very simple and precise, which it will not affect the real time requirements of such systems. Variations in the count range could cause a temporary positive startup rate, that could lead to incorrect addressing of function restoration guideline. (author)

  14. Higher Rate of Tuberculosis in Second Generation Migrants Compared to Native Residents in a Metropolitan Setting in Western Europe

    Science.gov (United States)

    Marx, Florian M.; Fiebig, Lena; Hauer, Barbara; Brodhun, Bonita; Glaser-Paschke, Gisela; Haas, Walter

    2015-01-01

    Background In Western Europe, migrants constitute an important risk group for tuberculosis, but little is known about successive generations of migrants. We aimed to characterize migration among tuberculosis cases in Berlin and to estimate annual rates of tuberculosis in two subsequent migrant generations. We hypothesized that second generation migrants born in Germany are at higher risk of tuberculosis compared to native (non-migrant) residents. Methods A prospective cross-sectional study was conducted. All tuberculosis cases reported to health authorities in Berlin between 11/2010 and 10/2011 were eligible. Interviews were conducted using a structured questionnaire including demographic data, migration history of patients and their parents, and language use. Tuberculosis rates were estimated using 2011 census data. Results Of 314 tuberculosis cases reported, 154 (49.0%) participated. Of these, 81 (52.6%) were first-, 14 (9.1%) were second generation migrants, and 59 (38.3%) were native residents. The tuberculosis rate per 100,000 individuals was 28.3 (95CI: 24.0–32.6) in first-, 10.2 (95%CI: 6.1–16.6) in second generation migrants, and 4.6 (95%CI: 3.7–5.6) in native residents. When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%. Conclusions There is a higher rate of tuberculosis among second generation migrants compared to native residents in Berlin. This may be explained by presumably frequent contact and transmission within migrant populations. Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship. Surveillance systems in Western Europe should allow for quantifying the tuberculosis burden in this important risk group. PMID:26061733

  15. Predicting chromium (VI) adsorption rate in the treatment of liquid ...

    African Journals Online (AJOL)

    Administrator

    The adsorption rate of chromium (VI) on commercial activated carbon during the ... time and initial chromium (VI) ion concentration. .... model, the separation factor r, according to Calvo et al (2001) cited .... Lead (II) and nickel (II) adsorption kinetics .... heavy metal by Talaromyces helicus: a trained fungus for copper and.

  16. Differences in methylphenidate abuse rates among methadone maintenance treatment patients in two clinics.

    Science.gov (United States)

    Peles, Einat; Schreiber, Shaul; Linzy, Shirley; Domani, Yoav; Adelson, Miriam

    2015-07-01

    Methylphenidate, an amphetamine-like prescription medication for attention deficit hyperactivity disorder (ADHD) was suspected as being abused among methadone maintenance treatment (MMT) patients. We tested its presence in the routine urine monitoring of all patients in both Tel Aviv and Las Vegas MMT clinics. Data on demographic and addiction history, ADHD (Wender Utah Rating Scale), cognitive impairment (Mini Mental State Exam), and lifetime DSM-IV-TR psychiatric diagnosis from admission were retrieved, and retention following 6 months. None of the 190 patients in Las Vegas tested positive for methylphenidate, while 14.7% (45/306) did in Tel Aviv. Abusers were less educated (p = 0.01), had higher ADHD scores (p = 0.02), lower cognitive scores (p = 0.05), and a higher benzodiazepine (BDZ) abuse rate (p cannabis, opiates, and cocaine abuse and infectious disease. Of the methylphenidate abuse 42.2% have take-home methadone dose privileges. Not like opiate use, being methylphenidate positive did not relate to 6-months retention. Compared to Tel Aviv, Las Vegas patients were more educated, with lower BDZ, and cocaine abuse. The greater abuse of methylphenidate among ADHD subjects might indicate their using it as self-medication, raising a possible indication for its prescription for that subgroup of MMT patients. The high rate of methylphenidate abuse in Israel needs future study. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. New aeration systems for higher efficiency in mine water treatment in the Lausitz region; Einsatz neuer Belueftungssysteme zur Effizienzsteigerung bei der Grubenwasserbehandlung in der Lausitz

    Energy Technology Data Exchange (ETDEWEB)

    Janneck, E.; Glombitza, F. [G.E.O.S. Freiberg Ingenieurgesellschaft mbH, Freiberg (Germany); Schlee, K.; Arnold, I. [Vattenfall Europe Mining AG, Cottbus (Germany)

    2006-07-01

    The article presents experiences and results of the application of new aerator-systems in the mine water treatment. The processes of ferrous iron oxidation and sludge removal became more stable and efficiently by the application of the aerators. For the first time, spiral aerators were used in the Lower Lusatia lignite mining district to clean ferrous iron containing mine water. These devices lead to an enhanced iron oxidation rate under the existing conditions, where the oxygen diffusion is the rate determining step. Furthermore, the application caused increased throughput, optimal lime utilisation and better sludge thickening, which led to a higher efficiency of the mine water treatment. (orig.)

  18. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

    OpenAIRE

    Mohamed, Yasser Helmy; Ono, Kozue; Kinoshita, Hirofumi; Uematsu, Masafumi; Tsuiki, Eiko; Fujikawa, Azusa; Kitaoka, Takashi

    2016-01-01

    Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual ac...

  19. Improving human papilloma virus vaccination rates throughout military treatment facilities.

    Science.gov (United States)

    Dawson, Rachel; Lemmon, Keith; Trivedi, Nidhi J; Hansen, Shana

    2018-03-07

    The four objectives of this study were to (1) educate military healthcare providers on HPV disease and vaccine, (2) assess short term recall of information presented at educational sessions, (3) assess provider comfort level with the vaccine, and (4) assess improvement in HPV vaccination rates. Standardized interactive educational sessions were conducted at military primary care clinics with pre- and post-educational quizzes administered before and immediately following the sessions. Provider attitudes were assessed using Likert scale questionnaires. Vaccination rates in children and young adolescents ages 11-18 at one of the participating regions that had a champion and started a Quality Improvement (QI) project were assessed at baseline, at 3-months and at 6-months post sessions. 200 providers were reached at 48 primary care clinics during May 2014 through October 2015 with 200 quizzes and Likert scale questionnaires returned. There was increase in knowledge following the educational sessions as revealed in the pre- and post- test scores [t(57) = -5.04, p knowledge recall and comfort level in answering parents' questions was seen. We found that educational sessions can improve HPV vaccination rates in military clinics that have a vaccine champion for up to 3-months. Further research into the effects of having clinic vaccine champions is critical. Copyright © 2018. Published by Elsevier Ltd.

  20. EFFECT OF POST-LOGGING SILVICULTURAL TREATMENT ON GROWTH RATES OF RESIDUAL STAND IN A TROPICAL FOREST

    Directory of Open Access Journals (Sweden)

    Haruni Krisnawati

    2010-12-01

    Full Text Available Post-logging silvicultural treatments are generally performed to improve yields of the remaining tree species by increasing their growth rate. In this study the effects of silvicultural treatment on the growth rates of commercial (dipterocarps and non-dipterocarps as well as non- commercial tree species in a tropical forest in West Kalimantan were examined and were compared to a control treatment. Silvicultural treatment applied was liberation of future crop trees from lianas and neighbouring competing trees. Treatments were applied to six plots of 80 m x 80 m each. The plots comprised 64 quadrats of 10 m x 10 m to allow better control of measurements. The treatment and control plots were established 6 years after logging. Effects were measured 2,4 and 7 years after treatment application. In all obser vation periods, the growth rates increased with silvicultural treatment. Overall, commercial dipterocarps, commercial non-dipterocarps and non-commercial tree species groups differed in response to silvicultural treatment. The growth rates of commercial tree species in plots that received silvicultural treatment were 62–97% higher than in the control plots. For non-commercial tree species, the increase of growth rates was 20–58%, compared to the control plots. These results indicate that the application of silvicultural treatments after logging could help improve the growth of the residual stands. These provide quantitative information that silvicultural treatments in logged-over forest should be considered as a viable management option and may guide the choice of cutting cycle.

  1. Prevalence, Diagnosis, and Treatment Rates of Mood Disorders among Opioid Users under Criminal Justice Supervision.

    Science.gov (United States)

    Mbaba, Mary; Brown, Shan-Estelle; Wooditch, Alese; Kiss, Marissa; Murphy, Amy; Kumari, Suneeta; Taxman, Faye; Altice, Frederick; Lawson, William B; Springer, Sandra A

    2018-01-15

    Individuals involved in the criminal justice system have disproportionately high rates of psychiatric disorders when compared to the general U.S. If left untreated, the likelihood of subsequent arrest increases and risk for adverse health consequences is great, particularly among opioid users. To explore the prevalence, characteristics, and treatment of mood disorders among justice involved opioid-dependent populations. The current study enrolled 258 treatment-seeking opioid-dependent individuals under community-based criminal justice supervision (e.g., probation, parole) screened from the larger parent study, Project STRIDE, a seek/test/treat randomized control trial (RCT) examining HIV and opioid use treatment. During baseline, individuals were screened for depression using the Patient Health Questionnaire-9 (PHQ-9) and screened for bipolar disorder using the Mood Disorder Questionnaire (MDQ) tool. Overall, 78 (30%) participants screened positive for moderate to severe depression and 54 (21%) screened positive for bipolar disorder. Participants self-reported mood disorders at higher rates than they screened positive for these conditions. Participants screening positive for these conditions experienced significantly greater family, legal, and medical problems on the Addiction Severity Index-Lite (ASI-Lite) than those who did not screen positive. Incidence of a lifetime suicide attempt was found to be associated with a positive screen for both mood disorders. Prescribed psychotropic treatment utilization was similar among those who screened positive for depression or bipolar disorder with approximately 38% reporting taking medication. Findings suggest universal mood disorder screening to improve comprehensive psychiatric care and treatment of opioid-dependent justice-involved individuals.

  2. Obese Japanese adults with type 2 diabetes have higher basal metabolic rates than non-diabetic adults.

    Science.gov (United States)

    Miyake, Rieko; Ohkawara, Kazunori; Ishikawa-Takata, Kazuko; Morita, Akemi; Watanabe, Shaw; Tanaka, Shigeho

    2011-01-01

    Several cross-sectional studies in Pima Indians and Caucasians have indicated that obese individuals with type 2 diabetes have a higher basal metabolic rate (BMR) than healthy, obese individuals. However, no study has investigated this comparison in Japanese subjects, who are known to be susceptible to type 2 diabetes due to genetic characteristics. Thirty obese Japanese adults with pre-type 2 diabetes (n=7) or type 2 diabetes (n=13) or without diabetes (n=10) participated in this study. BMR was measured using indirect calorimetry. The relationships between residual BMR (calculated as measured BMR minus BMR adjusted for fat-free mass, fat mass, age, and sex) and biomarkers including fasting glucose, glycosylated hemoglobin (HbA(1c)), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-R), triglycerides, and free fatty acids were examined using Pearson's correlation. BMR in diabetic subjects adjusted for fat-free mass, fat mass, age, and sex was 7.1% higher than in non-diabetic subjects. BMR in diabetic subjects was also significantly (pBMR and fasting glucose (r=0.391, p=0.032). These results indicate that in the Japanese population, obese subjects with type 2 diabetes have higher BMR compared with obese non-diabetic subjects. The fasting glucose level may contribute to these differences.

  3. Rates of homicide during the first episode of psychosis and after treatment: a systematic review and meta-analysis.

    Science.gov (United States)

    Nielssen, Olav; Large, Matthew

    2010-07-01

    The observation that almost half of the homicides committed by people with a psychotic illness occur before initial treatment suggests an increased risk of homicide during the first episode of psychosis. The aim of this study was to estimate the rates of homicide during the first episode of psychosis and after treatment. A systematic search located 10 studies that reported details of all the homicide offenders with a psychotic illness within a known population during a specified period and reported the number of people who had received treatment prior to the offense. Meta-analysis of these studies showed that 38.5% (95% confidence interval [CI] = 31.1%-46.5%) of homicides occurred during the first episode of psychosis, prior to initial treatment. Homicides during first-episode psychosis occurred at a rate of 1.59 homicides per 1000 (95% CI = 1.06-2.40), equivalent to 1 in 629 presentations. The annual rate of homicide after treatment for psychosis was 0.11 homicides per 1000 patients (95% CI = 0.07-0.16), equivalent to 1 homicide in 9090 patients with schizophrenia per year. The rate ratio of homicide in the first episode of psychosis in these studies was 15.5 (95% CI = 11.0-21.7) times the annual rate of homicide after treatment for psychosis. Hence, the rate of homicide in the first episode of psychosis appears to be higher than previously recognized, whereas the annual rate of homicide by patients with schizophrenia after treatment is lower than previous estimates. Earlier treatment of first-episode psychosis might prevent some homicides.

  4. Is the higher rate of parental child homicide in stepfamilies an effect of non-genetic relatedness?

    Institute of Scientific and Technical Information of China (English)

    Hans TEMRIN; Johanna NORDLUND; Mikael RYING; Birgitta S. TULLBERG

    2011-01-01

    In an evolutionary perspective individuals are expected to vary the degree of parental love and care in relation to the fitness value that a child represents. Hence, stepparents are expected to show less solicitude than genetically related parents, and this lack of genetic relatedness has been used to explain the higher frequencies of child abuse and homicide found in stepfamilies.However, other factors than non-genetic relatedness may cause this over-representation in stepfamilies. Here we use a 45-year data set of parental child homicides in Sweden to test two hypotheses related to the higher incidence in stepfamilies: 1) adults in different types of family differ in their general disposition to use violence, and 2) parents are more likely to kill stepchildren than genetically related children. Of the 152 perpetrators in biparental families there was an overrepresentation of perpetrators in stepfamilies (n=27) compared with the general population. We found support for the first hypothesis in that both general and violent crime rates were higher in stepfamilies, both in the general population and among perpetrators of child homicide. However, we found no support for the second hypothesis because of the 27 perpetrators in stepfamilies the perpetrator killed a genetically related child in 13 cases, a stepchild in 13 cases and both types of children in one case. Moreover, out of the 12 families where the perpetrator lived with both stepchildren and genetic children, there was no bias towards killing stepchildren. Thus, we found no evidence for an effect of non-genetic relatedness per se [Current Zoology 57 (3): 253-59, 2011].

  5. Training in Using Earplugs or Using Earplugs with a Higher than Necessary Noise Reduction Rating? A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    M Salmani Nodoushan

    2014-09-01

    Full Text Available Background: Noise-induced hearing loss (NIHL is one of the most common occupational diseases and the second most common cause of workers' claims for occupational injuries. Objective: Due to high prevalence of NIHL and several reports of improper use of hearing protective devices (HPDs, we conducted this study to compare the effect of face-to-face training in effective use of earplugs with appropriate NRR to overprotection of workers by using earplugs with higher than necessary noise reduction rating (NRR. Methods: In a randomized clinical trial, 150 workers referred to occupational medicine clinic were randomly allocated to three arms—a group wearing earplugs with an NRR of 25 with no training in appropriate use of the device; a group wearing earplugs with an NRR of 25 with training; another group wearing earplugs with an NRR of 30, with no training. Hearing threshold was measured in the study groups by real ear attenuation at threshold (REAT method. This trial is registered with Australian New Zealand clinical trials Registry, number ACTRN00363175. Results: The mean±SD age of the participants was 28±5 (range: 19–39 years. 42% of participants were female. The mean noise attenuation in the group with training was 13.88 dB, significantly higher than those observed in other groups. The highest attenuation was observed in high frequencies (4, 6, and 8 kHz in the group with training. Conclusion: Training in appropriate use of earplugs significantly affects the efficacy of earplugs—even more than using an earplug with higher NRR.

  6. Is the higher rate of parental child homicide in stepfamilies an effect of non-genetic relatedness?

    Directory of Open Access Journals (Sweden)

    Hans TEMRIN, Johanna NORDLUND, Mikael RYING, Birgitta S. TULLBERG

    2011-06-01

    Full Text Available In an evolutionary perspective individuals are expected to vary the degree of parental love and care in relation to the fitness value that a child represents. Hence, stepparents are expected to show less solicitude than genetically related parents, and this lack of genetic relatedness has been used to explain the higher frequencies of child abuse and homicide found in stepfamilies. However, other factors than non-genetic relatedness may cause this over-representation in stepfamilies. Here we use a 45-year data set of parental child homicides in Sweden to test two hypotheses related to the higher incidence in stepfamilies: 1 adults in different types of family differ in their general disposition to use violence, and 2 parents are more likely to kill stepchildren than genetically related children. Of the 152 perpetrators in biparental families there was an overrepresentation of perpetrators in stepfamilies (n=27 compared with the general population. We found support for the first hypothesis in that both general and violent crime rates were higher in stepfamilies, both in the general population and among perpetrators of child homicide. However, we found no support for the second hypothesis because of the 27 perpetrators in stepfamilies the perpetrator killed a genetically related child in 13 cases, a stepchild in 13 cases and both types of children in one case. Moreover, out of the 12 families where the perpetrator lived with both stepchildren and genetic children, there was no bias towards killing stepchildren. Thus, we found no evidence for an effect of non-genetic relatedness per se [Current Zoology 57 (3: 253–259, 2011].

  7. Racial Disparities in Treatment Rates for Chronic Hepatitis C: Analysis of a Population-Based Cohort of 73,665 Patients in the United States.

    Science.gov (United States)

    Vutien, Philip; Hoang, Joseph; Brooks, Louis; Nguyen, Nghia H; Nguyen, Mindie H

    2016-05-01

    Chronic hepatitis C (CHC) disproportionately affects racial minorities in the United States (US). Although prior studies have reported lower treatment rates in Blacks than in Caucasians, the rates of other minorities remain understudied. We aimed to examine antiviral treatment rates by race and to evaluate the effect of other demographic, medical, and psychiatric factors on treatment rates. We performed a population-based study of adult CHC patients identified via ICD-9CM query from OptumInsight's Data Mart from January 2009 to December 2013. Antiviral treatment was defined by pharmaceutical claims for interferon and/or pegylated-interferon. A total of 73,665 insured patients were included: 51,282 Caucasians, 10,493 Blacks, 8679 Hispanics, and 3211 Asians. Caucasians had the highest treatment rate (10.7%) followed by Blacks (8.8%), Hispanics (8.8%), and Asians (7.9%, P 73 (CI: 0.62-0.86) for Asians versus Caucasians. Racial minorities had lower treatment rates than Caucasians. Despite fewer medical and psychiatric comorbidities and higher incomes and educational levels, Asians had the lowest treatment rates. Hispanics also had lower treatment rates than Caucasians despite having higher rates of cirrhosis. Future studies should aim to identify underlying racial-related barriers to hepatitis C virus treatment besides socioeconomic status and medical or psychiatric comorbidities.

  8. The Offer of Advanced Imaging Techniques Leads to Higher Acceptance Rates for Screening Colonoscopy - a Prospective Study.

    Science.gov (United States)

    Albrecht, Heinz; Gallitz, Julia; Hable, Robert; Vieth, Michael; Tontini, Gian Eugenio; Neurath, Markus Friedrich; Riemann, Jurgen Ferdinand; Neumann, Helmut

    2016-01-01

    Colonoscopy plays a fundamental role in early diagnosis and management of colorectal cancer and requires public and professional acceptance to ensure the ongoing success of screening programs. The aim of the study was to prospectively assess whether patient acceptance rates to undergo screening colonoscopy could be improved by the offer of advanced imaging techniques. Overall, 372 randomly selected patients were prospectively included. A standardized questionnaire was developed that inquired of the patients their knowledge regarding advanced imaging techniques. Second, several media campaigns and information events were organized reporting about advanced imaging techniques, followed by repeated evaluation. After one year the evaluation ended. At baseline, 64% of the patients declared that they had no knowledge about new endoscopic methods. After twelve months the overall grade of information increased significantly from 14% at baseline to 34%. The percentage of patients who decided to undergo colonoscopy because of the offer of new imaging methods also increased significantly from 12% at baseline to 42% after 12 months. Patients were highly interested in the offer of advanced imaging techniques. Knowledge about these techniques could relatively easy be provided using local media campaigns. The offer of advanced imaging techniques leads to higher acceptance rates for screening colonoscopies.

  9. Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population

    Science.gov (United States)

    Sewell, Justin L.; Kushel, Margot B.; Inadomi, John M.; Yee, Hal F.

    2009-01-01

    Goals We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. Background Missed clinic appointments reduce the efficiency and availability of healthcare, but subspecialty clinic attendance among patients with established healthcare access has not been studied. Study We performed an observational study using secondary data from administrative sources to study patients referred to, and scheduled for an appointment in, the adult gastroenterology clinic serving the safety net healthcare system of San Francisco, California. Our dependent variable was whether subjects attended or missed a scheduled appointment. Analysis included multivariable logistic regression and classification tree analysis. 1,833 patients were referred and scheduled for an appointment between 05/2005 and 08/2006. Prisoners were excluded. All patients had a primary care provider. Results 683 patients (37.3%) missed their appointment; 1,150 (62.7%) attended. Language was highly associated with attendance in the logistic regression; non-English speakers were less likely than English speakers to miss an appointment (adjusted odds ratio 0.42 [0.28,0.63] for Spanish, 0.56 [0.38,0.82] for Asian language, p gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access. PMID:19169147

  10. 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Alexandre Peltier

    2013-01-01

    Full Text Available Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice. Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol. Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05. There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection. Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

  11. Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia.

    Science.gov (United States)

    Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Black, Deborah; Taylor, Colman; Dickson, Cara; Jan, Stephen; Palmer, Cameron S; Langcake, Mary; Myburgh, John

    2014-01-01

    Accurate economic data are fundamental for improving current funding models and ultimately in promoting the efficient delivery of services. The financial burden of a high trauma casemix to designated trauma centres in Australia has not been previously determined, and there is some evidence that the episode funding model used in Australia results in the underfunding of trauma. To describe the costs of acute trauma admissions in trauma centres, identify predictors of higher treatment costs and cost variance in New South Wales (NSW), Australia. Data linkage of admitted trauma patient and financial data provided by 12 Level 1 NSW trauma centres for the 08/09 financial year was performed. Demographic, injury details and injury scores were obtained from trauma registries. Individual patient general ledger costs (actual trauma patient costs), Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs (which form the basis of funding) were obtained. The actual costs incurred by the hospital were then compared with the state-wide AR-DRG average costs. Multivariable multiple linear regression was used for identifying predictors of costs. There were 17,522 patients, the average per patient cost was $10,603 and the median was $4628 (interquartile range: $2179-10,148). The actual costs incurred by trauma centres were on average $134 per bed day above AR-DRG costs-determined costs. Falls, road trauma and violence were the highest causes of total cost. Motor cyclists and pedestrians had higher median costs than motor vehicle occupants. As a result of greater numbers, patients with minor injury had comparable total costs with those generated by patients with severe injury. However the median cost of severely injured patients was nearly four times greater. The count of body regions injured, sex, length of stay, serious traumatic brain injury and admission to the Intensive Care Unit were significantly associated with increased costs (p<0.001). This

  12. E-beam treatment of trichloroethylene-air mixtures: products and rates

    International Nuclear Information System (INIS)

    Mill, Theodore; Minggong Su; Yao, C.C.D.; Matthews, S.M.; Wang, F.T.S.

    1997-01-01

    Electron beam (E-beam) treatment of 3000 ppmv trichloroethylene (TCE) vapor in dry and wet air led to rapid, nearly quantitative, conversion of TCE to dichloroacetyl chloride, plus small amounts of phosgene. Higher E-beam dose, up to 110 kGy, led to oxidation of the initial products to CO, CO 2 , HCl and Cl 2 . The results parallel results found for photo- and Cl-atom initiated oxidation of TCE vapor, and are accounted for by an efficient Cl-atom chain oxidation. Lack of effect of 28,000 ppmv water vapor (90% RH) on rates or products reflects a very high efficiency for the Cl-atom chain oxidation and the very slow reaction of vapor phase water with acyl halides. Irradiation experiments conducted with TCE dissolved in aerated and deaerated water at 10 and 300 ppm showed marked differences in radiolytic products from those found in the vapor phase. A preliminary cost estimate indicates that E-beam treatment of TCE vapor is very competitive with conventional activated carbon treatment and catalytic oxidation. (author)

  13. 5 CFR 536.307 - Treatment of a retained rate as basic pay for other purposes.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Treatment of a retained rate as basic pay... CIVIL SERVICE REGULATIONS GRADE AND PAY RETENTION Pay Retention § 536.307 Treatment of a retained rate... for accumulated and annual leave under 5 CFR part 550, subpart L; (8) General Schedule pay...

  14. Fuel treatment effectiveness in reducing fire intensity and spread rate - An experimental overview

    Science.gov (United States)

    Eric Mueller; Nicholas Skowronski; Albert Simeoni; Kenneth Clark; Robert Kremens; William Mell; Michael Gallagher; Jan Thomas; Alexander Filkov; Mohamad El Houssami; John Hom; Bret Butler

    2014-01-01

    Fuel treatments represent a significant component of the wildfire mitigation strategy in the United States. However, the lack of research aimed at quantifying the explicit effectiveness of fuel treatments in reducing wildfire intensity and spread rate limits our ability to make educated decisions about the type and placement of these treatments. As part of a larger...

  15. Treatment rate improvement of the ozone oxidation method for laundry waste water

    International Nuclear Information System (INIS)

    Matsuo, Toshiaki; Nishi, Takashi

    2001-01-01

    Radioactive laundry waste water generated in nuclear power plants includes organic compounds to be removed, for which ozone oxidation treatment is a possibility. To verify the applicability, its total organic carbon concentration (TOC) lowering rate improvement was examined in 0.5x10 -3 m 3 batch and 3x10 -2 m 3 pilot equipment experiments. In the batch experiments, ozone at a concentration of 200 g/Nm 3 was dispersed into 0.5x10 -3 m 3 of Simulated Laundry Waste Water (SLWW) with TOC of 11 mM. Total organic carbon concentration was measured every hour to see the effects of the temperature, and the initial concentrations of both H 2 O 2 and NaOH which were added to urge OH radical generation from ozone. In the pilot equipment experiments, 1x10 -2 to 3x10 -2 m 3 of the SLWW were circulated using an ejector to disperse the ozone. The influences of the flow rate and the SLWW volume on lowering TOC were examined, because they were related to the ejector dispersion performance and the appropriate ozone addition per SLWW volume. Appropriate initial H 2 O 2 and NaOH concentrations in the batch experiments were 14.7 mM and 1 mM, respectively. Lowering of TOC became faster at higher temperatures, because ozone self-decomposition and OH radial diffusion to the organic compound molecules were promoted. Lowering of TOC also became faster at higher flow rates, while the influence of the volume became saturated. (author)

  16. HIV positivity but not HPV/p16 status is associated with higher recurrence rate in anal cancer.

    Science.gov (United States)

    Meyer, Joshua E; Panico, Vinicius J A; Marconato, Heloisa M F; Sherr, David L; Christos, Paul; Pirog, Edyta C

    2013-12-01

    .06). The regional and distant failure rate was not related to HPV/p16 positivity or histologic differentiation of ACA; however, HIV positivity appeared to be associated with a higher recurrence rate and worse recurrence-free survival.

  17. 14 CFR 399.44 - Treatment of deferred Federal income taxes for rate purposes.

    Science.gov (United States)

    2010-01-01

    ... TRANSPORTATION (AVIATION PROCEEDINGS) POLICY STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs § 399.44 Treatment of deferred Federal income taxes for rate purposes. For rate-making purposes other than the determination of subsidy under section 406(b), it is the policy of the Board that...

  18. Satellite telemetry reveals higher fishing mortality rates than previously estimated, suggesting overfishing of an apex marine predator.

    Science.gov (United States)

    Byrne, Michael E; Cortés, Enric; Vaudo, Jeremy J; Harvey, Guy C McN; Sampson, Mark; Wetherbee, Bradley M; Shivji, Mahmood

    2017-08-16

    Overfishing is a primary cause of population declines for many shark species of conservation concern. However, means of obtaining information on fishery interactions and mortality, necessary for the development of successful conservation strategies, are often fisheries-dependent and of questionable quality for many species of commercially exploited pelagic sharks. We used satellite telemetry as a fisheries-independent tool to document fisheries interactions, and quantify fishing mortality of the highly migratory shortfin mako shark ( Isurus oxyrinchus ) in the western North Atlantic Ocean. Forty satellite-tagged shortfin mako sharks tracked over 3 years entered the Exclusive Economic Zones of 19 countries and were harvested in fisheries of five countries, with 30% of tagged sharks harvested. Our tagging-derived estimates of instantaneous fishing mortality rates ( F = 0.19-0.56) were 10-fold higher than previous estimates from fisheries-dependent data (approx. 0.015-0.024), suggesting data used in stock assessments may considerably underestimate fishing mortality. Additionally, our estimates of F were greater than those associated with maximum sustainable yield, suggesting a state of overfishing. This information has direct application to evaluations of stock status and for effective management of populations, and thus satellite tagging studies have potential to provide more accurate estimates of fishing mortality and survival than traditional fisheries-dependent methodology. © 2017 The Author(s).

  19. Water Exchange Produces Significantly Higher Adenoma Detection Rate Than Water Immersion: Pooled Data From 2 Multisite Randomized Controlled Trials.

    Science.gov (United States)

    Leung, Felix W; Koo, Malcolm; Cadoni, Sergio; Falt, Premysl; Hsieh, Yu-Hsi; Amato, Arnaldo; Erriu, Matteo; Fojtik, Petr; Gallittu, Paolo; Hu, Chi-Tan; Leung, Joseph W; Liggi, Mauro; Paggi, Silvia; Radaelli, Franco; Rondonotti, Emanuele; Smajstrla, Vit; Tseng, Chih-Wei; Urban, Ondrej

    2018-03-02

    To test the hypothesis that water exchange (WE) significantly increases adenoma detection rates (ADR) compared with water immersion (WI). Low ADR was linked to increased risk for interval colorectal cancers and related deaths. Two recent randomized controlled trials of head-to-head comparison of WE, WI, and traditional air insufflation (AI) each showed that WE achieved significantly higher ADR than AI, but not WI. The data were pooled from these 2 studies to test the above hypothesis. Two trials (5 sites, 14 colonoscopists) that randomized 1875 patients 1:1:1 to AI, WI, or WE were pooled and analyzed with ADR as the primary outcome. The ADR of AI (39.5%) and WI (42.4%) were comparable, significantly lower than that of WE (49.6%) (vs. AI P=0.001; vs. WI P=0.033). WE insertion time was 3 minutes longer than that of AI (Prate (vs. AI) of the >10 mm advanced adenomas. Right colon combined advanced and sessile serrated ADR of AI (3.4%) and WI (5%) were comparable and were significantly lower than that of WE (8.5%) (vs. AI P<0.001; vs. WI P=0.039). Compared with AI and WI, the superior ADR of WE offsets the drawback of a significantly longer insertion time. For quality improvement focused on increasing adenoma detection, WE is preferred over WI. The hypothesis that WE could lower the risk of interval colorectal cancers and related deaths should be tested.

  20. Regional differences in treatment rates for patients with chronic hepatitis C infection: Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Philip Vutien

    Full Text Available Treatment rates with interferon-based therapies for chronic hepatitis C have been low. Our aim was to perform a systematic review of available data to estimate the rates and barriers for antiviral therapy for chronic hepatitis C.We conducted a systematic review and meta-analysis searching MEDLINE, SCOPUS through March 2016 and abstracts from recent major liver meetings for primary literature with available hepatitis C treatment rates. Random-effects models were used to estimate effect sizes and meta-regression to test for potential sources of heterogeneity.We included 39 studies with 476,443 chronic hepatitis C patients. The overall treatment rate was 25.5% (CI: 21.1-30.5% and by region 34% for Europe, 28.3% for Asia/Pacific, and 18.7% for North America (p = 0.008. On multivariable meta-regression, practice setting (tertiary vs. population-based, p = 0.04, region (Europe vs. North America p = 0.004, and data source (clinical chart review vs. administrative database, p = 0.025 remained significant predictors of heterogeneity. The overall treatment eligibility rate was 52.5%, and 60% of these received therapy. Of the patients who refused treatment, 16.2% cited side effects, 13.8% cited cost as reasons for treatment refusal, and 30% lacked access to specialist care.Only one-quarter of chronic hepatitis C patients received antiviral therapy in the pre-direct acting antiviral era. Treatment rates should improve in the new interferon-free era but, cost, co-morbidities, and lack of specialist care will likely remain and need to be addressed. Linkage to care should even be of higher priority now that well-tolerated cure is available.

  1. Higher Serum Uric Acid Levels in Multiple Sclerosis Patients After Longterm Interferon Beta Treatment

    Directory of Open Access Journals (Sweden)

    Toncev Gordana

    2017-10-01

    Full Text Available Interferon beta is a safe and efficacious treatment for relapsing multiple sclerosis (MS. However, there is some evidence that uric acid, a scavenger of peroxynitrite, is involved in MS pathology and that increasing serum uric acid levels might have beneficial therapeutic effects. The aim of this study is to investigate serum uric acid levels in MS patients before and after long-term interferon beta treatment. Blood samples from 101 MS patients (53 receiving interferon beta 1a treatment and 48 receiving interferon beta 1b treatment; 28 male and 73 female; mean age at treatment onset 32,4±7,3 years; mean duration of disease at treatment onset 5,1±3,2 years; mean EDSS 2±1,3 before and after interferon beta treatment (mean treatment duration 3±2 years were analysed. Serum uric acid levels were measured using a quantitative enzymatic assay (Elitech Diagnostic, Sees, France. MS patients had significantly increased serum uric acid levels after treatment compared with those at the beginning of treatment (272,31±78,21 μmol/l vs. 210,17±53,65 μmol/l; p=0,019, Wilcoxon Mann-Whitney U-test. We did not find significant differences in serum uric acid levels between the interferon beta 1a and interferon beta 1b groups (p=0.98. These results indicate that one of the beneficial effects of interferon beta in MS might be based on the elevation of serum uric acid levels as a natural scavenger of peroxynitrite.

  2. Core-needle biopsy of breast cancer is associated with a higher rate of distant metastases 5 to 15 years after diagnosis than FNA biopsy.

    Science.gov (United States)

    Sennerstam, Roland B; Franzén, Bo S H; Wiksell, Hans O T; Auer, Gert U

    2017-10-01

    The literature offers discordant results regarding whether diagnostic biopsy is associated with the dissemination of cancer cells, resulting in local and/or distant metastasis. The long-term outcomes of patients with breast cancer were compared between those who were diagnosed using either fine-needle aspiration biopsy (FNAB) or core-needle biopsy (CNB) during 2 decades: the 1970s and 1990s. In the 1970s, the only diagnostic needle biopsy method used for breast cancer in Sweden was FNAB. CNB was introduced 1989 and became established in Stockholm Gotland County in the early 1990s. The authors compared the clinical outcomes of patients diagnosed using FNAB from 1971 to 1976 (n = 354) versus those of patients diagnosed using CNB from 1991 to 1995 (n = 1729). Adjusting for differences in various treatment modalities, mammography screening, tumor size, DNA ploidy, and patient age between the 2 decades, 2 strictly matched samples representing FNAB (n = 181) and CNB (n = 203) were selected for a 15-year follow-up study. In a comparison of the rates of distant metastasis in the strictly matched patient groups from the FNAB and CNB cohorts, significantly higher rates of late-appearing (5-15 years after diagnosis) distant metastasis were observed among the patients who were diagnosed on CNB compared with those who were diagnosed on FNAB. No significant difference in local metastasis was observed between the 2 groups. At 5 to 15 years after diagnosis of the primary tumor, CNB-diagnosed patients had significantly higher rates of distant metastases than FNAB-diagnosed patients. Cancer Cytopathol 2017;125:748-56. © 2017 American Cancer Society. © 2017 American Cancer Society.

  3. Prediction of outcome of bright light treatment in patients with seasonal affective disorder: Discarding the early response, confirming a higher atypical balance, and uncovering a higher body mass index at baseline as predictors of endpoint outcome.

    Science.gov (United States)

    Dimitrova, Tzvetelina D; Reeves, Gloria M; Snitker, Soren; Lapidus, Manana; Sleemi, Aamar R; Balis, Theodora G; Manalai, Partam; Tariq, Muhammad M; Cabassa, Johanna A; Karim, Naila N; Johnson, Mary A; Langenberg, Patricia; Rohan, Kelly J; Miller, Michael; Stiller, John W; Postolache, Teodor T

    2017-11-01

    We tested the hypothesis that the early improvement in mood after the first hour of bright light treatment compared to control dim-red light would predict the outcome at six weeks of bright light treatment for depressed mood in patients with Seasonal Affective Disorder (SAD). We also analyzed the value of Body Mass Index (BMI) and atypical symptoms of depression at baseline in predicting treatment outcome. Seventy-eight adult participants were enrolled. The first treatment was controlled crossover, with randomized order, and included one hour of active bright light treatment and one hour of control dim-red light, with one-hour washout. Depression was measured on the Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD version (SIGH-SAD). The predictive association of depression scores changes after the first session. BMI and atypical score balance with treatment outcomes at endpoint were assessed using multivariable linear and logistic regressions. No significant prediction by changes in depression scores after the first session was found. However, higher atypical balance scores and BMI positively predicted treatment outcome. Absence of a control intervention for the six-weeks of treatment (only the first session in the laboratory was controlled). Exclusion of patients with comorbid substance abuse, suicidality and bipolar I disorder, and patients on antidepressant medications, reducing the generalizability of the study. Prediction of outcome by early response to light treatment was not replicated, and the previously reported prediction of baseline atypical balance was confirmed. BMI, a parameter routinely calculated in primary care, was identified as a novel predictor, and calls for replication and then exploration of possible mediating mechanisms. Published by Elsevier B.V.

  4. Pyrolysis of Algal Biomass Obtained from High-Rate Algae Ponds Applied to Wastewater Treatment

    International Nuclear Information System (INIS)

    Vargas e Silva, Fernanda; Monteggia, Luiz Olinto

    2015-01-01

    This work presents the results of the pyrolysis of algal biomass obtained from high-rate algae ponds treating sewage. The two high-rate algae ponds (HRAP) were built and operated at the São João Navegantes Wastewater Treatment Plant. The HRAP A was fed with raw sewage while the HRAP B was fed with effluent from an upflow anaerobic sludge blanket (UASB) reactor. The HRAP B provided higher productivity, presenting total solids concentration of 487.3 mg/l and chlorophyll a of 7735 mg/l. The algal productivity in the average depth was measured at 41.8 g·m −2 day −1 in pond A and at 47.1 g·m −2 day −1 in pond B. Algae obtained from the HRAP B were separated by the process of coagulation/flocculation and sedimentation. In the presence of alum, a separation efficiency in the range of 97% solid removal was obtained. After centrifugation the biomass was dried and comminuted. The biofuel production experiments were conducted via pyrolysis in a tubular quartz glass reactor which was inserted in a furnace for external heating. The tests were carried out in an inert nitrogen atmosphere at a flow rate of 60 ml/min. The system was operated at 400, 500, and 600°C in order to determine the influence of temperature on the obtained fractional yields. The studies showed that the pyrolysis product yield was influenced by temperature, with a maximum liquid phase (bio-oil and water) production rate of 44% at 500°C, 45% for char and around 11% for gas.

  5. PYROLYSIS OF ALGAL BIOMASS OBTAINED FROM HIGH RATE ALGAE PONDS APPLIED TO WASTEWATER TREATMENT

    Directory of Open Access Journals (Sweden)

    Fernanda eVargas E Silva

    2015-06-01

    Full Text Available This work presents the results of the pyrolysis of algal biomass obtained from high rate algae ponds treating sewage. The two high-rate algae ponds (HRAP were built and operated at the São João Navegantes Wastewater Treatment Plant. The HRAP A was fed with raw sewage while the HRAP B was fed with effluent from an Upflow Anaerobic Sludge Blanket (UASB reactor. The HRAP B provided higher productivity, presenting total solids concentration of 487.3mg/l and chlorophyll a of 7735mg/l. The algal productivity in the average depth was measured at 41,8 gm-2day-1 in pond A and at 47.1 gm-2day-1 in pond B. Algae obtained from the HRAP B were separated by the process of coagulation/flocculation and sedimentation. In the presence of alum, a separation efficiency in the range of 97% solids removal was obtained. After centrifugation the biomass was dried and comminuted. The biofuel production experiments were conducted via pyrolysis in a tubular quartz glass reactor which was inserted in a furnace for external heating. The tests were carried out in an inert nitrogen atmosphere at a flow rate of 60ml/min. The system was operated at 400°C, 500°C and 600°C in order to determine the influence of temperature on the obtained fractional yields. The studies showed that the pyrolysis product yield was influenced by temperature, with a maximum liquid phase (bio-oil and water production rate of 44% at 500°C, 45% for char and around 11% for gas.

  6. Pyrolysis of Algal Biomass Obtained from High-Rate Algae Ponds Applied to Wastewater Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Vargas e Silva, Fernanda, E-mail: fervs@globo.com; Monteggia, Luiz Olinto [Institute of Hydraulic Research, Federal University of Rio Grande do Sul, Porto Alegre (Brazil)

    2015-06-30

    This work presents the results of the pyrolysis of algal biomass obtained from high-rate algae ponds treating sewage. The two high-rate algae ponds (HRAP) were built and operated at the São João Navegantes Wastewater Treatment Plant. The HRAP A was fed with raw sewage while the HRAP B was fed with effluent from an upflow anaerobic sludge blanket (UASB) reactor. The HRAP B provided higher productivity, presenting total solids concentration of 487.3 mg/l and chlorophyll a of 7735 mg/l. The algal productivity in the average depth was measured at 41.8 g·m{sup −2} day{sup −1} in pond A and at 47.1 g·m{sup −2} day{sup −1} in pond B. Algae obtained from the HRAP B were separated by the process of coagulation/flocculation and sedimentation. In the presence of alum, a separation efficiency in the range of 97% solid removal was obtained. After centrifugation the biomass was dried and comminuted. The biofuel production experiments were conducted via pyrolysis in a tubular quartz glass reactor which was inserted in a furnace for external heating. The tests were carried out in an inert nitrogen atmosphere at a flow rate of 60 ml/min. The system was operated at 400, 500, and 600°C in order to determine the influence of temperature on the obtained fractional yields. The studies showed that the pyrolysis product yield was influenced by temperature, with a maximum liquid phase (bio-oil and water) production rate of 44% at 500°C, 45% for char and around 11% for gas.

  7. International comparisons of preterm birth: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death.

    Science.gov (United States)

    Lisonkova, S; Sabr, Y; Butler, B; Joseph, K S

    2012-12-01

    To examine international rates of preterm birth and potential associations with stillbirths and neonatal deaths at late preterm and term gestation. Ecological study. Canada, USA and 26 countries in Europe. All deliveries in 2004. Information on preterm birth (Statistics Canada, the EURO-PERISTAT project and the National Center for Health Statistics. Pearson correlation coefficients and random-intercept Poisson regression were used to examine the association between preterm birth rates and gestational age-specific stillbirth and neonatal death rates. Rate ratios with 95% confidence intervals were estimated after adjustment for maternal age, parity and multiple births. Stillbirths and neonatal deaths ≥ 32 and ≥ 37 weeks of gestation. International rates of preterm birth (births. Preterm birth rates at 32-36 weeks were inversely associated with stillbirths at ≥ 32 weeks (adjusted rate ratio 0.94, 95% CI 0.92-0.96) and ≥ 37 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) of gestation and inversely associated with neonatal deaths at ≥ 32 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) and ≥ 37 weeks (adjusted rate ratio 0.82, 95% CI 0.78-0.86) of gestation. Countries with high rates of preterm birth at 32-36 weeks of gestation have lower stillbirth and neonatal death rates at and beyond 32 weeks of gestation. Contemporary rates of preterm birth are indicators of both perinatal health and obstetric care services. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  8. Deep breathing exercises with positive expiratory pressure at a higher rate improve oxygenation in the early period after cardiac surgery--a randomised controlled trial.

    Science.gov (United States)

    Urell, Charlotte; Emtner, Margareta; Hedenström, Hans; Tenling, Arne; Breidenskog, Marie; Westerdahl, Elisabeth

    2011-07-01

    In addition to early mobilisation, a variety of breathing exercises are used to prevent postoperative pulmonary complications after cardiac surgery. The optimal duration of the treatment is not well evaluated. The aim of this study was to determine the effect of 30 versus 10 deep breaths hourly, while awake, with positive expiratory pressure on oxygenation and pulmonary function the first days after cardiac surgery. A total of 181 patients, undergoing cardiac surgery, were randomised into a treatment group, performing 30 deep breaths hourly the first postoperative days, or into a control group performing 10 deep breaths hourly. The main outcome measurement arterial blood gases and the secondary outcome pulmonary function, evaluated with spirometry, were determined on the second postoperative day. Preoperatively, both study groups were similar in terms of age, SpO(2), forced expiratory volume in 1s and New York Heart Association classification. On the second postoperative day, arterial oxygen tension (PaO(2)) was 8.9 ± 1.7 kPa in the treatment group and 8.1 ± 1.4 kPa in the control group (p = 0.004). Arterial oxygen saturation (SaO(2)) was 92.7 ± 3.7% in the treatment group and 91.1 ± 3.8% in the control group (p = 0.016). There were no differences in measured lung function between the groups or in compliance to the breathing exercises. Compliance was 65% of possible breathing sessions. A significantly increased oxygenation was found in patients performing 30 deep breaths the first two postoperative days compared with control patients performing 10 deep breaths hourly. These results support the implementation of a higher rate of deep breathing exercises in the initial phase after cardiac surgery. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  9. High-dose-rate interstitial brachytherapy for the treatment of penile carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Petera, J.; Odrazka, K.; Zouhar, M.; Bedrosova, J.; Dolezel, M. [Dept. of Oncology and Radiotherapy, Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic)

    2004-02-01

    Background: interstitial low-dose-rate (LDR) brachytherapy allows conservative treatment of T1-T2 penile carcinoma. High-dose-rate (HDR) is often considered to be dangerous for interstitial implants because of a higher risk of complications, but numerous reports suggest that results may be comparable to LDR. Nevertheless, there are no data in the literature available regarding HDR interstitial brachytherapy for carcinoma of the penis. Case report: a 64-year-old man with T1 NO MO epidermoid carcinoma of the glans is reported. Interstitial HDR brachytherapy was performed using the stainless hollow needle technique and a breast template for fixation and good geometry. The dose delivered was 18 x 3 Gy twice daily. Results: after 232 days from brachytherapy, the patient was without any evidence of the tumor, experienced no serious radiation-induced complications, and had a fully functional organ. Conclusion: HDR interstitial brachytherapy is feasible in selected case of penis carcinoma, when careful planning and small single fractions are used. (orig.)

  10. Does adding metformin to clomifene citrate lead to higher pregnancy rates in a subset of women with polycystic ovary syndrome?

    NARCIS (Netherlands)

    Moll, E.; Korevaar, J. C.; Bossuyt, P. M. M.; van der Veen, F.

    2008-01-01

    BACKGROUND: An RCT among newly diagnosed, therapy naive women with polycystic ovary syndrome (PCOS) showed no significant differences in ovulation rate, ongoing pregnancy rate or spontaneous abortion rate in favour of clomifene citrate plus metformin compared with clomifene citrate. We wanted to

  11. Pulsed dose rate (PDR) brachytherapy as salvage treatment of locally advanced or recurrent gynecologic cancer

    DEFF Research Database (Denmark)

    Jensen, P T; Roed, H; Engelholm, S A

    1998-01-01

    PURPOSE: Pulsed dose rate (PDR) brachytherapy is a new treatment option permitting dose distribution optimization in interstitial implants. It possesses the advantage of equipment simplification and radiation protection to the staff, compared to the manually afterloading technique. This study pre...

  12. Sustainable policy: Higher medication use & adherence during reimbursement of pharmacologic smoking cessation treatments

    NARCIS (Netherlands)

    Van Boven, J.F.; Vemer, P.

    2014-01-01

    Background: The discussion on the reimbursement of Smoking Cessation Treatment (SCT) has known many stages in The Netherlands. From January 2011, SCTs were reimbursed, until January 2012 when the reimbursement of nicotine replacement therapies (NRTs) and pharmacotherapeutic SCT (pSCT) was

  13. Differences in Recurrence Rate and De Novo Incontinence after Endoscopic Treatment of Vesicourethral Stenosis and Bladder Neck Stenosis

    Directory of Open Access Journals (Sweden)

    Jennifer Kranz

    2017-08-01

    Full Text Available ObjectivesThe objective of this study was to compare the recurrence rate and de novo incontinence after endoscopic treatment of vesicourethral stenosis (VUS after radical prostatectomy (RP and for bladder neck stenosis (BNS after transurethral resection of the prostate (TURP.MethodsRetrospective analysis of patients treated endoscopically for VUS after RP or for BNS after TURP at three German tertiary care centers between March 2009 and June 2016. Investigated endpoints were recurrence rate and de novo incontinence. Chi-squared tests and t-tests were used to model the differences between groups.ResultsA total of 147 patients underwent endoscopic therapy for VUS (59.2% or BNS (40.8%. Mean age was 68.3 years (range 44–86, mean follow-up 27.1 months (1–98. Mean time to recurrence after initial therapy was 23.9 months (1–156, mean time to recurrence after prior endoscopic therapy for VUS or BNS was 12.0 months (1–159. Patients treated for VUS underwent significantly more often radiotherapy prior to endoscopic treatment (33.3 vs. 13.3%; p = 0.006 and the recurrence rate was significantly higher (59.8 vs. 41.7%; p = 0.031. The overall success rate of TUR for VUS was 40.2%, success rate of TUR for BNS was 58.3%. TUR for BNS is significantly more successful (p = 0.031. The mean number of TUR for BNS vs. TUR for VUS in successful cases was 1.5 vs. 1.8, which was not significantly different. The rate of de novo incontinence was significantly higher in patients treated for VUS (13.8 vs. 1.7%; p = 0.011. After excluding those patients with radiotherapy prior to endoscopic treatment, the recurrence rate did not differ significantly between both groups (60.3% for VUS vs. 44.2% for BNS; p = 0.091, whereas the rate of de novo incontinence (13.8 for VUS vs. 0% for BNS; p = 0.005 stayed significantly higher in patients treated for VUS.ConclusionMost patients with BNS are successfully treated endoscopically. In patients with

  14. Estimating the effect of a rare time-dependent treatment on the recurrent event rate.

    Science.gov (United States)

    Smith, Abigail R; Zhu, Danting; Goodrich, Nathan P; Merion, Robert M; Schaubel, Douglas E

    2018-05-30

    In many observational studies, the objective is to estimate the effect of treatment or state-change on the recurrent event rate. If treatment is assigned after the start of follow-up, traditional methods (eg, adjustment for baseline-only covariates or fully conditional adjustment for time-dependent covariates) may give biased results. We propose a two-stage modeling approach using the method of sequential stratification to accurately estimate the effect of a time-dependent treatment on the recurrent event rate. At the first stage, we estimate the pretreatment recurrent event trajectory using a proportional rates model censored at the time of treatment. Prognostic scores are estimated from the linear predictor of this model and used to match treated patients to as yet untreated controls based on prognostic score at the time of treatment for the index patient. The final model is stratified on matched sets and compares the posttreatment recurrent event rate to the recurrent event rate of the matched controls. We demonstrate through simulation that bias due to dependent censoring is negligible, provided the treatment frequency is low, and we investigate a threshold at which correction for dependent censoring is needed. The method is applied to liver transplant (LT), where we estimate the effect of development of post-LT End Stage Renal Disease (ESRD) on rate of days hospitalized. Copyright © 2018 John Wiley & Sons, Ltd.

  15. 5 CFR 531.610 - Treatment of locality rate as basic pay.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Treatment of locality rate as basic pay... REGULATIONS PAY UNDER THE GENERAL SCHEDULE Locality-Based Comparability Payments § 531.610 Treatment of... part 550, subpart L, for accumulated and accrued annual leave; (m) Grade and pay retention under 5 U.S...

  16. Behavioral Treatments and Pharmacotherapy: Acceptability Ratings by Elderly Individuals in Residential Settings.

    Science.gov (United States)

    Burgio, Louis D.; Sinnott, Jan

    1990-01-01

    Presented residents of life care community and nursing homes with scenarios of older woman. Client varied by cognitive capacity and behavior problem (aggression, verbal abuse, noncompliance). Participants rated three treatments: differential reinforcement of incompatible behavior (DRI), time-out, and haloperidol. All treatments were acceptable;…

  17. Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids

    DEFF Research Database (Denmark)

    Jiang, Ping; Baumann, René; Dunst, Jürgen

    2016-01-01

    PURPOSE: To prospectively evaluate high-dose-rate brachytherapy in the treatment of therapy-resistant keloids and report first results, with emphasis on feasibility and early treatment outcome. METHODS AND MATERIALS: From 2009 to 2014, 24 patients with 32 recurrent keloids were treated with immed...

  18. Low rate of membrane lithium transport during treatment correlates with outcome of maintenance pharmacotherapy in bipolar disorder.

    Science.gov (United States)

    Mallinger, A G; Frank, E; Thase, M E; Dippold, C S; Kupfer, D J

    1997-05-01

    Lithium is transported across cell membranes by an exchange diffusion process (Na(+)-Li+ countertransport) that is inhibited during lithium treatment. We hypothesized that low rates of lithium efflux (a potential manifestation of strong transport inhibition) would be associated with better clinical outcome of maintenance pharmacotherapy. We measured the erythrocyte (RBC) apparent rate constant for lithium efflux (kexch) in 22 patients with bipolar disorder who had been euthymic on lithium for 1 month. Subsequently, clinical mood ratings and in vivo RBC: plasma lithium ratios (LiR) were determined monthly. Outcome was categorized according to whether subjects completed 1 year of successful maintenance treatment (n = 10), experienced a recurrent affective episode (n = 8), or dropped out (n = 4). The kexch at the outset of the study was significantly lower (potentially because of greater transport inhibition) in 1-year completers than in patients with recurrences or those who dropped out (median kexch = 0.09, 0.24, and 0.27 h-1, respectively; P lower were successfully maintained on lithium for 1 year, whereas only 23% of those with a kexch greater than or equal to 0.12 h-1 had a successful treatment outcome. LiR measured during the course of maintenance treatment was significantly higher (suggesting greater transport inhibition) in 1-year completers than in noncompleters (recurrences and dropouts). Measurement of kexch at an early point in treatment may provide a means for prospectively identifying those bipolar patients at greater risk for failure of maintenance lithium therapy.

  19. An alternative treatment of phenomenological higher-order strain-gradient plasticity theory

    DEFF Research Database (Denmark)

    Kuroda, Mitsutoshi; Tvergaard, Viggo

    2010-01-01

    strain is discussed, applying a dislocation theory-based consideration. Then, a differential equation for the equivalent plastic strain-gradient is introduced as an additional governing equation. Its weak form makes it possible to deduce and impose extra boundary conditions for the equivalent plastic...... strain. A connection between the present treatment and strain-gradient theories based on an extended virtual work principle is discussed. Furthermore, a numerical implementation and analysis of constrained simple shear of a thin strip are presented....

  20. Prevalence, Treatment, and Control Rates of Conventional and Ambulatory Hypertension Across 10 Populations in 3 Continents

    DEFF Research Database (Denmark)

    Melgarejo, Jesus D.; Maestre, Gladys E; Thijs, Lutgarde

    2017-01-01

    Hypertension is a major global health problem, but prevalence rates vary widely among regions. To determine prevalence, treatment, and control rates of hypertension, we measured conventional blood pressure (BP) and 24-hour ambulatory BP in 6546 subjects, aged 40 to 79 years, recruited from 10 com...

  1. Improved Completion Rates and Characterization of Drug Reactions with an Intensive Chagas Disease Treatment Program in Rural Bolivia

    Science.gov (United States)

    Tornheim, Jeffrey A.; Lozano Beltran, Daniel F.; Gilman, Robert H.; Castellon, Mario; Solano Mercado, Marco A.; Sullca, Walter; Torrico, Faustino; Bern, Caryn

    2013-01-01

    Background Chagas disease treatment is limited by drug availability, adverse side effect profiles of available medications, and poor adherence. Methods Adult Chagas disease patients initiating 60-days of benznidazole were randomized to weekly or twice-weekly evaluations of medication adherence and screening for adverse drug events (ADEs). Mid-week evaluations employed phone-based evaluations. Adherence was measured by self-report, pill counts with intentional over-distribution, and Medication Event Monitoring Systems (MEMS). Prospective data were compared to historical controls treated with benznidazole at the same hospital. Results 162 prospective patients were compared to 172 historical patients. Pill counts correlated well with MEMS data (R = 0.498 for 7-day intervals, R = 0.872 for intervals >7 days). Treatment completion rates were higher among prospective than historical patients (82.1% vs. 65.1%), primarily due to lower abandonment rates. Rates of ADEs were lower among prospective than historical patients (56.8% vs. 66.9%). Twice-weekly evaluations increased identification of mild ADEs, prompting higher suspension rates than weekly evaluations. While twice-weekly evaluations identified ADEs earlier, they did not reduce incidence of moderate or severe ADEs. Many dermatologic ADEs were moderately severe upon presentation (35.6%), were not reduced by use of antihistamines, occurred among adult patients of all ages, and occurred throughout treatment, rather than the first few weeks alone. Conclusions Intensive management improved completion and identified more ADEs, but did not reduce moderate or severe ADEs. Risk of dermatologic ADEs cannot be reduced by selecting younger adults or monitoring only during the first few weeks of treatment. Pill counts and phone-based encounters are reliable tools for treatment programming in rural Bolivia. PMID:24069472

  2. Higher dropout rate in non-native patients than in native patients in rehabilitation in The Netherlands

    NARCIS (Netherlands)

    Sloots, Maurits; Scheppers, Emmanuel F.; van de Weg, Frans B.; Bartels, Edien A.; Geertzen, Jan H.; Dekker, Joost; Dekker, Jaap

    Dropout from a rehabilitation programme often occurs in patients with chronic nonspecific low back pain of non-native origin. However, the exact dropout rate is not known. The objective of this study was to determine the difference in dropout rate between native and non-native patients with chronic

  3. Accounting for Risk of Non-Completion in Private and Social Rates of Return to Higher Education

    Science.gov (United States)

    Toutkoushian, Robert K.; Shafiq, M. Najeeb; Trivette, Michael J.

    2013-01-01

    Conventional studies of the private and social rates of return to a Bachelor's degree focus on the earnings difference between Bachelor degree holders and high school graduates, and find that there are large rates of return for degree recipients. The estimates in these studies, however, do not take into account the risk of not completing a degree.…

  4. Trauma centers with higher rates of angiography have a lesser incidence of splenectomy in the management of blunt splenic injury.

    Science.gov (United States)

    Capecci, Louis M; Jeremitsky, Elan; Smith, R Stephen; Philp, Frances

    2015-10-01

    Nonoperative management (NOM) for blunt splenic injury (BSI) is well-established. Angiography (ANGIO) has been shown to improve success rates with NOM. Protocols for NOM are not standardized and vary widely between centers. We hypothesized that trauma centers that performed ANGIO at a greater rate would demonstrate decreased rates of splenectomy compared with trauma centers that used ANGIO less frequently. A large, multicenter, statewide database (Pennsylvania Trauma Systems Foundation) from 2007 to 2011 was used to generate the study cohort of patients with BSI (age ≥ 13). The cohort was divided into 2 populations based on admission to centers with high (≥13%) or low (Splenectomy rates were then compared between the 2 groups, and multivariable logistic regression for predictors of splenectomy (failed NOM) were also performed. The overall rate of splenectomy in the entire cohort was 21.0% (1,120 of 5,333 BSI patients). The high ANGIO group had a lesser rate of splenectoy compared with the low ANGIO group (19% vs 24%; P splenectomy compared with low ANGIO centers (odds ratio, 0.68; 95% CI 0.58-0.80; P splenectomy rates compared with centers with lesser rate of ANGIO. Inclusion of angiographic protocols for NOM of BSI should be considered strongly. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. [Comparison of curative effect of low flow rate plasma exchange combined with hemofiltration for treatment of liver failure].

    Science.gov (United States)

    Yang, Yong-feng; Huang, Ping; Zhang, Ning; Gai, Xiao-dong; Feng, Xiao-ning; Zhong, Yan-dan; Wang, Li-rong; Yang, Yi-jun; Zhao, Wei

    2009-02-01

    To investigate the effect of plasma exchange (PE) combined with hemofiltration (HF) on liver failure. Seventy-seven inpatients with liver failure admitted during January 2006 to August 2007 were randomly assigned to receive PE combined with HF (PE+HF group, 38 cases), or PE alone (PE group, 39 cases). Forty-one inpatients with liver failure who had not received artificial liver support treatment were assigned to serve as control group. The survival rates and biochemical parameters of three groups were compared. There was no significant difference in biochemical parameters before treatment among three groups. Compared with pre-treatment values, albumin (Alb), cholinesterase (ChE) and prothrombin activity (PTA) of both PE group and PE+HF group were significantly increased after treatment, and total bilirubin (TBIL), alanine transaminase (ALT), aspartate transaminase (AST) of both PE group and PE+HF group were significantly decreased after treatment (Prate of PE group, PE+HF group and control group was 48.7% (19/39), 68.4% (26/38), and 29.3% (12/41) respectively. The survival rate of PE+HF group was significantly higher than that of control group (chi(2)=12.11, Prate of recovery of consciousness of patients with hepatic encephalopathy in PE+HF group was higher than that of PE group (42.8% vs. 0, P<0.05). Compared with PE alone, the result was better when it was combined with HF in correction of electrolyte disturbance and acid-base imbalance (19/23 vs. 0/21, P<0.05). Treatment of liver failure by PE combined with HF is safe and effective, and its efficacy is higher than PE alone.

  6. The Effect of Heat Treatments and Coatings on the Outgassing Rate of Stainless Steel Chambers

    Energy Technology Data Exchange (ETDEWEB)

    Mamum, Md Abdullah A. [Old Dominion Univ., Norfolk, VA (United States); Elmustafa, Abdelmageed A, [Old Dominion Univ., Norfolk, VA (United States); Stutzman, Marcy L. [JLAB, Newport News, VA (United States); Adderley, Philip A. [JLAB, Newport News, VA (United States); Poelker, Matthew [JLAB, Newport News, VA (United States)

    2014-03-01

    The outgassing rates of four nominally identical 304L stainless steel vacuum chambers were measured to determine the effect of chamber coatings and heat treatments. One chamber was coated with titanium nitride (TiN) and one with amorphous silicon (a-Si) immediately following fabrication. One chamber remained uncoated throughout, and the last chamber was first tested without any coating, and then coated with a-Si following a series of heat treatments. The outgassing rate of each chamber was measured at room temperatures between 15 and 30 deg C following bakes at temperatures between 90 and 400 deg C. Measurements for bare steel showed a significant reduction in the outgassing rate by more than a factor of 20 after a 400 deg C heat treatment (3.5 x 10{sup 12} TorrL s{sup -1}cm{sup -2} prior to heat treatment, reduced to 1.7 x 10{ sup -13} TorrL s{sup -1}cm{sup -2} following heat treatment). The chambers that were coated with a-Si showed minimal change in outgassing rates with heat treatment, though an outgassing rate reduced by heat treatments prior to a-Si coating was successfully preserved throughout a series of bakes. The TiN coated chamber exhibited remarkably low outgassing rates, up to four orders of magnitude lower than the uncoated stainless steel. An evaluation of coating composition suggests the presence of elemental titanium which could provide pumping and lead to an artificially low outgassing rate. The outgassing results are discussed in terms of diffusion-limited versus recombination-limited processes.

  7. Higher Precision of Heart Rate Compared with VO2 to Predict Exercise Intensity in Endurance-Trained Runners.

    Science.gov (United States)

    Reis, Victor M; den Tillaar, Roland Van; Marques, Mario C

    2011-01-01

    The aim of the present study was to assess the precision of oxygen uptake with heart rate regression during track running in highly-trained runners. Twelve national and international level male long-distance road runners (age 30.7 ± 5.5 yrs, height 1.71 ± 0.04 m and mass 61.2 ± 5.8 kg) with a personal best on the half marathon of 62 min 37 s ± 1 min 22 s participated in the study. Each participant performed, in an all-weather synthetic track five, six min bouts at constant velocity with each bout at an increased running velocity. The starting velocity was 3.33 m·s(-1) with a 0.56 m·s(-1) increase on each subsequent bout. VO2 and heart rate were measured during the runs and blood lactate was assessed immediately after each run. Mean peak VO2 and mean peak heart rate were, respectively, 76.2 ± 9.7 mL·kg(-1)·min(-1) and 181 ± 13 beats·min(-1). The linearity of the regressions between heart rate, running velocity and VO2 were all very high (r > 0.99) with small standard errors of regression (i.e. Sy.x at the velocity associated with the 2 and 4 mmol·L(-1) lactate thresholds). The strong relationships between heart rate, running velocity and VO2 found in this study show that, in highly trained runners, it is possible to have heart rate as an accurate indicator of energy demand and of the running speed. Therefore, in this subject cohort it may be unnecessary to use VO2 to track changes in the subjects' running economy during training periods. Key pointsHeart rate is used in the control of exercise intensity in endurance sports.However, few studies have quantified the precision of its relationship with oxygen uptake in highly trained runners.We evaluated twelve elite half-marathon runners during track running at various intensities and established three regressions: oxygen uptake / heart rate; heart rate / running velocity and oxygen uptake / running velocity.The three regressions presented, respectively, imprecision of 4,2%, 2,75% and 4,5% at the velocity

  8. High-rate wastewater treatment combining a moving bed biofilm reactor and enhanced particle separation.

    Science.gov (United States)

    Helness, H; Melin, E; Ulgenes, Y; Järvinen, P; Rasmussen, V; Odegaard, H

    2005-01-01

    Many cities around the world are looking for compact wastewater treatment alternatives since space for treatment plants is becoming scarce. In this paper development of a new compact, high-rate treatment concept with results from experiments in lab-scale and pilot-scale are presented. The idea behind the treatment concept is that coagulation/floc separation may be used to separate suspended and colloidal matter (resulting in > 70% organic matter removal in normal wastewater) while a high-rate biofilm process (based on Moving Bed biofilm reactors) may be used for removing low molecular weight, easily biodegradable, soluble organic matter. By using flotation for floc/biomass separation, the total residence time for a plant according to this concept will normally be treatment) and sufficient P-removal.

  9. Are Cancer incidence Rates Among Present And Past Workers Of The research Centers Of The Atomic Energy Commission higher Than The Rates Among The General Population?

    International Nuclear Information System (INIS)

    Litai, D.

    1999-01-01

    Cancer incidence rates among the workers of the AEC and its retirees have increased several fold in the last decade compared to the rates experienced in previous ones. This has brought about a wave of claims for compensation with negative repercussions in the media about the state of radiation safety in the nuclear research centers in the country. The Nuclear Research Center - Negev, being, generally closed to public and media visits, has taken the brunt of this criticism. Consequently, the question spelled out in the title has caused much concern and deserves to be discussed and explained. The purpose of this paper is to review what we know in this context and to show that the observed morbidity rates, worrying as they may be, are entirely natural, and, by and large, unrelated to the occupational exposures of the workers. It is well known that cancer incidence rates in the population rise steeply with age, especially over 50. As both research centers are approaching the age of 40, it is clear that a very large fraction of the workers and all retirees have passed this age and many are already in their sixties and even seventies. It is a well established fact that close to 40% of the population in this country (and many others as well) develop some type of cancer during their lifetime and close to a half of these succumb to it. As most of those cancers occur after the age of 50, this explains the increased rates alluded to above. Notably, numerous research centers around the globe have reached similar ages in the last decade and experience similar increases in morbidity, that have caused understandable concern and the initiation of epidemiological studies intended to identify the health effects of extended exposures to low doses, if any. Such studies have been carried out in several countries and followed, altogether, about 100,000 workers through 40 years. The studies showed no excess of cancer mortality among workers compared to the general population (adjusted

  10. Faster eating rates are associated with higher energy intakes during an ad libitum meal, higher BMI and greater adiposity among 4·5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort.

    Science.gov (United States)

    Fogel, Anna; Goh, Ai Ting; Fries, Lisa R; Sadananthan, Suresh A; Velan, S Sendhil; Michael, Navin; Tint, Mya-Thway; Fortier, Marielle V; Chan, Mei Jun; Toh, Jia Ying; Chong, Yap-Seng; Tan, Kok Hian; Yap, Fabian; Shek, Lynette P; Meaney, Michael J; Broekman, Birit F P; Lee, Yung Seng; Godfrey, Keith M; Chong, Mary F F; Forde, Ciarán G

    2017-04-01

    Faster eating rates are associated with increased energy intake, but little is known about the relationship between children's eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children (n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning (n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake (r 0·61, P<0·001) and a positive linear relationship between eating rate and children's BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal); 95 % CI 107·6, 154·4, P<0·001), and had higher whole-body (P<0·05) and subcutaneous abdominal adiposity (Δ118·3 cc; 95 % CI 24·0, 212·7, P=0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal (b 13·59; 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z-score and adiposity.

  11. HIGHER PRECISION OF HEART RATE COMPARED WITH VO2 TO PREDICT EXERCISE INTENSITY IN ENDURANCE-TRAINED RUNNERS

    Directory of Open Access Journals (Sweden)

    Victor M. Reis

    2011-03-01

    Full Text Available The aim of the present study was to assess the precision of oxygen uptake with heart rate regression during track running in highly-trained runners. Twelve national and international level male long-distance road runners (age 30.7 ± 5.5 yrs, height 1.71 ± 0.04 m and mass 61.2 ± 5.8 kg with a personal best on the half marathon of 62 min 37 s ± 1 min 22 s participated in the study. Each participant performed, in an all-weather synthetic track five, six min bouts at constant velocity with each bout at an increased running velocity. The starting velocity was 3.33 m·s-1 with a 0.56 m·s-1 increase on each subsequent bout. VO2 and heart rate were measured during the runs and blood lactate was assessed immediately after each run. Mean peak VO2 and mean peak heart rate were, respectively, 76.2 ± 9.7 mL·kg-1·min-1 and 181 ± 13 beats·min-1. The linearity of the regressions between heart rate, running velocity and VO2 were all very high (r > 0.99 with small standard errors of regression (i.e. Sy.x < 5% at the velocity associated with the 2 and 4 mmol·L-1 lactate thresholds. The strong relationships between heart rate, running velocity and VO2 found in this study show that, in highly trained runners, it is possible to have heart rate as an accurate indicator of energy demand and of the running speed. Therefore, in this subject cohort it may be unnecessary to use VO2 to track changes in the subjects' running economy during training periods.

  12. Predictors of dropout in concurrent treatment of posttraumatic stress disorder and alcohol dependence: Rate of improvement matters

    Science.gov (United States)

    Zandberg, Laurie J.; Rosenfield, David; Alpert, Elizabeth; McLean, Carmen P.; Foa, Edna B.

    2016-01-01

    Objective The present study examined predictors and moderators of dropout among 165 adults meeting DSM-IV criteria for posttraumatic stress disorder (PTSD) and alcohol dependence (AD). Participants were randomized to 24 weeks of naltrexone (NAL), NAL and prolonged exposure (PE), pill placebo, or pill placebo and PE. All participants received supportive AD counseling (the BRENDA manualized model). Method Logistic regression using the Fournier approach was conducted to investigate baseline predictors of dropout across the entire study sample. Rates of PTSD and AD symptom improvement were included to evaluate the impact of symptom change on dropout. Results Trauma type and rates of PTSD and AD improvement significantly predicted dropout, accounting for 76% of the variance in dropout. Accidents and “other” trauma were associated with the highest dropout, and physical assault was associated with the lowest dropout. For participants with low baseline PTSD severity, faster PTSD improvement predicted higher dropout. For those with high baseline severity, both very fast and very slow rates of PTSD improvement were associated with higher dropout. Faster rates of drinking improvement predicted higher dropout among participants who received PE. Conclusions The current study highlights the influence of symptom trajectory on dropout risk. Clinicians may improve retention in PTSD-AD treatments by monitoring symptom change at regular intervals, and eliciting patient feedback on these changes. PMID:26972745

  13. Predictors of dropout in concurrent treatment of posttraumatic stress disorder and alcohol dependence: Rate of improvement matters.

    Science.gov (United States)

    Zandberg, Laurie J; Rosenfield, David; Alpert, Elizabeth; McLean, Carmen P; Foa, Edna B

    2016-05-01

    The present study examined predictors and moderators of dropout among 165 adults meeting DSM-IV criteria for posttraumatic stress disorder (PTSD) and alcohol dependence (AD). Participants were randomized to 24 weeks of naltrexone (NAL), NAL and prolonged exposure (PE), pill placebo, or pill placebo and PE. All participants received supportive AD counseling (the BRENDA manualized model). Logistic regression using the Fournier approach was conducted to investigate baseline predictors of dropout across the entire study sample. Rates of PTSD and AD symptom improvement were included to evaluate the impact of symptom change on dropout. Trauma type and rates of PTSD and AD improvement significantly predicted dropout, accounting for 76% of the variance in dropout. Accidents and "other" trauma were associated with the highest dropout, and physical assault was associated with the lowest dropout. For participants with low baseline PTSD severity, faster PTSD improvement predicted higher dropout. For those with high baseline severity, both very fast and very slow rates of PTSD improvement were associated with higher dropout. Faster rates of drinking improvement predicted higher dropout among participants who received PE. The current study highlights the influence of symptom trajectory on dropout risk. Clinicians may improve retention in PTSD-AD treatments by monitoring symptom change at regular intervals, and eliciting patient feedback on these changes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. [Coverage rate and satisfaction of populations after mass treatment with praziquantel and albendazole in Mali].

    Science.gov (United States)

    Sangho, H; Dabo, A; Sidibé, A; Dembélé, R; Diawara, A; Diallo, A; Konaté, S

    2009-01-01

    In Mali, schistosomiasis always remains a major public health problem. In 2005, mass treatment campaigns with praziquantel and albendazole have been organized in all endemic regions. The present study aimed to assess the impact of these mass treatment campaigns and the recipient's satisfaction in two endemic areas (Mopti and Ségou). It was a cross-sectional study with one passage from February to March 2006. The study carried out on political authorities (n=142), teachers and school administers (n=70), health workers (n=46), community distributors (n=33), community members (n=2170) and pupils (n=2480). We used Lot Quality Assurance Sample (LQAS) to determine treatment coverage and recipient's satisfaction. Two types of lots were considered, villages and schools. Questionnaires were used for investigation. In Ségou, the treatment rates varied from 100% at school level and in community in Bla district to 97.2% in the community of Ségou town. In Mopti, a treatment rate of 100% was observed in Bankass and Douentza both at school and in the community. The proportion of happiest individuals (to feel well) after the mass treatment campaign was 72.3% among pupils and 76.6% in the community. The results of this study suggest that the high treatment coverage rates observed during these campaigns should be sustained by a yearly chemotherapy strategy preceded by a community's health education programmes.

  15. Modeling Hydrogen Generation Rates in the Hanford Waste Treatment and Immobilization Plant

    Energy Technology Data Exchange (ETDEWEB)

    Camaioni, Donald M.; Bryan, Samuel A.; Hallen, Richard T.; Sherwood, David J.; Stock, Leon M.

    2004-03-29

    This presentation describes a project in which Hanford Site and Environmental Management Science Program investigators addressed issues concerning hydrogen generation rates in the Hanford waste treatment and immobilization plant. The hydrogen generation rates of radioactive wastes must be estimated to provide for safe operations. While an existing model satisfactorily predicts rates for quiescent wastes in Hanford underground storage tanks, pretreatment operations will alter the conditions and chemical composition of these wastes. Review of the treatment process flowsheet identified specific issues requiring study to ascertain whether the model would provide conservative values for waste streams in the plant. These include effects of adding hydroxide ion, alpha radiolysis, saturation with air (oxygen) from pulse-jet mixing, treatment with potassium permanganate, organic compounds from degraded ion exchange resins and addition of glass-former chemicals. The effects were systematically investigated through literature review, technical analyses and experimental work.

  16. Hydraulic conductance as well as nitrogen accumulation plays a role in the higher rate of leaf photosynthesis of the most productive variety of rice in Japan.

    Science.gov (United States)

    Taylaran, Renante D; Adachi, Shunsuke; Ookawa, Taiichiro; Usuda, Hideaki; Hirasawa, Tadashi

    2011-07-01

    An indica variety Takanari is known as one of the most productive rice varieties in Japan and consistently produces 20-30% heavier dry matter during ripening than Japanese commercial varieties in the field. The higher rate of photosynthesis of individual leaves during ripening has been recognized in Takanari. By using pot-grown plants under conditions of minimal mutual shading, it was confirmed that the higher rate of leaf photosynthesis is responsible for the higher dry matter production after heading in Takanari as compared with a japonica variety, Koshihikari. The rate of leaf photosynthesis and shoot dry weight became larger in Takanari after the panicle formation and heading stages, respectively, than in Koshihikari. Roots grew rapidly in the panicle formation stage until heading in Takanari compared with Koshihikari. The higher rate of leaf photosynthesis in Takanari resulted not only from the higher content of leaf nitrogen, which was caused by its elevated capacity for nitrogen accumulation, but also from higher stomatal conductance. When measured under light-saturated conditions, stomatal conductance was already decreased due to the reduction in leaf water potential in Koshihikari even under conditions of a relatively small difference in leaf-air vapour pressure difference. In contrast, the higher stomatal conductance was supported by the maintenance of higher leaf water potential through the higher hydraulic conductance in Takanari with the larger area of root surface. However, no increase in root hydraulic conductivity was expected in Takanari. The larger root surface area of Takanari might be a target trait in future rice breeding for increasing dry matter production.

  17. Association between higher levels of sexual function, activity, and satisfaction and self-rated successful aging in older postmenopausal women

    Science.gov (United States)

    Thompson, Wesley K.; Charo, Lindsey; Vahia, Ipsit V.; Depp, Colin; Allison, Matthew; Jeste, Dilip V.

    2014-01-01

    Objectives To determine if measures of successful-aging are associated with sexual activity, satisfaction, and function in older post-menopausal women. Design Cross-sectional study using self-report surveys; analyses include chi-square and t-tests and multiple linear regression analyses. Setting Community-dwelling older post-menopausal women in the greater San Diego Region. Participants 1,235 community-dwelling women aged 60-89 years participating at the San Diego site of the Women's Health Initiative. Measurements Demographics and self-report measures of sexual activity, function, and satisfaction and successful aging. Results Sexual activity and functioning (desire, arousal, vaginal tightness, use of lubricants, and ability to climax) were negatively associated with age, as were physical and mental health. In contrast, sexual satisfaction and self-rated successful aging and quality of life remained unchanged across age groups. Successful aging measures were positively associated with sexual measures, especially self-rated quality of life and sexual satisfaction. Conclusions Self-rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and are positively associated with each other across ages 60-89 years. PMID:21797827

  18. Broader Considerations of Higher Doses of Donepezil in the Treatment of Mild, Moderate, and Severe Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Camryn Berk

    2012-01-01

    Full Text Available Donepezil, a highly selective acetylcholinesterase inhibitor (AChEI, is approved as a symptomatic treatment mild, moderate, and severe Alzheimer's disease (AD. Donepezil exerts its treatment effect through multiple mechanisms of action including nicotinic receptor stimulation, mitigation of excitotoxicity, and influencing APP processing. The use of donepezil at higher doses is justified given the worsening cholinergic deficit as the disease advances. Donepezil has been investigated in several clinical trials of subjects with moderate-to-severe AD. While the side effects are class specific (cholinergically driven, demonstrable benefit has been shown at the 10 mg dose and the 23 mg doses. Here, we review the clinical justification, efficacy, safety, and tolerability of use of donepezil in the treatment of moderate-to-severe AD.

  19. Evaluation of mortality rate and predictors of outcome in dogs receiving outpatient treatment for parvoviral enteritis.

    Science.gov (United States)

    Sarpong, Kathryn J; Lukowski, Jennifer M; Knapp, Cassandra G

    2017-11-01

    OBJECTIVE To determine mortality rates and prognostic factors for dogs with parvoviral enteritis receiving outpatient treatment. DESIGN Retrospective case series and case-control study. ANIMALS 130 client-owned dogs with a diagnosis of parvoviral enteritis between August 1, 2012, and January 31, 2015, that were treated with outpatient care. PROCEDURES Medical records were reviewed and data extracted regarding dog age, body weight, breed, and vaccination history; treatments administered; and short-term (≥ 3 day) outcome (determined via telephone call with owner). Treatments were administered according to clinician preference. Mortality rates were calculated overall and for various signalment and treatment groupings and compared. RESULTS 97 (75%) dogs survived and 33 (25%) dogs failed to survive for ≥ 3 days after initial diagnosis of parvoviral enteritis. Compared with distributions in the general hospital population, Chihuahuas, German Shepherd Dogs, pit bull-type dogs, and males were overrepresented. No significant difference was identified between survivors and nonsurvivors regarding age, body weight, or sex. Dogs prescribed a caloric supplement fed every 2 to 4 hours had a mortality rate of 19% (16/85). Most of these dogs had also received fluids administered SC, an antiemetic, and antimicrobials. CONCLUSIONS AND CLINICAL RELEVANCE Clinicians should note the 25% mortality rate of the dogs with parvoviral enteritis that received outpatient care in this study setting when discussing treatment options with owners of affected dogs who are financially unable to pursue hospitalization.

  20. Non-linear indices of heart rate variability during endodontic treatment.

    Science.gov (United States)

    Santana, Milana Drumond Ramos; Pita Neto, Ivo Cavalcante; Martiniano, Eli Carlos; Monteiro, Larissa Raylane Lucas; Ramos, José Lucas Souza; Garner, David M; Valenti, Vitor Engácia; Abreu, Luiz Carlos de

    2016-01-01

    Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of α1 in T2 compared to T1 and T4 (p endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation.

  1. Dynamic Behavior for an SIRS Model with Nonlinear Incidence Rate and Treatment

    Directory of Open Access Journals (Sweden)

    Junhong Li

    2013-01-01

    Full Text Available This paper considers an SIRS model with nonlinear incidence rate and treatment. It is assumed that susceptible and infectious individuals have constant immigration rates. We investigate the existence of equilibrium and prove the global asymptotical stable results of the endemic equilibrium. We then obtained that the model undergoes a Hopf bifurcation and existences a limit cycle. Some numerical simulations are given to illustrate the analytical results.

  2. SUBJECTIVE CURE RATES AFTER TVT PROCEDURE FOR TREATMENT OF FEMALE URINARY INCONTINENCE – A QUESTIONNAIRE BASED STUDY

    Directory of Open Access Journals (Sweden)

    Igor But

    2003-12-01

    Full Text Available Background. The aim of this study was to assess the subjective cure rate after the tension-free vaginal tape (TVT procedure in patients with stress (SUI and mixed (MUI urinary incontinence.Methods. This is a questionnaire based study done in 43 patients with SUI and 52 patients with MUI. In the assessement of the subjective cure rate the visual analogue scale and the symptom assessment index (SAI were used. Data were analyzed using nonparametric statistics.Results. The subjective cure rate assessed 19.6 months after TVT amounted to 89.3%. Urinary incontinence after TVT procedure was noted in 26 patients (27.4% and the majority of these women (73.1% were diagnosed with MUI. In patients with SUI and postoperative stable bladder a higher success rate was observed (96.7%. In 18.6% patients with SUI, de novo overactive bladder symptoms occurred. These patients estimated a significantly (p = 0.027 lower cure rate (81.9% after TVT procedure. In patients with MUI, the cure rate after TVT amounted to 85.6%. The subjective cure rate was lower (79.4% in case of persistent overactive bladder symptoms. However, it was significantly higher (97.5% in case of a postoperatively stable bladder (p = 0.016. In the group of MUI patients, the symptoms of overactive bladder disease resolved spontaneously in 17 patients (32.7% postoperatively. The patients were satisfied with TVT and 92.6% would recommend this procedure to others.Conclusions. The TVT procedure is a very effective method of treatment for stress as well as mixed urinary incontinence. The success rate of the procedure is high, however, it is influenced by bladder activity.

  3. EFFECT OF SULFATE LOADING RATE AND ORGANIC LOADING RATE ON ANAEROBIC BAFFLED REACTORS USED FOR TREATMENT OF SANITARY LANDFILL LEACHATES

    Directory of Open Access Journals (Sweden)

    O. Burbano-Figueroa

    2015-06-01

    Full Text Available AbstractThis study investigated the effect of organic loading rate (OLR and sulfate loading rate (SLR on landfill leachate treatment by a lab-scale anaerobic baffled reactor (ABR. Landfill leachate contained a concentration of organic matter between 3966 and 5090 mg COD.L-1 and no detectable amounts of sulfate. Reactors were started-up by feeding them with iron-sulfate at a SLR of 0.05 g SO42-.L-1.day-1 (4 weeks. Factorial design and response surface techniques were used to evaluate and optimize the effects of these operating variables on COD removal. ABRs were operated at OLRs ranging from 0.30 up to 6.84 g COD.L-1.day-1 by changes in influent volumetric flow. SO42- was added to the influent at a SRL from 0.06 to 0.13 g SO42-.L-1.day-1. The highest value of COD removal (66% was reached at an OLR of 3.58 g COD.L-1.day-1 and SLR of 0.09 g SO4-2.L-1.day-1 with a COD/SO4-2 ratio of 40. Under these conditions sulfate is mainly used for molecular hydrogen consumption while organic matter is preferentially degraded via methanogesis.

  4. Do More Hospital Beds Lead to Higher Hospitalization Rates? A Spatial Examination of Roemer’s Law

    Science.gov (United States)

    Delamater, Paul L.; Messina, Joseph P.; Grady, Sue C.; WinklerPrins, Vince; Shortridge, Ashton M.

    2013-01-01

    Background Roemer’s Law, a widely cited principle in health care policy, states that hospital beds that are built tend to be used. This simple but powerful expression has been invoked to justify Certificate of Need regulation of hospital beds in an effort to contain health care costs. Despite its influence, a surprisingly small body of empirical evidence supports its content. Furthermore, known geographic factors influencing health services use and the spatial structure of the relationship between hospital bed availability and hospitalization rates have not been sufficiently explored in past examinations of Roemer’s Law. We pose the question, “Accounting for space in health care access and use, is there an observable association between the availability of hospital beds and hospital utilization?” Methods We employ an ecological research design based upon the Anderson behavioral model of health care utilization. This conceptual model is implemented in an explicitly spatial context. The effect of hospital bed availability on the utilization of hospital services is evaluated, accounting for spatial structure and controlling for other known determinants of hospital utilization. The stability of this relationship is explored by testing across numerous geographic scales of analysis. The case study comprises an entire state system of hospitals and population, evaluating over one million inpatient admissions. Results We find compelling evidence that a positive, statistically significant relationship exists between hospital bed availability and inpatient hospitalization rates. Additionally, the observed relationship is invariant with changes in the geographic scale of analysis. Conclusions This study provides evidence for the effects of Roemer’s Law, thus suggesting that variations in hospitalization rates have origins in the availability of hospital beds. This relationship is found to be robust across geographic scales of analysis. These findings suggest

  5. Hypnosis in the Treatment of Major Depression: An Analysis of Heart Rate Variability.

    Science.gov (United States)

    Chen, Xiuwen; Yang, Rongqian; Ge, Lulu; Luo, Jie; Lv, Ruixue

    2017-01-01

    Hypnosis is an adjuvant treatment of major depression (MD). Heart rate variability (HRV) can assess the autonomic nervous system, which is associated with MD, and HRV is decreased in MD patients. There is a lack of research on HRV changes before, during, and after the use of hypnosis in MD patients. A total of 21 MD patients participated in this study, and 5-minute electrocardiograms were recorded before, during, and after hypnosis. Compared with the prehypnotic condition, HRV parameters significantly (p hypnosis treatment should bring some functional improvement to the autonomic nervous system. HRV is potentially a useful tool that quantifies the physiological impact of hypnosis treatment in MD patients.

  6. Is It All about the Higher Dose? Why Psychoanalytic Therapy Is an Effective Treatment for Major Depression.

    Science.gov (United States)

    Zimmermann, Johannes; Löffler-Stastka, Henriette; Huber, Dorothea; Klug, Günther; Alhabbo, Sarah; Bock, Astrid; Benecke, Cord

    2015-01-01

    Empirical evidence for the effectiveness of long-term psychodynamic psychotherapy (LTPP) in patients with mood disorders is growing. However, it is unclear whether the effectiveness of LTPP is due to distinctive features of psychodynamic/psychoanalytic techniques or to a higher number of sessions. We tested these rival hypotheses in a quasi-experimental study comparing psychoanalytic therapy (i.e., high-dose LTPP) with psychodynamic therapy (i.e., low-dose LTPP) and cognitive-behavioural therapy (CBT) for depression. Analyses were based on a subsample of 77 subjects, with 27 receiving psychoanalytic therapy, 26 receiving psychodynamic therapy and 24 receiving CBT. Depressive symptoms, interpersonal problems and introject affiliation were assessed prior to treatment, after treatment and at the 1-, 2- and 3-year follow-ups. Psychoanalytic techniques were assessed from three audiotaped middle sessions per treatment using the Psychotherapy Process Q-Set. Subjects receiving psychoanalytic therapy reported having fewer interpersonal problems, treated themselves in a more affiliative way directly after treatment and tended to improve in depressive symptoms and interpersonal problems during follow-up as compared with patients receiving psychodynamic therapy and/or CBT. Multilevel mediation analyses suggested that post-treatment differences in interpersonal problems and introject affiliation were mediated by the higher number of sessions, and follow-up differences in depressive symptoms were mediated by the more pronounced application of psychoanalytic techniques. We also found some evidence for indirect treatment effects via psychoanalytic techniques on changes in introject affiliation during follow-up. These results provide support for the prediction that both a high dose and the application of psychoanalytic techniques facilitate therapeutic change in patients with major depression. Psychoanalytic therapy is an effective treatment for major depression, especially in the

  7. Treatment of carcinoma of uterine cervix with high-dose-rate intracavitary irradiation using Ralstron

    International Nuclear Information System (INIS)

    Suh, C.O.; Kim, G.E.; Loh, J.J.K.

    1988-01-01

    From May 1979 through December 1981, a total of 530 patients with carcinoma of the uterine cervix were treated with radiation therapy with curative intent. Of the 530 patients, 365 were treated with a high-dose-rate remote-controlled afterloading system (RALS) using a cobalt source, and 165 patients received a low dose rate using a radium source. External pelvic irradiation with a total of 40-50 Gy to the whole pelvis followed by intracavitary radiation (ICR) with a total dose of 30-39 Gy in ten to 13 fractions to point A was the treatment protocol. ICR was given three times a week with a dose of 3 Gy per fraction. Five-year actuarial survival rate with high-dose-rate ICR by stage was as follows: stage I:82.7% (N = 19) stage II:69.6% (N = 184), and stage III:52.2% (N = 156). The above results were comparable with those with conventional low-dose-rate ICR treatment, and late complications were far less. The application of high-dose-rate ICR was technically simple and easily performed on an outpatient basis without anesthesia, and the patients tolerated it very well. Radiation exposure to personnel was virtually none as compared with that of low-dose-rate ICR. Within a given period of time, more patients can be treated with high-dose-rate ICR because of the short treatment time. The authors therefore conclude that high-dose-rate ICR is suitable for a cancer center where a large number of patients are to be treated

  8. Treatment of cooling appliances. Interrelations between environmental protection, resource conservation, and recovery rates

    International Nuclear Information System (INIS)

    Laner, David; Rechberger, Helmut

    2007-01-01

    The treatment of cooling appliances in Austria is primarily influenced by two factors. On the one hand is their changing composition and on the other hand the ordinance on Waste Prevention, Collection and Treatment of Waste Electrical and Electronic Equipment (WEEE ordinance), which stipulates a minimum recycling rate of 75% for cooling appliances. This paper investigates whether this recycling rate leads to optimal treatment practices for cooling appliances with respect to resource conservation and environmental protection. Two different treatment technologies which achieve recycling rates between 50-60% and 80-90%, respectively, are compared both for cooling appliances containing Chlorofluorocarbons (CFCs) and for appliances containing Volatile Organic Compounds (VOC). Materials and energy balances are developed for each model. To evaluate resource consumption, expenditures as well as savings of energy and materials are incorporated via the Cumulative Energy Demand (CED). In order to analyse the environmental impact of the different practices, balances for CFC, CO 2 , HF, HCl and solid residues are established. The results show that the treatment type aiming for a maximum of materials recycling contributes more to resource conservation than the other treatment type. But for CFC appliances the former is associated with substantial CFC emissions, which turn out to be most relevant when treating these appliances. Generally, it is found that the optimum recycling rate is a function of the composition of the appliance and the technologies applied, both in recycling and in primary production. A high recycling rate per se does not automatically result in an optimal solution with regard to resource conservation and environmental protection. (author)

  9. Fish community reassembly after a coral mass mortality: higher trophic groups are subject to increased rates of extinction.

    Science.gov (United States)

    Alonso, David; Pinyol-Gallemí, Aleix; Alcoverro, Teresa; Arthur, Rohan

    2015-05-01

    Since Gleason and Clements, our understanding of community dynamics has been influenced by theories emphasising either dispersal or niche assembly as central to community structuring. Determining the relative importance of these processes in structuring real-world communities remains a challenge. We tracked reef fish community reassembly after a catastrophic coral mortality in a relatively unfished archipelago. We revisited the stochastic model underlying MacArthur and Wilson's Island Biogeography Theory, with a simple extension to account for trophic identity. Colonisation and extinction rates calculated from decadal presence-absence data based on (1) species neutrality, (2) trophic identity and (3) site-specificity were used to model post-disturbance reassembly, and compared with empirical observations. Results indicate that species neutrality holds within trophic guilds, and trophic identity significantly increases overall model performance. Strikingly, extinction rates increased clearly with trophic position, indicating that fish communities may be inherently susceptible to trophic downgrading even without targeted fishing of top predators. © 2015 John Wiley & Sons Ltd/CNRS.

  10. The Active Management of Risk in Multiparous Pregnancy at Term: association between a higher preventive labor induction rate and improved birth outcomes

    Science.gov (United States)

    Nicholson, James M.; Caughey, Aaron; Stenson, Ms. Morghan H.; Cronholm, Peter; Kellar, Lisa; Bennett, Ian; Margo, Katie; Stratton, Joseph

    2009-01-01

    Objective To determine if exposure of multiparous women to a high rate of preventive labor induction was associated with a significantly lower cesarean delivery rate. Study Design Retrospective cohort study involving 123 multiparas, who were exposed to the frequent use of preventive labor induction, and 304 multiparas, who received standard management. Rates of cesarean delivery and other adverse birth outcomes were compared in the two groups. Logistic regression controlled for confounding covariates. Results The exposed group had a lower cesarean delivery rate (aOR 0.09, 0.8% vs. 9.9%, p = 0.02) and a higher uncomplicated vaginal delivery rate (OR 0.53, 78.9% vs. 66.4%, p=0.01). Exposure was not associated with higher rates of other adverse birth outcomes. Conclusion Exposure of multiparas to a high rate of preventive labor induction was significantly associated with improved birth outcomes including a very low cesarean delivery rate. A prospective randomized trial is needed to determine causality. PMID:19254584

  11. Potential impact on HIV incidence of higher HIV testing rates and earlier antiretroviral therapy initiation in MSM

    DEFF Research Database (Denmark)

    Phillips, Andrew N; Cambiano, Valentina; Miners, Alec

    2015-01-01

    count 350/μl. We investigated what would be required to reduce HIV incidence in MSM to below 1 per 1000 person-years (i.e. cost-effective. METHODS: A dynamic, individual-based simulation model was calibrated to multiple data sources...... with viral suppression to 80%, and it would be 90%, if ART is initiated at diagnosis. The scenarios required for such a policy to be cost-effective are presented. CONCLUSION: This analysis provides targets for the proportion of all HIV-positive MSM with viral suppression required to achieve substantial......BACKGROUND: Increased rates of testing, with early antiretroviral therapy (ART) initiation, represent a key potential HIV-prevention approach. Currently, in MSM in the United Kingdom, it is estimated that 36% are diagnosed by 1 year from infection, and the ART initiation threshold is at CD4 cell...

  12. Dependability and Treatment Sensitivity of Multi-Item Direct Behavior Rating Scales for Interpersonal Peer Conflict

    Science.gov (United States)

    Daniels, Brian; Volpe, Robert J.; Briesch, Amy M.; Gadow, Kenneth D.

    2017-01-01

    Direct behavior rating (DBR) represents a feasible method for monitoring student behavior in the classroom; however, limited work to date has focused on the use of multi-item scales. The purposes of the study were to examine the (a) dependability of data obtained from a multi-item DBR designed to assess peer conflict and (b) treatment sensitivity…

  13. Pregnancy Rates among Juvenile Justice Girls in Two Randomized Controlled Trials of Multidimensional Treatment Foster Care

    Science.gov (United States)

    Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia

    2009-01-01

    Preventing adolescent pregnancy is a national research priority that has had limited success. In the present study, the authors examined whether Multidimensional Treatment Foster Care (MTFC) relative to intervention services as usual (group care [GC]) decreased pregnancy rates among juvenile justice girls mandated to out-of-home care. Girls (13-17…

  14. Follow-up, treatment, and reinfection rates among asymptomatic Chlamydia trachomatis cases in general practice

    NARCIS (Netherlands)

    Van Valkengoed, Irene G.M.; Morré, Servaas A.; Van Den Brule, Adriaan J.C.; Meijer, Chris J.L.M.; Bouter, Lex M.; Van Eijk, Jacques Th M.; Boeke, A. Joan P.

    2002-01-01

    Background: Adequate treatment and follow-up of patients is essential to the success of a screening programme for Chlamydia trachomatis. There has been a lack of data on follow-up, confirmation of infections, and reinfection rates among asymptomatic patients in general practice. Aim: To study the

  15. Follow-up, treatment, and reinfection rates among asymptomatic Chlamydia trachomatis cases in general practice

    NARCIS (Netherlands)

    Van Valkengoed, Irene G.M.; Morré, Servaas A.; Van Den Brule, Adriaan J.C.; Meijer, Chris J.L.M.; Bouter, Lex M.; Van Eijk, Jacques Th M.; Boeke, A. Joan P.

    2002-01-01

    BACKGROUND: Adequate treatment and follow-up of patients is essential to the success of a screening programme for Chlamydia trachomatis. There has been a lack of data on follow-up, confirmation of infections, and reinfection rates among asymptomatic patients in general practice. AIM: 7b study the

  16. Follow-up, treatment, and reinfection rates among asymptomatic chlamydia trachomatis cases in general practice

    NARCIS (Netherlands)

    van Valkengoed, Irene G. M.; Morré, Servaas A.; van den Brule, Adriaan J. C.; Meijer, Chris J. L. M.; Bouter, Lex M.; van Eijk, Jacques Th M.; Boeke, A. Joan P.

    2002-01-01

    BACKGROUND: Adequate treatment and follow-up of patients is essential to the success of a screening programme for Chlamydia trachomatis. There has been a lack of data on follow-up, confirmation of infections, and reinfection rates among asymptomatic patients in general practice. AIM: 7b study the

  17. Silvicultural treatments enhance growth rates of future crop trees in a tropical dry forest

    NARCIS (Netherlands)

    Villegas, Z.; Peña-Claros, M.; Mostacedo, B.; Alarcón, A.; Licona, J.C.; Leaño, C.; Pariona, W.; Choque, U.

    2009-01-01

    Silvicultural treatments are often needed in selectively logged tropical forest to enhance the growth rates of many commercial tree species and, consequently, for recovering a larger proportion of the initial volume harvested over the next cutting cycle. The available data in the literature suggest,

  18. Reliability, validity and treatment sensitivity of the Schizophrenia Cognition Rating Scale.

    Science.gov (United States)

    Keefe, Richard S E; Davis, Vicki G; Spagnola, Nathan B; Hilt, Dana; Dgetluck, Nancy; Ruse, Stacy; Patterson, Thomas D; Narasimhan, Meera; Harvey, Philip D

    2015-02-01

    Cognitive functioning can be assessed with performance-based assessments such as neuropsychological tests and with interview-based assessments. Both assessment methods have the potential to assess whether treatments for schizophrenia improve clinically relevant aspects of cognitive impairment. However, little is known about the reliability, validity and treatment responsiveness of interview-based measures, especially in the context of clinical trials. Data from two studies were utilized to assess these features of the Schizophrenia Cognition Rating Scale (SCoRS). One of the studies was a validation study involving 79 patients with schizophrenia assessed at 3 academic research centers in the US. The other study was a 32-site clinical trial conducted in the US and Europe comparing the effects of encenicline, an alpha-7 nicotine agonist, to placebo in 319 patients with schizophrenia. The SCoRS interviewer ratings demonstrated excellent test-retest reliability in several different circumstances, including those that did not involve treatment (ICC> 0.90), and during treatment (ICC>0.80). SCoRS interviewer ratings were related to cognitive performance as measured by the MCCB (r=-0.35), and demonstrated significant sensitivity to treatment with encenicline compared to placebo (Pcognition in schizophrenia, and may be useful for clinical practice. The weaknesses of the SCoRS include its reliance on informant information, which is not available for some patients, and reduced validity when patient's self-report is the sole information source. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  19. Rapamycin treatment is associated with an increased apoptosis rate in experimental vein grafts.

    Science.gov (United States)

    Schachner, Thomas; Oberhuber, Alexander; Zou, Yping; Tzankov, Alexandar; Ott, Harald; Laufer, Günther; Bonatti, Johannes

    2005-02-01

    Rapamycin is an immunosuppressive agent with marked antiproliferative properties and is effective in reducing in stent restenosis and vein graft neointimal hyperplasia. Apoptosis is one mechanism counterbalancing cellular proliferation. We therefore investigated the role of apoptosis in rapamycin treated vein grafts in a mouse model. C57BL6J mice underwent interposition of the inferior vena cava from isogenic donor mice into the common carotid artery using a cuff technique. In the treatment group 200 microg of rapamycin were applied locally in pluronic gel. The control group did not receive local treatment. Vein grafts were harvested at 4 weeks postoperatively and underwent morphometric analysis as well as immunohistochemical analysis for apoptosis (TUNEL). In grafted veins without treatment (controls) neointimal thickness was 50 (12-58) microm at 4 weeks postoperatively. In 200 microg rapamycin treated grafts the neointimal thickness was 17 (5-55) microm. Rapamycin treated vein grafts showed a significantly increased rate of apoptosis in the adventitia as compared with controls (P=0.032). In the neointima the apoptosis rate was lower in both groups with no significant difference between rapamycin treated grafts and controls. We conclude that treatment of experimental vein grafts with rapamycin is associated with an increased apoptosis rate in the vascular wall and a trend towards reduction of neointimal hyperplasia. These results suggest that apoptosis may be a beneficial antiproliferative component for the treatment of vein graft disease.

  20. Study of the Al-Si-X system by different cooling rates and heat treatment

    Directory of Open Access Journals (Sweden)

    Miguel Angel Suarez

    2012-10-01

    Full Text Available The solidification behavior of the Al-12.6% Si (A1, the hypereutectic Al-20%Si (A2 and the Al-20%Si-1.5% Fe-0.5%Mn (A3 (in wt. (% alloys, at different cooling rates is reported and discussed. The cooling rates ranged between 0.93 °C/s and 190 °C/s when cast in sand and copper wedge-shaped molds, respectively. A spheroidization heat treatment was carried out to the alloys in the as-cast condition at 540 °C for 11 hours and quench in water with a subsequent heat treatment at 170 °C for 5 hours with the purpose of improving the mechanical properties. The samples were characterized by optical microscopy, scanning electron microscopy and mechanically by tensile test, in order to evaluate the response of the heat treatment on the different starting microstructures and mechanical properties. It was found that alloys cooled at rates greater than 10.8 °C/s had a smaller particle size and better distribution, also showed a greater response to spheroidization heat treatment of all silicon (Si phases. The spheroidization heat treatment caused an increase in the ultimate tensile stress (UTS and elongation when compared with the alloys in the as-cast condition. The highest UTS value of 174 MPa was obtained for the (A1 alloy.

  1. Industrial wastewater treatment using higher aquatic vegetation in the former mining company of the Far Eastern Federal district

    Science.gov (United States)

    Krupskaya, L. T.; Zvereva, V. P.; Gula, K. E.; Gul', L. P.; Golubev, D. A.; Filatova, M. Yu.

    2017-09-01

    The article describes the results of studying the problems of industrial wastewater treatment using higher aquatic vegetation (hydrophytes) in the former mining enterprise of the Far Eastern Federal District (FEFD). They are aimed at reducing the negative environment impact of toxic tin ore wastes. The material of research were drainage, mine and slime waters as well as Lemna minor and Common reed grass (Phragmites communis). In the work conventional modern physico-chemical, chemical, biological and mathematical-statistical methods were used, as well as in the process of research the methods of atomic absorption spectrophotometry for AAS and mass spectrometry with inductively coupled plasma on ISP-MS ELASN DRS II PerkinElmer was applied. The data obtained in the course of the experiment (2015-2016), indicate that a degree of wastewater treatment, using Lemna minor, is high. Virtually, all compounds of toxic chemical elements contained in industrial wastewater (zinc, cobalt, nickel, cadmium, iron, manganese, lead, etc.) were fully absorbed by a hydrophyte. Pollutant extraction was almost 95%. The obtained results of the study in laboratory conditions proved the possibility of effective use of the Lemna minor for the purification of drainage and mine waters. A key contribution of this paper is the relationship between possible toxic metals contained in industrial wastewater and a higher degree of absorption by their higher aquatic vegetation. These hydrophytes absorb these possible toxic metals in an aqueous medium and are contaminated with these heavy metals.

  2. PCR reveals significantly higher rates of Trypanosoma cruzi infection than microscopy in the Chagas vector, Triatoma infestans: High rates found in Chuquisaca, Bolivia

    Directory of Open Access Journals (Sweden)

    Lucero David E

    2007-06-01

    Full Text Available Abstract Background The Andean valleys of Bolivia are the only reported location of sylvatic Triatoma infestans, the main vector of Chagas disease in this country, and the high human prevalence of Trypanosoma cruzi infection in this region is hypothesized to result from the ability of vectors to persist in domestic, peri-domestic, and sylvatic environments. Determination of the rate of Trypanosoma infection in its triatomine vectors is an important element in programs directed at reducing human infections. Traditionally, T. cruzi has been detected in insect vectors by direct microscopic examination of extruded feces, or dissection and analysis of the entire bug. Although this technique has proven to be useful, several drawbacks related to its sensitivity especially in the case of small instars and applicability to large numbers of insects and dead specimens have motivated researchers to look for a molecular assay based on the polymerase chain reaction (PCR as an alternative for parasitic detection of T. cruzi infection in vectors. In the work presented here, we have compared a PCR assay and direct microscopic observation for diagnosis of T. cruzi infection in T. infestans collected in the field from five localities and four habitats in Chuquisaca, Bolivia. The efficacy of the methods was compared across nymphal stages, localities and habitats. Methods We examined 152 nymph and adult T. infestans collected from rural areas in the department of Chuquisaca, Bolivia. For microscopic observation, a few drops of rectal content obtained by abdominal extrusion were diluted with saline solution and compressed between a slide and a cover slip. The presence of motile parasites in 50 microscopic fields was registered using 400× magnification. For the molecular analysis, dissection of the posterior part of the abdomen of each insect followed by DNA extraction and PCR amplification was performed using the TCZ1 (5' – CGA GCT CTT GCC CAC ACG GGT GCT – 3

  3. Persistence, switch rates, drug consumption and costs of biological treatment of rheumatoid arthritis: an observational study in Italy.

    Science.gov (United States)

    Degli Esposti, Luca; Favalli, Ennio Giulio; Sangiorgi, Diego; Di Turi, Roberta; Farina, Giuseppina; Gambera, Marco; Ravasio, Roberto

    2017-01-01

    The aim of this analysis was to provide an estimate of drug utilization indicators (persistence, switch rate and drug consumption) on biologics and the corresponding costs (drugs, admissions and specialist care) incurred by the Italian National Health Service in the management of adult patients with rheumatoid arthritis (RA). We conducted an observational retrospective cohort analysis using the administrative databases of three local health units. We considered all patients aged ≥18 years with a diagnosis of RA and at least one biologic drug prescription between January 2010 and December 2012 (recruitment period). Persistence was defined as maintenance over the last 3 months of the follow-up period of the same biological therapy administered at the index date. A switch was defined as the presence of a biological therapy other than that administered at the index date during the last 3 months of the follow-up period. Hospital admissions (with a diagnosis of RA or other RA-related diagnoses), specialist outpatient services, instrumental diagnostics and pharmaceutical consumption were assessed. The drug utilization analysis took into account only biologics with at least 90 patients on treatment at baseline (adalimumab n=144, etanercept n=236 and infliximab n=94). In each year, etanercept showed better persistence with initial treatment than adalimumab or infliximab. Etanercept was characterized by the lowest number of patients increasing the initial drug consumption (2.6%) and by the highest number of patients reducing the initial drug consumption (10.5%). The mean cost of treatment for a patient persisting with the initial treatment was €12,388 (€14,182 for adalimumab, €12,103 for etanercept and €11,002 for infliximab). The treatment costs for patients switching from initial treatment during the first year of follow-up were higher than for patients who did not switch (€12,710 vs. €11,332). Persistence, switch rate and drug consumption seem to directly

  4. Effect of temperature during ion sputtering on the surface segregation rate of antimony in an iron-antimony alloy at higher temperatures

    International Nuclear Information System (INIS)

    Oku, M.; Hirokawa, K.; Kimura, H.; Suzuki, S.

    1986-01-01

    The surface segregation of antimony in an iron-0.23 at% antimony alloy was studied by XPS. The segregation rate in the temperature range between 800 and 900 K depends on the temperature during sputtering with argon ion of kinetic energy of 1 keV. The sputtering at room temperature or 473 K gives higher values of the segregation rate than those at 673 K. Both cases give the activation energy of 170 kJmol -1 for the surface segregation rate. The segregation of antimony is not observed after the sample is heated at 1000 K. (author)

  5. Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder.

    Science.gov (United States)

    Williams, Arthur Robin; Santaella-Tenorio, Julian; Mauro, Christine M; Levin, Frances R; Martins, Silvia S

    2017-11-01

    Most US states have passed medical marijuana laws (MMLs), with great variation in program regulation impacting enrollment rates. We aimed to compare changes in rates of marijuana use, heavy use and cannabis use disorder across age groups while accounting for whether states enacted medicalized (highly regulated) or non-medical mml programs. Difference-in-differences estimates with time-varying state-level MML coded by program type (medicalized versus non-medical). Multi-level linear regression models adjusted for state-level random effects and covariates as well as historical trends in use. Nation-wide cross-sectional survey data from the US National Survey of Drug Use and Health (NSDUH) restricted use data portal aggregated at the state level. Participants comprised 2004-13 NSDUH respondents (n ~ 67 500/year); age groups 12-17, 18-25 and 26+ years. States had implemented eight medicalized and 15 non-medical MML programs. Primary outcome measures included (1) active (past-month) marijuana use; (2) heavy use (> 300 days/year); and (3) cannabis use disorder diagnosis, based on DSM-IV criteria. Covariates included program type, age group and state-level characteristics throughout the study period. Adults 26+ years of age living in states with non-medical MML programs increased past-month marijuana use 1.46% (from 4.13 to 6.59%, P = 0.01), skewing towards greater heavy marijuana by 2.36% (from 14.94 to 17.30, P = 0.09) after MMLs were enacted. However, no associated increase in the prevalence of cannabis use disorder was found during the study period. Our findings do not show increases in prevalence of marijuana use among adults in states with medicalized MML programs. Additionally, there were no increases in adolescent or young adult marijuana outcomes following MML passage, irrespective of program type. Non-medical marijuana laws enacted in US states are associated with increased marijuana use, but only among adults aged 26+ years. Researchers and

  6. Comparison of rate of maxillary canine movement with or without modified corticotomy facilitated orthodontic treatment: A prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Harshal N Suryavanshi

    2015-01-01

    Full Text Available Background and Objectives: The average orthodontic treatment time for extraction therapy is 31 months. One of the main disadvantages of orthodontic treatment is time. Alveolar corticotomies have been used in conjunction with orthodontics to reduce the treatment time by increasing the rate of tooth movement. Concerns about the possible risks of corticotomy procedure have led to the modification of this technique. Germeη et al. reported a case treated by their modified corticotomy technique and noted reduced treatment time without any adverse effects on the periodontium and the vitality of teeth with their new conservative corticotomy technique. This study was undertaken to clinically evaluate the efficacy of the aforesaid technique. Materials and Methods: A split-mouth study design was carried out to compare the rate of maxillary canine movement with and without modified corticotomy facilitated orthodontic treatment in 10 patients requiring maxillary first premolar extractions. The modified corticotomy procedure was performed on the maxillary arch unilaterally. The upper arch was immediately activated bilaterally after surgical procedure using equal orthodontic forces for retraction of the maxillary canines. The amount of tooth movement was recorded at an interval of every month till the completion of canine retraction. The rate of canine movement on experimental and control site was compared. The patients were followed for 6 months to check the occurrence of undesired effects such as root resorption, periodontal damage and loss of vitality of teeth on the experimental side. Results: Higher mean velocity was observed in canines with modified corticotomy facilitated retraction compared to conventionally retracted canines; with the difference in mean velocity between the two groups was found to be clinically significant as well as statistically significant (P < 0.001. Interpretation and Conclusion: The results suggested that modified corticotomy

  7. Being born under adverse economic conditions leads to a higher cardiovascular mortality rate later in life: evidence based on individuals born at different stages of the business cycle

    DEFF Research Database (Denmark)

    van den Berg, Gerard J; Doblhammer-Reiter, Gabriele; Christensen, Kaare

    2011-01-01

    since the 1870s and including the cause of death. To capture exogenous variation of conditions early in life, we use the state of the business cycle around birth. We find significant negative effects of economic conditions around birth on the individual CV mortality rate at higher ages...

  8. Boarding is associated with higher rates of medication delays and adverse events but fewer laboratory-related delays.

    Science.gov (United States)

    Sri-On, Jiraporn; Chang, Yuchiao; Curley, David P; Camargo, Carlos A; Weissman, Joel S; Singer, Sara J; Liu, Shan W

    2014-09-01

    Hospital crowding and emergency department (ED) boarding are large and growing problems. To date, there has been a paucity of information regarding the quality of care received by patients boarding in the ED compared with the care received by patients on an inpatient unit. We compared the rate of delays and adverse events at the event level that occur while boarding in the ED vs while on an inpatient unit. This study was a secondary analysis of data from medical record review and administrative databases at 2 urban academic teaching hospitals from August 1, 2004, through January 31, 2005. We measured delayed repeat cardiac enzymes, delayed partial thromboplastin time level checks, delayed antibiotic administration, delayed administration of home medications, and adverse events. We compared the incidence of events during ED boarding vs while on an inpatient unit. Among 1431 patient medical records, we identified 1016 events. Emergency department boarding was associated with an increased risk of home medication delays (risk ratio [RR], 1.54; 95% confidence interval [CI], 1.26-1.88), delayed antibiotic administration (RR, 2.49; 95% CI, 1.72-3.52), and adverse events (RR, 2.36; 95% CI, 1.15-4.72). On the contrary, ED boarding was associated with fewer delays in repeat cardiac enzymes (RR, 0.17; 95% CI, 0.09-0.27) and delayed partial thromboplastin time checks (RR, 0.54; 95% CI, 0.27-0.96). Compared with inpatient units, ED boarding was associated with more medication-related delays and adverse events but fewer laboratory-related delays. Until we can eliminate ED boarding, it is critical to identify areas for improvement. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Low-birthweight rates higher among Bangladeshi neonates measured during active birth surveillance compared to national survey data.

    Science.gov (United States)

    Klemm, Rolf D W; Merrill, Rebecca D; Wu, Lee; Shamim, Abu Ahmed; Ali, Hasmot; Labrique, Alain; Christian, Parul; West, Keith P

    2015-10-01

    Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small-for-gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth size distributions were explored based on raw values as well as after z-score standardisation in reference to World Health Organization (WHO) 2006 growth standards. Mean (SD) birthweight (g), length (cm) and head circumference (cm) measurements, completed within [median (25th, 75th percentile)] 15 (8, 23) h of life, were 2433 (425), 46.4 (2.4) and 32.4 (1.6), respectively. Twenty-two per cent were born preterm. Over one-half (55.3%) of infants were born low birthweight; 46.6%, 37.0% and 33.6% had a weight, length and head circumference below -2 z-scores of the WHO growth standard at birth; and 70.9%, 72.2% and 59.8% were SGA for weight based on Alexander et al., Oken et al. and Olsen et al. references, respectively. Infants in this typical rural Bangladesh setting were commonly born small, reflecting a high burden of fetal growth restriction and preterm birth. Our findings, produced by active birth surveillance, suggest that low birthweight is far more common than suggested by cross-sectional survey estimates. Interventions that improve fetal growth during pregnancy may have the largest impact on reducing SGA rates. © 2013 John Wiley & Sons Ltd.

  10. Numerical and experimental investigation of the bell-mouth inlet design of a centrifugal fan for higher internal flow rate

    International Nuclear Information System (INIS)

    Kim, Sang Hyeon; Heo, Seung; Cheong, Cheolung; Kim, Tae Hoon

    2013-01-01

    The energy efficiency of a household refrigerator is one of the most critical characteristics considered by manufacturers and consumers. Numerous studies in various fields have been conducted to increase energy efficiency. One of the most efficient methods to reduce the energy consumption of a refrigerator is by improving the performance of fans inside the refrigerator. A number of studies reported various ways to enhance fan performance. However, the majority of these studies focused solely on the fan and did not consider the working environment of the fan, such as the inlet and outlet flow characteristics. The expected performance of fans developed without consideration of these characteristics cannot be determined because complex inlet and outlet flow passage could adversely affect performance. This study investigates the effects of the design of the bell-mouth inlet on the performance of a centrifugal fan in a household refrigerator. In preliminary numerical studies, significant flow loss is identified through the bell-mouth inlet in the target fan system. Several design factors such as tip clearance, inner fence, motor-box struts, and guide vane are proposed to resolve these flow losses. The effects of these factors on fan performance are investigated using computational fluid dynamics techniques to solve incompressible Reynolds-averaged Navier-Stokes equations for predicting the circulating flow of the fan. Experiments are then performed to validate the numerical predictions. Results indicate that four design factors positively affect fan performance in terms of flow rate. The guide vane is the most effective design factor to consider for improving fan performance. Further studies are conducted to investigate the detailed effects of the guide vane by varying its install angle, install location, height, and length. These studies determine the optimum design of the guide vane to achieve the highest performance of the fan and the related flow characteristics

  11. Numerical and experimental investigation of the bell-mouth inlet design of a centrifugal fan for higher internal flow rate

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Hyeon; Heo, Seung; Cheong, Cheolung [Pusan National University, Busan (Korea, Republic of); Kim, Tae Hoon [Refrigeration Division, Changwon (Korea, Republic of)

    2013-08-15

    The energy efficiency of a household refrigerator is one of the most critical characteristics considered by manufacturers and consumers. Numerous studies in various fields have been conducted to increase energy efficiency. One of the most efficient methods to reduce the energy consumption of a refrigerator is by improving the performance of fans inside the refrigerator. A number of studies reported various ways to enhance fan performance. However, the majority of these studies focused solely on the fan and did not consider the working environment of the fan, such as the inlet and outlet flow characteristics. The expected performance of fans developed without consideration of these characteristics cannot be determined because complex inlet and outlet flow passage could adversely affect performance. This study investigates the effects of the design of the bell-mouth inlet on the performance of a centrifugal fan in a household refrigerator. In preliminary numerical studies, significant flow loss is identified through the bell-mouth inlet in the target fan system. Several design factors such as tip clearance, inner fence, motor-box struts, and guide vane are proposed to resolve these flow losses. The effects of these factors on fan performance are investigated using computational fluid dynamics techniques to solve incompressible Reynolds-averaged Navier-Stokes equations for predicting the circulating flow of the fan. Experiments are then performed to validate the numerical predictions. Results indicate that four design factors positively affect fan performance in terms of flow rate. The guide vane is the most effective design factor to consider for improving fan performance. Further studies are conducted to investigate the detailed effects of the guide vane by varying its install angle, install location, height, and length. These studies determine the optimum design of the guide vane to achieve the highest performance of the fan and the related flow characteristics

  12. An enhanced treatment program with markedly reduced mortality after a transtibial or higher non-traumatic lower extremity amputation

    DEFF Research Database (Denmark)

    Kristensen, Morten T; Holm, Gitte; Krasheninnikoff, Michael

    2016-01-01

    Background and purpose - Historically, high 30-day and 1-year mortality post-amputation rates (> 30% and 50%, respectively) have been reported in patients with a transtibial or higher non-traumatic lower extremity amputation (LEA). We evaluated whether allocating experienced staff and implementing...... adjusted for age, sex, residential and health status, the disease that caused the amputation, and the index amputation level showed that 30-day and 1-year mortality risk was reduced by 52% (HR =0.48, 95% CI: 0.25-0.91) and by 46% (HR =0.54, 95% CI: 0.35-0.86), respectively, in the intervention group...

  13. Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment

    Directory of Open Access Journals (Sweden)

    Milana Drumond Ramos Santana

    2017-01-01

    Full Text Available We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1, during (T2, and immediately (T3 and T4 after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4 or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.

  14. Do Increasing Rates of Loss to Follow-up in Antiretroviral Treatment Programs Imply Deteriorating Patient Retention?

    Science.gov (United States)

    Johnson, Leigh F.; Estill, Janne; Keiser, Olivia; Cornell, Morna; Moolla, Haroon; Schomaker, Michael; Grimsrud, Anna; Davies, Mary-Ann; Boulle, Andrew

    2014-01-01

    In several studies of antiretroviral treatment (ART) programs for persons with human immunodeficiency virus infection, investigators have reported that there has been a higher rate of loss to follow-up (LTFU) among patients initiating ART in recent years than among patients who initiated ART during earlier time periods. This finding is frequently interpreted as reflecting deterioration of patient retention in the face of increasing patient loads. However, in this paper we demonstrate by simulation that transient gaps in follow-up could lead to bias when standard survival analysis techniques are applied. We created a simulated cohort of patients with different dates of ART initiation. Rates of ART interruption, ART resumption, and mortality were assumed to remain constant over time, but when we applied a standard definition of LTFU, the simulated probability of being classified LTFU at a particular ART duration was substantially higher in recently enrolled cohorts. This suggests that much of the apparent trend towards increased LTFU may be attributed to bias caused by transient interruptions in care. Alternative statistical techniques need to be used when analyzing predictors of LTFU—for example, using “prospective” definitions of LTFU in place of “retrospective” definitions. Similar considerations may apply when analyzing predictors of LTFU from treatment programs for other chronic diseases. PMID:25399412

  15. Azacitidine-lenalidomide (ViLen) combination yields a high response rate in higher risk myelodysplastic syndromes (MDS)-ViLen-01 protocol.

    Science.gov (United States)

    Mittelman, Moshe; Filanovsky, Kalman; Ofran, Yishai; Rosenbaum, Hanna; Raanani, Pia; Braester, Andrei; Goldschmidt, Neta; Kirgner, Ilya; Herishanu, Yair; Perri, Chava; Ellis, Martin; Oster, Howard S

    2016-10-01

    Azacitidine treatment is effective in higher risk MDS (HR-MDS), with less than 50 % response, lasting 2 years. Aza and lenalidomide (Len) have a potential synergistic effect. ViLen-01 phase IIa trial includes 6-month induction (Aza 75 mg/m(2)/day, days 1-5, Len 10 mg/day, days 6-21, every 28 days), 6-month consolidation (Aza 75 mg/m(2)/day, days 1-5, every 28 days), and 12-month maintenance (Len 10 mg/day, days 1-21, every 28 days). Response was evaluated according to IWG criteria. Totally, 25 patients enrolled, with an average of 76.3 years old (60-87), and 88 % with major comorbidities. Thirteen patients completed induction, 7 proceeded for consolidation, and 2 for maintenance. The overall response rate (ORR) was 72 % (18/25), with 6 (24 %) for CR, 3 (12 %) for marrow CR, and 9 (36 %) for hematologic improvement (HI). The 7 non-responding patients were on the study 3 days to 4.1 months. At 6 months, 4 of 6 evaluable patients achieved complete cytogenetic response and 2 with del (5q) at diagnosis. Adverse events (AEs) were as expected in these patients: grades III-IV, mainly hematologic-thrombocytopenia (20 patients) and neutropenia (13 patients). The common non-hematologic AEs were infections (14 patients), nausea (7), vomiting (7), diarrhea (7), and skin reactions (5). The median progression-free survival (PFS) was 12 ± 1.36 months, with median overall survival (OS) of 12 ± 1.7 months. Quality of life (FACT questionnaire) data were available for 12 patients with a tendency towards improved QoL. This trial with elderly HR-MDS patients with an expected poor prognosis demonstrates a high (72 %) response rate and a reasonable expected safety profile but a relatively short PFS and OS.

  16. Reporting success rates in the treatment of vestibular schwannomas: are we accounting for the natural history?

    Science.gov (United States)

    Miller, Timothy; Lau, Tsz; Vasan, Rohit; Danner, Christopher; Youssef, A Samy; van Loveren, Harry; Agazzi, Siviero

    2014-06-01

    Stereotactic radiosurgery is generally accepted as one of the best treatment options for vestibular schwannomas. We question whether growth control is an accurate measure of success in vestibular schwannoma treatment. We aim to clarify the success rate of stereotactic radiosurgery and adjust the reported results to the benign natural history of untreated tumors. All articles were taken from a PubMed search of the English literature from the years 2000-2011. Inclusion criteria were articles containing the number of patients treated, radiation technique, average tumor size, follow-up time, and percentage of tumors growing during follow-up. Data were extracted from 19 articles. Success rates were adjusted using published data that 17% to 30% of vestibular schwannomas grow. The average reported success rate for stereotactic radiosurgery across all articles was 95.5%. When considering 17% or 30% natural growth without intervention, the adjusted success rates became 78.2% and 86.9% respectively. These rates were obtained by applying the natural history growth percentages to any tumors not reported to be growing before radiosurgical intervention. Success in the treatment of vestibular schwannomas with stereotactic radiosurgery is often defined as lack of further growth. Recent data on the natural growth history of vestibular schwannomas raise the question of whether this is the best definition of success. We have identified a lack of continuity regarding the reporting of success and emphasize the importance of the clarification of the success of radiosurgery to make informed decisions regarding the best treatment options for vestibular schwannoma. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Effect of solution treatment temperature and cooling rate on the mechanical properties of tungsten heavy alloy

    Energy Technology Data Exchange (ETDEWEB)

    Kumari, Anjali, E-mail: anjalikumari1261@gmail.com; Prabhu, G.; Sankaranarayana, M.; Nandy, T.K.

    2017-03-14

    The present study investigates the effect of solution treatment temperature and cooling rate on mechanical properties of a tungsten heavy alloy (89.6W-6.2Ni-1.8Fe-2.4Co). In addition to water quenching, rapid argon quenching has been attempted in this study since it is a relatively cleaner process and it can be used in conjunction with vacuum treatment. Since in these alloys, there is a possibility of incomplete dissolution of intermetallics or segregation of impurities during heat treatment, which results in scatter in the mechanical properties, it was decided that the solution treatment temperature for both water and argon quenching would be varied from 1100 to 1250 °C in order to see its effect on the microstructure and mechanical properties. Solution treatment at varying temperatures followed by water quenching resulted in tensile strength ranging from 908 to 921 MPa and % elongation varied from 19% to 26%. On the other hand, the argon quenching heat treatment resulted in tensile strength in the range of 871–955 MPa and % elongation from 9% to 25%. No significant trend with respect to solution treatment temperature on tensile properties was seen in both argon and water quenched samples. % elongation to failure and impact values of water quenched specimens were better than those of argon quenched specimens for a given solution treatment temperature. The impact values appeared to improve with increasing solution treatment temperature in water quenched condition. The properties were correlated with underlying microstructure and fractographs of the failed specimens. The study showed the argon quenching may not be appropriate for the heat treatment of heavy alloys since it results in inferior mechanical properties as compared to water quenching.

  18. [Rate of prevalence, awareness, treatment and control of hypertension among women at reproductive age in China in 2013].

    Science.gov (United States)

    Wang, Z Q; Zhao, Y F; Yang, J; Wang, L M; Zhao, Z P; Zeng, X Y; Wang, L H

    2017-12-06

    Objective: To analyze the rate of prevalence, awareness, treatment and control of hypertension among women at reproductive age (18-49 years old) in China in 2013. Methods: The analysis used data obtained from the China Chronic and non-communicable disease surveillance in 2013.The surveillance included 176 534 adults aging ≥18 years old, who were selected from 302 surveillance points by multi-stage cluster random sampling method. A total of 46 674 women at reproductive age (18-49 years old) were investigated. Blood pressures were measured by electronic blood pressure monitor. After being weighted according to complex sampling scheme and post-stratification, the rate of prevalence, awareness, treatment and control of hypertension were compared by different characteristics such as age, education, urban and rural areas, and geographic locations. Results: The prevalence of hypertension among women at reproductive age (18-49 years old) in China in 2013 was 13.5%. The rate in the rural areas was higher than that in urban areas (χ(2)=46.23, P 0.05). The hypertension prevalence in all age groups (18-24, 25-29, 30-34, 35-39, 40-44, 45-49 years old) were 6.6%, 9.2%, 9.6%, 12.0%, 17.9% and 28.3%, respectively. The prevalence of hypertension showed a rising trend with age increasing ( t= 12.32, Pareas; and 21.3%, 18.5% and 5.9%, respectively in rural areas. The rates in urban areas were all higher than those in rural areas (chi square were separately 18.98, 21.31, and 6.80, P values areas.

  19. In-vitro maturation versus IVF with GnRH antagonist for women with polycystic ovary syndrome: treatment outcome and rates of ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Das, Mausumi; Son, Weon-Young; Buckett, William; Tulandi, Togas; Holzer, Hananel

    2014-11-01

    In-vitro maturation (IVM) treatment has gained popularity for decreasing the incidence of ovarian hyperstimulation syndrome (OHSS) by eliminating or minimizing the use of gonadotrophins in women with polycystic ovary syndrome (PCOS). Studies have shown that IVF with GnRH-antagonist protocol is associated with a lower incidence of OHSS. Data comparing the relative success of these two treatments is, however, lacking. Treatment outcome and rates of OHSS were compared in patients with PCOS who underwent assisted conception with either IVM or IVF with GnRH-antagonist protocol between 2006 and 2011. The number of oocytes retrieved was higher in the IVM group, whereas the number of mature oocytes, fertilization rate and number of embryos cleaved were comparable. The implantation rate was higher in the IVF group. The clinical pregnancy rates per embryo transfer were not statistically different (IVF: 45.8% versus IVM: 32.4%). The live-birth rate was higher in the IVF group (IVF: 40.7% versus IVM: 23.5%; P = 0.04). Five women developed moderate or severe OHSS in the IVF group, whereas none did in the IVM group. Both IVM and IVF with GnRH-antagonist protocol seem to be effective treatment regimens in women with PCOS, although IVM is associated with a lower risk of OHSS. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Factors influencing dropout rate of intermittent preventive treatment of malaria during pregnancy.

    Science.gov (United States)

    Doku, David Teye; Zankawah, Mumuni Mukaila; Adu-Gyamfi, Addae Boateng

    2016-10-10

    The burden of malaria in terms of morbidity and mortality is huge is Sub-Saharan Africa, particularly among pregnant women. Among the measures to curb down this burden include intermittent preventive treatment (IPT) and effective case management. These strategies were adopted by Ghana and implemented since 2003; however, there is still high dropout rate in IPT coverage. This study sought to investigate factors contributing to high dropout rate between IPT1 and IPT3 in the Tamale Metropolis, one of the health facilities with the highest IPT dropout rates in Ghana. Survey, in-depth interviews and short ethnographic techniques were conducted among pregnant women, antenatal care (ANC) health workers and heads of health facilities to investigate factors which account for dropout rate of intermittent treatment of malaria. Shortage of sulphadoxine pyrimethamine (SP), inadequate supply of portable water for administration of SP, unavailability of IPT during outreach services, lack of knowledge by ANC staff about the dropout rate in their area of jurisdiction and poor attitude of some health workers were identified as barriers to achieving high IPT3 coverage. Late ANC visit, provider and logistical barriers account for the women's missed opportunities to prevent malaria in pregnancy through IPT. Addressing the above barriers will contribute to saving lives and ensuring progress towards the goal of combating malaria as well as reducing maternal, neonatal and child mortalities.

  1. Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles.

    Science.gov (United States)

    Smith, Andrew D A C; Tilling, Kate; Nelson, Scott M; Lawlor, Debbie A

    The likelihood of achieving a live birth with repeat in vitro fertilization (IVF) is unclear, yet treatment is commonly limited to 3 or 4 embryo transfers. To determine the live-birth rate per initiated ovarian stimulation IVF cycle and with repeated cycles. Prospective study of 156,947 UK women who received 257,398 IVF ovarian stimulation cycles between 2003 and 2010 and were followed up until June 2012. In vitro fertilization, with a cycle defined as an episode of ovarian stimulation and all subsequent separate fresh and frozen embryo transfers. Live-birth rate per IVF cycle and the cumulative live-birth rates across all cycles in all women and by age and treatment type. Optimal, prognosis-adjusted, and conservative cumulative live-birth rates were estimated, reflecting 0%, 30%, and 100%, respectively, of women who discontinued due to poor prognosis and having a live-birth rate of 0 had they continued. Among the 156,947 women, the median age at start of treatment was 35 years (interquartile range, 32-38; range, 18-55), and the median duration of infertility for all 257,398 cycles was 4 years (interquartile range, 2-6; range, cycle was 29.5% (95% CI, 29.3%-29.7%). This remained above 20% up to and including the fourth cycle. The cumulative prognosis-adjusted live-birth rate across all cycles continued to increase up to the ninth cycle, with 65.3% (95% CI, 64.8%-65.8%) of women achieving a live birth by the sixth cycle. In women younger than 40 years using their own oocytes, the live-birth rate for the first cycle was 32.3% (95% CI, 32.0%-32.5%) and remained above 20% up to and including the fourth cycle. Six cycles achieved a cumulative prognosis-adjusted live-birth rate of 68.4% (95% CI, 67.8%-68.9%). For women aged 40 to 42 years, the live-birth rate for the first cycle was 12.3% (95% CI, 11.8%-12.8%), with 6 cycles achieving a cumulative prognosis-adjusted live-birth rate of 31.5% (95% CI, 29.7%-33.3%). For women older than 42 years, all rates within each cycle

  2. 42 CFR 413.220 - Methodology for calculating the per-treatment base rate under the ESRD prospective payment system...

    Science.gov (United States)

    2010-10-01

    ... rate under the ESRD prospective payment system effective January 1, 2011. 413.220 Section 413.220...-treatment base rate under the ESRD prospective payment system effective January 1, 2011. (a) Data sources. The methodology for determining the per treatment base rate under the ESRD prospective payment system...

  3. APPRAISAL OF STUDENT RATING AS A MEASURE TO MANAGE THE QUALITY OF HIGHER EDUCATION IN INDIA: AN INSTITUTIONAL STUDY USING SIX SIGMA MODEL APPROACH

    Directory of Open Access Journals (Sweden)

    Arun Vijay

    2013-12-01

    Full Text Available Students' rating of teaching is one of the most widely accepted methods of measuring the quality in Higher Education worldwide. The overall experience gained by the students during their academic journey in their respective college is a key factor to determine the Institutional Quality. This study was conducted among the Physical Therapy students with an objective to capture the overall experience related to various aspects of their Academic environment including teaching and learning process adopted in their college. To facilitate that, a unique questionnaire called,"Academic Environment Evaluation Questionnaire (AEEQ was developed covering all the important teaching elements of the Higher Education Institutions. The students' opinion was captured and analyzed through six sigma analytical tool using Poisson distribution model. From the non-conformance level captured through the responses from the students about the various categories of teaching and learning elements, the corresponding Sigma rating for each teaching element was measured. Accordingly, a six point Quality rating system was developed customizing to each sigma values. This study brings a new, innovative student driven Quality rating system for the Higher Education Institutions in India.

  4. The potential impact of increased treatment rates for alcohol dependence in the United Kingdom in 2004.

    Science.gov (United States)

    Shield, Kevin D; Rehm, Jürgen; Rehm, Maximilien X; Gmel, Gerrit; Drummond, Colin

    2014-02-05

    Alcohol consumption has been linked to a considerable burden of disease in the United Kingdom (UK), with most of this burden due to heavy drinking and Alcohol Dependence (AD). However, AD is undertreated in the UK, with only 8% of those individuals with AD being treated in England and only 6% of those individuals with AD being treated in Scotland. Thus, the objective of this paper is to quantify the deaths that would have been avoided in the UK in 2004 if the treatment rate for AD had been increased. Data on the prevalence of AD, alcohol consumption, and mortality were obtained from the Adult Psychiatric Morbidity Survey, the Global Information System on Alcohol and Health, and the 2004 Global Burden of Disease study respectively. Data on the effectiveness of pharmacological treatment and Motivational Interviewing/Cognitive Behavioural Therapy were obtained from Cochrane reviews and meta-analyses. Simulations were used to model the number of deaths under different treatment scenarios. Sensitivity analyses were performed to model the effects of Brief Interventions and to examine the effect of using AD prevalence data obtained from the National Institute for Health and Clinical Excellence. In the UK, 320 female and 1,385 male deaths would have been avoided if treatment coverage of pharmacological treatment had been increased to 20%. This decrease in the number of deaths represents 7.9% of all alcohol-attributable deaths (7.0% of all alcohol-attributable deaths for women and 8.1% of all alcohol-attributable deaths for men). If we used lower AD prevalence rates obtained from the National Institute for Health and Clinical Excellence, then treatment coverage of pharmacological treatment in hospitals for 20% of the population with AD would have resulted in the avoidance of 529 deaths in 2004 (99 deaths avoided for women and 430 deaths avoided for men). Increasing AD treatment in the UK would have led to a large number of deaths being avoided in 2004. Increased AD

  5. An analysis of acute complications and perioperative morbidity from high dose rate brachytherapy in the treatment of gynecological malignancies

    International Nuclear Information System (INIS)

    Sarkaria, Jann N.; Petereit, Daniel G.; Kinsella, Timothy J.; Buchler, Dolores A.

    1995-01-01

    Purpose: To evaluate the acute morbidity and mortality for high dose-rate (HDR) brachytherapy performed in an outpatient setting in the treatment of gynecological malignancies, and to identify possible risk factors for adverse outcomes. Materials and Methods: One hundred seventy-one patients with cervical (n=129) or uterine (n=42) carcinoma with an intact uterus were evaluated and treated from August 1989 through December 1994, with at least part of their therapy delivered with intracavitary HDR 192 Ir radiation. A total of 830 ICR insertions were performed with greater than 95% done on an outpatient basis under heavy intravenous sedation using fentanyl and midazolam. Perioperative morbidity and mortality were recorded for any event occurring within 30 days of the completion of therapy. Anesthesia risk was evaluated retrospectively in all patients based on the American Society of Anesthesiologists' (ASA) Physical Class System. Results: The uterine patients, many treated with radiation alone because of morbid obesity or medical inoperability, had a significantly higher perioperative morbidity and mortality rate as compared to the cervix patient cohort. Thirteen of the 42 (31%) uterine patients and 8 of the 129 (6%) cervix patients required hospitalization within 30 days of treatment completion (p 2) experienced greater morbidity and mortality, while the best predictor of complications in the cervix patients was age greater than 70 years. For the entire cohort of patients, no correlation was found between the 30 day morbidity and mortality and the doses of fentanyl and midazolam used or the length of the procedure. Conclusions: The acute complication rate from HDR brachytherapy performed on an outpatient basis with heavy intravenous sedation is acceptable for the great majority of patients who present for treatment. However, the high morbidity and mortality experienced by certain patient cohorts suggests that careful assessment of the risk/benefit ratio for treatment

  6. Custom-made micro applicators for high-dose-rate brachytherapy treatment of chronic psoriasis

    Directory of Open Access Journals (Sweden)

    Ivan M. Buzurovic

    2017-06-01

    Full Text Available Purpose: In this study, we present the treatment of the psoriatic nail beds of patients refractory to standard therapies using high-dose-rate (HDR brachytherapy. The custom-made micro applicators (CMMA were designed and constructed for radiation dose delivery to small curvy targets with complicated topology. The role of the HDR brachytherapy treatment was to stimulate the T cells for an increased immune response. Material and methods: The patient diagnosed with psoriatic nail beds refractory to standard therapies received monthly subunguinal injections that caused significant pain and discomfort in both hands. The clinical target was defined as the length from the fingertip to the distal interphalangeal joint. For the accurate and reproducible setup in the multi-fractional treatment delivery, the CMMAs were designed. Five needles were embedded into the dense plastic mesh and covered with 5 mm bolus material for each micro applicator. Five CMMAs were designed, resulting in the usage of 25 catheters in total. Results: The prescription dose was planned to the depth of the anterior surface of the distal phalanx, allowing for the sparing of the surrounding tissue. The total number of the active dwell positions was 145 with step size of 5 mm. The total treatment time was 115 seconds with a 7.36 Ci activity of the 192Ir source. The treatment resulted in good pain control. The patient did not require further injections to the nail bed. After this initial treatment, additional two patients with similar symptoms received HDR brachytherapy. The treatment outcome was favorable in all cases. Conclusions : The first HDR brachytherapy treatment of psoriasis of the nail bed is presented. The initial experience revealed that brachytherapy treatment was well-tolerated and resulted in adequate control of the disease. A larger cohort of patients will be required for additional conclusions related to the long-term clinical benefits.

  7. Pulsed Dose Rate (PDR - BT) brachytherapy in treatment of breast cancer

    International Nuclear Information System (INIS)

    Skowronek, J.

    2007-01-01

    Breast conserving surgery (BCS) and radiotherapy (EBRT) of the conserved breast became widely accepted in the last decades for the treatment of early invasive breast cancer. The standard technique of RT after breast conservation is to treat the whole breast up to a total dose of 45 to 50 Gy. Initially brachytherapy for breast cancer was used in addition of external radiation to boost a portion of the breast to higher doses. However, over the past 10 years, the application of brachytherapy in breast cancer has changed. In early stage breast cancer, research has shown that the area that requires radiation treatment to prevent the cancer from returning is the breast tissue that surrounds the area where the initial cancer was removed. Because this typically includes only a part of the breast, brachytherapy is now being used to treat the targeted portion of the breast and as a result allows accelerated delivery of the radiation dose so that treatment is completed in four to five days. Another indications for PDR - BT as a part of treatment in locally advanced breast cancer or as a palliative treatment are discussed in the paper, too. Preliminary results with PDR - BT boost technique are promising. However, more experience and longer follow-up are required to define whether these methods might improve local tumor control for breast cancer patients. In this article the current status, indications, technical aspects and published results of PDR brachytherapy (PDR - BT) in breast cancer treatment are reviewed. (author)

  8. Focal low-dose rate brachytherapy for the treatment of prostate cancer

    Directory of Open Access Journals (Sweden)

    Tong WY

    2013-09-01

    Full Text Available William Y Tong, Gilad Cohen, Yoshiya Yamada Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY, USA Abstract: Whole-gland low-dose rate (LDR brachytherapy has been a well-established modality of treating low-risk prostate cancer. Treatment in a focal manner has the advantages of reduced toxicity to surrounding organs. Focal treatment using LDR brachytherapy has been relatively unexplored, but it may offer advantages over other modalities that have established experiences with a focal approach. This is particularly true as prostate cancer is being detected at an earlier and more localized stage with the advent of better detection methods and newer imaging modalities. Keywords: prostate cancer, focal, low dose rate, brachytherapy

  9. The association between cinacalcet use and missed in-center hemodialysis treatment rate.

    Science.gov (United States)

    Brunelli, Steven M; Sibbel, Scott; Dluzniewski, Paul J; Cooper, Kerry; Bensink, Mark E; Bradbury, Brian D

    2016-11-01

    Missed in-center hemodialysis treatments (MHT) are a general indicator of health status in hemodialysis patients. This analysis was conducted to estimate the association between cinacalcet use and MHT rate. We studied patients receiving hemodialysis and prescription benefits services from a large dialysis organization. Incident cinacalcet users were propensity score matched to controls on 31 demographic, clinical, and laboratory variables. We applied inverse probability (IP) of censoring and crossover weights to account for informative censoring. Weighted negative binomial modeling was used to estimate MHT rates and pooled logistics models were used to estimate the association between cinacalcet use and MHT. Baseline demographic and clinical variables included serum calcium, phosphorus, parathyroid hormone, and vitamin D use, and were balanced between 15,474 new cinacalcet users and 15,474 matched controls. In an analysis based on intention-to-treat principles, 40.8% of cinacalcet users and 46.5% of nonusers were censored. MHT rate was 13% lower among cinacalcet initiators versus controls: IP of censoring weighted incidence rate ratio was 0.87 (95% confidence interval [CI]: 0.84-0.90 p < 0.001). In analyses based on as-treated principles, 72.8% and 61.5% of cinacalcet users and nonusers, respectively, crossed over or were censored. MHT rate was 15% lower among cinacalcet initiators versus controls: IP of censoring/crossover weighted incidence rate ratio was 0.85 (95%CI: 0.82-0.87 p < 0.001). After controlling for indication and differential censoring, cinacalcet treatment was associated with lower MHT rates, which may reflect better health status. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Reducing uranium and thorium level in Zircon: effect of heat treatment on rate of leaching

    International Nuclear Information System (INIS)

    Meor Yusoff Meor Sulaiman

    2002-01-01

    Considerable amount of uranium and thorium are found in Malaysian zircon and the level is much higher than the minimum value adopted by many importing countries. Selective leaching had been applied as an important technique to reduce these elements. An initial study was carried out using hydrochloric acid leaching system but the result was not favourable. The rate of uranium and thorium leached can be further improved by introducing a heat pretreatment process prior to leaching (Author)

  11. Efficacy of an Internet-based depression intervention to improve rates of treatment in adolescent mothers.

    Science.gov (United States)

    Cynthia Logsdon, M; Myers, John; Rushton, Jeff; Gregg, Jennifer L; Josephson, Allan M; Davis, Deborah Winders; Brothers, Kyle; Baisch, Kristin; Carabello, Anissa; Vogt, Krista; Jones, Kayla; Angermeier, Jennifer

    2018-06-01

    Approximately 400,000 adolescents give birth in the USA annually. Although one-half experience depressive symptoms, less than 25% comply with referrals for depression evaluation and treatment. The current study tested the effectiveness of an Internet-based depression intervention on seeking depression treatment. Based upon the theory of planned behavior (TPB), the intervention included vignettes, questions and answers, and resources. Before the intervention, immediately after the intervention, and 2 weeks later the adolescent mothers (n = 151) answered questions related to TPB variables and depression treatment. Data were compared to adolescent mothers (n = 138) in the control group. Data were collected in community organizations or home visits for the control group. Adolescent mothers in the intervention group answered questions and completed the intervention from a computer of their choice. The adolescents were primarily African American (89.2%), less than high school educated (51.7%), had given birth in last year (97.1%), with a mean age 18.2 years. The intervention led to significant changes in attitude, perceived control, intention to seek mental health treatment, and actually seeking depression treatment. Untreated postpartum depression dramatically impacts a mother's relationship with her child, her functioning at work and school, health care-seeking behaviors, mothering skills, and her development as well as the development of her child. An Internet-based depression intervention is an inexpensive method to increase rates of depression treatment.

  12. Assessment of Osmotic Pre-Drying Treatment on Drying Rates of Fresh Tomato Fruits

    Directory of Open Access Journals (Sweden)

    P. A. Idah

    2014-06-01

    Full Text Available The aim of this work is to investigate the influence of osmotic pre-drying treatments on drying rates of tomato (Lycopersiconesculentum at various drying temperatures. Fresh Roma tomato fruit samples were sliced to a thickness of 5 mm and the seeds were removed. Weight of 300 g was measured for each of the three replicates and immersed in a hypertonic solution of sucrose of different concentrations 40 and 60 oBrix each held for osmotic duration of 1 and 2 hours, drained for 10 min and then dried at 50, 60, and 70 oC in a mechanical dryer. Control samples were also weighed 300 g per replicate and dried at 50, 60, and 70 oC without pre-drying treatment. The initial moisture content of fresh tomato used was 94.5% (wb. Moisture loss of each sample was monitored and recorded hourly until the product has reached the desired final moisture content (≤ 7%.The data collected were subjected to statistical analysis of variance (ANOVA and Duncan New Multiple range tests (DNMRT to ascertain the level of significance differences between the individual treatments and their interaction at p ≤ 0.05.The results show that at all the drying temperatures used, the control tomato samples exhibited the fastest drying rate with an average of 35.2 g/hr, samples pre-treated at 40 oBrix has an average drying rate of 26.6 g/hr, while samples pre-treated at 60 oBrix has the slowest drying rate of 25.2 g/hr. It was also revealed that samples subjected to 1 hour osmotic time have faster drying rates than those treated for 2 hours osmotic time.

  13. Comparative Study of Erythrocyte Sedimentation Rate after Aminoglycoside and Aminocyclitol Treatment in Goats (Capra hircus

    Directory of Open Access Journals (Sweden)

    Toncho DINEV

    2016-07-01

    Full Text Available The aim of the present study was to follow up the erythrocyte sedimentation rate (ESR in healthy female goats during and after 5-day parenteral treatment with amikacin (10 mg/kg, tobramycin (5 mg/kg, apramycin (20 mg/kg, gentamicin (4 mg/kg, kanamycin (10 mg/kg and spectinomycin (20 mg/kg. Gentamicin and tobramycin caused an initial increase followed by a significant decrease of ESR on the 5th day for gentamicin and the 10th day for tobramycin, respectively, followed by recovery after the treatment. Reversely, amikacin and especially spectinomycin produced an increase of ESR without recovery several days post treatment. Kanamycin caused decrease of ESR on the 5th day without recovery in the subsequent days. Only apramycin did not give rise to increasing of ESR. In conclusion the aminoglycosides, especially tobramycin and gentamicin, caused more severe alterations of ESR than the aminocyclitols.

  14. Independent technique of verifying high-dose rate (HDR) brachytherapy treatment plans

    International Nuclear Information System (INIS)

    Saw, Cheng B.; Korb, Leroy J.; Darnell, Brenda; Krishna, K. V.; Ulewicz, Dennis

    1998-01-01

    Purpose: An independent technique for verifying high-dose rate (HDR) brachytherapy treatment plans has been formulated and validated clinically. Methods and Materials: In HDR brachytherapy, dwell times at respective dwell positions are computed, using an optimization algorithm in a HDR treatment-planning system to deliver a specified dose to many target points simultaneously. Because of the variability of dwell times, concerns have been expressed regarding the ability of the algorithm to compute the correct dose. To address this concern, a commercially available low-dose rate (LDR) algorithm was used to compute the doses at defined distances, based on the dwell times obtained from the HDR treatment plans. The percent deviation between doses computed using the HDR and LDR algorithms were reviewed for HDR procedures performed over the last year. Results: In this retrospective study, the difference between computed doses using the HDR and LDR algorithms was found to be within 5% for about 80% of the HDR procedures. All of the reviewed procedures have dose differences of less than 10%. Conclusion: An independent technique for verifying HDR brachytherapy treatment plans has been validated based on clinical data. Provided both systems are available, this technique is universal in its applications and not limited to either a particular implant applicator, implant site, or implant type

  15. Root resorption, treatment time and extraction rate during orthodontic treatment with self-ligating and conventional brackets

    Science.gov (United States)

    2014-01-01

    Introduction This study determined the amount and severity of EARR (external apical root resorption) after orthodontic treatment with self-ligating (SL) and conventional (Non-SL) brackets. Differences regarding rate of extraction cases, appointments and treatment time were evaluated. Material and methods 213 patients with a mean age of 12.4 ± 2.2 years were evaluated retrospectively. The treatments were performed with SL brackets (n = 139, Smartclip, 3 M Unitek, USA) or Non-SL brackets (n = 74, Victory Series, 3 M Unitek, USA). Measurements of the crown and root length of the incisors were taken using panoramic radiographs. Three-factor analysis of variance (ANOVA) was performed for an appliance effect. Results There was no difference between patients treated with Non-SL or SL brackets regarding the amount (in percentage) of EARR (Non-SL: 4.5 ± 6.6 vs. SL: 3.0 ± 5.6). Occurrence of severe EARR (sEARR) did also not differ between the two groups (Non-SL 0.5 vs. SL: 0.3). The percentage of patients with need of tooth extraction for treatment (Non SL: 8.1 vs. SL: 6.9) and the number of appointments (Non-SL: 12.4 ± 3.4 vs. SL: 13.9 ± 3.3) did not show any differences. The treatment time was shorter with Non-SL brackets (Non-SL: 18.1 ± 5.3 vs. SL: 20.7 ± 4.9 months). Conclusions This is the largest study showing that there is no difference in the amount of EARR, number of appointments and extraction rate between conventional and self-ligating brackets. For the first time we could demonstrate that occurrence of sEARR does not differ between the two types of brackets. PMID:24456620

  16. Financial Prospect to The Application of High Rate Water Treatment Plant System

    Directory of Open Access Journals (Sweden)

    Mohajit Mohajit

    2015-10-01

    Full Text Available The High Rate Water Treatment Plant (HR-WTP system, which is inexpensive, effective and efficient, has been developed to reduce the common operational problems, and also as an alternative for the development of water treatment plant systems capacity in Indonesia.Implementation of HR-WTP system in up-rating of the Dekeng-WTP system at PDAM Kota Bogor proved successful in increasing the plant capacity from its original of 500 Lps to more than 1200 Lps. The performance of the WTP system was also significantly improved from poor performance to very good performance.The investment cost for up-rating proved competitive when compared to alternatively constructing a new WTP system with an equivalent capacity and performance. Application of HR-WTP systems for the development of WTP system in Indonesia, i.e. rehabilitation, up-grading, and up-rating, as well as construction of a new WTP system, is expected to bring technical, financial, and economic benefits. This new approach might be an innovative solution to the challenge of Millennium Development Goals in Water Supply Sector in Indonesia, where an additional capacity of ca 150,000 Lps should be developed within a 15 years period with an estimated budget of US $1.5 billions. This budget might be reduced to less than 50% through the application of the HR-WTP system.

  17. Early definitive treatment rate as a quality indicator of care in acute gallstone pancreatitis.

    Science.gov (United States)

    Green, R; Charman, S C; Palser, T

    2017-11-01

    Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition. A retrospective cohort study was conducted using the Hospital Episode Statistics database. All emergency admissions to National Health Service hospitals in England with a first time diagnosis of acute gallstone pancreatitis in the financial years 2008, 2009 and 2010 were examined. Trends in early definitive treatment between hospital trusts were examined and patient morbidity outcomes were determined. During the study interval there were 19 510 patients with an overall rate of early definitive treatment at 34·7 (range 9·4-84·7) per cent. In the 1-year follow-up period, 4661 patients (23·9 per cent) had one or more emergency readmissions for complications related to gallstone pancreatitis. Of these, 2692 (57·8 per cent) were readmissions for acute pancreatitis; 911 (33·8 per cent) were within the first 2 weeks of discharge, with the remaining 1781 (66·2 per cent) occurring after the point at which definitive treatment should have been received. Early definitive treatment resulted in a 39 per cent reduction in readmission risk (adjusted risk ratio (RR) 0·61, 95 per cent c.i. 0·58 to 0·65). The risk was further reduced for acute pancreatitis readmissions to 54 per cent in the early definitive treatment group (adjusted RR 0·46, 0·42 to 0·51). In acute gallstone pancreatitis, compliance with recommended early definitive treatment varied considerably, with associated variation in outcomes. Compliance should be used as a quality indicator to improve care. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  18. The effect of texture, heat treatment and elongation rate on stress corrosion cracking in irradiated zircaloy

    International Nuclear Information System (INIS)

    Pettersson, K.; Stany, W.; Hellstrand, E.

    1979-03-01

    Irradiated zircaloy samples with different textures and heat treatments have been tested concerning stress corrosion. Irradiated samples of Zr-1Nb, pure Zr and beta quenched zircaloy have also been investigated. Stress-relieve annealled zircaloy is even after irradiation more sensitive to stress corrosion than recrystallized zircaloy. Zr-1Nb and beta quenched zircaloy are much more sinsitive to stress corrosion than the samples with different textures. As a rule irradiated zircaloy is sensitive to stress corrosion at stresses far below the yield point. The breaking stress decreases with the elongation rate. The extension of cracks is much faster in irradiated zircaloy than in unirradiated zircaloy. There is no simple failure criterium for irradiated zircaloy. However for a certain stress and a certain elongation rate the probability for a failure before this stress is reached with a constant elongation rate can be given. (E.R.)

  19. Factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone.

    Science.gov (United States)

    el-Nahas, Ahmed R; Eraky, Ibrahim; Shokeir, Ahmed A; Shoma, Ahmed M; el-Assmy, Ahmed M; el-Tabey, Nasr A; Soliman, Shady; Elshal, Ahmed M; el-Kappany, Hamdy A; el-Kenawy, Mahmoud R

    2012-06-01

    To determine factors affecting the stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of staghorn stones. The computerized database of patients who underwent PNL for treatment of staghorn stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting stone-free and complication rates. The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral stones). The stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual stones were complete staghorn stone and presence of secondary calyceal stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Factors affecting the incidence of residual stones after PNL are complete staghorn stones and the presence of secondary calyceal stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Comparison of survival rates among different treatment methods of transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Yong Woon; Lee, Jong Tae; Yoo, Hyung Sik; Lee, Do Yun; Jun, Pyoung Jun; Chang, So Yong [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-06-01

    To compare the survival rates of patients with hepatoma using different methods of transcatheter arterial chemoemblization(THAE). Four hundred and eighty three patients with hepatoma diagnosed by biopsy, serum alpha-fetoprotein, abdominal CT scan, abdominal ultrasonography or hepatic angiography were included, but not all had received surgical treatment. They were divided onto two groups according to Child's classification and into subgroups according to different methods of THAE. Five-tear survival rates among these groups were retrospectively compared. The patients were aged between 24 and 85(mean, 58) ; male to female ratio was 324 : 61 for those who received THAE (369 : 87 when only hepatic angiography was considered.). In the group with more than a single episode of chemoembolization, regardless of Child's classification, a better survival rate compared to the other groups with or without concommitant radiotherapy or without chemoembolization was noted. There was no difference in the survival rate of patients with multiple chemoembolization. moreover, no difference in this rate was observed no matter what chemotherapeutic agents, including Adriamycin, Cis-Diaminedichloroplatinum of I-131-Lipiodol, were used. Amortization by gelfoam in conjuction with Adriamycin resulted in no difference in survival rate regardless of frequency of chemoembolization. An improved survival rate was seen when multiple episodes of chemoembolization were applied, but no difference was seen when there was concomitant application of either gelfoam or radiotherapy. Two different chemotherapeutic agents, Adriamycin and Cis-Diaminedichloroplatinum, were used, but there was no difference between them in their effect on survival rates.

  1. Endometrial Scratch Injury Induces Higher Pregnancy Rate for Women With Unexplained Infertility Undergoing IUI With Ovarian Stimulation: A Randomized Controlled Trial.

    Science.gov (United States)

    Maged, Ahmed M; Al-Inany, Hesham; Salama, Khaled M; Souidan, Ibrahim I; Abo Ragab, Hesham M; Elnassery, Noura

    2016-02-01

    To explore the impact of endometrial scratch injury (ESI) on intrauterine insemination (IUI) success. One hundred and fifty four infertile women received 100 mg of oral clomiphene citrate for 5 days starting on day 3 of the menstrual cycle. Patients were randomized to 2 equal groups: Group C received IUI without ESI and group S had ESI. Successful pregnancy was confirmed by ultrasound. 13, 21, and 10 women got pregnant after the first, second, and third IUI trials, respectively, with 28.6% cumulative pregnancy rate (PR). The cumulative PR was significantly higher in group S (39%) compared to group C (18.2%). The PR in group S was significantly higher compared to that in group C at the second and third trials. The PR was significantly higher in group S at the second trial compared to that reported in the same group at the first trial but nonsignificantly higher compared to that reported during the third trial, while in group C, the difference was nonsignificant. Eight pregnant women had first trimester abortion with 18.2% total abortion rate with nonsignificant difference between studied groups. The ESI significantly improves the outcome of IUI in women with unexplained infertility especially when conducted 1 month prior to IUI. © The Author(s) 2015.

  2. Heart rate variability during exertional heat stress: effects of heat production and treatment.

    Science.gov (United States)

    Flouris, Andreas D; Bravi, Andrea; Wright-Beatty, Heather E; Green, Geoffrey; Seely, Andrew J; Kenny, Glen P

    2014-04-01

    We assessed the efficacy of different treatments (i.e., treatment with ice water immersion vs. natural recovery) and the effect of exercise intensities (i.e., low vs. high) for restoring heart rate variability (HRV) indices during recovery from exertional heat stress (EHS). Nine healthy adults (26 ± 3 years, 174.2 ± 3.8 cm, 74.6 ± 4.3 kg, 17.9 ± 2.8 % body fat, 57 ± 2 mL·kg·(-1) min(-1) peak oxygen uptake) completed four EHS sessions incorporating either walking (4.0-4.5 km·h(-1), 2 % incline) or jogging (~7.0 km·h(-1), 2 % incline) on a treadmill in a hot-dry environment (40 °C, 20-30 % relative humidity) while wearing a non-permeable rain poncho for a slow or fast rate of rectal temperature (T re) increase, respectively. Upon reaching a T re of 39.5 °C, participants recovered until T re returned to 38 °C either passively or with whole-body immersion in 2 °C water. A comprehensive panel of 93 HRV measures were computed from the time, frequency, time-frequency, scale-invariant, entropy and non-linear domains. Exertional heat stress significantly affected 60/93 HRV measures analysed. Analyses during recovery demonstrated that there were no significant differences between HRV measures that had been influenced by EHS at the end of passive recovery vs. whole-body cooling treatment (p > 0.05). Nevertheless, the cooling treatment required statistically significantly less time to reduce T re (p whole-body immersion in 2 °C water results in faster cooling, there were no observed differences in restoration of autonomic heart rate modulation as measured by HRV indices with whole-body cold-water immersion compared to passive recovery in thermoneutral conditions.

  3. Live birth rates are satisfactory following multiple IVF treatment cycles in poor prognosis patients.

    Science.gov (United States)

    Mustafa, Kamarul B; Keane, Kevin N; Walz, Nikita L; Mitrovic, Katarina I; Hinchliffe, Peter M; Yovich, John L

    2017-03-01

    This seven-year retrospective study analysed the live birth rate (LBR) for women undergoing IVF treatment with various antral follicle counts (AFC). The LBR decreased with lower AFC ratings, and in 290 treatment cycles for women in the poorest AFC category, ≤4 follicles (group E), the LBR was the lowest at 10.7%. The pregnancy loss rate (PLR) significantly increased with poorer AFC categories, from 21.8% in AFC group A (≥20 follicles), to 54.4% in AFC group E (p<0.0001). This trend was repeated with advancing age, from 21.6% for younger women (<35years), to 32.9, 48.5 and 100% for ages 35-39, 40-44 and ≥45 years, respectively (p<0.0001). However, LBR within the specific AFC group E cohort was also age-dependent and decreased significantly from 30.0% for <35 years old, to 13.3, 3.9 and 0% for patients aged 35-39, 40-44 and ≥45 years, respectively. Most, importantly, LBR rates within these age groups were not dependent on the number of IVF attempts (1st, 2nd, 3rd or ≥4 cycles), which indicated that cycle number should not be the primary deciding factor for cessation of IVF treatment in responding women <45years old. Copyright © 2016 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  4. Trends in the incidence rate, type and treatment of surgically verified endometriosis - a nationwide cohort study.

    Science.gov (United States)

    Saavalainen, Liisu; Tikka, Tuulia; But, Anna; Gissler, Mika; Haukka, Jari; Tiitinen, Aila; Härkki, Päivi; Heikinheimo, Oskari

    2018-01-01

    To study the trends in incidence rate, type and surgical treatment, and patient characteristics of surgically verified endometriosis during 1987-2012. This is a register-based cohort study. We identified women receiving their first diagnosis of endometriosis in surgery from the Finnish Hospital Discharge Register (FHDR). Quality of the FHDR records was assessed bidirectionally. The age-standardized incidence rates of the first surgically verified endometriosis was assessed by calendar year. The cohort comprises 49 956 women. The quality assessment suggested the FHDR data to be of good quality. The most common diagnosis, ovarian endometriosis (46%), was associated with highest median age 38.5 years (interquartile range 31.0-44.8) and the second most common diagnosis, peritoneal endometriosis (40%), with median age 34.9 years (28.6-41.7). Between 1987 and 2012, a decrease was observed in the median age, from 38.8 (32.3-43.6) to 34.0 (28.9-41.0) years, and in the age-standardized incidence rate from 116 [95% confidence interval (CI) 112-121] to 45 (42-48) per 100 000 women. The proportion of hysterectomy as a first surgical treatment decreased from 38 to 19%, whereas that of laparoscopy increased from 42 to 73% when comparing 1987-1995 with 1996-2012. This nationwide cohort of surgically verified endometriosis showed a decrease in the incidence rate and in the patient age at the time of first diagnosis, even though the proportion of laparoscopy has increased. The number of hysterectomies has decreased. These changes are likely to reflect the evolving diagnostics, increasing awareness of endometriosis, and effective use of medical treatment before surgery. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Being born under adverse economic conditions leads to a higher cardiovascular mortality rate later in life: evidence based on individuals born at different stages of the business cycle.

    Science.gov (United States)

    van den Berg, Gerard J; Doblhammer-Reiter, Gabriele; Christensen, Kaare

    2011-05-01

    We connect the recent medical and economic literatures on the long-run effects of early-life conditions by analyzing the effects of economic conditions on the individual cardiovascular (CV) mortality rate later in life, using individual data records from the Danish Twin Registry covering births since the 1870s and including the cause of death. To capture exogenous variation of conditions early in life, we use the state of the business cycle around birth. We find significant negative effects of economic conditions around birth on the individual CV mortality rate at higher ages. There is no effect on the cancer-specific mortality rate. From variation within and between monozygotic and dizygotic twin pairs born under different conditions, we conclude that the fate of an individual is more strongly determined by genetic and household-environmental factors if early-life conditions are poor. Individual-specific qualities come more to fruition if the starting position in life is better.

  6. Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment.

    Science.gov (United States)

    Li, Hang Wun Raymond; Lee, Vivian Chi Yan; Lau, Estella Yee Lan; Yeung, William Shu Biu; Ho, Pak Chung; Ng, Ernest Hung Yu

    2014-02-01

    This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment. We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers combined after the same stimulation cycle. Women in both the PCOS (n = 104) and isolated PCO groups (n = 184) had higher ovarian response parameters compared to age-matched controls (n = 576), and higher rates of withholding fresh embryo transfer for risk of ovarian hyperstimulation syndrome (OHSS). The actual incidence of moderate to severe OHSS was significantly higher in the PCOS (11.5 %) but not the isolated PCO group (8.2%) compared to controls (4.9%). The live birth rates in the fresh cycle were comparable among the 3 groups, but the PCOS group had a significantly higher miscarriage rate compared to the other 2 groups. Cumulative live birth rate was significantly higher in the isolated PCO group (60.3%), but not the PCOS group (50.0%), compared to controls (47.5%). Women in the isolated PCO group, but not the PCOS group, had a significantly higher cumulative live birth rate compared to controls. This could be explained by the quantitative effect of the higher number of transferable embryos obtained per stimulation cycle, which is uncompromised by the unfavourable embryo competence otherwise observed in PCOS.

  7. Evaluation of treatment response in depression studies using a Bayesian parametric cure rate model.

    Science.gov (United States)

    Santen, Gijs; Danhof, Meindert; Della Pasqua, Oscar

    2008-10-01

    Efficacy trials with antidepressant drugs often fail to show significant treatment effect even though efficacious treatments are investigated. This failure can, amongst other factors, be attributed to the lack of sensitivity of the statistical method as well as of the endpoints to pharmacological activity. For regulatory purposes the most widely used efficacy endpoint is still the mean change in HAM-D score at the end of the study, despite evidence from literature showing that the HAM-D scale might not be a sensitive tool to assess drug effect and that changes from baseline at the end of treatment may not reflect the extent of response. In the current study, we evaluate the prospect of applying a Bayesian parametric cure rate model (CRM) to analyse antidepressant effect in efficacy trials with paroxetine. The model is based on a survival approach, which allows for a fraction of surviving patients indefinitely after completion of treatment. Data was extracted from GlaxoSmithKline's clinical databases. Response was defined as a 50% change from baseline HAM-D at any assessment time after start of therapy. Survival times were described by a log-normal distribution and drug effect was parameterised as a covariate on the fraction of non-responders. The model was able to fit the data from different studies accurately and results show that response to treatment does not lag for two weeks, as is mythically believed. In conclusion, we demonstrate how parameterisation of a survival model can be used to characterise treatment response in depression trials. The method contrasts with the long-established snapshot on changes from baseline, as it incorporates the time course of response throughout treatment.

  8. Automated high-dose rate brachytherapy treatment planning for a single-channel vaginal cylinder applicator

    Science.gov (United States)

    Zhou, Yuhong; Klages, Peter; Tan, Jun; Chi, Yujie; Stojadinovic, Strahinja; Yang, Ming; Hrycushko, Brian; Medin, Paul; Pompos, Arnold; Jiang, Steve; Albuquerque, Kevin; Jia, Xun

    2017-06-01

    High dose rate (HDR) brachytherapy treatment planning is conventionally performed manually and/or with aids of preplanned templates. In general, the standard of care would be elevated by conducting an automated process to improve treatment planning efficiency, eliminate human error, and reduce plan quality variations. Thus, our group is developing AutoBrachy, an automated HDR brachytherapy planning suite of modules used to augment a clinical treatment planning system. This paper describes our proof-of-concept module for vaginal cylinder HDR planning that has been fully developed. After a patient CT scan is acquired, the cylinder applicator is automatically segmented using image-processing techniques. The target CTV is generated based on physician-specified treatment depth and length. Locations of the dose calculation point, apex point and vaginal surface point, as well as the central applicator channel coordinates, and the corresponding dwell positions are determined according to their geometric relationship with the applicator and written to a structure file. Dwell times are computed through iterative quadratic optimization techniques. The planning information is then transferred to the treatment planning system through a DICOM-RT interface. The entire process was tested for nine patients. The AutoBrachy cylindrical applicator module was able to generate treatment plans for these cases with clinical grade quality. Computation times varied between 1 and 3 min on an Intel Xeon CPU E3-1226 v3 processor. All geometric components in the automated treatment plans were generated accurately. The applicator channel tip positions agreed with the manually identified positions with submillimeter deviations and the channel orientations between the plans agreed within less than 1 degree. The automatically generated plans obtained clinically acceptable quality.

  9. Higher success rate with transcranial electrical stimulation of motor-evoked potentials using constant-voltage stimulation compared with constant-current stimulation in patients undergoing spinal surgery.

    Science.gov (United States)

    Shigematsu, Hideki; Kawaguchi, Masahiko; Hayashi, Hironobu; Takatani, Tsunenori; Iwata, Eiichiro; Tanaka, Masato; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Tanaka, Yuu; Tanaka, Yasuhito

    2017-10-01

    During spine surgery, the spinal cord is electrophysiologically monitored via transcranial electrical stimulation of motor-evoked potentials (TES-MEPs) to prevent injury. Transcranial electrical stimulation of motor-evoked potential involves the use of either constant-current or constant-voltage stimulation; however, there are few comparative data available regarding their ability to adequately elicit compound motor action potentials. We hypothesized that the success rates of TES-MEP recordings would be similar between constant-current and constant-voltage stimulations in patients undergoing spine surgery. The objective of this study was to compare the success rates of TES-MEP recordings between constant-current and constant-voltage stimulation. This is a prospective, within-subject study. Data from 100 patients undergoing spinal surgery at the cervical, thoracic, or lumbar level were analyzed. The success rates of the TES-MEP recordings from each muscle were examined. Transcranial electrical stimulation with constant-current and constant-voltage stimulations at the C3 and C4 electrode positions (international "10-20" system) was applied to each patient. Compound muscle action potentials were bilaterally recorded from the abductor pollicis brevis (APB), deltoid (Del), abductor hallucis (AH), tibialis anterior (TA), gastrocnemius (GC), and quadriceps (Quad) muscles. The success rates of the TES-MEP recordings from the right Del, right APB, bilateral Quad, right TA, right GC, and bilateral AH muscles were significantly higher using constant-voltage stimulation than those using constant-current stimulation. The overall success rates with constant-voltage and constant-current stimulations were 86.3% and 68.8%, respectively (risk ratio 1.25 [95% confidence interval: 1.20-1.31]). The success rates of TES-MEP recordings were higher using constant-voltage stimulation compared with constant-current stimulation in patients undergoing spinal surgery. Copyright © 2017

  10. Direct Vision Internal Urethrotomy for Short Anterior Urethral Strictures and Beyond: Success Rates, Predictors of Treatment Failure, and Recurrence Management.

    Science.gov (United States)

    Kluth, Luis A; Ernst, Lukas; Vetterlein, Malte W; Meyer, Christian P; Reiss, C Philip; Fisch, Margit; Rosenbaum, Clemens M

    2017-08-01

    To determine success rates, predictors of recurrence, and recurrence management of patients treated for short anterior urethral strictures by direct vision internal urethrotomy (DVIU). We identified 128 patients who underwent DVIU of the anterior urethra between December 2009 and March 2016. Follow-up was conducted by telephone interviews. Success rates were assessed by Kaplan-Meier estimators. Predictors of stricture recurrence and different further therapy strategies were identified by uni- and multivariable Cox regression analyses. The mean age was 63.8 years (standard deviation: 16.3) and the overall success rate was 51.6% (N = 66) at a median follow-up of 16 months (interquartile range: 6-43). Median time to stricture recurrence was six months (interquartile range: 2-12). In uni- and multivariable analyses, only repeat DVIU (hazard ratio [HR] = 1.87, 95% confidence interval (CI) = 1.13-3.11, P= .015; and HR=1.78, 95% CI = 1.05-3.03, P = .032, respectively) was a risk factor for recurrence. Of 62 patients with recurrence, 35.5% underwent urethroplasty, 29% underwent further endoscopic treatment, and 33.9% did not undergo further interventional therapy. Age (HR = 1.05, 95% CI = 1.01-1.09, P = .019) and diabetes (HR = 2.90, 95% CI = 1.02-8.26, P = .047) were predictors of no further interventional therapy. DVIU seems justifiable in short urethral strictures as a primary treatment. Prior DVIU was a risk factor for recurrence. In case of recurrence, about one-third of the patients did not undergo any further therapy. Higher age and diabetes predicted the denial of any further treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Stenting in the treatment of chronic mesenteric ischemia. Technical and clinical success rates

    International Nuclear Information System (INIS)

    Heiss, P.; Zorger, N.; Kaempfe, I.; Jung, E.M.; Paetzel, C.; Feuerbach, S.; Herold, T.; Pfister, K.

    2008-01-01

    Purpose: to evaluate the technical and clinical success rates of percutaneous stent revascularization in the treatment of chronic mesenteric ischemia (CMI). Patients and methods: 17 patients (12 female) with typical symptoms of CMI were treated by percutaneous stent placement for stenoses of the splanchnic arteries (celiac trunk; superior mesenteric artery, SMA; inferior mesenteric artery, IMA). The primary and secondary technical success, primary and secondary clinical success, and the long-term clinical outcome were determined. Results: a total of 24 stents were implanted in 21 splanchnic arteries (12 stents in the celiac trunk, 11 in the SMA and 1 in the IMA). The primary technical success rate was 91% (19/21 arteries), the secondary technical success rate was 95% (21/22 arteries). Clinical follow-up was available for 16 patients. The primary clinical success rate was 81% (13/16 patients). Following two secondary interventions, the secondary clinical success rate was 94% (15/16 patients). Long-term clinical success was achieved in 15 of 16 patients (94%) with a mean follow-up of 26 months. One patient died within 30 days of the intervention and two patients demonstrated major complications (1 dissection, 1 stent dislocation). None of the patients required surgical revascularization and none of the patients died due to recurrent mesenteric ischemia. (orig.)

  12. High-dose-rate brachytherapy in the treatment of uterine cervix cancer. Analysis of dose effectiveness and late complications

    International Nuclear Information System (INIS)

    Ferrigno, Robson; Novaes, Paulo Eduardo Ribeiro dos Santos; Pellizzon, Antonio Cassio Assis; Maia, Maria Aparecida Conte; Fogarolli, Ricardo Cesar; Gentil, Andre Cavalcanti; Salvajoli, Joao Victor

    2001-01-01

    Purpose: This retrospective analysis aims to report results of patients with cervix cancer treated by external beam radiotherapy (EBR) and high-dose-rate (HDR) brachytherapy. Methods and Materials: From September 1992 to December 1996, 138 patients with FIGO Stages II and III and mean age of 56 years were treated. Median EBR to the whole pelvis was 45 Gy in 25 fractions. Parametrial boost was performed in 93% of patients, with a median dose of 14.4 Gy. Brachytherapy with HDR was performed during EBR or following its completion with a dose of 24 Gy in four weekly fractions of 6 Gy to point A. Median overall treatment time was of 60 days. Patient age, tumor stage, and overall treatment time were variables analyzed for survival and local control. Cumulative biologic effective dose (BED) at rectal and bladder reference points were correlated with late complications in these organs and dose of EBR at parametrium was correlated with small bowel complications. Results: Median follow-up time was 38 months. Overall survival, disease-free survival, and local control at 5 years was 53.7%, 52.7%, and 62%, respectively. By multivariate and univariate analysis, overall treatment time up to 50 days was the only statistically significant adverse variable for overall survival (p=0.003) and actuarial local control (p=0.008). The 5-year actuarial incidence of rectal, bladder, and small bowel late complications was 16%, 11%, and 14%, respectively. Patients treated with cumulative BED at rectum points above 110 Gy 3 and at bladder point above 125 Gy 3 had a higher but not statistically significant 5-year actuarial rate of complications at these organs (18% vs. 12%, p=0.49 and 17% vs. 9%, p=0.20, respectively). Patients who received parametrial doses larger than 59 Gy had a higher 5-year actuarial rate of complications in the small bowel; however, this was not statistically significant (19% vs. 10%, p=0.260). Conclusion: This series suggests that 45 Gy to the whole pelvis combined with

  13. Palliative sedation in Germany: factors and treatment practices associated with different sedation rate estimates in palliative and hospice care services.

    Science.gov (United States)

    Stiel, Stephanie; Nurnus, Mareike; Ostgathe, Christoph; Klein, Carsten

    2018-03-13

    Clinical practice of Palliative Sedation (PS) varies between institutions worldwide and sometimes includes problematic practices. Little available research points at different definitions and frameworks which may contribute to uncertainty of healthcare professionals in the application of PS. This analysis investigates what demographic factors and characteristics of treatment practices differ between institutions with high versus low sedation rates estimates in Palliative and Hospice Care in Germany. Data sets from 221 organisations from a prior online survey were separated into two sub-groups divided by their estimated sedation rate A) lower/equal to 16% (n = 187; 90.8%) and B) higher than 16% (n = 19; 9.2%) for secondary analysis. Demographic factors and characteristics of PS treatment practices between the two groups were compared using T-Tests and Chi 2 / Fisher Exact Tests and considered significant (*) at two-sided p palliative and hospice care representatives show divergence, which may be influenced one by another. A comprehensive framework considering conceptual, clinical, ethical, and legal aspects of different definitions of PS could help to better distinguish between different types and nuances of PS.

  14. Combining high-rate aerobic wastewater treatment with anaerobic digestion of waste activated sludge at a pulp and paper mill.

    Science.gov (United States)

    Magnusson, Björn; Ekstrand, Eva-Maria; Karlsson, Anna; Ejlertsson, Jörgen

    2018-05-01

    The activated sludge process within the pulp and paper industry is generally run to minimize the production of waste activated sludge (WAS), leading to high electricity costs from aeration and relatively large basin volumes. In this study, a pilot-scale activated sludge process was run to evaluate the concept of treating the wastewater at high rate with a low sludge age. Two 150 L containers were used, one for aeration and one for sedimentation and sludge return. The hydraulic retention time was decreased from 24 hours to 7 hours, and the sludge age was lowered from 12 days to 2-4 days. The methane potential of the WAS was evaluated using batch tests, as well as continuous anaerobic digestion (AD) in 4 L reactors in mesophilic and thermophilic conditions. Wastewater treatment capacity was increased almost four-fold at maintained degradation efficiency. The lower sludge age greatly improved the methane potential of the WAS in batch tests, reaching 170 NmL CH 4 /g VS at a sludge age of 2 days. In addition, the continuous AD showed a higher methane production at thermophilic conditions. Thus, the combination of high-rate wastewater treatment and AD of WAS is a promising option for the pulp and paper industry.

  15. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Adriana Campos Passanezi Sant'Ana

    2011-04-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17 or IG- "intervention" (n=16. IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP, professional prophylaxis (PROPH and oral hygiene instruction (OHI. NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD, clinical attachment level (CAL, plaque index (PI and sulcular bleeding index (SBI at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (0.05 at IG and worsening of all periodontal parameters at NIG (p<0.0001, except for PI. Signifcant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001. The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. CONCLUSIONS: Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.

  16. Improving the ablation efficiency of excimer laser systems with higher repetition rates through enhanced debris removal and optimized spot pattern.

    Science.gov (United States)

    Arba-Mosquera, Samuel; Klinner, Thomas

    2014-03-01

    To evaluate the reasons for the required increased radiant exposure for higher-repetition-rate excimer lasers and determine experimentally possible compensations to achieve equivalent ablation profiles maintaining the same single-pulse energies and radiant exposures for laser repetition rates ranging from 430 to 1000 Hz. Schwind eye-tech-solutions GmbH and Co. KG, Kleinostheim, Germany. Experimental study. Poly(methyl methacrylate) (PMMA) plates were photoablated. The pulse laser energy was maintained during all experiments; the effects of the flow of the debris removal, the shot pattern for the correction, and precooling the PMMA plates were evaluated in terms of achieved ablation versus repetition rate. The mean ablation performance ranged from 88% to 100%; the variability between the profile measurements ranged from 1.4% to 6.2%. Increasing the laser repetition rate from 430 Hz to 1000 Hz reduced the mean ablation performance from 98% to 91% and worsened the variability from 1.9% to 4.3%. Increasing the flow of the debris removal, precooling the PMMA plates to -18°C, and adapting the shot pattern for the thermal response of PMMA to excimer ablation helped stabilize the variability. Only adapting the shot pattern for the thermal response of PMMA to excimer ablation helped stabilize the mean ablation performance. The ablation performance of higher-repetition-rate excimer lasers on PMMA improved with improvements in the debris removal systems and shot pattern. More powerful debris removal systems and smart shot patterns in terms of thermal response improved the performance of these excimer lasers. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Treatment of Recurrent Bronchial Carcinoma: The Role of High-Dose-Rate Endoluminal Brachytherapy

    International Nuclear Information System (INIS)

    Hauswald, Henrik; Stoiber, Eva; Rochet, Nathalie; Lindel, Katja; Grehn, Christian; Becker, Heinrich D.; Debus, Juergen; Harms, Wolfgang

    2010-01-01

    Purpose: This study's aim was to assess outcome and toxicity of high-dose-rate endoluminal brachytherapy (HDREB) for recurrent bronchial carcinoma. Methods and Materials: From 1987 to 2005, 41 patients were treated with HDREB for symptomatic recurrent bronchial carcinoma. All patients had previously undergone external beam radiotherapy (EBRT) with a median dose of 56 Gy (range, 30-70 Gy). The median HDREB dose applied was 15 Gy (range, 5-29 Gy). The median time interval between primary EBRT and reirradiation was 9 months (range, 2-54 months). Results: After a median follow-up of 6.7 months, the 6-, 12-, and 24-month overall survival rates were 58%, 18%, and 7%, respectively. The median overall survival time was 6.7 months. Local remission was achieved in 73% of patients (n = 30). A total of 24% of patients (n = 10) showed no response or progressive disease within 8 weeks after treatment. In 1 patient, treatment response was not documented. The 6-, 12-, and 24-month local control rates were 38%, 17%, and 3%, respectively. The median local progression-free survival time was 4 months (range, 1-23 months). Prognostic factors were a total dose of ≥15 Gy of HDREB (p = 0.029) and a Karnofsky performance score of ≥80% (p = 0.0012). The cause of death was locoregional progression in 27% of patients (n = 11), distant metastases in 24% of patients (n = 10), fatal hemorrhage in 15% of patients (n = 6), and other causes in 29% of patients (n = 12). None of the patients with locally controlled disease showed grade 3 or 4 late effects. Conclusions: Palliative treatment of symptomatic, locally recurrent bronchial carcinoma with HDREB can effectively relieve symptoms in the majority of patients while causing only few complications. Still, time to progression is short.

  18. Opioid treatment and hypoalbuminemia are associated with increased hospitalisation rates in chronic pancreatitis outpatients.

    Science.gov (United States)

    Olesen, Søren S; Poulsen, Jakob Lykke; Broberg, Marie C H; Madzak, Adnan; Drewes, Asbjørn M

    2016-01-01

    Chronic pancreatitis (CP) is a complex and debilitating disease with high resource utilisation. Prospective data on hospital admission rates and associated risk factors are scarce. We investigated hospitalisation rates, causes of hospitalisations and associated risk factors in CP outpatients. This was a prospective cohort study comprising 170 patients with CP. The primary outcome was time to first pancreatitis related hospitalisation and secondary outcomes were the annual hospitalisation frequency (hospitalisation burden) and causes of hospitalisations. A number of clinical and demographic parameters, including pain pattern and severity, opioid use and parameters related to the nutritional state, were analysed for their association with hospitalisation rates. Of the 170 patients, 57 (33.5%) were hospitalised during the follow-up period (median 11.4 months [IQR 3.8-26.4]). The cumulative hospitalisation incidence was 7.6% (95% CI; 4.5-12.2) after 30 days and 28.8% (95% CI; 22.2-35.7) after 1 year. Eighteen of the hospitalised patients (32%) had three or more admissions per year. High dose opioid treatment (>100 mg per day) (Hazard Ratio 3.1 [95% CI; 1.1-8.5]; P = 0.03) and hypoalbuminemia (risk factors for hospitalisation. The most frequent causes of hospitalisations were pain exacerbation (40%) and common bile duct stenosis (28%). One-third of CP outpatients account for the majority of hospital admissions and associated risk factors are high dose opioid treatment and hypoalbuminemia. This information should be implemented in outpatient monitoring strategies to identify risk patients and improve treatment. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  19. Interferon alpha 2 maintenance therapy may enable high rates of treatment discontinuation in chronic myeloid leukemia.

    Science.gov (United States)

    Burchert, A; Saussele, S; Eigendorff, E; Müller, M C; Sohlbach, K; Inselmann, S; Schütz, C; Metzelder, S K; Ziermann, J; Kostrewa, P; Hoffmann, J; Hehlmann, R; Neubauer, A; Hochhaus, A

    2015-06-01

    A minority of chronic myeloid leukemia (CML) patients is capable of successfully discontinuing imatinib. Treatment modalities to increase this proportion are currently unknown. Here, we assessed the role of interferon alpha 2a (IFN) on therapy discontinuation in a previously reported cohort of 20 chronic phase CML patients who were treated upfront with IFN alpha plus imatinib followed by IFN monotherapy to maintain cytogenetic or molecular remission (MR) after imatinib discontinuation. After a median follow-up of 7.9 years (range, 5.2-12.2), relapse-free survival was 73% (8/11 patients) and 84% (5/6 patients) for patients who discontinued imatinib in major MR (MMR) and MR4/MR4.5, respectively. Ten patients discontinued IFN after a median of 4.5 years (range, 0.24-9.3). After a median of 2.8 years (range, 0.7-5.1), nine of them remain in ongoing treatment-free remission with MR5 (n=6) and MR4.5 (n=3). The four patients who still administer IFN are in stable MR5, MR4.5, MR4, and MMR, respectively. In conclusion, an IFN/imatinib induction treatment followed by a temporary IFN maintenance therapy may enable a high rate of treatment discontinuation in CML patients in at least MMR when stopping imatinib.

  20. Increased rate of treatment with antidepressants in patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Harhoff, Mette; Andersen, Per Kragh

    2008-01-01

    The prevalence of depression and anxiety is increased in patients with multiple sclerosis, but it has not been investigated whether these conditions are treated in clinical practice. The objective of this study was to investigate whether the rate of treatment with antidepressants is increased...... in patients with multiple sclerosis compared with patients with other chronic illnesses and compared with the general population. By linkage of nationwide case registers, all patients were identified, who had received a main diagnosis of multiple sclerosis or osteoarthritis at first admission or during...... outpatient contact in the period 1995-2000 in Denmark. Rates of subsequent purchase of antidepressants for these patients were calculated. In total, 417 patients with a main diagnosis of multiple sclerosis and 12 127 patients with a main diagnosis of osteoarthritis, at first discharge from hospital...

  1. Older Adults With a Combination of Vision and Hearing Impairment Experience Higher Rates of Cognitive Impairment, Functional Dependence, and Worse Outcomes Across a Set of Quality Indicators.

    Science.gov (United States)

    Davidson, Jacob G S; Guthrie, Dawn M

    2017-08-01

    Hearing and vision impairment were examined across several health-related outcomes and across a set of quality indicators (QIs) in home care clients with both vision and hearing loss (or dual sensory impairment [DSI]). Data collected using the Resident Assessment Instrument for Home Care (RAI-HC) were analyzed in a sample of older home care clients. The QIs represent the proportion of clients experiencing negative outcomes (e.g., falls, social isolation). The average age of clients was 82.8 years ( SD = 7.9), 20.5% had DSI and 8.5% had a diagnosis of Alzheimer's disease (AD). Clients with DSI were more likely to have a diagnosis of dementia (not AD), have functional impairments, report loneliness, and have higher rates across 20 of the 22 QIs, including communication difficulty and cognitive decline. Clients with highly impaired hearing, and any visual impairment, had the highest QI rates. Individuals with DSI experience higher rates of adverse events across many health-related outcomes and QIs. Understanding the unique contribution of hearing and vision in this group can promote optimal quality of care.

  2. Effects of Heating Rate on the Dynamic Tensile Mechanical Properties of Coal Sandstone during Thermal Treatment

    Directory of Open Access Journals (Sweden)

    Ming Li

    2017-01-01

    Full Text Available The effects of coal layered combustion and the heat injection rate on adjacent rock were examined in the process of underground coal gasification and coal-bed methane mining. Dynamic Brazilian disk tests were conducted on coal sandstone at 800°C and slow cooling from different heating rates by means of a Split Hopkinson Pressure Bar (SHPB test system. It was discovered that thermal conditions had significant effects on the physical and mechanical properties of the sandstone including longitudinal wave velocity, density, and dynamic linear tensile strength; as the heating rates increased, the thermal expansion of the sandstone was enhanced and the damage degree increased. Compared with sandstone at ambient temperature, the fracture process of heat-treated sandstone was more complicated. After thermal treatment, the specimen had a large crack in the center and cracks on both sides caused by loading; the original cracks grew and mineral particle cracks, internal pore geometry, and other defects gradually appeared. With increasing heating rates, the microscopic fracture mode transformed from ductile fracture to subbrittle fracture. It was concluded that changes in the macroscopic mechanical properties of the sandstone were result from changes in the composition and microstructure.

  3. Effect of loading rate variation on soybean protein wastewater treatment by UASB reactor

    Science.gov (United States)

    Sun, Yi; Li, Yongfeng; Guo, Zi-rui; Jiao, An-ying; Han, Wei; Yang, Chuan-ping

    2010-11-01

    In order to improve the efficiency and evaluate the feasibility of anaerobic digestion for treatment of soybean protein wastewater. The stability and performance of the Up-Flow Anaerobic Sludge Blanket (UASB) process was investigated at different organic loading rates (OLRS) and hydraulic retention times over 200 days. When chemical oxygen demand (COD) reached maximum, the loading rate was adjusted in a small way and indicators such as VFA, pH and COD in effluent as well as gas production are observed. These experimental results clearly showed that, the most proper corresponding organic loading rate (OLR) and hydraulic retention time were 6 kg/ (m3ṡd) (COD = 6000 mg/L) and 24 h respectively. Up to 85% of COD was removed and the CH4 production rate of 3.2 m3/(m3ṡd) was obtained. The produced biogas contained 72% of CH4. In the mean time, anaerobic sludge multiplies more faster and exiguous particles appeared. Granules with diameter 1-3 mm.

  4. Surface treatments for controlling corrosion rate of biodegradable Mg and Mg-based alloy implants

    International Nuclear Information System (INIS)

    Uddin, M S; Hall, Colin; Murphy, Peter

    2015-01-01

    Due to their excellent biodegradability characteristics, Mg and Mg-based alloys have become an emerging material in biomedical implants, notably for repair of bone as well as coronary arterial stents. However, the main problem with Mg-based alloys is their rapid corrosion in aggressive environments such as human bodily fluids. Previously, many approaches such as control of alloying materials, composition and surface treatments, have been attempted to regulate the corrosion rate. This article presents a comprehensive review of recent research focusing on surface treatment techniques utilised to control the corrosion rate and surface integrity of Mg-based alloys in both in vitro and in vivo environments. Surface treatments generally involve the controlled deposition of thin film coatings using various coating processes, and mechanical surfacing such as machining, deep rolling or low plasticity burnishing. The aim is to either make a protective thin layer of a material or to change the micro-structure and mechanical properties at the surface and sub-surface levels, which will prevent rapid corrosion and thus delay the degradation of the alloys. We have organised the review of past works on coatings by categorising the coatings into two classes—conversion and deposition coatings—while works on mechanical treatments are reviewed based on the tool-based processes which affect the sub-surface microstructure and mechanical properties of the material. Various types of coatings and their processing techniques under two classes of coating and mechanical treatment approaches have been analysed and discussed to investigate their impact on the corrosion performance, biomechanical integrity, biocompatibility and cell viability. Potential challenges and future directions in designing and developing the improved biodegradable Mg/Mg-based alloy implants were addressed and discussed. The literature reveals that no solutions are yet complete and hence new and innovative approaches

  5. Surface treatments for controlling corrosion rate of biodegradable Mg and Mg-based alloy implants

    Science.gov (United States)

    Uddin, M S; Hall, Colin; Murphy, Peter

    2015-01-01

    Due to their excellent biodegradability characteristics, Mg and Mg-based alloys have become an emerging material in biomedical implants, notably for repair of bone as well as coronary arterial stents. However, the main problem with Mg-based alloys is their rapid corrosion in aggressive environments such as human bodily fluids. Previously, many approaches such as control of alloying materials, composition and surface treatments, have been attempted to regulate the corrosion rate. This article presents a comprehensive review of recent research focusing on surface treatment techniques utilised to control the corrosion rate and surface integrity of Mg-based alloys in both in vitro and in vivo environments. Surface treatments generally involve the controlled deposition of thin film coatings using various coating processes, and mechanical surfacing such as machining, deep rolling or low plasticity burnishing. The aim is to either make a protective thin layer of a material or to change the micro-structure and mechanical properties at the surface and sub-surface levels, which will prevent rapid corrosion and thus delay the degradation of the alloys. We have organised the review of past works on coatings by categorising the coatings into two classes—conversion and deposition coatings—while works on mechanical treatments are reviewed based on the tool-based processes which affect the sub-surface microstructure and mechanical properties of the material. Various types of coatings and their processing techniques under two classes of coating and mechanical treatment approaches have been analysed and discussed to investigate their impact on the corrosion performance, biomechanical integrity, biocompatibility and cell viability. Potential challenges and future directions in designing and developing the improved biodegradable Mg/Mg-based alloy implants were addressed and discussed. The literature reveals that no solutions are yet complete and hence new and innovative approaches

  6. Central nervous system tumours among adolescents and young adults (15-39 years) in Southern and Eastern Europe: Registration improvements reveal higher incidence rates compared to the US.

    Science.gov (United States)

    Georgakis, Marios K; Panagopoulou, Paraskevi; Papathoma, Paraskevi; Tragiannidis, Athanasios; Ryzhov, Anton; Zivkovic-Perisic, Snezana; Eser, Sultan; Taraszkiewicz, Łukasz; Sekerija, Mario; Žagar, Tina; Antunes, Luis; Zborovskaya, Anna; Bastos, Joana; Florea, Margareta; Coza, Daniela; Demetriou, Anna; Agius, Domenic; Strahinja, Rajko M; Sfakianos, Georgios; Nikas, Ioannis; Kosmidis, Sofia; Razis, Evangelia; Pourtsidis, Apostolos; Kantzanou, Maria; Dessypris, Nick; Petridou, Eleni Th

    2017-11-01

    To present incidence of central nervous system (CNS) tumours among adolescents and young adults (AYAs; 15-39 years) derived from registries of Southern and Eastern Europe (SEE) in comparison to the Surveillance, Epidemiology and End Results (SEER), US and explore changes due to etiological parameters or registration improvement via evaluating time trends. Diagnoses of 11,438 incident malignant CNS tumours in AYAs (1990-2014) were retrieved from 14 collaborating SEE cancer registries and 13,573 from the publicly available SEER database (1990-2012). Age-adjusted incidence rates (AIRs) were calculated; Poisson and joinpoint regression analyses were performed for temporal trends. The overall AIR of malignant CNS tumours among AYAs was higher in SEE (28.1/million) compared to SEER (24.7/million). Astrocytomas comprised almost half of the cases in both regions, albeit the higher proportion of unspecified cases in SEE registries (30% versus 2.5% in SEER). Similar were the age and gender distributions across SEE and SEER with a male-to-female ratio of 1.3 and an overall increase of incidence by age. Increasing temporal trends in incidence were documented in four SEE registries (Greater Poland, Portugal North, Turkey-Izmir and Ukraine) versus an annual decrease in Croatia (-2.5%) and a rather stable rate in SEER (-0.3%). This first report on descriptive epidemiology of AYAs malignant CNS tumours in the SEE area shows higher incidence rates as compared to the United States of America and variable temporal trends that may be linked to registration improvements. Hence, it emphasises the need for optimisation of cancer registration processes, as to enable the in-depth evaluation of the observed patterns by disease subtype. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Higher than standard radiation doses (≥72 Gy) with or without androgen deprivation in the treatment of localized prostate cancer

    International Nuclear Information System (INIS)

    Kupelian, Patrick A.; Mohan, Dasarahally S.; Lyons, Janice; Klein, Eric A.; Reddy, Chandana A.

    2000-01-01

    ), iPSA (continuous variable), bGS (≤6 vs. ≥7), use of AD (yes vs. no), radiation technique (conformal versus standard), and radiation dose (continuous variable). T-stage (p < 0.001), iPSA (p < 0.001), bGS (p < 0.001), and RT dose (p < 0.001) were independent predictors of outcome. Age (p = 0.74), race (p = 0.96), radiation technique (p = 0.15), and use of AD (p = 0.31) were not. We observed 11% clinical failures (local, distant, or both) at 5 years and 15% at 8 years for the entire cohort. There was a statistically significant improvement with higher radiation doses (p 0.032). The 5-year clinical relapse rates for patients receiving ≥72 Gy versus <72 Gy were 5% and 12%, respectively. The 8-year clinical relapse rates for patients receiving radiation doses ≥72 Gy versus <72 Gy were 5% and 17%, respectively (p = 0.026). Conclusion: Patients receiving radiation doses exceeding 72 Gy had significantly better bRFS and clinical disease-free survival rates. Although results need to be confirmed with longer follow-up, these preliminary results are extremely encouraging. If these results are confirmed by other institutions and by longer follow-up, RT doses exceeding 72 Gy should be considered as standard of care

  8. Persistence, switch rates, drug consumption and costs of biological treatment of rheumatoid arthritis: an observational study in Italy

    Directory of Open Access Journals (Sweden)

    Degli Esposti L

    2016-12-01

    treatment than adalimumab or infliximab. Etanercept was characterized by the lowest number of patients increasing the initial drug consumption (2.6% and by the highest number of patients reducing the initial drug consumption (10.5%. The mean cost of treatment for a patient persisting with the initial treatment was €12,388 (€14,182 for adalimumab, €12,103 for etanercept and €11,002 for infliximab. The treatment costs for patients switching from initial treatment during the first year of follow-up were higher than for patients who did not switch (€12,710 vs. €11,332.Conclusion: Persistence, switch rate and drug consumption seem to directly influence treatment costs. In subjects not persisting with initial treatment, other health care costs were approximately three times higher than for persistent patients. This difference could suggest a positive effect on the quality of life for persistent patients. Etanercept showed the highest persistence with treatment. Keywords: rheumatoid arthritis, biologic drugs, real-life clinical conditions

  9. Enhancing Brain Lesions during Acute Optic Neuritis and/or Longitudinally Extensive Transverse Myelitis May Portend a Higher Relapse Rate in Neuromyelitis Optica Spectrum Disorders.

    Science.gov (United States)

    Orman, G; Wang, K Y; Pekcevik, Y; Thompson, C B; Mealy, M; Levy, M; Izbudak, I

    2017-05-01

    Neuromyelitis optica spectrum disorders are inflammatory demyelinating disorders with optic neuritis and/or longitudinally extensive transverse myelitis episodes. We now know that neuromyelitis optica spectrum disorders are associated with antibodies to aquaporin-4, which are highly concentrated on astrocytic end-feet at the blood-brain barrier. Immune-mediated disruption of the blood-brain barrier may manifest as contrast enhancement on brain MR imaging. We aimed to delineate the extent and frequency of contrast enhancement on brain MR imaging within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and to correlate contrast enhancement with outcome measures. Brain MRIs of patients with neuromyelitis optica spectrum disorders were evaluated for patterns of contrast enhancement (periependymal, cloudlike, leptomeningeal, and so forth). The Fisher exact test was used to evaluate differences between the proportion of contrast enhancement in patients who were seropositive and seronegative for aquaporin-4 antibodies. The Mann-Whitney test was used to compare the annualized relapse rate and disease duration between patients with and without contrast enhancement and with and without seropositivity. Brain MRIs of 77 patients were evaluated; 59 patients (10 males, 49 females) were scanned within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and were included in the analysis. Forty-eight patients were seropositive, 9 were seronegative, and 2 were not tested for aquaporin-4 antibodies. Having brain contrast enhancement of any type during an acute attack was significantly associated with higher annualized relapse rates ( P = .03) and marginally associated with shorter disease duration ( P = .05). Having periependymal contrast enhancement was significantly associated with higher annualized relapse rates ( P = .03). Brain MRIs of patients with neuromyelitis optica spectrum disorders with contrast

  10. Higher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection.

    LENUS (Irish Health Repository)

    O'Seaghdha, C M

    2011-04-06

    We analyzed the association between whole-blood trough tacrolimus (TAC) levels in the first days post-kidney transplant and acute cellular rejection (ACR) rates. Four hundred and sixty-four consecutive, deceased-donor kidney transplant recipients were included. All were treated with a combination of TAC, mycophenolate mofetil and prednisolone. Patients were analyzed in four groups based on quartiles of the mean TAC on days 2 and 5 post-transplant: Group 1: median TAC 11 ng\\/mL (n = 122, range 2-13.5 ng\\/mL), Group 2: median 17 ng\\/mL (n = 123, range 14-20 ng\\/mL), Group 3: median 24 ng\\/mL (n = 108, range 20.5-27 ng\\/mL) and Group 4: median 33.5 ng\\/mL (n = 116, range 27.5-77.5 ng\\/mL). A graded reduction in the rates of ACR was observed for each incremental days 2-5 TAC. The one-yr ACR rate was 24.03% (95% CI 17.26-32.88), 22.20% (95% CI 15.78-30.70), 13.41% (95% CI 8.15-21.63) and 8.69% (95% CI 4.77-15.55) for Groups 1-4, respectively (p = 0.003). This study suggests that higher early TACs are associated with reduced rates of ACR at one yr.

  11. Meta-analysis of rates of erectile function after treatment of localized prostate carcinoma

    International Nuclear Information System (INIS)

    Robinson, John W.; Moritz, Sabine; Fung, Tak

    2002-01-01

    Purpose: The results of a 1997 meta-analysis of the rates of erectile function after external beam radiotherapy (EBRT) and radical prostatectomy have been widely used in patient and professional education materials and as a reference against which new findings are compared. With a number of recent publications, it is now possible to update this analysis and compare brachytherapy with or without EBRT with EBRT alone, standard and nerve-sparing radical prostatectomy, and cryotherapy. Methods: A comprehensive literature review and subsequent meta-analysis of the rates of erectile dysfunction associated with the treatments of localized prostate carcinoma was conducted. A simple logistic regression analysis was used to combine the data from the 54 articles that met the selection criteria. Results: The predicted probability of maintaining erectile function after brachytherapy was 0.76, after brachytherapy plus EBRT 0.60, after EBRT 0.55, after nerve-sparing radical prostatectomy 0.34, after standard radical prostatectomy 0.25, and after cryotherapy 0.13. When only studies reporting ≥2 years follow-up were considered, the only significant change was a decline in the probability for nerve-sparing radical prostatectomy. No brachytherapy studies had a follow-up of ≥2 years. When the probabilities were adjusted for age, the spread between the RT methods and surgical approaches was greater. Conclusion: The differences in the probability of maintaining erectile function after different treatments of localized prostate cancer are significant

  12. Mini-review: high rate algal ponds, flexible systems for sustainable wastewater treatment.

    Science.gov (United States)

    Young, P; Taylor, M; Fallowfield, H J

    2017-06-01

    Over the last 20 years, there has been a growing requirement by governments around the world for organisations to adopt more sustainable practices. Wastewater treatment is no exception, with many currently used systems requiring large capital investment, land area and power consumption. High rate algal ponds offer a sustainable, efficient and lower cost option to the systems currently in use. They are shallow, mixed lagoon based systems, which aim to maximise wastewater treatment by creating optimal conditions for algal growth and oxygen production-the key processes which remove nitrogen and organic waste in HRAP systems. This design means they can treat wastewater to an acceptable quality within a fifth of time of other lagoon systems while using 50% less surface area. This smaller land requirement decreases both the construction costs and evaporative water losses, making larger volumes of treated water available for beneficial reuse. They are ideal for rural, peri-urban and remote communities as they require minimum power and little on-site management. This review will address the history of and current trends in high rate algal pond development and application; a comparison of their performance with other systems when treating various wastewaters; and discuss their potential for production of added-value products. Finally, the review will consider areas requiring further research.

  13. Effect of Pertubation on Pregnancy Rates before Intrauterine Insemination Treatment in Patients with Unexplained Infertility

    Directory of Open Access Journals (Sweden)

    Funda Yildiz

    2014-03-01

    Full Text Available Background: The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. Materials and Methods: In this prospective randomized study, a total of 180 patients were included in the study. Amongst these, pertubation of the uterine cavity was carried out in 79 patients prior to insemination. One patient in the pertubation group was later excluded because insemination could not be performed due to cycle cancellation. Results: There were no significant differences in demographic characteristics between the study and control groups. When the pregnancy rates of both groups were evaluated, 14(17.8% patients in the study group achieved pregancy. Three (3.8% had a biochemical pregnancy, 1(1.3% miscarried and 10(12.7% had live births. In the control group, a total of 24(23.8% pregnancies were achieved, amongst which one (1% had a biochemical pregnancy, 3(3% miscarried and 20(19.8% resulted in live births. There was no significant difference between groups in terms of total pregnancy and live birth rates (p>0.05. There was a 21% total pregnancy loss rate. There was no significant difference between the control and study groups in terms of pregnancy loss rates (p>0.05. Conclusion: This study on a homogenous group of unexplained infertile patients determined that the addition of pertubation to a controlled ovarian hyperstimulation plus intrauterine insemination (COH+IUI treatment protocol did not affect pregnancy rates (Registration Number: NCT01999959.

  14. Treatment outcome with low-dose-rate interstitial brachytherapy in early-stage oral tongue cancers

    Directory of Open Access Journals (Sweden)

    Bhalavat Rajendra

    2009-01-01

    Full Text Available Purpose : Although radical radiotherapy is known to be equally effective for early-stage oral tongue cancers (T1-2 N0 with the added advantage of organ and function preservation, surgery remains the preferred treatment. We present outcome of patients treated with brachytherapy (BT either radical or boost. Materials and Methods : Fifty-seven patients (T1/T2 31/26 were studied. Seventeen patients (30% were treated with radical BT (50-67 Gy while 40 (70% with external beam radiation therapy (EBRT + BT (36-56 Gy + 15-38 Gy]. Low-dose-rate (LDR BT was delivered with 192 Ir wires, using plastic bead technique with varied dose rates (< 60 cGy/h in 29 patients, 60-90 cGy/h in 17, and> 90 cGy/h in 11. Results : The overall local control (LCR was achieved in 59.7% (34/57 patients. LCR for T1 and T2 was 67.8% and 50%, respectively. A total of 23 patients had failures [local: 20 (T1: 8; T2: 12 patients, node: 5 (T1:2; T2: 3, and local + nodal: 3]. Overall 5-year disease-free survival and overall survival (OAS were 51% and 67%, respectively and those for T1 and T2 was 64.5/77.4% and 38.5/54% respectively (P = 0.002. All 16 patients were salvaged. Median survival after salvage treatment was 13.5 months (6-100 months. Soft tissue necrosis was observed in 12.3% (7/57 and osteoradionecrosis in two patients. Conclusion : BT, as an integral part of radical radiation therapy in early-stage tongue cancers, appears to be an effective alternative treatment modality with preservation of the organ and function without jeopardizing the outcome.

  15. Relapse rate of uveitis post-methotrexate treatment in juvenile idiopathic arthritis.

    Science.gov (United States)

    Kalinina Ayuso, Viera; van de Winkel, Evelyne Leonce; Rothova, Aniki; de Boer, Joke Helena

    2011-02-01

    To evaluate the efficacy of methotrexate (MTX) and the effect of its withdrawal on relapse rate of uveitis associated with juvenile idiopathic arthritis (JIA). Retrospective case series. Data of 22 pediatric JIA patients who were being treated with MTX for active uveitis were studied retrospectively. Relapse rate after the withdrawal of MTX was established. Anterior chamber (AC) inflammation, topical steroid use during the first year of MTX treatment, and associations of relapses after the withdrawal were evaluated statistically. Duration of MTX treatment and its withdrawal was determined individually in collaboration with a rheumatologist with an intention to continue the treatment for at least 1 year and to withdraw in case of inactivity of uveitis and arthritis. Inactivity of uveitis was defined as the presence of ≤0.5+ cells in the AC. Eighteen patients (18/22; 82%) showed improvement of their uveitis with a significant decrease in activity of AC inflammation after a minimal period of 3 months of MTX treatment. A topical steroid-sparing effect was observed when MTX was administered for a period of 3 to 9 months. MTX was discontinued because of inactive uveitis in 13 patients. In 9 patients (8/13; 69%) a relapse of uveitis was observed after a mean time of 7.5 months (± SD 7.3). Six patients (6/13; 46%) had a relapse within the first year after the withdrawal. Relapse-free survival after withdrawal of MTX was significantly longer in patients who had been treated with MTX for more than 3 years (P = .009), children who were older than 8 years at the moment of withdrawal (P = .003), and patients who had an inactivity of uveitis of longer than 2 years before withdrawal of MTX (P = .033). Longer inactivity under MTX therapy was independently protective for relapses after the withdrawal (hazard ratio = 0.07; 95% confidence interval 0.01-0.86; P = .038), which means that 1-year increase of duration of inactive uveitis before the withdrawal of MTX results in a

  16. Volatile amines treatment: Corrosion rates and Atucha I nuclear power plant experience

    International Nuclear Information System (INIS)

    Iglesias, Alberto M.; Jimenez Rebagliati, Raul; Raffo Calderon, Maria C.; Manzi, Ricardo

    2000-01-01

    Steam generators water treatment with volatile amines in place of ammonia is usual today. This option seems an acceptable alternative to the generalize use of ammonia-sodium phosphate and has advantages when copper alloys are present. There are several amines that can work as corrosion inhibitor but the most useful for plant applications are: morpholine, ethanolamine and cyclohexylamine. In this work, are present the obtained results of corrosion rates measurements by electrochemical methods. The hydrothermal conditions of our experiences were similar to that of the Atucha I nuclear power plant (CNA I). pH, conductivity and dissolved oxygen measures were correlated with corrosion rates of the CNA I materials as carbon steel and admiralty brass. The faradaic impedance spectroscopy techniques allows a more detailed interpretation of corrosion rates process. Morpholine and ammonia behavior can be evaluated under power plant operations conditions with the accumulated experience of CNA I. Results are present throughout material release and his effects over heat transfer parameters. (author)

  17. A win for the patient: Direct patient notification improves treatment rates of active Helicobacter pylori infection.

    Science.gov (United States)

    Selvaratnam, Sriharan; Yeoh, Joey; Hsiang, John; Patrick, Alasdair B

    2014-01-01

    Current international guidelines recommend the commencement of effective eradication therapy as soon as active Helicobacter pylori (H. pylori) infection is confirmed. At our institution, all positive Campylobacter-like Organism (CLO) test results were automatically communicated to general practitioners (GPs) via a standardised letter, which also advised the commencement of eradication therapy. Despite this endeavour, a clinical audit conducted in 2011 demonstrated that only 66 per cent of confirmed H. pylori-positive South Auckland patients received eradication treatment and only 83 per cent of these patients received treatment within one month. Improve the timely initiation of H. pylori eradication therapy through direct patient notification. A prospective clinical audit of 109 consecutive outpatients with a positive CLO test identified at gastroscopy. In addition to standard general practitioner notification, patients were also directly notified of their positive CLO test result via a standardised letter, which provided information about H. pylori and its disease associations as well as advising patients to seek consultation with their GP to commence eradication therapy. Dispensing data was examined using Test Safe electronic records to determine the total uptake and timing of treatment compared to data from a preliminary 2011 audit. Ninety-five per cent of H. pylori-positive patients received standard triple therapy; therefore, treatment of active H. pylori infection was significantly higher when patients were directly notified in addition to standard GP notification, when compared to GP notification alone (95 per cent vs 66 per cent, paudit in 2011 (100 per cent vs. 83 per cent, pstrategy that significantly improves the timely initiation of eradication therapy for active H. pylori infection. This has since been integrated into standard practice at our District Health Board (DHB).

  18. An analysis of acute complications and perioperative morbidity from high dose rate brachytherapy in the treatment of gynecological malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Sarkaria, Jann N; Petereit, Daniel G; Kinsella, Timothy J; Buchler, Dolores A

    1995-07-01

    Purpose: To evaluate the acute morbidity and mortality for high dose-rate (HDR) brachytherapy performed in an outpatient setting in the treatment of gynecological malignancies, and to identify possible risk factors for adverse outcomes. Materials and Methods: One hundred seventy-one patients with cervical (n=129) or uterine (n=42) carcinoma with an intact uterus were evaluated and treated from August 1989 through December 1994, with at least part of their therapy delivered with intracavitary HDR {sup 192}Ir radiation. A total of 830 ICR insertions were performed with greater than 95% done on an outpatient basis under heavy intravenous sedation using fentanyl and midazolam. Perioperative morbidity and mortality were recorded for any event occurring within 30 days of the completion of therapy. Anesthesia risk was evaluated retrospectively in all patients based on the American Society of Anesthesiologists' (ASA) Physical Class System. Results: The uterine patients, many treated with radiation alone because of morbid obesity or medical inoperability, had a significantly higher perioperative morbidity and mortality rate as compared to the cervix patient cohort. Thirteen of the 42 (31%) uterine patients and 8 of the 129 (6%) cervix patients required hospitalization within 30 days of treatment completion (p<0.001). Four of these uterine patients (10%) died of medical complications related to therapy or disease progression within 30 days, while 2 of the cervix patients (1.5%) died: one from disease progression and the other due to radiation enteritis (p=0.05). Preliminary analysis suggests that uterine patients with a high anesthesia risk score (ASA>2) experienced greater morbidity and mortality, while the best predictor of complications in the cervix patients was age greater than 70 years. For the entire cohort of patients, no correlation was found between the 30 day morbidity and mortality and the doses of fentanyl and midazolam used or the length of the procedure

  19. Obstructive urination problems after high-dose-rate brachytherapy boost treatment for prostate cancer are avoidable

    International Nuclear Information System (INIS)

    Kragelj, Borut

    2016-01-01

    Aiming at improving treatment individualization in patients with prostate cancer treated with combination of external beam radiotherapy and high-dose-rate brachytherapy to boost the dose to prostate (HDRB-B), the objective was to evaluate factors that have potential impact on obstructive urination problems (OUP) after HDRB-B. In the follow-up study 88 patients consecutively treated with HDRB-B at the Institute of Oncology Ljubljana in the period 2006-2011 were included. The observed outcome was deterioration of OUP (DOUP) during the follow-up period longer than 1 year. Univariate and multivariate relationship analysis between DOUP and potential risk factors (treatment factors, patients’ characteristics) was carried out by using binary logistic regression. ROC curve was constructed on predicted values and the area under the curve (AUC) calculated to assess the performance of the multivariate model. Analysis was carried out on 71 patients who completed 3 years of follow-up. DOUP was noted in 13/71 (18.3%) of them. The results of multivariate analysis showed statistically significant relationship between DOUP and anti-coagulation treatment (OR 4.86, 95% C.I. limits: 1.21-19.61, p = 0.026). Also minimal dose received by 90% of the urethra volume was close to statistical significance (OR = 1.23; 95% C.I. limits: 0.98-1.07, p = 0.099). The value of AUC was 0.755. The study emphasized the relationship between DOUP and anticoagulation treatment, and suggested the multivariate model with fair predictive performance. This model potentially enables a reduction of DOUP after HDRB-B. It supports the belief that further research should be focused on urethral sphincter as a critical structure for OUP

  20. Obstructive urination problems after high-dose-rate brachytherapy boost treatment for prostate cancer are avoidable.

    Science.gov (United States)

    Kragelj, Borut

    2016-03-01

    Aiming at improving treatment individualization in patients with prostate cancer treated with combination of external beam radiotherapy and high-dose-rate brachytherapy to boost the dose to prostate (HDRB-B), the objective was to evaluate factors that have potential impact on obstructive urination problems (OUP) after HDRB-B. In the follow-up study 88 patients consecutively treated with HDRB-B at the Institute of Oncology Ljubljana in the period 2006-2011 were included. The observed outcome was deterioration of OUP (DOUP) during the follow-up period longer than 1 year. Univariate and multivariate relationship analysis between DOUP and potential risk factors (treatment factors, patients' characteristics) was carried out by using binary logistic regression. ROC curve was constructed on predicted values and the area under the curve (AUC) calculated to assess the performance of the multivariate model. Analysis was carried out on 71 patients who completed 3 years of follow-up. DOUP was noted in 13/71 (18.3%) of them. The results of multivariate analysis showed statistically significant relationship between DOUP and anti-coagulation treatment (OR 4.86, 95% C.I. limits: 1.21-19.61, p = 0.026). Also minimal dose received by 90% of the urethra volume was close to statistical significance (OR = 1.23; 95% C.I. limits: 0.98-1.07, p = 0.099). The value of AUC was 0.755. The study emphasized the relationship between DOUP and anticoagulation treatment, and suggested the multivariate model with fair predictive performance. This model potentially enables a reduction of DOUP after HDRB-B. It supports the belief that further research should be focused on urethral sphincter as a critical structure for OUP.

  1. Tetracycline removal during wastewater treatment in high-rate algal ponds

    International Nuclear Information System (INIS)

    Godos, Ignacio de; Muñoz, Raúl; Guieysse, Benoit

    2012-01-01

    Highlights: ► Tetracycline removal was most likely caused by photodegradation and biosorption. ► Tetracycline presence was linked to biomass deflocculation and poor settleability. ► Deflocculation did not impact treatment efficiency. ► Deflocculation may hamper biomass recover during full-scale treatment. - Abstract: With the hypothesis that light supply can impact the removal of veterinary antibiotics during livestock wastewater treatment in high rate algal ponds (HRAPs), this study was undertaken to determine the mechanisms of tetracycline removal in these systems. For this purpose, two HRAPs were fed with synthetic wastewater for 46 days before tetracycline was added at 2 mg L −1 to the influent of one of the reactors (Te-HRAP). From day 62, dissolved tetracycline removal stabilized around 69 ± 1% in the Te-HRAP and evidence from batch assays suggests that this removal was mainly caused by photodegradation and biosorption. Tetracycline addition was followed by the deflocculation of the Te-HRAP biomass but had otherwise no apparent impact on the removal of the chemical oxygen demand (COD) and biomass productivity. The results from the batch assays also suggested that the light-shading and/or pollutant-sequestrating effects of the biomass limited tetracycline removal in the pond. For the first time, these results demonstrate that the shallow geometry of HRAPs is advantageous to support the photodegradation of antibiotics during wastewater biological treatment but that the presence of these pollutants could hamper biomass recovery. These findings have significant implications for algal-based environmental biotechnologies and must be confirmed under field conditions.

  2. Ways to be different: Foraging adaptations that facilitate higher intake rates in a northerly wintering shorebird compared with a low-latitude conspecific

    Science.gov (United States)

    Ruthrauff, Daniel R.; Dekinga, Anne; Gill, Robert E.; van Gils, Jan A.; Piersma, Theunis

    2015-01-01

    At what phenotypic level do closely related subspecies that live in different environments differ with respect to food detection, ingestion and processing? This question motivated an experimental study on rock sandpipers (Calidris ptilocnemis). The species' nonbreeding range spans 20 deg of latitude, the extremes of which are inhabited by two subspecies: C. p. ptilocnemis that winters primarily in upper Cook Inlet, Alaska (61°N) and C. p. tschuktschorum that overlaps slightly with C. p. ptilocnemis but whose range extends much farther south (∼40°N). In view of the strongly contrasting energetic demands of their distinct nonbreeding distributions, we conducted experiments to assess the behavioral, physiological and sensory aspects of foraging and we used the bivalve Macoma balthica for all trials. C. p. ptilocnemis consumed a wider range of prey sizes, had higher maximum rates of energy intake, processed shell waste at higher maximum rates and handled prey more quickly. Notably, however, the two subspecies did not differ in their abilities to find buried prey. The subspecies were similar in size and had equally sized gizzards, but the more northern ptilocnemis individuals were 10–14% heavier than their same-sex tschuktschorum counterparts. The higher body mass in ptilocnemis probably resulted from hypertrophy of digestive organs (e.g. intestine, liver) related to digestion and nutrient assimilation. Given the previously established equality of the metabolic capacities of the two subspecies, we propose that the high-latitude nonbreeding range of ptilocnemis rock sandpipers is primarily facilitated by digestive (i.e. physiological) aspects of their foraging ecology rather than behavioral or sensory aspects.

  3. Overall response rates to radiation therapy for patients with painful uncomplicated bone metastases undergoing initial treatment and retreatment

    International Nuclear Information System (INIS)

    Bedard, Gillian; Hoskin, Peter; Chow, Edward

    2014-01-01

    Introduction: Radiation therapy has been shown to successfully palliate bone metastases. A number of systematic reviews and large clinical trials have reported response rates for initial treatment and retreatment. Objective: To determine overall response rates of patients with painful uncomplicated bone metastases undergoing initial treatment and retreatment. Methods: Intent-to-treat and evaluable patient statistics from a systematic review of palliative radiotherapy trials for initial treatment of bone metastases and a randomized clinical trial of retreatment were pooled and analyzed to determine the overall response rates for patients receiving initial treatment and retreatment. Results: In the intent-to-treat calculation, 71–73% of patients had an overall response to radiation treatment and in the evaluable patient population; 85–87% of patients did so. Response rates varied slightly whether patients underwent single or multiple fractions in initial treatment or retreatment. Conclusions: Single and multiple fraction radiation treatment yielded very similar overall response rates. Patients treated with a single fraction for both initial and repeat radiation experience almost identical overall response to those patients treated with multiple fraction treatment. It is therefore recommended that patients with uncomplicated painful bone metastases be treated with a single 8 Gy fraction of radiation at both the initial treatment and retreatment

  4. Effect of 60Co γ-irradiation on germination rate of corms and selection of a higher temperature-tolerance mutant 'zf893' of Crocus sativus L

    International Nuclear Information System (INIS)

    Zhang Qiaosheng; Wang Zhiping; Pan Jianyong; Li Xuebing; Xu Bujin; Zou Fenglian; Lu Gang

    2009-01-01

    The effects of 60 Co γ-rays irradiation on germination rate of corms of saffron (Crocus sativus L.) were studied and the results were as follows: (1) The corm germination rate raised with the corm fresh weight M (g) increasing, and the corms of 3 60 Co γ-rays, the typical radiation effect of dose on germination rate were obtained, and the semi-lethal dose (D 50 ) for the corms of 3 60 Co γ-rays and the stigma productivity of ZF893 was 1.3 times as that of the parent, for the field growing period, total weight of daughter corms and flower numbers of ZF893 were 22%, 27% and 30% higher than that of the parent, respectively. (4) The soluble protein SDS-PAGE patterns between ZF893 and it's parent were very similar, but the 54.8kD bands were much stronger in ZF893 and the 20.9 kD bands which were clear in ZF893, but were nearly absent in it's parent. (authors)

  5. Mechanistic dissimilarities between environmentally-influenced fatigue-crack propagation at near-threshold and higher growth rates in lower-strength steels

    Energy Technology Data Exchange (ETDEWEB)

    Suresh, S.; Ritchie, R. O.

    1981-11-01

    The role of hydrogen gas in influencing fatigue crack propagation is examined for several classes of lower strength pressure vessel and piping steels. Based on measurements over a wide range of growth rates from 10/sup -8/ to 10/sup -2/ mm/cycle, crack propagation rates are found to be significantly higher in dehumidified gaseous hydrogen compared to moist air in two distinct regimes of crack growth, namely (i) at the intermediate range of growth typically above approx. 10/sup -5/ mm/cycle, and (ii) at the near-threshold region below approx. 10/sup -6/ mm/cycle approaching lattice dimensions per cycle. Both effects are seen at maximum stress intensities (K/sub max/) far below the sustained-load threshold stress intensity for hydrogen-assisted cracking (K/sub Iscc/). Characteristics of environmentally influenced fatigue crack growth in each regime are shown to be markedly different with regard to fractography and the effect of such variables as load ratio and frequency. It is concluded that the primary mechanisms responsible for the influence of the environment in each regime are distinctly different. Whereas corrosion fatigue behavior at intermediate growth rates can be attributed to hydrogen embrittlement processes, the primary role of moist environments at near-threshold levels is shown to involve a contribution from enhanced crack closure due to the formation of crack surface corrosion deposits at low load ratios.

  6. Population trends and live birth rates associated with common ART treatment strategies.

    Science.gov (United States)

    Chambers, Georgina M; Wand, Handan; Macaldowie, Alan; Chapman, Michael G; Farquhar, Cynthia M; Bowman, Mark; Molloy, David; Ledger, William

    2016-11-01

    Have ART live birth rates improved in Australia over the last 12 years? There were striking improvements in per-cycle live birth rates observed for frozen/thaw embryo transfers, blastocyst transfer and single embryo transfer (SET), while live birth rates following ICSI were lower than IVF for non-male factor infertility in most years. ART and associated techniques have become the predominant treatment of infertility over the past 30 years in most developed countries. However, there are differences in ART laboratory and clinical practices, and success rates worldwide. Australia has one of the highest ART utilization rates and lowest multiple birth rates in the world, thus providing a unique setting to investigate the contribution of common ART strategies in an unrestricted population of patients to ART success rates. A retrospective cohort study of 585 065 ART treatment cycles performed in Australia between 2002 and 2013 using the Australian and New Zealand Assisted Reproduction Database (ANZARD). An unrestricted population of all women who underwent autologous ART treatment between 2002 and 2013. Visual descriptive analysis was used to assess the trends in ART procedures by the calendar years. Adjusted odds ratios (aORs) of a live birth for four common ART techniques were calculated after controlling for important confounders including female age, infertility diagnosis, stage of the embryo (blastocyst versus cleavage stage), type of embryo (fresh versus thawed), fertilization method (IVF versus ICSI) and number of embryos transferred (SET versus multiple embryos). The overall live birth rate per embryo transfer increased from 19.2% in 2002 to 23.3% in 2013 (21.9-24.3% for fresh embryo transfers and 14.6-23.3% for frozen/thaw embryo transfers). This occurred concurrently with an increase in SET from 29.7% to 78.9%, and an increase in the average age of women undergoing treatment from 35.0 to 35.9 years. Individuals who had a frozen/thaw embryo transfer cycle in 2002

  7. Geometrical Sparing Factors for the Rectum and Bladder in the Prediction of Grade 2 and Higher Complications After High-Dose-Rate Brachytherapy for Cervical Cancer

    International Nuclear Information System (INIS)

    Chen, S.-W.; Liang, J.-A.; Hung, Y.-C.; Yeh, L.-S.; Chang, W.-C.; Yang, S.-N.; Lin, F.-J.

    2009-01-01

    Purpose: This study aimed to assess the predictive values of geometrical sparing factors for the rectum and bladder in high-dose-rate intracavitary brachytherapy (HDRICB) for Grade 2 and higher late sequelae in patients with cervical cancer. Methods: A total of 392 patients were enrolled in this study. They were treated with external beam radiotherapy to the pelvis, after which HDRICB was performed using Ir-192 remote after-loading at 1-week intervals for three or four sessions. The geometrical sparing factor (GSF) was defined as the average of the ratios between the reference doses and the Point A dose. Results: A total of 46 patients (11.7%) had Grade 2 or higher late rectal complications (36 Grade 2, 9 Grade 3, and 1 Grade 4). In all, 32 patients (8.2%) had Grade 2 or higher late bladder complications (14 Grade 2, 16 Grade 3, and 2 Grade 4). Multivariate analysis demonstrated a high risk of rectal sequelae in patients who developed bladder complications (p = 0.0004, hazard ratio 3.54) and had a rectal GSF greater than 0.7 (p = 0.01, hazard ratio 1.99). The high risk factors for bladder complications were development of rectal complications (p = 0.0004, hazard ratio 3.74), concurrent chemotherapy (p = 0.0001, relative risk 3.94), and a bladder GSF greater than 0.9 (p = 0.01, hazard ratio, 2.53). Conclusion: This study demonstrates the predictive value of GSFs in HDRICB for cervical cancer. Patients with rectal GSFs greater than 0.7 or bladder GSFs greater than 0.9 are at risk for Grade 2 and higher late sequelae.

  8. Geometrical sparing factors for the rectum and bladder in the prediction of grade 2 and higher complications after high-dose-rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Chen, Shang-Wen; Liang, Ji-An; Hung, Yao-Ching; Yeh, Lian-Shung; Chang, Wei-Chun; Yang, Shih-Neng; Lin, Fang-Jen

    2009-12-01

    This study aimed to assess the predictive values of geometrical sparing factors for the rectum and bladder in high-dose-rate intracavitary brachytherapy (HDRICB) for Grade 2 and higher late sequelae in patients with cervical cancer. A total of 392 patients were enrolled in this study. They were treated with external beam radiotherapy to the pelvis, after which HDRICB was performed using Ir-192 remote after-loading at 1-week intervals for three or four sessions. The geometrical sparing factor (GSF) was defined as the average of the ratios between the reference doses and the Point A dose. A total of 46 patients (11.7%) had Grade 2 or higher late rectal complications (36 Grade 2, 9 Grade 3, and 1 Grade 4). In all, 32 patients (8.2%) had Grade 2 or higher late bladder complications (14 Grade 2, 16 Grade 3, and 2 Grade 4). Multivariate analysis demonstrated a high risk of rectal sequelae in patients who developed bladder complications (p = 0.0004, hazard ratio 3.54) and had a rectal GSF greater than 0.7 (p = 0.01, hazard ratio 1.99). The high risk factors for bladder complications were development of rectal complications (p = 0.0004, hazard ratio 3.74), concurrent chemotherapy (p = 0.0001, relative risk 3.94), and a bladder GSF greater than 0.9 (p = 0.01, hazard ratio, 2.53). This study demonstrates the predictive value of GSFs in HDRICB for cervical cancer. Patients with rectal GSFs greater than 0.7 or bladder GSFs greater than 0.9 are at risk for Grade 2 and higher late sequelae.

  9. On a Stochastic SEIS Model with Treatment Rate of Latent Population

    Directory of Open Access Journals (Sweden)

    Shujing Gao

    2014-01-01

    Full Text Available The asymptotic dynamics of a stochastic SEIS epidemic model with treatment rate of latent population is investigated. First, we show that the system provides a unique positive global solution starting from the positive initial value. Then, the long-term asymptotic behavior of the model is studied: if R0, which is called the basic reproduction number of the corresponding deterministic model, is not more than unity, the solution of the model is oscillating around the disease-free equilibrium of the corresponding deterministic system, whereas if R0 is larger than unity, we show how the solution spirals around the endemic equilibrium of deterministic system under certain parametric restrictions. Finally, numerical simulations are carried out to support our theoretical findings.

  10. Disparities in treatment rates of paediatric end-stage renal disease across Europe

    DEFF Research Database (Denmark)

    Chesnaye, Nicholas C; Schaefer, Franz; Groothoff, Jaap W

    2015-01-01

    /1321 km, P rates were found in wealthier countries (2.47 pmc/€10 378 GDP per capita, P among those...... and physical access to treatment were collected through an online survey and from the World Bank database. The estimated effect is presented per 1SD increase for each indicator. RESULTS: The incidence of paediatric RRT in Europe was 5.4 cases pmc. Incidence decreased from Western to Eastern Europe (-1.91 pmc...... that tend to spend more on healthcare (1.45 pmc/1.7% public health expenditure, P among countries where patients pay less out-of-pocket for healthcare (-1.29 pmc/11.7% out-of-pocket health expenditure, P

  11. Batch leachate treatment using stirred electrocoagulation reactor with variation of residence time and stirring rate

    Science.gov (United States)

    Sitorus, I. S.; Astono, W.; Iswanto, B.

    2018-01-01

    This study aims to reduce pollutant levels of the leachate by electrocoagulation method using a stirred electrocoagulation reactor as the electrochemical water treatment. The release of active coagulants as metallic ions took place in the anode, while in the cathode, the electrolysis reaction in the form of hydrogen gas dischargeoccurred. The source of wastewater is Waste Water Treatment Plant inlet III of Bantar Gebang, Bekasi. Some parameters were analyzed in this research, i.e., Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), NH3, NO3 -, NO2 -, N-total, and organic substances as well as the microorganism growth before and after electrocoagulation, with variations of detention time (seconds) of 10, 20, 120, 600 and rapid mixing conditions (rpm) of 60, 100 and 200. The results show that the greater the rapid mixing speed and the detention time of electrolysis, the higher the removal of contaminants in liquid waste. The optimum condition of electrocoagulation was encountered at 200 rpm rapid mixing with 600 seconds of processing time. The removal efficiencies of electrocoagulation method for each parameter are TSS of 46.80%, BOD5 of 71.33%, COD of 73.77%, Pb of 62.5%,and NH3-N of 57.92%,whereas the pH value has been increased from 8.03 to 8.95. The electrocoagulation method can reduce levels of pollutants, complying with the environmental standards.

  12. Interstitial high-dose-rate brachytherapy in the treatment of base of tongue carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Takacsi-Nagy, Z.; Polgar, C.; Somogyi, A.; Major, T.; Fodor, J.; Nemeth, G. [Dept. of Radiotherapy, National Inst. of Oncology, Budapest (Hungary); Oberna, F. [Dept. of Maxillofacial Surgery, St. Rokus Hospital, Budapest (Hungary); Remenar, E.; Kasler, M. [Dept. of Head and Neck, Maxillofacial and Reconstructive Plastic Surgery, National Inst. of Oncology, Budapest (Hungary)

    2004-12-01

    Background and purpose: to date none of the studies examined the feasibility and efficacy of interstitial high-dose-rate (HDR) brachytherapy in the treatment of carcinoma of the tongue base. Therefore the aim of this study was to contribute to this issue. Patients and methods: between 1992 and 2000 37 patients (mean age 55 years) with T1-4 and NO-3 carcinoma of the base of tongue were presented. Neck dissection was carried out in twelve cases (32%). 30 patients with advanced stage received brachytherapy boost after 50-66.5 Gy (mean, 60 Gy) locoregional external beam irradiation (EBI) and 7 patients with early stage (T1-2, NO) were managed locally with wide tumor excision and sole brachytherapy. 4 of them underwent neck dissection and the others were subjected to 50 Gy regional EBI. The mean dose of boost and sole brachytherapy was 18 Gy and 28 Gy, respectively. Results: the median follow-up time for surviving patients was 51 months. The 7 sole brachytherapy patients are living with no evidence of disease. For patients treated with EBI and brachytherapy boost, the 5-year actuarial rate of local, locoregional recurrence-free and overall survival was 60%, 52% and 46%, respectively. For all patients in univariate analysis larger tumor size (T4 vs. T1-3) was significant negative predictor of local (RR: 7.23) and locoregional control (RR: 3.87), but nodal involvement was not. Delayed soft tissue ulceration and osteoradionecrosis occurred in 4 (13%) EBI and brachytherapy treated patients. None of the sole brachytherapy patients experienced severe late radiation toxicity. Conclusion: EBI combined with interstitial HDR brachytherapy boost result in acceptable local tumor control with low incidence of late side effects in patients with advanced disease. Fractionated sole HDR brachytherapy following tumor excision is a feasible treatment option for patients with early stage cancer and gives excellent local results. (orig.)

  13. High dose rate versus low dose rate brachytherapy in the treatment of stage IIIB cervical cancer, and the importance of brachytherapy timing

    International Nuclear Information System (INIS)

    Petereit, Daniel G.; Sarkaria, Jann N.; Czyzewski, Ann; Buchler, Dolores A.

    1996-01-01

    LDR brachytherapy for the treatment of Stage IIIB cervical cancer patients suggest lower survival and pelvic control for the HDR approach. Potential reasons for this include very high pelvic control rates in the LDR group, different patient cohorts with a higher TBS in the HDR group and performing the first HDR insertion before adequate tumor shrinkage. This trend became apparent over one year ago and dramatic changes in the HDR approach for Stage IIIB patients were implemented. These changes include performing the first insertion after 45 to 50 Gy of EBR, dose escalation to an LDR equivalent of 90 Gy and performing HDR fractionated interstitial brachytherapy in tumors that are poorly regressing. It appears that timing of the first HDR insertion with the EBR may be critical, and HDR brachytherapy should start only after adequate tumor shrinkage, possibly 45 Gy at a minimum. Finally, the literature at this point does not indicate that HDR is inferior to LDR in the treatment of Stage IIIB cervical cancer patients, and a high TBS at presentation may warrant more aggressive therapy

  14. Effect of periodontal treatment on preterm birth rate: a systematic review of meta-analyses.

    Science.gov (United States)

    López, Néstor J; Uribe, Sergio; Martinez, Benjamín

    2015-02-01

    Preterm birth is a major cause of neonatal morbidity and mortality in both developed and developing countries. Preterm birth is a highly complex syndrome that includes distinct clinical subtypes in which many different causes may be involved. The results of epidemiological, molecular, microbiological and animal-model studies support a positive association between maternal periodontal disease and preterm birth. However, the results of intervention studies carried out to determine the effect of periodontal treatment on reducing the risk of preterm birth are controversial. This systematic review critically analyzes the methodological issues of meta-analyses of the studies to determine the effect of periodontal treatment to reduce preterm birth. The quality of the individual randomized clinical trials selected is of highest relevance for a systematic review. This article describes the methodological features that should be identified a priori and assessed individually to determine the quality of a randomized controlled trial performed to evaluate the effect of periodontal treatment on pregnancy outcomes. The AMSTAR and the PRISMA checklist tools were used to assess the quality of the six meta-analyses selected, and the bias domain of the Cochrane Collaboration's Tool was applied to evaluate each of the trials included in the meta-analyses. In addition, the methodological characteristics of each clinical trial were assessed. The majority of the trials included in the meta-analyses have significant methodological flaws that threaten their internal validity. The lack of effect of periodontal treatment on preterm birth rate concluded by four meta-analyses, and the positive effect of treatment for reducing preterm birth risk concluded by the remaining two meta-analyses are not based on consistent scientific evidence. Well-conducted randomized controlled trials using rigorous methodology, including appropriate definition of the exposure, adequate control of confounders for

  15. Comparison of high-dose-rate and low-dose-rate brachytherapy in the treatment of endometrial carcinoma

    International Nuclear Information System (INIS)

    Fayed, Alaa; Mutch, David G.; Rader, Janet S.; Gibb, Randall K.; Powell, Matthew A.; Wright, Jason D.; El Naqa, Issam; Zoberi, Imran; Grigsby, Perry W.

    2007-01-01

    Purpose: To compare the outcomes for endometrial carcinoma patients treated with either high-dose-rate (HDR) or low-dose-rate (LDR) brachytherapy. Methods and Materials: This study included 1,179 patients divided into LDR (1,004) and HDR groups (175). Patients with International Federation of Gynecology and Obstetrics (FIGO) surgical Stages I-III were included. All patients were treated with postoperative irradiation. In the LDR group, the postoperative dose applied to the vaginal cuff was 60-70 Gy surface doses to the vaginal mucosa. The HDR brachytherapy prescription was 6 fractions of 2 Gy each to a depth of 0.5 cm from the surface of the vaginal mucosa. Overall survival, disease-free survival, local control, and complications were endpoints. Results: For all stages combined, the overall survival, disease-free survival, and local control at 5 years in the LDR group were 70%, 69%, and 81%, respectively. For all stages combined, the overall survival, disease-free survival, and local control at 5 years in the HDR group were 68%, 62%, and 78%, respectively. There were no significant differences in early or late Grade III and IV complications in the HDR or LDR groups. Conclusion: Survival outcomes, pelvic tumor control, and Grade III and IV complications were not significantly different in the LDR brachytherapy group compared with the HDR group

  16. Post operative high dose rate intravaginal irradiation in endometrial cancer: a safe and effective outpatient treatment

    International Nuclear Information System (INIS)

    Chen, Peter; Gibbons, Susan; Vicini, Frank; Weiner, Sheldon; Dmuchowski, Carl; Mele, Beth; Brabbins, Donald; Jennings, John; Gustafson, Gary; Martinez, Alvaro

    1995-01-01

    Purpose: We reviewed our experience with out patient high dose rate (HDR) intravaginal irradiation given post-operatively in endometrial cancer to assess local control, survival, and toxicity when used alone or in combination with external beam irradiation. Methods and Materials: From (12(88)) to (12(92)), 78 patients underwent TAH/BSO and received post-operative HDR intravaginal irradiation for endometrial cancer. Pathologic stage distribution was IB/IC: 56%, II: 22%, III: 22%. Adjuvant therapy was given in one of three schemes: HDR vaginal radiation alone (6 weekly fractions of 500 cGy prescribed 5 mm from the applicator surface treating the upper 4 cm of the vagina), pelvic irradiation with vaginal HDR (500 cGy x 4 weekly fractions) or whole abdomen/pelvic irradiation (WAPI) with vaginal HDR treatment (500 cGy x 3 weekly fractions). Prior to the first HDR vaginal treatment, a simulation with placement of vaginal apex metallic markers was performed to assure proper positioning of the intravaginal cylinders. Pelvic midline blocking was designed from the HDR intravaginal simulation films. The 55 patients who underwent combined external beam irradiation/brachytherapy received a median dose to the pelvis of 5040 cGy (range 25.2-51.6 Gy), and a median total vaginal dose of 5060 cGy (range 30.0-57.6 Gy). Results: Median follow-up is 37 months (range 6-73 months). Local control (vaginally) is 98.7%. The one vaginal failure was in the distal vagina, outside the treatment volume. All other failures (4) were distant with the vagina controlled [3 intra-abdominal and one bone/intra-abdominal]. For stages I and II, the disease free survival is 92.8%. For stage III the disease free survival is 86.5%. Median overall time to failure is 14.3 months (range 8.5-18.6 months). In terms of acute toxicity, no grade 3-4 acute toxicity of the vagina or bladder was seen. However, 9% acute GI toxicity was encountered. Chronic grade 1-2 toxicities included: vaginal 21.8% (foreshortening and

  17. Analysis of 162 colon injuries in patients with penetrating abdominal trauma: concomitant stomach injury results in a higher rate of infection.

    Science.gov (United States)

    O'Neill, Patricia A; Kirton, Orlando C; Dresner, Lisa S; Tortella, Bartholomew; Kestner, Mark M

    2004-02-01

    Fecal contamination from colon injury has been thought to be the most significant factor for the development of surgical site infection (SSI) after trauma. However, there are increasing data to suggest that other factors may play a role in the development of postinjury infection in patients after colon injury. The purpose of this study was to determine the impact of gastric wounding on the development of SSI and nonsurgical site infection (NSSI) in patients with colon injury. Post hoc analysis was performed on data prospectively collected for 317 patients presenting with penetrating hollow viscus injury. One hundred sixty-two patients with colon injury were subdivided into one of three groups: patients with isolated colon wounds (C), patients with colon and stomach wounds with or without other organ injury (C+S), and patients with colon and other organ injury but no stomach injury (C-S) and assessed for the development of SSI and NSSI. Infection rates were also determined for patients who sustained isolated gastric injury (S) and gastric injury in combination with other injuries other than colon (S-C). Penetrating Abdominal Trauma Index, operative times, and transfusion were assessed. Discrete variables were analyzed by Cochran-Mantel-Haenszel chi2 test and Fisher's exact test. Risk factor analysis was performed by multivariate logistic regression. C+S patients had a higher rate of SSI infection (31%) than C patients (3.6%) (p=0.008) and C-S patients (13%) (p=0.021). Similarly, the incidence of NSSI was also significantly greater in the C+S group (37%) compared with the C patients (7.5%) (p=0.07) and the C-S patients (17%) (p=0.019). There was no difference in the rate of SSI or NSSI between the C and C-S groups (p=0.3 and p=0.24, respectively). The rate of SSI was significantly greater in the C+S patients when compared with the S-C patients (31% vs. 10%, p=0.008), but there was no statistical difference in the rate of NSSI in the C+S group and the S-C group (37

  18. Effect of ketamine dose on self-rated dissociation in patients with treatment refractory anxiety disorders.

    Science.gov (United States)

    Castle, Cameron; Gray, Andrew; Neehoff, Shona; Glue, Paul

    2017-10-01

    Patients receiving ketamine for refractory depression and anxiety report dissociative symptoms in the first 60 min post-dose. The most commonly used instrument to assess this is the Clinician-Administered Dissociative States Scale (CADSS), developed based on the assessment of patients with dissociative symptoms. Its psychometric properties for ketamine-induced dissociation have not been reported. We evaluated these from a study using 0.25-1 mg/kg ketamine and midazolam (as an active control) in 18 patients with treatment-resistant anxiety. Dissociation ratings were increased by ketamine in a dose-dependent manner. In contrast, midazolam showed no effect on ratings of dissociation. For individual CADSS items, the magnitude of change and the ketamine dose at which changes were observed were not homogenous. The Cronbach alpha for the total scale was high (0.937), with acceptable item-rest correlations for almost all individual items. Purposefully removing items to maximise alpha did not lead to meaningful improvements. Acceptable internal consistency was still observed after removing items which lacked evidence of responsiveness at lower doses. The high Cronbach alpha values identified in this study suggests that the CADSS is an internally consistent instrument for evaluating ketamine-induced dissociation in clinical trials in anxiety, although it does not capture symptoms such as thought disorder.

  19. The Effect of Organic Loading Rate on Milk WastewaterTreatment Using Sequencing Batch Reactor (SBR

    Directory of Open Access Journals (Sweden)

    Hooman Hajiabadi

    2009-09-01

    Full Text Available In this study, four aerobic sequencing batch reactors (SBRs were operated under the same conditions for the treatment of milk wastewater at different organic loading rates (OLRs. Cylindrical Plexiglas reactors were run for 56 days (including 21 days of acclimatization and 35 days of data gathering. Effective volume, influent wastewater flowrate, and sludge retention time (SRT of reactors were 5.5 L, 3.5 L/d, and 10 d, respectively. The average COD removal efficiency for the reactors R1, R2, R3, and R4 with influent OLRave values of 633, 929, 1915, and 3261 gCOD/m3d were 95, 96, 95, and 82 percent, respectively. The average effluent suspended solid (SS for all reactors was lower than 44 mg/L. Also, except for R4 with an average effluent turbidity of 270 NTU, other reactors met the Iranian wastewater emission standard (50 NTU. In addition, the average sludge volume index of reactors R1 to R3 was found to be lower than 67 mL/g. According to the results, the overall variation of COD removal efficiency versus influent OLR shows a decreasing rate with a correlation factor of 0.8 (R2.

  20. Treatment Planning for Pulsed Reduced Dose-Rate Radiotherapy in Helical Tomotherapy

    International Nuclear Information System (INIS)

    Rong Yi; Paliwal, Bhudatt; Howard, Steven P.; Welsh, James

    2011-01-01

    Purpose: Pulsed reduced dose-rate radiotherapy (PRDR) is a valuable method of reirradiation because of its potential to reduce late normal tissue toxicity while still yielding significant tumoricidal effect. A typical method using a conventional linear accelerator (linac) is to deliver a series of 20-cGy pulses separated by 3-min intervals to give an effective dose-rate of just under 7 cGy/min. Such a strategy is fraught with difficulties when attempted on a helical tomotherapy unit. We investigated various means to overcome this limitation. Methods and Materials: Phantom and patient cases were studied. Plans were generated with varying combinations of field width (FW), pitch, and modulation factor (MF) to administer 200 cGy per fraction to the planning target in eight subfractions, thereby mimicking the technique used on conventional linacs. Plans were compared using dose-volume histograms, homogeneity indices, conformation numbers, and treatment time. Plan delivery quality assurance was performed to assess deliverability. Results: It was observed that for helical tomotherapy, intrinsic limitations in leaf open time in the multileaf collimator deteriorate plan quality and deliverability substantially when attempting to deliver very low doses such as 20-40 cGy. The various permutations evaluated revealed that the combination of small FW (1.0 cm), small MF (1.3-1.5), and large pitch (∼0.86), along with the half-gantry-angle-blocked scheme, can generate clinically acceptable plans with acceptable delivery accuracy (±3%). Conclusion: Pulsed reduced dose-rate radiotherapy can be accurately delivered using helical tomotherapy for tumor reirradiation when the appropriate combination of FW, MF, and pitch is used.

  1. Elevated basal progesterone levels are associated with increased preovulatory progesterone rise but not with higher pregnancy rates in ICSI cycles with GnRH antagonists.

    Science.gov (United States)

    Mutlu, Mehmet Firat; Erdem, Mehmet; Mutlu, Ilknur; Bulut, Berk; Erdem, Ahmet

    2017-09-01

    To ascertain the association between basal progesterone (P) levels and the occurrence of preovulatory progesterone rise (PPR) and clinical pregnancy rates (CPRs) in ICSI cycles with GnRH antagonists. Serum P levels of 464 patients were measured on day 2 and day of hCG of cycles. Cycles with basal P levels>1.6ng/mL were cancelled. All embryos were cryopreserved in cycles with P levels≥2ng/mL on the day of hCG. The primary outcome measures were the incidence of PPR (P>1.5ng/mL) and CPR with regard to basal P. Basal P levels were significantly higher in cycles with PPR than in those without PPR (0.63±0.31 vs. 0.48±0.28ng/mL). Area under the curve for basal P according to ROC analysis to discriminate between elevated and normal P levels on the day of hCG was 0.65 (0.58-0.71 95% CI, pcycles with and without PPR was 0.65ng/mL. Cycles with basal P levels above 0.65ng/mL had a significantly higher incidence of PPR (30.9% vs. 13.5%) but similar clinical and cumulative pregnancy rates (38.8% vs. 31.1% and 41.7% vs. 32.6%, respectively) in comparison to cycles with basal P levels below 0.65ng/mL. In multivariate regression analysis, basal P levels, LH level on the first day of antagonist administration, and estradiol levels on the day of hCG trigger were the variables that predicted PPR. Basal P levels were associated with increased incidence of PPR but not with CPR. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Treatment staff turnover in organizations implementing evidence-based practices: Turnover rates and their association with client outcomes

    Science.gov (United States)

    Garner, Bryan R.; Hunter, Brooke D.; Modisette, Kathryn C.; Ihnes, Pamela C.; Godley, Susan H.

    2011-01-01

    High staff turnover has been described as a problem for the substance use disorder treatment field. This assertion is based primarily on the assumption that staff turnover adversely impacts treatment delivery and effectiveness. This assumption, however, has not been empirically tested. In this study, we computed annualized rates of turnover for treatment staff (n=249) participating in an evidence-based practice implementation initiative and examined the association between organizational-level rates of staff turnover and client-level outcomes. Annualized rates of staff turnover were 31% for clinicians and 19% for clinical supervisors. Additionally, multilevel analyses did not reveal the expected relationship between staff turnover and poorer client-level outcomes. Rather, organizational-level rates of staff turnover were found to have a significant positive association with two measures of treatment effectiveness: less involvement in illegal activity and lower social risk. Possible explanations for these findings are discussed. PMID:22154040

  3. Thermal and epithermal neutron fluence rate gradient measurements by PADC detectors in LINAC radiotherapy treatments-field

    Energy Technology Data Exchange (ETDEWEB)

    Barrera, M. T., E-mail: mariate9590@gmail.com; Barros, H.; Pino, F.; Sajo-Bohus, L. [Universidad Simón Bolívar, Nuclear Physics Laboratory, Sartenejas, Caracas (Venezuela, Bolivarian Republic of); Dávila, J. [Física Médica C. A. and Universidad Central de Venezuela, Caracas (Venezuela, Bolivarian Republic of)

    2015-07-23

    LINAC VARIAN 2100 is where energetic electrons produce Bremsstrahlung radiation, with energies above the nucleon binding energy (E≈5.5MeV). This radiation induce (γ,n) and (e,e’n) reactions mainly in the natural tungsten target material (its total photoneutron cross section is about 4000 mb in a energy range from 9-17 MeV). These reactions may occur also in other components of the system (e.g. multi leaf collimator). During radiation treatment the human body may receive an additional dose inside and outside the treated volume produced by the mentioned nuclear reactions. We measured the neutron density at the treatment table using nuclear track detectors (PADC-NTD). These covered by a boron-converter are employed, including a cadmium filter, to determine the ratio between two groups of neutron energy, i.e. thermal and epithermal. The PADC-NTD detectors were exposed to the radiation field at the iso-center during regular operation of the accelerator. Neutron are determined indirectly by the converting reaction {sup 10}B(n,α){sup 7}Li the emerging charged particle leave their kinetic energy in the PADC forming a latent nuclear track, enlarged by chemical etching (6N, NaOH, 70°C). Track density provides information on the neutron density through calibration coefficient (∼1.6 10{sup 4} neutrons /track) obtained by a californium source. We report the estimation of the thermal and epithermal neutron field and its gradient for photoneutrons produced in radiotherapy treatments with 18 MV linear accelerators. It was obsered that photoneutron production have higher rate at the iso-center.

  4. What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Mohammed Mohammed A

    2007-06-01

    Full Text Available Abstract Background Despite increasing interest and publication of risk-adjusted hospital mortality rates, the relationship with underlying quality of care remains unclear. We undertook a systematic review to ascertain the extent to which variations in risk-adjusted mortality rates were associated with differences in quality of care. Methods We identified studies in which risk-adjusted mortality and quality of care had been reported in more than one hospital. We adopted an iterative search strategy using three databases – Medline, HealthSTAR and CINAHL from 1966, 1975 and 1982 respectively. We identified potentially relevant studies on the basis of the title or abstract. We obtained these papers and included those which met our inclusion criteria. Results From an initial yield of 6,456 papers, 36 studies met the inclusion criteria. Several of these studies considered more than one process-versus-risk-adjusted mortality relationship. In total we found 51 such relationships in a widen range of clinical conditions using a variety of methods. A positive correlation between better quality of care and risk-adjusted mortality was found in under half the relationships (26/51 51% but the remainder showed no correlation (16/51 31% or a paradoxical correlation (9/51 18%. Conclusion The general notion that hospitals with higher risk-adjusted mortality have poorer quality of care is neither consistent nor reliable.

  5. A systematic review of undisplaced femoral neck fracture treatments for patients over 65 years of age, with a focus on union rates and avascular necrosis.

    Science.gov (United States)

    Xu, Dan-Feng; Bi, Fang-Gang; Ma, Chi-Yuan; Wen, Zheng-Fa; Cai, Xun-Zi

    2017-02-10

    It remains unclear whether conservative treatment should be used to treat the common undisplaced femoral neck fractures that develop in the elderly. Herein, we systematically review the rates of union and avascular necrosis after conservative and surgical treatment of undisplaced femoral neck fractures. We searched the EMBASE, PubMed, OVID, Cochrane Library, Web of Science, and Scopus databases for randomized controlled trials or observational studies that assessed the outcomes of conservative or surgical treatments of undisplaced femoral neck fractures. No language or publication year limitation was imposed. Statistical analyses were performed with the aid of the chi-squared test. We evaluated the quality of each publication and the risk of bias. Twenty-nine studies involving 5071 patients were ultimately included; 1120 patients were treated conservatively and 3951 surgically. The union rates were 68.8% (642/933) and 92.6% (635/686) in the former and latter groups, respectively (p avascular necrosis rate in the conservatively treated group was 10.3% (39/380), while it was 7.7% (159/2074) in the surgically treated group (p = 0.09). Surgery to treat undisplaced femoral neck fractures was associated with a higher union rate and a tendency toward less avascular necrosis than conservative treatment.

  6. Acquired Apraxia of Speech: The Effects of Repeated Practice and Rate/Rhythm Control Treatments on Sound Production Accuracy

    Science.gov (United States)

    Wambaugh, Julie L.; Nessler, Christina; Cameron, Rosalea; Mauszycki, Shannon C.

    2012-01-01

    Purpose: This investigation was designed to elucidate the effects of repeated practice treatment on sound production accuracy in individuals with apraxia of speech (AOS) and aphasia. A secondary purpose was to determine if the addition of rate/rhythm control to treatment provided further benefits beyond those achieved with repeated practice.…

  7. Robustness of IPSA optimized high-dose-rate prostate brachytherapy treatment plans to catheter displacements.

    Science.gov (United States)

    Poder, Joel; Whitaker, May

    2016-06-01

    Inverse planning simulated annealing (IPSA) optimized brachytherapy treatment plans are characterized with large isolated dwell times at the first or last dwell position of each catheter. The potential of catheter shifts relative to the target and organs at risk in these plans may lead to a more significant change in delivered dose to the volumes of interest relative to plans with more uniform dwell times. This study aims to determine if the Nucletron Oncentra dwell time deviation constraint (DTDC) parameter can be optimized to improve the robustness of high-dose-rate (HDR) prostate brachytherapy plans to catheter displacements. A set of 10 clinically acceptable prostate plans were re-optimized with a DTDC parameter of 0 and 0.4. For each plan, catheter displacements of 3, 7, and 14 mm were retrospectively applied and the change in dose volume histogram (DVH) indices and conformity indices analyzed. The robustness of clinically acceptable prostate plans to catheter displacements in the caudal direction was found to be dependent on the DTDC parameter. A DTDC value of 0 improves the robustness of planning target volume (PTV) coverage to catheter displacements, whereas a DTDC value of 0.4 improves the robustness of the plans to changes in hotspots. The results indicate that if used in conjunction with a pre-treatment catheter displacement correction protocol and a tolerance of 3 mm, a DTDC value of 0.4 may produce clinically superior plans. However, the effect of the DTDC parameter in plan robustness was not observed to be as strong as initially suspected.

  8. Effect of pyrophyllite filler treatment toward water absorbance rate of SAPC and its application test

    International Nuclear Information System (INIS)

    Jadigia Ginting

    2015-01-01

    An optimization treatment to pyrophyllite filler has been done to synthesis super absorbent polymers composite (SAPC) with copolymerization of acrylic. Pyrophyllite is one of a silicate mineral with chemical formula Al 2 Si 4 O 10 (OH) 2 having a reactive functional group -OH that easily making a bonding and therefore it is suitable for water absorbance materials. The pyrophyllite were studied as its weight composition and its powder-size in the SAPC preparation. To obtain the fine-size, the filler pyrophyllite were milled with high energy mechanical milling (HEMM) into divers hours of milling. The syntheses were carried out by using the settle method from Chemicals Engineering group of ITB Bandung. The samples of SAPC-prflt were then characterized with fourier-transform infra red spectroscopy (FTIR), Xray diffraction (XRD) and scanning electron microscopy(SEM). Effect of filler treatment toward water absorbance rate is the SAPC-prflt with 0.5 gr filler having the highest gradient absorbance 1,610; SAPC prflt which milled for 9 hours has gradient absorbance 1,526; SAPC-prflt after hot water test at 40°C has gradient absorbence 2,241 and SAPC-prflt as pampers test has the gradient absorbance 1,607. XRD data analysis showed a broad peak 2 θ at scale 5 w which correspond to the micrographs picture of the sample which has 0.5 gr filler pyrophyllite and sample after milled for 9 hours, that proposed increase the sample strength and stability which induce the increasing of its water absorbance.

  9. Strontium-89 in palliative treatment of widespread painful bone metastases: Response rate and duration

    International Nuclear Information System (INIS)

    Haddad, Peiman; Ghadiri, Farhad

    2005-01-01

    Full text: Intravenous injection of Strontium-89 (Sr-89) is an accepted palliative treatment for bone metastases. We evaluated the pain relief achieved with this radiopharmaceutical in patients with widespread painful bone metastases from prostate and breast cancers. Pain intensity on a 9-grade scale and use of narcotics was recorded before and after Sr-89 injection, and the ensuing palliative effect was divided into complete, partial and no response. The duration of response was also recorded. Thirty-five patients with widespread painful bone metastases were treated with Sr-89, of whom 22 had prostate and 13 breast cancers. Mean follow-up was 227 days, during which death was recorded for 32 patients. Fourteen patients (40%) had a complete response, 9 (26%) partial and 12 (34%) no response. In the 23 responding patients, mean duration of response was 6 months. In 17 patients the response was present until death. There was no significant relationship between pain response and patients' age or type of primary cancer. No side effects were recorded other than mild and temporary drop in white blood cell and platelet counts. Three patients with a complete response had a second injection of Sr-89 after progression of pain. One of these patients had a second partial response; the other 2 did not show a response to the second injection. The use of Sr-89 for treatment of widespread painful bone metastases from prostate and breast cancers in our department showed a 66% rate of response and a mean response duration of 6 months, with no significant side effects. (author)

  10. High dose rate brachytherapy for the treatment of soft tissue sarcoma of the extremity

    International Nuclear Information System (INIS)

    Speight, J.L.; Streeter, O.E.; Chawla, S.; Menendez, L.E.

    1996-01-01

    Purpose: we examined the role of preoperative neoadjuvant chemoradiation and adjuvant high-dose rate brachytherapy on the management of prognostically unfavorable soft tissue sarcomas of the extremities. Our goal was to examine the effect of high dose rate interstitial brachytherapy (HDR IBT) on reducing the risk of local recurrence following limb-sparing resection, as well as shortening treatment duration. Materials and methods: eleven patients, ranging in age from 31 to 73 years old, with soft tissue sarcoma of the extremity were treated at USC/Norris Comprehensive Cancer Center during 1994 and 1995. All patients had biopsy proven soft tissue sarcoma, and all were suitable candidates for limb-sparing surgery. All lesions were greater than 5cm in size and were primarily high grade. Tumor histologies included malignant fibrous histiocytoma (45%), liposarcoma (18%) and leiomyosarcoma, synovial cell sarcoma and spindle cell sarcoma (36%). Sites of tumor origin were the lower extremity (55%), upper extremity (18%) and buttock (9%), 1 patient (9%) had lesions in both the upper and lower extremity. Patients received HDR IBT following combined chemotherapy and external beam irradiation (EBRT) and en bloc resection of the sarcoma. Neoadjuvant chemotherapy consisted of three to four cycles of either Ifosfamide/Mesna with or without Adriamycin, or Mesna, Adriamycin, Ifosfamide and Dacarbazine. One patient received Cis-platin in addition to Ifos/Adr. A minimum of two cycles of chemotherapy were administered prior to EBRT. Additional cycles of chemotherapy were completed concurrently with EBRT but prior to HDR IBT. Preoperative EBRT doses ranging from 40 to 59.4 Gy were given in daily fractions of 180 to 200cGy. Following en bloc resection, HDR IBT was administered using the Omnitron tm 2000 remote afterloading system. Doses ranging from 13 to 30 Gy were delivered to the surgical tumor bed at depths of 0.5mm to 0.75mm from the radioactive source. Results: median follow-up was

  11. Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe.

    Science.gov (United States)

    Judd, A; Lodwick, R; Noguera-Julian, A; Gibb, D M; Butler, K; Costagliola, D; Sabin, C; van Sighem, A; Ledergerber, B; Torti, C; Mocroft, A; Podzamczer, D; Dorrucci, M; De Wit, S; Obel, N; Dabis, F; Cozzi-Lepri, A; García, F; Brockmeyer, N H; Warszawski, J; Gonzalez-Tome, M I; Mussini, C; Touloumi, G; Zangerle, R; Ghosn, J; Castagna, A; Fätkenheuer, G; Stephan, C; Meyer, L; Campbell, M A; Chene, G; Phillips, A

    2017-03-01

    The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection. We analysed individual patient data from cohorts in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). A total of 5972 participants starting antiretroviral therapy (ART) from 1998, aged 500 HIV-1 RNA copies/mL despite ≥ 4 months of use. TCVF was defined as cumulative failure of two NRTIs, an NNRTI and a bPI. The median number of weeks between diagnosis and the start of ART was higher in participants with perinatal HIV infection compared with participants with heterosexually acquired HIV infection overall [17 (interquartile range (IQR) 4-111) vs. 8 (IQR 2-38) weeks, respectively], and highest in perinatally infected participants aged 10-14 years [49 (IQR 9-267) weeks]. The cumulative proportion with TCVF 5 years after starting ART was 9.6% [95% confidence interval (CI) 7.0-12.3%] in participants with perinatally acquired infection and 4.7% (95% CI 3.9-5.5%) in participants with heterosexually acquired infection, and highest in perinatally infected participants aged 10-14 years when starting ART (27.7%; 95% CI 13.2-42.1%). Across all participants, significant predictors of TCVF were those with perinatal HIV aged 10-14 years, African origin, pre-ART AIDS, NNRTI-based initial regimens, higher pre-ART viral load and lower pre-ART CD4. The results suggest a beneficial effect of starting ART before adolescence, and starting young people on boosted PIs, to maximize treatment response during this transitional stage of development. © 2016 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

  12. Effects of the Cooling Rate After Annealing Treatment on the Microstructure and the Mechanical Properties of Super-Duplex Stainless Steel

    International Nuclear Information System (INIS)

    Kwon, Gi-Hyoun; Park, Yong-Ho; Na, Young-Sang; Yoo, Wee-Do; Lee, Jong-Hoon

    2012-01-01

    The aim of this study was to analyze the effect of the cooling rate after heat treatment on the microstructure and mechanical properties of 2507 duplex stainless steels. Heat treatment was carried out at 1050°C for 1 hr, followed by controlled cooling. The cooling rates were 175.6 × 10 - 3°C/s, 47.8 × 10 - 3°C/s, 33.3 × 10 - 3°C/s, 16.7 × 10 - 3°C/s, 11.7 × 10 - 3°C/s, 5.8 × 10 - 3°C/s and 2.8 × 10 - 3°C/s, which resulted in variations of the microstructure, such as the fractional change of the ferrite phase and sigma phase formation. Fatigue, hardness, impact and tensile tests were performed on the specimens with different cooling rates. The precipitation of the σ phase caused a hardness increase and a sharp decrease of toughness and tensile elongation. The fatigue limit of the sample with a cooling rate of 5.8 × 10 - 3°C/s was 26 MPa higher than that of the sample with a cooling rate of 175.6 × 10 - 3°C/s. Our observations of the fracture surface confirmed that the higher fatigue resistance of the specimen with a cooling rate of 5.8 × 10 - 3°C/s was caused by the delay of the fatigue crack growth, in addition to higher yield strength.

  13. Effects of the Cooling Rate After Annealing Treatment on the Microstructure and the Mechanical Properties of Super-Duplex Stainless Steel

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Gi-Hyoun; Park, Yong-Ho [Pusan National University, Pusan (Korea, Republic of); Na, Young-Sang; Yoo, Wee-Do; Lee, Jong-Hoon [Korea Institute of Materials Science, Changwon (Korea, Republic of)

    2012-10-15

    The aim of this study was to analyze the effect of the cooling rate after heat treatment on the microstructure and mechanical properties of 2507 duplex stainless steels. Heat treatment was carried out at 1050°C for 1 hr, followed by controlled cooling. The cooling rates were 175.6 × 10{sup -}3°C/s, 47.8 × 10{sup -}3°C/s, 33.3 × 10{sup -}3°C/s, 16.7 × 10{sup -}3°C/s, 11.7 × 10{sup -}3°C/s, 5.8 × 10{sup -}3°C/s and 2.8 × 10{sup -}3°C/s, which resulted in variations of the microstructure, such as the fractional change of the ferrite phase and sigma phase formation. Fatigue, hardness, impact and tensile tests were performed on the specimens with different cooling rates. The precipitation of the σ phase caused a hardness increase and a sharp decrease of toughness and tensile elongation. The fatigue limit of the sample with a cooling rate of 5.8 × 10{sup -}3°C/s was 26 MPa higher than that of the sample with a cooling rate of 175.6 × 10{sup -}3°C/s. Our observations of the fracture surface confirmed that the higher fatigue resistance of the specimen with a cooling rate of 5.8 × 10{sup -}3°C/s was caused by the delay of the fatigue crack growth, in addition to higher yield strength.

  14. Poor quality evidence suggests that failure rates for atraumatic restorative treatment and conventional amalgam are similar.

    Science.gov (United States)

    Hurst, Dominic

    2012-06-01

    The Medline, Cochrane CENTRAL, Biomed Central, Database of Open Access Journals (DOAJ), OpenJ-Gate, Bibliografia Brasileira de Odontologia (BBO), LILACS, IndMed, Sabinet, Scielo, Scirus (Medicine), OpenSIGLE and Google Scholar databases were searched. Hand searching was performed for journals not indexed in the databases. References of included trials were checked. Prospective clinical trials with test and control groups with a follow up of at least one year were included. Data abstraction was conducted independently and clinical and methodologically homogeneous data were pooled using a fixed-effects model. Eighteen trials were included. From these 32 individual dichotomous datasets were extracted and analysed. The majority of the results show no differences between both types of intervention. A high risk of selection-, performance-, detection- and attrition bias was identified. Existing research gaps are mainly due to lack of trials and small sample size. The current evidence indicates that the failure rate of high-viscosity GIC/ART restorations is not higher than, but similar to that of conventional amalgam fillings after periods longer than one year. These results are in line with the conclusions drawn during the original systematic review. There is a high risk that these results are affected by bias, and thus confirmation by further trials with suitably high numbers of participants is needed.

  15. Temporal trends in obesity, osteoporosis treatment, bone mineral density, and fracture rates: a population-based historical cohort study.

    Science.gov (United States)

    Leslie, William D; Lix, Lisa M; Yogendran, Marina S; Morin, Suzanne N; Metge, Colleen J; Majumdar, Sumit R

    2014-04-01

    Diverging international trends in fracture rates have been observed, with most reports showing that fracture rates have stabilized or decreased in North American and many European populations. We studied two complementary population-based historical cohorts from the Province of Manitoba, Canada (1996-2006) to determine whether declining osteoporotic fracture rates in Canada are attributable to trends in obesity, osteoporosis treatment, or bone mineral density (BMD). The Population Fracture Registry included women aged 50 years and older with major osteoporotic fractures, and was used to assess impact of changes in osteoporosis treatment. The BMD Registry included all women aged 50 years and older undergoing BMD tests, and was used to assess impact of changes in obesity and BMD. Model-based estimates of temporal changes in fracture rates (Fracture Registry) were calculated. Temporal changes in obesity and BMD and their association with fracture rates (BMD Registry) were estimated. In the Fracture Registry (n=27,341), fracture rates declined 1.6% per year (95% confidence interval [CI], 1.3% to 2.0%). Although osteoporosis treatment increased from 5.6% to 17.4%, the decline in fractures was independent of osteoporosis treatment. In the BMD Registry (n=36,587), obesity increased from 12.7% to 27.4%. Femoral neck BMD increased 0.52% per year and lumbar spine BMD increased 0.32% per year after covariate adjustment (pobesity or osteoporosis treatment. © 2014 American Society for Bone and Mineral Research.

  16. Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

    Science.gov (United States)

    Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

    2015-01-01

    Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

  17. HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact.

    Science.gov (United States)

    Martin, N K; Foster, G R; Vilar, J; Ryder, S; Cramp, M E; Gordon, F; Dillon, J F; Craine, N; Busse, H; Clements, A; Hutchinson, S J; Ustianowski, A; Ramsay, M; Goldberg, D J; Irving, W; Hope, V; De Angelis, D; Lyons, M; Vickerman, P; Hickman, M

    2015-04-01

    Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37-48% HCV chronic prevalence among PWID), East London (37-48%), Manchester (48-56%), Nottingham (37-44%), Plymouth (30-37%), Dundee (20-27%) and North Wales (27-33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33-57%] and 61% genotypes 2/3 [95%CI 47-76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence. © 2014 The Authors Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

  18. Drug treatment rates with beta-blockers and ACE-inhibitors/angiotensin receptor blockers and recurrences in takotsubo cardiomyopathy: A meta-regression analysis.

    Science.gov (United States)

    Brunetti, Natale Daniele; Santoro, Francesco; De Gennaro, Luisa; Correale, Michele; Gaglione, Antonio; Di Biase, Matteo

    2016-07-01

    In a recent paper Singh et al. analyzed the effect of drug treatment on recurrence of takotsubo cardiomyopathy (TTC) in a comprehensive meta-analysis. The study found that recurrence rates were independent of clinic utilization of BB prescription, but inversely correlated with ACEi/ARB prescription: authors therefore conclude that ACEi/ARB rather than BB may reduce risk of recurrence. We aimed to re-analyze data reported in the study, now weighted for populations' size, in a meta-regression analysis. After multiple meta-regression analysis, we found a significant regression between rates of prescription of ACEi and rates of recurrence of TTC; regression was not statistically significant for BBs. On the bases of our re-analysis, we confirm that rates of recurrence of TTC are lower in populations of patients with higher rates of treatment with ACEi/ARB. That could not necessarily imply that ACEi may prevent recurrence of TTC, but barely that, for example, rates of recurrence are lower in cohorts more compliant with therapy or more prescribed with ACEi because more carefully followed. Randomized prospective studies are surely warranted. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Effect of heating rate on mechanical property, microstructure and texture evolution of Al–Mg–Si–Cu alloy during solution treatment

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaofeng; Guo, Mingxing, E-mail: mingxingguo@skl.ustb.edu.cn; Cao, Lingyong; Luo, Jinru; Zhang, Jishan; Zhuang, Linzhong

    2015-01-05

    The effect of heating rate on the mechanical properties, microstructure and texture of Al–Mg–Si–Cu alloy during solution treatment was investigated through tensile testing, scanning electron microscope, scanning transmission electron microscope, metallographic observation and EBSD measurement. The experimental results reveal that there are great differences in the mechanical properties, microstructures and textures after the solution treatment with two different heating rates. Compared with the alloy sheet solution treated with slow heating rate, the alloy sheet solution treated with rapid heating rate possesses weak mechanical property anisotropy and higher average r value. The equiaxed grain is the main recrystallization microstructure for the case of rapid heating rate, while the elongated grain appears in the case of slow heating rate. The texture components are also quite different in the two cases, Cube{sub ND} orientation is the main texture component for the former case, while the latter one includes Cube, R, Goss, P and Brass orientations. The relationship between r value, texture components and microstructure has also been established in this paper.

  20. Effect of heating rate on mechanical property, microstructure and texture evolution of Al–Mg–Si–Cu alloy during solution treatment

    International Nuclear Information System (INIS)

    Wang, Xiaofeng; Guo, Mingxing; Cao, Lingyong; Luo, Jinru; Zhang, Jishan; Zhuang, Linzhong

    2015-01-01

    The effect of heating rate on the mechanical properties, microstructure and texture of Al–Mg–Si–Cu alloy during solution treatment was investigated through tensile testing, scanning electron microscope, scanning transmission electron microscope, metallographic observation and EBSD measurement. The experimental results reveal that there are great differences in the mechanical properties, microstructures and textures after the solution treatment with two different heating rates. Compared with the alloy sheet solution treated with slow heating rate, the alloy sheet solution treated with rapid heating rate possesses weak mechanical property anisotropy and higher average r value. The equiaxed grain is the main recrystallization microstructure for the case of rapid heating rate, while the elongated grain appears in the case of slow heating rate. The texture components are also quite different in the two cases, Cube ND orientation is the main texture component for the former case, while the latter one includes Cube, R, Goss, P and Brass orientations. The relationship between r value, texture components and microstructure has also been established in this paper

  1. Treatment of skin carcinomas of the face by high-dose-rate brachytherapy and custom-made surface molds

    International Nuclear Information System (INIS)

    Guix, Benjamin; Finestres, Fernando; Tello, Jose-Ignacio; Palma, Cesar; Martinez, Antonio; Guix, Jose-Ramon; Guix, Ricardo

    2000-01-01

    Purpose: To analyze the results obtained in a prospective group of patients with basal or squamous cell skin carcinomas of the face treated by high-dose-rate (HDR) brachytherapy via custom-made surface molds. Methods and Materials: A total of 136 patients with basal or squamous cell carcinomas of the face were treated between March 1992 and March 1997 by surface molds and HDR brachytherapy with iridium-192. Nineteen patients were treated with standard Brock applicators and 117 patients with custom-made polymethyl methacrylate applicators, built over a plaster mold obtained of the patient's face. Minimum dose administered to the tumor was 6000 to 6500 cGy in 33 to 36 fractions at 180 cGy/fraction in lesions of up to 4 cm. Lesions greater than 4 cm were boosted up to 7500-8000 cGy after a 3-week pause. Results: With the custom-made surface molds, the dose distribution was uniform in the surface of the skin and at 5 mm depth in the whole area of the applicator. Differences between the areas of maximum and minimum dose at this depth never reached values higher than 5% of the prescribed dose. At the edges of the custom-made molds dose gradient was sharp, with the detected dose at 5 mm from the applicator being negligible. All the patients were complete responders. There were 3 local recurrences, 1/73 patients treated for primary tumor and 2/63 patients treated for recurrent tumor. Actuarial local control at 5 years for all patients was 98%, for those patients with primary tumors 99%, and for recurrent patients 87%. The treatment tolerance was excellent in all cases. No severe, early, or late, complications were detected. Conclusions: Radiotherapy is a highly effective treatment of skin carcinomas of the face. Custom-made molds, to be used in conjunction with HDR brachytherapy equipment, make possible a uniform dose distribution, with a sharp dose gradient in the limits of applicators. Custom-made surface molds are easy and safe to use, and they fit very accurately for

  2. After microvascular decompression to treat trigeminal neuralgia, both immediate pain relief and recurrence rates are higher in patients with arterial compression than with venous compression.

    Science.gov (United States)

    Shi, Lei; Gu, Xiaoyan; Sun, Guan; Guo, Jun; Lin, Xin; Zhang, Shuguang; Qian, Chunfa

    2017-07-04

    We explored differences in postoperative pain relief achieved through decompression of the trigeminal nerve compressed by arteries and veins. Clinical characteristics, intraoperative findings, and postoperative curative effects were analyzed in 72 patients with trigeminal neuralgia who were treated by microvascular decompression. The patients were divided into arterial and venous compression groups based on intraoperative findings. Surgical curative effects included immediate relief, delayed relief, obvious reduction, and invalid result. Among the 40 patients in the arterial compression group, 32 had immediate pain relief of pain (80.0%), 5 cases had delayed relief (12.5%), and 3 cases had an obvious reduction (7.5%). In the venous compression group, 12 patients had immediate relief of pain (37.5%), 13 cases had delayed relief (40.6%), and 7 cases had an obvious reduction (21.9%). During 2-year follow-up period, 6 patients in the arterial compression group experienced recurrence of trigeminal neuralgia, but there were no recurrences in the venous compression group. Simple artery compression was followed by early relief of trigeminal neuralgia more often than simple venous compression. However, the trigeminal neuralgia recurrence rate was higher in the artery compression group than in the venous compression group.

  3. Thermal post-deposition treatment effects on nanocrystalline hydrogenated silicon prepared by PECVD under different hydrogen flow rates

    Energy Technology Data Exchange (ETDEWEB)

    Amor, Sana Ben, E-mail: sana.benamor1@gmail.com [Photovoltaic Laboratory Research and Technology Centre of Energy, Borj-Cedria Science and Technology Park, BP 95, 2050 Hammam-Lif (Tunisia); University of Applied Medical Sciences of Hafr El Baten (Saudi Arabia); Meddeb, Hosny; Daik, Ridha; Othman, Afef Ben; Slama, Sonia Ben; Dimassi, Wissem; Ezzaouia, Hatem [Photovoltaic Laboratory Research and Technology Centre of Energy, Borj-Cedria Science and Technology Park, BP 95, 2050 Hammam-Lif (Tunisia)

    2016-01-01

    Graphical abstract: At high annealing temperatures, many atoms do not suffer the attraction of surface species due to the thermal agitation and consequently few atoms are adsorbed. As the temperature is lowered the adsorption is more efficient to the point that is no more atoms in the gas phase. Indeed at relatively low temperatures, the atoms have too little energy to escape from the surface or even to vibrate against it. They lost their degree of freedom in the direction perpendicular to the surface. But this does not prevent the atoms to diffuse along the surface. As a result, the layer's thickness decrease with increasing the annealing temperature. - Highlights: The results extracted from this work are: • The post-deposition thermal treatment improves the crystallinity the film at moderate temperature (500 °C). • The higher annealing temperature can lead to decrease the silicon–hydrogen bonds and increase the Si–Si bonds. • Moderate annealing temperature (700 °C) seems to be crucial for obtaining high minority carrier life times. • Hydrogen effusion phenomenon start occurring at 500–550 °C and get worsen at 900 °C. - Abstract: In this paper, hydrogenated nanocrystalline silicon (nc-Si:H) thin films were deposited on mono-crystalline silicon substrate by plasma enhanced chemical vapor deposition (PECVD) under different hydrogen flow rates followed by a thermal treatment in an infrared furnace at different temperature ranging from 300 to 900 °C. The investigated structural, morphological and optoelectronic properties of samples were found to be strongly dependent on the annealing temperature. Raman spectroscopy revealed that nc-Si:H films contain crystalline, amorphous and mixed structures as well. We find that post-deposition thermal treatment may lead to a tendency for structural improvement and a decrease of the disorder in the film network at moderate temperature under 500 °C. As for annealing at higher temperature up to 900

  4. Effect of thermal treatment on the body temperature, respiration and pulse rate in dogs chronically irradiated with γ-rays

    International Nuclear Information System (INIS)

    Popova, N.A.; Petrovnin, M.G.

    1975-01-01

    Male dogs were chronically gamma-irradiated at different dose rates (0.06, 0.17, 0.34 rad/day) and subjected to heat treatment (raising of temperature from 22 0 C to 40 0 C) during winter and summer. Internal (rectal) temperature, respiration rate and heart rate were recorded. The respiration rate changed appreciably in all groups during all periods of temperature rise and fall in the chamber, but the variations were more pronounced in all groups during the winter experiment than during the summer experiment; no significant differences were found between the groups of animals while the respiration rate was changing, either in the winter or in the summer experiment. In both experiments, there were considerable heart rate variations only in the control group and in the group exposed to a dose rate of 0.06 rad/day. (V.A.P.)

  5. Dosimetric Evaluation of High-Dose-Rate Interstitial Brachytherapy Boost Treatments for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Froehlich, Georgina; Agoston, Peter; Loevey, Jozsef; Somogyi, Andras; Fodor, Janos; Polgar, Csaba; Major, Tibor

    2010-01-01

    Purpose: to quantitatively evaluate the dose distributions of high-dose-rate (HDR) prostate implants regarding target coverage, dose homogeneity, and dose to organs at risk. Material and methods: treatment plans of 174 implants were evaluated using cumulative dose-volume histograms (DVHs). The planning was based on transrectal ultrasound (US) imaging, and the prescribed dose (100%) was 10 Gy. The tolerance doses to rectum and urethra were 80% and 120%, respectively. Dose-volume parameters for target (V90, V100, V150, V200, D90, D min ) and quality indices (DNR [dose nonuniformity ratio], DHI [dose homogeneity index], CI [coverage index], COIN [conformal index]) were calculated. Maximum dose in reference points of rectum (D r ) and urethra (D u ), dose to volume of 2 cm 3 of the rectum (D 2ccm ), and 0.1 cm 3 and 1% of the urethra (D 0.1ccm and D1) were determined. Nonparametric correlation analysis was performed between these parameters. Results: the median number of needles was 16, the mean prostate volume (V p ) was 27.1 cm 3 . The mean V90, V100, V150, and V200 were 90%, 97%, 39% and 13%, respectively. The mean D90 was 109%, and the D min was 87%. The mean doses in rectum and urethra reference points were 75% and 119%, respectively. The mean volumetric doses were D 2ccm = 49% for the rectum, D 0.1ccm = 126%, and D1 = 140% for the urethra. The mean DNR was 0.37, while the DHI was 0.60. The mean COIN was 0.66. The Spearman rank order correlation coefficients for volume doses to rectum and urethra were R(D r , D 2ccm ) = 0.69, R(D u , D 0.1ccm ) = 0.64, R(D u , D1) = 0.23. Conclusion: US-based treatment plans for HDR prostate implants based on the real positions of catheters provided acceptable dose distributions. In the majority of the cases, the doses to urethra and rectum were kept below the defined tolerance levels. For rectum, the dose in reference points correlated well with dose-volume parameters. For urethra dose characterization, the use of D1 volumetric

  6. Dosimetric Evaluation of High-Dose-Rate Interstitial Brachytherapy Boost Treatments for Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, Georgina [Semmelweis Univ., Budapest (Hungary); Dept. of Radiotherapy, National Inst. of Oncology, Budapest (Hungary); Agoston, Peter; Loevey, Jozsef; Somogyi, Andras; Fodor, Janos; Polgar, Csaba; Major, Tibor [Dept. of Radiotherapy, National Inst. of Oncology, Budapest (Hungary)

    2010-07-15

    Purpose: to quantitatively evaluate the dose distributions of high-dose-rate (HDR) prostate implants regarding target coverage, dose homogeneity, and dose to organs at risk. Material and methods: treatment plans of 174 implants were evaluated using cumulative dose-volume histograms (DVHs). The planning was based on transrectal ultrasound (US) imaging, and the prescribed dose (100%) was 10 Gy. The tolerance doses to rectum and urethra were 80% and 120%, respectively. Dose-volume parameters for target (V90, V100, V150, V200, D90, D{sub min}) and quality indices (DNR [dose nonuniformity ratio], DHI [dose homogeneity index], CI [coverage index], COIN [conformal index]) were calculated. Maximum dose in reference points of rectum (D{sub r}) and urethra (D{sub u}), dose to volume of 2 cm{sup 3} of the rectum (D{sub 2ccm}), and 0.1 cm{sup 3} and 1% of the urethra (D{sub 0.1ccm} and D1) were determined. Nonparametric correlation analysis was performed between these parameters. Results: the median number of needles was 16, the mean prostate volume (V{sub p}) was 27.1 cm{sup 3}. The mean V90, V100, V150, and V200 were 90%, 97%, 39% and 13%, respectively. The mean D90 was 109%, and the D{sub min} was 87%. The mean doses in rectum and urethra reference points were 75% and 119%, respectively. The mean volumetric doses were D{sub 2ccm} = 49% for the rectum, D{sub 0.1ccm} = 126%, and D1 = 140% for the urethra. The mean DNR was 0.37, while the DHI was 0.60. The mean COIN was 0.66. The Spearman rank order correlation coefficients for volume doses to rectum and urethra were R(D{sub r}, D{sub 2ccm}) = 0.69, R(D{sub u}, D{sub 0.1ccm}) = 0.64, R(D{sub u}, D1) = 0.23. Conclusion: US-based treatment plans for HDR prostate implants based on the real positions of catheters provided acceptable dose distributions. In the majority of the cases, the doses to urethra and rectum were kept below the defined tolerance levels. For rectum, the dose in reference points correlated well with dose

  7. Dosimetric evaluation of high-dose-rate interstitial brachytherapy boost treatments for localized prostate cancer.

    Science.gov (United States)

    Fröhlich, Georgina; Agoston, Péter; Lövey, József; Somogyi, András; Fodor, János; Polgár, Csaba; Major, Tibor

    2010-07-01

    To quantitatively evaluate the dose distributions of high-dose-rate (HDR) prostate implants regarding target coverage, dose homogeneity, and dose to organs at risk. Treatment plans of 174 implants were evaluated using cumulative dose-volume histograms (DVHs). The planning was based on transrectal ultrasound (US) imaging, and the prescribed dose (100%) was 10 Gy. The tolerance doses to rectum and urethra were 80% and 120%, respectively. Dose-volume parameters for target (V90, V100, V150, V200, D90, D(min)) and quality indices (DNR [dose nonuniformity ratio], DHI [dose homogeneity index], CI [coverage index], COIN [conformal index]) were calculated. Maximum dose in reference points of rectum (D(r)) and urethra (D(u)), dose to volume of 2 cm(3) of the rectum (D(2ccm)), and 0.1 cm(3) and 1% of the urethra (D(0.1ccm) and D1) were determined. Nonparametric correlation analysis was performed between these parameters. The median number of needles was 16, the mean prostate volume (V(p)) was 27.1 cm(3). The mean V90, V100, V150, and V200 were 99%, 97%, 39%, and 13%, respectively. The mean D90 was 109%, and the D(min) was 87%. The mean doses in rectum and urethra reference points were 75% and 119%, respectively. The mean volumetric doses were D(2ccm) = 49% for the rectum, D(0.1ccm) = 126%, and D1 = 140% for the urethra. The mean DNR was 0.37, while the DHI was 0.60. The mean COIN was 0.66. The Spearman rank order correlation coefficients for volume doses to rectum and urethra were R(D(r),D(2ccm)) = 0.69, R(D(u),D0.(1ccm)) = 0.64, R(D(u),D1) = 0.23. US-based treatment plans for HDR prostate implants based on the real positions of catheters provided acceptable dose distributions. In the majority of the cases, the doses to urethra and rectum were kept below the defined tolerance levels. For rectum, the dose in reference points correlated well with dose-volume parameters. For urethra dose characterization, the use of D1 volumetric parameter is recommended.

  8. Flow rate analysis of wastewater inside reactor tanks on tofu wastewater treatment plant

    Science.gov (United States)

    Mamat; Sintawardani, N.; Astuti, J. T.; Nilawati, D.; Wulan, D. R.; Muchlis; Sriwuryandari, L.; Sembiring, T.; Jern, N. W.

    2017-03-01

    The research aimed to analyse the flow rate of the wastewater inside reactor tanks which were placed a number of bamboo cutting. The resistance of wastewater flow inside reactor tanks might not be occurred and produce biogas fuel optimally. Wastewater from eleven tofu factories was treated by multi-stages anaerobic process to reduce its organic pollutant and produce biogas. Biogas plant has six reactor tanks of which its capacity for waste water and gas dome was 18 m3 and 4.5 m3, respectively. Wastewater was pumped from collecting ponds to reactors by either serial or parallel way. Maximum pump capacity, head, and electrical motor power was 5m3/h, 50m, and 0.75HP, consecutively. Maximum pressure of biogas inside the reactor tanks was 55 mbar higher than atmosphere pressure. A number of 1,400 pieces of cutting bamboo at 50-60 mm diameter and 100 mm length were used as bacteria growth media inside each reactor tank, covering around 14,287 m2 bamboo area, and cross section area of inner reactor was 4,9 m2. In each reactor, a 6 inches PVC pipe was installed vertically as channel. When channels inside reactor were opened, flow rate of wastewater was 6x10-1 L.sec-1. Contrary, when channels were closed on the upper part, wastewater flow inside the first reactor affected and increased gas dome. Initially, wastewater flowed into each reactor by a gravity mode with head difference between the second and third reactor was 15x10-2m. However, head loss at the second reactor was equal to the third reactor by 8,422 x 10-4m. As result, wastewater flow at the second and third reactors were stagnant. To overcome the problem pump in each reactor should be installed in serial mode. In order to reach the output from the first reactor and the others would be equal, and biogas space was not filled by wastewater, therefore biogas production will be optimum.

  9. Treatment as Part of Drug Court: The Impact on Graduation Rates

    Science.gov (United States)

    Taxman, Faye S.; Bouffard, Jeffrey A.

    2005-01-01

    Drug treatment is one of the critical components of drug court programming, yet it has not been thoroughly studied in the drug court literature. Very little is understood about the nature of drug treatment services provided in the drug court setting. The purpose of this study was to examine the effects of selected treatment variables on drug court…

  10. Comparison of pregnancy rates in PCOS patients undergoing clomiphene citrate and IUI treatment with different leading follicular sizes.

    Science.gov (United States)

    Seckin, Berna; Pekcan, Meryem Kuru; Bostancı, Esra Isci; Inal, Hasan Ali; Cicek, Mahmut Nedim

    2016-04-01

    The objective of the study was to compare the pregnancy rates in PCOS patients undergoing clomiphene citrate (CC) and intrauterine insemination (IUI) treatment with different leading follicular sizes. A total of 358 infertile women with PCOS who underwent 563 clomiphene citrate and IUI treatment cycles were included in this prospective study. Treatment cycles were divided into three groups according to leading follicular size on the day of hCG administration: Group I: follicular size 17-18 mm (n = 177), Group II: 19-22 mm (n = 321), and Group III : >22 mm (n = 65). Pregnancy rates were evaluated. Treatment outcomes of the groups were further analyzed related to endometrial thickness measurement on the day of hCG. For this purpose, cycles were placed into three subgroups as follows: endometrial thickness 9 mm. There was no statistically significant difference in clinical pregnancy rate per cycle between the groups (8.5, 10, and 9.2 % for Group I, II, and III, respectively, p = 0.86). In further analyses related to endometrial thickness, no significant difference was also found in pregnancy rate among the groups. This results suggest that pregnancy rate is not related to leading follicle size on the day of hCG administration in PCOS patients treated with CC and IUI. In addition, pregnancy rate in women with different follicular sizes is not influenced by the endometrial thickness.

  11. Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones.

    Science.gov (United States)

    Aydemir, Hüseyin; Budak, Salih; Kumsar, Şükrü; Köse, Osman; Sağlam, Hasan Salih; Adsan, Öztuğ

    2014-09-01

    In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery. Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded. The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm(2) in the PNL, 1.4±0.1 cm(2) in the RIRS, and 3.1±0.9 cm(2) in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups. PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity.

  12. Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial.

    Science.gov (United States)

    Manhart, Lisa E; Gillespie, Catherine W; Lowens, M Sylvan; Khosropour, Christine M; Colombara, Danny V; Golden, Matthew R; Hakhu, Navneet R; Thomas, Katherine K; Hughes, James P; Jensen, Nicole L; Totten, Patricia A

    2013-04-01

    Azithromycin or doxycycline is recommended for nongonococcal urethritis (NGU); recent evidence suggests their efficacy has declined. We compared azithromycin and doxycycline in men with NGU, hypothesizing that azithromycin was more effective than doxycycline. From January 2007 to July 2011, English-speaking males ≥16 years, attending a sexually transmitted diseases clinic in Seattle, Washington, with NGU (visible urethral discharge or ≥5 polymorphonuclear leukocytes per high-power field [PMNs/HPF]) were eligible for this double-blind, parallel-group superiority trial. Participants received active azithromycin (1 g) + placebo doxycycline or active doxycycline (100 mg twice daily for 7 days) + placebo azithromycin. Urine was tested for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Ureaplasma urealyticum biovar 2 (UU-2), and Trichomonas vaginalis (TV) using nucleic acid amplification tests. Clinical cure (urethral symptoms and absence of discharge) and microbiologic cure (negative tests for CT, MG, and/or UU-2) were determined after 3 weeks. Of 606 men, 304 were randomized to azithromycin and 302 to doxycycline; CT, MG, TV, and UU-2 were detected in 24%, 13%, 2%, and 23%, respectively. In modified intent-to-treat analyses, 172 of 216 (80%; 95% confidence interval [CI], 74%-85%) receiving azithromycin and 157 of 206 (76%; 95% CI, 70%-82%) receiving doxycycline experienced clinical cure (P = .40). In pathogen-specific analyses, clinical cure did not differ by arm, nor did microbiologic cure differ for CT (86% vs 90%, P = .56), MG (40% vs 30%, P = .41), or UU-2 (75% vs 70%, P = .50). No unexpected adverse events occurred. Clinical and microbiologic cure rates for NGU were somewhat low and there was no significant difference between azithromycin and doxycycline. Mycoplasma genitalium treatment failure was extremely common. Clinical Trials Registration.NCT00358462.

  13. Which dose of bevacizumab is more effective for the treatment of aggressive posterior retinopathy of prematurity: lower or higher dose?

    Directory of Open Access Journals (Sweden)

    Seyhan Dikci

    Full Text Available ABSTRACT Purpose: To compare 0.5 mg and 0.625 mg of bevacizumab for treating aggressive posterior retinopathy of prematurity (AP-ROP. Methods: The medical records of patients with AP-ROP who were administered intravitreal bevacizumab (IVB as a primary treatment at a university clinic were evaluated retrospectively. Five eyes of three patients (Group 1 who received 0.625 mg/0.025 ml IVB and 10 eyes of another five patients (Group 2 who received 0.5 mg/0.02 ml IVB were evaluated. Laser photocoagulation was used as additional treatment after relapses. Anatomic results and complications were evaluated in both groups. Results: We evaluated 15 eyes of eight patients (four girls and four boys with a flat demarcation line at posterior zone 2 and plus disease or stage-3 disease in this study. The mean gestational age of the three babies in Group 1 was 26 ± 1 weeks and the mean birth weight was 835.33 ± 48.01 g. The corresponding values were 25.2 ± 1.6 weeks and 724 ± 139.03 g, respectively, for the five babies in Group 2. Retinal vascularization was completed at a mean postmenstrual duration of 53.6 ± 1.5 weeks without additional treatment in the five eyes in Group 1. Laser photocoagulation for relapse was administered to five of the 10 eyes in Group 2. Retinal vascularization was completed at a mean postmenstrual duration of 47.6 ± 1.5 weeks in the remaining five eyes. None of the patients developed complications such as cataract, glaucoma, retinal tear, retinal or vitreous hemorrhage, or retinal detachment. Conclusion: Although lower IVB doses in the treatment of AP-ROP are expected to be safer in terms of local and systemic side effects in premature infants, these patients may require additional treatment with IVB or laser photocoagulation.

  14. A consideration of distributions and treatment schedules in high dose rate intracavitary therapy of carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Sakata, Suoh; Sato, Sigehiro; Nakano, Masao; Iida, Koyo; Yui, Nobuharu

    1979-01-01

    A remotely controlled afterloading device for high dose rate intracavitary radiation, the remote afterloader Shimadzu Ralstron MTSW-20, was installed at Chiba Cancer Center Hospital in 1973 and put into clinical use for the treatment of carcinoma of the uterine cervix. Before the clinical use, isodose distributions and treatment schedules were investigated, compared with the low dose rate intracavitary radiation by linear sources of 137 Cs used hitherto. The isodose distributions, calculated by using an electronic computer, for various combinations of the length of uterine canal and the separation of vaginal applicators, were the same as those obtained with linear sources. As for the treatment schedules, by using PT (partial tolerance) which was derived from NSD concept of Ellis, a number of fractional radiation regimes with high dose rate, equivalent to continuous low dose rate radiation, was calculated. From these, a dose of 600 rad per fraction to point A every week has been chosen as the standard radiation schedule. The number of fractions has been varied with the clinical stages. Furthermore, some changes of total dose or small modification of dose distribution have been made for individual lesions. According to the preliminary results, three-year cumulative survival rate was 68.7% and complication rate was 15.2%. Comparing these results with those of the treatment at low dose rate, the former is nearly equal, while the latter is lower. The reduction of complication rate is probably due to the improvement of therapeutic techniques such as continuous observation by fractionated intracavitary radiation, variety of isodose distributions and accuracy of source placement by a short treatment time. (author)

  15. Treatment rates for injectable tiamulin and lincomycin as an estimate of morbidity in a swine herd with endemic swine dysentery.

    Science.gov (United States)

    Walczak, Krysia; Friendship, Robert; Brockoff, Egan; Greer, Amy; Poljak, Zvonimir

    2017-05-01

    Treatment can be used as an indirect measure of morbidity, and treatment records can be used to describe disease patterns in a population. The aim of this study was to describe the rates of treatments with tiamulin and lincomycin by the intramuscular route in cohorts of pigs affected by swine dysentery. Data from treatment records from 19 cohorts of a 1500-head grower-finisher barn were analyzed using Poisson regression to determine factors associated with rates of treatment. Serial interval and reproductive numbers were extracted. Treatment rates displayed marked seasonality. The mean serial interval was estimated at 17 d with variability among batches. In the early period of most cohorts, the effective reproductive number did not exceed 1, and the highest estimate was 2.15 (95% CI: 1.46, 3.20). The average days-to-first treatment was 4.8 which suggests that pigs could have been infected at time of entry. The information about possible sources of infection and likely seasonality should be considered when developing disease and infection control measures in affected barns.

  16. Indexed effective orifice area is a significant predictor of higher mid- and long-term mortality rates following aortic valve replacement in patients with prosthesis-patient mismatch.

    Science.gov (United States)

    Chen, Jian; Lin, Yiyun; Kang, Bo; Wang, Zhinong

    2014-02-01

    Prosthesis-patient mismatch (PPM) is defined as a too-small effective orifice area (EOA) of an inserted prosthetic relative to body size, resulting in an abnormally high postoperative gradient. It is unclear, however, whether residual stenosis after aortic valve replacement (AVR) has a negative impact on mid- and long-term survivals. We searched electronic databases, including PubMed, Embase, Medline and the Cochrane controlled trials register, through October 2012, to identify published full-text English studies on the association between PPM and mortality rates. A significant PPM was defined as an indexed EOA (iEOA)<0.85 cm2/m2, and severe PPM as an iEOA<0.65 cm2/m2. Two reviewers independently assessed the studies for inclusion and extracted data. Fourteen observational studies, involving 14 874 patients, met our final inclusion criteria. Meta-analysis demonstrated that PPM significantly increased mid-term (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.19-1.69) and long-term (OR 1.52, 95% CI 1.26-1.84) all-cause mortalities. Subgroup analysis showed that PPM was associated with higher mid- and long-term mortality rates only in younger and predominantly female populations. Risk-adjusted sensitivity analysis showed that severe PPM was associated with reduced survival (adjusted hazard ratio [HR] 1.50, 95% CI 1.24-1.80), whereas moderate PPM was not (adjusted HR 0.96, 95% CI 0.86-1.07). Regardless of severity, however, PPM had a negative effect on survival in patients with impaired ejection fraction (adjusted HR 1.26, 95% CI 1.09-1.47). PPM (iEOA<0.85 cm2/m2) after AVR tended to be associated with increased long-term all-cause mortality in younger patients, females and patients with preoperative left ventricular dysfunction. Severe PPM (iEOA<0.65 cm2/m2) was a significant predictor of reduced long-term survival in all populations undergoing AVR.

  17. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Hardev; De La Fuente Herman, Tania; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin [Department of Radiation Oncology, Peggy and Charles Stephenson Oklahoma Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104 (United States)

    2012-10-23

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem and ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

  18. Lignocellulose-derived thin stillage composition and efficient biological treatment with a high-rate hybrid anaerobic bioreactor system.

    Science.gov (United States)

    Oosterkamp, Margreet J; Méndez-García, Celia; Kim, Chang-H; Bauer, Stefan; Ibáñez, Ana B; Zimmerman, Sabrina; Hong, Pei-Ying; Cann, Isaac K; Mackie, Roderick I

    2016-01-01

    This study aims to chemically characterize thin stillage derived from lignocellulosic biomass distillation residues in terms of organic strength, nutrient, and mineral content. The feasibility of performing anaerobic digestion on these stillages at mesophilic (40 °C) and thermophilic (55 °C) temperatures to produce methane was demonstrated. The microbial communities involved were further characterized. Energy and sugar cane stillage have a high chemical oxygen demand (COD of 43 and 30 g/L, respectively) and low pH (pH 4.3). Furthermore, the acetate concentration in sugar cane stillage was high (45 mM) but was not detected in energy cane stillage. There was also a high amount of lactate in both types of stillage (35-37 mM). The amount of sugars was 200 times higher in energy cane stillage compared to sugar cane stillage. Although there was a high concentration of sulfate (18 and 23 mM in sugar and energy cane stillage, respectively), both thin stillages were efficiently digested anaerobically with high COD removal under mesophilic and thermophilic temperature conditions and with an organic loading rate of 15-21 g COD/L/d. The methane production rate was 0.2 L/g COD, with a methane percentage of 60 and 64, and 92 and 94 % soluble COD removed, respectively, by the mesophilic and thermophilic reactors. Although both treatment processes were equally efficient, there were different microbial communities involved possibly arising from the differences in the composition of energy cane and sugar cane stillage. There was more acetic acid in sugar cane stillage which may have promoted the occurrence of aceticlastic methanogens to perform a direct conversion of acetate to methane in reactors treating sugar cane stillage. Results showed that thin stillage contains easily degradable compounds suitable for anaerobic digestion and that hybrid reactors can efficiently convert thin stillage to methane under mesophilic and thermophilic conditions. Furthermore, we found

  19. Lignocellulose-derived thin stillage composition and efficient biological treatment with a high-rate hybrid anaerobic bioreactor system

    KAUST Repository

    Oosterkamp, Margreet J.

    2016-06-06

    Background This study aims to chemically characterize thin stillage derived from lignocellulosic biomass distillation residues in terms of organic strength, nutrient, and mineral content. The feasibility of performing anaerobic digestion on these stillages at mesophilic (40 °C) and thermophilic (55 °C) temperatures to produce methane was demonstrated. The microbial communities involved were further characterized. Results Energy and sugar cane stillage have a high chemical oxygen demand (COD of 43 and 30 g/L, respectively) and low pH (pH 4.3). Furthermore, the acetate concentration in sugar cane stillage was high (45 mM) but was not detected in energy cane stillage. There was also a high amount of lactate in both types of stillage (35–37 mM). The amount of sugars was 200 times higher in energy cane stillage compared to sugar cane stillage. Although there was a high concentration of sulfate (18 and 23 mM in sugar and energy cane stillage, respectively), both thin stillages were efficiently digested anaerobically with high COD removal under mesophilic and thermophilic temperature conditions and with an organic loading rate of 15–21 g COD/L/d. The methane production rate was 0.2 L/g COD, with a methane percentage of 60 and 64, and 92 and 94 % soluble COD removed, respectively, by the mesophilic and thermophilic reactors. Although both treatment processes were equally efficient, there were different microbial communities involved possibly arising from the differences in the composition of energy cane and sugar cane stillage. There was more acetic acid in sugar cane stillage which may have promoted the occurrence of aceticlastic methanogens to perform a direct conversion of acetate to methane in reactors treating sugar cane stillage. Conclusions Results showed that thin stillage contains easily degradable compounds suitable for anaerobic digestion and that hybrid reactors can efficiently convert thin stillage to methane under mesophilic and thermophilic conditions

  20. How to increase treatment effectiveness and efficiency in psychiatry: creative psychopharmacotherapy - part 1: definition, fundamental principles and higher effectiveness polypharmacy.

    Science.gov (United States)

    Jakovljević, Miro

    2013-09-01

    Psychopharmacotherapy is a fascinating field that can be understood in many different ways. It is both a science and an art of communication with a heavily subjective dimension. The advent of a significant number of the effective and well tolerated mental health medicines during and after 1990s decade of the brain has increased our possibilities to treat major mental disorders in more successful ways with much better treatment outcome including full recovery. However, there is a huge gap between our possibilities for achieving high treatment effectiveness and not satisfying results in day-to-day clinical practice. Creative approach to psychopharmacotherapy could advance everyday clinical practice and bridge the gap. Creative psychopharmacotherapy is a concept that incorporates creativity as its fundamental tool. Creativity involves the intention and ability to transcend limiting traditional ideas, rules, patterns and relationships and to create meaningful new ideas, interpretations, contexts and methods in clinical psychopharmacology.

  1. Negative Suction Drain Through a Mini Periareolar Incision for the Treatment of Lactational Breast Abscess Shortens Hospital Stay and Increases Breastfeeding Rates.

    Science.gov (United States)

    Wei, Jinli; Zhang, Jiaxin; Fu, Deyuan

    2016-06-01

    Although breast abscess is a serious uncommon complication of mastitis with high morbidity rate, there is a lack of high-quality randomized trial to demonstrate the best treatments. We reported a novel way of applying negative suction drain through a mini periareolar incision. We retrospectively analyzed and compared the clinical characteristics of 62 patients with lactational breast abscess in our department from August 2012 to April 2015. Thirty-two patients went through traditional incision and drainage (Group A) and 30 patients were placed on negative suction drain through mini periareolar incision (Group B). There is no significant difference between the two groups in terms of age, white blood cell (WBC) count, size of the abscess cavity, and positive rate of Staphylococcus aureus (SA) or methicillin-resistant Staphylococcus aureus (MRSA). Patients in Group B had a shorter hospitalized stay (p = 0.003) and had a higher rate of continuation of breastfeeding (p breast abscess and maintaining breastfeeding.

  2. Novel use of ViewRay MRI guidance for high-dose-rate brachytherapy in the treatment of cervical cancer.

    Science.gov (United States)

    Ko, Huaising C; Huang, Jessie Y; Miller, Jessica R; Das, Rupak K; Wallace, Charles R; De Costa, Anna-Maria A; Francis, David M; Straub, Margaret R; Anderson, Bethany M; Bradley, Kristin A

    To characterize image quality and feasibility of using ViewRay MRI (VR)-guided brachytherapy planning for cervical cancer. Cervical cancer patients receiving intracavitary brachytherapy with tandem and ovoids, planned using 0.35T VR MRI at our institution, were included in this series. The high-risk clinical target volume (HR-CTV), visible gross tumor volume, bladder, sigmoid, bowel, and rectum contours for each fraction of brachytherapy were evaluated for dosimetric parameters. Typically, five brachytherapy treatments were planned using the T2 sequence on diagnostic MRI for the first and third fractions, and a noncontrast true fast imaging with steady-state precession sequence on VR or CT scan for the remaining fractions. Most patients received 5.5 Gy × 5 fractions using high-dose-rate Ir-192 following 45 Gy of whole-pelvis radiotherapy. The plan was initiated at 5.5 Gy to point A and subsequently optimized and prescribed to the HR-CTV. The goal equivalent dose in 2 Gy fractions for the combined external beam and brachytherapy dose was 85 Gy. Soft-tissue visualization using contrast-to-noise ratios to distinguish normal tissues from tumor at their interface was compared between diagnostic MRI, CT, and VR. One hundred and forty-two fractions of intracavitary brachytherapy were performed from April 2015 to January 2017 on 29 cervical cancer patients, ranging from stages IB1 to IVA. The median HR-CTV was 27.78 cc, with median D 90 HR-CTV of 6.1 Gy. The median time from instrument placement to start of treatment using VR was 65 min (scan time 2 min), compared to 105 min using diagnostic MRI (scan time 11 min) (t-test, p < 0.01). The contrast-to-noise ratio of tumor to cervix in both diagnostic MRI and VR had significantly higher values compared to CT (ANOVA and t-tests, p < 0.01). We report the first clinical use of VR-guided brachytherapy. Time to treatment using this approach was shorter compared to diagnostic MRI. VR also provided significant

  3. Increased extravasation and lymphatic return rate of albumin during diuretic treatment of ascites in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Schlichting, P

    1981-01-01

    During steady state the overall lymphatic return rate of albumin equals the transvascular escape rate of albumin [TERalb, i.e. the fraction of intravascular mass of albumin (IVMalb) passing to the extravascular space per unit time] provided local back-transport is negligible, as previously substa......), indicating a net transport of albumin from the peritoneal cavity to the plasma during diuretic treatment. The results suggest an increased lymphatic drainage of albumin during diuretic treatment, which may play a role in amelioration of cirrhotic ascites....

  4. Soil and phosphorus accretion rates in sub-tropical wetlands: Everglades Stormwater Treatment Areas as a case example.

    Science.gov (United States)

    Bhomia, R K; Inglett, P W; Reddy, K R

    2015-11-15

    Wetlands are known to serve as sinks for particulate matter and associated nutrients and contaminants. Consequently rate of soil accretion is critical for continued performance of wetlands to provide ecosystem services including water quality improvement and reduce excess contaminant loads into downstream waters. Here we demonstrate a new technique to determine rate of soil accretion in selected subtropical treatment wetlands located in southern USA. We also report changes in soil accretion rates and subsequent phosphorus (P) removal efficiency with increasing operational history of these treatment wetlands. Utilizing discernible signatures preserved within the soil depth profiles, 'change points' (CP) that corresponded to specific events in the life history of a wetland were determined. The CP was observed as an abrupt transition in the physico-chemical properties of soil as a manifestation of prevailing historical conditions (e.g. startup of treatment wetlands in this case). Vertical depth of CP from the soil surface was equivalent to the depth of recently accreted soil (RAS) and used for soil accretion rate calculations. Annual soil and P accretion rates determined using CP technique (CPT) in studied wetlands ranged from 1.0±0.3 to 1.7±0.8 cm yr(-1) and 1.3±0.6 to 3.3±2 g m(-2) yr(-1), respectively. There was no difference in RAS depth between emergent and submerged aquatic vegetation communities found at the study location. Our results showed that soil and P accretion rates leveled off after 10 yr of treatment wetlands' operation. On comparison, soil accretion rates and RAS depth determined by CPT were commensurate with that measured by other techniques. CPT can be easily used where a reliable record of wetland establishment date or some significant alteration/perturbation is available. This technique offers a relatively simple alternative to determine vertical accretion rates in free-water surface wetlands. Copyright © 2015 Elsevier B.V. All rights

  5. Unintended Consequences of Evidence-Based Treatment Policy Reform: Is Implementation the Goal or the Strategy for Higher Quality Care?

    Science.gov (United States)

    Park, Alayna L; Tsai, Katherine H; Guan, Karen; Chorpita, Bruce F

    2018-02-14

    This study examined patterns of evidence-based treatment (EBT) delivery following a county-wide EBT reform initiative. Data were gathered from 60 youth and their 21 providers, who were instructed to deliver therapy as they normally would under the EBT initiative. Results showed limited applicability of county-supported EBTs to this service sample, and that most youth did not receive traditional delivery of EBTs. Findings suggest that it may be unrealistic to expect providers to deliver EBTs with fidelity with all clients, and that EBT implementation may be best thought of as a strategy for improving mental health services rather than a goal.

  6. Direction-Modulated Brachytherapy for High-Dose-Rate Treatment of Cervical Cancer. I: Theoretical Design

    International Nuclear Information System (INIS)

    Han, Dae Yup; Webster, Matthew J.; Scanderbeg, Daniel J.; Yashar, Catheryn; Choi, Dongju; Song, Bongyong; Devic, Slobodan; Ravi, Ananth; Song, William Y.

    2014-01-01

    Purpose: To demonstrate that utilization of the direction-modulated brachytherapy (DMBT) concept can significantly improve treatment plan quality in the setting of high-dose-rate (HDR) brachytherapy for cervical cancer. Methods and Materials: The new, MRI-compatible, tandem design has 6 peripheral holes of 1.3-mm diameter, grooved along a nonmagnetic tungsten-alloy rod (ρ = 18.0 g/cm 3 ), enclosed in Delrin tubing (polyoxymethylene, ρ = 1.41 g/cm 3 ), with a total thickness of 6.4 mm. The Monte Carlo N-Particle code was used to calculate the anisotropic 192 Ir dose distributions. An in-house-developed inverse planning platform, geared with simulated annealing and constrained-gradient optimization algorithms, was used to replan 15 patient cases (total 75 plans) treated with a conventional tandem and ovoids (T and O) applicator. Prescription dose was 6 Gy. For replanning, we replaced the conventional tandem with that of the new DMBT tandem for optimization but left the ovoids in place and kept the dwell positions as originally planned. All DMBT plans were normalized to match the high-risk clinical target volume V100 coverage of the T and O plans. Results: In general there were marked improvements in plan quality for the DMBT plans. On average, D2cc for the bladder, rectum, and sigmoid were reduced by 0.59 ± 0.87 Gy (8.5% ± 28.7%), 0.48 ± 0.55 Gy (21.1% ± 27.2%), and 0.10 ± 0.38 Gy (40.6% ± 214.9%) among the 75 plans, with best single-plan reductions of 3.20 Gy (40.8%), 2.38 Gy (40.07%), and 1.26 Gy (27.5%), respectively. The high-risk clinical target volume D90 was similar, with 6.55 ± 0.96 Gy and 6.59 ± 1.06 Gy for T and O and DMBT, respectively. Conclusions: Application of the DMBT concept to cervical cancer allowed for improved organ at risk sparing while achieving similar target coverage on a sizeable patient population, as intended, by maximally utilizing the anatomic information contained in 3-dimensional imaging. A

  7. Toward a 'all high rate' brachytherapy: organisation, biology and perspectives after treatment of 192 patients

    International Nuclear Information System (INIS)

    Hannoun-Levi, J.M.; Ferre, M.; Gautier, M.; Marcie, S.

    2007-01-01

    As a result of radiation protection regulations aimed at reducing the exposure to ionizing radiation from care-givers, low dose rate brachytherapy is usually replaced by a pulsed rate brachytherapy. The center Antoine Lacassagne has directed the outset to the use of a high-dose rate brachytherapy. The implications in terms of organization, biology and the prospects for such a change are the principal questions studied. (N.C.)

  8. Application of AGES prognostic rate for treatment of a well differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Sosa Martin, Gimel; Morales Portuondo, Kelvis; Martinez Valenzuela, Noslen

    2009-01-01

    At the present times, the selection a suitable surgical treatment for patients presenting with an early differentiated thyroid carcinoma is a controversial question. The aim of present research was to describe and to assessment the diagnosis results and the treatment of this condition during 5 years

  9. Modeling fuel treatment leverage: Encounter rates, risk reduction, and suppression cost impacts

    Science.gov (United States)

    Matthew P. Thompson; Karin L. Riley; Dan Loeffler; Jessica R. Haas

    2017-01-01

    The primary theme of this study is the cost-effectiveness of fuel treatments at multiple scales of investment. We focused on the nexus of fuel management and suppression response planning, designing spatial fuel treatment strategies to incorporate landscape features that provide control opportunities that are relevant to fire operations. Our analysis explored the...

  10. Treatment Outcome of Medium-Dose-Rate Intracavitary Brachytherapy for Carcinoma of the Uterine Cervix: Comparison With Low-Dose-Rate Intracavitary Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kaneyasu, Yuko, E-mail: kaneyasu@hiroshima-u.ac.jp [Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan); Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Kita, Midori [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Department of Clinical Radiology, Tokyo Metropolitan Tama Medical Center, Tokyo (Japan); Okawa, Tomohiko [Evaluation and Promotion Center, Utsunomiya Memorial Hospital, Tochigi (Japan); Maebayashi, Katsuya [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Kohno, Mari [Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women' s Medical University Hospital, Tokyo (Japan); Sonoda, Tatsuo; Hirabayashi, Hisae [Department of Radiology, Tokyo Women' s Medical University Hospital, Tokyo (Japan); Nagata, Yasushi [Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan)

    2012-09-01

    Purpose: To evaluate and compare the efficacy of medium-dose-rate (MDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for uterine cervical cancer. Methods and Materials: We evaluated 419 patients with squamous cell carcinoma of the cervix who were treated by radical radiotherapy with curative intent at Tokyo Women's Medical University from 1969 to 1999. LDR was used from 1969 to 1986, and MDR has been used since July 1987. When compared with LDR, fraction dose was decreased and fraction size was increased (1 or 2 fractions) for MDR to make the total dose of MDR equal to that of LDR. In general, the patients received a total dose of 60 to 70 Gy at Point A with external beam radiotherapy combined with brachytherapy according to the International Federation of Gynecology and Obstetrics stage. In the LDR group, 32 patients had Stage I disease, 81 had Stage II, 182 had Stage III, and 29 had Stage IVA; in the MDR group, 9 patients had Stage I disease, 19 had Stage II, 55 had Stage III, and 12 had Stage IVA. Results: The 5-year overall survival rates for Stages I, II, III, and IVA in the LDR group were 78%, 72%, 55%, and 34%, respectively. In the MDR group, the 5-year overall survival rates were 100%, 68%, 52%, and 42%, respectively. No significant statistical differences were seen between the two groups. The actuarial rates of late complications Grade 2 or greater at 5 years for the rectum, bladder, and small intestine in the LDR group were 11.1%, 5.8%, and 2.0%, respectively. The rates for the MDR group were 11.7%, 4.2%, and 2.6%, respectively, all of which were without statistical differences. Conclusion: These data suggest that MDR ICBT is effective, useful, and equally as good as LDR ICBT in daytime (about 5 hours) treatments of patients with cervical cancer.

  11. Treatment Outcome of Medium-Dose-Rate Intracavitary Brachytherapy for Carcinoma of the Uterine Cervix: Comparison With Low-Dose-Rate Intracavitary Brachytherapy

    International Nuclear Information System (INIS)

    Kaneyasu, Yuko; Kita, Midori; Okawa, Tomohiko; Maebayashi, Katsuya; Kohno, Mari; Sonoda, Tatsuo; Hirabayashi, Hisae; Nagata, Yasushi; Mitsuhashi, Norio

    2012-01-01

    Purpose: To evaluate and compare the efficacy of medium-dose-rate (MDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for uterine cervical cancer. Methods and Materials: We evaluated 419 patients with squamous cell carcinoma of the cervix who were treated by radical radiotherapy with curative intent at Tokyo Women’s Medical University from 1969 to 1999. LDR was used from 1969 to 1986, and MDR has been used since July 1987. When compared with LDR, fraction dose was decreased and fraction size was increased (1 or 2 fractions) for MDR to make the total dose of MDR equal to that of LDR. In general, the patients received a total dose of 60 to 70 Gy at Point A with external beam radiotherapy combined with brachytherapy according to the International Federation of Gynecology and Obstetrics stage. In the LDR group, 32 patients had Stage I disease, 81 had Stage II, 182 had Stage III, and 29 had Stage IVA; in the MDR group, 9 patients had Stage I disease, 19 had Stage II, 55 had Stage III, and 12 had Stage IVA. Results: The 5-year overall survival rates for Stages I, II, III, and IVA in the LDR group were 78%, 72%, 55%, and 34%, respectively. In the MDR group, the 5-year overall survival rates were 100%, 68%, 52%, and 42%, respectively. No significant statistical differences were seen between the two groups. The actuarial rates of late complications Grade 2 or greater at 5 years for the rectum, bladder, and small intestine in the LDR group were 11.1%, 5.8%, and 2.0%, respectively. The rates for the MDR group were 11.7%, 4.2%, and 2.6%, respectively, all of which were without statistical differences. Conclusion: These data suggest that MDR ICBT is effective, useful, and equally as good as LDR ICBT in daytime (about 5 hours) treatments of patients with cervical cancer.

  12. Correlation between therapy and lipid profile of leprosy patients: is there a higher risk for developing cardiovascular diseases after treatment?

    Science.gov (United States)

    Silva, Rosalba V G; de Araújo, Rafael S; Aarão, Tinara L S; da Silva Costa, Paulo Diovanne; Sousa, Jorge R; Quaresma, Juarez A S

    2017-05-01

    The impact of leprosy reduces health-related quality of life of affected patients, interfering with different factors such as nutrition. This study investigated the lipid profile, nutritional status, and risk for cardiovascular disease (CVD) in patients who underwent leprosy treatment in Brazil. Eighty-four adult patients of both genders ranging in age from 20 to 60 years and diagnosed with paucibacillary (PB) or multibacillary (MB) leprosy were selected after undergoing multidrug treatment. The following data were collected: sociodemographic and clinical data; food intake; anthropometric measures (weight, height, and waist circumference); and lipid profile components (total cholesterol, high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c], and triglycerides). Among the study population, there was a predominance of males (65.48%) aged 50 to 60 years, patients with an income of 248-496 American dollars (63.10%), patients who completed elementary school (65.48%), inactive patients (76.19%), non-smokers (46.43%), and non-drinking patients (69.05%). The levels (mean ± standard deviation) of total cholesterol were 193.8 ± 29.4 mg/dL in the PB form and 203.5 ± 41.7 mg/dL in the MB form. The mean LDL-c was 116.9 ± 22.7 mg/dL in PB patients and 121 ± 31.3 mg/dL in MB patients. Mean triglyceride levels were 123.4 ± 45.2 mg/dL in the PB form and 147.4 ± 88.9 mg/dL in the MB form. The evaluation of nutritional status showed that 41.67% of the patients were eutrophic, while 55.96% had excess weight. Food intake was significantly associated with HDL-c in male patients (P = 0.0264) and with triglycerides in patients above the ideal weight (P = 0.0049). The risk of acquiring CVDs was observed to be high due to patients' excess weight and increased waist circumference. This study will guide clinicians in the adequate treatment of patients with leprosy in order to avoid adverse cardiovascular

  13. Dropout rates and factors associated with dropout from treatment among elderly patients attending the outpatient services of a tertiary care hospital.

    Science.gov (United States)

    Grover, Sandeep; Dua, Devakshi; Chakrabarti, Subho; Avasthi, Ajit

    2018-01-01

    This study aimed to evaluate the "dropout" rates from treatment and associated factors among elderly patients attending a tertiary care psychiatry outpatient facility. Data of 1422 patients aged ≥60 years, attending the walk-in clinic were evaluated. Out of 1422 patients, 406 (28.55%) belonged to the "dropout" group. In the "dropout" group, the age of patients was significantly higher than the followed-up group, and a higher proportion of patients were >70 years old. Significantly lower proportion of patients with diagnosis of depressive disorders belonged to the "dropout" group and significantly higher proportion of patients with "other" diagnoses belonged to the dropped out group. In patients with depressive disorders, a higher proportion of the patients in the "dropout" group were Hindu by religion (68.7% vs. 58.7%; χ 2 = 4.26; P = 0.03). In patients with bipolar disorder, patients in the "dropout" group had significantly higher income (Rs. 13,323 [standard deviation [SD] = 16,769] vs. 5681 [SD = 9422]; t -test value: 2-25; P = 0.028) and lesser proportion of patients were of the male gender (63.15 vs. 86.95%; Mann-Whitney U value = 257.5; P = 0.039). In the group of other diagnoses, a higher proportion of patients in the "dropout" group were currently single (32.3% vs. 18.7%; χ 2 = 4.12; P = 0.042), from rural locality (63.1% vs. 46.72%; χ 2 = 4.33; P = 0.037) and were not prescribed medications (40% vs. 22.4%; χ 2 = 6.05; P = 0.04). Dropout from treatment among elderly patients is associated with higher age, not being prescribed medications, and diagnosis other than the affective disorders, psychotic disorders, and the cognitive disorders.

  14. Endoluminal high dose rate brachytherapy in the treatment of primary and recurrent bronchogenic tree malignancies

    Directory of Open Access Journals (Sweden)

    Maria Fortunato

    2009-03-01

    Full Text Available Introduction: Locally advanced tumours as the initial form of presentation of tumours in the bronchial tree are not a rare event. Bronchogenic recurrence is frequent in the natural history of some tumours. The choice of therapeutic options from the raft available depends on such variables as initial therapy, place of recurrence, symptoms and patient's physical status. Aim: To demonstrate the advantages of endoluminal brachytherapy (EBT with high dose rate (HDR in primary and recurrent tumour of the bronchial tree. Material and methods: A retrospective study of seven patients (pts with primary tumours of the colon, trachea and lung. Tracheobronchial recurrence (trachea, two pts, bronchus, five pts occurred betweenMarch 2003 and September 2004. Patients under-went EBT with HDR for primary or recurrent therapy in association with external radiotherapy, laser therapy and chemotherapy with palliative or curative intention. EBT with HDR doses of 5 to 7 Gy in 2 to 4 fractions at 1 cm from the source axis were given. Treatment included endoluminal application of Ir192 with a French 6 catheter. Results: There was symptomatic relief related to reduction of tumour in six of the seven patients treated. In one of the six patients studied, there was progression of the local disease between the second and third fractions of the treatment (obstruction of the trachea. In a mean follow up of 17 (2-40 months between EBT and this study, three patients are alive, one has no evidence of disease while two have had bronchial recurrence, four patients have died, one after massive haemoptysis and three due to disease progression. Discussion and conclusions: Patients undergoing brachytherapy for symptomatic primary tumours or endobronchial recurrence show good tolerance, important symptom relief and improved quality of life. Despite the small size of our sample, it is clear that EBT with HDR plays an important role in the palliative/curative treatment of these patients

  15. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial.

    Science.gov (United States)

    Sant'Ana, Adriana Campos Passanezi; Campos, Marinele R de; Passanezi, Selma Campos; Rezende, Maria Lúcia Rubo de; Greghi, Sebastião Luiz Aguiar; Passanezi, Euloir

    2011-04-01

    The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG--"no intervention" (n=17) or IG--"intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (pperiodontal conditions of IG and NIG were observed at 2nd examination (ppregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.

  16. Higher neonatal growth rate and body condition score at 7 months are predictive factors of obesity in adult female Beagle dogs.

    Science.gov (United States)

    Leclerc, Lucie; Thorin, Chantal; Flanagan, John; Biourge, Vincent; Serisier, Samuel; Nguyen, Patrick

    2017-04-13

    The risks during early growth on becoming overweight in adulthood are widely studied in humans. However, early-life predictive factors for canine adult overweight and obesity have not yet been studied. To identify factors that may help explain the development of overweight and obesity at adulthood in dogs, a longitudinal study of 2 years was conducted in 24 female Beagle dogs of the same age, sexual status, and raised under identical environmental conditions. By means of a hierarchical classification on principal components with the following quantitative values: fat-free mass (FFM), percentage fat mass and pelvic circumference at 2 years of age, three groups of dogs were established and were nominally named: ideal weight (IW, n = 9), slightly overweight (OW1, n = 6) and overweight (OW2, n = 9). With the aim of identifying predictive factors of development of obesity at adulthood parental characteristics, growth pattern, energy balance and plasma factors were analysed by logistic regression analysis. At 24 months, the group compositions were in line with the body condition scores (BCS 1-9) values of the IW (5 or 6/9), the OW1 (6/9) and the OW2 (7 or 8/9) groups. Logistic regression analysis permitted the identification of neonatal growth rate during the first 2 weeks of life (GR 2W ) and BCS at 7 months as predictors for the development of obesity at adulthood. Seventy percent of dogs with either GR 2W >125% or with BCS > 6/9 at 7 months belonged to the OW2 group. Results from energy intake and expenditure, corrected for FFM, showed that there was a greater positive energy imbalance between 7 and 10 months for the OW2, compared to the IW group. This study expands the understanding of previously reported risk factors for being overweight or obese in dogs, establishing that (i) 15 out of 24 of the studied dogs became overweight and (ii) GR 2W and BCS at 7 months of age could be used as predictive factors as overweight adult dogs in the OW2

  17. Advantages of high-dose rate (HDR) brachytherapy in treatment of prostate cancer

    Science.gov (United States)

    Molokov, A. A.; Vanina, E. A.; Tseluyko, S. S.

    2017-09-01

    One of the modern methods of preserving organs radiation treatment is brachytherapy. This article analyzes the results of prostate brachytherapy. These studies of the advantages of high dose brachytherapy lead to the conclusion that this method of radiation treatment for prostate cancer has a favorable advantage in comparison with remote sensing methods, and is competitive, preserving organs in comparison to surgical methods of treatment. The use of the method of polyfocal transperineal biopsy during the brachytherapy session provides information on the volumetric spread of prostate cancer and adjust the dosimetry plan taking into account the obtained data.

  18. Rates of auxiliary is and are in African American English speaking children with specific language impairment following language treatment.

    Science.gov (United States)

    Smith, Shana; Bellon-Harn, Monica L

    2015-02-01

    The purpose of this exploratory study is to examine rates of auxiliary is and are across dialect patterns produced by African American English with specific language impairment (AAE-SLI) children following language treatment. The following research question is asked: Do AAE-SLI children exhibit rates of auxiliary is and are across dialect patterns consistent with previous reports of typically developing children and adult AAE speakers? A pre-/post-test design was used to identify patterns in which auxiliary is and are were produced at significant levels. Individual performance was included to examine variable rates of use across patterns. Group and individual results suggest children used auxiliary is and are in dialect patterns at rates consistent with typically developing child and adult AAE speakers. We conclude that rates of use may contribute to evidence-based guidelines for morphological intervention with AAE-SLI children.

  19. Tuberculosis incidence rates during 8 years of follow-up of an antiretroviral treatment cohort in South Africa: comparison with rates in the community.

    Directory of Open Access Journals (Sweden)

    Ankur Gupta

    Full Text Available Although antiretroviral therapy (ART is known to be associated with time-dependent reductions in tuberculosis (TB incidence, the long-term impact of ART on incidence remains imprecisely defined due to limited duration of follow-up and incomplete CD4 cell count recovery in existing studies. We determined TB incidence in a South African ART cohort with up to 8 years of follow-up and stratified rates according to CD4 cell count recovery. We compared these rates with those of HIV-uninfected individuals living in the same community.Prospectively collected clinical data on patients receiving ART in a community-based cohort in Cape Town were analysed. 1544 patients with a median follow-up of 5.0 years (IQR 2.4-5.8 were included in the analysis. 484 episodes of incident TB (73.6% culture-confirmed were diagnosed in 424 patients during 6506 person-years (PYs of follow-up. The TB incidence rate during the first year of ART was 12.4 (95% CI 10.8-14.4 cases/100PYs and decreased to 4.92 (95% CI 3.64-8.62 cases/100PYs between 5 and 8 years of ART. During person-time accrued within CD4 cell strata 0-100, 101-200, 201-300, 301-400, 401-500, 501-700 and ≥700 cells/µL, TB incidence rates (95% CI were 25.5 (21.6-30.3, 11.2 (9.4-13.5, 7.9 (6.4-9.7, 5.0 (3.9-6.6, 5.1 (3.8-6.8, 4.1 (3.1-5.4 and 2.7 (1.7-4.5 cases/100PYs, respectively. Overall, 75% (95% CI 70.9-78.8 of TB episodes were recurrent cases. Updated CD4 cell count and viral load measurements were independently associated with long-term TB risk. TB rates during person-time accrued in the highest CD4 cell count stratum (>700 cells/µL were 4.4-fold higher that the rate in HIV uninfected individuals living in the same community (2.7 versus 0.62 cases/100PYs; 95%CI 0.58-0.65.TB rates during long-term ART remained substantially greater than rates in the local HIV uninfected populations regardless of duration of ART or attainment of CD4 cell counts exceeding 700 cells/µL.

  20. Eating disorder subtypes differ in their rates of psychosocial improvement over treatment

    OpenAIRE

    Kelly, Allison C; Carter, Jacqueline C

    2014-01-01

    Background Individuals with Anorexia Nervosa (AN) are renowned for their poor short- and long-term treatment outcomes. To gain more insight into the reasons for these poor outcomes, the present study compared patients with AN-R (restrictive subtype), AN-BP (binge-purge subtype), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS) over 12 weeks of specialized eating disorders treatment. Eighty-nine patients completed the Eating Disorder Examination- Questionnaire (EDE-Q) ...

  1. Report on the Study of the Tax and Rate Treatment of Renewable Energy Projects

    International Nuclear Information System (INIS)

    Hadley, S.W.

    1993-01-01

    This study was conducted in response to Section 1205 of the Energy Policy Act of 1992 (EPACT), requiring the U.S. Department of Energy in conjunction with state regulatory commissions to determine if conventional tax measures and ratemaking procedures provide economic barriers to or incentives for the adoption of renewable electric generating plants compared to conventional ones. For this study, we defined barriers and incentives in terms of financial criteria used by investor-owned utilities (IOUs) and nonutility electricity generators (NUGs) when making decisions on technologies for new generating plants. For IOUs, the major criterion used was the levelized cost of producing power over the useful life of the technology. For NUGs, the major criterion used was the internal rate of return. Clearly, there are many factors outside the scope of this study that relate to the decisionmaking process of IOUs and NUGs. This study to determine barriers and incentives does not attempt to determine which technologies would most likely be adopted by IOUs and NUGs. Technologies are only cost (in)effective relative to a given power system and its set of internal and external conditions. Other technology-related factors such as availability, dispatchability, diversity, and reliability of generating alternatives are also considered in the decisionmaking process used by IOUs and NUGs. The results of this study show only the relative impact of certain tax measures and ratemaking procedures on financial criteria that IOUs and NUGs use as inputs to make technology-adoption decisions. Where these tax measures and ratemaking procedures provide incentives for an alternative, they increase the likelihood that the alternative will be selected by IOUs or NUGs when making generating-resource decisions. In quantifying the parameters of the seven renewable and four conventional generating options studied, we used today's ''conventional wisdom'' on the values of variables defining the

  2. Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment

    DEFF Research Database (Denmark)

    Pinborg, A; Hougaard, C O; Andersen, A Nyboe

    2009-01-01

    occurred for 5.9% (48/817) of the women. Positive prognostic factors for delivery were male infertility, female age infertility and less than three previous treatment cycles. CONCLUSIONS A crude delivery rate of 69.4% in the total population 5 years after referral to tertiary......BACKGROUND The objective was to assess crude 5-year delivery rates after assisted reproductive technology (ART) treatment, intrauterine inseminations (IUI), spontaneous conceptions (SC) and adoptions in a large infertile cohort. METHODS A prospective longitudinal survey comprised 1338 infertile...... couples starting public infertility programmes offering IUIs and three free ART cycles during 2000-2001. The cohort was cross-linked with the National Medical Birth Register to obtain delivery rates for all 1338 couples. More detailed data were available from 817 women responding to a 5-year follow...

  3. Higher-Than-Conventional Radiation Doses in Localized Prostate Cancer Treatment: A Meta-analysis of Randomized, Controlled Trials

    International Nuclear Information System (INIS)

    Viani, Gustavo Arruda; Stefano, Eduardo Jose; Afonso, Sergio Luis

    2009-01-01

    Purpose: To determine in a meta-analysis whether the outcomes in men with localized prostate cancer treated with high-dose radiotherapy (HDRT) are better than those in men treated with conventional-dose radiotherapy (CDRT), by quantifying the effect of the total dose of radiotherapy on biochemical control (BC). Methods and Materials: The MEDLINE, EMBASE, CANCERLIT, and Cochrane Library databases, as well as the proceedings of annual meetings, were systematically searched to identify randomized, controlled studies comparing HDRT with CDRT for localized prostate cancer. To evaluate the dose-response relationship, we conducted a meta-regression analysis of BC ratios by means of weighted linear regression. Results: Seven RCTs with a total patient population of 2812 were identified that met the study criteria. Pooled results from these RCTs showed a significant reduction in the incidence of biochemical failure in those patients with prostate cancer treated with HDRT (p 2 gastrointestinal toxicity after HDRT than after CDRT. In the subgroup analysis, patients classified as being at low (p = 0.007), intermediate (p < 0.0001), and high risk (p < 0.0001) of biochemical failure all showed a benefit from HDRT. The meta-regression analysis also detected a linear correlation between the total dose of radiotherapy and biochemical failure (BC = -67.3 + [1.8 x radiotherapy total dose in Gy]; p = 0.04). Conclusions: Our meta-analysis showed that HDRT is superior to CDRT in preventing biochemical failure in low-, intermediate-, and high-risk prostate cancer patients, suggesting that this should be offered as a treatment for all patients, regardless of their risk status.

  4. High-dose-rate versus low-dose-rate brachytherapy in the treatment of cervical cancer: analysis of tumor recurrence - the University of Wisconsin experience

    International Nuclear Information System (INIS)

    Petereit, Daniel G.; Sarkaria, Jann N.; Potter, David M.; Schink, Julian C.

    1999-01-01

    Purpose: To retrospectively compare the clinical outcome for cervical cancer patients treated with high-dose-rate (HDR) vs. low-dose-rate (LDR) brachytherapy. Methods and Materials: One hundred ninety-one LDR patients were treated from 1977 to 1988 and compared to 173 HDR patients treated from 1989 to 1996. Patients of similar stage and tumor volumes were treated with identical external beam fractionation schedules. Brachytherapy was given in either 1 or 2 LDR implants for the earlier patient cohort, and 5 HDR implants for the latter cohort. For both patient groups, Point A received a minimum total dose of 80 Gy. The linear-quadratic formula was used to calculate the LDR dose-equivalent contribution to Point A for the HDR treatments. The primary endpoints assessed were survival, pelvic control, relapse-free survival, and distant metastases. Endpoints were estimated using the Kaplan-Meier method. Comparisons between treatment groups were performed using the log-rank test and Cox proportional hazards models. Results: The median follow-up was 65 months (2 to 208 months) in the LDR group and 22 months (1 to 85 months) in the HDR group. For all stages combined there was no difference in survival, pelvic control, relapse-free survival, or distant metastases between LDR and HDR patients. For Stage IB and II HDR patients, the pelvic control rates were 85% and 80% with survival rates of 86% and 65% at 3 years, respectively. In the LDR group, Stage IB and II patients had 91% and 78% pelvic control rates, with 82% and 58% survival rates at 3 years, respectively. No difference was seen in survival or pelvic control for bulky Stage I and II patients combined (> 5 cm). Pelvic control at 3 years was 44% (HDR) versus 75% (LDR) for Stage IIIB patients (p = 0.002). This difference in pelvic control was associated with a lower survival rate in the Stage IIIB HDR versus LDR population (33% versus 58%, p = 0.004). The only major difference, with regard to patient characteristics

  5. Bifidobacterium lactis B94 plus inulin for Treatment of Helicobacter pylori infection in children: does it increase eradication rate and patient compliance?

    Science.gov (United States)

    Islek, A; Sayar, E; Yilmaz, A; Artan, R

    2015-01-01

    The aim of this study is to investigate the effects of Bifidobacterium lactis B94 and inulin (synbiotic) treatment on eradication rate and patient compliance in subjects treated for symptomatic H. pylori infection. Patients with symptomatic H. pylori infection were divided into two groups. One group was treated with standard triple therapy (lansoprazole, amoxicillin, and clarithromycin) and B. lactis B94 (5 × 109 CFU/dose) plus inulin (900 mg) twice daily for seven days. The control group was treated with standard triple therapy and placebo. The side effects and eradication rates were evaluated at the end of the study. Ninety-three patients with H. pylori infection were treated with either synbiotic plus triple therapy (n = 47) or placebo plus triple therapy (n = 46). The infection eradication rates were not significantly different between the synbiotic and placebo groups [intent-to-treat (ITT), 80.8% and 67.3%, p = 0.13, respectively; per-protocol (PP), 86.3% and 81.5%, p = 0.55, respectively]. The drug side effects were significantly higher in the placebo group than in the synbiotic group (63% and 17%, respectively, p < 0.01). Although no intolerable adverse side effects were observed in the synbiotic group, intolerable adverse side effects were observed in 13% of the placebo group (p = 0.01). Our results suggest that twice daily 5 × 109 CFU/dose B. lactis B94 plus 900 mg inulin treatment did not have a direct positive effect on the H. pylori eradication rate. However, this treatment had significantly reduced side effects and indirectly increased eradication rates by increasing patient compliance. © Acta Gastro-Enterologica Belgica.

  6. Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Ping, E-mail: ping.jiang@uksh.de [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Baumann, René [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Dunst, Juergen [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, University of Copenhagen, Copenhagen (Denmark); Geenen, Matthias [Department of Reconstructive Surgery, Lubinus Clinic Kiel, Kiel (Germany); Siebert, Frank-André [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Niehoff, Peter [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, Community Clinic Köln, Köln (Germany); Department of Radiation Oncology, University Witten/Herdecke, Witten (Germany); Bertolini, Julia; Druecke, Daniel [Department of Reconstructive Surgery, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany)

    2016-03-01

    Purpose: To prospectively evaluate high-dose-rate brachytherapy in the treatment of therapy-resistant keloids and report first results, with emphasis on feasibility and early treatment outcome. Methods and Materials: From 2009 to 2014, 24 patients with 32 recurrent keloids were treated with immediate perioperative high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiation therapy and presented with recurrences in the pretreated areas. Two or more different treatment modalities had been tried in all patients and had failed to achieve remission. After (re-)excision of the keloids, a single brachytherapy tube was placed subcutaneously before closing the wound. The target volume covered the scar in total length. Brachytherapy was given in 3 fractions with a single dose of 6 Gy in 5 mm tissue depth. The first fraction was given within 6 hours after surgery, the other 2 fractions on the first postoperative day. Thus, a total dose of 18 Gy in 3 fractions was administered within 36 hours after the resection. Results: The treatment was feasible in all patients. No procedure-related complications (eg, secondary infections) occurred. Nineteen patients had keloid-related symptoms before treatment like pain and pruritus; disappearance of symptoms was noticed in all patients after treatment. After a median follow-up of 29.4 months (range, 7.9-72.4 months), 2 keloid recurrences and 2 mildly hypertrophied scars were observed. The local control rate was 94%. Pigmentary abnormalities were detected in 3 patients, and an additional 6 patients had a mild delay in the wound-healing process. Conclusions: The early results of this study prove the feasibility and the efficacy of brachytherapy for the prevention of keloids. The results also suggest that brachytherapy may be advantageous in the management of high-risk keloids or as salvage treatment for failure after external beam therapy.

  7. Evaluating higher doses of Shunthi - Guduchi formulations for safety in treatment of osteoarthritis knees: A Government of India NMITLI arthritis project

    OpenAIRE

    Arvind Chopra; Manjit Saluja; Girish Tillu; Anuradha Venugopalan; Gumdal Narsimulu; Sanjeev Sarmukaddam; Bhushan Patwardhan

    2012-01-01

    Background: Results of an exploratory trial suggested activity trends of Zingiber officinale-Tinopsora cordifolia (platform combination)-based formulations in the treatment of Osteoarthritis (OA) Knees. These formulations were "platform combination+Withania somnifera+Tribulus terrestris0" (formulation B) and "platform combination+Emblica officinale" (formulation C). This paper reports safety of these formulations when used in higher doses (1.5-2 times) along with Sallaki Guggul and Bhallataka...

  8. Modeling Fuel Treatment Leverage: Encounter Rates, Risk Reduction, and Suppression Cost Impacts

    Directory of Open Access Journals (Sweden)

    Matthew P. Thompson

    2017-11-01

    Full Text Available The primary theme of this study is the cost-effectiveness of fuel treatments at multiple scales of investment. We focused on the nexus of fuel management and suppression response planning, designing spatial fuel treatment strategies to incorporate landscape features that provide control opportunities that are relevant to fire operations. Our analysis explored the frequency and magnitude of fire-treatment encounters, which are critical determinants of treatment efficacy. Additionally, we examined avoided area burned, avoided suppression costs, and avoided damages, and combined all three under the umbrella of leverage to explore multiple dimensions with which to characterize return on investment. We chose the Sierra National Forest, California, USA, as our study site, due to previous work providing relevant data and analytical products, and because it has the potential for large, long-duration fires and corresponding potential for high suppression expenditures. Modeling results generally confirmed that fire-treatment encounters are rare, such that median suppression cost savings are zero, but in extreme years, savings can more than offset upfront investments. Further, reductions in risk can expand areas where moderated suppression response would be appropriate, and these areas can be mapped in relation to fire control opportunities.

  9. Contextual factors associated with treatment-seeking and higher-risk sexual behaviour in Botswana among men with symptoms of sexually transmitted infections.

    Science.gov (United States)

    Langeni, Tabitha

    2007-11-01

    This study investigates contextual factors associated with treatment-seeking behaviour and higher-risk sexual conduct of men symptomatic of sexually transmitted infections (STIs) in Botswana. Data were drawn from a randomly selected, nationally representative sample of 8 222 men, aged 15-64 years, who had reported having symptoms suggestive of an STI during the previous twelve months. Higher-risk behaviour continues to sustain the HIV epidemic in Botswana. At the heart of Botswana's epidemic lies men's reluctance to seek medical treatment, engaging in unprotected sex, and having sex with multiple partners while symptomatic of an STI. The odds of engaging in unprotected sex while symptomatic of an STI were significantly higher among teenage males and males in urban households. For every year's increase in the age difference between partners there was a 28% increase in the odds of the male having had unprotected sex. Being married and having had more than one sexual partner in the last year multiplied the odds of having unprotected sex while symptomatic of an STI by three times. The longer an infected man remained with symptoms before seeking help, the more likely it was to have unprotected sex while infected and the more likely to seek treatment from a traditional healer. Notably, having sought medical treatment from hospitals, clinics and health workers, as opposed to consulting traditional healers, significantly reduced the odds of having had unprotected sex while infected with an STI by 48%. The results indicate the need to encourage men to utilise public healthcare services. The public health sector in Botswana needs to provide healthcare services that are user-friendly for men. Increasing the number of treatment sites may also contribute to preventing onward transmission of STIs. Special attention needs to be paid to boys' socialisation towards gender norms, and men are to be encouraged to play a responsible role in HIV prevention.

  10. Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kontopodis, Nikolaos, E-mail: kontopodisn@yahoo.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece); Metaxa, Eleni, E-mail: emmetaxa@gmail.com [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Papaharilaou, Yannis, E-mail: yannisp@iacm.forth.gr [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Georgakarakos, Efstratios, E-mail: efstratiosgeorg@gmail.com [Vascular Surgery Department, “Demokritus” University of Thrace Medical School, Alexandroupolis (Greece); Tsetis, Dimitris, E-mail: tsetis@med.uoc.gr [Interventional Radiology Unit, Department of Radiology, University of Crete Medical School, Heraklion, Crete (Greece); Ioannou, Christos V., E-mail: ioannou@med.uoc.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece)

    2014-07-15

    Purpose: To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement. Materials and methods: Thirty-four small AAAs (initially presenting a maximum diameter <5.5 cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined. Median increase and percentile annual change of these variables was calculated. Correlation between growth rates as determined by the new indices under evaluation and those of maximum diameter were assessed. AAAs were divided according to outcome (surveillance vs. elective repair after follow-up which is based on the maximum diameter criterion) and according to growth rate (high vs. low) based on four indices. Contingency between groups of high/low growth rate regarding each of the four indices on one hand and those regarding need for surgical repair on the other was assessed. Results: A strong correlation between growth rates of maximum diameter and those of AAA and ILT volumes could be established. Evaluation of contingency between groups of outcome and those of growth rate revealed significant associations only for AAA and ILT volumes. Subsequently AAAs with a rapid volumetric increase over time had a likelihood ratio of 10 to be operated compared to those with a slower enlargement. Regarding increase of maximum diameter, likelihood ratio between AAAs with rapid and those with slow expansion was only 3. Conclusion: Growth rate of aneurysms regarding 3Dimensional indices of AAA and ILT volumes is significantly associated with the need for surgical intervention while the same does not hold for growth rates determined by 2Dimensional indices of maximum diameter and ILT thickness.

  11. Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment

    International Nuclear Information System (INIS)

    Kontopodis, Nikolaos; Metaxa, Eleni; Papaharilaou, Yannis; Georgakarakos, Efstratios; Tsetis, Dimitris; Ioannou, Christos V.

    2014-01-01

    Purpose: To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement. Materials and methods: Thirty-four small AAAs (initially presenting a maximum diameter <5.5 cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined. Median increase and percentile annual change of these variables was calculated. Correlation between growth rates as determined by the new indices under evaluation and those of maximum diameter were assessed. AAAs were divided according to outcome (surveillance vs. elective repair after follow-up which is based on the maximum diameter criterion) and according to growth rate (high vs. low) based on four indices. Contingency between groups of high/low growth rate regarding each of the four indices on one hand and those regarding need for surgical repair on the other was assessed. Results: A strong correlation between growth rates of maximum diameter and those of AAA and ILT volumes could be established. Evaluation of contingency between groups of outcome and those of growth rate revealed significant associations only for AAA and ILT volumes. Subsequently AAAs with a rapid volumetric increase over time had a likelihood ratio of 10 to be operated compared to those with a slower enlargement. Regarding increase of maximum diameter, likelihood ratio between AAAs with rapid and those with slow expansion was only 3. Conclusion: Growth rate of aneurysms regarding 3Dimensional indices of AAA and ILT volumes is significantly associated with the need for surgical intervention while the same does not hold for growth rates determined by 2Dimensional indices of maximum diameter and ILT thickness

  12. Lactoferricin treatment decreases the rate of cell proliferation of a human colon cancer cell line.

    Science.gov (United States)

    Freiburghaus, C; Janicke, B; Lindmark-Månsson, H; Oredsson, S M; Paulsson, M A

    2009-06-01

    Food components modify the risk of cancer at a large number of sites but the mechanism of action is unknown. In the present investigation, we studied the effect of the peptide lactoferricin derived from bovine milk lactoferrin on human colon cancer CaCo-2 cells. The cells were either untreated or treated with 2.0, 0.2, or 0.02 microM lactoferricin. Cell cycle kinetics were investigated with a bromodeoxyuridine DNA flow cytometric method. The results show that lactoferricin treatment slightly but significantly prolonged the S phase of the cell cycle. Lactoferricin treatment lowered the level of cyclin E1, a protein involved in the regulation of genes required for G(1)/S transition and consequently for efficient S phase progression. The slight prolongation of the S phase resulted in a reduction of cell proliferation, which became more apparent after a long treatment time.

  13. The effect of nitrogen gas flow rate on heat treatment of AISI SS-430: Study of microstructure and hardness

    Science.gov (United States)

    Sebayang, Perdamean; Darmawan, Bobby Aditya; Simbolon, Silviana; Alfirano, Sudiro, Toto; Aryanto, Didik

    2018-05-01

    The aim of this research was to obtain the austenite phase from ferritic stainless steel through sample heat treatment. The AISI 430 ferritic steel with the thickness of about 0.4 mm was used. The heat treatment was conducted in a tube furnace at elevated temperature of 1150, 1200, 1250 °C and nitrogen gas flow rate of 0.57 and 0.73 l/s. The samples were then rapidly quenched in water bath. An optical microscope, XRD, SEM-EDS and micro vickers hardness tester were used to characterize the sample before and after het treatment. The presence of anneal twins indicated the formation of austenite phase in the sample. Its fraction was varied from 10.89 wt% to 35.10 wt%. In addition, the heat treatment temperature strongly affected the sample hardness. The optimum hardness obtained was about 542.69 HV. According to the results, this material can be considered for biomedical applications.

  14. Participation rate of cancer patients in treatment decisions: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Mohammad Khammarnia

    2017-12-01

    Full Text Available Background and objective: Cancer is one of the most common diseases and the second reason of death in Iran. Giving decision making authority to patients is one of the fundamental principles of the protection of patients. Patients have rights as consumers of health care services that nurses, physician and other health professionals are responsible for maintaining and protecting it. This study aimed to determine cancer patients’ involvement in treatment decisions making. Methods: This cross-sectional study was carried out as descriptive-analytic with practical purpose in 2017 in Zahedan University of Medical Sciences. The study population included 1,000 patients who had cancer that whom 450 patients were selected by simple random sampling. To measure patient participation in treatment decisions, was used of Levente Kristona standard questionnaire. Reliability and validity of the questionnaire was confirmed (coefficient = 0.82. For data analysis used of software spss21 with descriptive statistics and chi-square tests Results: among the patients, 197 men (53% and 177 women (47% with a mean age of 31 years were examined. The results of this study showed that the score of mean participation in treatment decisions among the cancer patients was 30 ± 12 and it was in low level. The patients’ participation in treatment decisions had a significant relationship with education level (P = 0.027, however, it was not statistical significant with gender, age, income, occupation and type of cancer and other demographic variables (P> 0.05. Conclusion: In general, that patients' participation in clinical decision making is weak and low. Since patients’ participation in clinical decisions could affect the quality of treatment decisions, therefore, health care providers should attention more to this fact. Also, culturalizating and education according to patients’ knowledge and use of treatment techniques are recommended for clinical decision making promotion

  15. Progesterone concentration, pregnancy and calving rate in Simmental dairy cows after oestrus synchronisation and hCG treatment during the early luteal phase.

    Science.gov (United States)

    Šuluburić, Adam; Milanović, Svetlana; Vranješ-Đurić, Sanja; Jovanović, Ivan B; Barna, Tomislav; Stojić, Milica; Fratrić, Natalija; Szenci, Ottó; Gvozdić, Dragan

    2017-09-01

    Early embryonic development may be negatively affected by insufficient progesterone (P4) production. Therefore, the aim of our study was to increase P4 by gonadotropin-releasing hormone (GnRH) and/or human chorionic gonadotropin (hCG) treatments after inducing oestrus by prostaglandin (PG) treatment. Lactating Simmental dairy cows (n = 110), between 1 to 5 lactations, with an average milk production of 6,500 1/305 days, at 40-80 days postpartum were used and grouped as follows: (1) PG + GnRH treatment at AI (GnRH group), (2) PG + hCG treatment at day 7 after AI (hCG group), (3) PG + GnRH at AI + hCG treatment at day 7 after AI (GnRH/hCG group), and (4) spontaneous oestrus (C: control group). All animals were double inseminated (at the time of oestrus detection and 12 ± 2 h thereafter). Blood serum and milk samples were collected at the day of observed oestrus (day 0), and 14, 21 and 28 days after AI. Serum P4 was determined using a commercial radioimmunoassay (RIA) test (INEP, Zemun), and milk P4 was determined using enzyme-linked immunoassay (ELISA) test (NIV Novi Sad). Pregnancy status was confirmed by ultrasonography between days 28 and 35 after AI. Differences of serum or milk P4 medians, pregnancy (and calving) rate were determined using Dunn's Multiple Comparison Tests and Z test, respectively. Serum P4 medians were significantly higher at days 14, 21 and 28 after AI in the hCG-treated animals, indicating increased luteal activity, with a similar tendency in whole milk P4 values. Treatment with hCG during the early luteal phase significantly contributed to the maintenance of gestation at days 28-35 after AI, and also increased the calving rate in Simmental dairy cows.

  16. The multi-class binomial failure rate model for the treatment of common-cause failures

    International Nuclear Information System (INIS)

    Hauptmanns, U.

    1995-01-01

    The impact of common cause failures (CCF) on PSA results for NPPs is in sharp contrast with the limited quality which can be achieved in their assessment. This is due to the dearth of observations and cannot be remedied in the short run. Therefore the methods employed for calculating failure rates should be devised such as to make the best use of the few available observations on CCF. The Multi-Class Binomial Failure Rate (MCBFR) Model achieves this by assigning observed failures to different classes according to their technical characteristics and applying the BFR formalism to each of these. The results are hence determined by a superposition of BFR type expressions for each class, each of them with its own coupling factor. The model thus obtained flexibly reproduces the dependence of CCF rates on failure multiplicity insinuated by the observed failure multiplicities. This is demonstrated by evaluating CCFs observed for combined impulse pilot valves in German NPPs. (orig.) [de

  17. Combination of high-dose rate brachytherapy and external beam radiotherapy for the treatment of advanced scalp angiosarcoma - case report

    International Nuclear Information System (INIS)

    Gentil, Andre Cavalcanti; Lima Junior, Carlos Genesio Bezerra; Soboll, Danyel Scheidegger; Novaes, Paulo Eduardo R.S.; Pereira, Adelino Jose; Pellizon, Antonio Carlos Assis

    2001-01-01

    The authors report a case of a patient with an extensive angiosarcoma of the scalp that was submitted only to radiotherapy with a combination of orthovoltage roentgentherapy and high-dose rate brachytherapy, using a mould. The clinical and technical features as well as the therapeutic outcome are presented, and the usefulness and peculiarities of high-dose rate brachytherapy for this particular indication is discussed. A comparative analysis of the difficulties and limitations of employing low-dose rate brachytherapy is also presented. The authors concluded that high-dose rate brachytherapy might be an useful, practical and safe option to treat neoplastic lesions of the scalp, and an alternative treatment to electrontherapy. (author)

  18. Essays in applied macroeconomics: Asymmetric price adjustment, exchange rate and treatment effect

    Science.gov (United States)

    Gu, Jingping

    This dissertation consists of three essays. Chapter II examines the possible asymmetric response of gasoline prices to crude oil price changes using an error correction model with GARCH errors. Recent papers have looked at this issue. Some of these papers estimate a form of error correction model, but none of them accounts for autoregressive heteroskedasticity in estimation and testing for asymmetry and none of them takes the response of crude oil price into consideration. We find that time-varying volatility of gasoline price disturbances is an important feature of the data, and when we allow for asymmetric GARCH errors and investigate the system wide impulse response function, we find evidence of asymmetric adjustment to crude oil price changes in weekly retail gasoline prices. Chapter III discusses the relationship between fiscal deficit and exchange rate. Economic theory predicts that fiscal deficits can significantly affect real exchange rate movements, but existing empirical evidence reports only a weak impact of fiscal deficits on exchange rates. Based on US dollar-based real exchange rates in G5 countries and a flexible varying coefficient model, we show that the previously documented weak relationship between fiscal deficits and exchange rates may be the result of additive specifications, and that the relationship is stronger if we allow fiscal deficits to impact real exchange rates non-additively as well as nonlinearly. We find that the speed of exchange rate adjustment toward equilibrium depends on the state of the fiscal deficit; a fiscal contraction in the US can lead to less persistence in the deviation of exchange rates from fundamentals, and faster mean reversion to the equilibrium. Chapter IV proposes a kernel method to deal with the nonparametric regression model with only discrete covariates as regressors. This new approach is based on recently developed least squares cross-validation kernel smoothing method. It can not only automatically smooth

  19. Changes of Heart Rate Variability during Methylphenidate Treatment in Attention-Deficit Hyperactivity Disorder Children: A 12-Week Prospective Study.

    Science.gov (United States)

    Kim, Hayeon Jennifer; Yang, Jaewon; Lee, Moon Soo

    2015-09-01

    The aim of this study was to clarify the relationship between the autonomic nervous system and attention deficit hyperactivity disorder (ADHD) rating scales and to evaluate the usefulness of heart rate variability (HRV) as a psychophysiological biomarker for ADHD. Subjects were recruited from outpatients in the Department of Child and Adolescent Psychiatry at the Korea University Medical Center from August 2007 to December 2010. Subjects received methylphenidate. Time- and frequency-domain analyses of HRV, the Korean ADHD rating scale (K-ARS), and computerized ADHD diagnostic system were evaluated before treatment. After a 12-week period of medication administration, we repeated the HRV measurements and K-ARS rating. Eighty-six subjects were initially enrolled and 37 participants completed the 12-week treatment and HRV measurements subsequent to the treatment. Significant correlations were found between the K-ARS inattention score and some HRV parameters. All of the HRV parameters, except the standard deviations of the normal-to-normal interval, very low frequency, and low frequency to high frequency, showed a significant positive correlation between baseline and endpoint measures in completers. High frequency (HF) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD), which are related to parasympathetic vagal tone, showed significant decreases from baseline to endpoint. The HRV test was shown to be reproducible. The decrease in HF and RMSSD suggests that parasympathetic dominance in ADHD can be altered by methylphenidate treatment. It also shows the possibility that HRV parameters can be used as psychophysiological markers in the treatment of ADHD.

  20. Low Complication Rates With Totally Implantable Access Port Use in Epoprostenol Treatment of Pulmonary Hypertension

    NARCIS (Netherlands)

    Dickinson, Michael G.; Scholvinck, Elisabeth H.; Boonstra, Anco; Vonk-Noordegraaf, Anton; Snijder, Repke J.; Berger, Rolf M. F.

    Background: Among patients with advanced pulmonary arterial hypertension (PAH) who are receiving epoprostenol treatment, complications due to the delivery system are known to be a cause of serious morbidity and mortality. In this study, we aimed to outline the complications associated with the use

  1. Are self-report scales as effective as clinician rating scales in measuring treatment response in routine clinical practice?

    Science.gov (United States)

    Zimmerman, Mark; Walsh, Emily; Friedman, Michael; Boerescu, Daniela A; Attiullah, Naureen

    2018-01-01

    Recent treatment guidelines have suggested that outcome should be measured in routine clinical practice. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared three self-report scales of depressive symptoms and the two most widely used clinician administered scales in treatment studies in their sensitivity to change and evaluation of treatment response in depressed patients treated in routine practice. At baseline and 4-month follow-up 153 depressed outpatients with DSM-IV MDD completed the Clinically Useful Depression Outcome Scale (CUDOS), Quick Inventory of Depressive Symptomatology-Self-report version (QIDS-SR), and Patient Health Questionnaire (PHQ-9). The patients were rated on the 17-item Hamilton Depression Rating Scale (HAMD) and the Montgomery-Asberg Depression Rating Scale (MADRS). On each scale treatment response was defined as a 50% or greater reduction in scores from baseline. While there were some differences in the percentage of patients considered to be responders on the different scales, a large effect size was found for each scale, with little variability amongst the scales. The level of agreement between the three self-report scales and the clinician rating scales was approximately the same LIMITATIONS: The present study was conducted in a single clinical practice in which the majority of the patients were white, female, and had health insurance. When measuring outcome in clinical practice the magnitude of change in depressive symptoms is as great on self-report scales as on clinician rating scales. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Milrinone treatment of bovine oocytes during in vitro maturation benefits production of nuclear transfer embryos by improving enucleation rate and developmental competence.

    Science.gov (United States)

    Naruse, Kenji; Iga, Kosuke; Shimizu, Manabu; Takenouchi, Naoki; Akagi, Satoshi; Somfai, Tamas; Hirao, Yuji

    2012-01-01

    In the production of cattle nuclear transfer embryos, the production efficiency is affected by the oocyte developmental competence and successful enucleation rate. This study investigated the effect of treating oocytes with milrinone, a phosphodiesterase inhibitor, on these two characteristics. When cumulus-oocyte complexes (COCs) were cultured for 19 h with 0, 50 or 100 μM of milrinone, the enucleation rate was significantly improved by 100 μM milrinone. However, milrinone treatment during in vitro maturation (IVM) also delayed meiotic progression by at least 2 h, which would affect the examination of enucleation rate and developmental competence of oocytes. Thus, in the second experiment, meiotic resumption was temporarily inhibited with butyrolactone I (BL-I; 100 μM, 18 h) to decrease the delayed maturation caused by milrinone; this enabled a more accurate comparison of the effects of milrinone after oocyte maturation. In nuclear transfer embryo production, oocytes treated with milrinone (100 μM, 20 h) showed a significantly higher rate of enucleation compared with that of control oocytes. This improved enucleation rate was associated with a closer location of the metaphase plate to the first polar body in the treated oocytes compared with that in control oocytes. Furthermore, milrinone improved the frequency of development to the blastocyst stage in the resulting embryos. In conclusion, milrinone supplementation during IVM improved enucleation rates by rendering the metaphase plate in close proximity to the first polar body, and this treatment also improved oocyte developmental competence. These benefits additively improved the yield of cloned embryos that developed to the blastocyst stage.

  3. Comparison of high dose rate (HDR) and low dose rate (LDR) brachytherapy in the treatment of stage IIIB cervix cancer with radiation therapy alone. The preliminary results

    International Nuclear Information System (INIS)

    Trippe, Nivaldo; Novaes, P.E.; Ferrigno, R.; Pellizzon, A.C.; Salvajoli, J.V.; Fogaroli, R.C.; Maia, M.A.C.; Baraldi, H.E.

    1996-01-01

    Purpose/Objective: To compare the results between HDR and LDR brachytherapy in the treatment of stage IIIB cervix cancer with radiation therapy alone through a prospective and randomized trial. Materials and Methods: From September 1992 to December 1993, 65 patients with stage IIIB cervical cancer were randomized to one of the following treatment schedule according to the brachytherapy used to complement the dose of external beam radiotherapy (EBRT): 1 - High dose rate (HDR) - 36 patients - 4 weekly insertions of 6,0 Gy at point A 2 - Low dose rate (LDR) - 29 patients - 2 insertions two weeks apart of 17,5 Gy at point A The External Beam radiotherapy was performed through a Linac 4MV, in box arrangement for whole pelvis and in AP-PA fields for parametrial complementation of dose. The dose at the whole pelvis was 45 Gy in 25 fractions of 1,8 Gy and the parametrial dose was 16 Gy. The brachytherapy was realized with Fletcher colpostats and intrauterine tandem, in both arms. The HDR brachytherapy was realized through a Micro-Selectron device, working with Iridium-192 with initial activity of 10 Ci and started ten days after the beginning of EBRT. The total treatment time was shortened in two weeks for this group. The LDR brachytherapy started only after the end of EBRT. Results: With the minimum follow up of 24 months and medium of 31 months, the disease free survival was 50% among the 36 patients in HDR group and 47,8% among the 29 patients in LDR group. Local failures occurred in 50% and 52,8% respectively. Grade I and II complications were restricted to rectites and cistites and the incidence of them was 8,3% for HDR group and 13% for LDR group. Until the time of evaluation there were no grade III complications in any group. Conclusions: Although the number of patients is small and the time of follow up still short, these preliminary results suggest that the HDR brachytherapy has an equivalent efficiency in local control as the LDR in the treatment of stage IIIB

  4. Changes in ocular higher-order aberrations following botulinum toxin treatment in patients with blepharospasm : BTX improves dry eye in patients with BEB.

    Science.gov (United States)

    Isshiki, Yoshihiko; Ishikawa, Hiroto; Mimura, Osamu

    2016-11-01

    To evaluate the effects of botulinum toxin type A (BTX-A) treatment in patients with benign essential blepharospasm (BEB) by monitoring the ocular surface and ocular higher-order aberrations (HOAs) before and after treatment. The present study reports a prospective case series of 38 patients (76 eyes, 11 men and 27 women; mean age 66.8 ± 9.8 years) with BEB who underwent BTX-A treatment at Kokura Memorial Hospital between 2013 and 2014. Patients were evaluated for ophthalmoscopic findings, Schirmer I test, tear film break-up time (t-BUT), HOAs, fluctuation index (FI), stability index (SI) using a wavefront aberrometer, 15 subjective symptoms using the Dry Eye-Related Quality of Life Score (DEQS), and complications before and after the treatment. After BTX-A treatment, the Schirmer I test score improved significantly from 5.9 ± 5.4 to 8.7 ± 6.1 mm and t-BUT recovered from 5.2 ± 1.7 to 7.3 ± 1.7 s. HOAs were classified into four patterns: stable (60.5 %), small fluctuation (14.5 %), sawtooth (17.1 %), and reverse sawtooth (7.9 %), and they significantly reduced after the treatment. Only FI (not SI) showed a marked reduction, and the DEQS significantly improved from 44.7 ± 21.6 to 37.6 ± 21.0 after the treatment (p treatment with a high potential to improve ocular surface disorders induced by BEB.

  5. Patterns of Change in Collaboration Are Associated with Baseline Characteristics and Predict Outcome and Dropout Rates in Treatment of Multi-Problem Families. A Validation Study

    Directory of Open Access Journals (Sweden)

    Egon Bachler

    2017-07-01

    Full Text Available Objective: The present study validates the Multi-Problem Family (MPF-Collaboration Scale, which measures the progress of goal directed collaboration of patients in the treatment of families with MPF and its relation to drop-out rates and treatment outcome.Method: Naturalistic study of symptom and competence-related changes in children of ages 4–18 and their caregivers.Setting: Integrative, structural outreach family therapy.Measures: The data of five different groups of goal directed collaboration (deteriorating collaboration, stable low collaboration, stable medium collaboration, stable high collaboration, improving collaboration were analyzed in their relation to treatment expectation, individual therapeutic goals (ITG, family adversity index, severity of problems and global assessment of a caregiver’s functioning, child, and relational aspects.Results: From N = 810 families, 20% displayed stable high collaboration (n = 162 and 21% had a pattern of improving collaboration. The families with stable high or improving collaboration rates achieved significantly more progress throughout therapy in terms of treatment outcome expectancy (d = 0.96; r = 0.43, reaching ITG (d = 1.17; r = 0.50, family adversities (d = 0.55; r = 0.26, and severity of psychiatric symptoms (d = 0.31; r = 0.15. Furthermore, families with stable high or improving collaboration maintained longer treatments and had a bigger chance of finishing the therapy as planned. The odds of having a stable low or deteriorating collaboration throughout treatment were significantly higher for subjects who started treatment with low treatment expectation or high family-related adversities.Conclusion: The positive outcomes of homebased interventions for multi-problem families are closely related to “stable high” and an “improving” collaboration as measured with the MPF-Collaboration Scale. Patients who fall into these groups have a high treatment outcome expectancy and reduce

  6. Radiological assessment of water treatment processes in a water treatment plant in Saudi Arabia: Water and sludge radium content, radon air concentrations and dose rates

    Energy Technology Data Exchange (ETDEWEB)

    Al-Jaseem, Q.Kh., E-mail: qjassem@kacst.edu.sa [Nuclear Science Research Institute (NSRI), King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442 (Saudi Arabia); Almasoud, Fahad I. [Nuclear Science Research Institute (NSRI), King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442 (Saudi Arabia); Ababneh, Anas M. [Physics Dept., Faculty of Science, Islamic University in Madinah, Al-Madinah, P.O. Box 170 (Saudi Arabia); Al-Hobaib, A.S. [Nuclear Science Research Institute (NSRI), King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442 (Saudi Arabia)

    2016-09-01

    There is an increase demand for clean water sources in Saudi Arabia and, yet, renewable water resources are very limited. This has forced the authorities to explore deep groundwater which is known to contain large concentrations of radionuclides, mainly radium isotopes. Lately, there has been an increase in the number of water treatment plants (WTPs) around the country. In this study, a radiological assessment of a WTP in Saudi Arabia was performed. Raw water was found to have total radium activity of 0.23 Bq/L, which exceeds the international limit of 0.185 Bq/L (5 pCi/L). The WTP investigated uses three stages of treatment: flocculation/sedimentation, sand filtration and reverse osmosis. The radium removal efficiency was evaluated for each stage and the respective values were 33%, 22% and 98%. Moreover, the activity of radium in the solid waste generated from the WTP in the sedimentation and sand filtrations stages were measured and found to be 4490 and 6750 Bq/kg, respectively, which exceed the national limit of 1000 Bq/kg for radioactive waste. A radiological assessment of the air inside the WTP was also performed by measuring the radon concentrations and dose rates and were found in the ranges of 2–18 Bq/m{sup 3} and 70–1000 nSv/h, respectively. The annual effective dose was calculated and the average values was found to be 0.3 mSv which is below the 1 mSv limit. - Highlights: • Radiological assessment of groundwater treatment plant was performed. • Radium Removal efficiency was calculated for different stages during water treatment. • Radium concentrations in sludge were measured and found to exceed the national limit for radioactive waste. • Air radon concentrations and dose rates were monitored in the water treatment plant. • The Reverse Osmosis (RO) unit was found to record the highest air radon concentrations and dose rates.

  7. New Treatments for Autism: Effects of a Gluten-Free Diet on Rate of Learning.

    Science.gov (United States)

    Grace, Jennifer B.; Velez, Denise M.; Chambliss, Catherine

    This study assessed the effects of a gluten-free diet over one year on learning patterns in three autistic children (ages 5 to 8) participating in an applied behavioral analysis program. Rates of learning for five behavioral targets 3 months, 6 months, 9 months, and 12 months after the start of the diet were compared using a within-subjects…

  8. Generalization of the Activated Complex Theory of Reaction Rates. II. Classical Mechanical Treatment

    Science.gov (United States)

    Marcus, R. A.

    1964-01-01

    In its usual classical form activated complex theory assumes a particular expression for the kinetic energy of the reacting system -- one associated with a rectilinear motion along the reaction coordinate. The derivation of the rate expression given in the present paper is based on the general kinetic energy expression.

  9. Beyond reduced-impact logging: silvicultural treatments to increase growth rates of tropical trees

    NARCIS (Netherlands)

    Peña-Claros, M.; Fredericksen, T.S.; Alarcón, A.; Blate, G.M.; Choque, U.; Leaño, C.; Licona, J.C.; Mostacedo, B.; Pariona, W.; Villegas, Z.; Putz, F.E.

    2008-01-01

    Use of reduced-impact logging (RIL) techniques has repeatedly been shown to reduce damage caused by logging. Unfortunately, these techniques do not necessarily ameliorate the low growth rates of many commercial species or otherwise assure recovery of the initial volume harvested during the next

  10. Age- and time-dependent changes in the rates of radiation-induced cancers in patients with ankylosing spondylitis following a single course of X-ray treatment

    International Nuclear Information System (INIS)

    Smith, P.G.; Doll, R.

    1978-01-01

    The causes of death have been analysed in 14111 patients with ankylosing spondylitis following a single course of X-ray treatment. Patients who were re-treated with X-rays were followed until the end of the year following their second course of treatment and deaths subsequent to this time were ignored. An attempt was made to follow the remaining patients to 1 January 1970, or their date of death or emigration, whichever was the earlier. A total of 7455 (52.8%) patients were re-treated before 1 January 1970, 1759 (12.5%) patients had died and 269 (1.9%) had emigrated. A total of 208 (1.5%) patients were lost to follow-up and the remaining 4420 (31.3%), who had all received one course of treatment, were alive. The number of deaths from all causes was 66% greater than the expected number computed from national age and sex specific mortality rates. There were 31 deaths from leukaemia (6.5 expected), 259 from cancers of ''heavily irradiated'' sites (167.5 expected) and 79 from cancers of ''lightly irradiated'' sites, which was not significantly higher than the 65.6 expected. The ratio of observed to expected deaths and the excess death rate from leukaemia was greatest in the period three to five years after first treatment and subsequently declined. The ratio of observed to expected deaths from cancers of heavily irradiated sites was high in the two years following treatment, fell to a minimum six to eight years after treatment and then rose. Data for individual heavily irradiated sites showed little variation in the ratio of observed to expected numbers of deaths, apart from those due to tumours of the spinal cord. The ratio of observed to expected deaths for both leukaemia and cancers of the heavily irradiated sites showed no apparent change according to the age of the patients at their first treatment but the excess death rate showed a highly significant increase with increasing age at first treatment

  11. High Dose Rate Brachytherapy in Two 9 Gy Fractions in the Treatment of Locally Advanced Cervical Cancer - a South Indian Institutional Experience.

    Science.gov (United States)

    Ghosh, Saptarshi; Rao, Pamidimukkala Bramhananda; Kotne, Sivasankar

    2015-01-01

    Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. This is a prospective institutional study in Southern India carried on from 1st June 2012 to 31st July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

  12. Complex dynamics of an SEIR epidemic model with saturated incidence rate and treatment

    Science.gov (United States)

    Khan, Muhammad Altaf; Khan, Yasir; Islam, Saeed

    2018-03-01

    In this paper, we describe the dynamics of an SEIR epidemic model with saturated incidence, treatment function, and optimal control. Rigorous mathematical results have been established for the model. The stability analysis of the model is investigated and found that the model is locally asymptotically stable when R0 1. The proposed model may possess a backward bifurcation. The optimal control problem is designed and obtained their necessary results. Numerical results have been presented for justification of theoretical results.

  13. Odour emission inventory of German wastewater treatment plants--odour flow rates and odour emission capacity.

    Science.gov (United States)

    Frechen, F-B

    2004-01-01

    Wastewater Treatment plants can cause odour emissions that may lead to significant odour annoyance in their vicinity. Thus, over the past 20 years, several measurements were taken of the odour emissions that occur at WWTPs of different sizes, treatment technology, plant design and under different operating conditions. The specific aspects of odour sampling and measurement have to be considered. I presented some of the results of my odour emission measurements 11 years ago. However, it is now necessary to update the figures by evaluating newer measurement results obtained from measurements taken from 1994 to 2003. These are presented in this paper. Also, the paper highlights the odour emission capacity (OEC) measurement technique which characterises liquids and can be used to assess the results achieved by different types of treatment in the liquid phase, e.g. in a sewerage system. In addition, the OEC is a suitable parameter to set standards for the odorant content of industrial wastewaters that are discharged into the publicly owned sewerage system.

  14. Methadone-maintained patients in primary care have higher rates of chronic disease and multimorbidity, and use health services more intensively than matched controls

    LENUS (Irish Health Repository)

    O’Toole, John

    2014-05-01

    Background: Methadone maintenance treatment in primary care is cost-effective and improves outcomes for opiate-dependent patients. A more developed understanding of the evolving needs of this important cohort will facilitate further improvements in their integrated care within the community.\\r\

  15. Brachytherapy optimization using radiobiological-based planning for high dose rate and permanent implants for prostate cancer treatment

    Science.gov (United States)

    Seeley, Kaelyn; Cunha, J. Adam; Hong, Tae Min

    2017-01-01

    We discuss an improvement in brachytherapy--a prostate cancer treatment method that directly places radioactive seeds inside target cancerous regions--by optimizing the current standard for delivering dose. Currently, the seeds' spatiotemporal placement is determined by optimizing the dose based on a set of physical, user-defined constraints. One particular approach is the ``inverse planning'' algorithms that allow for tightly fit isodose lines around the target volumes in order to reduce dose to the patient's organs at risk. However, these dose distributions are typically computed assuming the same biological response to radiation for different types of tissues. In our work, we consider radiobiological parameters to account for the differences in the individual sensitivities and responses to radiation for tissues surrounding the target. Among the benefits are a more accurate toxicity rate and more coverage to target regions for planning high-dose-rate treatments as well as permanent implants.

  16. Rates of Second Malignancies After Definitive Local Treatment for Ductal Carcinoma In Situ of the Breast

    International Nuclear Information System (INIS)

    Shaitelman, Simona F.; Grills, Inga S.; Kestin, Larry L.; Ye Hong; Nandalur, Sirisha; Huang Jiayi; Vicini, Frank A.

    2011-01-01

    Purpose: We analyzed the risk of second malignancies developing in patients with ductal carcinoma in situ (DCIS) undergoing surgery and radiotherapy (S+RT) vs. surgery alone. Methods and Materials: The S+RT cohort consisted of 256 women treated with breast-conserving therapy at William Beaumont Hospital. The surgery alone cohort consisted of 2,788 women with DCIS in the regional Surveillance, Epidemiology, and End Results database treated during the same time period. A matched-pair analysis was performed in which each S+RT patient was randomly matched with 8 surgery alone patients (total of 2,048 patients). Matching criteria included age ± 2 years. The rates of second malignancies were analyzed overall and as contralateral breast vs. non-breast cancers and by organ system. Results: Median follow-up was 13.7 years for the S+RT cohort and 13.3 years for the surgery alone cohort. The overall 10-/15-year rates of second malignancies among the S+RT and surgery alone cohorts were 14.2%/24.2% and 16.4%/22.6%, respectively (p = 0.668). The 15-year second contralateral breast cancer rate was 14.2% in the S+RT cohort and 10.3% in the surgery alone cohort (p = 0.439). The 15-year risk of a second non-breast malignancy was 14.2% for the S+RT cohort and 13.4% for the surgery alone cohort (p = 0.660). When analyzed by organ system, the 10- and 15-year rates of second malignancies did not differ between the S+RT and surgery alone cohorts for pulmonary, gastrointestinal, central nervous system, gynecologic, genitourinary, lymphoid, sarcomatoid, head and neck, or unknown primary tumors. Conclusions: Compared with surgery alone, S+RT is not associated with an overall increased risk of second malignancies in women with DCIS.

  17. Generalization of the Activated Complex Theory of Reaction Rates. I. Quantum Mechanical Treatment

    Science.gov (United States)

    Marcus, R. A.

    1964-01-01

    In its usual form activated complex theory assumes a quasi-equilibrium between reactants and activated complex, a separable reaction coordinate, a Cartesian reaction coordinate, and an absence of interaction of rotation with internal motion in the complex. In the present paper a rate expression is derived without introducing the Cartesian assumption. The expression bears a formal resemblance to the usual one and reduces to it when the added assumptions of the latter are introduced.

  18. Lower Mortality Rate in Elderly Patients With Community?Onset Pneumonia on Treatment With Aspirin

    OpenAIRE

    Falcone, Marco; Russo, Alessandro; Cangemi, Roberto; Farcomeni, Alessio; Calvieri, Camilla; Barill?, Francesco; Scarpellini, Maria Gabriella; Bertazzoni, Giuliano; Palange, Paolo; Taliani, Gloria; Venditti, Mario; Violi, Francesco

    2015-01-01

    Background Pneumonia is complicated by high rate of mortality and cardiovascular events (CVEs). The potential benefit of aspirin, which lowers platelet aggregation by inhibition of thromboxane A2 production, is still unclear. The aim of the study was to assess the impact of aspirin on mortality in patients with pneumonia. Methods and Results Consecutive patients admitted to the University?Hospital Policlinico Umberto I (Rome, Italy) with community?onset pneumonia were recruited and prospectiv...

  19. Treatment of thin stillage in a high-rate anaerobic fluidized bed bioreactor (AFBR).

    Science.gov (United States)

    Andalib, Mehran; Hafez, Hisham; Elbeshbishy, Elsayed; Nakhla, George; Zhu, Jesse

    2012-10-01

    The primary objective of this work was to investigate the treatability of thin stillage as a by-product of bioethanol production plants using an anaerobic fluidized bed bioreactor (AFBR) employing zeolite with average diameter of (d(m)) of 425-610 μm and specific surface area (SSA) of 26.5m(2)/g as the carrier media. Despite the very high strength of thin stillage with chemical oxygen demand of 130,000 mg TCOD/L and suspended solids of 47,000 mg TSS/L, the AFBR showed up to 88% TCOD and 78% TSS removal at very high organic and solids loading rates (OLR and SLR) of 29 kg COD/m(3)d and 10.5 kg TSS/m(3)d respectively and hydraulic retention time (HRT) of 3.5 days. Methane production rates of up to 160 L/d at the steady state equivalent to 40 L(CH4)/L(thin stillage)d and biogas production rate per reactor volume of 15.8L(gas)/L(reactor)d were achieved. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Optimum injection dose rate of hydrogen sulfide scavenger for treatment of petroleum crude oil

    Directory of Open Access Journals (Sweden)

    T.M. Elshiekh

    2016-03-01

    Full Text Available Hydrogen sulfide H2S scavengers are chemicals that favorably react with hydrogen sulfide gas to eliminate it and produce environmental friendly products. These products depend on the type and composition of the scavenger and the conditions at which the reaction takes place. The scavenger should be widely available and economical for industry acceptance by having a low unit cost. The optimum values of H2S scavenger injection dose rate of scavenging hydrogen sulfide from the multiphase fluid produced at different wells conditions in one of the Petroleum Companies in Egypt were studied. The optimum values of H2S scavenger injection dose rate depend on pipe diameter, pipe length, gas molar mass velocity, inlet H2S concentration and pressure. The optimization results are obtained for different values of these parameters using the software program Lingo. In general, the optimum values of H2S scavenger injection dose rate of the scavenging of hydrogen sulfide are increased by increasing of the pipe diameter and increasing the inlet H2S concentration, and decreased by increasing the pipe length, gas molar mass velocity and pressure.

  1. Simulation for estimation of hydrogen sulfide scavenger injection dose rate for treatment of crude oil

    Directory of Open Access Journals (Sweden)

    T.M. Elshiekh

    2015-12-01

    Full Text Available The presence of hydrogen sulfide in the hydrocarbon fluids is a well known problem in many oil and gas fields. Hydrogen sulfide is an undesirable contaminant which presents many environmental and safety hazards. It is corrosive, malodorous, and toxic. Accordingly, a need has been long left in the industry to develop a process which can successfully remove hydrogen sulfide from the hydrocarbons or at least reduce its level during the production, storage or processing to a level that satisfies safety and product specification requirements. The common method used to remove or reduce the concentration of hydrogen sulfide in the hydrocarbon production fluids is to inject the hydrogen sulfide scavenger into the hydrocarbon stream. One of the chemicals produced by the Egyptian Petroleum Research Institute (EPRI is EPRI H2S scavenger. It is used in some of the Egyptian petroleum producing companies. The injection dose rate of H2S scavenger is usually determined by experimental lab tests and field trials. In this work, this injection dose rate is mathematically estimated by modeling and simulation of an oil producing field belonging to Petrobel Company in Egypt which uses EPRI H2S scavenger. Comparison between the calculated and practical values of injection dose rate emphasizes the real ability of the proposed equation.

  2. Does provider-initiated HIV testing and counselling lead to higher HIV testing rate and HIV case finding in Rwandan clinics?

    NARCIS (Netherlands)

    Kayigamba, Felix R.; van Santen, Daniëla; Bakker, Mirjam I.; Lammers, Judith; Mugisha, Veronicah; Bagiruwigize, Emmanuel; de Naeyer, Ludwig; Asiimwe, Anita; Schim van der Loeff, Maarten F.

    2016-01-01

    Provider-initiated HIV testing and counselling (PITC) is promoted as a means to increase HIV case finding. We assessed the effectiveness of PITC to increase HIV testing rate and HIV case finding among outpatients in Rwandan health facilities (HF). PITC was introduced in six HFs in 2009-2010. HIV

  3. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts

    DEFF Research Database (Denmark)

    Astor, Brad C; Matsushita, Kunihiro; Gansevoort, Ron T

    2011-01-01

    We studied here the independent associations of estimated glomerular filtration rate (eGFR) and albuminuria with mortality and end-stage renal disease (ESRD) in individuals with chronic kidney disease (CKD). We performed a collaborative meta-analysis of 13 studies totaling 21,688 patients selected...

  4. Payment for antiretroviral drugs is associated with a higher rate of patients lost to follow-up than those offered free-of-charge therapy in Nairobi, Kenya

    NARCIS (Netherlands)

    Zachariah, R.; van Engelgem, I.; Massaquoi, M.; Kocholla, L.; Manzi, M.; Suleh, A.; Phillips, M.; Borgdorff, M.

    2008-01-01

    This retrospective analysis of routine programme data from Mbagathi District Hospital, Nairobi, Kenya shows the difference in rates of loss to follow-up between a cohort that paid 500 shillings/month (approximately US$7) for antiretroviral drugs (ART) and one that received medication free of charge.

  5. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts

    NARCIS (Netherlands)

    van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C.; Woodward, Mark; Levey, Andrew S.; de Jong, Paul E.; Gansevoort, Ron T.

    Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative

  6. Self-rated treatment outcomes in medical rehabilitation among German and non-German nationals residing in Germany: an exploratory cross-sectional study.

    Science.gov (United States)

    Brzoska, P; Sauzet, O; Yilmaz-Aslan, Y; Widera, T; Razum, O

    2016-03-28

    In many European countries, foreign nationals experience, on average, less favorable treatment outcomes in rehabilitative care than the respective majority population. In Germany, this for example is reflected in a lower occupational performance and a higher risk of disability retirement after rehabilitation as analyses of routine data show. However, little is known about the perspective of health care users. The aim of the present study was to compare self-rated treatment outcomes between German and non-German nationals undergoing in-patient medical rehabilitation in Germany. We analyzed data from a cross-sectional representative rehabilitation patient survey of 239,811 patients from 642 clinics in Germany who completed about 3 weeks of in-patient rehabilitative treatment. The self-rating of the treatment outcome was based on a dichotomized Likert scale consisting of three items. A multilevel logistic regression analysis adjusted for various demographic, socio-economic, health and other covariates was conducted to examine differences in the self-rated treatment outcome between German and non-German nationals. Of the 239,811 respondents 0.9% were nationals from Turkey, 0.8% had a nationality from a former Yugoslavian country, 0.9% held a nationality from the South European countries Portugal, Spain, Italy or Greece and 1.9% were nationals from other countries. Non-German nationals reported a less favorable self-rated outcome than Germans. Adjusted odds ratios [OR] for reporting a less favorable treatment outcome were 1.24 (95%-confidence interval [95%-CI]: 1.12-1.37) for nationals from the South European countries Portugal/Spain/Italy/Greece, 1.62 (95%-CI: 1.45-1.80) for Turkish nationals and 1.68 (95%-CI: 1.52-1.85) for nationals from Former Yugoslavia. Knowledge on health outcomes from the patients' point of view is important for the provision of patient-centered health care. Our study showed that non-German nationals report less favorable outcomes of

  7. Flare-up rate in molars with periapical radiolucency in one-visit vs two-visit endodontic treatment.

    Science.gov (United States)

    Akbar, Iftikhar; Iqbal, Azhar; Al-Omiri, Mahmoud K

    2013-05-01

    The objective of this study was to compare postobturation flare-ups following single and two-visit endodontic treatment of molar teeth with periapical radiolucency. A total of 100 patients with asymptomatic molar teeth with periapical radiolucency were selected. They were randomly allocated into two groups. Fifty patients received complete endodontic treatment in one-visit. Fifty patients received treatment by debridement and instrumentation at the first visit followed by obturation at the second visit. 10% of patients had flare-ups in the single visit group and 8% of patients had flare-ups in the two-visit group. Number of visits did not affect the success of endodontic treatment (p>0.05). Age, gender and tooth type had no effects on the occurrence of flare-ups regardless the number of visits (p>0.05). One-visit endodontic treatment was as successful as two-visit endodontic treatment as evaluated by rate of flareups in asymptomatic molar teeth with periapical radiolucency.

  8. Higher risk sexual behaviour is associated with unawareness of HIV-positivity and lack of viral suppression - implications for Treatment as Prevention.

    Science.gov (United States)

    Huerga, Helena; Venables, Emilie; Ben-Farhat, Jihane; van Cutsem, Gilles; Ellman, Tom; Kenyon, Chris

    2017-11-23

    Efficacy of Treatment as Prevention Strategy depends on a variety of factors including individuals' likelihood to test and initiate treatment, viral load and sexual behaviour. We tested the hypothesis that people with higher risk sexual behaviour are less likely to know their HIV-positive status and be virologically suppressed. A cross-sectional population-based survey of individuals aged 15-59 years old was conducted in 2013 in KwaZulu-Natal, South Africa. A two-stage cluster probability sampling was used. After adjustment for age and sex, lack of awareness of HIV-positivity was strongly associated with having more than one sexual partner in the preceding year (aOR: 2.1, 95%CI: 1.5-3.1). Inconsistent condom use was more common in individuals with more than one sexual partner (aOR: 16.6, 95%CI: 7.6-36.7) and those unaware (aOR: 3.7, 95%CI: 2.6-5.4). Among people aware of their HIV-positivity, higher risk sexual behaviour was associated with lack of viral suppression (aOR: 2.2, 95%CI: 1.1-4.5). Risky sexual behaviour seems associated with factors linked to poor health-seeking behaviour which may have negative implications for HIV testing and Treatment as Prevention. Innovative strategies, driven by improved epidemiological and anthropological understanding, are needed to enable comprehensive approaches to HIV prevention.

  9. Assessment of modified Forssell’s myectomy success rate in the treatment of crib biting in horses

    Directory of Open Access Journals (Sweden)

    Šárka Krisová

    2015-01-01

    Full Text Available The objective of this retrospective study was to assess the success rate of Forssell’s modified myectomy – surgical treatment of crib biting on 33 horses of various breeds identified as stereotypical cribbers which were referred to the Equine Clinic in Brno between January 2001 and December 2010. The long term outcome was available for all horses. The overall success of the surgery without considering influencing factors was 61%. Thirteen horses (39% returned to the stereotypical behaviour sooner or later after the surgery. In this retrospective study we confirmed the dependence of success of the surgery on the necessity of early treatment of the problem (up to 6 months after the appearance of initial signs, with the significance level of P = 0.037. Any connection between age, breed or sex, and positive outcome of the surgery were not confirmed during statistical evaluation. When the horses were diagnosed early enough, an 80% success rate in surgical treatment performed within 6 months from the initial signs of crib biting was recorded, which seems to be very promising. It can be concluded that surgical treatment of crib biting by modified Forsell’s myectomy is the recommended option in the therapy of this oral stereotype.

  10. Radiation treatment of esophageal carcinoma using a high-dose-rate remote afterloader

    International Nuclear Information System (INIS)

    Hishikawa, Yoshio

    1984-01-01

    Between May 1980 and March 1983, 31 patients with esophageal carcinoma were treated with a high-dose-rate remote controlled afterloading unit, as a boost therapy of the intracavitary irradiation following the external irradiation. The data of these patients were analyzed by the regression analysis which is one of the multivariate analyses, and following results were obtained. 1) Factors which affect local control achieved by intracavitary irradiation were the existence of deep ulcer or stenosis after external irradiation, age of the patient, dosage of intracavitary irradiation and tumor length. 2) The local control estimation index was determined by these five factors. Local control estimation index=1.38950-0.01571 x age+0.04517 x tumor length+0.62167 x stenosis* + 0.94811 x deep ulcer*-0.02969 x dosage of intracavitary irradiation. * Existence of stenosis/ulcer was represented by 1, and absence was represented by 0. 3) The local control estimation indices obtained in the above formula were then approved by applying internal samples, and also external samples. Indices of 0.5 or more mean local failure, and those of less than 0.5 mean possible local control. Examination was then made as to the local control estimation indices of another group of 30 patients who had been treated by external irradiation alone between November 1974 and April 1980. Comparison of the indices of the two groups showed the following results. 1) Rate of possible local control by external irradiation alone was 23%. 2) Rate of possible local control was increased up to 62% by using intracavitary irradiation following external irradiation. (author)

  11. Low dose-rate irradiation in the treatment of acute myelogenous leukaemia in first remission

    Energy Technology Data Exchange (ETDEWEB)

    Cattell, P A; Unwin, S F [Royal Marsden Hospital, Sutton (UK)

    1981-04-01

    Thirty-six patients with acute myelogenous leukaemia (AML) in first remission received sibling bone marrow transplants following cyclophosphamide and a single dose of 1000 rad total body irradiation (TBI). The preparation programme for a patient undergoing a bone marrow transplant is described. The aim of the cyclophosphamide and TBI is to eradicate all active bone marrow present in the patient and to reduce the immune response of the patient to the graft, thus preventing rejection. The cobalt unit and treatment box used for the TBI is described together with details of the planning for TBI including test doses on the patient. The procedure on the day of the 8 hour TBI treatment is then given. The likely reactions following the TBI and the graft are described. Of these transplanted patients, 64% remain alive, well and disease-free, nine of them for more than one year and one surviving more than three years. These results are a significant improvement on the results of AML treated with chemotherapy and immunotherapy.

  12. EXCHANGE RATE DIFFERENCES-THE ACCOUNTING TREATMENT AND ITS INFLUENCE ON THE FINANCIAL PERFORMANCE OF AN ECONOMIC ENTITY

    Directory of Open Access Journals (Sweden)

    Nicoleta Cristina MATEI

    2016-06-01

    Full Text Available Currency rate differences arise when there are certain debt rights or obligations in foreign currency of an economic entity which are collected, i.e. paid for at a different course from the one displayed by the Romanian National Bank on the date of their establishment. Such differences, according to the situation, generate expenditure or revenue which affects a company's financial result and, consequently, the accountant result as well. The results registered by an economic entity presented in the Profit and Loss Account provide information about its financial performance. This performance can be influenced by the favorable or unfavorable exchange rate differences existing when an economic entity carries out transactions or has incurred foreign currency loans having a significant share in the total amount of transactions or in capitals. The present paper shows the accounting treatment of the exchange rate differences and its impact on the financial performance.

  13. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... also have higher rates of cigarette and drug addiction, and more driving infractions. The good news is that effective treatment is available . With the right medical treatment, children with ADHD can improve their ability ...

  14. Pharmacokinetic-Pharmacodynamic modelling of intracellular Mycobacterium tuberculosis growth and kill rates is predictive of clinical treatment duration.

    Science.gov (United States)

    Aljayyoussi, Ghaith; Jenkins, Victoria A; Sharma, Raman; Ardrey, Alison; Donnellan, Samantha; Ward, Stephen A; Biagini, Giancarlo A

    2017-03-29

    Tuberculosis (TB) treatment is long and complex, typically involving a combination of drugs taken for 6 months. Improved drug regimens to shorten and simplify treatment are urgently required, however a major challenge to TB drug development is the lack of predictive pre-clinical tools. To address this deficiency, we have adopted a new high-content imaging-based approach capable of defining the killing kinetics of first line anti-TB drugs against intracellular Mycobacterium tuberculosis (Mtb) residing inside macrophages. Through use of this pharmacokinetic-pharmacodynamic (PK-PD) approach we demonstrate that the killing dynamics of the intracellular Mtb sub-population is critical to predicting clinical TB treatment duration. Integrated modelling of intracellular Mtb killing alongside conventional extracellular Mtb killing data, generates the biphasic responses typical of those described clinically. Our model supports the hypothesis that the use of higher doses of rifampicin (35 mg/kg) will significantly reduce treatment duration. Our described PK-PD approach offers a much needed decision making tool for the identification and prioritisation of new therapies which have the potential to reduce TB treatment duration.

  15. Lower mortality rate in elderly patients with community-onset pneumonia on treatment with aspirin.

    Science.gov (United States)

    Falcone, Marco; Russo, Alessandro; Cangemi, Roberto; Farcomeni, Alessio; Calvieri, Camilla; Barillà, Francesco; Scarpellini, Maria Gabriella; Bertazzoni, Giuliano; Palange, Paolo; Taliani, Gloria; Venditti, Mario; Violi, Francesco

    2015-01-06

    Pneumonia is complicated by high rate of mortality and cardiovascular events (CVEs). The potential benefit of aspirin, which lowers platelet aggregation by inhibition of thromboxane A2 production, is still unclear. The aim of the study was to assess the impact of aspirin on mortality in patients with pneumonia. Consecutive patients admitted to the University-Hospital Policlinico Umberto I (Rome, Italy) with community-onset pneumonia were recruited and prospectively followed up until discharge or death. The primary end point was the occurrence of death up to 30 days after admission; the secondary end point was the intrahospital incidence of nonfatal myocardial infarction and ischemic stroke. One thousand and five patients (age, 74.7±15.1 years) were included in the study: 390 were receiving aspirin (100 mg/day) at the time of hospitalization, whereas 615 patients were aspirin free. During the follow-up, 16.2% of patients died; among these, 19 (4.9%) were aspirin users and 144 (23.4%; PFiO(2) ratio <300 negatively influenced survival, whereas aspirin therapy was associated with improved survival. Compared to patients receiving aspirin, the propensity score adjusted analysis confirmed that patients not taking aspirin had a hazard ratio of 2.07 (1.08 to 3.98; P=0.029) for total mortality. This study shows that chronic aspirin use is associated with lower mortality rate within 30 days after hospital admission in a large cohort of patients with pneumonia. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  16. Case-mix analysis and variation in rates of non-surgical treatment of older women with operable breast cancer.

    Science.gov (United States)

    Morgan, J; Richards, P; Ward, S; Francis, M; Lawrence, G; Collins, K; Reed, M; Wyld, L

    2015-08-01

    Non-surgical management of older women with oestrogen receptor (ER)-positive operable breast cancer is common in the UK, with up to 40 per cent of women aged over 70 years receiving primary endocrine therapy. Although this may be appropriate for frailer patients, for some it may result in treatment failure, contributing to the poor outcomes seen in this age group. Wide variation in the rates of non-operative management of breast cancer in older women exists across the UK. Case mix may explain some of this variation in practice. Data from two UK regional cancer registries were analysed to determine whether variation in treatment observed between 2002 and 2010 at hospital and clinician level persisted after adjustment for case mix. Expected case mix-adjusted surgery rates were derived by logistic regression using the variables age, proxy Charlson co-morbidity score, deprivation quintile, method of cancer detection, tumour size, stage, grade and node status. Data on 17,129 women aged 70 years or more with ER-positive operable breast cancer were analysed. There was considerable variation in rates of surgery at both hospital and clinician level. Despite adjusting for case mix, this variation persisted at hospital level, although not at clinician level. This study demonstrates variation in selection criteria for older women for operative treatment of early breast cancer, indicating that some older women may be undertreated or overtreated, and may partly explain the inferior disease outcomes in this age group. It emphasizes the urgent need for evidence-based guidelines for treatment selection criteria in older women with breast cancer. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  17. Are High-Severity Fires Burning at Much Higher Rates Recently than Historically in Dry-Forest Landscapes of the Western USA?

    Science.gov (United States)

    Baker, William L

    2015-01-01

    Dry forests at low elevations in temperate-zone mountains are commonly hypothesized to be at risk of exceptional rates of severe fire from climatic change and land-use effects. Their setting is fire-prone, they have been altered by land-uses, and fire severity may be increasing. However, where fires were excluded, increased fire could also be hypothesized as restorative of historical fire. These competing hypotheses are not well tested, as reference data prior to widespread land-use expansion were insufficient. Moreover, fire-climate projections were lacking for these forests. Here, I used new reference data and records of high-severity fire from 1984-2012 across all dry forests (25.5 million ha) of the western USA to test these hypotheses. I also approximated projected effects of climatic change on high-severity fire in dry forests by applying existing projections. This analysis showed the rate of recent high-severity fire in dry forests is within the range of historical rates, or is too low, overall across dry forests and individually in 42 of 43 analysis regions. Significant upward trends were lacking overall from 1984-2012 for area burned and fraction burned at high severity. Upward trends in area burned at high severity were found in only 4 of 43 analysis regions. Projections for A.D. 2046-2065 showed high-severity fire would generally be still operating at, or have been restored to historical rates, although high projections suggest high-severity fire rotations that are too short could ensue in 6 of 43 regions. Programs to generally reduce fire severity in dry forests are not supported and have significant adverse ecological impacts, including reducing habitat for native species dependent on early-successional burned patches and decreasing landscape heterogeneity that confers resilience to climatic change. Some adverse ecological effects of high-severity fires are concerns. Managers and communities can improve our ability to live with high-severity fire in

  18. Post-treatment visual acuity in patients treated with episcleral plaque therapy for choroidal melanoma: Dose and dose rate effects

    International Nuclear Information System (INIS)

    Jones, Robert; Gore, Elizabeth; Mieler, William; Gillin, Michael; Albano, Katherine; Erickson, Beth

    1996-01-01

    Purpose: To determine the relationship between the long-term visual function and the dose and dose rates delivered to critical ocular structures in patients with choroidal melanoma treated with 125 I episcleral plaque radiotherapy. Methods and Materials: From 1987 to 1993, 63 patients underwent 125 I episcleral plaque application for the treatment of choroidal melanoma. Mean tumor height was 4.6 mm (range 1.7-8.3 mm). Plaques utilized were of COMS design. Doses and dose rates at the tumor apex, macula, and optic disc were obtained. Visual acuity data prior to and after plaque application was available for 52 patients. 9 patients were excluded from analysis secondary to co-morbidities or disease progression. 43 records were scored to assess if a decrease in visual acuity of ≥ 2 lines on a standard Snellen eye chart had occurred. Statistical analysis was performed using chi-square tests of significance. Results: Of the 63 total patients, 59 (93.7%) were alive at a median follow-up of 36 months. Local progression occurred in (7(63)) (11.1%). Median dose and dose rate to the tumor apex were 90 Gy and 97.2 cGy/hr, respectively. Of the 43 patients with post-treatment visual acuity analysis, 28 (65.1%) experienced visual loss of ≥ 2 lines on a standard eye chart. Median time to altered visual acuity was 20 months. Median dose and dose rates to the macula in patients with a significant visual loss were 123.3 Gy and 122.5 cGy/hr, respectively, compared with 38 Gy and 51.9 cGy/hr in those without notable visual change. These differences reached statistical significance at a dose and dose rate to the macula of 82.0 Gy (p 125 I plaque brachytherapy for choroidal melanoma experienced favorable tumor control, but with a measurable incidence of decreased visual acuity. Both total dose and dose rates to the macula and optic disc correlated strongly with post-treatment visual outcome. This information may be valuable in decisions about the dose and dose rates used to treat

  19. Post-treatment visual acuity in patients treated with episcleral plaque therapy for choroidal melanoma: dose and dose rate effects

    International Nuclear Information System (INIS)

    Jones, Robert; Gore, Elizabeth; Mieler, William; Murray, Kevin; Gillin, Michael; Albano, Katherine; Erickson, Beth

    1996-01-01

    Purpose: To determine the relationship between the long-term visual function and the dose and dose rates delivered to critical ocular structures in patients with choroidal melanoma treated with 125 I episcleral plaque radiotherapy. Methods and Materials: From 1987 to 1994, 63 patients underwent 125 I episcleral plaque application for the treatment of choroidal melanoma. Mean tumor height was 4.6 mm (range 1.7-8.3 mm). Plaques utilized were of COMS design. Doses and dose rates at the tumor apex, macula, and optic disc were obtained. Visual acuity data prior to and after plaque application was available for 52 patients. Nine patients were excluded from analysis secondary to co-morbidities or disease progression. Forty-three records were scored to assess if a decrease in visual acuity of ≥ 2 lines on a standard Snellen eye chart had occurred. Statistical analysis was performed using chi-square tests of significance. Results: Of the 63 total patients, 59 (93.7%) were alive at a median follow-up of 36 months. Local progression occurred in 7/63 (11.1%). Median dose and dose rate to the tumor apex were 90 Gy and 97.2 cGy/hr, respectively. Of the 43 patients with post-treatment visual acuity analysis, 28 (65.1%) experienced visual loss of ≥ 2 lines on a standard eye chart. Median time to altered visual acuity was 20 months. Median dose and dose rates to the macula in patients with a significant visual loss were 123.3 Gy and 122.5 cGy/hr, respectively, compared with 38 Gy and 51.9 cGy/hr in those without notable visual change. These differences reached statistical significance at a dose and dose rate to the macula of 82.0 Gy (p 125 I plaque brachytherapy for choroidal melanoma experienced favorable tumor control, but with a measurable incidence of decreased visual acuity. Both total dose and dose rates to the macula and optic disc correlated strongly with post-treatment visual outcome. This information may be valuable in decisions about the dose and dose rates used to

  20. Higher caloric intake in hospitalized adolescents with anorexia nervosa is associated with reduced length of stay and no increased rate of refeeding syndrome.

    Science.gov (United States)

    Golden, Neville H; Keane-Miller, Casey; Sainani, Kristin L; Kapphahn, Cynthia J

    2013-11-01

    To determine the effect of higher caloric intake on weight gain, length of stay (LOS), and incidence of hypophosphatemia, hypomagnesemia, and hypokalemia in adolescents hospitalized with anorexia nervosa. Electronic medical records of all subjects 10-21 years of age with anorexia nervosa, first admitted to a tertiary children's hospital from Jan 2007 to Dec 2011, were retrospectively reviewed. Demographic factors, anthropometric measures, incidence of hypophosphatemia (≤3.0 mg/dL), hypomagnesemia (≤1.7 mg/dL), and hypokalemia (≤3.5 mEq/L), and daily change in percent median body mass index (BMI) (%mBMI) from baseline were recorded. Subjects started on higher-calorie diets (≥1,400 kcal/d) were compared with those started on lower-calorie diets (Refeeding hypophosphatemia depends on the degree of malnutrition but not prescribed caloric intake, within the range studied. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Change of International Restless Legs Syndrome Study Group Rating Scale subscales with treatment and placebo: a pilot study

    Directory of Open Access Journals (Sweden)

    Mitchell UH

    2014-02-01

    Full Text Available Ulrike H Mitchell,1 Sterling C Hilton2 1Brigham Young University, Department of Exercise Sciences, 2Department of Educational Leadership and Foundations, Provo, UT, USA Background: In 2003, the 10-question International Restless Legs Syndrome Study Group Rating Scale (IRLS was developed as a means of assessing the severity of restless legs syndrome. Two subscales were identified: symptom severity (SS 1 and symptom impact (SS 2. Only one study has investigated the subscales' responsiveness to a 12-week treatment with ropinirole. This current study was undertaken to assess the impact of a 4-week, non-pharmaceutical treatment on the two subscales and to explore whether or not both subscales were impacted by the observed placebo effect. Methods: The pooled data from questionnaires of 58 patients (41 from both treatment groups and 17 from the sham treatment control group, who participated in two clinical studies, were reviewed. Their change in score over a 4-week trial was computed. The average change in both subscales in both groups was computed and t-tests were performed. Results: In the treatment group, the average scores of both subscales changed significantly from baseline to week 4 (P<0.005 for both. Compared to the control, SS 1 changed (P<0.001, but not SS 2 (P=0.18. In the sham treatment group, the scores for SS 1 changed significantly (P=0.002, but not for SS 2 (P=0.2. Conclusion: This study corroborated findings from an earlier study in which both subscales changed with a 12-week drug treatment. It also showed that the observed placebo effect is attributed to a small but significant change in symptom severity, but not symptom impact. Keywords: restless legs syndrome, RLS severity scale, IRLS subscales, symptom impact, symptom severity

  2. Implementation of the forced answering option within online surveys: Do higher item response rates come at the expense of participation and answer quality?

    Directory of Open Access Journals (Sweden)

    Décieux Jean Philippe

    2015-01-01

    Full Text Available Online surveys have become a popular method for data gathering for many reasons, including low costs and the ability to collect data rapidly. However, online data collection is often conducted without adequate attention to implementation details. One example is the frequent use of the forced answering option, which forces the respondent to answer each question in order to proceed through the questionnaire. The avoidance of missing data is often the idea behind the use of the forced answering option. However, we suggest that the costs of a reactance effect in terms of quality reduction and unit nonresponse may be high because respondents typically have plausible reasons for not answering questions. The objective of the study reported in this paper was to test the influence of forced answering on dropout rates and data quality. The results show that requiring participants answer every question increases dropout rates and decreases quality of answers. Our findings suggest that the desire for a complete data set has to be balanced against the consequences of reduced data quality.

  3. Apolipoprotein CIII overexpression exacerbates diet-induced obesity due to adipose tissue higher exogenous lipid uptake and retention and lower lipolysis rates.

    Science.gov (United States)

    Raposo, Helena F; Paiva, Adriene A; Kato, Larissa S; de Oliveira, Helena C F

    2015-01-01

    Hypertriglyceridemia is a common type of dyslipidemia found in obesity. However, it is not established whether primary hyperlipidemia can predispose to obesity. Evidences have suggested that proteins primarily related to plasma lipoprotein transport, such as apolipoprotein (apo) CIII and E, may significantly affect the process of body fat accumulation. We have previously observed an increased adiposity in response to a high fat diet (HFD) in mice overexpressing apoCIII. Here, we examined the potential mechanisms involved in this exacerbated response of apoCIII mice to the HFD. We measured body energy balance, tissue capacity to store exogenous lipids, lipogenesis and lipolysis rates in non-transgenic and apoCIII overexpressing mice fed a HFD during two months. Food intake, fat excretion and whole body CO2 production were similar in both groups. However, the adipose tissue mass (45 %) and leptin plasma levels (2-fold) were significantly greater in apoCIII mice. Lipogenesis rates were similar, while exogenous lipid retention was increased in perigonadal (2-fold) and brown adipose tissues (40 %) of apoCIII mice. In addition, adipocyte basal lipolysis (55 %) and in vivo lipolysis index (30 %) were significantly decreased in apoCIII mice. A fat tolerance test evidenced delayed plasma triglyceride clearance and greater transient availability of non-esterified fatty acids (NEFA) during the post-prandial state in the apoCIII mice plasma. Thus, apoCIII overexpression resulted in increased NEFA availability to adipose uptake and decreased adipocyte lipolysis, favoring lipid enlargement of adipose depots. We propose that plasma apoCIII levels represent a new risk factor for diet-induced obesity.

  4. Daily treatment with α-naphthoflavone enhances follicular growth and ovulation rate in the rat

    International Nuclear Information System (INIS)

    Barreiro, Karina A.; Di Yorio, Maria P.; Artillo-Guida, Romina D.; Paz, Dante A.; Faletti, Alicia G.

    2011-01-01

    The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor and the first protein involved in a variety of physiological and toxicological processes, including those of xenobiotic metabolizing enzymes. AhR has been found in the ovary of many species and seems to mediate the ovarian toxicity of many environmental contaminants, which are AhR ligands. However, the role of AhR in the ovarian function is unknown. Therefore, the aim of this work was to study the action of α-naphthoflavone (αNF), known to be an AhR antagonist, on both follicular growth and ovulation. Immature Sprague-Dawley rats were daily injected intraperitoneally with αNF (0.1-80 mg/kg) or vehicle for 12 days, and primed with gonadotrophins (eCG/hCG) to induce follicular growth and ovulation. Ovaries were obtained 20 h after hCG administration. By means of immunohistochemistry, we found that the numbers of primordial, primary and antral follicles were increased in rats treated with 80 mg/kg αNF and that there were no differences with other doses. Likewise, the ovarian weight and the ovulation rate, measured by both number of oocytes within oviducts and corpora lutea in ovarian sections, were increased when the rats received either 1 or 10 mg/kg daily. Although further studies are necessary to know the mechanism of action of αNF, it is possible that the different ovarian processes can be differentially responsive to the presence of different levels of αNF, and that the same or different endogenous AhR ligands can be involved in these ovarian processes in a cell type-dependent manner.

  5. Infusion-related febrile reaction after haploidentical stem cell transplantation in children is associated with higher rates of engraftment syndrome and acute graft-versus-host disease.

    Science.gov (United States)

    Chen, Yao; Huang, Xiao-Jun; Liu, Kai-Yan; Chen, Huan; Chen, Yu-Hong; Zhang, Xiao-Hui; Wang, Feng-Rong; Han, Wei; Wang, Jing-Zhi; Wang, Yu; Yan, Chen-Hua; Zhang, Yuan-Yuan; Sun, Yu-Qian; Xu, Lan-Ping

    2015-12-01

    The clinical significance and prognostic impact of IRFR in pediatric recipients of haploidentical SCT are not clearly understood. Therefore, we attempted to determine how IRFR affects clinical outcomes in children. Clinical data from 100 consecutive pediatric patients (60 boys and 40 girls; median age, 12 yr [range, 2-18 yr] after haploidentical SCT between January 2010 and December 2012 were collected retrospectively. IRFR was described as unexplained fever (>38 °C) within 24 h after the infusion of haploidentical PBSCs. Thirty-eight (38.0%) cases met the criteria for IRFR. ES was found in 24 (63.2%) of the 38 children with IRFR, with the median time of developing ES of +9 (7-16) days, while only 15 (25.4%) of the 59 children without IRFR were found with ES (p children after haploidentical SCT. Thirty-eight children comprised the IRFR group, and 59 were in the control (non-IRFR) group. High incidence of ES was observed in children with the occurrence of IRFR. Similarly, the incidence of stage I-IV and II-IV aGVHD was significantly higher in the febrile group. Multivariate analysis showed IRFR to be the risk factor for ES and aGVHD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Evaluation of a Machine-Learning Algorithm for Treatment Planning in Prostate Low-Dose-Rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nicolae, Alexandru [Department of Physics, Ryerson University, Toronto, Ontario (Canada); Department of Medical Physics, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Morton, Gerard; Chung, Hans; Loblaw, Andrew [Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Jain, Suneil; Mitchell, Darren [Department of Clinical Oncology, The Northern Ireland Cancer Centre, Belfast City Hospital, Antrim, Northern Ireland (United Kingdom); Lu, Lin [Department of Radiation Therapy, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Helou, Joelle; Al-Hanaqta, Motasem [Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Heath, Emily [Department of Physics, Carleton University, Ottawa, Ontario (Canada); Ravi, Ananth, E-mail: ananth.ravi@sunnybrook.ca [Department of Medical Physics, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)

    2017-03-15

    Purpose: This work presents the application of a machine learning (ML) algorithm to automatically generate high-quality, prostate low-dose-rate (LDR) brachytherapy treatment plans. The ML algorithm can mimic characteristics of preoperative treatment plans deemed clinically acceptable by brachytherapists. The planning efficiency, dosimetry, and quality (as assessed by experts) of preoperative plans generated with an ML planning approach was retrospectively evaluated in this study. Methods and Materials: Preimplantation and postimplantation treatment plans were extracted from 100 high-quality LDR treatments and stored within a training database. The ML training algorithm matches similar features from a new LDR case to those within the training database to rapidly obtain an initial seed distribution; plans were then further fine-tuned using stochastic optimization. Preimplantation treatment plans generated by the ML algorithm were compared with brachytherapist (BT) treatment plans in terms of planning time (Wilcoxon rank sum, α = 0.05) and dosimetry (1-way analysis of variance, α = 0.05). Qualitative preimplantation plan quality was evaluated by expert LDR radiation oncologists using a Likert scale questionnaire. Results: The average planning time for the ML approach was 0.84 ± 0.57 minutes, compared with 17.88 ± 8.76 minutes for the expert planner (P=.020). Preimplantation plans were dosimetrically equivalent to the BT plans; the average prostate V150% was 4% lower for ML plans (P=.002), although the difference was not clinically significant. Respondents ranked the ML-generated plans as equivalent to expert BT treatment plans in terms of target coverage, normal tissue avoidance, implant confidence, and the need for plan modifications. Respondents had difficulty differentiating between plans generated by a human or those generated by the ML algorithm. Conclusions: Prostate LDR preimplantation treatment plans that have equivalent quality to plans created

  7. Evaluation of a Machine-Learning Algorithm for Treatment Planning in Prostate Low-Dose-Rate Brachytherapy

    International Nuclear Information System (INIS)

    Nicolae, Alexandru; Morton, Gerard; Chung, Hans; Loblaw, Andrew; Jain, Suneil; Mitchell, Darren; Lu, Lin; Helou, Joelle; Al-Hanaqta, Motasem; Heath, Emily; Ravi, Ananth

    2017-01-01

    Purpose: This work presents the application of a machine learning (ML) algorithm to automatically generate high-quality, prostate low-dose-rate (LDR) brachytherapy treatment plans. The ML algorithm can mimic characteristics of preoperative treatment plans deemed clinically acceptable by brachytherapists. The planning efficiency, dosimetry, and quality (as assessed by experts) of preoperative plans generated with an ML planning approach was retrospectively evaluated in this study. Methods and Materials: Preimplantation and postimplantation treatment plans were extracted from 100 high-quality LDR treatments and stored within a training database. The ML training algorithm matches similar features from a new LDR case to those within the training database to rapidly obtain an initial seed distribution; plans were then further fine-tuned using stochastic optimization. Preimplantation treatment plans generated by the ML algorithm were compared with brachytherapist (BT) treatment plans in terms of planning time (Wilcoxon rank sum, α = 0.05) and dosimetry (1-way analysis of variance, α = 0.05). Qualitative preimplantation plan quality was evaluated by expert LDR radiation oncologists using a Likert scale questionnaire. Results: The average planning time for the ML approach was 0.84 ± 0.57 minutes, compared with 17.88 ± 8.76 minutes for the expert planner (P=.020). Preimplantation plans were dosimetrically equivalent to the BT plans; the average prostate V150% was 4% lower for ML plans (P=.002), although the difference was not clinically significant. Respondents ranked the ML-generated plans as equivalent to expert BT treatment plans in terms of target coverage, normal tissue avoidance, implant confidence, and the need for plan modifications. Respondents had difficulty differentiating between plans generated by a human or those generated by the ML algorithm. Conclusions: Prostate LDR preimplantation treatment plans that have equivalent quality to plans created

  8. Interferon alpha therapy for hepatitis C: treatment completion and response rates among patients with substance use disorders

    Directory of Open Access Journals (Sweden)

    Loftis Jennifer M

    2007-01-01

    Full Text Available Abstract Background Individuals with substance use disorders (SUDs are at increased risk for hepatitis C viral infection (HCV, and few studies have explored their treatment responses empirically. The objective of this study was to assess interferon alpha therapy (IFN completion and response rates among patients with HCV who had a history of comorbid SUDs. More data is needed to inform treatment strategies and guidelines for these patients. Using a medical record database, information was retrospectively collected on 307,437 veterans seen in the Veterans Integrated Service Network 20 (VISN 20 of the Veterans Healthcare Administration (VHA between 1998 and 2003. For patients treated with any type of IFN (including regular or pegylated IFN or combination therapy (IFN and ribavirin who had a known HCV genotype, IFN completion and response rates were compared among patients with a history of SUD (SUD+ Group and patients without a history of SUD (SUD- Group. Results Odds ratio analyses revealed that compared with the SUD- Group, the SUD+ Group was equally likely to complete IFN therapy if they had genotypes 2 and 3 (73.1% vs. 68.0%, and if they had genotypes 1 and 4 (39.5% vs. 39.9%. Within the sample of all patients who began IFN therapy, the SUD- and SUD+ groups were similarly likely to achieve an end of treatment response (genotypes 2 and 3, 52.8% vs. 54.3%; genotypes 1 and 4, 24.5% vs. 24.8% and a sustained viral response (genotypes 2 and 3, 42.6% vs. 41.1%; genotypes 1 and 4: 16.0% vs. 22.3%. Conclusion Individuals with and without a history of SUD responded to antiviral therapy for HCV at similar rates. Collectively, these findings suggest that patients who have co-morbid SUD and HCV diagnoses can successfully complete a course of antiviral therapy.