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Sample records for inappropriate proliferation due

  1. Clinical hyperthyroidism due to non-neoplastic inappropriate thyrotrophin secretion.

    OpenAIRE

    Chan, A. W.; MacFarlane, I. A.; van Heyningen, C.; Foy, P. M.

    1990-01-01

    We report a case of hyperthyroidism due to inappropriate thyrotrophin (TSH) secretion in a patient with selective pituitary resistance to thyroid hormone action. Symptoms of hyperthyroidism in patients with this disorder are usually mild, implying some peripheral tissue resistance to the metabolic effects of thyroid hormone. Our patient had unusually severe symptoms, including marked weight loss and cardiac arrythmias which required carbimazole and beta-blocker therapy for control. Somatostat...

  2. The frequency of agitation due to inappropriate use of naltrexone in addicts

    Directory of Open Access Journals (Sweden)

    Sima Siadat

    2014-01-01

    Conclusion: Considering the high prevalence of agitation in the poisoning emergency department due to inappropriate use of naltrexone, more accurate planning for administration of naltrexone in addicts seems necessary.

  3. Inappropriate shock delivery by implantable cardioverter defibrillator due to electrical interference with washing machine.

    Science.gov (United States)

    Chongtham, Dhanaraj Singh; Bahl, Ajay; Kumar, Rohit Manoj; Talwar, K K

    2007-05-31

    We report a patient with hypertrophic cardiomyopathy who received an inappropriate implantable cardioverter defibrillator shock due to electrical interference from a washing machine. This electrical interference was detected as an episode of ventricular fibrillation with delivery of shock without warning symptoms.

  4. [Inappropriate test methods in allergy].

    Science.gov (United States)

    Kleine-Tebbe, J; Herold, D A

    2010-11-01

    Inappropriate test methods are increasingly utilized to diagnose allergy. They fall into two categories: I. Tests with obscure theoretical basis, missing validity and lacking reproducibility, such as bioresonance, electroacupuncture, applied kinesiology and the ALCAT-test. These methods lack both the technical and clinical validation needed to justify their use. II. Tests with real data, but misleading interpretation: Detection of IgG or IgG4-antibodies or lymphocyte proliferation tests to foods do not allow to separate healthy from diseased subjects, neither in case of food intolerance, allergy or other diagnoses. The absence of diagnostic specificity induces many false positive findings in healthy subjects. As a result unjustified diets might limit quality of life and lead to malnutrition. Proliferation of lymphocytes in response to foods can show elevated rates in patients with allergies. These values do not allow individual diagnosis of hypersensitivity due to their broad variation. Successful internet marketing, infiltration of academic programs and superficial reporting by the media promote the popularity of unqualified diagnostic tests; also in allergy. Therefore, critical observation and quick analysis of and clear comments to unqualified methods by the scientific medical societies are more important than ever.

  5. Is modification of the VVI backup mode in implantable cardioverter-defibrillators from St Jude medical required due to increased risk of inappropriate shocks?

    DEFF Research Database (Denmark)

    Philbert, Berit Thornvig; Tfelt-Hansen, Jacob; Jacobsen, Peter K

    2017-01-01

    Inappropriate implantable cardioverter-defibrillator (ICD) shock therapy is painful, stressful, and typically occurs unexpected in conscious patients and may be related to a less favourable prognosis. In our institution, we have observed four cases of multiple inappropriate ICD shocks during reset...... a ventricular fibrillation (VF) zone starting at 146 b.p.m., with shock therapy only and changes in sensitivity settings making the ICD more sensitive. In all cases, the reason for the multiple inappropriate shocks was that the VF zone was reached due to exercise-induced sinus tachycardia or due to oversensing...... during sinus rhythm. The VVI backup mode has to balance between protection from failure of ICD therapy during life-threatening ventricular arrhythmias and from inappropriate shocks. It seems the non-programmable parameters in VVI backup mode of St Jude Medical ICDs carry an unacceptable high risk...

  6. Inappropriate shocks in the subcutaneous ICD

    DEFF Research Database (Denmark)

    Olde Nordkamp, Louise R A; Brouwer, Tom F; Barr, Craig

    2015-01-01

    shocks have been reported. METHODS: We analyzed the incidence, predictors and management of inappropriate shocks in the EFFORTLESS S-ICD Registry, which collects S-ICD implantation information and follow-up data from clinical centers in Europe and New Zealand. RESULTS: During a follow-up of 21 ± 13...... xyphoid to V6) reduced the risk. Reprogramming or optimization of SVT treatment after the first clinical event of inappropriate shock was successful in preventing further inappropriate shocks for cardiac oversensing and SVT events. CONCLUSIONS: Inappropriate shocks, mainly due to cardiac oversensing...

  7. Peroxisome proliferation due to di(2-ethylhexyl) phthalate (DEHP): species differences and possible mechanisms

    International Nuclear Information System (INIS)

    Elcombe, C.R.; Mitchell, A.M.

    1986-01-01

    The exposure of cultured rat hepatocytes to mono(2-ethyhexyl)phthalate (MEHP) for 72 hr resulted in marked induction of peroxisomal enzyme activity (β-oxidation; cyanide-insensitive palmitoyl CoA oxidase) and concomitant increases in the number of peroxisomes. Similar treatment of cultured guinea pig, marmoset, or human hepatocytes revealed little or no effect of MEHP. In order to eliminate possible confounding influences of biotransformation, the proximate peroxisome proliferator(s) derived from MEHP have been identified. Using cultured hepatocytes these agents were found to be metabolite VI [mono(2-ethyl-5-oxohexyl) phthalate] and metabolite IX [mono(2-ethyl-5-hydroxyhexyl) phthalate]. The addition of these active metabolites to cultured guinea pig, marmoset, or human hepatocytes again revealed little effect upon peroxisomes or related enzyme activities (peroxisomal β-oxidation or microsomal lauric acid hydroxylation). These studies demonstrate a marked species difference in the response of hepatocytes to MEHP-elicited peroxisome proliferation. Preliminary studies have also suggested that peroxisome proliferation due to MEHP may be due to an initial biochemical lesion of fatty acid metabolism

  8. Inappropriate prescribing in the elderly.

    LENUS (Irish Health Repository)

    Gallagher, P

    2012-02-03

    BACKGROUND AND OBJECTIVE: Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. METHODS: We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. RESULTS AND DISCUSSION: Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. CONCLUSION: Given the high prevalence of inappropriate prescribing despite the widespread use of drug-utilization review tools, prospective randomized controlled trials are necessary to identify useful interventions. Drug

  9. Hyponatremia in aneurysmal subarachnoid hemorrhage is due to the syndrome of inappropriate antidiuresis and acute glucocorticoid deficiency

    LENUS (Irish Health Repository)

    Hannon, M J

    2011-06-01

    Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH) and contributes to increased morbidity and mortality. Retrospective data suggests that the syndrome of inappropriate diuresis (SIAD) is the most common cause of hyponatraemia in SAH, though cerebral salt wasting has been postulated by some workers to be the predominant abnormality. Data which has shown acute glucocorticoid deficiency following SAH has suggested that some cases of euvolaemic hyponatraemia may also be caused by this mechanism.We prospectively studied the hormonal and haemodynamic influences involved in the development of hyponatraemia in 100 patients (61% female, median age 53 (range 16-82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (pNa), urea, osmolality, glucose and 0900h cortisol (PC), and urinary sodium and osmolality measured on days 1, 2, 3, 4, 6, 8, 10 and 12 following SAH. Fluid balance and haemodynamic parameters were recorded daily. Results were compared with 15 patients admitted to ITU following vascular surgery. A PC<300nmol\\/L in a patient in ITU was regarded clinically as inappropriately low.49% of patients developed hyponatraemia (pNa<135 mmol\\/L), including 14% who developed clinically significantly hyponatraemia (pNa<130 mmol\\/L). 36\\/49 (73.4%) developed hyponatraemia between days 1 and 3 post SAH. The median duration of hyponatraemia was 3 days (range 1–10 days).In 35\\/49 (71.4%), hyponatraemia was due to SIAD as defined by standard diagnostic criteria. 14% of SAH patients had at least one PC<300nmol\\/L; 5 of these (35.7%) developed hyponatraemia. In 4 patients hyponatraemia was preceded by acute cortisol deficiency and responded to hydrocortisone treatment. In contrast, all controls had PC>500 nmol\\/L on day 1, and >300 nmol on days 3–12. There were no cases of cerebral salt wasting. There was no relationship between the incidence of hyponatraemia and the defined anatomical territory or severity of

  10. Inappropriate prescribing: criteria, detection and prevention.

    LENUS (Irish Health Repository)

    O'Connor, Marie N

    2012-06-01

    Inappropriate prescribing is highly prevalent in older people and is a major healthcare concern because of its association with negative healthcare outcomes including adverse drug events, related morbidity and hospitalization. With changing population demographics resulting in increasing proportions of older people worldwide, improving the quality and safety of prescribing in older people poses a global challenge. To date a number of different strategies have been used to identify potentially inappropriate prescribing in older people. Over the last two decades, a number of criteria have been published to assist prescribers in detecting inappropriate prescribing, the majority of which have been explicit sets of criteria, though some are implicit. The majority of these prescribing indicators pertain to overprescribing and misprescribing, with only a minority focussing on the underprescribing of indicated medicines. Additional interventions to optimize prescribing in older people include comprehensive geriatric assessment, clinical pharmacist review, and education of prescribers as well as computerized prescribing with clinical decision support systems. In this review, we describe the inappropriate prescribing detection tools or criteria most frequently cited in the literature and examine their role in preventing inappropriate prescribing and other related healthcare outcomes. We also discuss other measures commonly used in the detection and prevention of inappropriate prescribing in older people and the evidence supporting their use and their application in everyday clinical practice.

  11. Emergency readmissions to paediatric surgery and urology: The impact of inappropriate coding.

    Science.gov (United States)

    Peeraully, R; Henderson, K; Davies, B

    2016-04-01

    Introduction In England, emergency readmissions within 30 days of hospital discharge after an elective admission are not reimbursed if they do not meet Payment by Results (PbR) exclusion criteria. However, coding errors could inappropriately penalise hospitals. We aimed to assess the accuracy of coding for emergency readmissions. Methods Emergency readmissions attributed to paediatric surgery and urology between September 2012 and August 2014 to our tertiary referral centre were retrospectively reviewed. Payment by Results (PbR) coding data were obtained from the hospital's Family Health Directorate. Clinical details were obtained from contemporaneous records. All readmissions were categorised as appropriately coded (postoperative or nonoperative) or inappropriately coded (planned surgical readmission, unrelated surgical admission, unrelated medical admission or coding error). Results Over the 24-month period, 241 patients were coded as 30-day readmissions, with 143 (59%) meeting the PbR exclusion criteria. Of the remaining 98 (41%) patients, 24 (25%) were inappropriately coded as emergency readmissions. These readmissions resulted in 352 extra bed days, of which 117 (33%) were attributable to inappropriately coded cases. Conclusions One-quarter of non-excluded emergency readmissions were inappropriately coded, accounting for one-third of additional bed days. As a stay on a paediatric ward costs up to £500 a day, the potential cost to our institution due to inappropriate readmission coding was over £50,000. Diagnoses and the reason for admission for each care episode should be accurately documented and coded, and readmission data should be reviewed at a senior clinician level.

  12. Prevalence of inappropriate prescribing in primary care

    DEFF Research Database (Denmark)

    Bregnhøj, Lisbeth; Thirstrup, Steffen; Kristensen, Mogens Brandt

    2007-01-01

    to the patients. Topical, dermatological medications and medications not used regularly were excluded. RESULTS: 212 patients were prescribed 1621 medications by their GPs at baseline. In all, 640 (39.5%) of the medications had one or more inappropriate ratings in the 10 criteria making up the MAI. The main part...... is good. However, the majority of patients used one or more medications with inappropriate ratings. The inappropriate prescribing relates to specific therapeutic groups and criteria, which should be targeted in future interventions....

  13. Encephalitis associated with inappropriate antidiuretic hormone secretion due to chikungunya infection in Recife, State of Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Norma Lucena-Silva

    Full Text Available Abstract The symptoms of chikungunya virus (CHIKV infection include fever, headache, muscle aches, skin rash, and polyarthralgia, characterized by intense pain, edema, and temporary functional impairment. This is the first report of encephalitis caused by CHIKV infection associated with an atypical presentation of syndrome of inappropriate antidiuretic hormone secretion, evolving to cognitive impairment and apraxia of speech.

  14. Characteristics of the overflow pollution of storm drains with inappropriate sewage entry.

    Science.gov (United States)

    Yin, Hailong; Lu, Yi; Xu, Zuxin; Li, Huaizheng; Schwegler, Benedict R

    2017-02-01

    To probe the overflow pollution of separate storm drains with inappropriate sewage entries, in terms of the relationship between sewage entries and the corresponding dry-weather and wet-weather overflow, the monitoring activities were conducted in a storm drainage system in the Shanghai downtown area (374 ha). In this study site, samples from inappropriately entered dry-weather sewage and the overflow due to storm pumps operation on dry-weather and wet-weather days were collected and then monitored for six water quality constituents. It was found that overflow concentrations of dry-weather period could be higher than those of wet-weather period; under wet-weather period, the overflow concentrations of storm drains were close to or even higher than that of combined sewers. Relatively strong first flush mostly occurred under heavy rain that satisfied critical rainfall amount, maximum rainfall intensity, and maximum pumping discharge, while almost no first flush effect or only weak first flush effect was found for the other rainfall events. Such phenomenon was attributed to lower in-line pipe storage as compared to that of the combined sewers, and serious sediment accumulation within the storm pipes due to sewage entry. For this kind of system, treating a continuous overflow rate is a better strategy than treating the maximum amount of early part of the overflow. Correcting the key inappropriate sewage entries into storm drains should also be focused.

  15. Explicit versus implicit evaluation to detect inappropriate medication use in geriatric outpatients.

    Science.gov (United States)

    Bahat, Gulistan; Ilhan, Birkan; Bay, Ilker; Kilic, Cihan; Kucukdagli, Pinar; Oren, Meryem Merve; Karan, Mehmet Akif

    2018-04-19

    The rates and reasons why clinicians decide not to follow recommendations from explicit-criteria have been studied scarce. We aimed to compare STOPP version 2 representing one of the most commonly used excplicit tool with the implicit comprehensive geriatric assessment mediated clinical evaluation considered as gold standard. Two hundred and six (n = 206) outpatients ≥65 years old were included. The study was designed as retrospective, cross-sectional, and randomised. STOPP version 2 criteria were systematically used to assess pre-admission treatments followed by implicit clinical evaluation regarding two questions: Were the STOPP criteria recommendations valid for the individual patient and were there any potentially inappropriate-prescription other than depicted by STOPP version 2 criteria? The underlying reason(s) and associated clinical-features were noted. About 62.6% potentially inappropriate-prescriptions were identified (0.6 per-subject) according to systematic application of STOPP v2 while it was 53.4% (0.5 potentially inappropriate-prescriptions per subject) by clinician's application of STOPP v2. Prevalence of non-compliance was 14.7% in 18 (21.7%) of 83 patients identified by systematic application. Suggestion to stop a drug was not accepted because of need of treatment despite likelihood of anticipated side-effects in about 2/3 and with no-anticipated side-effects in about 1/3 of non-compliances. Not following STOPP v2 was significantly associated with lower functional level. According to clinician's implicit-evaluation, there were an extra 59.2% potentially inappropriate-prescriptions (0.6 per subject) in 80 (38.8%) patients yielding a total of 112.6% potentially inappropriate-prescription. Most of the STOPP v2 directed drug cessations are decided valid by the clinicians. In patients with higher functional dependency, it is likely that they are not followed due to palliation focussed care/patient-family preferences. There may be as much as STOPP

  16. Inappropriate medication use and risk of falls – A prospective study in a large community-dwelling elderly cohort

    Directory of Open Access Journals (Sweden)

    Fourrier Annie

    2009-07-01

    Full Text Available Abstract Background Explicit criteria for determining potentially inappropriate medication consumption in elderly were elaborated by Beers et al. These lists have been used worldwide to evaluate medical prescriptions but there is little epidemiologic evidence demonstrating negative consequences of inappropriate medication use. It has been reported that some drugs could increase the risk of falls, which are a frequent and serious problem in elderly population. We aimed to evaluate the association between the use of potentially inappropriate medications and the risk of falls. Methods The 3C Study is a multicentre prospective cohort study conducted in France with 4 years of follow-up. Non-institutionalized men and women aged 65 years or over (N = 6343 were randomly selected from electoral rolls. Data on socio-demographic, medical characteristics and medication use (based on self-reports and data from the national healthcare insurance were collected. Use of inappropriate medication for elderly was defined from established criteria. Data about falls were collected at the two follow-up examinations (2 years and 4 years after baseline. The association between the exposure to inappropriate medications and the risk of falls was evaluated using multivariate models (Cox model and logistic regression. Results 32% of subjects reported inappropriate medication use at baseline and 29% at least two of the three examinations; 22% had fallen 2 times or more during follow-up. Overall, inappropriate medication users had an increased risk of falling. This increase was mainly due to the use of long-acting benzodiazepines (adjusted odds ratio (OR = 1.4, 95% confidence interval: [1.1–1.8], in both occasional and regular users, other inappropriate psychotropics (adjusted OR = 1.7 [1.7–2.7] in regular users, or medication with anticholinergic properties (adjusted OR = 1.6 [1.2–2.1] in regular users. Neither occasional, nor regular use of short- or intermediate

  17. [Reasons for inappropriate prescribing of antibiotics in a high-complexity pediatric hospital].

    Science.gov (United States)

    Ruvinsky, Silvina; Mónaco, Andrea; Pérez, Guadalupe; Taicz, Moira; Inda, Laura; Kijko, Ivana; Constanzo, Patricia; Bologna, Rosa

    2011-12-01

    Determine the reasons for inappropriate prescription of antibiotics and identify opportunities to improve prescription of these drugs in pediatric patients hospitalized in intermediate and intensive care units. A prospective, descriptive longitudinal study was conducted of pediatric patients in intermediate and intensive care units who received parenteral administration of antibiotics, with the exception of newborns, burn unit patients, and surgical prophylaxis patients. A univariate analysis and multiple logistic regression were performed. A total of 376 patients with a median of age of 50 months were studied (interquartile range [IQR] 14.5-127 months). Out of the total patients studied, 75% had one or more underlying conditions. A total of 40.6% of these patients had an oncologic pathology and 33.5% had neurological conditions. The remaining 25.9% had other underlying conditions. Antibiotic treatment was inappropriate in 35.6% of the patients studied (N = 134). In 73 (54.4%) of the 134 cases, inappropriate use was due to the type of antibiotic prescribed, the dose administered, or the treatment period. The 61 (45.5%) remaining cases did not require antibiotic treatment. In the multivariate analysis, the risk factors for inappropriate use of antibiotics were: administration of ceftriaxone OR 2 (95% CI, 1.3-3.7; P = 0.02); acute lower respiratory tract infection OR 1.8 (95% CI, 1.1-3.3; P < 0.04); onset of fever of unknown origin in hospital inpatients OR 5.55 (95% CI, 2.5-12; P < 0.0001); and febrile neutropenia OR 0.3 (95% CI, 0.1-0.7; P = 0.009). Inappropriate use of antibiotics was less common in the clinical conditions that were well-characterized. Prescribing practices that could be improved were identified through the preparation and circulation of guidelines for antibiotic use in hospital inpatients.

  18. Inappropriate Antidiuretic Hormone Secretion

    African Journals Online (AJOL)

    1974-06-08

    Jun 8, 1974 ... with Addison's disease, diarrhoea or salt-losing nephritis. (asymptomatic hyponatraemia).~ Schwartz et al.3 stud;ed two patients with anaplastic bronchus carcinoma and hyponatraemia in 1957, and they suggested that there was an inappropriate secretion of antidiuretic hormone (ADH). It is now well ...

  19. The syndrome of inappropriate antidiuretic hormone: prevalence, causes and consequences.

    LENUS (Irish Health Repository)

    Hannon, M J

    2010-06-01

    Hyponatraemia is the commonest electrolyte abnormality found in hospital inpatients, and is associated with a greatly increased morbidity and mortality. The syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent cause of hyponatraemia in hospital inpatients. SIADH is the clinical and biochemical manifestation of a wide range of disease processes, and every case warrants investigation of the underlying cause. In this review, we will examine the prevalence, pathophysiology, clinical characteristics and clinical consequences of hyponatraemia due to SIADH.

  20. Setting Limits: The Child Who Uses Inappropriate Language

    Science.gov (United States)

    Greenberg, Polly

    2004-01-01

    This article discusses how to work with a child who uses inappropriate language. The words inappropriately used by young children are grouped into five categories: (1) names of body parts considered as private, and their nicknames; (2) bathroom words and body products; (3) religion-related words; (4) sexually charged words overheard when adults…

  1. Carbon dioxide narcosis due to inappropriate oxygen delivery: a case report.

    Science.gov (United States)

    Herren, Thomas; Achermann, Eva; Hegi, Thomas; Reber, Adrian; Stäubli, Max

    2017-07-28

    Oxygen delivery to patients with chronic obstructive pulmonary disease may be challenging because of their potential hypoxic ventilatory drive. However, some oxygen delivery systems such as non-rebreathing face masks with an oxygen reservoir bag require high oxygen flow for adequate oxygenation and to avoid carbon dioxide rebreathing. A 72-year-old Caucasian man with severe chronic obstructive pulmonary disease was admitted to the emergency department because of worsening dyspnea and an oxygen saturation of 81% measured by pulse oximetry. Oxygen was administered using a non-rebreathing mask with an oxygen reservoir bag attached. For fear of removing the hypoxic stimulus to respiration the oxygen flow was inappropriately limited to 4L/minute. The patient developed carbon dioxide narcosis and had to be intubated and mechanically ventilated. Non-rebreathing masks with oxygen reservoir bags must be fed with an oxygen flow exceeding the patient's minute ventilation (>6-10 L/minute.). If not, the amount of oxygen delivered will be too small to effectively increase the arterial oxygen saturation. Moreover, the risk of carbon dioxide rebreathing dramatically increases if the flow of oxygen to a non-rebreathing mask is lower than the minute ventilation, especially in patients with chronic obstructive pulmonary disease and low tidal volumes. Non-rebreathing masks (with oxygen reservoir bags) must be used cautiously by experienced medical staff and with an appropriately high oxygen flow of 10-15 L/minute. Nevertheless, arterial blood gases must be analyzed regularly for early detection of a rise in partial pressure of carbon dioxide in arterial blood in patients with chronic obstructive pulmonary disease and a hypoxic ventilatory drive. These patients are more safely managed using a nasal cannula with an oxygen flow of 1-2L/minute or a simple face mask with an oxygen flow of 5L/minute.

  2. MOX-fuel inherent proliferation-protection due to {sup 231}Pa admixture

    Energy Technology Data Exchange (ETDEWEB)

    Kryuchkov, E.F.; Glebov, V.B.; Apse, V.A.; Shmelev, A.N. [Moscow Engineering Physics Institute (State University), Moscow (Russian Federation)

    2003-07-01

    The proliferation protection levels of MOX-fuel containing small additions of protactinium are evaluated for equilibrium closed and open cycles of a light-water reactor (LWR).Analysis of the ways to the proliferation protection of MOX-fuel by small {sup 231}Pa addition and comparison of this way with another options for giving MOX-fuel the proliferation self-protection property enable us to make the 3 following conclusions: -1) Unique nature of protactinium as a small addition to MOX-fuel is determined by the following properties: - Protactinium is available in the nature (uranium ore) as a long-lived mono-isotope {sup 231}Pa, - under neutron irradiation, {sup 231}Pa is converted into {sup 232}U, which is a long-term source of high energy gamma-radiation and practically non-separable from main fuel mass, - essentially, {sup 231}Pa is a high-quality burnable neutron absorber. -2) From the proliferation self-protection point of view, nuclear fuel cycle closure with fuel recycle is a preferable option because, under this condition, introduction of protactinium into MOX-fuel allows to create the inherent radiation barrier which is in action during full cycle of fuel management at the level corresponding to the accepted today criterion of the Spent Fuel Standard (SFS). In particular, the considered example of multiple MOX-fuel recycle with small addition of {sup 231}Pa (0.2% HM) at each cycle demonstrates a possibility to reach the proliferation protection level of fresh MOX-fuel corresponding to once irradiated fuel with the same cooling time. In this case, the lethal dose (at 30 cm distance from fuel assembly) is received within the minute range. -3) Introduction of {sup 231}Pa into MOX-fuel composition in amount of 0.5% HM allows to prolong action of the SFS from 100 to 200 years. If {sup 231}Pa content is increased up to 5% HM, then MOX-fuel conserves the proliferation self-protection property in respect to short-term unauthorized actions for 200-year period of its

  3. [The forensic medical aspects of the inappropriate medical care in the modern-day Ukraine].

    Science.gov (United States)

    Franchuk, V V

    2018-01-01

    Despite the fact that the ever growing relevance of the problem of the inappropriate medical care was long ago brought to the worldwide attention, it has not been practically addressed in the Ukraine since the country gained independence in 1991. The objective of the present study was to consider the specific features of expert examination of the cases of inappropriate medical care as exemplified by the materials of the legal actions and lawsuits instituted against healthcare specialists violating their occupational duties. The results of forensic medical examination by the local Bureaux of forensic medical expertise concerning the 350 so-called malpractice suits instituted in the Ternopol, Zhitomir, and Chernovtsy regions during the period from 207 to 2016 were available for the analysis. The facts of inadequate and inappropriate medical care were documented in 245 (72.0%) cases. The frequency of diagnostic and therapeutic errors amounted to 29.7% and 26.9% respectively while the improper formulation of the medical documentation was recorded in 21.3% of the cases. The cases of poor organization of the diagnostic and treatment process accounted for 14.6% of the total whereas the improper behaviour of the medical personnel was reported in 7.5% of all the known cases of provision of the healthcare services. It is concluded that in the majority of the cases, the citizens of the modern-day Ukraine receive the inappropriate (insufficient and untimely) medical care. Over 80% of the cases of the inappropriate medical care currently provided in the country can be accounted for by the objective reasons, with each fifths case being due to the violation of professional responsibilities by the healthcare providers.

  4. Correlation analysis between team communication characteristics and frequency of inappropriate communications

    International Nuclear Information System (INIS)

    Kim, Ar Ryum; Lee, Seung Woo; Park, Jinkyun; Kang, Hyun Gook; Seong, Poong Hyun

    2013-01-01

    Highlights: • We proposed a method to evaluate team communication characteristics based on social network analysis. • We compare team communication characteristics with the frequency of inappropriate communications. • Frequency of inappropriate communications were decreased when more operators perform the same types of role as others. • Frequency of inappropriate communications were decreased for teams who provide more number of acknowledgment. - Abstract: The characteristics of team communications are important since large process systems such as nuclear power plants, airline, and railways are operated by operating teams. In such situation, inappropriate communications can cause a lack of situational information and lead to serious consequences for the systems. As a result, the communication characteristics of operating teams should be understood in order to extract meaningful insights to address the nature of inappropriate communications. The purpose of this study was to develop a method to evaluate the characteristics of team communications based on social network analysis and compare them with the frequency of inappropriate communications. In order to perform the analysis, verbal protocol data, which were audio-visual recorded under training sessions by operating teams, were used and interfacing system loss of coolant accident scenarios were selected. As a result of the study, it was found that the frequency of inappropriate communications decreased when more operators perform the same types of role as other operators, since they can easily and effectively back up each other. Also, the frequency of inappropriate communication is decreased for teams which provide a relatively large communication content that acknowledge or confirm another communication content

  5. Potentially inappropriate prescribing in an Irish elderly population in primary care.

    LENUS (Irish Health Repository)

    Ryan, Cristín

    2009-12-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * Potentially inappropriate prescribing in older people is a well-documented problem and has been associated with adverse drug reactions and hospitalization. * Beers\\' criteria, Screening Tool of Older Persons\\' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) are screening tools that have been formulated to help physicians and pharmacists identify potentially inappropriate prescribing and potential prescribing omissions. * The prevalence of potentially inappropriate prescribing and prescribing omissions in the elderly population presenting to hospital with acute illness is high according to STOPP and START criteria.

  6. Potentially inappropriate prescriptions for older patients in long-term care

    Directory of Open Access Journals (Sweden)

    Laurin Danielle

    2004-10-01

    Full Text Available Abstract Background Inappropriate medication use is a major healthcare issue for the elderly population. This study explored the prevalence of potentially inappropriate prescriptions (PIPs in long-term care in metropolitan Quebec. Methods A cross sectional chart review of 2,633 long-term care older patients of the Quebec City area was performed. An explicit criteria list for PIPs was developed based on the literature and validated by a modified Delphi method. Medication orders were reviewed to describe prescribing patterns and to determine the prevalence of PIPs. A multivariate analysis was performed to identify predictors of PIPs. Results Almost all residents (94.0% were receiving one or more prescribed medication; on average patients had 4.8 prescribed medications. A majority (54.7% of treated patients had a potentially inappropriate prescription (PIP. Most common PIPs were drug interactions (33.9% of treated patients, followed by potentially inappropriate duration (23.6%, potentially inappropriate medication (14.7% and potentially inappropriate dosage (9.6%. PIPs were most frequent for medications of the central nervous system (10.8% of prescribed medication. The likelihood of PIP increased significantly as the number of drugs prescribed increased (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 1.33 – 1.43 and with the length of stay (OR: 1.78, CI: 1.43 – 2.20. On the other hand, the risk of receiving a PIP decreased with age. Conclusion Potentially inappropriate prescribing is a serious problem in the highly medicated long-term care population in metropolitan Quebec. Use of explicit criteria lists may help identify the most critical issues and prioritize interventions to improve quality of care and patient safety.

  7. Reduction in inappropriate hospital use based on analysis of the causes

    Directory of Open Access Journals (Sweden)

    Soria-Aledo Víctor

    2012-10-01

    Full Text Available Abstract Background To reduce inappropriate admissions and stays with the application of an improvement cycle in patients admitted to a University Hospital. The secondary objective is to analyze the hospital cost saved by reducing inadequacy after the implementation of measures proposed by the group for improvement. Methods Pre- and post-analysis of a sample of clinical histories studied retrospectively, in which the Appropriateness Evaluation Protocol (AEP was applied to a representative hospital sample of 1350 clinical histories in two phases. In the first phase the AEP was applied retrospectively to 725 admissions and 1350 stays. The factors associated with inappropriateness were analysed together with the causes, and specific measures were implemented in a bid to reduce inappropriateness. In the second phase the AEP was reapplied to a similar group of clinical histories and the results of the two groups were compared. The cost of inappropriate stays was calculated by cost accounting. Setting: General University Hospital with 426 beds serving a population of 320,000 inhabitants in the centre of Murcia, a city in south-eastern Spain. Results Inappropriate admissions were reduced significantly: 7.4% in the control group and 3.2% in the intervention group. Likewise, inappropriate stays decreased significantly from 24.6% to 10.4%. The cost of inappropriateness in the study sample fell from 147,044 euros to 66,642 euros. The causes of inappropriateness for which corrective measures were adopted were those that showed the most significant decrease. Conclusions It is possible to reduce inadequacy by applying measures based on prior analysis of the situation in each hospital.

  8. Emotion Knowledge and Attentional Differences in Preschoolers Showing Context-Inappropriate Anger.

    Science.gov (United States)

    Locke, Robin L; Lang, Nichole J

    2016-08-01

    Some children show anger inappropriate for the situation based on the predominant incentives, which is called context-inappropriate anger. Children need to attend to and interpret situational incentives for appropriate emotional responses. We examined associations of context-inappropriate anger with emotion recognition and attention problems in 43 preschoolers (42% male; M age = 55.1 months, SD = 4.1). Parents rated context-inappropriate anger across situations. Teachers rated attention problems using the Child Behavior Checklist-Teacher Report Form. Emotion recognition was ability to recognize emotional faces using the Emotion Matching Test. Anger perception bias was indicated by anger to non-anger situations using an adapted Affect Knowledge Test. 28% of children showed context-inappropriate anger, which correlated with lower emotion recognition (β = -.28) and higher attention problems (β = .36). Higher attention problems correlated with more anger perception bias (β = .32). This cross-sectional, correlational study provides preliminary findings that children with context-inappropriate anger showed more attention problems, which suggests that both "problems" tend to covary and associate with deficits or biases in emotion knowledge. © The Author(s) 2016.

  9. Potentially inappropriate prescribing in older patients admitted to psychiatric hospital

    NARCIS (Netherlands)

    Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.

    2016-01-01

    OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

  10. Predictors of Inappropriate Use of Diagnostic Tests and Management of Bronchiolitis

    Science.gov (United States)

    Sarmiento, Lorena; Rojas-Soto, Gladys E.

    2017-01-01

    Background The aim of the present study was to determine predictors of inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. Methods In an analytical cross-sectional study, we determined independent predictors of the inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. We defined a composite outcome score as the main outcome variable. Results Of the 303 included patients, 216 (71.3%) experienced an inappropriate use of diagnostic tests and treatment of bronchiolitis. After controlling for potential confounders, it was found that atopic dermatitis (OR 5.30; CI 95% 1.14–24.79; p = 0.034), length of hospital stay (OR 1.48; CI 95% 1.08–2.03; p = 0.015), and the number of siblings (OR 1.92; CI 95% 1.13–3.26; p = 0.015) were independent predictors of an inappropriate use of diagnostic tests and treatment of the disease. Conclusions Inappropriate use of diagnostic tests and treatment of bronchiolitis was a highly prevalent outcome in our population of study. Participants with atopic dermatitis, a longer hospital stay, and a greater number of siblings were at increased risk for inappropriate use of diagnostic tests and management of the disease. PMID:28758127

  11. Evaluation of electrical aversion therapy for inappropriate sexual behaviour after traumatic brain injury: a single case experimental design study

    Science.gov (United States)

    ter Mors, Bert Jan; van Heugten, Caroline M; van Harten, Peter N

    2012-01-01

    Inappropriate sexual behaviour after acquired brain injury is a severe complication. Evidence for effective treatment is not available. Electrical aversion therapy (EAT) is a behavioural therapeutic option used in persons with intellectual disabilities, which might be suitable for brain-injured individuals for whom other therapies are not effective. The effect of EAT in brain injury has not been investigated previously. A single case experimental design was used. In an ABBA (baseline-treatment-treatment-withdrawal) design the frequency of the target behaviour (ie, inappropriate sexual behaviour) in a 40-year-old man was measured daily. A total of 551 measurements were recorded. A significant reduction of the target behaviour was seen after the first treatment phase (baseline 12.18 (2.59) vs 3.15 (3.19) mean target behaviours daily); this reduction remained stable over time. We conclude that EAT was effective in this patient with inappropriate sexual behaviour due to severe brain injury. EAT can therefore be considered in therapy resistant inappropriate sexual behaviour in brain-injured patients. PMID:22922913

  12. Discontinuing Inappropriate Medication Use in Nursing Home Residents : A Cluster Randomized Controlled Trial

    NARCIS (Netherlands)

    Wouters, Hans; Scheper, Jessica; Koning, Hedi; Brouwer, Chris; Twisk, Jos W.; van der Meer, Helene; Boersma, Froukje; Zuidema, Sytse U.; Taxis, Katja

    2017-01-01

    Background: Inappropriate prescribing is a well-known clinical problem in nursing home residents, but few interventions have focused on reducing inappropriate medication use. Objective: To examine successful discontinuation of inappropriate medication use and to improve prescribing in nursing home

  13. Potentially inappropriate prescribing and cost outcomes for older people: a national population study.

    LENUS (Irish Health Repository)

    Cahir, Caitriona

    2010-05-01

    Optimization of drug prescribing in older populations is a priority due to the significant clinical and economic costs of drug-related illness. This study aimed to: (i) estimate the prevalence of potentially inappropriate prescribing (PIP) in a national Irish older population using European specific explicit prescribing criteria; (ii) investigate the association between PIP, number of drug classes, gender and age and; (iii) establish the total cost of PIP.

  14. Understanding inappropriate hospital admissions of patients presenting to the Emergency Department.

    Directory of Open Access Journals (Sweden)

    Roberta Siliquini

    2005-06-01

    Full Text Available

    Objectives. To identify 1 the characteristics of patients receiving non acute (inappropriate care and 2 the variables associated to inappropriate hospital use, in order to 3 estimate the relevance of the problem and to 4 focus future concurrent reviews and efforts to allocate patients to alternative health care settings.

    Design. A prospective review of a random sample of adult patients who presented to the Emergency Department of the Molinette Hospital. Patients were assessed at admission and on day 3, 5and 8 using the Appropriateness Evaluation Protocol (Italian validated version. Patients: 490 overall; 312 (64 % medical and 178 (36 % surgical.

    Outcome measures. Acute (appropriate and non acute (inappropriate admissions, Major Disease Category, costs, mean weights of Diagnosis Related Groups, and length of stay (days.

    Results. The proportion of patients requiring acute care declined rapidly from presentation (84.5% to the fifth day of admission (60.9%. Patients admitted during weekends showed a higher rate of inappropriate stay on day 5 (P=0.04. The proportion of inappropriate admissions was higher for medical rather than surgical patients (P=0.07 at presentation and at day 5 (P < 0.01. Traditional social-demographic variables were not significant risk indicators for inappropriate admissions. The likelihood ratio for inappropriate admission at presentation was significantly higher for minor illnesses and disturbances (P=0.03.

    Inappropriate stay on day 5 was significantly associated with lower cost (P < 0.01, lower mean DRG weight (P < 0.01 and shorter length of stay (P=0.05 for medical but not for surgical admissions.

    Conclusions. Traditional epidemiological indicators are inadequate to target prospective concurrent reviews. Qualitative studies focusing on patient physician dialogue in different situations and contexts could

  15. Inappropriateness of cardiovascular radiological imaging testing; a tertiary care referral center study.

    Directory of Open Access Journals (Sweden)

    Clara Carpeggiani

    Full Text Available AIMS: Radiological inappropriateness in medical imaging leads to loss of resources and accumulation of avoidable population cancer risk. Aim of the study was to audit the appropriateness rate of different cardiac radiological examinations. METHODS AND PRINCIPAL FINDINGS: With a retrospective, observational study we reviewed clinical records of 818 consecutive patients (67 ± 12 years, 75% males admitted from January 1-May 31, 2010 to the National Research Council - Tuscany Region Gabriele Monasterio Foundation cardiology division. A total of 940 procedures were audited: 250 chest x-rays (CXR; 240 coronary computed tomographies (CCT; 250 coronary angiographies (CA; 200 percutaneous coronary interventions (PCI. For each test, indications were rated on the basis of guidelines class of recommendation and level of evidence: definitely appropriate (A, including class I, appropriate, and class IIa, probably appropriate, uncertain (U, class IIb, probably inappropriate, or inappropriate (I, class III, definitely inappropriate. Appropriateness was suboptimal for all tests: CXR (A = 48%, U = 10%, I = 42%; CCT (A = 58%, U = 24%, I = 18%; CA (A = 45%, U = 25%, I = 30%; PCI (A = 63%, U = 15%, I = 22%. Top reasons for inappropriateness were: routine on hospital admission (70% of inappropriate CXR; first line application in asymptomatic low-risk patients (42% of CCT or in patients with unchanged clinical status post-revascularization (20% of CA; PCI in patients either asymptomatic or with miscellaneous symptoms and without inducible ischemia on non-invasive testing (36% of inappropriate PCI. CONCLUSION AND SIGNIFICANCE: Public healthcare system--with universal access paid for with public money--is haemorrhaging significant resources and accumulating avoidable long-term cancer risk with inappropriate cardiovascular imaging prevention.

  16. Primary Sjogren's syndrome associated with inappropriate ...

    African Journals Online (AJOL)

    A patient in whom primary Sjogren's syndrome and inappropriate antiduretic hormone secretion were associated is reported. This is the first report of such an association. The possible pathophysiological mechanisms are discussed and vasculitis proposed as the underlying pathogenetic mechanism.

  17. Suppression of Human T Cell Proliferation Mediated by the Cathepsin B Inhibitor, z-FA-FMK Is Due to Oxidative Stress.

    Directory of Open Access Journals (Sweden)

    Tanuja Rajah

    Full Text Available The cathepsin B inhibitor, benzyloxycarbonyl-phenylalanine-alanine-fluoromethyl ketone (z-FA-FMK readily inhibits anti-CD3-induced human T cell proliferation, whereas the analogue benzyloxycarbonyl-phenylalanine-alanine-diazomethyl ketone (z-FA-DMK had no effect. In contrast, benzyloxycarbonyl-phenylalanine-alanine-chloromethyl ketone (z-FA-CMK was toxic. The inhibition of T cell proliferation mediated by z-FA-FMK requires not only the FMK moiety, but also the benzyloxycarbonyl group at the N-terminal, suggesting some degree of specificity in z-FA-FMK-induced inhibition of primary T cell proliferation. We showed that z-FA-FMK treatment leads to a decrease in intracellular glutathione (GSH with a concomitant increase in reactive oxygen species (ROS levels in activated T cells. The inhibition of anti-CD3-induced T cell proliferation mediated by z-FA-FMK was abolished by the presence of low molecular weight thiols such as GSH, N-acetylcysteine (NAC and L-cysteine, whereas D-cysteine which cannot be metabolised to GSH has no effect. The inhibition of anti-CD3-induced up-regulation of CD25 and CD69 expression mediated by z-FA-FMK was also attenuated in the presence of exogenous GSH. Similar to cell proliferation, GSH, NAC and L-cysteine but not D-cysteine, completely restored the processing of caspase-8 and caspase-3 to their respective subunits in z-FA-FMK-treated activated T cells. Our collective results demonstrated that the inhibition of T cell activation and proliferation mediated by z-FA-FMK is due to oxidative stress via the depletion of GSH.

  18. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

    Directory of Open Access Journals (Sweden)

    Yamada Yukari

    2006-01-01

    Full Text Available Abstract Background The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Methods We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1% of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%. There were 300 (18.0% patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511, medication cost of per day (OR = 1.173, number of medications (OR = 1.140, and age (OR = 0.981 as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.

  19. Prevalence and predictors of potentially inappropriate medications among home care elderly patients in Qatar.

    Science.gov (United States)

    Alhmoud, Eman; Khalifa, Sabah; Bahi, Asma Abdulaziz

    2015-10-01

    Older patients receiving home health care are particularly at risk of receiving potentially inappropriate medications compared to community-dwelling population. Data on appropriateness of prescribing in these patients is limited. To investigate the prevalence, patterns and determinants of potentially inappropriate medications among elderly patients receiving Home Health Care Services in Qatar. Home Health Care Services department in Hamad Medical Corporation-Qatar. A cross-sectional study, conducted over a 3 months period. Patients 65 years and older, taking at least one medication and receiving home care services were included. Potentially inappropriate medications were identified and classified in accordance with the American Geriatrics Society 2012 Beers Criteria. Prevalence of potentially inappropriate medications using updated Beers criteria. A total of 191 patients (38.2%) had at least one potentially inappropriate medication. As per Beers criteria, 35% of medications were classified as medications to be avoided in older adults regardless of conditions and 9% as potentially inappropriate medications when used with certain diseases or syndromes. The majority of potentially inappropriate medications (56%) were classified as medications to be used with caution. The two leading classes of potentially inappropriate medications were antipsychotics (27.4%) and selective serotonin reuptake inhibitors (16%). Significant predictors of inappropriate prescribing were hypertension [adjusted OR 1.7; 95% CI (1.0, 2.8)], dementia [adjusted OR 2.0; 95% CI (1.2, 3.1)], depression [adjusted OR 21.6; 95% CI (2.8, 168.4)], and taking more than ten prescribed medications [adjusted OR 1.9; 95% CI (1.3, 2.8)]. Prescribing potentially inappropriate medications is common among older adults receiving home health care services in Qatar, a finding that warrants further attention. Polypharmacy, hypertension, depression and dementia were significantly associated with potentially

  20. Functional Analysis of Inappropriate Social Interactions in Students with Asperger's Syndrome

    Science.gov (United States)

    Roantree, Christina F.; Kennedy, Craig H.

    2012-01-01

    We analyzed the inappropriate social interactions of 3 students with Asperger's syndrome whose behavior was maintained by social positive reinforcement. We tested whether inappropriate social behavior was sensitive to social positive reinforcement contingencies and whether such contingencies could be reversed to increase the probability of…

  1. [Inappropriate prescription in older patients: the STOPP/START criteria].

    LENUS (Irish Health Repository)

    Delgado Silveira, Eva

    2009-09-01

    Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

  2. Lost in hospital: a qualitative interview study that explores the perceptions of NHS inpatients who spent time on clinically inappropriate hospital wards.

    Science.gov (United States)

    Goulding, Lucy; Adamson, Joy; Watt, Ian; Wright, John

    2015-10-01

    Prior research suggests that the placement of patients on clinically inappropriate hospital wards may increase the risk of experiencing patient safety issues. To explore patients' perspectives of the quality and safety of the care received during their inpatient stay on a clinically inappropriate hospital ward. Qualitative study using semi-structured interviews. Nineteen patients who had spent time on at least one clinically inappropriate ward during their hospital stay at a large NHS teaching hospital in England. Patients would prefer to be treated on the correct specialty ward, but it is generally accepted that this may not be possible. When patients are placed on inappropriate wards, they may lack a sense of belonging. Participants commented on potential failings in communication, medical staff availability, nurses' knowledge and the resources available, each of which may contribute to unsafe care. Patients generally acknowledge the need for placement on inappropriate wards due to demand for inpatient beds, but may report dissatisfaction in terms of preference and belonging. Importantly, patients recount issues resulting from this placement that may compromise their safety. Hospital managers should be encouraged to appreciate this insight and potential threat to safe practice and where possible avoid inappropriate ward transfers and admissions. Where such admissions are unavoidable, staff should take action to address the gaps in safety of care that have been identified. © 2013 John Wiley & Sons Ltd.

  3. Congenital short QT syndrome and implantable cardioverter defibrillator treatment: inherent risk for inappropriate shock delivery.

    Science.gov (United States)

    Schimpf, Rainer; Wolpert, Christian; Bianchi, Francesca; Giustetto, Carla; Gaita, Florenzo; Bauersfeld, Urs; Borggrefe, Martin

    2003-12-01

    A congenital short QT interval constitutes a new primary electrical abnormality associated with syncope and/or sudden cardiac death. We report on the initial use of implantable cardioverter defibrillator (ICD) therapy in patients with inherited short QT interval and discuss sensing abnormalities and detection issues. In five consecutive patients from two unrelated European families who had structurally normal hearts, excessively shortened QT intervals, and a strong positive family history of sudden cardiac death, ICDs were placed for primary and secondary prevention. Mean QT intervals were 252 +/- 13 ms (QTc 287 +/- 13 ms). Despite normal sensing behavior during intraoperative and postoperative device testing, 3 of 5 patients experienced inappropriate shock therapies for T wave oversensing 30 +/- 26 days after implantation. Programming lower sensitivities and decay delays prevented further inappropriate discharges. The congenital short QT syndrome constitutes a new clinical entity with an increased risk for sudden cardiac death. Currently, ICD treatment is the only therapeutic option. In patients with short QT interval and implanted ICD, increased risk for inappropriate therapy is inherent due to the detection of short-coupled and prominent T waves. Careful testing of ICD function and adaptation of sensing levels and decay delays without sacrificing correct arrhythmia detection are essential.

  4. Inappropriate gestational weight gain among teenage pregnancies: prevalence and pregnancy outcomes.

    Science.gov (United States)

    Vivatkusol, Yada; Thavaramara, Thaovalai; Phaloprakarn, Chadakarn

    2017-01-01

    To study the prevalence and pregnancy outcomes of inappropriate gestational weight gain (GWG) among teenage pregnant women. A retrospective descriptive study was conducted on 2,165 teenage pregnant women who attended our antenatal clinic between January 2007 and August 2015. Adverse pregnancy outcomes, including maternal and neonatal outcomes of women with inappropriate GWG, including underweight and overweight, were studied and compared with those of women with appropriate GWG. Complete data of 1,943 women were obtained. Among these women, the mean age was 17.4±1.4 years and mean body mass index at first visit was 19.1±3.0 kg/m 2 . The prevalence of inappropriate GWG was 61.7%. Underweight women were more likely to experience anemia and preterm delivery, whereas overweight women required more cesarean sections because of cephalopelvic disproportion and preeclampsia, compared to women with appropriate weight gain (all P teenage pregnancies showed inappropriate GWG. GWG had a significant impact on pregnancy outcomes.

  5. HiRITER - An evaluation tool to reduce the adverse effect of inappropriate human actions in nuclear power plants

    International Nuclear Information System (INIS)

    Park, J.; Jung, W.; Kim, J.; Kim, S.; Heo, G.

    2012-01-01

    From end-users to regulatory bodies, it is widely recognized that human-induced events including inappropriate human actions are one of the most crucial sources degrading the overall safety of nuclear power plants (NPPs). This means that a systematic framework through which inappropriate human actions can be effectively identified is necessary to enhance the safety of NPPs. For this reason, HiRITER (High Risk Inducible Task Evaluator) has been developed, which is able to evaluate the effect of inappropriate human actions on risk as well as performance. To this end, HiRITER integrates three modules that have distinctive roles: human error prediction module that is able to determine the types of failure modes resulting from inappropriate human actions with the associated daily task, performance evaluation module that computes the loss of electric power due to the change of component configurations caused by human error and risk evaluation module that clarifies whether or not the propagation of human error can trigger an unexpected shutdown of NPPs. In addition, a couple of real events that had occurred in domestic NPPs are simulated in order to validate the feasibility of HiRITER. As a result, it is observed that the results of HiRITER are largely congruent with those of real events. Therefore, although a huge amount of additional effort is indispensable to enhance the overall accuracy of estimated results, it is expected that HiRITER could be a good starting point to reduce the adverse effect of inappropriate human actions in NPPs

  6. Potentially inappropriate medication prescribed to elderly outpatients at a general medicine unit

    Directory of Open Access Journals (Sweden)

    Christine Grützmann Faustino

    2011-03-01

    Full Text Available Objective: To establish the prevalence of potentially inappropriate medications prescribed for elderly patients, to identify the most commonly involved drugs, and to investigate whether age, sex and number of medications were related with the prescription of these drugs. Methods: Prescriptions for 1,800 elderly patients (≥ 60 years were gathered from a database. These prescriptions were written by general physicians at a tertiary level university hospital in the city of Sao Paulo, Brazil, from February to May 2008. Only one prescription per patient was considered. The prescriptions were classified according to sex and age (60-69, 70-79 and ≥ 80. The Beers criteria (2003 version were used to evaluate potentially inappropriate medications. Results: Most of the sample comprised women (66.6% with a mean age of 71.3 years. The mean prevalence of potentially inappropriate medication prescriptions was 37.6%. The 60-69 age group presented the highest prevalence (49.9%. The most frequently prescribed potentially inappropriate medications to women were carisoprodol, amitriptyline, and fluoxetine; amitriptyline, carisoprodol, fluoxetine and clonidine were prescribed more often to men. The female sex (p<0.001; OR=2.0 and number of medications prescribed (p<0.001 were associated with prescription of potentially inappropriate medications. The chance of having a prescription of these drugs was lower among patients aged over 80 years (OR=0.7. The mean number of prescribed medications for both sexes and all age groups was 7.1. The mean number of medications per patient was higher among females (p<0.001; this result was not age-dependent (p=0.285. Conclusion: The prevalence of potentially inappropriate medications was similar to previously reported values in the literature and was correlated with the female sex. The chance of having a potentially inappropriate medication prescription was lower among patients aged over 80 years. The chance of having a

  7. Individual and hospital-related determinants of potentially inappropriate admissions emerging from administrative records.

    Science.gov (United States)

    Fusco, Marco; Buja, Alessandra; Piergentili, Paolo; Golfetto, Maria Teresa; Serafin, Gianni; Gallo, Silvia; Dalla Barba, Livio; Baldo, Vincenzo

    2016-11-01

    The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards. Univariate analyses and logistic regression models were used to test associations with demographic, clinical and hospital ward covariates, including organizational indicators. Inappropriate reliance on acute care beds ranged from 6% to 28%, depending on the type of quality indicator analyzed. Some individual features, and wards' specific characteristics were associated with at least one of the phenomena of inappropriate hospital resource usage. In particular, male gender, younger age and transferals seemed to affect inappropriate admissions to surgical wards. Potentially avoidable admissions featuring inpatients amenable to day hospital care were associated with subjects with fewer comorbidities and lower case-mix wards, while inappropriately short medical stays were influenced by patients' higher functional status and local residency and by lower bed occupancy rates. In conclusion, inappropriately long hospital stays for elderly cases were associated with patients with multiple pathologies in wards with a low bed-occupancy. Education level and citizenship did not seem to influence inappropriate admissions. Some individual, clinical ad structural characteristics of patients and wards emerging from administrative records could be associated with inappropriate reliance on acute hospital beds. Analyzing the indicators considered in this study could generate

  8. Meeting Summary of Kitchen Cabinet on Financial Due Diligence to Reduce Proliferation Risks

    Energy Technology Data Exchange (ETDEWEB)

    Hund, Gretchen [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Weise, Rachel A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Carr, Geoffrey A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-08-15

    The U.S. Department of Energy’s Pacific Northwest National Laboratory convened the Kitchen Cabinet (KC) to facilitate a candid discussion about the role of financial institutions (FIs) in antiproliferation efforts to reduce nuclear proliferation risks by identifying suspicious business transactions and exports when making lending or insurance decisions. The meeting brought together a group of export control specialists, largely representatives from the Nuclear Suppliers Group (NSG) Participating Governments (PGs) and finance experts representing banks and insurance companies. By assembling a KC of experts, the group could understand what suspicious transactions look like from each other’s perspectives and better inform each of their operations. The goal was to develop red flags FIs could use to identify suspicious proliferation-related transactions and to help governments gain a clearer picture of proliferation using financial information.

  9. Inappropriate gestational weight gain among teenage pregnancies: prevalence and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Vivatkusol Y

    2017-05-01

    Full Text Available Yada Vivatkusol, Thaovalai Thavaramara, Chadakarn Phaloprakarn Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand Objective: To study the prevalence and pregnancy outcomes of inappropriate gestational weight gain (GWG among teenage pregnant women.Methods: A retrospective descriptive study was conducted on 2,165 teenage pregnant women who attended our antenatal clinic between January 2007 and August 2015. Adverse pregnancy outcomes, including maternal and neonatal outcomes of women with inappropriate GWG, including underweight and overweight, were studied and compared with those of women with appropriate GWG.Results: Complete data of 1,943 women were obtained. Among these women, the mean age was 17.4±1.4 years and mean body mass index at first visit was 19.1±3.0 kg/m2. The prevalence of inappropriate GWG was 61.7%. Underweight women were more likely to experience anemia and preterm delivery, whereas overweight women required more cesarean sections because of cephalopelvic disproportion and preeclampsia, compared to women with appropriate weight gain (all P<0.001. The rates of gestational diabetes mellitus among women who were underweight, overweight, or appropriate weight were not significantly different.Conclusion: More than 60% of teenage pregnancies showed inappropriate GWG. GWG had a significant impact on pregnancy outcomes. Keywords: prevalence, pregnancy outcome, inappropriate gestational weight gain, teenage pregnancy

  10. Meeting Summary of Kitchen Cabinet on Financial Due Diligence to Reduce Proliferation Risks

    International Nuclear Information System (INIS)

    Hund, Gretchen; Weise, Rachel A.; Carr, Geoffrey A.

    2016-01-01

    The U.S. Department of Energy's Pacific Northwest National Laboratory convened the Kitchen Cabinet (KC) to facilitate a candid discussion about the role of financial institutions (FIs) in antiproliferation efforts to reduce nuclear proliferation risks by identifying suspicious business transactions and exports when making lending or insurance decisions. The meeting brought together a group of export control specialists, largely representatives from the Nuclear Suppliers Group (NSG) Participating Governments (PGs) and finance experts representing banks and insurance companies. By assembling a KC of experts, the group could understand what suspicious transactions look like from each other's perspectives and better inform each of their operations. The goal was to develop red flags FIs could use to identify suspicious proliferation-related transactions and to help governments gain a clearer picture of proliferation using financial information.

  11. Discontinuing Inappropriate Medication in Nursing Home Residents (DIM-NHR study): A cluster randomized controlled trial

    NARCIS (Netherlands)

    Wouters, H.; Scheper, J.; Koning, H.; Brouwer, C.; Twisk, J.; Van Der Meer, H.; Boersma, F.; Zuidema, S.; Taxis, K.

    2017-01-01

    Introduction: Inappropriate prescribing is a prevalent problem in nursing home residents that is associated with cognitive and physical impairment. Few interventions have been shown to reduce inappropriate prescribing. The aim was therefore to examine successful discontinuation of inappropriate

  12. Physical violence by an intimate partner and the inappropriate use of prenatal care services among women in Northeastern Brazil.

    Science.gov (United States)

    Carneiro, Jackelyne Faierstein; Valongueiro, Sandra; Ludermir, Ana Bernarda; Araújo, Thália Velho Barreto de

    2016-01-01

    To analyze the association between physical violence by an intimate partner (PVIP) and the inappropriate use of prenatal care services. A nested cross-sectional study was conducted with 1,026 women, based on data from a prospective cohort study designed to investigate intimate partner violence among pregnant women enrolled in the Family Health Program (PSF) in Recife, Northeastern Brazil. The use of prenatal care services was assessed with basis on the guidelines from the Program for Humanization of Prenatal Care and Childbirth (Brazilian Ministry of Health) and considered the time of the first prenatal care visit and the total number of visits during the pregnancy. Data were collected through two face-to-face interviews (one in the last pregnancy trimester and the other in the postpartum period), using standardized questionnaires and data on Pregnancy Card records. An unconditional logistic regression was performed to estimate the odds ratio (OR) and the 95% confidence intervals to measure the association between an PVIP and the inappropriate use of prenatal care services, using the stepwise method. The prevalence of the inappropriate use of prenatal care services was 44.1% and of an PVIP, 25.6%. In the logistic regression analysis, an intimatePVIP was associated with inappropriate prenatal care (OR = 1.37; 95%CI 1.01 - 1.85; p = 0.04) after adjustment by variables confirmed as confounders (parity, alcohol use in pregnancy, and education level). Women who are victims of an PVIP have more chance of receiving inappropriate prenatal care due to late onset of prenatal care, fewer prenatal care visits, or both.

  13. Prevalence and Predictors of Inappropriate Medications Prescribing ...

    African Journals Online (AJOL)

    Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer's criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, ...

  14. What is inappropriate hospital use for elderly people near the end of life?

    DEFF Research Database (Denmark)

    Cardona-Morrell, Magnolia; Kim, James C H; Brabrand, Mikkel

    2017-01-01

    : English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital. OUTCOMES: measurements of inappropriateness. A 17-item quality score was estimated...... estimation of clinical inappropriateness. CONCLUSIONS: Clinical inappropriateness and system factors that preclude alternative community care must be measured separately. They are two very different justifications for hospital admissions, requiring different solutions. Society has a duty to ensure...

  15. Frequent Home Monitoring of ICD Is Effective to Prevent Inappropriate Defibrillator Shock Delivery

    Directory of Open Access Journals (Sweden)

    Paolo Bifulco

    2014-01-01

    Full Text Available Recently, in the context of telemedicine, telemonitoring services are gaining attention. They are offered, for example, to patients with implantable cardioverter defibrillators (ICDs. A major problem associated with ICD therapy is the occurrence of inappropriate shocks which impair patients’ quality of life and may also be arrhythmogenic. The telemonitoring can provide a valid support to intensify followup visits, in order to improve the prevention of inappropriate defibrillator shock, thus enhancing patient safety. Inappropriate shock generally depends on atrial fibrillation, supraventricular tachycardia, and abnormal sensing (such as those caused by electromagnetic interferences. As a practical example, an unusual case of an ICD patient who risked an inappropriate shock while taking a shower is reported. Continuous remote telemonitoring was able to timely warn cardiologist via GSM-SMS, who were able to detect improper sensing examining the intracardiac electrogram via Web. Patient was promptly contacted and warned to not further come in contact with the hydraulic system and any electrical appliance to prevent an inappropriate defibrillator shock. This demonstrates the effectiveness and usefulness of continuous remote telemonitoring in supporting ICD patients.

  16. Risk factors for inappropriate blood requisition among hospitals in Tanzania.

    Science.gov (United States)

    Mauka, Wilhellmuss I; Mtuy, Tara B; Mahande, Michael J; Msuya, Sia E; Mboya, Innocent B; Juma, Abdul; Philemon, Rune N

    2018-01-01

    Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. This was a cross sectional study using secondary data of 14,460 patients' blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%). The proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.

  17. Design and methods of the Echo WISELY (Will Inappropriate Scenarios for Echocardiography Lessen SignificantlY) study: An investigator-blinded randomized controlled trial of education and feedback intervention to reduce inappropriate echocardiograms.

    Science.gov (United States)

    Bhatia, R Sacha; Ivers, Noah; Yin, Cindy X; Myers, Dorothy; Nesbitt, Gillian; Edwards, Jeremy; Yared, Kibar; Wadhera, Rishi; Wu, Justina C; Wong, Brian; Hansen, Mark; Weinerman, Adina; Shadowitz, Steven; Johri, Amer; Farkouh, Michael; Thavendiranathan, Paaladinesh; Udell, Jacob A; Rambihar, Sherryn; Chow, Chi-Ming; Hall, Judith; Thorpe, Kevin E; Rakowski, Harry; Weiner, Rory B

    2015-08-01

    Appropriate use criteria (AUC) for transthoracic echocardiography (TTE) were developed to address concerns regarding inappropriate use of TTE. A previous pilot study suggests that an educational and feedback intervention can reduce inappropriate TTEs ordered by physicians in training. It is unknown if this type of intervention will be effective when targeted at attending level physicians in a variety of clinical settings. The aim of this international, multicenter study is to evaluate the hypothesis that an AUC-based educational and feedback intervention will reduce the proportion of inappropriate echocardiograms ordered by attending physicians in the ambulatory environment. In an ongoing multicentered, investigator-blinded, randomized controlled trial across Canada and the United States, cardiologists and primary care physicians practicing in the ambulatory setting will be enrolled. The intervention arm will receive (1) a lecture outlining the AUC and most recent available evidence highlighting appropriate use of TTE, (2) access to the American Society of Echocardiography mobile phone app, and (3) individualized feedback reports e-mailed monthly summarizing TTE ordering behavior including information on inappropriate TTEs and brief explanations of the inappropriate designation. The control group will receive no education on TTE appropriate use and order TTEs as usual practice. The Echo WISELY (Will Inappropriate Scenarios for Echocardiography Lessen Significantly in an education RCT) study is the first multicenter randomized trial of an AUC-based educational intervention. The study will examine whether an education and feedback intervention will reduce the rate of outpatient inappropriate TTEs ordered by attending level cardiologists and primary care physicians (www.clinicaltrials.gov identifier NCT02038101). Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Development of new taxonomy of inappropriate communication and its application to operating teams in nuclear power plants

    International Nuclear Information System (INIS)

    Kim, Ar Ryum; Lee, Seung Woo; Jang, In Seok; Kang, Hyun Gook; Seong, Poong Hyun; Park, Jin Kyun

    2012-01-01

    Inappropriate communications can cause a lack of necessary information exchange between operators and lead to serious consequences in large process systems such as nuclear power plants (NPPs). In this regard, various kinds of taxonomies of inappropriate communications have been developed to prevent inappropriate communications. However, there seems to be difficult to identify inappropriate communications from verbal protocol data between operators. Because the existing taxonomies were developed for use in report analysis, there is a problem of 'uncertainty'. In consequence, this paper proposes a new taxonomy of inappropriate communications and provides some insights to prevent inappropriate communications. In order to develop the taxonomy, existing taxonomies for four industries from 1980 to 2010 were collected and a new taxonomy is developed based on the simplified one-way communication model. In addition, the ratio of inappropriate communications from 8 samples of audio-visual format verbal protocol data recorded during emergency training sessions by operating teams is compared with performance scores calculated based on the task analysis. As a result, inappropriate communications can be easily identified from the verbal protocol data using the suggested taxonomy, and teams with a higher ratio of inappropriate communications tend to have a lower performance score.

  19. Development of new taxonomy of inappropriate communication and its application to operating teams in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ar Ryum; Lee, Seung Woo; Jang, In Seok; Kang, Hyun Gook; Seong, Poong Hyun [Dept. of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Park, Jin Kyun [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-12-15

    Inappropriate communications can cause a lack of necessary information exchange between operators and lead to serious consequences in large process systems such as nuclear power plants (NPPs). In this regard, various kinds of taxonomies of inappropriate communications have been developed to prevent inappropriate communications. However, there seems to be difficult to identify inappropriate communications from verbal protocol data between operators. Because the existing taxonomies were developed for use in report analysis, there is a problem of 'uncertainty'. In consequence, this paper proposes a new taxonomy of inappropriate communications and provides some insights to prevent inappropriate communications. In order to develop the taxonomy, existing taxonomies for four industries from 1980 to 2010 were collected and a new taxonomy is developed based on the simplified one-way communication model. In addition, the ratio of inappropriate communications from 8 samples of audio-visual format verbal protocol data recorded during emergency training sessions by operating teams is compared with performance scores calculated based on the task analysis. As a result, inappropriate communications can be easily identified from the verbal protocol data using the suggested taxonomy, and teams with a higher ratio of inappropriate communications tend to have a lower performance score.

  20. Performance costs when emotion tunes inappropriate cognitive abilities: implications for mental resources and behavior.

    Science.gov (United States)

    Storbeck, Justin

    2012-08-01

    Emotion tunes cognition, such that approach-motivated positive states promote verbal cognition, whereas withdrawal-motivated negative states promote spatial cognition (Gray, 2001). The current research examined whether self-control resources become depleted and influence subsequent behavior when emotion tunes an inappropriate cognitive tendency. In 2 experiments, either an approach-motivated positive state or a withdrawal-motivated negative state was induced, and then participants completed a verbal or a spatial working memory task creating conditions of emotion-cognition alignment (e.g., approach/verbal) or misalignment (e.g., approach/spatial). A control condition was also included. To examine behavioral costs due to depleted self-control resources, participants completed either a Stroop task (Stroop, 1935; Experiment 1) or a Black/White implicit association test (IAT; Greenwald, McGhee, & Schwartz, 1998; Experiment 2). Participants in the misalignment conditions performed worse on the Stroop task, and they were worse at controlling their implicit attitude biases on the IAT. Thus, when emotion tunes inappropriate cognitive tendencies for one's current environment, self-control resources become depleted, impairing behavioral control. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  1. [Impact of potentially inappropriate drug usage on health insurance business results].

    Science.gov (United States)

    Kirschke, Malin; Böhme, Jacqueline

    2014-09-01

    In Germany a list was drawn up that included 83 potentially inappropriate drugs. The PRISCUS list published in 2010 was intended to highlight certain problems in the pharmakotherapy of elderly patients and serve as a support for improved medicine safety. Almost a third of the insurance portfolio of the HALLESCHE Krankenversicherung aged over 75 years takes drugs that are on the PRISCUS list. Benzodiazepine and Z-drugs are taken most frequently. The costs per insurant with potentially inappropriate medication are on average higher than for policyholders who do not take drugs on the PRISCUS list. The costs per insurant are rising, with an increase in the number of PRISCUS agents being taken as well. However, there is still no scientific proof that potentially inappropriate drugs lead to adverse drug events.

  2. Missed opportunities and inappropriately given vaccines reduce ...

    African Journals Online (AJOL)

    Objectives: To quantify missed opportunities for immunisation, document reasons for their occurrence and evaluate the extent of inappropriately given vaccine doses. Design: A cross sectional study of children under two years of age attending health facilities. Setting: Six health facilities predominantly serving the slums of ...

  3. The Association between Inappropriate Weight Control Behaviors and Suicide Ideation and Attempt among Korean Adolescents.

    Science.gov (United States)

    Lee, Sang Ah; Jang, Suk Yong; Shin, Jaeyong; Ju, Yeong Jun; Nam, Jin Young; Park, Eun Cheol

    2016-10-01

    Suicide is a leading cause of death among adolescents globally, and body weight is also a recognized reason for adolescent suicide. Therefore, we investigated the association between weight control behaviors (WCB) and suicide ideation and attempt, focusing on inappropriate weight control measures. We used data from the 2014 Korea Youth Risk Behavior Web-based Survey, representing a total of 35,224 boys and 34,361 girls aged 12 to 18 years. Adolescents were classified into groups based on WCB: appropriate WCB, inappropriate WCB, and no WCB. We performed logistic regression models to examine associations between WCB and suicide ideation and attempt, controlling for covariates. Both boys and girls with inappropriate WCB were more likely to report suicide ideation and attempt. Underweight and normal weight boys with inappropriate WCB were more likely to think or attempt suicide, and underweight girls with inappropriate WCB were also more likely to attempt suicide. Among five common WCB combinations, the combination of "regular exercise, fasting, eating less" was highly associated with suicide ideation and attempt. We confirmed that inappropriate WCB is associated with suicide ideation and attempt among Korean adolescents. Given the high incidence rate of suicide among adolescents and the adverse effect of inappropriate WCB, encouraging adolescents to control their weight in healthy ways is imperative.

  4. Inappropriate secretion of antidiuretic hormone treated with frusemide.

    Science.gov (United States)

    Decaux, G; Waterlot, Y; Genette, F; Hallemans, R; Demanet, J C

    1982-07-10

    Seven out of nine patients with chronic inappropriate secretion of antidiuretic hormone were successfully treated with 40 mg frusemide daily. One patient needed 80 mg, and the remaining patient achieved only a small increase in diuresis after 40 mg frusemide; this was probably related to his low creatinine clearance. In order to maintain a salt intake high enough to compensate for the loss of urine electrolytes 3 to 6 g sodium chloride was added as tablets to the sodium-free diet in six patients. Hypokalaemia occurred in five patients but was easily corrected with either supplements of potassium chloride or a potassium-sparing diuretic. These findings add further weight to evidence that Frusemide is a good alternative for the treatment of patients with inappropriate secretion of antidiuretic hormone who cannot tolerate water restriction.

  5. Children's Context Inappropriate Anger and Salivary Cortisol

    Science.gov (United States)

    Locke, Robin L.; Davidson, Richard J.; Kalin, Ned H.; Goldsmith, H. Hill

    2009-01-01

    Some children show emotion that is not consistent with normative appraisal of the context and can therefore be defined as context inappropriate (CI). The authors used individual growth curve modeling and hierarchical multiple regression analyses to examine whether CI anger predicts differences in hypothalamic-pituitary-adrenal axis activity, as…

  6. Potentially inappropriate medication use: the Beers' Criteria used among older adults with depressive symptoms

    Directory of Open Access Journals (Sweden)

    Lee D

    2013-09-01

    Full Text Available INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3 years and 59% were women. The median number of medications used was 6 (range 1-21 medications. The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49% of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale ≥5 and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54. DISCUSSION: Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed.

  7. Fractionated laser resurfacing corrects the inappropriate UVB response in geriatric skin.

    Science.gov (United States)

    Spandau, Dan F; Lewis, Davina A; Somani, Ally-Khan; Travers, Jeffrey B

    2012-06-01

    Non-melanoma skin cancer is a disease primarily afflicting geriatric patients as evidenced by the fact that 80% of all non-melanoma skin cancers are diagnosed in patients over the age of 60 years. As such, geriatric skin responds to cancer-inducing UVB irradiation in a manner that allows the establishment of tumor cells. Currently, the only effective treatment for non-melanoma skin cancer is the removal of the tumors after they appear, indicating the need for a more cost-effective prophylactic therapy. Geriatric volunteers were treated with fractionated laser resurfacing therapy on either sun-protected (upper buttocks) or chronically sun-exposed (dorsal forearm) skin. Fractionated laser resurfacing therapy was shown to decrease the occurrence of senescent fibroblasts in geriatric dermis, increase the dermal expression of IGF-1, and correct the inappropriate UVB response observed in untreated geriatric skin. These responses to fractionated laser resurfacing were equal to the effects seen previously using the more aggressive wounding following dermabrasion. Furthermore, fractionated laser resurfacing was equally effective in both sun-protected and sun-exposed skin. The ability of fractionated laser resurfacing treatment to protect against the occurrence of UVB-damaged proliferating keratinocytes indicates the potential of fractionated laser resurfacing to reduce or prevent aging-associated non-melanoma skin cancer.

  8. Potentially inappropriate medication use among institutionalized elderly individuals in southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Mauro Cunha Xavier Pinto

    2013-12-01

    Full Text Available In recent decades, the elderly population in Brazil has grown rapidly, as has concern for the health of this population. Institutionalization in nursing homes has appeared as an alternative form of health care for frail elderly that live alone. The present study evaluated the pharmacotherapy and inappropriate drug prescriptions for institutionalized elderly patients living in long-term institutions in southeastern Brazil. This research was conducted at five institutions with a total sample of 151 individuals aged at least 60 years. Databases were used to identify drug interactions, defined daily dose and inappropriate prescriptions. The prevalence of drug intake among the elderly was 95.36%, and there were an average of 3.31 ± 1.80 drug prescriptions per individual. Based on Beers criteria, the prevalence of inappropriate prescriptions was 25.83%. In addition, 70.2% of prescriptions were prescribed at a higher dosage than the defined daily dose (ATC/WHO. Potential drug interactions were identified for 54.11% of prescriptions; 81.42% of these were of moderate severity. The main inappropriate drugs were prescribed for cardiovascular and nervous system problems. Institutionalized elderly individuals presented a high consumption and misuse of medications, requiring professional intervention to monitor prescriptions and improve the quality of service for this population.

  9. Electromagnetic Interference from Swimming Pool Generator Current Causing Inappropriate ICD Discharges

    Directory of Open Access Journals (Sweden)

    Edward Samuel Roberto

    2017-01-01

    Full Text Available Electromagnetic interference (EMI includes any electromagnetic field signal that can be detected by device circuitry, with potentially serious consequences: incorrect sensing, pacing, device mode switching, and defibrillation. This is a unique case of extracardiac EMI by alternating current leakage from a submerged motor used to recycle chlorinated water, resulting in false rhythm detection and inappropriate ICD discharge. A 31-year-old female with arrhythmogenic right ventricular cardiomyopathy and Medtronic dual-chamber ICD placement presented after several inappropriate ICD shocks at the public swimming pool. Patient had never received prior shocks and device was appropriate at all regular follow-ups. Intracardiac electrograms revealed unique, high-frequency signals at exactly 120 msec suggestive of EMI from a strong external source of alternating current. Electrical artifact was incorrectly sensed as a ventricular arrhythmia which resulted in discharge. ICD parameters including sensing, pacing thresholds, and impedance were all normal suggesting against device malfunction. With device failure and intracardiac sources excluded, EMI was therefore strongly suspected. Avoidance of EMI source brought complete resolution with no further inappropriate shocks. After exclusion of intracardiac interference, device malfunction, and abnormal settings, extracardiac etiologies such as EMI must be thoughtfully considered and excluded. Elimination of inappropriate shocks is to “first, do no harm.”

  10. Spinal Microgliosis Due to Resident Microglial Proliferation Is Required for Pain Hypersensitivity after Peripheral Nerve Injury

    Directory of Open Access Journals (Sweden)

    Nan Gu

    2016-07-01

    Full Text Available Peripheral nerve injury causes neuropathic pain accompanied by remarkable microgliosis in the spinal cord dorsal horn. However, it is still debated whether infiltrated monocytes contribute to injury-induced expansion of the microglial population. Here, we found that spinal microgliosis predominantly results from local proliferation of resident microglia but not from infiltrating monocytes after spinal nerve transection (SNT by using two genetic mouse models (CCR2RFP/+:CX3CR1GFP/+ and CX3CR1creER/+:R26tdTomato/+ mice as well as specific staining of microglia and macrophages. Pharmacological inhibition of SNT-induced microglial proliferation correlated with attenuated neuropathic pain hypersensitivities. Microglial proliferation is partially controlled by purinergic and fractalkine signaling, as CX3CR1−/− and P2Y12−/− mice show reduced spinal microglial proliferation and neuropathic pain. These results suggest that local microglial proliferation is the sole source of spinal microgliosis, which represents a potential therapeutic target for neuropathic pain management.

  11. Functional Analysis and Reduction of Inappropriate Spitting

    Science.gov (United States)

    Carter, Stacy L.; Wheeler, John J.

    2007-01-01

    Functional analysis was used to determine the possible function of inappropriate spitting behavior of an adult woman who had been diagnosed with profound mental retardation. Results of an initial descriptive assessment indicated a possible attention function and led to an attention-based intervention, which was deemed ineffective at reducing the…

  12. Inappropriate self-medication among adolescents and its association with lower medication literacy and substance use.

    Directory of Open Access Journals (Sweden)

    Chun-Hsien Lee

    Full Text Available While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication.In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication.The prevalence of self-medication in the past year among the adolescents surveyed was 45.8%, and the most frequently reported drugs for self-medication included nonsteroidal anti-inflammatory drugs or pain relievers (prevalence = 31.1%, cold or cough medicines (prevalence = 21.6%, analgesics (prevalence = 19.3%, and antacids (prevalence = 17.3%. Of the participants who practiced self-medication, the prevalence of inappropriate self-medication behaviors included not reading drug labels or instructions (10.1%, using excessive dosages (21.6%, and using prescription and nonprescription medicine simultaneously without advice from a health provider (polypharmacy (30.3%. The results of multiple logistic regression analysis showed that after controlling for school level, gender, and chronic diseases, the participants with lower medication knowledge, lower self-efficacy, lower medication literacy, and who consumed tobacco or alcohol were more likely to engage in inappropriate self-medication.Lower medication literacy and substance use were associated with inappropriate self-medication among adolescents.

  13. The inappropriate use of lumbar magnetic resonance imaging in a health service area

    International Nuclear Information System (INIS)

    Rodriguez Recio, F. J.; Sanz, J. C.; Vera, S.; Peiro, S.

    1999-01-01

    To identify the percentage of inappropriate lumbar spine magnetic resonance imaging in the Soria Health Service, to quantify the costs and the possible association between inadequate use, the characteristics of the patient and the services requested. A descriptive study of the inappropriate use of MRI of the lumbar spine, taken from the retrospective examination, carried out by a radiologist, of the 233 MRI's requested between 1995 and 1998. For the valuation, the criteria of the American College of Radiology (ACR) and the Basque Agency for the Evaluation of Technologies (OSTEBA) were used. All the MRI's were carried out at an approved centre, the costs were calculated taken form the expenses paid by the Insalud, including the transport costs, calculated at prices applicable for the year in question. 11.7% of the studies were values as inappropriate, 2.1% debatable and the remainder adequate according to the ACR criteria, concentrating the inadequacy on studies for lumbago, that reached 80% of the inappropriate requests. The ACR and OSTEBA criteria coincided to a high degree (kappa statistics: 0.87). The expense related to the unnecessary studies was a litter higher than a million pesetas. No differences were found in the proportion of inappropriate studies according to the characteristics of the patient or the service requested, except the one already mentioned for the supposition diagnosis. Although the results of the study cannot be generalised to other environments, they suggest the possibility of a significant proportion of inappropriate use of lumbar spine MRI that could have an important repercussion on health care expenses. (Author) 11 refs

  14. Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

    Science.gov (United States)

    Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina

    2017-12-01

    The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.

  15. Cost analysis of inappropriate treatments for suspected dermatomycoses

    Directory of Open Access Journals (Sweden)

    Emanuela Fiammenghi

    2015-06-01

    Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease

  16. Using a social story intervention to decrease inappropriate behavior of preschool children with autism

    Directory of Open Access Journals (Sweden)

    Angkhana Khantreejitranon

    2018-01-01

    Full Text Available This research investigated the inappropriate behavior of preschool children with autism in a classroom and examined the effectiveness of the use of social stories to decrease inappropriate autistic behavior. An A-B-A-B single subject design was used across the five participants selected for the study. Investigating the problematic social skills and developing a social story intervention for the preschool autistic children was completed, followed by an examination of the effectiveness of the social story intervention. Ten common problematic social skills among the autistic children in preschool were identified—walking around, making loud noises, not sharing their toys with others, showing frustration when feeling unsatisfied, having no patience, not putting toys away when finished, taking other people's belongings without permission, not knowing how to greet others, destroying things when feeling frustrated, and giving a hug to other people at inappropriate times. It was found that the social story intervention helped to decrease inappropriate behavior in children with autism. The social story intervention consisted of five social story books and five e-books (one story per child using a single subject design with an A-B-A-B pattern. The autistic children preferred social stories from the hardcopy books compared with stories from the e-books. A fourth stage time trial was used over 6 weeks, five times per week, for a total of 30 times. The findings suggested that the use of properly constructed social stories can be effective in decreasing the inappropriate behavior of children with autism. However, each story intervention should be applied with caution because of individual differences between children. The social story intervention should be designed only for autistic children who exhibit specific inappropriate social behavior. Keywords: autistic child, inappropriate behavior, social skills, social story

  17. Potentially inappropriate prescribing in elderly population: A study in medicine out-patient department

    Directory of Open Access Journals (Sweden)

    Ajit Kumar Sah

    2017-03-01

    Full Text Available Background & Objectives: Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The study was conducted with objectives to determine the prevalence of potentially inappropriate medicine (PIM prescribing in older Nepalese patients in a medicine outpatient department.Materials & Methods: A prospective observational analysis of drugs prescribed in medicine out-patient department (OPD of a tertiary hospital of central Nepal was conducted during November 2012 to October 2013 among 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM in elderly patients was analysed using Beer’s Criteria updated to 2013. Results: In the 869 patients included, the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%, amlodipine (23.16%, paracetamol (17.6%, salbutamol (15.72% and vitamin B complex (13.26%. The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Conclusion: Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with number of medications prescribed. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.

  18. Dual effect of LPS on murine myeloid leukemia cells: Pro-proliferation and anti-proliferation

    International Nuclear Information System (INIS)

    Yu, Lingling; Zhao, Yingmin; Gu, Xin; Wang, Jijun; Pang, Lei; Zhang, Yanqing; Li, Yaoyao; Jia, Xiaoqin; Wang, Xin; Gu, Jian; Yu, Duonan

    2016-01-01

    Modification of the bone marrow microenvironment is considered as a promising strategy to control leukemic cell proliferation, diseases progression and relapse after treatment. However, due to the diversity and complexity of the cellular and molecular compartments in the leukemic microenvironment, it is extremely difficult to dissect the role of each individual molecule or cell type in vivo. Here we established an in vitro system to dissect the role of lipopolysaccharide (LPS), stromal cells and endothelial cells in the growth of mouse myeloid tumor cells and B-lymphoma cells. We found that either LPS or bone marrow stromal cells as a feeder layer in culture is required for the proliferation of myeloid tumor cells. Surprisingly, the growth of myeloid leukemic cells on stromal cells is strongly inhibited when coupled with LPS in culture. This opposing effect of LPS, a complete switch from pro-proliferation to antitumor growth is due, at least in part, to the rapidly increased production of interleukin 12, Fas ligand and tissue inhibitor of metalloproteinases-2 from stromal cells stimulated by LPS. These results demonstrate that LPS can either facilitate or attenuate tumor cell proliferation, thus changing the disease course of myeloid leukemias through its direct effect or modulation of the tumor microenvironment. - Highlights: • LPS alone in culture is required for the proliferation of murine myeloid tumor cells. • Bone marrow stromal cells as a feeder layer is also required for the proliferation of myeloid tumor cells. • However, the growth of myeloid tumor cells is inhibited when LPS and stromal cells are both available in culture. • Thus LPS can either facilitate or attenuate tumor growth through its direct effect or modulation of tumor microenvironment.

  19. Dual effect of LPS on murine myeloid leukemia cells: Pro-proliferation and anti-proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Lingling [Department of Pediatrics, Jingjiang People' s Hospital, Yangzhou University, Jingjiang 214500 (China); Noncoding RNA Center, Yangzhou University, Yangzhou 225001 (China); Zhao, Yingmin [Department of Pediatrics, Jingjiang People' s Hospital, Yangzhou University, Jingjiang 214500 (China); Gu, Xin; Wang, Jijun; Pang, Lei; Zhang, Yanqing; Li, Yaoyao; Jia, Xiaoqin; Wang, Xin [Noncoding RNA Center, Yangzhou University, Yangzhou 225001 (China); Gu, Jian [Department of Hematology, Yangzhou University School of Clinical Medicine, Yangzhou 225001 (China); Yu, Duonan, E-mail: duonan@yahoo.com [Department of Pediatrics, Jingjiang People' s Hospital, Yangzhou University, Jingjiang 214500 (China); Noncoding RNA Center, Yangzhou University, Yangzhou 225001 (China); Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Disease, Yangzhou 225001 (China); Institute of Comparative Medicine, Yangzhou University, Yangzhou 225001 (China); Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonosis, Yangzhou 225001 (China)

    2016-06-10

    Modification of the bone marrow microenvironment is considered as a promising strategy to control leukemic cell proliferation, diseases progression and relapse after treatment. However, due to the diversity and complexity of the cellular and molecular compartments in the leukemic microenvironment, it is extremely difficult to dissect the role of each individual molecule or cell type in vivo. Here we established an in vitro system to dissect the role of lipopolysaccharide (LPS), stromal cells and endothelial cells in the growth of mouse myeloid tumor cells and B-lymphoma cells. We found that either LPS or bone marrow stromal cells as a feeder layer in culture is required for the proliferation of myeloid tumor cells. Surprisingly, the growth of myeloid leukemic cells on stromal cells is strongly inhibited when coupled with LPS in culture. This opposing effect of LPS, a complete switch from pro-proliferation to antitumor growth is due, at least in part, to the rapidly increased production of interleukin 12, Fas ligand and tissue inhibitor of metalloproteinases-2 from stromal cells stimulated by LPS. These results demonstrate that LPS can either facilitate or attenuate tumor cell proliferation, thus changing the disease course of myeloid leukemias through its direct effect or modulation of the tumor microenvironment. - Highlights: • LPS alone in culture is required for the proliferation of murine myeloid tumor cells. • Bone marrow stromal cells as a feeder layer is also required for the proliferation of myeloid tumor cells. • However, the growth of myeloid tumor cells is inhibited when LPS and stromal cells are both available in culture. • Thus LPS can either facilitate or attenuate tumor growth through its direct effect or modulation of tumor microenvironment.

  20. Unveiling common responses of Medicago truncatula to appropriate and inappropriate rust species

    Science.gov (United States)

    Vaz Patto, Maria Carlota; Rubiales, Diego

    2014-01-01

    Little is known about the nature of effective defense mechanisms in legumes to pathogens of remotely related plant species. Some rust species are among pathogens with broad host range causing dramatic losses in various crop plants. To understand and compare the different host and nonhost resistance (NHR) responses of legume species against rusts, we characterized the reaction of the model legume Medicago truncatula to one appropriate (Uromyces striatus) and two inappropriate (U. viciae-fabae and U. lupinicolus) rusts. We found that similar pre and post-haustorial mechanisms of resistance appear to be operative in M. truncatula against appropriate and inappropriate rust fungus. The appropriate U. striatus germinated better on M. truncatula accessions then the inappropriate U. viciae-fabae and U. lupinicolus, but once germinated, germ tubes of the three rusts had a similar level of success in finding stomata and forming an appressoria over a stoma. However, responses to different inappropriate rust species also showed some specificity, suggesting a combination of non-specific and specific responses underlying this legume NHR to rust fungi. Further genetic and expression analysis studies will contribute to the development of the necessary molecular tools to use the present information on host and NHR mechanisms to breed for broad-spectrum resistance to rust in legume species. PMID:25426128

  1. Unveiling common responses of Medicago truncatula to appropriate and inappropriate rust species

    Directory of Open Access Journals (Sweden)

    Maria Carlota eVaz Patto

    2014-11-01

    Full Text Available Little is known about the nature of effective defense mechanisms in legumes to pathogens of remotely related plant species. Some rust species are among pathogens with broad host range causing dramatic losses in various crop plants. To understand and compare the different host and nonhost resistance responses of legume species against rusts, we characterized the reaction of the model legume Medicago truncatula to one appropriate (Uromyces striatus and two inappropriate (U. viciae-fabae and U. lupinicolus rusts. We found that similar pre and post-haustorial mechanisms of resistance appear to be operative in M. truncatula against appropriate and inappropriate rust fungus. The appropriate U. striatus germinated better on M. truncatula accessions then the inappropriate U. viciae-fabae and U. lupinicolus, but once germinated, germ tubes of the three rusts had a similar level of success in finding stomata and forming an appressoria over a stoma. However responses to different inappropriate rust species also showed some specificity, suggesting a combination of non specific and specific responses underlying this legume nonhost resistance to rust fungi. Further genetic and expression analysis studies will contribute to the development of the necessary molecular tools to use the present information on host and nonhost resistance mechanisms to breed for broad-spectrum resistance to rust in legume species.

  2. Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India

    Directory of Open Access Journals (Sweden)

    Binit N Jhaveri

    2014-01-01

    Full Text Available Aim: To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary care teaching hospital. Materials and Methods: Retrospective analysis was performed for cases of elderly patients admitted between January 2010 and December 2010. Data on age, gender, diagnosis, duration of hospital stay, treatment, and outcome were collected. Prescriptions were assessed for the use of potentially inappropriate medications in geriatric patients by using American Geriatric Society Beer′s criteria (2012 and PRISCUS list (2010. Results: A total of 676 geriatric patients (52.12% females were admitted in the medicine ward. The average age of geriatric patients was 72.69 years. According to Beer′s criteria, at least one inappropriate medicine was prescribed in 590 (87.3% patients. Metoclopramide (54.3%, alprazolam (9%, diazepam (8%, digoxin > 0.125 mg/day (5%, and diclofenac (3.7% were the commonly used inappropriate medications. Use of nonsteroidal anti-inflammatory drugs (NSAIDs in heart and renal failure patients was the commonly identified drug-disease interaction. According to PRISCUS list, at least one inappropriate medication was prescribed in 210 (31.06% patients. Conclusion: Use of inappropriate medicines is highly prevalent in elderly patients.

  3. Factors predisposing nursing home resident to inappropriate transfer to emergency department. The FINE study protocol

    Directory of Open Access Journals (Sweden)

    Amélie Perrin

    2017-09-01

    Full Text Available Background: Each year, around one out of two nursing home (NH residents are hospitalized in France, and about half to the emergency department (ED. These transfers are frequently inappropriate. This paper describes the protocol of the FINE study. The first aim of this study is to identify the factors associated with inappropriate transfers to ED. Methods/design: FINE is a case-control observational study. Sixteen hospitals participate. Inclusion period lasts 7 days per season in each center for a total period of inclusion of one year. All the NH residents admitted in ED during these periods are included. Data are collected in 4 times: before transfer in the NH, at the ED, in hospital wards in case of patient's hospitalization and at the patient's return to NH. The appropriateness of ED transfers (i.e. case versus control NH residents is determined by a multidisciplinary team of experts. Results: Our primary objective is to determine the factors predisposing NH residents to inappropriate transfer to ED. Our secondary objectives are to assess the cost of the transfers to ED; study the evolution of NH residents' functional status and the psychotropic and inappropriate drugs prescription between before and after the transfer; calculate the prevalence of potentially avoidable transfers to ED; and identify the factors predisposing NH residents to potentially avoidable transfer to ED. Discussion: A better understanding of the determinant factors of inappropriate transfers to ED of NH residents may lead to proposals of recommendations of better practice in NH and would allow implementing quality improvement programs in the health organization. Keywords: Inappropriate transfer, Nursing home resident, Emergency department transfer, Potentially avoidable transfer, Appropriateness of transfer, Inappropriate hospitalization

  4. Impact of a warning CPOE system on the inappropriate pill splitting of prescribed medications in outpatients.

    Directory of Open Access Journals (Sweden)

    Chia-Chen Hsu

    Full Text Available Prescribing inappropriate pill splitting is not rare in clinical practice. To reduce inappropriate pill splitting, we developed an automatic warning system linked to a computerized physician order entry (CPOE system for special oral formulation drugs in outpatient settings. We examined the impact of the warning system on inappropriate prescribing of pill splitting and assess prescribers' responses to the warnings.Drugs with extended-release or enteric-coated formulations that were not originally intended to be split were recognized as "special oral formulations". A hard-stop system which could examine non-integer doses of drugs with special oral formulations, provide warnings to interrupt inappropriate prescriptions was integrated in CPOE in a medical center since June 2010. We designed an intervention study to compare the inappropriate splitting before and after the implementation of the warning system (baseline period 2010 January to May vs. intervention period 2010 June to 2011 August. During the intervention period, prescription changes in response to a warning were logged and analyzed.A total of 470,611 prescribed drug items with 34 different drugs with special oral formulations were prescribed in the study period. During the 15-month intervention period, 909 warnings for 26 different drugs were triggered among 354,523 prescribed drug items with special oral formulations. The warning rate of inappropriate splitting in the late intervention period was lower than those in baseline period (0.16% vs. 0.61%, incidence rate ratio 0.27, 95% CI 0.23-0.31, P<0.001. In respond to warnings, physicians had to make adjustments, of which the majority was changing to an unsplit pill (72.9%.The interruptive warning system could avoid the prescriptions with inappropriate pill splitting. Accordingly, physicians changed their behavior of prescribing special oral formulations regarding inappropriate pill splitting. We suggest the establishment of such system

  5. Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study.

    Science.gov (United States)

    Kutyifa, Valentina; Daubert, James P; Schuger, Claudio; Goldenberg, Ilan; Klein, Helmut; Aktas, Mehmet K; McNitt, Scott; Stockburger, Martin; Merkely, Bela; Zareba, Wojciech; Moss, Arthur J

    2016-01-01

    The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate therapy (MADIT-RIT) trial showed a significant reduction in inappropriate implantable cardioverter defibrillator (ICD) therapy in patients programmed to high-rate cut-off (Arm B) or delayed ventricular tachycardia therapy (Arm C), compared with conventional programming (Arm A). There is limited data on the effect of cardiac resynchronization therapy with a cardioverter defibrillator (CRT-D) on the effect of ICD programming. We aimed to elucidate the effect of CRT-D on ICD programming to reduce inappropriate ICD therapy in patients implanted with CRT-D or an ICD, enrolled in MADIT-RIT. The primary end point of this study was the first inappropriate ICD therapy. Secondary end points were inappropriate anti-tachycardia pacing and inappropriate ICD shock. The study enrolled 742 (49%) patients with an ICD and 757 (51%) patients with a CRT-D. Patients implanted with a CRT-D had 62% lower risk of inappropriate ICD therapy than those with an ICD only (hazard ratio [HR] =0.38, 95% confidence interval: 0.25-0.57; Pprogramming significantly reduced the risk of inappropriate ICD therapy compared with conventional ICD programming in ICD (HR=0.14 [B versus A]; HR=0.21 [C versus A]) and CRT-D patients (HR=0.15 [B versus A]; HR=0.23 [C versus A]; Pprogramming significantly reduces the risk of inappropriate ICD therapy in both ICD and CRT-D patients. http://clinicaltrials.gov; Unique identifier: NCT00947310. © 2016 American Heart Association, Inc.

  6. Inappropriate use of urinary catheters in patients admitted to medical wards in a university hospital.

    Science.gov (United States)

    Fernández-Ruiz, Mario; Calvo, Beatriz; Vara, Rebeca; Villar, Rocío N; Aguado, José María

    2013-10-01

    The prevalence and predisposing factors were determined for inappropriate urinary catheterization (UC) among inpatients in medical wards. A cross-sectional study was conducted including all patients aged ≥ 18 years admitted to medical wards in a 1300-bed tertiary-care centre, and who had a urinary catheter in place on the day of the survey. Of 380 patients observed, 46 (12.1%) had a urinary catheter in place. Twelve of them (26.1%) were inappropriately catheterized. The most common indication for inappropriate UC was urine output monitoring in a cooperative, non-critically ill patient. Inappropriateness was associated with increased age, poor functional status, urinary incontinence, dementia, and admission from a long-term care facility. Further educational efforts should be focused on improving catheterization prescribing practices by physicians. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  7. Inappropriate prescribing of proton pump inhibitors among patients ...

    African Journals Online (AJOL)

    By comparing the patients according to their site of care, 52.4 % (43/82) of ICU patients compared to 87.4 % (97/111) of medically hospitalized patient (non-ICU) were inappropriately receiving PPIs (p = 0.000). Conclusion: Adherence to the current practice guidelines for safe prescription of PPIs is poor. Thus, updating ...

  8. [Renal cell carcinoma producing erythrocytosis due to inappropriate production of erythropoietin].

    Science.gov (United States)

    Villanueva-Gimeno, M M; Vicario-Bermúdez, J M; Fonseca-López, Ch; Caballero-Castro, J P; Zabala-López, S I; Sánchez-Elipe, M A; González-Gómez, N

    2013-01-01

    Erythrocytosis, or polycythaemia, is an increase, in absolute terms, of the erythrocyte mass. The most common solid tumour related to this phenomenon is renal cell carcinoma, which can produce erythrocytosis by increasing erythropoietin production. About 30% of symptomatic renal cell carcinomas are diagnosed due to the appearance of a paraneoplastic syndrome. Polycythaemia is one of these. Surgery, (radical or partial nephrectomy), is the treatment of choice in renal cell carcinoma and helps to keep the erythrocytosis situation under control. Copyright © 2011 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  9. Polypharmacy and Potentially Inappropriate Medication in People with Dementia

    DEFF Research Database (Denmark)

    Kristensen, Rachel Underlien; Nørgaard, Ane; Jensen-Dahm, Christina

    2018-01-01

    BACKGROUND: Polypharmacy (use of ≥5 different medications) and potentially inappropriate medication (PIM) are well-known risk factors for numerous negative health outcomes. However, the use of polypharmacy and PIM in people with dementia is not well-described. OBJECTIVE: To examine the prevalence...

  10. Inappropriate prescribing in geriatric patients.

    LENUS (Irish Health Repository)

    Barry, Patrick J

    2012-02-03

    Inappropriate prescribing in older people is a common condition associated with significant morbidity, mortality, and financial costs. Medication use increases with age, and this, in conjunction with an increasing disease burden, is associated with adverse drug reactions. This review outlines why older people are more likely to develop adverse drug reactions and how common the problem is. The use of different tools to identify and measure the problem is reviewed. Common syndromes seen in older adults (eg, falling, cognitive impairment, sleep disturbance) are considered, and recent evidence in relation to medication use for these conditions is reviewed. Finally, we present a brief summary of significant developments in the recent literature for those caring for older people.

  11. Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.

    LENUS (Irish Health Repository)

    Gallagher, Paul F

    2012-02-03

    INTRODUCTION: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers\\' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. METHODS: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers\\' Criteria applied. RESULTS: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects. CONCLUSION: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers\\' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.

  12. Inappropriate use of urinary catheters and its common complications in different hospital wards

    Directory of Open Access Journals (Sweden)

    Parivash Davoodian

    2012-01-01

    Full Text Available Inappropriate use of indwelling urinary catheters (IUCs and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6% had IUCs used appropriately while 42 of them (20.6% were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%, 16 (19.0% and 14 patients (24.6%, respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2% and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.

  13. An automated technique to identify potential inappropriate traditional Chinese medicine (TCM) prescriptions.

    Science.gov (United States)

    Yang, Hsuan-Chia; Iqbal, Usman; Nguyen, Phung Anh; Lin, Shen-Hsien; Huang, Chih-Wei; Jian, Wen-Shan; Li, Yu-Chuan

    2016-04-01

    Medication errors such as potential inappropriate prescriptions would induce serious adverse drug events to patients. Information technology has the ability to prevent medication errors; however, the pharmacology of traditional Chinese medicine (TCM) is not as clear as in western medicine. The aim of this study was to apply the appropriateness of prescription (AOP) model to identify potential inappropriate TCM prescriptions. We used the association rule of mining techniques to analyze 14.5 million prescriptions from the Taiwan National Health Insurance Research Database. The disease and TCM (DTCM) and traditional Chinese medicine-traditional Chinese medicine (TCMM) associations are computed by their co-occurrence, and the associations' strength was measured as Q-values, which often referred to as interestingness or life values. By considering the number of Q-values, the AOP model was applied to identify the inappropriate prescriptions. Afterwards, three traditional Chinese physicians evaluated 1920 prescriptions and validated the detected outcomes from the AOP model. Out of 1920 prescriptions, 97.1% of positive predictive value and 19.5% of negative predictive value were shown by the system as compared with those by experts. The sensitivity analysis indicated that the negative predictive value could improve up to 27.5% when the model's threshold changed to 0.4. We successfully applied the AOP model to automatically identify potential inappropriate TCM prescriptions. This model could be a potential TCM clinical decision support system in order to improve drug safety and quality of care. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Inappropriate use of payment weights to risk adjust readmission rates.

    Science.gov (United States)

    Fuller, Richard L; Goldfield, Norbert I; Averill, Richard F; Hughes, John S

    2012-01-01

    In this article, the authors demonstrate that the use of relative weights, as incorporated within the National Quality Forum-endorsed PacifiCare readmission measure, is inappropriate for risk adjusting rates of hospital readmission.

  15. Proliferation resistance design of a plutonium cycle (Proliferation Resistance Engineering Program: PREP)

    Energy Technology Data Exchange (ETDEWEB)

    Sorenson, R.J.; Roberts, F.P.; Clark, R.G.

    1979-01-19

    This document describes the proliferation resistance engineering concepts developed to counter the threat of proliferation of nuclear weapons in an International Fuel Service Center (IFSC). The basic elements of an International Fuel Service Center are described. Possible methods for resisting proliferation such as processing alternatives, close-coupling of facilities, process equipment layout, maintenance philosophy, process control, and process monitoring are discussed. Political and institutional issues in providing proliferation resistance for an International Fuel Service Center are analyzed. The conclusions drawn are (1) use-denial can provide time for international response in the event of a host nation takeover. Passive use-denial is more acceptable than active use-denial, and acceptability of active-denial concepts is highly dependent on sovereignty, energy dependence and economic considerations; (2) multinational presence can enhance proliferation resistance; and (3) use-denial must be nonprejudicial with balanced interests for governments and/or private corporations being served. Comparisons between an IFSC as a national facility, an IFSC with minimum multinational effect, and an IFSC with maximum multinational effect show incremental design costs to be less than 2% of total cost of the baseline non-PRE concept facility. The total equipment acquisition cost increment is estimated to be less than 2% of total baseline facility costs. Personnel costs are estimated to increase by less than 10% due to maximum international presence. 46 figures, 9 tables.

  16. Proliferation resistance design of a plutonium cycle (Proliferation Resistance Engineering Program: PREP)

    International Nuclear Information System (INIS)

    Sorenson, R.J.; Roberts, F.P.; Clark, R.G.

    1979-01-01

    This document describes the proliferation resistance engineering concepts developed to counter the threat of proliferation of nuclear weapons in an International Fuel Service Center (IFSC). The basic elements of an International Fuel Service Center are described. Possible methods for resisting proliferation such as processing alternatives, close-coupling of facilities, process equipment layout, maintenance philosophy, process control, and process monitoring are discussed. Political and institutional issues in providing proliferation resistance for an International Fuel Service Center are analyzed. The conclusions drawn are (1) use-denial can provide time for international response in the event of a host nation takeover. Passive use-denial is more acceptable than active use-denial, and acceptability of active-denial concepts is highly dependent on sovereignty, energy dependence and economic considerations; (2) multinational presence can enhance proliferation resistance; and (3) use-denial must be nonprejudicial with balanced interests for governments and/or private corporations being served. Comparisons between an IFSC as a national facility, an IFSC with minimum multinational effect, and an IFSC with maximum multinational effect show incremental design costs to be less than 2% of total cost of the baseline non-PRE concept facility. The total equipment acquisition cost increment is estimated to be less than 2% of total baseline facility costs. Personnel costs are estimated to increase by less than 10% due to maximum international presence. 46 figures, 9 tables

  17. Inappropriate prescribing in the older population: need for new criteria.

    LENUS (Irish Health Repository)

    O'Mahony, Denis

    2012-02-03

    Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers\\' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers\\' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.

  18. Vancomycin intoxication in a patient with inappropriate antidiuretic hormone syndrome and diarrhea

    Directory of Open Access Journals (Sweden)

    Patricia Hidalgo-Collazos

    2015-07-01

    Full Text Available Vancomycin is an antibiotic used for infections by gram-positive bacteria with a two-compartment pharmacokinetic model. Its monitoring has an established therapeutic range (10-20 mg/L to prevent nephrotoxicity and ototoxicity due to supratherapeutic levels, and inefficiency and development of resistance by subtherapeutic levels. Nephrotoxicity for vancomycin monotherapy at standard doses according to pathogen and typical regimens (usual dose: 15-20 mg/kg/12 h is rare and usually reversible. Moreover, monitoring plasma concentrations allows to achieve concentrations within therapeutic range to allow safe and effective drug use. The renal hypoperfusion can cause pre-renal damage, resulting in elevated levels of serum creatinine, resulting in decreased antibiotic elimination and nephrotoxicity. We report a case of unexpected vancomycin nephrotoxicity in a patient with syndrome Inappropriate antidiuretic hormone secretion associated paraneoplastic

  19. Age-Related Differences in Judgments of Inappropriate Behavior are Related to Humor Style Preferences

    Science.gov (United States)

    Stanley, Jennifer Tehan; Lohani, Monika; Isaacowitz, Derek M.

    2014-01-01

    Identifying social gaffes is important for maintaining relationships. Older adults are less able than young to discriminate between socially appropriate and inappropriate behavior in video clips. One open question is how these social appropriateness ratings relate to potential age differences in the perception of what is actually funny or not. In the present study, young, middle-aged, and older adults were equally able to discriminate between appropriate and inappropriate social behavior in a diverse set of clips relevant to both age groups. However, young and middle-aged adults rated the gaffe clips as funnier than control clips and young adults smiled more during the inappropriate clips than the control clips. Older adults did not show this pattern, suggesting that they did not find the inappropriate clips funny. Additionally, young adults endorsed a more aggressive humor style than middle-aged and older adults and aggressive humor style endorsement mediated age differences in social appropriateness ratings. Results are discussed in terms of possible mechanisms such as cohort differences in humor and developmental prioritization of certain humor styles, as well as the importance of investigating age differences in both abilities and preferences. PMID:25244473

  20. Amusia results in abnormal brain activity following inappropriate intonation during speech comprehension.

    Science.gov (United States)

    Jiang, Cunmei; Hamm, Jeff P; Lim, Vanessa K; Kirk, Ian J; Chen, Xuhai; Yang, Yufang

    2012-01-01

    Pitch processing is a critical ability on which humans' tonal musical experience depends, and which is also of paramount importance for decoding prosody in speech. Congenital amusia refers to deficits in the ability to properly process musical pitch, and recent evidence has suggested that this musical pitch disorder may impact upon the processing of speech sounds. Here we present the first electrophysiological evidence demonstrating that individuals with amusia who speak Mandarin Chinese are impaired in classifying prosody as appropriate or inappropriate during a speech comprehension task. When presented with inappropriate prosody stimuli, control participants elicited a larger P600 and smaller N100 relative to the appropriate condition. In contrast, amusics did not show significant differences between the appropriate and inappropriate conditions in either the N100 or the P600 component. This provides further evidence that the pitch perception deficits associated with amusia may also affect intonation processing during speech comprehension in those who speak a tonal language such as Mandarin, and suggests music and language share some cognitive and neural resources.

  1. Amusia results in abnormal brain activity following inappropriate intonation during speech comprehension.

    Directory of Open Access Journals (Sweden)

    Cunmei Jiang

    Full Text Available Pitch processing is a critical ability on which humans' tonal musical experience depends, and which is also of paramount importance for decoding prosody in speech. Congenital amusia refers to deficits in the ability to properly process musical pitch, and recent evidence has suggested that this musical pitch disorder may impact upon the processing of speech sounds. Here we present the first electrophysiological evidence demonstrating that individuals with amusia who speak Mandarin Chinese are impaired in classifying prosody as appropriate or inappropriate during a speech comprehension task. When presented with inappropriate prosody stimuli, control participants elicited a larger P600 and smaller N100 relative to the appropriate condition. In contrast, amusics did not show significant differences between the appropriate and inappropriate conditions in either the N100 or the P600 component. This provides further evidence that the pitch perception deficits associated with amusia may also affect intonation processing during speech comprehension in those who speak a tonal language such as Mandarin, and suggests music and language share some cognitive and neural resources.

  2. Potentially inappropriate prescribing to older patients in primary care in the Netherlands: a retrospective longitudinal study

    NARCIS (Netherlands)

    Bruin-Huisman, Linette; Abu-Hanna, Ameen; van Weert, Henk C. P. M.; Beers, Erna

    2017-01-01

    potentially inappropriate prescribing (PIP) is associated with adverse health effects in older patients. PIP comprises prescription of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). to estimate the prevalence of PIMs and PPOs among older patients in primary

  3. Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why.

    Science.gov (United States)

    Beddows, Nicola; Brooks, Rachel

    2016-08-01

    Autism spectrum disorder (ASD) is a neurodevelopmental disorder impairing social skills and communication. Adolescents with ASD have sexual needs, but may not understand their physical and emotional development resulting in inappropriate sexual behaviour. The aim of this review is to describe the type of inappropriate behaviour that presents in these adolescents, explain why such behaviours occur, suggest what education is suitable and identify current gaps in research. The databases EMBASE, OVID MEDLINE and PSYCINFO were searched for relevant articles. In total, 5241 articles were found, with an additional 15 sources found via soft searches, of which 42 met inclusion criteria and were subsequently reviewed. Sexual behaviours that occur in these adolescents with ASD include hypermasturbation, public masturbation, inappropriate romantic gestures, inappropriate arousal and exhibitionism. Such behaviours are thought to be caused via a lack of understanding of normal puberty, the absence of appropriate sex education, the severity of their ASD and other associated problems. It is suggested that individualized, repetitive education should be started from an early age in an accessible form. Social skills development is also important before more technical aspects of sex education are taught. Despite being such a common problem for schools, institutions and families to manage, it is surprising how sparse literature is particularly regarding why inappropriate behaviour occurs and what education is effective. © 2015 Wiley Publishing Asia Pty Ltd.

  4. Evaluation of potentially inappropriate medications among older residents of Malaysian nursing homes.

    Science.gov (United States)

    Chen, Li Li; Tangiisuran, Balamurugan; Shafie, Asrul Akmal; Hassali, Mohamed Azmi Ahmad

    2012-08-01

    There is an increasing evidence of medicines related issues such as inappropriate prescribing among older people. Inappropriate prescribing is an important risk factor for adverse drug reactions and hospitalizations in the older people. To assess and characterize the prevalence of Potentially Inappropriate Medications (PIMs) in nursing home care in Malaysia as defined by Screening Tool of Older Peoples Prescriptions (STOPP) and Beers criteria. Four Nursing Homes situated in Penang, Malaysia. A multicenter and cross-sectional study was conducted over 2 months period at four large non-governmental organizations nursing homes in Penang, Malaysia. The study population included older residents (≥65 years old) taking at least one medication. Residents who had been diagnosed with dementia or taking anti dementia drugs, delirium, too frail or refused to give consent were excluded. Demographic, clinical data and concurrent medications were collected through direct interview and also by reviewing medical records. STOPP and Beers criteria were applied in the medical review to screen for PIMs. Potentially Inappropriate Medication using STOPP and Beers criteria. Two hundred eleven residents were included in the study with the median age of 77 (inter quartile range (IQR) 72-82) years. Median number of prescription medicines was 4 (IQR 1-14). STOPP identified less residents (50 residents, 23.7 %) being prescribed on PIMs compared with Beers criteria (69 residents, 32.7 %) (p older residents living in the nursing homes and are associated with number of medications and longer nursing home stay. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.

  5. Detecting Inappropriate Access to Electronic Health Records Using Collaborative Filtering.

    Science.gov (United States)

    Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila

    2014-04-01

    Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility's security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized "finger-print" based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access.

  6. Inappropriate Practices in Fitness Testing and Reporting: Alternative Strategies

    Science.gov (United States)

    Zhu, Xihe; Davis, Summer; Kirk, T. Nicole; Haegele, Justin A.; Knott, Stephen E.

    2018-01-01

    Fitness education is becoming an integrated component for many physical education programs. As such, many physical educators conduct health-related fitness tests on a regular basis. Some states even mandate certain types of physical fitness tests to be administered and reported annually or by semester. Yet, inappropriate practices have been…

  7. Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

    Directory of Open Access Journals (Sweden)

    West LM

    2012-12-01

    Full Text Available Appropriate prescribing remains an important priority in all medical areas of practice. Objective: The objective of this study was to apply a Medication Appropriateness Index (MAI to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED.Method: This study was carried out at Malta’s general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for. Results: Treatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92% patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1% medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19. The most common medication classes with appropriateness problems were supplements (20.1%, antibiotics (20.0% and steroids (19.8%. The most common problems involved incorrect directions (26% and incorrect dosages (18.5%. There were 36 omitted medications with untreated indications. Conclusion: There is considerable inappropriate prescribing which could have significant negative effects regarding patient care.

  8. The challenge of nuclear proliferation control in South Asia

    International Nuclear Information System (INIS)

    Mian, J.A.

    1996-01-01

    Prevention of nuclear weapon proliferation in South Asia is considered a a difficult challenge. The paper discusses the difficulties met in implementing the nuclear non-proliferation policy due to numerous disputes concerning China, North and South Korea, India and Pakistan, and the countries of former Soviet Union. Matters preventing proliferation are mentioned as well as obstacles to non-proliferation proposing that decisions whether voluntary or, eventually, compulsory would have to be consistently enforced by the Security Council, if states are to rely upon those methods for their security

  9. Inappropriate shocks in the subcutaneous ICD: Incidence, predictors and management

    NARCIS (Netherlands)

    Olde Nordkamp, Louise R. A.; Brouwer, Tom F.; Barr, Craig; Theuns, Dominic A. M. J.; Boersma, Lucas V. A.; Johansen, Jens B.; Neuzil, Petr; Wilde, Arthur A. M.; Carter, Nathan; Husby, Michael; Lambiase, Pier D.; Knops, Reinoud E.

    2015-01-01

    The entirely subcutaneous implantable cardioverter-defibrillator (S-ICD) eliminates the need for transvenous leads, and therefore has the potential to improve lead-longevity and reduce lead-related complications. The S-ICD has a morphology-based sensing algorithm of which inappropriate shocks have

  10. Standardized programming to reduce the burden of inappropriate therapies in implantable cardioverter defibrillators - Single centre follow up results

    Directory of Open Access Journals (Sweden)

    U. Boles

    2018-03-01

    Full Text Available Background: Current algorithms and device morphology templates have been proposed in current Implantable Cardioverter-Defibrillators (ICDs to minimize inappropriate therapies (ITS, but this has not been completely successful. Aim: Assess the impact of a deliberate strategy of using an atrial lead implant with standardized parameters; based on all current ICD discriminators and technologies, on the burden of ITS. Method: A retrospective single-centre analysis of 250 patients with either dual chamber (DR ICDs or biventricular ICDs (CRTDs over a (41.9 ± 27.3 month period was performed. The incidence of ITS on all ICD and CRTD patients was chronicled after the implementation of standardized programming. Results: 39 events of anti-tachycardial pacing (ATP and/or shocks were identified in 20 patients (8% incidence rate among patients. The total number of individual therapies was 120, of which 34% were inappropriate ATP, and 36% were inappropriate shocks. 11 patients of the 250 patients received ITS (4.4%. Of the 20 patients, four had ICDs for primary prevention and 16 for a secondary prevention. All the episodes in the primary indication group were inappropriate, while seven patients (43% of the secondary indication group experienced inappropriate therapies. Conclusions: The burden of ITS in the population of patients receiving ICDs was 4.4% in the presence of atrial leads. The proposed rationalized programming criteria seems an effective strategy to minimize the burden of inappropriate therapies and will require further validation. Keywords: Implantable cardioverter-defibrillator (ICDs, Inappropriate therapies, Standardized programming

  11. Quetiapine effective in treatment of inappropriate sexual behavior of lewy body disease with predominant frontal lobe signs.

    Science.gov (United States)

    Prakash, Ravi; Pathak, Amit; Munda, Sanjay; Bagati, Dhruv

    2009-01-01

    Dementia of Lewy body disease is the second most common degenerative cause of dementia after Alzheimer's disease, among all the dementias. The core features are a progressive dementia, fluctuations in cognitive functions, visual hallucinations, and spontaneous parkinsonism. Rapid eye movement sleep behavior disorder, severe neuroleptic sensitivity, and low dopamine transporter uptake in basal ganglia are other suggestive features. Behavioral abnormalities are commonly present in the form of aggressive behavior, irritability, and uninhibited behaviors. These are mostly seen in the advanced stages of dementia. However, inappropriate sexual behavior is uncommonly seen in such cases. Three types of inappropriate sexual behaviors commonly found in cases of dementia are sex talks, sexual acts, and implied sexual acts. Such inappropriate sexual behaviors have not been described adequately in dementia of Lewy body disease. We report inappropriate sexual behaviors in a case of dementia of Lewy body disease, which improved rapidly after treatment with quetiapine.

  12. Assessment of inappropriate antibiotic prescribing among a large cohort of general dentists in the United States.

    Science.gov (United States)

    Durkin, Michael J; Feng, Qianxi; Warren, Kyle; Lockhart, Peter B; Thornhill, Martin H; Munshi, Kiraat D; Henderson, Rochelle R; Hsueh, Kevin; Fraser, Victoria J

    2018-05-01

    The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P = .001). Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. From these authors' definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All

  13. Impact of carvedilol and metoprolol on inappropriate implantable cardioverter-defibrillator therapy

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Abu-Zeitone, Abeer; Jons, Christian

    2013-01-01

    The goal of this study was to evaluate the effects of carvedilol and metoprolol on the endpoint of inappropriate implantable cardioverter-defibrillator therapy in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy) study....

  14. Dementia and inappropriate sexual behavior: What we know and what we need to know

    Directory of Open Access Journals (Sweden)

    Josep Fabà

    2012-06-01

    Full Text Available Traditionally, there has been no place for sexuality in older age. However, research has shown that sexuality plays an important role in older people’s life, even in situations such as dementia. The goal of the article is to review the scientific literature regarding the inappropriate sexual behavior that these kind of patients might present. In order to do so, we will firstly address the definition of inappropriate sexual behavior or, more precisely, its multiple definitions. After that, we will deal with other issues such as its prevalence, factors that can cause its appearance, its consequences and some of the available therapeutic options. Finally, in the last section some recommendations for future research will be provided, such as the need to clarify the concept of inappropriate sexual behavior, to find more efficient ways to address this problem, and the desirability of considering sexuality as a human dimension with a high potential for adaptation in old age.

  15. Brief Report: Reduction of Inappropriate Vocalizations for a Child with Autism Using a Self-Management Treatment Program.

    Science.gov (United States)

    Mancina, Catherine; Tankersley, Melody; Kamps, Debra; Kravits, Tammy; Parrett, Jean

    2000-01-01

    A study examined the effects of a self-management program used to reduce high rates of inappropriate vocalizations (e.g., humming, tongue clucking, perseveration, and echolalic words/phases) in a 12-year-old girl with autism. When self-management was applied to inappropriate vocalizations during leisure, prevocational, and reading tasks, the…

  16. Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials

    Directory of Open Access Journals (Sweden)

    Gjerberg Elisabeth

    2011-04-01

    Full Text Available Abstract Background Studies have shown that residents in nursing homes often are exposed to inappropriate medication. Particular concern has been raised about the consumption of psychoactive drugs, which are commonly prescribed for nursing home residents suffering from dementia. This review is an update of a Norwegian systematic review commissioned by the Norwegian Directorate of Health. The purpose of the review was to identify and summarise the effect of interventions aimed at reducing potentially inappropriate use or prescribing of drugs in nursing homes. Methods We searched for systematic reviews and randomised controlled trials in the Cochrane Library, MEDLINE, EMBASE, ISI Web of Knowledge, DARE and HTA, with the last update in April 2010. Two of the authors independently screened titles and abstracts for inclusion or exclusion. Data on interventions, participants, comparison intervention, and outcomes were extracted from the included studies. Risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Table and GRADE, respectively. Outcomes assessed were use of or prescribing of drugs (primary and the health-related outcomes falls, physical limitation, hospitalisation and mortality (secondary. Results Due to heterogeneity in interventions and outcomes, we employed a narrative approach. Twenty randomised controlled trials were included from 1631 evaluated references. Ten studies tested different kinds of educational interventions while seven studies tested medication reviews by pharmacists. Only one study was found for each of the interventions geriatric care teams, early psychiatric intervening or activities for the residents combined with education of health care personnel. Several reviews were identified, but these either concerned elderly in general or did not satisfy all the requirements for systematic reviews. Conclusions Interventions using educational outreach, on-site education given alone or as part of an

  17. Successful recovery from iatrogenic severe hypernatremia and severe metabolic acidosis resulting from accidental use of inappropriate bicarbonate concentrate for hemodialysis treatment

    Directory of Open Access Journals (Sweden)

    Guruprasad P Bhosale

    2015-01-01

    Full Text Available Bicarbonate dialysis is the treatment modality of choice for correction of metabolic acidosis in chronic renal failure. However, improper selection of dialysate concentrate can result in life-threatening human errors. We report a case of iatrogenic severe hypernatremia (sodium 207 mEq/L and severe metabolic acidosis (pH 6.65 that resulted due to accidental use of inappropriate bicarbonate concentrate for hemodialysis treatment. There was successful recovery in this patient with no neurological sequelae. To the best of our knowledge, this is the first case report in adults of severe hypernatremia along with severe metabolic acidosis due to error in the preparation of dialysis fluid.

  18. Inappropriate drug donations: what has happened since the 1999 WHO guidelines?

    Science.gov (United States)

    van Dijk, D P; Dinant, G; Jacobs, J A

    2011-08-01

    Drug donations to developing countries may be part of medical relief operations in acute emergencies, development aid in non-emergency situations, or a corporate donations programme. After a number of documented inappropriate drug donations, the World Health Organization developed the 'Guidelines for Drug Donations', with the second and final version published in 1999. We reviewed the medical literature on drug donations since the Guidelines publication in 1999. Literature was retrieved from PubMed and other on-line databases as well as from relevant websites providing medical literature for use in developing countries. We considered the following donations to be inappropriate: (i) essential drugs in excessive quantities; (ii) mixed unused drugs (unsorted medicines and free samples); and (iii) drug dumping (large quantities of useless medicines). We retrieved 25 publications dated after 1999, including 20 and 5 from the scientific literature and 'grey' literature (technical reports, working papers), respectively. New information concerned emergencies in East Timor, Mozambique, El Salvador, Gujarat State (India), Aceh (Indonesia) and Sri Lanka. Except for East Timor and Gujarat, inappropriate donations still occurred, accounting for 85%, 37%, 70% and 80% of donations in Mozambique, El Salvador, Aceh and Sri Lanka, respectively. Very little information was found on drug donations in non-emergency situations. There are few recent reports on the compliance of drug donations with the World Health Organization guidelines. For emergency situations, there is still room for improvement. Drug donations in non-emergency situations need to be evaluated. A reform of drug donations policy is needed.

  19. Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil.

    Science.gov (United States)

    Guimarães, Djalma S; Soares, Eduardo J O; Júnior, Gileno Ferraz; Medeiros, Denise D

    2015-02-18

    The current economic and social context has required health systems to provide top quality services and to be efficient in controlling costs. An obstacle to achieve these goals is the inappropriate health services demand. This study aims to present these inappropriate health service demand determinants from data on telephone calls made to a medical advice call centre. This study used a Brazilian medical advice call centre data sample in the period of November and December 2012 (n = 19690), which supplied data on the user's initial request, the physician's recommendation, information on the patient and circumstances (the day and time of the day of the telephone call). The convergence between user intent and medical recommendation consists in adequate demand; otherwise the divergence consists in an inadequate one. In this way, using a logistic regression model, the critical factors that determine inappropriate health services request could be estimated. In general, the user's initial intent is the most critical for the inappropriate health system demand occurrence: the greater the complexity of the patient's initial intent, the greater the chance the intent is wrong: (OR: 1.160; 95% CI: 1.113-1.210). With regard to the social characteristics, men are more likely to make inappropriate requests (OR: 1.102; 95% CI: 1038-1169); as well as youngsters are more likely to use the system incorrectly (OR = .993; 95% CI: .992 - .994). Regarding the circumstances (day and time of the call), requests in the final hours of the day and on days close to the weekend are more likely to be the inappropriate ones (OR: 1.082 for each six hour increase; 95% CI: 1.049-1.116) and weekday (OR: 1.017 for each day increase; 95% CI: 1.002-1.032). The critical profile for the inappropriate use occurrence consists of males and youngsters, who use the health service in the final hours of the day and at weekends, and mainly want to use more complex services. A practical implication of this

  20. Impact of oncology-related direct-to-consumer advertising: association with appropriate and inappropriate prescriptions.

    Science.gov (United States)

    Abel, Gregory A; Chen, Kun; Taback, Nathan; Hassett, Michael J; Schrag, Deborah; Weeks, Jane C

    2013-03-01

    Little is known about the impact of direct-to-consumer advertising (DTCA) on appropriate versus inappropriate prescribing. Aromatase inhibitor (AI) therapy for breast cancer provides an ideal paradigm for studying this issue, because AIs have been the focus of substantial DTCA, and because they should only be used in postmenopausal women, age can serve as a simple surrogate marker of appropriateness. Data regarding national DTCA spending for the AIs were obtained from TNS Multimedia; hormonal therapy prescription data were obtained from IMS Health. Time series analyses were performed to characterize the association between monthly changes in DTCA spending for the AIs and monthly changes in the proportion of all new hormonal therapy prescriptions represented by the AIs from October 2005 to September 2007. Analyses were stratified by age, considering prescriptions for women ≤ 40 (likely premenopausal) to be inappropriate and those for women > 60 (likely postmenopausal) to be appropriate. Monthly dollars spent on AI-associated DTCA varied considerably ($118,600 to $22,019,660). Time series analysis revealed that for every million dollars spent on DTCA for the AIs, there was an associated increase 3 months later in the new AI prescription proportion of 0.15% for all ages (P 60 years (P < .0001), but no significant change for those ≤ 40 at any time from 0 to 6 months. DTCA for the AIs was associated with increases in appropriate prescriptions with no significant effect on inappropriate prescriptions, suggesting that DTCA may not foster inappropriate medication use for certain drug classes. Copyright © 2012 American Cancer Society.

  1. Clinical analysis of asthenopia caused by wearing inappropriate glasses in college students

    Directory of Open Access Journals (Sweden)

    Li Wang

    2015-01-01

    Full Text Available AIM: To proposed control measures by exploring visual fatigue caused by college students wearing inappropriate glasses.METHODS: A total of 124 cases of asthenopia patients underwent optometry students audition, checked the original spectacles; TOPCON-CL100 computer center was used to checked the original mirror glasses(glasses, the distance between the optical center; with near vision as the standard examination table nearly with vergence and regulation near point, and checked the visual function. RESULTS: All 124 cases(248 eyeshad refractive errors, 77% were spherical mirror and 69% column mirror with error ≥±0.50D, and the pupil center distance from the lens had significant difference(U=5.27, PCONCLUSION: Students wearing inappropriate spectacle asthenopia is caused by one of the main scientific wearing glasses can effectively control asthenopia.

  2. Hyperthyroidism due to inappropriate secretion of thyroid-stimulating hormone: diagnosis and management.

    Science.gov (United States)

    Hermus, A; Ross, H; van Liessum, P; Naber, A; Smals, A; Kloppenborg, P

    1991-06-01

    The case histories of three patients with hyperthyroidism due to overproduction of thyroid-stimulating hormone (TSH) by the pituitary gland are described. In the first patient treatment with the T3-metabolite 3,5,3'-triiodothyroacetic acid (TRIAC) led to complete clinical and biochemical normalization. In the second patient treatment with the dopaminergic agonist bromocriptine led to a temporal amelioration of hyperthyroidism. In the third patient, who was the only one with a proven pituitary adenoma, hypersecretion of TSH could be controlled by administration of the somatostatin analogue octreotide. It is emphasized that patients with this disorder should preferably not be treated with thyrostatic drugs, radioactive iodine or thyroid surgery. The success rate of these treatment modalities is lower than normal, they may lead to an increase of goiter size, and they potentially may promote growth or development of a TSH-producing adenoma. Treatment should be aimed at diminishing TSH hypersecretion.

  3. Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria

    Directory of Open Access Journals (Sweden)

    Bonet M

    2012-06-01

    Full Text Available Objective: The aims of this study were to identify potentially inappropriate prescribing using the Beers and STOPP criteria. The START criteria were applied to detect prescription omission in the geriatric population. We compared the utility of these criteria in institutionalised older people.Methods: Descriptive study reviewing the medication and clinical records of 81 residents (aged 65 years and more by pharmacists in a nursing home in the Lleida region (Spain.Results: The mean patients’ age was 84 (SD=8 years, with an average of 5 drugs per resident (total prescriptions: 416 medicines. The Beers criteria identified potentially inappropriate medication use in 25% of patients and 48% of patients used at least 1 inappropriate medication according to STOPP criteria. The most frequent potentially inappropriate medications for both criteria were long-acting benzodiazepines and NSAIDs. START detected 58 potential prescribing omissions in 44% of patients. Calcium-vitamin D supplementation in osteoporosis was the most frequent rule (15%, but omissions corresponding to the cardiovascular system implied 23% of patients.Conclusion: The STOPP-START criteria reveal that potentially inappropriate prescribing (PIP is a highly prevalent problem among Spanish nursing home residents, and a statistically significant positive correlation was found between the number of medicines prescribed and the number of PIP detected in this study. The STOPP criteria detect a larger number of PI medications in this geriatric population than the Beers criteria. The prescribing omissions detected by the START criteria are relevant and require intervention. Pharmacists’ review of medications may help identify potentially inappropriate prescribing and, through an interdisciplinary approach, working with physicians may improve prescribing practices among geriatric residents of nursing homes.

  4. Long-Term Outcomes in a Family with Nephrogenic Syndrome of Inappropriate Antidiuresis

    Directory of Open Access Journals (Sweden)

    Yoon Hi Cho

    2009-01-01

    Full Text Available We report a familial case of the nephrogenic syndrome of inappropriate antidiuresis (NSIAD, including 30-year followup data on two patients. The proband and one maternal uncle presented in their infancy with severe recurrent hyponatremia, and clinical pictures consistent with the syndrome of inappropriate antidiuretic hormone (SIADH in the absence of an elevated ADH level. They were both confirmed to be hemizygous for the R137C mutation on the V2R gene (AVPR2, the same locus of the gain of function mutation demonstrated in the original reports of this condition. The proband's mother was identified as an asymptomatic carrier of this X-linked condition. Our case describes a favourable long-term outcome for NSIAD, in particular, successful treatment with oral urea during the infancy period, and with self-regulated precautions on fluid intake into adult life.

  5. Long-Term Outcomes in a Family with Nephrogenic Syndrome of Inappropriate Antidiuresis

    Directory of Open Access Journals (Sweden)

    Rosenthal Stephen

    2009-12-01

    Full Text Available We report a familial case of the nephrogenic syndrome of inappropriate antidiuresis (NSIAD, including 30-year followup data on two patients. The proband and one maternal uncle presented in their infancy with severe recurrent hyponatremia, and clinical pictures consistent with the syndrome of inappropriate antidiuretic hormone (SIADH in the absence of an elevated ADH level. They were both confirmed to be hemizygous for the R137C mutation on the V2R gene (AVPR2, the same locus of the gain of function mutation demonstrated in the original reports of this condition. The proband's mother was identified as an asymptomatic carrier of this X-linked condition. Our case describes a favourable long-term outcome for NSIAD, in particular, successful treatment with oral urea during the infancy period, and with self-regulated precautions on fluid intake into adult life.

  6. Substantial reduction of inappropriate tablet splitting with computerised decision support: a prospective intervention study assessing potential benefit and harm

    Directory of Open Access Journals (Sweden)

    Quinzler Renate

    2009-06-01

    Full Text Available Abstract Background Currently ambulatory patients break one in four tablets before ingestion. Roughly 10% of them are not suitable for splitting because they lack score lines or because enteric or modified release coating is destroyed impairing safety and effectiveness of the medication. We assessed impact and safety of computerised decision support on the inappropriate prescription of split tablets. Methods We performed a prospective intervention study in a 1680-bed university hospital. Over a 15-week period we evaluated all electronically composed medication regimens and determined the fraction of tablets and capsules that demanded inappropriate splitting. In a subsequent intervention phase of 15 weeks duration for 10553 oral drugs divisibility characteristics were indicated in the system. In addition, an alert was generated and displayed during the prescription process whenever the entered dosage regimen demanded inappropriate splitting (splitting of capsules, unscored tablets, or scored tablets unsuitable for the intended fragmentation. Results During the baseline period 12.5% of all drugs required splitting and 2.7% of all drugs (257/9545 required inappropriate splitting. During the intervention period the frequency of inappropriate splitting was significantly reduced (1.4% of all drugs (146/10486; p = 0.0008. In response to half of the alerts (69/136 physicians adjusted the medication regimen. In the other half (67/136 no corrections were made although a switch to more suitable drugs (scored tablets, tablets with lower strength, liquid formulation was possible in 82% (55/67. Conclusion This study revealed that computerised decision support can immediately reduce the frequency of inappropriate splitting without introducing new safety hazards.

  7. Urea for long-term treatment of syndrome of inappropriate secretion of antidiuretic hormone.

    Science.gov (United States)

    Decaux, G; Genette, F

    1981-10-24

    The efficacy of oral urea in producing a sufficiently high osmotic diuresis was tested in seven patients with the syndrome of inappropriate secretion of antidiuretic hormone. In all patients urea corrected the hyponatraemia despite a normal fluid intake. Five patients were controlled (serum sodium concentration greater than 128 mmol(mEq)/1) with a dose of 30 g urea daily, and two with 60 g daily. The patients who needed 30 g drank 1-2 1 of fluid daily, while those who needed 60 g drank up to 3.1 per day. No major side effects were noted, even after treatment periods of up to 270 days. These findings suggest that urea is a safe and efficacious treatment of the syndrome of inappropriate secretion of antidiuretic hormone.

  8. Health IT and inappropriate utilization of outpatient imaging: A cross-sectional study of U.S. hospitals.

    Science.gov (United States)

    Appari, Ajit; Johnson, M Eric; Anthony, Denise L

    2018-01-01

    To determine whether the use of information technology (IT), measured by Meaningful Use capability, is associated with lower rates of inappropriate utilization of imaging services in hospital outpatient settings. A retrospective cross-sectional analysis of 3332 nonfederal U.S. hospitals using data from: Hospital Compare (2011 outpatient imaging efficiency measures), HIMSS Analytics (2009 health IT), and Health Indicator Warehouse (market characteristics). Hospitals were categorized for their health IT infrastructure including EHR Stage-1 capability, and three advanced imaging functionalities/systems including integrated picture archiving and communication system, Web-based image distribution, and clinical decision support (CDS) with physician pathways. Three imaging efficiency measures suggesting inappropriate utilization during 2011 included: percentage of "combined" (with and without contrast) computed tomography (CT) studies out of all CT studies for abdomen and chest respectively, and percentage of magnetic resonance imaging (MRI) studies of lumbar spine without antecedent conservative therapy within 60days. For each measure, three separate regression models (GLM with gamma-log link function, and denominator of imaging measure as exposure) were estimated adjusting for hospital characteristics, market characteristics, and state fixed effects. Additionally, Heckman's Inverse Mills Ratio and propensity for Stage-1 EHR capability were used to account for selection bias. We find support for association of each of the four health IT capabilities with inappropriate utilization rates of one or more imaging modality. Stage-1 EHR capability is associated with lower inappropriate utilization rates for chest CT (incidence rate ratio IRR=0.72, p-value value value value value value value use of Stage-1 Meaningful Use capable EHR systems along with advanced imaging related functionalities could have a beneficial impact on reducing some of the inappropriate utilization of

  9. Position paper on nuclear proliferation issues preventing nuclear proliferation. A duty for the nuclear community

    Energy Technology Data Exchange (ETDEWEB)

    Goldschmidt, Pierre; Bonin, Bernard [ENS High Scientific Council, Brussels (Belgium)

    2010-06-15

    The production of electricity from nuclear power plants is widely seen today as having an increasing role to play in meeting global energy requirements in a sustainable manner. Conscious of the inherently sensitive nature of nuclear technology and materials the ENS-HSC (European Nuclear Society - High Scientific Council) is well aware that a severe safety, security, environmental or proliferation mishap stemming from nuclear energy anywhere in the world would undermine the potential for nuclear energy to contribute to the global energy supply and the minimization of harmful carbon emissions. While the safety of nuclear power plants has continuously improved over the last three decades, the same degree of success cannot be claimed when it comes to the achievements of the international community in stemming the risk of nuclear weapons proliferation. This unfortunate situation is due to both technical and political reasons. The European nuclear industry is committed to the exclusively peaceful use of nuclear energy and to export nuclear facilities and related materials, equipment and technology solely in accordance with relevant national export laws and regulations, Nuclear Suppliers Group guidelines and pertinent United Nations Security Council Resolutions. The ENS-HSC considers that, as a manifestation of their strong commitment to nonproliferation, it is important for the nuclear industry to pay special attention to and promote proliferation-resistant designs and to take IAEA safeguards requirements into account at the design stage. Preventing nuclear proliferation is primarily the responsibility of states but, as major stakeholders, the nuclear industry and scientific community should actively support nuclear disarmament as foreseen in the Non-Proliferation Treaty and measures necessary to strengthen the non-proliferation regime, particularly the international control of the flux of nuclear material and technology. (orig.)

  10. Position paper on nuclear proliferation issues preventing nuclear proliferation. A duty for the nuclear community

    International Nuclear Information System (INIS)

    Goldschmidt, Pierre; Bonin, Bernard

    2010-01-01

    The production of electricity from nuclear power plants is widely seen today as having an increasing role to play in meeting global energy requirements in a sustainable manner. Conscious of the inherently sensitive nature of nuclear technology and materials the ENS-HSC (European Nuclear Society - High Scientific Council) is well aware that a severe safety, security, environmental or proliferation mishap stemming from nuclear energy anywhere in the world would undermine the potential for nuclear energy to contribute to the global energy supply and the minimization of harmful carbon emissions. While the safety of nuclear power plants has continuously improved over the last three decades, the same degree of success cannot be claimed when it comes to the achievements of the international community in stemming the risk of nuclear weapons proliferation. This unfortunate situation is due to both technical and political reasons. The European nuclear industry is committed to the exclusively peaceful use of nuclear energy and to export nuclear facilities and related materials, equipment and technology solely in accordance with relevant national export laws and regulations, Nuclear Suppliers Group guidelines and pertinent United Nations Security Council Resolutions. The ENS-HSC considers that, as a manifestation of their strong commitment to nonproliferation, it is important for the nuclear industry to pay special attention to and promote proliferation-resistant designs and to take IAEA safeguards requirements into account at the design stage. Preventing nuclear proliferation is primarily the responsibility of states but, as major stakeholders, the nuclear industry and scientific community should actively support nuclear disarmament as foreseen in the Non-Proliferation Treaty and measures necessary to strengthen the non-proliferation regime, particularly the international control of the flux of nuclear material and technology. (orig.)

  11. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients.

    LENUS (Irish Health Repository)

    Hamilton, Hilary

    2011-06-13

    Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness.

  12. Potentially Inappropriate Medication Use Among Elderly Home Care Patients in Europe

    Czech Academy of Sciences Publication Activity Database

    Fialová, D.; Topinková, E.; Gambassi, G.; Finne-Soveri, H.; Jónsson, P.; Carpenter, I.; Schroll, M.; Onder, G.; Sorbye, L.W.; Wagner, C.; Reissigová, Jindra; Bernabei, R.

    2005-01-01

    Roč. 293, č. 11 (2005), s. 1348-1358 ISSN 0098-7484 Institutional research plan: CEZ:AV0Z10300504 Keywords : potentially inappropriate medication * prevalence * independent correlates Subject RIV: FQ - Public Health Care , Social Medicine Impact factor: 23.332, year: 2005 http://jama.ama-assn.org/cgi/content/abstract/293/11/1348

  13. Real-Time Clinical Decision Support Decreases Inappropriate Plasma Transfusion.

    Science.gov (United States)

    Shah, Neil; Baker, Steven A; Spain, David; Shieh, Lisa; Shepard, John; Hadhazy, Eric; Maggio, Paul; Goodnough, Lawrence T

    2017-08-01

    To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less. The alert was suppressed for massive transfusion and within operative or apheresis settings. The plasma order was automatically removed upon alert acceptance while clinical exception reasons allowed for continued transfusion. Alert impact was studied comparing a 7-month control period with a 4-month intervention period. Monthly plasma utilization decreased 17.4%, from a mean ± SD of 3.40 ± 0.48 to 2.82 ± 0.6 plasma units per hundred patient days (95% confidence interval [CI] of difference, -0.1 to 1.3). Plasma transfused below an INR of 1.7 or less decreased from 47.6% to 41.6% (P = .0002; odds ratio, 0.78; 95% CI, 0.69-0.89). The alert recommendation was accepted 33% of the time while clinical exceptions were chosen in the remaining cases (active bleeding, 31%; other clinical indication, 33%; and apheresis, 2%). Alert acceptance rate varied significantly among different provider specialties. Clinical decision support can help curtail inappropriate plasma use but needs to be part of a comprehensive strategy including audit and feedback for comprehensive, long-term changes. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. [Prevalence of potentially inappropriate drug prescription in the elderly].

    Science.gov (United States)

    Fajreldines, A; Insua, J; Schnitzler, E

    2016-01-01

    One of the causes of preventable adverse drug events (ADES) in older patients constitutes inappropriate prescription of drugs (PIM). The PIM is where risks exceed the clinical benefit. Several instruments can be use to measure this problem, the most used are: a) Beers criteria; b) Screening tool to Older People Potentially inappropriate Prescription (STOPP); c) Screening tool to Alert Doctors to Right Appropriate indicated Treatments (START); d) The Medication Appropriateness Index (MAI). This study aims to assess the prevalence of PIM, in a population of older adults in three clinical scopes of university hospital. cross sectional study of 300 cases from a random sample of fields: hospitalization (n=100), ambulatory (n=100) and emergency (n=100), all patients over 65 years old or more who where treated at our hospital. 1355 prescription drugs were analized, finding patients hospitalized (PIM) of 57.7%, 55%, 26%, and 80% according to Beers, in ambulatory 36%, 36.5%, 5% and 52% with the same tools and in emergency 35%, 35%, 6% y 52% with the same tools. Was found significant association the PIM with polipharmacy with Beers, STOPP and MAI. results can be compare to world literature (26-80% vs 11-73.1%). The STOPP-START used in an integrated manner would be best estimating the problem of PIM. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Inappropriate emergency laboratory test ordering: defensive or peer evidence shared based medicine?

    Directory of Open Access Journals (Sweden)

    C. Descovich

    2013-05-01

    Full Text Available BACKGROUND The laboratory overuse is widely prevalent in hospital practice, mostly in the emergency care. Reasons for excessive and inappropriate test-ordering include defensive behaviour and fear or uncertainty, lack of experience, the misuse of protocols and guidelines, “routine” and local attitudes, inadequate educational feedback and clinician’s unawareness about the cost of examinations and their related implications. AIM OF THE STUDY AND METHODS The primary target of our working group was to reduce inappropriate ordering on a urgent basis test, implementing further examinations not yet previewed in the hospital panel of the available urgencies, according to the evidence based diagnosis concept. The secondary goal was to indicate strategies of re-engineering of the processes, improving turnaround time in the laboratory management of emergencies. After evaluating, as first intervention, the more reliable sources for practice guidelines, systematic reviews and RCTs, the committee further discussed main topics with in-hospital stakeholders, selected from Emergency, Internal Medicine and Surgery Depts. The working group, in many subsequent audits, tried to obtain a systematic feed back with all involved professionals. RESULTS After reviewing literature’s evidence, the board constrained testing options by defining the basic emergency laboratory panel tests (blood type, hemogram, blood urea nitrogen, plasma creatinine, glucose, sodium, potassium, chloride, osmolarity, CRP, bicarbonate, CPK, creatine phosphokinase-MB, myoglobin, troponin, BNP and NT-proBNP, PT-INR, PTT, D-dimer, beta- HCG, biochemical urinalysis etc.. As final result, the proposed tests reduced the overall number of inappropriate investigations and increased, with newer and updated tests, the available panel for critical patients. DISCUSSION A collegiate review of data reporting, in-hospital deepening of problems and the inter- professional discussion of the evidences

  16. A qualitative examination of inappropriate hospital admissions and lengths of stay

    Directory of Open Access Journals (Sweden)

    Hammond Christina L

    2009-03-01

    Full Text Available Abstract Background Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions. We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group. Methods Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach. Results The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS, including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations. Conclusion Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.

  17. Proximal femoral osteosarcoma: Diagnostic challenges translate into delayed and inappropriate management.

    Science.gov (United States)

    Dahan, M; Anract, P; Babinet, A; Larousserie, F; Biau, D

    2017-11-01

    The proximal femuris is an uncommon site of osteosarcoma. The unusual manifestations at this site may lead to diagnostic and therapeutic mistakes. We therefore performed a retrospective study to estimate the proportions of patients with imaging study findings and/or clinical manifestations typical for osteosarcoma and/or inappropriate treatment decisions. Proximal femoral osteosarcoma often produces atypical clinical and radiological presentations. Consecutive patients who underwent surgery at our center to treat proximal femoral osteosarcoma were included. For each patient, we collected the epidemiological characteristics, clinical symptoms, imaging study findings, treatment, and tumor outcome. Proportions were computed with their confidence intervals. Twelve patients had surgery for proximal femoral osteosarcoma between 1986 and 2015. Imaging findings were typical in 1 (8%) patient; they consisted of ill-defined osteolysis in 11/12 (92%) patients, a periosteal reaction in 1/12 (8%) patient, soft tissue involvement in 7/12 (58%) patients, and immature osteoid matrix in 11/12 (92%) patients. No patient had the typical combination of pain with a soft tissue swelling. Management was inappropriate in 2/12 (17%) patients, who did not undergo all the recommended imaging studies before surgery and were treated in another center before the correct diagnosis was established. At last follow-up, 4 patients had died (after a mean of 7 years) and 8 were alive (after a mean of 4 years). Proximal femoral osteosarcoma is uncommon and rarely produces the typical clinical and imaging study findings. The atypical presentation often results in diagnostic errors and inappropriate treatments. Ill-defined osteolysis on standard radiographs should prompt computed tomography or magnetic resonance imaging of the proximal femur. Treatment in a specialized center is imperative. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Future non-proliferation challenges

    International Nuclear Information System (INIS)

    Yelchenko, Volodymyr

    2008-01-01

    Having chaired the Second Session of the Preparatory Committee Mr. Volodymyr Yelchenko noted that the NPT States parties reaffirmed the important role of the Treaty as the cornerstone of the global non-proliferation regime. They stressed that non-compliance with the Treaty provisions by States parties undermined non-proliferation and placed emphasis on the mutually reinforcing nature of disarmament and non-proliferation, and due respect for the right of States parties to the peaceful use of nuclear energy in conformity with the treaty. They reaffirmed the importance of promoting the peaceful uses of nuclear energy and international nuclear cooperation for peaceful purposes in ways consistent with the non-proliferation goal of the Treaty. The universality aspect was brought to the front with the lack of progress in this area. States parties called upon India, Israel and Pakistan to accede to the Treaty as non-nuclear-weapons states, promptly and without conditions and to bring into force comprehensive safeguards agreements, together with Additional Protocols, for ensuring non-proliferation. There is concern that non-States actors could gain access to weapons of mass destruction. One of the underlying themes at the Second Prepcom was the total elimination of nuclear weapons as the only absolute guarantee against their proliferation. Negative consequences to nuclear non-proliferation were also mentioned in the context of the abrogation of the Anti-Ballistic Missile Treaty and the development of missile defense systems, with the risk of a new arms race on Earth and in outer space. The importance of the immediate commencement of negotiations in the Conference of Disarmament on a treaty concerning fissile material for nuclear weapons or other nuclear explosive devices and the urgent conclusion of such a treaty as a beneficial step towards non-proliferation was stressed. The NPT states parties reaffirmed the role of the IAEA as the sole competent authority responsible for

  19. Women born preterm or with inappropriate weight for gestational age are at risk of subsequent gestational diabetes and pre-eclampsia

    DEFF Research Database (Denmark)

    á Rogvi, Rasmus; Forman, Julie Lyng; Damm, Peter

    2012-01-01

    Low birthweight, which can be caused by inappropriate intrauterine growth or prematurity, is associated with development of gestational diabetes mellitus (GDM) as well as pre-eclampsia later in life, but the relative effects of prematurity and inappropriate intrauterine growth remain uncertain....

  20. Sudden Onset of Life-Threatening Methaemoglobinaemia After Intake of Inappropriately Stored Vegetable (Collard Greens Meal in a 2.5-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Ozlem Cakmak Yilmaz

    2015-06-01

    Full Text Available Acquired methaemoglobinaemia most commonly occurs due to intake of or contact to certain drugs, such as local anesthetics. However, intake of certain vegetables which are essential for a healthy diet may also cause methaemoglobinaemia due to their high nitrate or nitrite content, and prolonged and inappropriate storage after preparation of vegetable meals increases the risk. We present a 2.5-year-old girl with Down's syndrome who presented with central cyanosis due to severe methaemoglobinemiae with a methaemoglobin level of 62% after intake of collard greens (Brassica oleracea var. acephala soup. Although development of methaemoglobinaemia after food intake has been reported rarely before, recognition of this potentially life-threatening condition early in its course may be life-saving. [Cukurova Med J 2015; 40(2.000: 353-357

  1. Argentina’s nuclear development and the non-proliferation regime

    OpenAIRE

    Sandra Colombo; Cristian Guglielminotti; María Nevia Vera

    2017-01-01

    The development and transfer of nuclear technology have been put under strict control due to its possible military use, leading to the creation of international non-proliferation regimes. One of the latest proposals was the creation of multilateral banks of low enriched uranium (leu). The article states that, under the goal of non-proliferation, this initiative can contribute to accentuate the asymmetry in the distribution of world economic and political power, damaging the endogenous develop...

  2. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

    Science.gov (United States)

    Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

    2006-06-01

    Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P private sector for males (21% vs. 24%, P private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.

  3. For a consistent policy in the struggle against proliferation networks

    International Nuclear Information System (INIS)

    Schlumberger, Guillaume; Gruselle, Bruno

    2007-01-01

    Proliferation networks operate like companies. They must be capable of coordinating a series of elementary logistics, financial and technical functions. Due to the increase in worldwide exchanges, the reinforcement of existing export control tools alone will not be sufficient to face the increase in proliferation flows. Despite widespread reporting in the media, interdiction operations also can only have limited effect on networks, due to their occasional nature, if they are undertaken independently of an approach targeting other functions. It also seems hardly realistic to wish to neutralize a proliferation network only by freezing part of its credits in the framework of a repressive approach. Setting up an overall policy provides a means of coordinating intelligence actions, repression tools and interdiction means both nationally and internationally, and therefore appears as the only viable solution in the struggle against proliferation networks. This is a complex task for it requires the organization of inter-ministerial (or interagency) responsibilities, and in particular it requires an equilibrium between long term and short term actions. Finally, it depends on the reinforcement of links between the administrations involved and private participants including service companies, financial institutions and enterprises. (authors)

  4. Tariffs, Quotas, and the Corrupt Purchasing of Inappropriate Technology

    OpenAIRE

    Neil Campbell

    2005-01-01

    This paper develops a simple model where a manager of a firm in a Less-Developed Country (LDC) has the choice of whether or not to purchase an inappropriate technology in return for a bribe (kick-back) from the supplier of the technology. Provided that the manager achieves some minimum level of profit, the manager has a positive probability of not getting caught taking the bribe. The actual size of the bribe is determined by Nash axiomatic bargaining between the manager and the supplier. An i...

  5. How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

    Science.gov (United States)

    Piltcher, Otávio Bejzman; Kosugi, Eduardo Macoto; Sakano, Eulalia; Mion, Olavo; Testa, José Ricardo Gurgel; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, José Faibes; Sá, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, Edwin

    Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  6. Rates of inappropriate antiretroviral prescription among injection drug users

    Directory of Open Access Journals (Sweden)

    Bonner Simon

    2007-01-01

    Full Text Available Abstract Background Although the survival benefits of antiretroviral therapy (ART for the treatment of HIV infection are well established, the clinical management of HIV disease continues to present major challenges. There are particular concerns regarding access to appropriate HIV treatment among HIV-infected injection drug users (IDU. Methods In a prospective cohort study of HIV-infected IDU in Vancouver, Canada, we examined initial ART regimens vis-à-vis the provincial government's therapeutic guidelines at the time ART was initiated. Briefly, there have been four sets of guidelines: Era 1 (1992 to November 1995; double-drug (dual NRTIs ART for patients with a CD4 cell count of 350 or less; Era 2 (December 1995 to May 1996; double-drug therapy for patients with a CD4+ cell count of 500 or less; Era 3 (June 1996 to June 1997; triple-drug therapy (dual NRTIs with a PI or NNRTI for patients who had a plasma viral load of > 100,000 HIV-1 RNA copies/mL; dual therapy with two NRTIs for those with a plasma viral load of 5,000 to 100,000 HIV-1 RNA copies/mL; Era 4 (since July 1997; universal use of triple drug therapy as first-line treatment. Results Between May 1996 and May 2003, 431 HIV-infected individuals were enrolled into the cohort. By May 31, 2003, 291 (67.5% individuals had initiated ART. We noted instances of inappropriate antiretroviral prescription in each guideline era, with 9 (53% in Era 1, 3 (12% in Era 2, 22 (28% in Era 3, and 23 (15% in Era 4. Of the 57 subjects who received an inappropriate ART regimen initially, 14 never received the appropriate therapy; among the remaining 43, the median time to the initiation of a guideline-appropriate ART regimen was 12 months (inter-quartile range 5 – 20. Conclusion The present study identified measurable rates of guideline-inappropriate ART prescription for patients who were injection drug users. Rates were highest in the era of dual therapy, although high rates persisted into the triple

  7. Inappropriate prescribing in outpatient healthcare: an evaluation of respiratory infection visits among veterans in teaching versus non-teaching primary care clinics

    Directory of Open Access Journals (Sweden)

    Diane M. Parente

    2017-03-01

    Full Text Available Abstract A recent study led by the Centers for Disease Control and Prevention (CDC revealed at least 30% of antibiotic prescriptions in the outpatient setting were inappropriate. In this study of all ages, among adult patients, results were similar to the overall population, with the majority of inappropriate prescribing relating to respiratory infections. We applied the same methodology to investigate rates of antibiotic prescribing for respiratory tract infections in outpatient primary care clinics at the Providence Veterans Affairs Medical Center. The results of our evaluation reflected comparable rates of inappropriate prescribing, but when stratified by teaching versus non-teaching primary care clinics, inappropriate prescribing was significantly higher in non-teaching clinics (17.6% vs 44.0%, p < .0001. Respiratory infection visits in non-teaching outpatient clinics may be a pragmatic target for antimicrobial stewardship programs.

  8. Inappropriate prescribing and prescribing omissions among drug-related problems using STOPP-START criteria

    NARCIS (Netherlands)

    Verdoorn, M.A.; Kwint, H.-F.; Faber, A.; L. Bouvy, M.

    2013-01-01

    Background and objectives: Medication review has been suggested as a way to prevent drug related problems (DRPs). Screening tools have been formulated to identify potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) respectively called Screening Tool of Older

  9. Inappropriate colonoscopic surveillance of hyperplastic polyps.

    LENUS (Irish Health Repository)

    Keane, R A

    2011-11-15

    Colonoscopic surveillance of hyperplastic polyps alone is controversial and may be inappropriate. The colonoscopy surveillance register at a university teaching hospital was audited to determine the extent of such hyperplastic polyp surveillance. The surveillance endoscopy records were reviewed, those patients with hyperplastic polyps were identified, their clinical records were examined and contact was made with each patient. Of the 483 patients undergoing surveillance for colonic polyps 113 (23%) had hyperplastic polyps alone on last colonoscopy. 104 patients remained after exclusion of those under appropriate surveillance. 87 of the 104 patients (84%) were successfully contacted. 37 patients (8%) were under appropriate colonoscopic surveillance for a significant family history of colorectal carcinoma. 50 (10%) patients with hyperplastic polyps alone and no other clinical indication for colonoscopic surveillance were booked for follow up colonoscopy. This represents not only a budgetary but more importantly a clinical opportunity cost the removal of which could liberate valuable colonoscopy time for more appropriate indications.

  10. Improving Inappropriate Social Behavior of Autistic Students Using the LISTEN Intervention Strategy

    Science.gov (United States)

    Al-Shammari, Zaid; Daniel, Cathy; Faulkner, Paula; Yawkey, Thomas D.

    2010-01-01

    A case study was conducted on the development of the LISTEN intervention strategy for use with autistic students to improve inappropriate social behaviors. The study was conducted in a special education classroom in an autism school in Kuwait. Examination of LISTEN Intervention Strategy applications included: duration of targeted behavior; methods…

  11. Rooting out institutional corruption to manage inappropriate off-label drug use.

    Science.gov (United States)

    Rodwin, Marc A

    2013-01-01

    Prescribing drugs for uses that the FDA has not approved - off-label drug use - can sometimes be justified but is typically not supported by substantial evidence of effectiveness. At the root of inappropriate off-label drug use lie perverse incentives for pharmaceutical firms and flawed oversight of prescribing physicians. Typical reform proposals such as increased sanctions for manufacturers might reduce the incidence of unjustified off-label use, but they do not remove the source of the problem. Public policy should address the cause and control the practice. To manage inappropriate off-label drug use, off-label prescriptions must be tracked in order to monitor the risks and benefits and the manufacturers' conduct. Even more important, reimbursement rules should be changed so that manufacturers cannot profit from off-label sales. When off-label sales pass a critical threshold, manufacturers should also be required to pay for independent testing of the safety and effectiveness of off-label drug uses and for the FDA to review the evidence. Manufacturers should also finance, under FDA supervision, programs designed to warn physicians and the public about the risks of off-label drug use. © 2013 American Society of Law, Medicine & Ethics, Inc.

  12. Early diagnosis and successful treatment of paraneoplastic melanocytic proliferation.

    Science.gov (United States)

    Jansen, Joyce C G; Van Calster, Joachim; Pulido, Jose S; Miles, Sarah L; Vile, Richard G; Van Bergen, Tine; Cassiman, Catherine; Spielberg, Leigh H; Leys, Anita M

    2015-07-01

    Paraneoplastic melanocytic proliferation (bilateral diffuse uveal melanocytic proliferation, BDUMP) is a rare but devastating disease that causes progressive visual loss in patients who usually have an occult malignancy. Visual loss occurs as a result of paraneoplastic changes in the uveal tissue. In a masked fashion, the serum of two patients with BDUMP was evaluated for the presence of cultured melanocyte elongation and proliferation (CMEP) factor using cultured human melanocytes. We evaluated the efficacy of plasmapheresis as a treatment modality early in the disease in conjunction with radiation and chemotherapy. The serum of the first case patient was investigated after plasmapheresis and did not demonstrate proliferation of cultured human melanocytes. The serum of the second case was evaluated prior to treatment with plasmapheresis and did induce this proliferation. These findings are in accordance with the diminution of CMEP factor after plasmapheresis. Treatment with plasmapheresis managed to stabilise the ocular disease progression in both patients. In the past, visual loss due to paraneoplastic melanocytic proliferation was considered progressive and irreversible. We treated two patients successfully with plasmapheresis and demonstrated a relation between CMEP factor in the serum of these patients and proliferation of cultured melanocytes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. An Action Research Study of Intellectual Disabilities, Inappropriate Behaviors and Learned Helplessness

    Science.gov (United States)

    Luper, Elizabeth P. S.; Lockley, Jeannie

    2008-01-01

    This study focused on a population of 36 female patients, aged 25 to 65, who were diagnosed with intellectual disabilities, all of whom had long-standing patterns of inappropriate behaviors. In an attempt to increase more appropriate behaviors in these patients, a set of standardized contingency rules were established. These rules were implemented…

  14. 2012 American Geriatrics Society Beers criteria: enhanced applicability for detecting potentially inappropriate medications in European older adults? A comparison with the Screening Tool of Older Person's Potentially Inappropriate Prescriptions.

    Science.gov (United States)

    Blanco-Reina, Encarnación; Ariza-Zafra, Gabriel; Ocaña-Riola, Ricardo; León-Ortiz, Matilde

    2014-07-01

    To determine the prevalence of potentially inappropriate medications (PIMs) and related factors through a comparative analysis of the Screening Tool of Older Person's Potentially Inappropriate Prescriptions (STOPP), the 2003 Beers criteria, and the 2012 AGS update of the Beers criteria. Cross-sectional. Primary care. Community-dwelling persons aged 65 and older who live on the island of Lanzarote, Spain (N = 407). Sociodemographic characteristics; independence in activities of daily living; cognitive function; Geriatric Depression Scale; clinical diagnoses; and complete data on indication, dosage, and length of drug treatments. One thousand eight hundred seventh-two prescriptions were examined, and the rate of PIMs was assessed with the three criteria. The primary endpoint was the percentage of participants receiving at least one PIM. Multivariate logistic regression was used to examine the factors related to PIMs. Potentially inappropriate medications were present in 24.3%, 35.4%, and 44% of participants, according to the 2003 Beers criteria, STOPP, and 2012 Beers criteria, respectively. The profile of PIMs was also different (the most frequent being benzodiazepines in both Beers criteria lists and aspirin in the STOPP). The number of drugs was associated with risk of prescribing PIMs in all three models, as was the presence of a psychological disorder in the 2003 Beers criteria (odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.26-3.40) and the 2012 Beers criteria (OR = 2.91, 95% CI = 1.83-4.66). The kappa for degree of agreement between STOPP and the 2012 Beers criteria was 0.35 (95% CI = 0.25-0.44). The 2012 Beers criteria detected the highest number of PIMs, and given the scant overlapping with the STOPP criteria, the use of both tools may be seen as complementary. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  15. Inappropriate mode switching clarified by using a chest radiograph

    Directory of Open Access Journals (Sweden)

    Brian Marino, DO

    2015-08-01

    Full Text Available An 80-year-old woman with a history of paroxysmal atrial fibrillation and atrioventricular node disease status post-dual chamber pacemaker placement was noted to have abnormal pacing episodes during a percutaneous coronary intervention. Pacemaker interrogation revealed a high number of short duration mode switching episodes. Representative electrograms demonstrated high frequency nonphysiologic recordings predominantly in the atrial lead. Intrinsic pacemaker malfunction was excluded. A chest radiograph showed excess atrial and ventricular lead slack in the right ventricular inflow. It was suspected that lead–lead interaction resulted in artifacts and oversensing, causing frequent short episodes of inappropriate mode switching.

  16. The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial.

    Science.gov (United States)

    Sedláček, Kamil; Ruwald, Anne-Christine; Kutyifa, Valentina; McNitt, Scott; Thomsen, Poul Erik Bloch; Klein, Helmut; Stockburger, Martin; Wichterle, Dan; Merkely, Bela; DE LA Concha, Joaquin Fernandez; Swissa, Moshe; Zareba, Wojciech; Moss, Arthur J; Kautzner, Josef; Ruwald, Martin H

    2015-04-01

    The MADIT-RIT trial demonstrated reduction of inappropriate and appropriate ICD therapies and mortality by high-rate cut-off and 60-second-delayed VT therapy ICD programming in patients with a primary prophylactic ICD indication. The aim of this analysis was to study effects of MADIT-RIT ICD programming in patients with ischemic and nonischemic cardiomyopathy. First and total occurrences of both inappropriate and appropriate ICD therapies were analyzed by multivariate Cox models in 791 (53%) patients with ischemic and 707 (47%) patients with nonischemic cardiomyopathy. Patients with ischemic and nonischemic cardiomyopathy had similar incidence of first inappropriate (9% and 11%, P = 0.21) and first appropriate ICD therapy (11.6% and 14.1%, P = 0.15). Patients with ischemic cardiomyopathy had higher mortality rate (6.1% vs. 3.3%, P = 0.01). MADIT-RIT high-rate cut-off (arm B) and delayed VT therapy ICD programming (arm C) compared with conventional (arm A) ICD programming were associated with a significant risk reduction of first inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy (HR range 0.11-0.34, P programming and delayed VT therapy ICD programming in both ischemic and nonischemic cardiomyopathy patients. High-rate cut-off and delayed VT therapy ICD programming are associated with significant reduction in first and total inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy. © 2014 Wiley Periodicals, Inc.

  17. Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.

    LENUS (Irish Health Repository)

    Barry, P J

    2012-02-03

    BACKGROUND: In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers\\' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) - 2003 version]. The Beers\\' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers\\' criteria CD contains 19 different categories containing possible drug-disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug-disease interactions. OBJECTIVES: The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. METHODS: A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80.3 +\\/- 6.1 years) and all patients had both Beers\\' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. RESULTS: The results of the study identified a high rate of inappropriate prescribing among this population of community

  18. Excess Baggage for Birds: Inappropriate Placement of Tags on Gannets Changes Flight Patterns

    Science.gov (United States)

    Vandenabeele, Sylvie P.; Grundy, Edward; Friswell, Michael I.; Grogan, Adam; Votier, Stephen C.; Wilson, Rory P.

    2014-01-01

    Devices attached to flying birds can hugely enhance our understanding of their behavioural ecology for periods when they cannot be observed directly. For this, scientists routinely attach units to either birds' backs or their tails. However, inappropriate payload distribution is critical in aircraft and, since birds and planes are subject to the same laws of physics during flight, we considered aircraft aerodynamic constraints to explain flight patterns displayed by northern gannets Sula bassana equipped with (small ca. 14 g) tail- and back-mounted accelerometers and (larger ca. 30 g) tail-mounted GPS units. Tail-mounted GPS-fitted birds showed significantly higher cumulative numbers of flap-glide cycles and a higher pitch angle of the tail than accelerometer-equipped birds, indicating problems with balancing inappropriately placed weights with knock-on consequences relating to energy expenditure. These problems can be addressed by carefully choosing where to place tags on birds according to the mass of the tags and the lifestyle of the subject species. PMID:24671007

  19. Proliferation: myth or reality?; La proliferation: mythe ou realite?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This article analyzes the proliferation approach, its technical condition and political motivation, and the share between the myth (political deception, assumptions and extrapolations) and the reality of proliferation. Its appreciation is complicated by the irrational behaviour of some political actors and by the significant loss of the non-use taboo. The control of technologies is an important element for proliferation slowing down but an efficient and autonomous intelligence system remains indispensable. (J.S.)

  20. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

    DEFF Research Database (Denmark)

    Niwata, Satoko; Yamada, Yukari; Ikegami, Naoki

    2006-01-01

    dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511), medication cost of per day (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate...

  1. Inappropriate and Excessive Guilt: Instrument Validation and Developmental Differences in Relation to Depression

    Science.gov (United States)

    Tilghman-Osborne, Carlos; Cole, David A.; Felton, Julia W.

    2012-01-01

    Inappropriate or excessive guilt is listed as a symptom of depression by the American Psychiatric Association ("1994"). Although many measures of guilt have been developed, definitional and operational problems exist, especially in the application of such measures in childhood and adolescence. To address these problems, the current study…

  2. [Severe nutritional deficiencies in young infants with inappropriate plant milk consumption].

    Science.gov (United States)

    Le Louer, B; Lemale, J; Garcette, K; Orzechowski, C; Chalvon, A; Girardet, J-P; Tounian, P

    2014-05-01

    Over the past few years, we have observed increasing consumption of inappropriate plant milks as an alternative to infant milk formula. Some families believe that foods labeled as natural are the most healthy and an appropriate nutritional choice. However, their composition does not respect European recommendations. They are always hypocaloric and protein, vitamin, and mineral concentrations are inadequate. The aim of this study was to report severe nutritional complications after inappropriate plant milk consumption. Between 2008 and 2011, we studied severe nutritional deficiencies caused by consumption of plant milks bought in health food stores or online shops. Infants were identified in our centers and examined through medical history, physical examination, and laboratory testing. Nine cases of infants aged from 4 to 14 months were observed. In all cases, these milks were used as an alternative to milk formulas for supposed cow's milk allergy. At diagnosis, four patients were aged 6 months or less. They had received plant milk exclusively for 1-3 months. The beverages consumed were rice, soya, almond and sweet chestnut milks. In three cases, infants presented severe protein-calorie malnutrition with substantial hypoalbuminemia (slow down the progress of this social trend. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Inappropriate complementary feeding practice increases risk of stunting in children aged 12-24 months

    Directory of Open Access Journals (Sweden)

    Hijra Hijra

    2016-12-01

    Inappropriate complementary feeding practice increased the risk of stunting in 12-24 months old children by 8.26. This study confirms the need to scale up interventions during the first 2 years of life, including appropriate infant feeding practices.

  4. Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing.

    Science.gov (United States)

    Fried, Terri R; Niehoff, Kristina M; Street, Richard L; Charpentier, Peter A; Rajeevan, Nallakkandi; Miller, Perry L; Goldstein, Mary K; O'Leary, John R; Fenton, Brenda T

    2017-10-01

    To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. Randomized clinical trial. Primary care clinics at a Veterans Affairs Medical Center. Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128). TRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications (PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. Primary: subscales of the Patient Assessment of Care for Chronic Conditions (PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications. 29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs. TRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The

  5. Statin therapy reduces inappropriate shock in non-ischemic patients with mild heart failure

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine H.; Zareba, Wojciech; Jons, Christian

    2013-01-01

    tachycardia zone of 170 to 199 bpm (arm A), high-rate cutoff with a ventricular tachycardia zone ≥200 bpm (arm B), or 60-second-delayed therapy (arm C). The end points of inappropriate therapy, appropriate therapy, and death were assessed among 485 patients with and 998 without diabetes mellitus. Innovative...

  6. The syndrome of inappropriate antidiuretic hormone secretion after giant leaf frog (Phyllomedusa bicolor) venom exposure.

    Science.gov (United States)

    Leban, Vid; Kozelj, Gordana; Brvar, Miran

    2016-09-15

    In Europe body purification and natural balance restoring rituals are becoming increasingly popular, but an introduction of Amazonian shamanic rituals in urban Europe can result in unexpected adverse events. A 44-year-old woman attended a Kambô or Sapo ritual in Slovenia where dried skin secretion from a giant leaf frog (Phyllomedusa bicolor) was applied to five freshly burned wounds at her shoulder. Afterwards, she drank 6 litres of water and gradually developed nausea and vomiting, confusion, lethargy, muscle weakness, spasms and cramps, seizure, decreased consciousness level and short-term memory loss. The initial laboratory tests showed profound plasma hypoosmolality (251 mOsm/kg) proportional to hyponatremia (116 mmol/L) combined with inappropriately elevated urine osmolality (523 mOsm/kg) and high urine sodium concentration (87 mmol/L) indicating a syndrome of inappropriate antidiuretic hormone secretion. The patient was treated with 0.9% sodium chloride and a restriction of water intake. Plasma osmolality and hyponatremia improved one day after venom exposure, but the symptoms disappeared as late as the third day. In patients presenting with neurological symptoms and a line of small body burns Phyllomedusa bicolor venom exposure should be suspected. Acute symptomatic hyponatremia after Phyllomedusa bicolor venom exposure is the result of inappropriate antidiuretic hormone secretion that can be exacerbated by excessive water intake. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Non-proliferation

    International Nuclear Information System (INIS)

    Manley, I.T.

    1981-01-01

    Proliferation is a problem that can only be solved when the political problems which lead countries to contemplate, the possession of nuclear weapons are solved; in the meantime it can only be managed. Non-proliferation policy has to deal both with the political and the technical aspects of proliferation. It must seek to buy time by addressing the reasons why nations feel the political need to construct nuclear weapons, as well as delaying the moment when such nations feel capable of doing so. The subject is examined and proposals made. (author)

  8. Diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone

    DEFF Research Database (Denmark)

    Holm, Ellen Astrid; Bie, Peter; Ottesen, Michael

    2009-01-01

    BACKGROUND: Hyponatremia is a frequent condition in elderly patients. In diagnostic workup, a 24-hour urine sample is used to measure urinary osmolality and urinary sodium concentration necessary to confirm the diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH...... natriuretic peptides, renin, and aldosterone were measured in the supine and upright positions of patients and compared with nine healthy age-matched control patients. RESULTS: The patients had low plasma osmolality (median 266 mOsm/kg) and measurable levels of arginine vasopressin (median 1.8 pg/mL). Values...

  9. Using an Electronic Highlighter to Eliminate the Negative Effects of Pre-Existing, Inappropriate Highlighting

    Science.gov (United States)

    Gier, Vicki; Kreiner, David; Hudnell, Jason; Montoya, Jodi; Herring, Daniel

    2011-01-01

    The purpose of the present experiment was to determine whether using an active learning technique, electronic highlighting, can eliminate the negative effects of pre-existing, poor highlighting on reading comprehension. Participants read passages containing no highlighting, appropriate highlighting, or inappropriate highlighting. We hypothesized…

  10. Odontogenic Cyst with Verrucous Proliferation Exhibiting Melanin Pigmentation

    Directory of Open Access Journals (Sweden)

    Nidhi Manaktala

    2017-01-01

    Full Text Available Verrucous proliferation arising from odontogenic cysts is a rare entity. We report an unusual case of an infected odontogenic cyst with verrucous proliferation and melanin pigmentation in a 13-year-old male patient who presented with an intraoral swelling in relation to impacted teeth 26 and 27. The enucleated lesion was diagnosed as an odontogenic keratocyst and the patient died within two years of presentation due to multiple recurrences. The clinical, radiological, and microscopic features of the lesion are presented with an attempt to discuss the etiopathogenesis. The case hereby reported is uncommon with only eight cases reported in the literature.

  11. Ischial Pain and Sitting Disability Due to Ischiogluteal Bursitis: Visual Vignette.

    Science.gov (United States)

    Ekiz, Timur; Biçici, Vedat; Hatioglu, Cem; Yalçın, Süha; Cingöz, Kagan

    2015-01-01

    Ischial bursitis or ischiogluteal bursitis is the inflammation of the ischiogluteal bursa due to excessive or inappropriate physical exercise, prolonged sitting, running, repetitive jumping, and kicking. Since ischial bursitis is a rare, infrequently recognized pathology and is difficult to differentiate from the soft tissue disease and tumors (both malignant and benign), herein exemplified is a case with ischiogluteal bursitis whereby the role of magnetic resonance imaging (MRI) in the prompt diagnosis has been highlighted.

  12. Effect of rational and irrational statements on intensity and 'inappropriateness' of emotional distress and irrational beliefs in psychotherapy patients.

    Science.gov (United States)

    Cramer, D; Kupshik, G

    1993-09-01

    Ellis's rational-emotive theory postulates that since irrational statements augment emotional distress, replacing irrational with rational statements should lessen distress. This hypothesis was tested in the initial stages of psychotherapy by having 13 and 14 clinical out-patients respectively repeat for one minute either rational or irrational statements about their major presenting psychological problem. The distinction by Ellis & Harper (1975) that 'inappropriate' emotions differ qualitatively from 'appropriate' emotions was also examined. Although the experimental intervention had no effect on a post-test measure of irrational beliefs, patients repeating rational statements had significantly lower appropriate and inappropriate negative emotions at post-test, suggesting that inappropriate emotions do not differ qualitatively from appropriate emotions and that making rational statements may lower emotional distress in patients. Patients reiterating irrational statements showed no change in emotions, implying that these kinds of irrational cognitions may have already been present.

  13. A case of appropriate inappropriate device therapy: Hyperkalemia-induced ventricular oversensing

    OpenAIRE

    Oudit, Gavin Y; Cameron, Doug; Harris, Louise

    2008-01-01

    The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T ...

  14. Fissile material proliferation risk

    International Nuclear Information System (INIS)

    Dreicer, J.S.; Rutherford, D.A.

    1996-01-01

    The proliferation risk of a facility depends on the material attractiveness, level of safeguards, and physical protection applied to the material in conjunction with an assessment of the impact of the socioeconomic circumstances and threat environment. Proliferation risk is a complementary extension of proliferation resistance. The authors believe a better determination of nuclear proliferation can be achieved by establishing the proliferation risk for facilities that contain nuclear material. Developing a method that incorporates the socioeconomic circumstances and threat environment inherent to each country enables a global proliferation assessment. To effectively reduce the nuclear danger, a broadly based set of criteria is needed that provides the capability to relatively assess a wide range of nuclear related sites and facilities in different countries and still ensure a global decrease in proliferation risk for fissile material (plutonium and highly enriched uranium)

  15. Performance Costs when Emotion Tunes Inappropriate Cognitive Abilities: Implications for Mental Resources and Behavior

    Science.gov (United States)

    Storbeck, Justin

    2012-01-01

    Emotion tunes cognition, such that approach-motivated positive states promote verbal cognition, whereas withdrawal-motivated negative states promote spatial cognition (Gray, 2001). The current research examined whether self-control resources become depleted and influence subsequent behavior when emotion tunes an inappropriate cognitive tendency.…

  16. Syndrome of inappropriate antidiuretic hormone secretion induced by the phytotherapy Harpagophytum procumbers: case report

    Directory of Open Access Journals (Sweden)

    Renata Reis Carvalho

    Full Text Available Abstract Introduction: The syndrome of inappropriate antidiuretic hormone secretion (SIADH is the inability of antidiuretic hormone (ADH suppression, compromising the mechanisms of water excretion and urinary concentration. It manifests as hyponatremia and its symptoms, especially neurological. There are many causes that trigger such disease, notably: central nervous system disorders, malignant neoplasm, drugs and others. Case Report: A 65 years female hypertensive patient presented clinical and laboratory manifestations of hyponatremia due to SIADH. It happened twice under use of herbal medication for osteoarthritis treatment. Discussion: The drug-related hyponatremia can be triggered by direct effect of the drug or by association with SIADH. The clinical manifestations presented could have been related to psychiatric condition and may have severe outcome if not properly diagnosed. The association of an herbal medicine to SIADH could be confirmed after a new episode of hyponatremia related to Harpagophytum procumbers reintroduction. Our literature review did not find this herbal medicine associated with SIADH, so far. Conclusion: SIADH may be caused by herbal medicine described from now on their association in the literature.

  17. Inhibition of brain tumor cell proliferation by alternating electric fields

    International Nuclear Information System (INIS)

    Jeong, Hyesun; Oh, Seung-ick; Hong, Sunghoi; Sung, Jiwon; Jeong, Seonghoon; Yoon, Myonggeun; Koh, Eui Kwan

    2014-01-01

    This study was designed to investigate the mechanism by which electric fields affect cell function, and to determine the optimal conditions for electric field inhibition of cancer cell proliferation. Low-intensity (<2 V/cm) and intermediate-frequency (100–300 kHz) alternating electric fields were applied to glioblastoma cell lines. These electric fields inhibited cell proliferation by inducing cell cycle arrest and abnormal mitosis due to the malformation of microtubules. These effects were significantly dependent on the intensity and frequency of applied electric fields

  18. Inhibition of brain tumor cell proliferation by alternating electric fields

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hyesun; Oh, Seung-ick; Hong, Sunghoi, E-mail: shong21@korea.ac.kr, E-mail: radioyoon@korea.ac.kr [School of Biosystem and Biomedical Science, Korea University, Seoul 136-703 (Korea, Republic of); Sung, Jiwon; Jeong, Seonghoon; Yoon, Myonggeun, E-mail: shong21@korea.ac.kr, E-mail: radioyoon@korea.ac.kr [Department of Bio-convergence Engineering, Korea University, Seoul 136-703 (Korea, Republic of); Koh, Eui Kwan [Seoul Center, Korea Basic Science Institute, Seoul 136-713 (Korea, Republic of)

    2014-11-17

    This study was designed to investigate the mechanism by which electric fields affect cell function, and to determine the optimal conditions for electric field inhibition of cancer cell proliferation. Low-intensity (<2 V/cm) and intermediate-frequency (100–300 kHz) alternating electric fields were applied to glioblastoma cell lines. These electric fields inhibited cell proliferation by inducing cell cycle arrest and abnormal mitosis due to the malformation of microtubules. These effects were significantly dependent on the intensity and frequency of applied electric fields.

  19. Teaching Women with Intellectual Disabilities to Identify and Report Inappropriate Staff-to-Resident Interactions

    Science.gov (United States)

    Bollman, Jessica R.; Davis, Paula K.

    2009-01-01

    This study examined the effectiveness of behavioral skills training in teaching 2 adult women with mild intellectual disabilities to report inappropriate staff-to-resident interactions. The reporting skill included making a self-advocacy response, walking away, and reporting the interaction. Participants' performance was measured during baseline,…

  20. Morvan syndrome: a rare cause of syndrome of inappropriate antidiuretic hormone secretion

    OpenAIRE

    DEMIRBAS, SEREF; AYKAN, MUSA BARIS; ZENGIN, HAYDAR; MAZMAN, SEMIR; SAGLAM, KENAN

    2017-01-01

    The syndrome of inappropriate antidiuretic hormone secretion (SIADH) accounts for an important part of hyponatremia cases. The causes of SIADH can be detected almost always. As a rare disorder, Morvan Syndrome can be defined by the sum of peripheral nerve hyperexcitability, autonomic instability and neuropsychiatric features. Antibodies to voltage-gated potassium channels (Anti ? VGKC-Ab) including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated ...

  1. Different patterns of inappropriate antimicrobial use in surgical and medical units at a tertiary care hospital in Switzerland: a prevalence survey.

    Directory of Open Access Journals (Sweden)

    Alexia Cusini

    Full Text Available BACKGROUND: Unnecessary or inappropriate use of antimicrobials is associated with the emergence of antimicrobial resistance, drug toxicity, increased morbidity and health care costs. Antimicrobial use has been reported to be incorrect or not indicated in 9-64% of inpatients. We studied the quality of antimicrobial therapy and prophylaxis in hospitalized patients at a tertiary care hospital to plan interventions to improve the quality of antimicrobial prescription. METHODOLOGY/PRINCIPAL FINDINGS: Experienced infectious diseases (ID fellows performed audits of antimicrobial use at regular intervals among all patients--with or without antimicrobials--hospitalized in predefined surgical, medical, haemato-oncological, or intensive care units. Data were collected from medical and nursing patient charts with a standardized questionnaire. Appropriateness of antimicrobial use was evaluated using a modified algorithm developed by Gyssens et al.; the assessment was double-checked by a senior ID specialist. We evaluated 1577 patients of whom 700 (44.4% had antimicrobials, receiving a total of 1270 prescriptions. 958 (75.4% prescriptions were for therapy and 312 (24.6% for prophylaxis. 37.0% of therapeutic and 16.6% of prophylactic prescriptions were found to be inappropriate. Most frequent characteristics of inappropriate treatments included: No indication (17.5%; incorrect choice of antimicrobials (7.6%; incorrect application of drugs (9.3%; and divergence from institutional guidelines (8%. Characteristics of inappropriate prophylaxes were: No indication (9%; incorrect choice of antimicrobials (1%; duration too long or other inappropriate use (6.7%. Patterns of inappropriate antimicrobial varied widely in the different hospital units; empirical prescriptions were more frequently incorrect than prescriptions based on available microbiological results. CONCLUSIONS/SIGNIFICANCE: Audits of individual patient care provide important data to identify local

  2. Can patient safety be improved by reducing the volume of “inappropriate prescribing tasks” handed over to out-of-hours junior doctors?

    Directory of Open Access Journals (Sweden)

    Amis SM

    2018-03-01

    Full Text Available Samuel Martin Amis, Tobin Henry Edgar Osicki Department of Acute Internal Medicine, South Warwickshire Foundation Trust, Warwick, UK Background: First-year doctors found that during out-of-hours shifts they were being delayed and distracted from reviewing potentially sick/deteriorating patients by a high volume of prescribing tasks. This predominately consisted of oral anticoagulation prescribing and rewrites of drug charts. We hoped that if we could reduce this burden of “inappropriate prescribing tasks”, we could not only improve junior doctors’ job satisfaction and opportunities for training but also give them more time for patient reviews. Methods: Three weekends were initially audited to quantify the number of “inappropriate prescribing tasks” using data from the hospital’s computerized task assigning system. On three subsequent weekends, a checklist was handed out to the ward teams on Friday mornings. This checklist was designed to encourage the day teams to check that drug charts would not need oral anticoagulation or rewriting over the weekend. Results: An overall reduction in “inappropriate prescribing tasks” of 46% with a specific reduction in inappropriate oral anticoagulation prescribing of 65% was observed. Inappropriate drug chart rewrites were reduced by 30%. The reduction in the mean number of pre-intervention inappropriate prescribing tasks (as a percentage of total prescribing tasks and the post-intervention mean was 6.94% (95% confidence interval −0.54 to 14.42, p-value=0.062. Conclusion: Improved job satisfaction and a perceived reduced workload were noted from post-intervention qualitative surveys. While improved patient safety directly resulting from this intervention is more difficult to establish, and the observed reduction in inappropriate prescribing was only approaching statistical significance, our colleagues commented in post-intervention feedback that they felt they had more time, and felt less

  3. The effects and mechanisms of clinorotation on proliferation and differentiation in bone marrow mesenchymal stem cells

    International Nuclear Information System (INIS)

    Yan, Ming; Wang, Yongchun; Yang, Min; Liu, Yanwu; Qu, Bo; Ye, Zhengxu; Liang, Wei; Sun, Xiqing; Luo, Zhuojing

    2015-01-01

    Data from human and rodent studies have demonstrated that microgravity induces observed bone loss in real spaceflight or simulated experiments. The decrease of bone formation and block of maturation may play important roles in bone loss induced by microgravity. The aim of this study was to investigate the changes of proliferation and differentiation in bone marrow mesenchymal stem cells (BMSCs) induced by simulated microgravity and the mechanisms underlying it. We report here that clinorotation, a simulated model of microgravity, decreased proliferation and differentiation in BMSCs after exposure to 48 h simulated microgravity. The inhibited proliferation are related with blocking the cell cycle in G2/M and enhancing the apoptosis. While alterations of the osteoblast differentiation due to the decreased SATB2 expression induced by simulated microgravity in BMSCs. - Highlights: • Simulated microgravity inhibited proliferation and differentiation in BMSCs. • The decreased proliferation due to blocked cell cycle and enhanced the apoptosis. • The inhibited differentiation accounts for alteration of SATB2, Hoxa2 and Cbfa1

  4. Use of nonsteroidal anti-inflammatory drugs and renal failure in nursing home residents-results of the study "Inappropriate Medication in Patients with Renal Insufficiency in Nursing Homes".

    Science.gov (United States)

    Dörks, Michael; Herget-Rosenthal, Stefan; Schmiemann, Guido; Hoffmann, Falk

    2016-04-01

    Use of potentially inappropriate medications may result in increased morbidity, mortality and resource utilisation. Due to polypharmacy and age-related decline in renal function the elderly population is at particular risk. Therefore, the Beers Criteria include use of nonsteroidal anti-inflammatory drugs in chronic renal failure stage 4 and 5 as these drugs may worsen renal function. According to the summary of product characteristics, the nonsteroidal anti-inflammatory drugs ibuprofen and diclofenac are contraindicated in these patients. Objective was to assess the extent of nonsteroidal anti-inflammatory drug use in nursing homes with a focus on residents with severe renal failure. Multi-centre cross-sectional study in 21 German nursing homes. The study population comprised residents for whom at least one serum creatinine value and information about sex were available, so that creatinine clearance rate could be estimated. In all, 685 of 852 residents were included as they fulfilled the abovementioned criteria. Renal failure was severe (estimated creatinine clearance rate renal failure (20.8 %). With one exception, all residents prescribed nonsteroidal anti-inflammatory drugs with severe renal failure were treated with at least one nonsteroidal anti-inflammatory drug that was contraindicated due to the underlying renal function. Notwithstanding their classification as potentially inappropriate medications and underlying contraindications, use of nonsteroidal anti-inflammatory drugs is common among nursing home residents with severe renal failure.

  5. Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging

    Science.gov (United States)

    Ye, Siqin; Rabbani, LeRoy E.; Kelly, Christopher R.; Kelly, Maureen R.; Lewis, Matthew; Paz, Yehuda; Peck, Clara L.; Rao, Shaline; Bokhari, Sabahat; Weiner, Shepard D.; Einstein, Andrew J.

    2014-01-01

    Background We sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria (AUC) for radionuclide imaging (RNI) and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications. Methods and Results Four hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 AUC. Consensus classification by two cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests was calculated. Inter-rater reliability of the AUC was assessed using Cohen’s kappa statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 NSTs as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for non-cardiologist raters was modest (unweighted Cohen’s kappa, 0.51, 95% confidence interval, 0.45 to 0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%. Conclusions Inter-rater reliability for the 2009 AUC for RNI is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests. PMID:25563660

  6. Do physician outcome judgments and judgment biases contribute to inappropriate use of treatments? Study protocol

    Directory of Open Access Journals (Sweden)

    Lott Alison

    2007-06-01

    Full Text Available Abstract Background There are many examples of physicians using treatments inappropriately, despite clear evidence about the circumstances under which the benefits of such treatments outweigh their harms. When such over- or under- use of treatments occurs for common diseases, the burden to the healthcare system and risks to patients can be substantial. We propose that a major contributor to inappropriate treatment may be how clinicians judge the likelihood of important treatment outcomes, and how these judgments influence their treatment decisions. The current study will examine the role of judged outcome probabilities and other cognitive factors in the context of two clinical treatment decisions: 1 prescription of antibiotics for sore throat, where we hypothesize overestimation of benefit and underestimation of harm leads to over-prescription of antibiotics; and 2 initiation of anticoagulation for patients with atrial fibrillation (AF, where we hypothesize that underestimation of benefit and overestimation of harm leads to under-prescription of warfarin. Methods For each of the two conditions, we will administer surveys of two types (Type 1 and Type 2 to different samples of Canadian physicians. The primary goal of the Type 1 survey is to assess physicians' perceived outcome probabilities (both good and bad outcomes for the target treatment. Type 1 surveys will assess judged outcome probabilities in the context of a representative patient, and include questions about how physicians currently treat such cases, the recollection of rare or vivid outcomes, as well as practice and demographic details. The primary goal of the Type 2 surveys is to measure the specific factors that drive individual clinical judgments and treatment decisions, using a 'clinical judgment analysis' or 'lens modeling' approach. This survey will manipulate eight clinical variables across a series of sixteen realistic case vignettes. Based on the survey responses, we will be

  7. Empagliflozin Increases Short-Term Urinary Volume Output in Artificially Induced Syndrome of Inappropriate Antidiuresis

    Directory of Open Access Journals (Sweden)

    Julie Refardt

    2017-01-01

    Full Text Available Objective. Syndrome of inappropriate antidiuresis (SIADH is the predominant cause of hyponatremia, but treatment options are unsatisfying. SGLT2 inhibitors increase urinary glucose excretion with concomitant osmotic diuresis. We therefore hypothesized SGLT2-inhibitors as a novel treatment for SIADH. Design. Double-blind placebo-controlled randomised crossover study in 14 healthy volunteers. Methods. We induced an artificial SIADH model by administration of desmopressin and overhydration. Afterwards, empagliflozin 25 mg or placebo was given in random order. The main outcomes were total urinary excretion, glucosuria, and the area under the curve (AUC of serum sodium concentration. Outcome measures were obtained 2–8 hours after administration of study drug. Results. 14 participants (64% males, BMI 23 kg/m2 (±2.4, aged 28.6 years (±9, completed the study. Empagliflozin led to significantly increased total urinary excretion (579.3 ml (±194.8 versus 367.3 ml (±158.8; treatment effect 158 ml (CI 48.29, 267.74, p=0.017 due to glucosuria (74.18 mmol (±22.3 versus 0.12 mmol (±0.04; treatment effect (log scale 2.85 (CI 2.75, 2.96, p<0.001. There was no difference in the AUC of serum sodium concentration (treatment effect 0.2 (CI −7.38, 6.98, p=0.96. Conclusion. In our SIADH model, empagliflozin increased urinary excretion due to osmotic diuresis. Due to the short treatment duration, serum sodium levels remained unchanged. Real-live studies are needed to further examine empagliflozin as a new treatment for SIADH.

  8. Inappropriate implantable cardioverter-defibrillator shocks in Brugada syndrome: Pattern in primary and secondary prevention

    Directory of Open Access Journals (Sweden)

    Aimé Bonny

    2017-01-01

    Conclusion: Inappropriate shock is common in Brugada syndrome during the early periods after an ICD implantation, and seems to be more likely in asymptomatic patients. This finding may warrant a review of the indications for ICD implantation, especially in the young and apparently healthy population of patients with Brugada syndrome.

  9. Nuclear non proliferation and disarmament; Non-proliferation nucleaire et desarmement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    In the framework of the publication of a document on the ''weapons mastership, disarmament and non proliferation: the french action'', by the ministry of Foreign Affairs and the ministry of Defense, the French Documentation organization presents a whole document. This document describes and details the following topics: the conference on the treaty of non proliferation of nuclear weapons, the France, Usa and Non Governmental Organizations position, the threats of the proliferation, the french actions towards the disarmament, the disarmament in the world, a chronology and some bibliographic resources. (A.L.B.)

  10. Nanoparticles for cells proliferation enhancement

    International Nuclear Information System (INIS)

    Popa, V.; Braniste, F.; Tiginyanu, I.M.; Lisii, C.; Nacu, V.

    2013-01-01

    The potential of semiconductor nanoparticles as stimulator for avian mesenchyme stem cells proliferation enhancement is demonstrated. The effect is related to nanoparticles polarization due to external ultrasound field resulting in local electrical stimulation. Our preliminary results demonstrates that the number of cells have been increased by 23 % ±2%) in cell cultures under the action of external ultrasound stimulation. Morphological analysis and viability shows no differences between the control group and the group studied. These results suggest the possibility for tissue regeneration enhancement by remote stimulation of implanted semiconductor nanoparticles. (authors)

  11. The Antifibrosis Effects of Peroxisome Proliferator-Activated Receptor δ on Rat Corneal Wound Healing after Excimer Laser Keratectomy

    Directory of Open Access Journals (Sweden)

    Yun Gu

    2014-01-01

    Full Text Available Corneal stromal fibrosis characterized by myofibroblasts and abnormal extracellular matrix (ECM is usually the result of inappropriate wound healing. The present study tested the hypothesis that the ligand activation of peroxisome proliferator-activated receptor (PPAR δ had antifibrosis effects in a rat model of corneal damage. Adult Sprague-Dawley rats underwent bilateral phototherapeutic keratectomy (PTK. The eyes were randomized into four groups: PBS, GW501516 (a selective agonist of PPARδ, GSK3787 (a selective antagonist of PPARδ, or GW501516 combined with GSK3787. The agents were subconjunctivally administered twice a week until sacrifice. The cellular aspects of corneal wound healing were evaluated with in vivo confocal imaging and postmortem histology. A myofibroblast marker (α-smooth muscle actin and ECM production (fibronectin, collagen type III and collagen type I were examined by immunohistochemistry and RT-PCR. At the early stages of wound healing, GW501516 inhibited reepithelialization and promoted angiogenesis. During the remodeling phase of wound healing, GW501516 attenuated the activation and proliferation of keratocytes, which could be reversed by GSK3787. GW501516 decreased transdifferentiation from keratocytes into myofibroblasts, ECM synthesis, and corneal haze. These results demonstrate that GW501516 controls corneal fibrosis and suggest that PPARδ may potentially serve as a therapeutic target for treating corneal scars.

  12. A case of syndrome involving the inappropriate secretion of antidiuretic hormone developed during radiation therapy in a patient with invasive thymoma complicated with myasthenia gravis

    International Nuclear Information System (INIS)

    Chikuie, Naoki; Ishida, Simon; Sato, Tomohiko; Furutama, Daisuke; Sugino, Shyouichi; Kimura, Humihiro; Hanafusa, Toshiaki

    2007-01-01

    We present the case of a 56-year-old male with a syndrome involving the inappropriate secretion of antidiuretic hormone (SIADH), which developed during radiation therapy for invasive thymoma, complicated with myasthenia gravis (MG). Chest computed tomography revealed a huge mediastinal mass lesion spreading to the pulmonary artery, vena cava and pericardium. He was diagnosed with invasive thymoma, based on the pathological findings of a mediastinal tumor biopsy under computed tomography guidance. He received outpatient radiotherapy for the invasive thymoma, and two weeks after the initiation of radiation at a dose of 22 Gy, was admitted to our hospital because of hypercapnea due to weakness of the diaphragm and disturbance of consciousness. Laboratory examinations of the patient showed hyponatremia, plasma hypoosmolarity in the presence of concentrated urine and inappropriately increased concentration of the plasma antidiuretic hormone. He was also diagnosed as having myasthenia gravis, based on the existence of an anti-acetylcholine receptor antibody. The SIADH was treated by fluid restriction and sodium chloride, and MG was treated with plasma exchange and prednisolone. He recovered from respiratory failure, and his hyponatremia was improved. To our knowledge, this is a rare description of an invasive thymoma associated with SIADH. (author)

  13. The threat of proliferation

    International Nuclear Information System (INIS)

    Palme, Olof.

    1986-01-01

    The paper on the threat of proliferation, is a keynote speech delivered to the Colloquium on Nuclear War, Nuclear Proliferation and their Consequences, Geneva, 1985. Topics discussed in the address include: nuclear weapons, nuclear war, terrorists, Non-Proliferation Treaty, nuclear disarmament, and leadership in world affairs. (UK)

  14. An observation on inappropriate probiotic subgroup classifications in the meta-analysis by Lau and Chamberlain

    Directory of Open Access Journals (Sweden)

    McFarl

    2016-09-01

    Full Text Available Lynne V McFarland Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA I read with great interest the systematic review of meta-analysis assessing probiotics for the prevention of Clostridium difficile-associated diarrhea (CDAD published in the International Journal of General Medicine. These authors pooled 26 randomized controlled trials (RCTs and concluded that Lactobacilli, mixtures, and Saccharomyces probiotics were effective in preventing CDAD. However, the meta-analysis by Lau and Chamberlain is flawed due to improper classification by the types of probiotics. It is important to recognize that the efficacy of probiotics for various diseases has been shown to be strain specific for each probiotic product, and thus the data should only be pooled for probiotics that are of the identical type. In their analysis of probiotic subgroups by various species, the authors have inappropriately merged different types of Lactobacilli into one subgroup “Lactobacilli” and different types of mixtures into one group classified as “Mix”.View the original paper by Lau and Chamberlain. 

  15. Galectin-3-independent Down-regulation of GABABR1 due to Treatment with Korean Herbal Extract HAD-B Reduces Proliferation of Human Colon Cancer Cells

    Directory of Open Access Journals (Sweden)

    Kim Kyung-Hee

    2012-09-01

    Full Text Available Objectives: Many efforts have shown multi-oncologic roles of galectin-3 for cell proliferation, angiogenesis, and apoptosis. However, the mechanisms by which galectin-3 is involved in cell proliferation are not yet fully understood, especially in human colon cancer cells. Methods: To cluster genes showing positively or negatively correlated expression with galectin-3, we employed human colon cancer cell lines, SNU-61, SNU-81, SNU-769B, SNU-C4 and SNU-C5 in high-throughput gene expression profiling. Gene and protein expression levels were determined by using real-time quantitative polymerase chain reaction (PCR and western blot analysis, respectively. The proliferation rate of human colon cancer cells was measured by using a 3-(4, 5-dimethylthiazol-2-yl-2, 5-diphenyltetrazolium bromide (MTT assay. Results: Expression of γ-aminobutyric acid B receptor 1 (GABABR1 showed a positive correlation with galectin-3 at both the transcriptional and the translational levels. Downregulation of galectin-3 decreased not only GABABR1 expression but also the proliferation rate of human colon cancer cells. However, Korean herbal extract, HangAmDan-B (HAD-B, decreased expression of GABABR1 without any expressional change of galectin-3, and offset γ-aminobutyric acid (GABA-enhanced human colon cancer cell proliferation. Conclusions: Our present study confirmed that GABABR1 expression was regulated by galectin-3. HAD-B induced galectin-3-independent down-regulation of GABABR1, which resulted in a decreased proliferation of human colon cancer cells. The therapeutic effect of HAD-B for the treatment of human colon cancer needs to be further validated.

  16. Proliferation after the Iraq war; La proliferation apres la guerre d'Irak

    Energy Technology Data Exchange (ETDEWEB)

    Daguzan, J.F

    2004-09-15

    This article uses the Iraq war major event to analyze the approach used by the US to fight against proliferation. It questions the decision and analysis process which has led to the US-British intervention and analyzes the consequences of the war on the proliferation of other countries and on the expected perspectives. Finally, the future of proliferation itself is questioned: do we have to fear more threat or is the virtuous circle of non-proliferation well started? (J.S.)

  17. Ibuprofen Can Induce Syndrome of Inappropriate Diuresis in Healthy Young Patients

    Directory of Open Access Journals (Sweden)

    Céline Roche

    2013-01-01

    Full Text Available A 30-year-old caucasian woman, without past medical history or known drug use, was admitted to the emergency department for persistent fever and arthralgias. The laboratory analysis showed moderate hypoosmolar hyponatremia (Na: 132 mmol/L, osmolality: 239 mOsm/L, normal sodium excretion (<20 mmol/L, and a high urinary osmolality (415 mOsm/L. Later, she deteriorated with seizures and deeper hyponatremia (Na: 113 mmol/L and so was moved to the critical care unit. At first, no obvious aetiology was found, the patient was euvolemic, as she was well hydrated and lacked concerning findings of heart failure, renal disease, or liver cirrhosis. A syndrome of inappropriate diuresis (SIAD was proposed, and corrective measures were started immediately to reduce her hyponatremia, including restriction of fluid intake. The administration of intravenous hypertonic saline solution permitted normal neurological status to be restored and corrected the sodium concentration but induced reversible acute renal failure. Further investigation revealed that the patient had ingested 8 g ibuprofen two days before admission. After other aetiologies were ruled out, drug-induced SIAD due to ibuprofen was the most likely diagnosis for this patient. SIAD-associated hyponatremia and acute renal failure are rare side effects of nonsteroidal anti-inflammatory drugs, particularly in young people. Therefore, this case may represent a unique case of NSAID-induced SIAD and highlight the need to obtain thorough medication histories and exclude all other potential causes in hyponatremic patients.

  18. Random mtDNA mutations modulate proliferation capacity in mouse embryonic fibroblasts

    International Nuclear Information System (INIS)

    Kukat, Alexandra; Edgar, Daniel; Bratic, Ivana; Maiti, Priyanka; Trifunovic, Aleksandra

    2011-01-01

    Highlights: → Increased mtDNA mutations in MEFs lead to high level of spontaneous immortalization. → This process is independent of endogenous ROS production. → Aerobic glycolysis significantly contributes to spontaneous immortalization of MEFs. -- Abstract: An increase in mtDNA mutation load leads to a loss of critical cells in different tissues thereby contributing to the physiological process of organismal ageing. Additionally, the accumulation of senescent cells that display changes in metabolic function might act in an active way to further disrupt the normal tissue function. We believe that this could be the important link missing in our understanding of the molecular mechanisms of premature ageing in the mtDNA mutator mice. We tested proliferation capacity of mtDNA mutator cells in vitro. When cultured in physiological levels of oxygen (3%) their proliferation capacity is somewhat lower than wild-type cells. Surprisingly, in conditions of increased oxidative stress (20% O 2 ) mtDNA mutator mouse embryonic fibroblasts exhibit continuous proliferation due to spontaneous immortalization, whereas the same conditions promote senescence in wild-type cells. We believe that an increase in aerobic glycolysis observed in mtDNA mutator mice is a major mechanism behind this process. We propose that glycolysis promotes proliferation and allows a fast turnover of metabolites, but also leads to energy crisis due to lower ATP production rate. This could lead to compromised replication and/or repair and therefore, in rare cases, might lead to mutations in tumor suppressor genes and spontaneous immortalization.

  19. Collecting duct renal cell carcinoma with the syndrome of inappropriate antidiuresis: An autopsy case report

    Directory of Open Access Journals (Sweden)

    Emi Yasuda

    2013-01-01

    Full Text Available A 57-year-old Japanese man visited our hospital with a moist cough. Chest radiographic imaging showed a left hilar shadow. Adenocarcinoma cells were found on cytologic screening of fresh sputum. Although multiple metastases including brain were detected, no tumor was observed in the kidneys. The patient underwent whole-brain irradiation and chemotherapy for advanced-stage lung cancer. One month before his death, carcinomatous meningitis was detected. Hyponatremia, hypo-osmolality, and hypertonic urine suggested the syndrome of inappropriate antidiuresis. Restricting water intake improved the hyponatremia; however, he developed fever and hematuria. Despite systemic administration of an antibacterial drug, he died. Primary tumor in the lung was absent, but adenocarcinoma of the right kidney was evident on autopsy. Lectin histochemical analysis of the carcinoma revealed its distal nephron origin, confirming collecting duct carcinoma. Severe carcinomatous meningitis, which is possibly caused the syndrome of inappropriate antidiuresis, was observed, with no cancer involvement of the pituitary gland and hypothalamus.

  20. Hydrocephalus in mice following X-irradiation at early gestational stage. Possibly due to persistent deceleration of cell proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Aolad, H.M.; Inouye, Minoru; Darmanto, W.; Hayasaka, Shizu; Murata, Yoshiharu [Nagoya Univ. (Japan). Research Inst. of Environmental Medicine

    2000-09-01

    The pathogenesis of X-ray-induced congenital hydrocephalus was studied. Pregnant mice were irradiated at 1.4 Gy on gestational day 7 (G7). Four hours after irradiation, extensive cell death was evident in the neuroepithelium and underlying mesoderm of the head region, and proliferating cell nuclear antigen (PCNA)-immunoreactive cells almost disappeared. Embryos with thinner lamina terminalis of the telecephalon, when compared with that of the control, were found in the irradiated group on G9. As early as G11 in some irradiated embryos the telencephalic wall was thinner and lateral ventricles were larger than those of the control. The choroid invagination from the lamina terminalis began on G11 in the control brain, but not in the affected brain. During the following development, fetuses with readily apparent hydrocephalus were consistently found among irradiated fetuses. In these brains the brain mantle was thinner, the corpus striatum and thalamic regions were smaller, and lateral ventricles were larger than those of the control. Even on G11 and G13 the frequencies of PCNA-positive cells in the brain mantle and other brain regions were lower in the hydrocephalic brain than those of the control, suggesting a decelerated proliferation of successive cell generations following exposure to X-rays. The cerebral aqueduct was open in the hydrocephalic brain during the fetal period when the lateral ventricles were dilated. The head was vaulted after birth but the cerebral aqueduct was not completely occluded even in these animals. These findings suggested that cell death in the neuroepithelium followed by a persistent deceleration of neural cell proliferation, resulting in the hypoplasia of brain parenchyma with compensatory ventricular dilatation, is important for the establishment of hydrocephalus. (author)

  1. Hydrocephalus in mice following X-irradiation at early gestational stage. Possibly due to persistent deceleration of cell proliferation

    International Nuclear Information System (INIS)

    Aolad, H.M.; Inouye, Minoru; Darmanto, W.; Hayasaka, Shizu; Murata, Yoshiharu

    2000-01-01

    The pathogenesis of X-ray-induced congenital hydrocephalus was studied. Pregnant mice were irradiated at 1.4 Gy on gestational day 7 (G7). Four hours after irradiation, extensive cell death was evident in the neuroepithelium and underlying mesoderm of the head region, and proliferating cell nuclear antigen (PCNA)-immunoreactive cells almost disappeared. Embryos with thinner lamina terminalis of the telecephalon, when compared with that of the control, were found in the irradiated group on G9. As early as G11 in some irradiated embryos the telencephalic wall was thinner and lateral ventricles were larger than those of the control. The choroid invagination from the lamina terminalis began on G11 in the control brain, but not in the affected brain. During the following development, fetuses with readily apparent hydrocephalus were consistently found among irradiated fetuses. In these brains the brain mantle was thinner, the corpus striatum and thalamic regions were smaller, and lateral ventricles were larger than those of the control. Even on G11 and G13 the frequencies of PCNA-positive cells in the brain mantle and other brain regions were lower in the hydrocephalic brain than those of the control, suggesting a decelerated proliferation of successive cell generations following exposure to X-rays. The cerebral aqueduct was open in the hydrocephalic brain during the fetal period when the lateral ventricles were dilated. The head was vaulted after birth but the cerebral aqueduct was not completely occluded even in these animals. These findings suggested that cell death in the neuroepithelium followed by a persistent deceleration of neural cell proliferation, resulting in the hypoplasia of brain parenchyma with compensatory ventricular dilatation, is important for the establishment of hydrocephalus. (author)

  2. Introduction of inappropriate complementary feeding in the first year of life and associated factors in children with low socioeconomic status.

    Science.gov (United States)

    Dallazen, Camila; Silva, Sara Araújo da; Gonçalves, Vivian Siqueira Santos; Nilson, Eduardo Augusto Fernandes; Crispim, Sandra Patricia; Lang, Regina Maria Ferreira; Moreira, Júlia Dubois; Tietzmann, Daniela Cardoso; Vítolo, Márcia Regina

    2018-02-19

    The study aimed to identify factors associated with the introduction of inappropriate complementary feeding in the first year of life in children living in municipalities (counties) with low socioeconomic statusl. This was a cross-sectional multicenter study in 1,567 children 12 to 59 months of age in 48 municipalities participating in the Brazil Without Poverty plan in the South of Brazil. A structured questionnaire was applied to the children's parents to obtain socio-demographic information and the age at which inappropriate complementary foods were introduced for the first time in complementary feeding. Prevalence of introduction of sugar before four months of age was 35.5% (n = 497; 95%CI: 33.1-38.0). The prevalence rates for the introduction of cookies/crackers, creamy yogurt, and jelly before six months of age were 20.4% (n = 287; 95%CI: 18.3-22.3), 24.8% (n = 349; 95%CI: 22.4-27.1), and 13.8% (n = 192; 95%CI: 12.0-15.7), respectively. Associations were identified between low maternal schooling (PR = 1.25; 95%CI: 1.03-1.51) and low monthly family income (PR = 1.22; CI95%: 1.01-1.48) and the introduction of inappropriate complementary feeding. The study identified the introduction of inappropriate complementary feeding in the first year of life among children in municipalities with high socioeconomic vulnerability in the South of Brazil, associated with low maternal schooling and low monthly family income.

  3. The prognosis of retinal detachment due to lattice degeneration.

    Science.gov (United States)

    Benson, W E; Morse, P H

    1978-09-01

    In a series of 553 consecutive retinal detachments, 29% (120) were due to lattice degeneration. Forty-five percent of these were due to atrophic holes in the lattice degeneration and 55% were due to tears caused by traction posterior to or at the end of a patch of lattice. In phakic patients, retinal detachments due to atrophic holes were most common in young myopes. Detachments due to traction tears were seen in older, less myopic patients. The incidence of massive periretinal proliferation was less (5%) in detachments due to lattice degeneration than in detachments not due to lattice degeneration (6.5%).

  4. VASCULAR PROLIFERATION AS AN UNUSUAL CAUSE OF HEMORRHAGIC DIATHESIS IN MYELOFIBROSIS

    NARCIS (Netherlands)

    ALBEDA, FW; VANDERMEER, J; VELLENGA, E

    One year after splenectomy, a patient with myelofibrosis developed spontaneously large hematomas that were not due to coagulation abnormalities or functionally defective platelets. At autopsy, the liver, muscle, and skin showed extramedullary hematopoiesis associated with capillary proliferation and

  5. Uncertainties in Nuclear Proliferation Modeling

    International Nuclear Information System (INIS)

    Kim, Chul Min; Yim, Man-Sung; Park, Hyeon Seok

    2015-01-01

    There have been various efforts in the research community to understand the determinants of nuclear proliferation and develop quantitative tools to predict nuclear proliferation events. Such systematic approaches have shown the possibility to provide warning for the international community to prevent nuclear proliferation activities. However, there are still large debates for the robustness of the actual effect of determinants and projection results. Some studies have shown that several factors can cause uncertainties in previous quantitative nuclear proliferation modeling works. This paper analyzes the uncertainties in the past approaches and suggests future works in the view of proliferation history, analysis methods, and variable selection. The research community still lacks the knowledge for the source of uncertainty in current models. Fundamental problems in modeling will remain even other advanced modeling method is developed. Before starting to develop fancy model based on the time dependent proliferation determinants' hypothesis, using graph theory, etc., it is important to analyze the uncertainty of current model to solve the fundamental problems of nuclear proliferation modeling. The uncertainty from different proliferation history coding is small. Serious problems are from limited analysis methods and correlation among the variables. Problems in regression analysis and survival analysis cause huge uncertainties when using the same dataset, which decreases the robustness of the result. Inaccurate variables for nuclear proliferation also increase the uncertainty. To overcome these problems, further quantitative research should focus on analyzing the knowledge suggested on the qualitative nuclear proliferation studies

  6. Level, pattern, and determinants of polypharmacy and inappropriate use of medications by village doctors in a rural area of Bangladesh

    Directory of Open Access Journals (Sweden)

    Rasu RS

    2014-12-01

    Full Text Available Rafia S Rasu,1 Mohammad Iqbal,2 SMA Hanifi,2 Ariful Moula2 Shahidul Hoque,2 Sabrina Rasheed,2 Abbas Bhuiya2 1School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA; 2Centre for Equity and Health System, International Centre for Diarrhoeal Disease Research (ICDDR,B, Dhaka, Bangladesh Objective: Village doctors, informal health care providers practicing modern medicine, are dominant health care providers in rural Bangladesh. Given their role, it is important to examine their prescription pattern and inappropriate use of medication. Methods: These cross-sectional study data were collected through surveys of patients seen by village doctors during 2008 and 2010 at Chakaria, a typical rural area of Bangladesh. Categorization of appropriate, inappropriate, and harmful prescriptions by disease conditions was based on guidelines defined by the World Health Organization (WHO, the United Nations Children’s Fund (UNICEF, and the Government of Bangladesh. Analytical categorization of polypharmacy was defined when five or more medications were prescribed for a patient at a single visit. Findings: A total of 2,587 prescriptions were written by village doctors during the survey periods. Among the prescriptions were appropriate (10%, inappropriate (8%, combination of appropriate and inappropriate (63%, and harmful medications (19%. Village doctors with more than high school education were 53% less likely (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.26–0.86 to give polypharmacy prescriptions than those with less than high school education. While exploring determinants of prescribing inappropriate and harmful medications, this study found that polypharmacy prescriptions were six times more likely [OR: 6.00, 95% CI: 3.88–9.29] to have harmful medications than prescriptions with <5 medications. Conclusion: Village doctors’ training and supervision may improve the quality of services and establish accountability for the

  7. Proliferation Networks and Financing

    International Nuclear Information System (INIS)

    Gruselle, Bruno

    2007-01-01

    The objective of this study is to propose practical solutions aimed at completing and strengthening the existing arrangement for the control of nuclear proliferation through a control of financial as well as material or immaterial flows. In a first part, the author proposes a systemic analysis of networks of suppliers and demanders. He notably evokes the Khan's network and the Iraqi acquisition network during the 1993-2001 period. He also proposes a modelling of proliferation networks (supplier networks and acquisition networks) and of their interactions. In a second part, the author examines possible means and policies aimed at neutralising proliferation networks: organisation, adaptation and improvement of intelligence tools in front of proliferation networks, and means, limitations and perspectives of network neutralisation. He also briefly addresses the possibility of military action to contain proliferation flows

  8. Downregulation of miR-15a due to LMP1 promotes cell proliferation and predicts poor prognosis in nasal NK/T-cell lymphoma.

    Science.gov (United States)

    Komabayashi, Yuki; Kishibe, Kan; Nagato, Toshihiro; Ueda, Seigo; Takahara, Miki; Harabuchi, Yasuaki

    2014-01-01

    Nasal NK/T-cell lymphoma (NNKTL) is an Epstein-Barr virus (EBV)-associated malignancy and has distinct clinical and histological features. However, its genetic features are hitherto unclear. MicroRNAs (miRNAs) play a crucial role in the pathogenesis of several malignancies via regulating gene expression. In this study, we investigated whether the specific microRNAs were related to the tumor behaviors in NNKTL. MiRNA array and Quantitative RT-PCR analyses revealed that miR-15a was expressed at a much lower level in NNKTL cells (SNK-1, SNK-6, and SNT-8) than in normal peripheral NK cells and EBV-negative NK cell line KHYG-1. Quantitative PCR and western blot analyses showed that the expression of MYB and cyclin D1, which are validated targets of miR-15a, was higher in NNKTL cells. Transfection of NNKTL cells (SNK-6 and SNT-8) with a miR-15a precursor decreased MYB and cyclin D1 levels, thereby blocking G1/S transition and cell proliferation. Knockdown of EBV-encoded latent membrane protein 1 (LMP1) significantly increased miR-15a expression in SNK-6 cells. In NNKTL tissues, we found that reduced miR-15a expression, which correlated with MYB and cyclin D1 expression, was associated with poor prognosis of NNKTL patients. These data suggest that downregulation of miR-15a, possibly due to LMP1, implicates in the pathogenesis of NNKTL by inducing cell proliferation via MYB and cyclin D1. Thus, miR-15a could be a potential target for antitumor therapy and a prognostic predictor for NNKTL. Copyright © 2013 Wiley Periodicals, Inc.

  9. Can we predict nuclear proliferation

    International Nuclear Information System (INIS)

    Tertrais, Bruno

    2011-01-01

    The author aims at improving nuclear proliferation prediction capacities, i.e. the capacities to identify countries susceptible to acquire nuclear weapons, to interpret sensitive activities, and to assess nuclear program modalities. He first proposes a retrospective assessment of counter-proliferation actions since 1945. Then, based on academic studies, he analyzes what causes and motivates proliferation, with notably the possibility of existence of a chain phenomenon (mechanisms driving from one program to another). He makes recommendations for a global approach to proliferation prediction, and proposes proliferation indices and indicators

  10. NSAIDs and Cell Proliferation in Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Raj Ettarh

    2010-06-01

    Full Text Available Colon cancer is common worldwide and accounts for significant morbidity and mortality in patients. Fortunately, epidemiological studies have demonstrated that continuous therapy with NSAIDs offers real promise of chemoprevention and adjunct therapy for colon cancer patients. Tumour growth is the result of complex regulation that determines the balance between cell proliferation and cell death. How NSAIDs affect this balance is important for understanding and improving treatment strategies and drug effectiveness. NSAIDs inhibit proliferation and impair the growth of colon cancer cell lines when tested in culture in vitro and many NSAIDs also prevent tumorigenesis and reduce tumour growth in animal models and in patients, but the relationship to inhibition of tumour cell proliferation is less convincing, principally due to gaps in the available data. High concentrations of NSAIDs are required in vitro to achieve cancer cell inhibition and growth retardation at varying time-points following treatment. However, the results from studies with colon cancer cell xenografts are promising and, together with better comparative data on anti-proliferative NSAID concentrations and doses (for in vitro and in vivo administration, could provide more information to improve our understanding of the relationships between these agents, dose and dosing regimen, and cellular environment.

  11. Lymphocyte Proliferation Response in Patients with Acute and Chronic Brucellosis

    Directory of Open Access Journals (Sweden)

    Khadijeh Khosravi

    2016-05-01

    Full Text Available Abstract Background: Brucella is an intracellular bacterium that causes chronic infection in humans and domestic animals. The underlying mechanisms that cause prolonged illness are complex and not fully understood. Immune responses may have an important role in the chronicity of infection. Here, we evaluated the lymphocyte proliferation responses in patients with chronic and acute brucellosis. Materials and Methods: This descriptive - analytical study was performed on 22 patients with acute brucellosis, 21 patients with chronic brucellosis and 21 healthy people with the similar age, sex and genetic background as control group. Peripheral lymphocytes were isolated using Ficoll and the cellular proliferation was quantified in presence of antigen and phytohemaglutinin-A by MTT method. Results: The brucella antigen-specific stimulation index in patients with chronic brucellosis was significantly lower than the acute brucellosis patients (p=0.001. Also, stimulating the lymphocytes with phytohemaglutinin-A has shown that proliferative response in patients with chronic brucellosis was lower than the other groups (p=0.04. Conclusion: The results indicated that chronic brucellosis inhibits lymphocyte proliferation. This inhibition of lymphocyte proliferation may be due to the induction of anergy.

  12. Lean Methodology Reduces Inappropriate Use of Antipsychotics for Agitation at a Psychiatric Hospital.

    Science.gov (United States)

    Goga, Joshana K; Depaolo, Antonio; Khushalani, Sunil; Walters, J Ken; Roca, Robert; Zisselman, Marc; Borleis, Christopher

    2017-01-01

    To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. Historically Controlled Study. Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit. All Patients Admitted on the Dementia Unit Were 65 Years of Age and Older with a Primary Diagnosis of Dementia. our Multidisciplinary Team Used Lean Methodology to Identify the Root Causes and Interventions Necessary to Reduce Inappropriate Antipsychotic Use. The Primary Outcome Was Rate of Inappropriately Indicating Agitation as the Rationale When Prescribing Antipsychotic Medications. There Was a 90% (P Agitation. The Lean Methodology Interventions Led To A 90% (P Agitation and a 10% Rate Reduction in Overall Antipsychotic Prescribing. Key Words: Agitation Alzheimer's Antipsychotics Behavioral and Psychological Symptoms of Dementia Centers For Medicare & Medicaid Services Dementia Root-cause Analysis. BPSD = Behavioral and Psychological Symptoms of Dementia CATIE-AD = Clinical Antipsychotic Trials of Intervention Effectiveness in Alzheimer's Disease EMR = Electronic Medical Records GAO = Government Accountability Office GNCIS = Geriatric Neuropsychiatric Clinical Indicator Scale.

  13. The inappropriate use of lumbar magnetic resonance imaging in a health service area; Utilizacion inapropiada de la resonancia magnetica lumbar en un area de salud

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Recio, F. J.; Sanz, J. C.; Vera, S. [Hospital General de Soria (Spain); Peiro, S. [Fundacion de Investigacion en Servicios de Salud Valencia (Spain)

    1999-07-01

    To identify the percentage of inappropriate lumbar spine magnetic resonance imaging in the Soria Health Service, to quantify the costs and the possible association between inadequate use, the characteristics of the patient and the services requested. A descriptive study of the inappropriate use of MRI of the lumbar spine, taken from the retrospective examination, carried out by a radiologist, of the 233 MRI's requested between 1995 and 1998. For the valuation, the criteria of the American College of Radiology (ACR) and the Basque Agency for the Evaluation of Technologies (OSTEBA) were used. All the MRI's were carried out at an approved centre, the costs were calculated taken form the expenses paid by the Insalud, including the transport costs, calculated at prices applicable for the year in question. 11.7% of the studies were values as inappropriate, 2.1% debatable and the remainder adequate according to the ACR criteria, concentrating the inadequacy on studies for lumbago, that reached 80% of the inappropriate requests. The ACR and OSTEBA criteria coincided to a high degree (kappa statistics: 0.87). The expense related to the unnecessary studies was a litter higher than a million pesetas. No differences were found in the proportion of inappropriate studies according to the characteristics of the patient or the service requested, except the one already mentioned for the supposition diagnosis. Although the results of the study cannot be generalised to other environments, they suggest the possibility of a significant proportion of inappropriate use of lumbar spine MRI that could have an important repercussion on health care expenses. (Author) 11 refs.

  14. Which future for nuclear counter-proliferation?; Quel avenir pour la contre-proliferation nucleaire?

    Energy Technology Data Exchange (ETDEWEB)

    Duval, M.

    2010-07-15

    Dealing with the case of nuclear weapons possessed by nuclear states (but not eventually by terrorists), the author first identifies the constants of counter-proliferation: it is linked to interest conflicts between those who try to preserve their monopoly and those who try to acquire a new weapon either because of a threat or for reasons of regional prestige, the evolution from use to deterrence, the appearance of new actors after the USA and Russia, the role of nuclear tactical weapons, and the future of Russian weapons and know-how. He presents the international counter-proliferation context: the Non Proliferation Treaty (NPT), the IAEA and its controls, the Nuclear Supplier Group (NSG), the nuclear-free zones, the Comprehensive Test Ban Treaty (CTBT), the Missile Technology Control Regime (MTCR). He describes how and why proliferation occurs: uranium enrichment and plutonium technology, political reasons in different parts of the world. Then, he gives an overview of the proliferation status by commenting the cases of Israel, Iraq, India, Pakistan, North Korea, and Iran. He discusses the future of proliferation (involved countries, existence of a nuclear black market) and of counter-proliferation as far as Middle-East and North Korea are concerned. He tries finally to anticipate the consequences for nuclear deterrence strategy, and more particularly for Europe and France

  15. Non-proliferation and nuclear data

    International Nuclear Information System (INIS)

    Sowerby, M.G.

    1978-01-01

    A review is made of the problem of the proliferation of nuclear weapons with particular emphasis on proliferation and nuclear power. Some indications of the nuclear data requirements associated with methods of reducing proliferation risks are presented

  16. Comment on "No evidence of displacement due to wind turbines in breeding grassland songbirds"

    Science.gov (United States)

    Johnson, Douglas H.

    2016-01-01

    A recent article published in The Condor: Ornithological Applications by Hale et al. (2014) is entitled, “No evidence of displacement due to wind turbines in breeding grassland songbirds.” The conclusion stated in that title, unfortunately, is based on inappropriate statistical analysis of data collected by the authors. In fact, their data provide evidence of potential displacement by wind turbines in 2 of the 3 species considered.

  17. Extent and cost of inappropriate use of tumour markers in patients with pulmonary disease: a multicentre retrospective study in Shanghai, China.

    Science.gov (United States)

    Zhang, Haichen; Song, Yunxiao; Zhang, Xiong; Hu, Jun; Yuan, Suwei; Ma, Jin

    2018-02-28

    The currently implemented healthcare reform in China requires substantial capital investment. Although overtreatment results in serious waste, inappropriate laboratory use is widespread, and overuse of tumour markers (TMs) has attracted increasing attention. Retrospective study. The respiratory, thoracic surgery and oncology departments of three hospitals in Shanghai from 2014 to 2015. Patients with chronic obstructive pulmonary disease (COPD) and primary bronchogenic lung cancer (PLC). Based on clinical guidelines and physician experience, the criteria of suitability of TM examinations were determined, and the number, cost and proportion of inappropriate TM requests were analysed. The area under the receiver operating characteristic curve for carcinoembryonic antigen+cytokeratin fragment 21-1+squamous cell carcinoma antigen+neuron-specific enolase in patients with COPD and PLC was 0.813, in accordance with the cost-effectiveness principle, indicating good clinical and health economics values. In the 2706 patients, 12 496-16 956 (58.27%-79.06%) of TM requests were inappropriate. Furthermore, the involved expense was 650 200-1 014 156 yuan, accounting for 7.69%-12.00% of examination expenses and 1.35%-2.11% of hospitalisation costs. We found that the inappropriate use of TMs was widespread for patients with pulmonary disease. Clinicians should use TMs strictly according to the guidelines to effectively manage laboratory resources and control costs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Potentially inappropriate medication use in a city of Southeast Brazil

    Directory of Open Access Journals (Sweden)

    Mauro Cunha Xavier Pinto

    2012-03-01

    Full Text Available Potentially inappropriate medication use by the Diamantina (Minas Gerais State population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179 and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82 of prescriptions and 92.68% (n=76 of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268 while 21.99% (n=91 of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society, representing an issue requiring effective actions to promote rational use of medicines.O consumo inapropriado de medicamentos pela população de Diamantina-MG foi investigado através da análise do consumo de medicamentos, automedicação, polifarmácia e interações medicamentosas prescritas aos entrevistados. Também foi avaliado o nível de conhecimento sobre uso racional de medicamentos e sua relação com variáveis sócio-econômicas através de um questionário semi-estruturado. Este estudo transversal foi baseado em amostragem estratificada e contou com a participação de 423 indivíduos selecionados aleatoriamente. A prevalência do consumo de medicamentos prescritos foi de 42,32% (n=179, sendo os

  19. Proliferation: myth or reality?

    International Nuclear Information System (INIS)

    2005-01-01

    This article analyzes the proliferation approach, its technical condition and political motivation, and the share between the myth (political deception, assumptions and extrapolations) and the reality of proliferation. Its appreciation is complicated by the irrational behaviour of some political actors and by the significant loss of the non-use taboo. The control of technologies is an important element for proliferation slowing down but an efficient and autonomous intelligence system remains indispensable. (J.S.)

  20. Response to hypothetical social scenarios in individuals with traumatic brain injury who present inappropriate social behavior: a preliminary report.

    Science.gov (United States)

    Gagnon, Jean; Henry, Anne; Decoste, François-Pierre; Ouellette, Michel; McDuff, Pierre; Daelman, Sacha

    2013-03-01

    Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB) post-TBI (traumatic brain injury). To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB), have difficulty anticipating their own feelings of embarrassment and others' angry reactions following an ISB. Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB), 10 presenting with appropriate social behavior (TBI-ASB), and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A) and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B). TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. RESULTS regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. RESULTS suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying mechanisms affecting social behaviors after a TBI.

  1. Response to Hypothetical Social Scenarios in Individuals with Traumatic Brain Injury Who Present Inappropriate Social Behavior: A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Michel Ouellette

    2013-01-01

    Full Text Available Background: Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB post-TBI (traumatic brain injury. Objectives: To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB, have difficulty anticipating their own feelings of embarrassment and others’ angry reactions following an ISB. Methods: Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB, 10 presenting with appropriate social behavior (TBI-ASB, and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B. Results: TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. Results regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. Conclusions: Results suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying

  2. Using proliferation risk as a design metric in the development of nuclear systems

    International Nuclear Information System (INIS)

    Beard, C.; Lebouf, R.

    2001-01-01

    The necessity has arisen for newly proposed nuclear systems to be evaluated with regard to their potential aid to any proliferation. Thus, a mechanism is needed to introduce nonproliferation as a measure in the design phase of a new nuclear system. To accomplish this, a methodology for quantifying and measuring the proliferation risk of proposed system options is required. Such quantification has its difficulties due to inherent uncertainty, e.g. what is the probability that a quantity of material will be stolen in a given situation? Also, the lack of data on such occurrences makes the task of quantification nearly insurmountable. A systematic approach is necessary to estimate the proliferation risk. Currently, an advanced nuclear power system, the Accelerator Transmutation of Waste (ATW) program has been initiated to develop a system that will concurrently generate electricity while destroying long-lived radioactive isotopes. Therefore, because of the issues noted above, an effort to introduce proliferation risk into the design phase has been started. The purpose of this paper is to review previous work in quantification of proliferation risk in an effort to develop the proper basis for the current work. It should be noted that while proliferation on a national level has been studied extensively, efforts to quantify proliferation risk of individual nuclear systems or processes have been limited. Consequently, the available literature base is relatively sparse. (author)

  3. Using proliferation risk as a design metric in the development of nuclear systems

    Energy Technology Data Exchange (ETDEWEB)

    Beard, C.; Lebouf, R. [Texas Univ., Austin, TX (United States). Nuclear Engineering Teaching Lab.

    2001-07-01

    The necessity has arisen for newly proposed nuclear systems to be evaluated with regard to their potential aid to any proliferation. Thus, a mechanism is needed to introduce nonproliferation as a measure in the design phase of a new nuclear system. To accomplish this, a methodology for quantifying and measuring the proliferation risk of proposed system options is required. Such quantification has its difficulties due to inherent uncertainty, e.g. what is the probability that a quantity of material will be stolen in a given situation? Also, the lack of data on such occurrences makes the task of quantification nearly insurmountable. A systematic approach is necessary to estimate the proliferation risk. Currently, an advanced nuclear power system, the Accelerator Transmutation of Waste (ATW) program has been initiated to develop a system that will concurrently generate electricity while destroying long-lived radioactive isotopes. Therefore, because of the issues noted above, an effort to introduce proliferation risk into the design phase has been started. The purpose of this paper is to review previous work in quantification of proliferation risk in an effort to develop the proper basis for the current work. It should be noted that while proliferation on a national level has been studied extensively, efforts to quantify proliferation risk of individual nuclear systems or processes have been limited. Consequently, the available literature base is relatively sparse. (author)

  4. Neural control of colonic cell proliferation.

    Science.gov (United States)

    Tutton, P J; Barkla, D H

    1980-03-15

    The mitotic rate in rat colonic crypts and in dimethylhydrazine-induced colonic carcinomas was measured using a stathmokinetic technique. In sympathectomized animals cell proliferation was retarded in the crypts but not in the tumors, whereas in animals treated with Metaraminol, a drug which releases norepinephrine from nerve terminals, crypt cell but not tumor cell proliferation was accelerated. Blockade of alpha-adrenoceptors also inhibited crypt cell proliferation. However, stimulation of beta-adrenoceptors inhibited and blockade of beta-adrenoceptors accelerated tumor cell proliferation without influencing crypt cell proliferation. Injection of either serotonin or histamine stimulated tumor but not crypt cell proliferation and blockade or serotonin receptors or histamine H2-receptors inhibited tumor cell proliferation. It is postulated that cell proliferation in the colonic crypts, like that in the jejunal crypts, is under both endocrine and autonomic neural control whereas colonic tumor cell division is subject to endocrine regulation alone.

  5. Controlling nuclear proliferation

    International Nuclear Information System (INIS)

    Sweet, W.

    1981-01-01

    Nuclear non-proliferation policy depends on the 1968 Non-Proliferation Treaty, in which countries promise not to acquire nuclear weapons in exchange for open access to peaceful nuclear technology, and a system of international safeguards that are imposed on exported nuclear equipment and facilities operated by parties to the treaty. Critics have feared all along that non-nuclear countries might circumvent or exploit the system to obtain nuclear weapons and that the Atoms for Peace plan would spread the very technology it sought to control. The nuclear weapons states would like everyone else to believe that atomic bombs are undesirable, but they continue to rely on the bombs for their own defense. Israel's raid on Iraq's nuclear reactor focused world attention on the proliferation problem and helped to broaden and sterengthen its prospects. It also highlighted the weakness that there are no effective sanctions against violators. Until the international community can ageee on enforcement measures powerful enough to prevent nuclear proliferation, individual countries may be tempted to follow Israel's example, 19 references

  6. Proliferation risks

    International Nuclear Information System (INIS)

    Carchon, R.

    1998-09-01

    The report gives an overview of different aspects related to safeguards of fissile materials. Existing treaties including the Non-Proliferation Treaty, and the Tlatelolco and the Rarotonga Treaties are discussed. An overview of safeguards systems for the control of fissile materials as well as the role of various authorities is given. An overall overview of proliferation risks, the physical protection of fissile materials and the trade in fissile materials is given. Finally, the status in problem countries and de facto nuclear weapon states is discussed

  7. Proliferation after the Iraq war

    International Nuclear Information System (INIS)

    Daguzan, J.F.

    2004-09-01

    This article uses the Iraq war major event to analyze the approach used by the US to fight against proliferation. It questions the decision and analysis process which has led to the US-British intervention and analyzes the consequences of the war on the proliferation of other countries and on the expected perspectives. Finally, the future of proliferation itself is questioned: do we have to fear more threat or is the virtuous circle of non-proliferation well started? (J.S.)

  8. Effect of a multi-faceted quality improvement intervention on inappropriate antibiotic use in children with non-bloody diarrhoea admitted to district hospitals in Kenya

    Directory of Open Access Journals (Sweden)

    Opondo Charles

    2011-11-01

    Full Text Available Abstract Background There are few reports of interventions to reduce the common but irrational use of antibiotics for acute non-bloody diarrhoea amongst hospitalised children in low-income settings. We undertook a secondary analysis of data from an intervention comprising training of health workers, facilitation, supervision and face-to-face feedback, to assess whether it reduced inappropriate use of antibiotics in children with non-bloody diarrhoea and no co-morbidities requiring antibiotics, compared to a partial intervention comprising didactic training and written feedback only. This outcome was not a pre-specified end-point of the main trial. Methods Repeated cross-sectional survey data from a cluster-randomised controlled trial of an intervention to improve management of common childhood illnesses in Kenya were used to describe the prevalence of inappropriate antibiotic use in a 7-day period in children aged 2-59 months with acute non-bloody diarrhoea. Logistic regression models with random effects for hospital were then used to identify patient and clinician level factors associated with inappropriate antibiotic use and to assess the effect of the intervention. Results 9, 459 admission records of children were reviewed for this outcome. Of these, 4, 232 (44.7% were diagnosed with diarrhoea, with 130 of these being bloody (dysentery therefore requiring antibiotics. 1, 160 children had non-bloody diarrhoea and no co-morbidities requiring antibiotics-these were the focus of the analysis. 750 (64.7% of them received antibiotics inappropriately, 313 of these being in the intervention hospitals vs. 437 in the controls. The adjusted logistic regression model showed the baseline-adjusted odds of inappropriate antibiotic prescription to children admitted to the intervention hospitals was 0.30 times that in the control hospitals (95%CI 0.09-1.02. Conclusion We found some evidence that the multi-faceted, sustained intervention described in this

  9. Fissile material disposition and proliferation risk

    Energy Technology Data Exchange (ETDEWEB)

    Dreicer, J.S.; Rutherford, D.A. [Los Alamos National Lab., NM (United States). NIS Div.

    1996-05-01

    The proliferation risk of a facility is dependent on the material attractiveness, level of safeguards, and physical protection applied to the material in conjunction with an assessment of the impact of the socioeconomic circumstances and threat environment. Proliferation risk is a complementary extension of proliferation resistance. The authors believe a better determination of nuclear material proliferation can be achieved by establishing the proliferation risk for facilities that contain nuclear material. Developing a method that incorporates the socioeconomic circumstances and threat environment inherent to each country enables a global proliferation assessment. In order to effectively reduce the nuclear danger, a broadly based set of criteria is needed that provides the capability to relatively assess a wide range of disposition options/facilities in different countries and still ensure a global decrease in proliferation risk for plutonium.

  10. Fissile material disposition and proliferation risk

    International Nuclear Information System (INIS)

    Dreicer, J.S.; Rutherford, D.A.

    1996-01-01

    The proliferation risk of a facility is dependent on the material attractiveness, level of safeguards, and physical protection applied to the material in conjunction with an assessment of the impact of the socioeconomic circumstances and threat environment. Proliferation risk is a complementary extension of proliferation resistance. The authors believe a better determination of nuclear material proliferation can be achieved by establishing the proliferation risk for facilities that contain nuclear material. Developing a method that incorporates the socioeconomic circumstances and threat environment inherent to each country enables a global proliferation assessment. In order to effectively reduce the nuclear danger, a broadly based set of criteria is needed that provides the capability to relatively assess a wide range of disposition options/facilities in different countries and still ensure a global decrease in proliferation risk for plutonium

  11. Intelligence and Nuclear Proliferation: Lessons Learned

    International Nuclear Information System (INIS)

    Hansen, Keith A.

    2011-09-01

    Intelligence agencies play a fundamental role in the prevention of nuclear proliferation, as they help to understand other countries' intentions and assess their technical capabilities and the nature of their nuclear activities. The challenges in this area remain, however, formidable. Past experiences and the discoveries of Iraq's WMD programs, of North Korean nuclear weapon program, and of Iranian activities, have put into question the ability of intelligence to monitor small, clandestine proliferation activities from either states or non-state entities. This Proliferation Paper analyzes the complex challenges intelligence faces and the various roles it plays in supporting national and international nuclear non-proliferation efforts, and reviews its track record. In an effort to shed light on the role and contribution of intelligence in national and international efforts to halt, if not prevent, further nuclear weapon proliferation, this paper first analyzes the challenges intelligence faces in monitoring small, clandestine proliferation activities and the role it plays in supporting non-proliferation efforts. It then reviews the intelligence track record in monitoring proliferation including the lessons learned from Iraq. Finally, it addresses whether it is possible for intelligence to accurately monitor future clandestine proliferation efforts. (author)

  12. Getting serious about proliferation

    International Nuclear Information System (INIS)

    Leventhal, P.

    1984-01-01

    The US needs to give a higher priority to nuclear non-proliferation, but Reagan's policies assume that proliferation is inevitable and that it is more important to be a reliable supplier than to cause trade frictions by trading only with those nations which sign the non-proliferation treaty (NPT). This undercuts US leadership and the intent of the agreement. Several bills now before Congress could help to restore US leadership by tightening export restrictions and the use of plutonium from the US

  13. [Discontinuation of potentially inappropriate medications at the end of life: perspectives from patients, their relatives, and physicians

    NARCIS (Netherlands)

    Geijteman, E.C.; Tempelman, M.M.; Dees, M.K.; Huisman, B.A.H.; Perez, R.S.; Zuylen, L. van; Heide, A. van der

    2017-01-01

    OBJECTIVE: To obtain insight into the perspectives of patients, relatives and physicians towards potentially inappropriate medications (PIMs) at the end of life. DESIGN: Qualitative interview study. METHOD: An analysis of in-depth interviews with 17 patients who were diagnosed as having a life

  14. Collagen Promotes Higher Adhesion, Survival and Proliferation of Mesenchymal Stem Cells.

    Directory of Open Access Journals (Sweden)

    Chinnapaka Somaiah

    Full Text Available Mesenchymal stem cells (MSC can differentiate into several cell types and are desirable candidates for cell therapy and tissue engineering. However, due to poor cell survival, proliferation and differentiation in the patient, the therapy outcomes have not been satisfactory. Although several studies have been done to understand the conditions that promote proliferation, differentiation and migration of MSC in vitro and in vivo, still there is no clear understanding on the effect of non-cellular bio molecules. Of the many factors that influence the cell behavior, the immediate cell microenvironment plays a major role. In this context, we studied the effect of extracellular matrix (ECM proteins in controlling cell survival, proliferation, migration and directed MSC differentiation. We found that collagen promoted cell proliferation, cell survival under stress and promoted high cell adhesion to the cell culture surface. Increased osteogenic differentiation accompanied by high active RHOA (Ras homology gene family member A levels was exhibited by MSC cultured on collagen. In conclusion, our study shows that collagen will be a suitable matrix for large scale production of MSC with high survival rate and to obtain high osteogenic differentiation for therapy.

  15. Argentina’s nuclear development and the non-proliferation regime

    Directory of Open Access Journals (Sweden)

    Sandra Colombo

    2017-01-01

    Full Text Available The development and transfer of nuclear technology have been put under strict control due to its possible military use, leading to the creation of international non-proliferation regimes. One of the latest proposals was the creation of multilateral banks of low enriched uranium (leu. The article states that, under the goal of non-proliferation, this initiative can contribute to accentuate the asymmetry in the distribution of world economic and political power, damaging the endogenous development of this technology in emerging countries. Against this, the article investigates the existence of margins to maneuver in the international system from the case of study of Argentina, one of the few developing countries that have managed to export nuclear technology, and has declared the development of independent nuclear activity as a State policy

  16. Development of bioengineering system for stem cell proliferation

    Science.gov (United States)

    Park, H. S.; Shah, R.; Shah, C.

    2016-08-01

    From last decades, intensive research in the field of stem cells proliferation had been promoted due to the unique property of stem cells to self-renew themselves into multiples and has potential to replicate into an organ or tissues and so it's highly demanding though challenging. Bioreactor, a mechanical device, works as a womb for stem cell proliferation by providing nutritious environment for the proper growth of stem cells. Various factors affecting stem cells growth are the bioreactor mechanism, feeding of continuous nutrients, healthy environment, etc., but it always remains a challenge for controlling biological parameters. The present paper unveils the design of mechanical device commonly known as bioreactor in tissues engineering and biotech field, use for proliferation of stem cells and imparts the proper growing condition for stem cells. This high functional bioreactor provides automation mixing of cell culture and stem cells. This design operates in conjunction with mechanism of reciprocating motion. Compare to commercial bioreactors, this proposed design is more convenient, easy to operate and less maintenance is required as bioreactor culture bag is made of polyethylene which is single use purpose. Development of this bioengineering system will be beneficial for better growth and expansion of stem cell

  17. Nuclear proliferation: linkages and solutions

    International Nuclear Information System (INIS)

    Quester, G.H.

    1979-01-01

    Nuclear proliferation must be periodically re-examined as a moral as well as a practical foreign policy dilemma. The question is asked whether proliferation precludes a safe and peaceful world, or if a halt to proliferation is adequate without other arms control. The moral dilemma in foreign policy arises over the need to make practical choices which often serve one goal while sacrificing another. The ramifications of nuclear proliferation are examined and the conclusions reached that it is not an acceptable option. It is also decided that, because general disarmament steps will be more difficult to achieve, the world may have to accept a small number of nuclear arsenals as the price of state sovereignties. A high priority for making the effort to prevent proliferation is advised. 8 references

  18. The European dimension in non-proliferation

    International Nuclear Information System (INIS)

    Krause, J.

    1996-01-01

    Europe was for decades the focal point of efforts to prevent or constrain nuclear proliferation and the first region in which non-proliferation efforts failed. Paper deals with current proliferation problems in Europe, namely, diversion of weapons, diversion from dismantling, production over-capacity, security concerns. Legal instruments against proliferation in Europe described here include development of international norms; instruments of security assurance and cooperation; disarmament assistance; fissile material management; assistance in creating export control systems; improving and harmonizing export controls for dual-purpose items. Problems in implementing non-proliferation instruments are described separately

  19. Molecular imaging of proliferation with [{sup 18}F]FLT-PET; Molekulare Bildgebung der Proliferation mit [{sup 18}F]FLT-PET

    Energy Technology Data Exchange (ETDEWEB)

    Buck, A.K.; Herrmann, K.; Schwaiger, M.; Wester, H.J. [Klinikum rechts der Isar, Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik; Dechow, T.; Graf, N. [Klinikum rechts der Isar, Technische Univ. Muenchen (Germany). Medizinische Klinik III, Haematologi/Onkologie

    2009-06-15

    An increased proliferation fraction is a hallmark of malignant cells and a specific feature of malignant tumors which potentially allows more specific tumor imaging compared to increased glucose consumption (FDG-PET). The majority of therapeutic approaches aim at inhibition of proliferation or induction of apoptosis. Accordingly, non-invasive assessment of the proliferation fraction is also of interest for monitoring response to treatment and to early detect resistance to a specific kind of therapy. In clinical studies it has been demonstrated that the radiotracer 3'-deoxy-3'-[{sup 18}F]fluorothymidine (FLT) accumulates specifically in malignant tumors. Regression analysis of tumoral FLT-uptake and immunohistochemically detected proliferation fraction (PCNA, Ki-67) resulted in a significant correlation (e.g., in lung cancer, correlation coefficient r=0.87, p<0.0001). The possibility to non-invasively assess the proliferation fraction with FLT-PET has been shown in a variety of solid cancers. Compared to the standard radiotracer FDG, superior demonstration of the proliferative activity using FLT as the tracer has been demonstrated. On the other hand, accumulation of FLT was significantly lower compared to FDG. Malignant tumors with low proliferation rates did not present with increased FLT-uptake resulting in a reduced sensitivity. In lung cancer for example, the sensitivity was 86% of FLT-PET compared to 100% of FDG-PET. Also, regarding detection of locoregional lymph node metastases or distant metastases, FDG-PET was shown to have a higher sensitivity. Due to the reduced sensitivity, there is no advantage of specific imaging of tumor proliferation regarding tumor staging. In malignant lymphoma, FLT was similar effective for tumor staging as compared to FDG-PET. In a pilot study comprising 34 patients, both tracers showed a similar sensitivity regarding detection of lymphoma. An observed specificity of 100% indicates that FLT-PET represents a diagnostic

  20. Morvan syndrome: a rare cause of syndrome of inappropriate antidiuretic hormone secretion.

    Science.gov (United States)

    Demirbas, Seref; Aykan, Musa Baris; Zengin, Haydar; Mazman, Semir; Saglam, Kenan

    2017-01-01

    The syndrome of inappropriate antidiuretic hormone secretion (SIADH) accounts for an important part of hyponatremia cases. The causes of SIADH can be detected almost always. As a rare disorder, Morvan Syndrome can be defined by the sum of peripheral nerve hyperexcitability, autonomic instability and neuropsychiatric features. Antibodies to voltage-gated potassium channels (Anti - VGKC-Ab) including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated protein 1 antibodies (LGI1-Ab) were previously known for the potential association with this condition. We present a Morvan Syndrome in a patient who presented with various neuropsychiatric symptoms and SIADH.

  1. Proliferation resistance modeling

    International Nuclear Information System (INIS)

    Bari, R.; Peterson, P.; Roglans, J.; Mladineo, S.; Nuclear Engineering Division; BNL; Univ. of California at Berkely; PNNL

    2004-01-01

    The National Nuclear Security Administration is developing methods for nonproliferation assessments. A working group on Nonproliferation Assessment Methodology (NPAM) assembled a toolbox of methods for various applications in the nonproliferation arena. One application of this methodology is to the evaluation of the proliferation resistance of Generation IV nuclear energy systems. This paper first summarizes the key results of the NPAM program and then provides results obtained thus far in the ongoing application, which is co-sponsored by the DOE Office of Nuclear Energy Science and Technology. In NPAM, a top-level measure of proliferation resistance for a fuel cycle system is developed from a hierarchy of metrics. The problem is decomposed into: metrics to be computed, barriers to proliferation, and a finite set of threats. The analyst models the process undertaken by the proliferant to overcome barriers to proliferation and evaluates the outcomes. In addition to proliferation resistance (PR) evaluation, the application also addresses physical protection (PP) evaluation against sabotage and theft. The Generation IV goal for future nuclear energy systems is to assure that they are very unattractive and the least desirable route for diversion or theft of weapons-usable materials, and provide increased physical protection against terrorism. An Expert Group, addressing this application, has identified six high-level measures for the PR goals (six measures have also been identified for the PP goals). Combined together, the complete set of measures provides information for program policy makers and system designers to compare specific system design features and integral system characteristics and to make choices among alternative options. The Group has developed a framework for a phased evaluation approach to analyzing PR and PP of system characteristics and to quantifying metrics and measures. This approach allows evaluations to become more detailed and representative

  2. The syndrome of inappropriate antidiuretic hormone: current and future management options.

    LENUS (Irish Health Repository)

    Sherlock, Mark

    2010-06-01

    Hyponatraemia is the commonest electrolyte abnormality, and syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent underlying pathophysiology. Hyponatraemia is associated with significant morbidity and mortality, and as such appropriate treatment is essential. Treatment options for SIADH include fluid restriction, demeclocycline, urea, frusemide and saline infusion, all of which have their limitations. The introduction of the vasopressin-2 receptor antagonists has allowed clinicians to specifically target the underlying pathophysiology of SIADH. Initial studies have shown good efficacy and safety profiles in the treatment of mild to moderate hyponatraemia. However, studies assessing the efficacy and safety of these agents in acute severe symptomatic hyponatraemia are awaited. Furthermore, the cost of these agents at present may limit their use.

  3. The effect of cerium valence states at cerium oxide nanoparticle surfaces on cell proliferation

    KAUST Repository

    Naganuma, Tamaki

    2014-05-01

    Understanding and controlling cell proliferation on biomaterial surfaces is critical for scaffold/artificial-niche design in tissue engineering. The mechanism by which underlying integrin ligates with functionalized biomaterials to induce cell proliferation is still not completely understood. In this study, poly-l-lactide (PL) scaffold surfaces were functionalized using layers of cerium oxide nanoparticles (CNPs), which have recently attracted attention for use in therapeutic application due to their catalytic ability of Ce4+ and Ce3+ sites. To isolate the influence of Ce valance states of CNPs on cell proliferation, human mesenchymal stem cells (hMSCs) and osteoblast-like cells (MG63) were cultured on the PL/CNP surfaces with dominant Ce4+ and Ce3+ regions. Despite cell type (hMSCs and MG63 cells), different surface features of Ce4+ and Ce3+ regions clearly promoted and inhibited cell spreading, migration and adhesion behavior, resulting in rapid and slow cell proliferation, respectively. Cell proliferation results of various modified CNPs with different surface charge and hydrophobicity/hydrophilicity, indicate that Ce valence states closely correlated with the specific cell morphologies and cell-material interactions that trigger cell proliferation. This finding suggests that the cell-material interactions, which influence cell proliferation, may be controlled by introduction of metal elements with different valence states onto the biomaterial surface. © 2014 Elsevier Ltd.

  4. Theoretical Approaches to Nuclear Proliferation

    Directory of Open Access Journals (Sweden)

    Konstantin S. Tarasov

    2015-01-01

    Full Text Available This article analyses discussions between representatives of three schools in the theory of international relations - realism, liberalism and constructivism - on the driving factors of nuclear proliferation. The paper examines major theoretical approaches, outlined in the studies of Russian and foreign scientists, to the causes of nuclear weapons development, while unveiling their advantages and limitations. Much of the article has been devoted to alternative approaches, particularly, the role of mathematical modeling in assessing proliferation risks. The analysis also reveals a variety of different approaches to nuclear weapons acquisition, as well as the absence of a comprehensive proliferation theory. Based on the research results the study uncovers major factors both favoring and impeding nuclear proliferation. The author shows that the lack of consensus between realists, liberals and constructivists on the nature of proliferation led a number of scientists to an attempt to explain nuclear rationale by drawing from the insights of more than one school in the theory of IR. Detailed study of the proliferation puzzle contributes to a greater understating of contemporary international realities, helps to identify mechanisms that are most likely to deter states from obtaining nuclear weapons and is of the outmost importance in predicting short- and long-term security environment. Furthermore, analysis of the existing scientific literature on nuclear proliferation helps to determine future research agenda of the subject at hand.

  5. IL-6 modulates hepatocyte proliferation via induction of HGF/p21cip1: Regulation by SOCS3

    International Nuclear Information System (INIS)

    Sun Rui; Jaruga, Barbara; Kulkarni, Shailin; Sun Haoyu; Gao Bin

    2005-01-01

    The precise role of IL-6 in liver regeneration and hepatocyte proliferation is controversial and the role of SOCS3 in liver regeneration remains unknown. Here we show that in vitro treatment with IL-6 inhibited primary mouse hepatocyte proliferation. IL-6 induced p21 cip1 protein expression in primary mouse hepatocytes. Disruption of the p21 cip1 gene abolished the inhibitory effect of IL-6 on cell proliferation. Co-culture with nonparenchymal liver cells diminished IL-6 inhibition of hepatocyte proliferation, which was likely due to IL-6 stimulation of nonparenchymal cells to produce HGF. Finally, IL-6 induced higher levels of p21 cip1 protein expression and a slightly stronger inhibition of cell proliferation in SOCS3 +/- mouse hepatocytes compared to wild-type hepatocytes, while liver regeneration was enhanced and prolonged in SOCS3 +/- mice. Our findings suggest that IL-6 directly inhibits hepatocyte proliferation via a p21 cip1 -dependent mechanism and indirectly enhances hepatocyte proliferation via stimulating nonparenchymal cells to produce HGF. SOCS3 negatively regulates liver regeneration

  6. Ischemic Retinopathy and Neovascular Proliferation Secondary to Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Muge Coban-Karatas

    2014-01-01

    Full Text Available We report a case with severe head trauma and perforating globe injury in one eye and ischemic retinopathy and neovascular proliferation in the other eye. A 37-year-old male was brought to the emergency department after a motor vehicle accident with severe maxillofacial trauma. Ophthalmic examination revealed hematoma of the left eyelids as well as traumatic rupture and disorganization of the left globe. On the right eye, anterior segment and fundoscopic examination were normal. Primary globe repair was performed. At postoperative one-month visit, the right eye revealed no pathology of the optic disc and macula but severe neovascularization in the temporal peripheral retina. The patient was diagnosed as ischemic retinopathy and neovascular proliferation due to head trauma.

  7. Mechanical stimulation increases proliferation, differentiation and protein expression in culture

    DEFF Research Database (Denmark)

    Grossi, Alberto; Yadav, Kavita; Lawson, Moira Ann

    2007-01-01

    Myogenesis is a complex sequence of events, including the irreversible transition from the proliferation-competent myoblast stage into fused, multinucleated myotubes. Myogenic differentiation is regulated by positive and negative signals from surrounding tissues. Stimulation due to stretch- or load...... to elucidate also the signaling pathway by which this mechanical stimulation can causes an increase in protein expression. When mechanically stimulated via laminin receptors on cell surface, C(2)C(12) cells showed an increase in cell proliferation and differentiation. Populations undergoing mechanical...... stimulation through laminin receptors show an increase in expression of Myo-D, myogenin and an increase in ERK1/2 phosphorylation. Cells stimulated via fibronectin receptors show no significant increases in fusion competence. We conclude that load induced signalling through integrin containing laminin...

  8. Proliferating cell nuclear antigen (PCNA): a new marker to study human colonic cell proliferation.

    OpenAIRE

    Kubben, F J; Peeters-Haesevoets, A; Engels, L G; Baeten, C G; Schutte, B; Arends, J W; Stockbrügger, R W; Blijham, G H

    1994-01-01

    Immunohistochemistry of the S phase related proliferating cell nuclear antigen (PCNA) was studied as an alternative to ex-vivo bromodeoxyuridine (BrdU) immunohistochemistry for assessment of human colonic cell proliferation. From 16 subjects without colonic disease biopsy specimens were collected from five different sites along the colorectum and processed for BrdU and PCNA immunohistochemistry. The mean proliferation index of PCNA was significantly higher at 133% of the value obtained with B...

  9. An inappropriate tool: criminal law and HIV in Asia.

    Science.gov (United States)

    Csete, Joanne; Dube, Siddharth

    2010-09-01

    Asian countries have applied criminal sanctions widely in areas directly relevant to national HIV programmes and policies, including criminalization of HIV transmission, sex work, homosexuality and drug injection. This criminalization may impede universal access to HIV prevention and treatment services in Asia and undermine vulnerable people's ability to be part of the HIV response. To review the status of application of criminal law in key HIV-related areas in Asia and analyze its impact. Review of literature and application of human rights norms to analysis of criminal law measures. Criminal laws in the areas considered here and their enforcement, while intended to reduce HIV transmission, are inappropriate and counterproductive with respect to health and human rights. Governments should remove punitive laws that impede the HIV response and should ensure meaningful participation of people living with HIV, people who use illicit drugs, sex workers and men who have sex with men in combating stigma and discrimination and developing rights-centered approaches to HIV.

  10. The international nuclear non-proliferation system

    International Nuclear Information System (INIS)

    Simpson, J.; McGrew, T.

    1985-01-01

    This volume focuses upon the issues raised at this Conference, and attempts to address the international diplomatic, political and trading, rather than technical, questions which surround nuclear non-proliferation policies. It does so by bringing together chapters contributed by participants in non-proliferation diplomacy, those with experience in shaping International Atomic Energy Agency and national policies and academic observers of non-proliferation activities and the international nuclear industry. An analysis is provided of past non-proliferation policies and activities and current issues, and an attempt is made to offer ideas for new initiatives which may sustain the non-proliferation system in the future

  11. Analysis of Inappropriate Admissions of Residents of Medicalized Nursing Homes to Emergency Departments: A Prospective Multicenter Study in Burgundy.

    Science.gov (United States)

    Manckoundia, Patrick; Menu, Didier; Turcu, Alin; Honnart, Didier; Rossignol, Sylvie; Alixant, Jean-Christophe; Sylvestre, Franck-Henry; Bailly, Vanessa; Dion, Michèle; Putot, Alain

    2016-07-01

    To determine the rate of inappropriate admissions to emergency departments (EDs) and to identify determinants of these admissions. Prospective multicenter study. Burgundy (France), EDs and medical nursing homes (MNHs). 1000 Burgundy MNH residents admitted to EDs, from April 17 to June 20, 2013. For each subject, a questionnaire was completed. Data included age, gender, type of health professional who referred the resident to the ED (THP), whether or not a medical dispatcher organized the transfer to the ED, transport mode, reason for admission to the ED, level of independence according to the Groupes Iso-Ressource score (GIRS), and diagnosis made in the ED. The French version of the Appropriateness Evaluation Protocol grid was applied to each admission to the ED, and in some situations, the expert committee ruled on the appropriateness of the admission to the ED. MNH characteristics were also recorded. Two groups were constituted according to the appropriateness or not of admission to the ED. Mean age of the 1000 residents was 87. There were 706 women. Two-thirds were referred to the EDs by a physician, mainly a general practitioner. In 91.7%, the transfer to the ED was organized by a medical dispatcher, and 8.8% were transported by medicalized transport. More than 95% had a GIRS ≤4. Among the admissions to EDs, 18.1% were inappropriate. Female gender (P = .017), nonmedicalized transport (P = .002), public MNH (P = .044), and nonaccess to a geriatric opinion in an emergency (P = .043) were determinants of inappropriate admission to EDs. In this first study on admissions to EDs of MNH residents using French data, we found a lower rate of admissions to the ED than that reported in the literature. Female gender, nonmedicalized transport, public MNH, and nonaccess to a geriatric opinion in an emergency were associated with inappropriate admission to EDs. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier

  12. Cytotoxic activities of amentoflavone against human breast and cervical cancers are mediated by increasing of PTEN expression levels due to peroxisomes proliferate-activated receptor {gamma} activation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eunjung; Shin, Soyoung; Lee, Jeeyoung; Lee, So Jung; Kim, Jinkyoung; Yoon, Doyoung; Kim, Yangmee [Konkuk Univ., Seoul (Korea, Republic of); Woo, Eunrhan [Chosun Univ., Gwangju (Korea, Republic of)

    2012-07-15

    Human peroxisomes proliferate-activated receptor gamma (hPPAR{gamma}) has been implicated in numerous pathologies, including obesity, diabetes, and cancer. Previously, we verified that amentoflavone is an activator of hPPAR{gamma} and probed the molecular basis of its action. In this study, we investigated the mechanism of action of amentoflavone in cancer cells and demonstrated that amentoflavone showed strong cytotoxicity against MCF-7 and HeLa cancer cell lines. We showed that hPPAR{gamma} expression in MCF-7 and HeLa cells is specifically stimulated by amentoflavone, and suggested that amentoflavone-induced cytotoxic activities are mediated by activation of hPPAR{gamma} in these two cancer cell lines. Moreover, amentoflavone increased PTEN levels in these two cancer cell lines, indicating that the cytotoxic activities of amentoflavone are mediated by increasing of PTEN expression levels due to hPPAR{gamma} activation.

  13. Low-decontamination approach to a proliferation-resistant fuel cycle

    International Nuclear Information System (INIS)

    Asquith, J.G.; Grantham, L.F.

    1978-01-01

    To prevent the diversion of nuclear material from power production to weapon production either by a nation or by clandestine groups within a nation, the nuclear fuel cycle must be proliferation-resistant and safeguarded. Potentially proliferation-resistant and safeguarded fuel cycles based on low-decontamination pyroreprocessing have been developed for the light water reactor (LWR), fast breeder reactor (FBR), and FBR-LWR combination. The major penalty for recycling fission products to the LWR is that fuel enrichment must be somewhat greater to overcome parasitic fission product absorption of neutrons. In the FBR, the major penalty is a slight reduction in breeding ratio due to the displacement of fertile material by fission products. Preliminary cost analysis indicates that these fuel cycles are economically competitive with fuel cycles using conventional reprocessing or those using virgin uranium if spent fuel storage costs are considered

  14. Unicystic ameloblastoma with diverse mural proliferation - a hybrid lesion

    International Nuclear Information System (INIS)

    Mahadesh, Jyothi; Rayapati, Dilip Kumar; Maligi, Prathima M; Ramachandra, Prashanth

    2011-01-01

    A 46-year-old man was referred to our hospital for treatment, complaining of swelling on the right mandibular molar region. Radiographic examination revealed a well defined multilocular radiolucent lesion with root resorption of right lower anteriors and molars. Following biopsy, a diagnosis of unicystic ameloblastoma of mural type was made and hemimandibulectomy was performed under general anesthesia. Histopathological examination of the surgical specimen exhibited a unicystic ameloblastoma of luminal, intraluminal, and mural type. Intraluminal proliferation was of plexiform pattern and mural proliferation showed unusual histopathological findings, which revealed follicular, acanthomatous areas coexisted with desmoplastic areas. This mural picture was similar to the so-called 'hybrid lesion of ameloblastoma', whose biological profile is not elicited due to the lack of adequate published reports. Two years follow up till date has not revealed any signs of recurrence.

  15. Unicystic ameloblastoma with diverse mural proliferation - a hybrid lesion

    Energy Technology Data Exchange (ETDEWEB)

    Mahadesh, Jyothi [Sri Siddhartha Dental College and Hospital, (India); Rayapati, Dilip Kumar; Maligi, Prathima M; Ramachandra, Prashanth [Dayananda Sagar College of Dental Sciences, Bengaluru (India)

    2011-03-15

    A 46-year-old man was referred to our hospital for treatment, complaining of swelling on the right mandibular molar region. Radiographic examination revealed a well defined multilocular radiolucent lesion with root resorption of right lower anteriors and molars. Following biopsy, a diagnosis of unicystic ameloblastoma of mural type was made and hemimandibulectomy was performed under general anesthesia. Histopathological examination of the surgical specimen exhibited a unicystic ameloblastoma of luminal, intraluminal, and mural type. Intraluminal proliferation was of plexiform pattern and mural proliferation showed unusual histopathological findings, which revealed follicular, acanthomatous areas coexisted with desmoplastic areas. This mural picture was similar to the so-called 'hybrid lesion of ameloblastoma', whose biological profile is not elicited due to the lack of adequate published reports. Two years follow up till date has not revealed any signs of recurrence.

  16. Hypertrophic Pachymeningitis and the Syndrome of Inappropriate Antidiuretic Hormone Secretion: Coincidence or Cause?

    Science.gov (United States)

    Harsch, Igor Alexander; Schiffer, Anne; Konturek, Peter C

    2017-01-01

    To investigate a potential cause of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). A 70-year-old female patient had nausea and collapsed. Although euvolemic, pathological laboratory findings showed hyponatremia and hypoosmolality, and cerebral magnetic resonance imaging showed hypertrophic pachymeningitis. Secondary hypertrophic pachymeningitis was excluded. Other nonneurological reasons for SIADH were also excluded. Moderate fluid restriction restored an almost normal serum osmolality and sodium. This case of SIADH was conservatively treated with moderate fluid restriction that almost restored normal serum osmolality and sodium levels. © 2017 S. Karger AG, Basel.

  17. The challenge of sustainability in healthcare systems: Frequency and cost of inappropriate patterns of breast cancer care (the E.Pic.A study).

    Science.gov (United States)

    Massa, Ilaria; Balzi, William; Burattini, Costanza; Gentili, Nicola; Bucchi, Lauro; Nanni, Oriana; Gallegati, Davide; Pierini, Andrea; Amadori, Dino; Falcini, Fabio; Altini, Mattia

    2017-08-01

    In a context of decreasing economic health resources and a rise in health needs, it is urgent to face this sustainability crisis through the analysis of healthcare expenditures. Wastages, deriving from inappropriate interventions, erode resources which could be reallocated to high-value activities. To identify these areas of wastages, we developed a method for combining and analyzing data from multiple sources. Here we report the preliminary results of a retrospective cohort study evaluating the performance of breast cancer (BC) care at IRST, an Italian cancer institute. Four data sources gathered in a real-world setting (a clinical database, two administrative databases and a cancer registry) were linked. Essential Key Performance Indexes (KPIs) in the pattern of BC diagnosis (KPI 1 and 2) and treatment (KPI 3 and 4) based on current guidelines were developed by a board of professionals. The costs of inappropriate examinations were associated with the diagnostic KPIs. We found that 2798 patients treated at IRST from January 2010 to June 2016 received a total of 2516 inappropriate examinations accounting for € 573,510.80. Linkage from multiple routine healthcare data sources is feasible: it allows the measurement of important KPIs specifically designed for BC care, and the identification of areas of low-value use of the resources. If systematically applied, this method could help provide a complete picture of inappropriateness and waste, redirect these resources to higher-value interventions for patients, and fill the gap between proper use of the resources and the best clinical results. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2011-11-01

    Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe.

  19. Handbook for nuclear non-proliferation

    International Nuclear Information System (INIS)

    Lee, Byung Wook; Oh, Keun Bae; Lee, Kwang Seok; Lee, Dong Jin; Ko, Han Seok.

    1997-05-01

    This book analyzed international non-proliferation regime preventing from spread of nuclear weapon. This book took review from the historical background of non-proliferation regime to the recent changes and status. The regime, here, is divided into multilateral and bilateral regime. First of all, this book reports four multilateral treaties concluded for non-proliferation such as NPT, NWFZ, CTBT and others. Secondly, international organization and regimes concerned with non-proliferation are analyzed with emphasis of UN, IAEA, ZC and NSG, Regional Safeguards System and international conference. Finally, this book report the current circumstances of nuclear cooperation agreement related with Korea which is an important means for bilateral regime. (author). 13 tabs., 2 figs

  20. Handbook for nuclear non-proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Wook; Oh, Keun Bae; Lee, Kwang Seok; Lee, Dong Jin; Ko, Han Seok

    1997-05-01

    This book analyzed international non-proliferation regime preventing from spread of nuclear weapon. This book took review from the historical background of non-proliferation regime to the recent changes and status. The regime, here, is divided into multilateral and bilateral regime. First of all, this book reports four multilateral treaties concluded for non-proliferation such as NPT, NWFZ, CTBT and others. Secondly, international organization and regimes concerned with non-proliferation are analyzed with emphasis of UN, IAEA, ZC and NSG, Regional Safeguards System and international conference. Finally, this book report the current circumstances of nuclear cooperation agreement related with Korea which is an important means for bilateral regime. (author). 13 tabs., 2 figs.

  1. Between two beds: inappropriately delayed discharges from hospitals.

    Science.gov (United States)

    Holmås, Tor Helge; Islam, Mohammad Kamrul; Kjerstad, Egil

    2013-12-01

    Acknowledging the necessity of a division of labour between hospitals and social care services regarding treatment and care of patients with chronic and complex conditions, is to acknowledge the potential conflict of interests between health care providers. A potentially important conflict is that hospitals prefer comparatively short length of stay (LOS) at hospital, while social care services prefer longer LOS all else equal. Furthermore, inappropriately delayed discharges from hospital, i.e. bed blocking, is costly for society. Our aim is to discuss which factors that may influence bed blocking and to quantify bed blocking costs using individual Norwegian patient data, merged with social care and hospital data. The data allow us to divide hospital LOS into length of appropriate stay (LAS) and length of delay (LOD), the bed blocking period. We find that additional resources allocated to social care services contribute to shorten LOD indicating that social care services may exploit hospital resources as a buffer for insufficient capacity. LAS increases as medical complexity increases indicating hospitals incentives to reduce LOS are softened by considerations related to patients’ medical needs. Bed blocking costs constitute a relatively large share of the total costs of inpatient care.

  2. Luteolin Inhibits Angiotensin II-Stimulated VSMC Proliferation and Migration through Downregulation of Akt Phosphorylation

    Directory of Open Access Journals (Sweden)

    Tongda Xu

    2015-01-01

    Full Text Available Luteolin is a naturally occurring flavonoid found in many plants that possesses cardioprotective properties. The purpose of this study was to elucidate the effect of luteolin on vascular smooth muscle cells (VSMCs proliferation and migration induced by Angiotensin II (Ang II and to investigate the mechanism(s of action of this compound. Rat VSMCs were cultured in vitro, and the proliferation and migration of these cells following Ang II stimulation were monitored. Different doses of luteolin were added to VSMC cultures, and the proliferation and migration rate were observed by MTT and Transwell chamber assays, respectively. In addition, the expressions of p-Akt (308, p-Akt (473, and proliferative cell nuclear antigen (PCNA in VSMCs were monitored by Western blotting. This study demonstrated that luteolin has an inhibitory effect on Ang II-induced VSMC proliferation and migration. Further, the levels of p-Akt (308, p-Akt (473, and PCNA were reduced in VSMCs treated with both Ang II and luteolin compared to VSMCs treated with only Ang II. These findings strongly suggest that luteolin inhibits Ang II-stimulated proliferation and migration of VSMCs, which is partially due to downregulation of the Akt signaling pathway.

  3. Syndrome of inappropriate antidiuretic hormone secretion: Revisiting a classical endocrine disorder

    Directory of Open Access Journals (Sweden)

    Binu P Pillai

    2011-01-01

    Full Text Available Hyponatremia occurs in about 30% of hospitalized patients and syndrome of inappropriate antidiuretic hormone secretion (SIADH is a common cause of hyponatremia. SIADH should be differentiated from other causes of hyponatremia like diuretic therapy, hypothyroidism and hypocortisolism. Where possible, all attempts should be made to identify and rectify the cause of SIADH. The main problem in SIADH is fluid excess, and hyponatremia is dilutional in nature. Fluid restriction is the main stay in the treatment of SIADH; however, cerebral salt wasting should be excluded in the clinical setting of brain surgeries, subarachnoid hemorrhage, etc. Fluid restriction in cerebral salt wasting can be hazardous. Sodium correction in chronic hyponatremia (onset >48 hours should be done slowly to avoid deleterious effects in brain.

  4. MicroRNA-2400 promotes bovine preadipocyte proliferation

    International Nuclear Information System (INIS)

    Wei, Yao; Cui, Ya Feng; Tong, Hui Li; Zhang, Wei Wei; Yan, Yun Qin

    2016-01-01

    MicroRNAs (miRNAs) play critical roles in the proliferation of bovine preadipocytes. miR-2400 is a novel and unique miRNA from bovines. In the present study, we separated and identified preadipocytes from bovine samples. miR-2400 overexpression increased the rate of preadipocyte proliferation, which was analyzed with a combination of EdU and flow cytometry. Simultaneously, functional genes related to proliferation (PCNA, CCND2, CCNB1) were also increased, which was detected by real-time PCR. Furthermore, luciferase reporter assays showed that miR-2400 bound directly to the 3'untranslated regions (3′UTRs) of PRDM11 mRNA. These data suggested that miR-2400 could promote preadipocyte proliferation by targeting PRDM11. - Highlights: • miRNAs are important in bovine preadipocyte proliferation. • miR-2400 is a novel miRNA from bovines. • miR-2400 overexpression increased preadipocyte proliferation. • Functional genes related to preadipocyte proliferation were upregulated. • Preadipocyte proliferation was promoted by targeting PRDM11.

  5. The USA and proliferation in Northeast Asia

    International Nuclear Information System (INIS)

    Weeks, S.B.

    1995-01-01

    United States policy on proliferation in Northeast Asia poses a test of balance between general US global non-proliferation goals and specific US regional security goals for Northeast Asia. US policy on proliferation in Northeast Asia further poses a test of priorities for US bilateral relations with the key Northeast Asian states, as non-proliferation and regional security goals must be weighed against other (e.g., economic, human rights) declared US policy goals. The result is a US policy equation for Northeast Asia proliferation that is considerably more complex in execution than might be expected from the simple statement of the US goal to avoid nuclear proliferation in Northeast Asia. The question of security assurances - both negative and positive - may be closely related to US policies to avoid proliferation in Northeast Asia

  6. An imbalance between apoptosis and proliferation contributes to follicular persistence in polycystic ovaries in rats

    Directory of Open Access Journals (Sweden)

    Neme Leandro G

    2009-07-01

    Full Text Available Abstract Background Cystic ovarian disease is an important cause of infertility that affects bovine, ovine, caprine and porcine species and even human beings. Alterations in the ovarian micro-environment of females with follicular cysts could alter the normal processes of proliferation and programmed cell death in ovarian cells. Thus, our objective was to evaluate apoptosis and proliferation in ovarian cystic follicles in rats in order to investigate the cause of cystic follicle formation and persistence. Methods We compared the number of in situ apoptotic cells by TUNEL assay, expression of active caspase-3 and members of Bcl-2 family by immunohistochemistry; and cell proliferation by the expression of the proliferation markers: PCNA and Ki-67. Results The proliferation index was low in granulosa of tertiary and cystic follicles of light exposed rats when compared with tertiary follicles of control animals, while in theca interna only cystic follicles presented low proliferation index when compared with tertiary follicles (p Conclusion These results show that the combination of weak proliferation indices and low apoptosis observed in follicular cysts, could explain the cause of the slow growth of cystic follicles and the maintenance of a static condition without degeneration, which leads to their persistence. These alterations may be due to structural and functional modifications that take place in these cells and could be related to hormonal changes in animals with this condition.

  7. Strengthening the non proliferation regime: French views

    International Nuclear Information System (INIS)

    Delaune, P.

    2013-01-01

    3 main issues can be identified in the French policy concerning the backing of non proliferation: 1) responding resolutely to proliferation crises, 2) reinforcing substantive efforts to prevent and impede proliferation, and 3) strengthening the non-proliferation regime. The first issue is very important because combating proliferation is vital to the security of all. Concerning the second issue, France attaches particular importance to strengthening specific measures to prevent and check proliferation. Let me mention a few proposals that we put forward: exports need to be controlled more effectively, proliferation activities have to be criminalized, or the development of proliferation-resistant technologies should be supported. Concerning the third issue it means the strengthening of the non-proliferation regime, France proposes several means: -) aiming at the universalization of the additional protocol; -) ensuring that the Agency continues to have sufficient human, financial and technical resources to fulfill its verification mission effectively; -) encouraging the IAEA to make full use of the authority available to it; -) enhancing the use of information relevant to the delivery of the IAEA mandate; and -) sharing more accurate information concerning the breaches of commitments that happen. The paper is followed by the slides of the presentation. (A.C.)

  8. Nuclear proliferation

    International Nuclear Information System (INIS)

    Stencel, S.

    1978-01-01

    The terms and reactions to President Carter's nuclear policy, culminating in the 1978 Nuclear Non-Proliferation Act, are reviewed and analyzed. The new law increases restrictions on nuclear exports, encourages continued use of light water reactors in preference to plutonium-fueled reactors, and emphasizes technical solutions to proliferation problems. Critics of the law point out that it will hurt U.S. trade unfairly, that other countries do not have as many fuel options as the U.S. has, and that nuclear sales have as many political and economic as technical solutions. Compromise areas include new international safety guidelines, the possibility of an international nuclear fuel bank, and a willingness to consider each case on its merits. 21 references

  9. Putrefactive rigor: apparent rigor mortis due to gas distension.

    Science.gov (United States)

    Gill, James R; Landi, Kristen

    2011-09-01

    Artifacts due to decomposition may cause confusion for the initial death investigator, leading to an incorrect suspicion of foul play. Putrefaction is a microorganism-driven process that results in foul odor, skin discoloration, purge, and bloating. Various decompositional gases including methane, hydrogen sulfide, carbon dioxide, and hydrogen will cause the body to bloat. We describe 3 instances of putrefactive gas distension (bloating) that produced the appearance of inappropriate rigor, so-called putrefactive rigor. These gases may distend the body to an extent that the extremities extend and lose contact with their underlying support surface. The medicolegal investigator must recognize that this is not true rigor mortis and the body was not necessarily moved after death for this gravity-defying position to occur.

  10. The Blunt Tool: Inappropriateness of the Concept of Transition for the Analyses of Democratic Consolidation

    Directory of Open Access Journals (Sweden)

    Dražen Lalić

    2010-01-01

    Full Text Available The article is analyzing the inappropriateness of the “classical” theories of transition for the analyses of democratic consolidation in the contemporary post-communist societies, including the Croatian one. The authors are claiming that the aforementioned theories are insufficient for a subtle explanation of the recent ongoing major political and social changes in the post-communist societies. The article is stressing the most characteristic examples of the “bluntness”, i.e. of the inappropriateness of the transition theory basic concepts for the analyses of democratic consolidation, as well as of the socio-cultural and socio-structural assumptions and other important concepts related to the post-communist transition phenomenon. Furthermore, the article is exposing the problems connected with various interpretations of the phases of the transition period in relation to the cleavage between the institutional constitution of the democratic system and the democratic deficit characteristic of the post-communist states. Finally, the article is bolding the necessity of re-conceptualization of the basic concepts of the theory of transition; however, not towards the construction of a new theory, but rather towards the adaptation of the existing theory to the recent social and political processes in the contemporaneous post-communist societies.

  11. MANF Is Indispensable for the Proliferation and Survival of Pancreatic β Cells

    Directory of Open Access Journals (Sweden)

    Maria Lindahl

    2014-04-01

    Full Text Available All forms of diabetes mellitus (DM are characterized by the loss of functional pancreatic β cell mass, leading to insufficient insulin secretion. Thus, identification of novel approaches to protect and restore β cells is essential for the development of DM therapies. Mesencephalic astrocyte-derived neurotrophic factor (MANF is an endoplasmic reticulum (ER-stress-inducible protein, but its physiological role in mammals has remained obscure. We generated MANF-deficient mice that strikingly develop severe diabetes due to progressive postnatal reduction of β cell mass, caused by decreased proliferation and increased apoptosis. Additionally, we show that lack of MANF in vivo in mouse leads to chronic unfolded protein response (UPR activation in pancreatic islets. Importantly, MANF protein enhanced β cell proliferation in vitro and overexpression of MANF in the pancreas of diabetic mice enhanced β cell regeneration. We demonstrate that MANF specifically promotes β cell proliferation and survival, thereby constituting a therapeutic candidate for β cell protection and regeneration.

  12. Director's series on proliferation

    International Nuclear Information System (INIS)

    Bailey, K.C.; Price, M.E.

    1995-01-01

    This is an occasional publication of essays on the topics of nuclear, chemical, biological, and missile proliferation. The views represented are those of the author's. Essay topics include: Nuclear Proliferation: Myth and Reality; Problems of Enforcing Compliance with Arms Control Agreements; The Unreliability of the Russian Officer Corps: Reluctant Domestic Warriors; and Russia's Nuclear Legacy

  13. Differential effects of a complex organochlorine mixture on the proliferation of breast cancer cell lines

    Energy Technology Data Exchange (ETDEWEB)

    Aube, Michel, E-mail: 4aubem@videotron.ca [Axe de recherche en sante des populations et environnementale, Centre de recherche du Centre hospitalier universitaire de Quebec and Universite Laval, 2875 Boulevard Laurier, Edifice Delta 2, bureau 600, Quebec, QC, Canada G1V 2M2 (Canada); Larochelle, Christian, E-mail: christian.larochelle@inspq.qc.ca [Axe de recherche en sante des populations et environnementale, Centre de recherche du Centre hospitalier universitaire de Quebec and Universite Laval, 2875 Boulevard Laurier, Edifice Delta 2, bureau 600, Quebec, QC, Canada G1V 2M2 (Canada); Ayotte, Pierre, E-mail: pierre.ayotte@inspq.qc.ca [Axe de recherche en sante des populations et environnementale, Centre de recherche du Centre hospitalier universitaire de Quebec and Universite Laval, 2875 Boulevard Laurier, Edifice Delta 2, bureau 600, Quebec, QC, Canada G1V 2M2 (Canada); Laboratoire de Toxicologie, Institut national de sante publique du Quebec, 945 avenue Wolfe, Quebec, QC, Canada G1V 5B3 (Canada)

    2011-04-15

    Organochlorine compounds (OCs) are a group of persistent chemicals that accumulate in fatty tissues with age. Although OCs has been tested individually for their capacity to induce breast cancer cell proliferation, few studies examined the effect of complex mixtures that comprise compounds frequently detected in the serum of women. We constituted such an OC mixture containing 15 different components in environmentally relevant proportions and assessed its proliferative effects in four breast cancer cell lines (MCF-7, T47D, CAMA-1, MDAMB231) and in non-cancerous CV-1 cells. We also determined the capacity of the mixture to modulate cell cycle stage of breast cancer cells and to induce estrogenic and antiandrogenic effects using gene reporter assays. We observed that low concentrations of the mixture (100x10{sup 3} and 50x10{sup 3} dilutions) stimulated the proliferation of MCF-7 cells while higher concentrations (10x10{sup 3} and 5x10{sup 3} dilutions) had the opposite effect. In contrast, the mixture inhibited the proliferation of non-hormone-dependent cell lines. The mixture significantly increased the number of MCF-7 cells entering the S phase, an effect that was blocked by the antiestrogen ICI 182,780. Low concentrations of the mixture also caused an increase in CAMA-1 cell proliferation but only in the presence estradiol and dihydrotestosterone (p<0.05 at the 50x10{sup 3} dilution). DDT analogs and polychlorinated biphenyls all had the capacity to stimulate the proliferation of CAMA-1 cells in the presence of sex steroids. Reporter gene assays further revealed that the mixture and several of its constituents (DDT analogs, aldrin, dieldrin, {beta}-hexachlorocyclohexane, toxaphene) induced estrogenic effects, whereas the mixture and several components (DDT analogs, aldrin, dieldrin and PCBs) inhibited the androgen signaling pathway. Our results indicate that the complex OC mixture increases the proliferation of MCF-7 cells due to its estrogenic potential. The

  14. Nuclear non-proliferation

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    DOE's nuclear non-proliferation responsibilities are defined by the provisions of the Atomic Energy Act of 1954, as amended, and of the Nuclear Non-Proliferation Act of 1978 (NNPA). The Department's major responsibilities in this area are to: (1) provide technical assistance to the Department of State in negotiating agreements for civil cooperation in the peaceful uses of nuclear energy with other countries and international organizations; (2) join with other agencies to reach executive branch judgments with respect to the issuance of export licenses by the Nuclear Regulatory Commission; (3) be responsible for processing subsequent arrangements with other agencies as required by the Nuclear Non-Proliferation Act; (4) control the distribution of special nuclear materials, components, equipment, and nuclear technology exports; (5) participate in bilateral and multilateral cooperation with foreign governments and organizations to promote the peaceful uses of nuclear energy; and (6) act as a primary technical resource with respect to US participation in the International Atomic Energy Agency

  15. Cell Adhesion and Proliferation on Sulfonated and Non-Modified Chitosan Films.

    Science.gov (United States)

    Martínez-Campos, Enrique; Civantos, Ana; Redondo, Juan Alfonso; Guzmán, Rodrigo; Pérez-Perrino, Mónica; Gallardo, Alberto; Ramos, Viviana; Aranaz, Inmaculada

    2017-05-01

    Three types of chitosan-based films have been prepared and evaluated: a non-modified chitosan film bearing cationizable aliphatic amines and two films made of N-sulfopropyl chitosan derivatives bearing both aliphatic amines and negative sulfonate groups at different ratios. Cell adhesion and proliferation on chitosan films of C2C12 pre-myoblastic cells and B16 cells as tumoral model have been tested. A differential cell behavior has been observed on chitosan films due to their different surface modification. B16 cells have shown lower vinculin expression when cultured on sulfonated chitosan films. This study shows how the interaction among cells and material surface can be modulated by physicochemical characteristics of the biomaterial surface, altering tumoral cell adhesion and proliferation processes.

  16. Nuclear arbitration: Interpreting non-proliferation agreements

    International Nuclear Information System (INIS)

    Tzeng, Peter

    2015-01-01

    At the core of the nuclear non-proliferation regime lie international agreements. These agreements include, inter alia, the Nuclear Non-proliferation Treaty, nuclear co-operation agreements and nuclear export control agreements.1 States, however, do not always comply with their obligations under these agreements. In response, commentators have proposed various enforcement mechanisms to promote compliance. The inconvenient truth, however, is that states are generally unwilling to consent to enforcement mechanisms concerning issues as critical to national security as nuclear non-proliferation.3 This article suggests an alternative solution to the non-compliance problem: interpretation mechanisms. Although an interpretation mechanism does not have the teeth of an enforcement mechanism, it can induce compliance by providing an authoritative interpretation of a legal obligation. Interpretation mechanisms would help solve the non-compliance problem because, as this article shows, in many cases of alleged non-compliance with a non-proliferation agreement, the fundamental problem has been the lack of an authoritative interpretation of the agreement, not the lack of an enforcement mechanism. Specifically, this article proposes arbitration as the proper interpretation mechanism for non-proliferation agreements. It advocates the establishment of a 'Nuclear Arbitration Centre' as an independent branch of the International Atomic Energy Agency (IAEA), and recommends the gradual introduction of arbitration clauses into the texts of non-proliferation agreements. Section I begins with a discussion of international agreements in general and the importance of interpretation and enforcement mechanisms. Section II then discusses nuclear non-proliferation agreements and their lack of interpretation and enforcement mechanisms. Section III examines seven case studies of alleged non-compliance with non-proliferation agreements in order to show that the main problem in many cases

  17. Canada's nuclear non-proliferation policy

    International Nuclear Information System (INIS)

    1982-05-01

    Canada's non-proliferation safeguards policy has two objectives: 1) to promote a more effective and comprehensive international non-proliferation regime; and 2) to ensure that Canadian nuclear exports will not be used for any nuclear explosive purpose. By emphasizing the key role of the Non-Proliferation Treaty, promoting reliance upon and improvements in the IAEA safeguards system, treating nuclear weapon and non-weapon states alike, and working for new approaches covering reprocessing, Canada promotes attainment of the first objective. The second is served through the network of bilateral nuclear agreements that Canada has put into place with its partners. The Canadian objective in post-INFCE forums is to persuade the international community to devise a more effective and comprehensive non-proliferation regime into which Canada and other suppliers may subsume their national requirements

  18. The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients : A Nested Case Control Study

    NARCIS (Netherlands)

    van der Stelt, C. A K; Vermeulen Windsant-van den Tweel, A. M A; Egberts, A. C G; van den Bemt, P. M L A; Leendertse, A. J.; Hermens, W. A J J; van Marum, R. J.; Derijks, H. J.

    2016-01-01

    Introduction: Medication-related problems can cause serious adverse drug events (ADEs) that may lead to hospitalization of the patient. There are multiple screening methods to detect and reduce potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). Whether this will

  19. The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients: A Nested Case Control Study

    NARCIS (Netherlands)

    van der Stelt, C.A.K.; Vermeulen Windsant-van den Tweel, A.M.A.; Egberts, A.C.G.|info:eu-repo/dai/nl/162850050; van den Bemt, P.M.L.A.|info:eu-repo/dai/nl/151330689; Leendertse, A.J.; Hermens, W.A.J.J.; van Marum, R.J.; Derijks, Jeroen|info:eu-repo/dai/nl/304840505

    2016-01-01

    Introduction: Medication-related problems can cause serious adverse drug events (ADEs) that may lead to hospitalization of the patient. There are multiple screening methods to detect and reduce potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). Whether this will

  20. Impact of 2015 Update to the Beers Criteria on Estimates of Prevalence and Costs Associated with Potentially Inappropriate Use of Antimuscarinics for Overactive Bladder.

    Science.gov (United States)

    Suehs, Brandon T; Davis, Cralen; Ng, Daniel B; Gooch, Katherine

    2017-07-01

    Research has demonstrated that the use of potentially inappropriate medication (PIM) is highly prevalent among older individuals and may lead to increased healthcare costs, adverse drug reactions, hospitalizations, and mortality. The purpose of this study was to examine the impact of the 2015 updates to the Beers Criteria on estimates of prevalence and cost associated with potentially inappropriate use of antimuscarinic medications indicated for treatment of overactive bladder (OAB). A retrospective database analysis was conducted using a historical cohort design and including data collected between 2007 and 2013. Claims data were used to identify Medicare Advantage patients aged ≥65 years newly initiated on antimuscarinic OAB treatment. Patients were classified with potentially inappropriate use of antimuscarinic OAB drugs based on either the 2012 Beers Criteria or the 2015 Beers Criteria. Prevalence of PIM at the time of antimuscarinic initiation was determined. Bivariate comparisons of healthcare costs and medical condition burden were conducted to compare the marginal groups of patients (who qualified based on the 2012 Beers Criteria only or the 2015 Beers Criteria only). Differences in healthcare costs for patients with and without potentially inappropriate use of urinary antimuscarinics based on the 2012 and 2015 Beers Criteria were also examined. Of 66,275 patients, overall prevalence of potentially inappropriate use of OAB antimuscarinics was higher using 2015 Beers Criteria than when using the 2012 Beers Criteria (25.0 vs. 20.6%). Dementia was the most common PIM-qualifying condition under both versions. The 2015 Beers Criteria identified more females, more White people, and a younger population with PIM. Comorbid medical condition burden was lower using the 2015 Beers Criteria. The 2015 Beers Criteria only group had lower median unadjusted healthcare costs ($7104 vs. 8301; p cost associated with potentially inappropriate use of antimuscarinic

  1. Inappropriate eating behavior: a longitudinal study with female adolescents

    Directory of Open Access Journals (Sweden)

    Leonardo de Sousa Fortes

    2014-03-01

    Full Text Available Objective: To evaluate the inappropriate eating behaviors (IEB of female adolescents over a one-year period. Methods: 290 adolescents aged between 11 and 14 years old participated in the three research stages (T1: first four months, T2: second four months and T3: third four months. The Eating Attitudes Test (EAT-26 was applied to assess the IEB. Weight and height were measured to calculate body mass index (BMI in the three study periods. Analysis of variance for repeated measures was used to analyze the data, adjusted for the scores of the Body Shape Questionnaire and the Brazil Economic Classification Criteria. Results: Girls at T1 showed a higher frequency of IEB compared to T2 (p=0.001 and T3 (p=0.001. The findings also indicated higher values for BMI in T3 in relation to T1 (p=0.04. The other comparisons did not show statistically significant differences. Conclusions: IEB scores of female adolescents declined over one year.

  2. Hyperthyroidism due to thyroid-stimulating hormone secretion after surgery for Cushing's syndrome: a novel cause of the syndrome of inappropriate secretion of thyroid-stimulating hormone.

    Science.gov (United States)

    Tamada, Daisuke; Onodera, Toshiharu; Kitamura, Tetsuhiro; Yamamoto, Yuichi; Hayashi, Yoshitaka; Murata, Yoshiharu; Otsuki, Michio; Shimomura, Iichiro

    2013-07-01

    Hyperthyroidism with the syndrome of inappropriate secretion of TSH (SITSH) occurred by a decrease in hydrocortisone dose after surgery for Cushing's syndrome. This is a novel cause of SITSH. The aim of this study was to describe and discuss 2 cases of SITSH patients that were found after surgery for Cushing's syndrome. We also checked whether SITSH occurred in 7 consecutive patients with Cushing's syndrome after surgery. A 45-year-old Japanese woman with ACTH-independent Cushing's syndrome and a 37-year-old Japanese man with ACTH-dependent Cushing's syndrome presented SITSH caused by insufficient replacement of hydrocortisone for postoperative adrenal insufficiency. When the dose of hydrocortisone was reduced to less than 20 mg/d within 18 days after surgery, SITSH occurred in both cases. We examined whether the change of the hydrocortisone dose induced the secretion of TSH. Free T₃ and TSH were normalized by the hydrocortisone dose increase of 30 mg/d, and these were elevated by the dose decrease of 10 mg/d. We also checked TSH and thyroid hormone levels of the 7 consecutive patients with Cushing's syndrome after surgery. Six (66.6 %) of 9 patients showed SITSH. This is the first report that insufficient replacement of hydrocortisone after surgery for Cushing's syndrome caused SITSH. Hyperthyroidism by SITSH as well as adrenal insufficiency can contribute to withdrawal symptoms of hydrocortisone replacement. We need to consider the possibility of SITSH for the pathological evaluation of withdrawal syndrome of hydrocortisone replacement.

  3. Strengthening the nuclear non-proliferation regime

    International Nuclear Information System (INIS)

    Carlson, J.

    2003-01-01

    Although the nuclear non-proliferation regime has enjoyed considerable success, today the regime has never been under greater threat. Three states have challenged the objectives of the NPT, and there is a technology challenge - the spread of centrifuge enrichment technology and know-how. A major issue confronting the international community is, how to deal with a determined proliferator? Despite this gloomy scenario, however, the non-proliferation regime has considerable strengths - many of which can be developed further. The regime comprises complex interacting and mutually reinforcing elements. At its centre is the NPT - with IAEA safeguards as the Treaty's verification mechanism. Important complementary elements include: restraint in the supply and the acquisition of sensitive technologies; multilateral regimes such as the CTBT and proposed FMCT; various regional and bilateral regimes; the range of security and arms control arrangements outside the nuclear area (including other WMD regimes); and the development of proliferation-resistant technologies. Especially important are political incentives and sanctions in support of non-proliferation objectives. This paper outlines some of the key issues facing the non-proliferation regime

  4. Dynamics of nuclear proliferation

    International Nuclear Information System (INIS)

    Meyer, S.M.

    1984-01-01

    This book looks beyond policy disputes to make a systematic examination of the assumptions and contending hypotheses that constitute contemporary thinking on nuclear proliferation. Rather than determine who is right or wrong, the intent is to develop a better picture by using the various schools of thought as analytic windows. A better understanding of how the process operates should offer better guidance for predicting future nuclear proliferation and, ultimately, for controlling it. Separate chapters deal with the contending views, the technological and motivational bases of nuclear proliferation, the presence of a technological imperative, testing the motivational hypothesis, the dynamics of the process, and forecasting. Four appendices present historical decisions, the technical model, cost-estimating procedures, and procedures for estimating nuclear propensities. 288 references, 17 figures, 26 tables

  5. Analysis of FOXO transcriptional networks

    NARCIS (Netherlands)

    van der Vos, K.E.

    2010-01-01

    The PI3K-PKB-FOXO signalling module plays a pivotal role in a wide variety of cellular processes, including proliferation, survival, differentiation and metabolism. Inappropriate activation of this network is frequently observed in human cancer and causes uncontrolled proliferation and survival. In

  6. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2.

    Science.gov (United States)

    O'Mahony, Denis; O'Sullivan, David; Byrne, Stephen; O'Connor, Marie Noelle; Ryan, Cristin; Gallagher, Paul

    2015-03-01

    Screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria were first published in 2008. Due to an expanding therapeutics evidence base, updating of the criteria was required. We reviewed the 2008 STOPP/START criteria to add new evidence-based criteria and remove any obsolete criteria. A thorough literature review was performed to reassess the evidence base of the 2008 criteria and the proposed new criteria. Nineteen experts from 13 European countries reviewed a new draft of STOPP & START criteria including proposed new criteria. These experts were also asked to propose additional criteria they considered important to include in the revised STOPP & START criteria and to highlight any criteria from the 2008 list they considered less important or lacking an evidence base. The revised list of criteria was then validated using the Delphi consensus methodology. The expert panel agreed a final list of 114 criteria after two Delphi validation rounds, i.e. 80 STOPP criteria and 34 START criteria. This represents an overall 31% increase in STOPP/START criteria compared with version 1. Several new STOPP categories were created in version 2, namely antiplatelet/anticoagulant drugs, drugs affecting, or affected by, renal function and drugs that increase anticholinergic burden; new START categories include urogenital system drugs, analgesics and vaccines. STOPP/START version 2 criteria have been expanded and updated for the purpose of minimizing inappropriate prescribing in older people. These criteria are based on an up-to-date literature review and consensus validation among a European panel of experts. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society.

  7. Proliferation resistance of small modular reactors fuels

    Energy Technology Data Exchange (ETDEWEB)

    Polidoro, F.; Parozzi, F. [RSE - Ricerca sul Sistema Energetico,Via Rubattino 54, 20134, Milano (Italy); Fassnacht, F.; Kuett, M.; Englert, M. [IANUS, Darmstadt University of Technology, Alexanderstr. 35, D-64283 Darmstadt (Germany)

    2013-07-01

    In this paper the proliferation resistance of different types of Small Modular Reactors (SMRs) has been examined and classified with criteria available in the literature. In the first part of the study, the level of proliferation attractiveness of traditional low-enriched UO{sub 2} and MOX fuels to be used in SMRs based on pressurized water technology has been analyzed. On the basis of numerical simulations both cores show significant proliferation risks. Although the MOX core is less proliferation prone in comparison to the UO{sub 2} core, it still can be highly attractive for diversion or undeclared production of nuclear material. In the second part of the paper, calculations to assess the proliferation attractiveness of fuel in typical small sodium cooled fast reactor show that proliferation risks from spent fuel cannot be neglected. The core contains a highly attractive plutonium composition during the whole life cycle. Despite some aspects of the design like the sealed core that enables easy detection of unauthorized withdrawal of fissile material and enhances proliferation resistance, in case of open Non-Proliferation Treaty break-out, weapon-grade plutonium in sufficient quantities could be extracted from the reactor core.

  8. Symptomatic Hypoglycemia Related to Inappropriately High IGF-II Serum Levels in a Patient with Desmoplastic Small Round Cell Tumor

    Directory of Open Access Journals (Sweden)

    Williams Fernandes Barra

    2010-01-01

    Full Text Available A 45-year old man was diagnosed with desmoplastic small round cell tumor (DSRCT with involvement of the peritoneum and pelvis. Disease progression was observed despite systemic chemotherapy. Six months after diagnosis, he developed severe hypoglycemia presented with seizures. He received intravenous glucose infusion and hydrocortisone with poor glycemic control, but with seizures resolution. The investigation excluded insulinoma, adrenal, liver and GH deficiencies. Laboratory showed slight rise of IGF-II and significant increase of the ratio IGF-II : IGF-I, which is pathognomonic of non-islet cell tumor hypoglycemia (NICTH. He received the diagnoses of NICTH related to IGF-II inappropriate production by DSRCT. Despite the attempt to control tumor mass and hypoglycemia, the patient died 9 months after diagnosis. NICTH related to inappropriate IGF-II secretion should be investigated in all cancer patients with refractory hypoglycemia whom insulinoma and other metabolic abnormalities were excluded from.

  9. Non-proliferation and multinational enterprises

    International Nuclear Information System (INIS)

    1979-04-01

    The paper supplements CC/WG.2/9 in presenting the Japanese delegation's contribution in the areas of non-proliferation and multi-national enterprises. The paper questions whether multinational enrichment enterprises would constitute a significant non-proliferation factor, noting that the nature of the venture might create a potential for the dissemination of sensitive information. The paper also argues that a multi-national venture which was not economically competitive (with national facilities) would have questionable viability. The conclusion is that non-proliferation advantages, if any, would be a result, not an objective of such a venture

  10. Nuclear non proliferation and disarmament

    International Nuclear Information System (INIS)

    2000-01-01

    In the framework of the publication of a document on the ''weapons mastership, disarmament and non proliferation: the french action'', by the ministry of Foreign Affairs and the ministry of Defense, the French Documentation organization presents a whole document. This document describes and details the following topics: the conference on the treaty of non proliferation of nuclear weapons, the France, Usa and Non Governmental Organizations position, the threats of the proliferation, the french actions towards the disarmament, the disarmament in the world, a chronology and some bibliographic resources. (A.L.B.)

  11. Which future for nuclear counter-proliferation?

    International Nuclear Information System (INIS)

    Duval, M.

    2010-01-01

    Dealing with the case of nuclear weapons possessed by nuclear states (but not eventually by terrorists), the author first identifies the constants of counter-proliferation: it is linked to interest conflicts between those who try to preserve their monopoly and those who try to acquire a new weapon either because of a threat or for reasons of regional prestige, the evolution from use to deterrence, the appearance of new actors after the USA and Russia, the role of nuclear tactical weapons, and the future of Russian weapons and know-how. He presents the international counter-proliferation context: the Non Proliferation Treaty (NPT), the IAEA and its controls, the Nuclear Supplier Group (NSG), the nuclear-free zones, the Comprehensive Test Ban Treaty (CTBT), the Missile Technology Control Regime (MTCR). He describes how and why proliferation occurs: uranium enrichment and plutonium technology, political reasons in different parts of the world. Then, he gives an overview of the proliferation status by commenting the cases of Israel, Iraq, India, Pakistan, North Korea, and Iran. He discusses the future of proliferation (involved countries, existence of a nuclear black market) and of counter-proliferation as far as Middle-East and North Korea are concerned. He tries finally to anticipate the consequences for nuclear deterrence strategy, and more particularly for Europe and France

  12. Dangerous Pressurization and Inappropriate Alarms during Water Occlusion of the Expiratory Circuit of Commonly Used Infant Ventilators.

    Directory of Open Access Journals (Sweden)

    Murray Hinder

    Full Text Available Non-invasive continuous positive airways pressure is commonly a primary respiratory therapy delivered via multi-purpose ventilators in premature newborns. Expiratory limb occlusion due to water accumulation or 'rainout' from gas humidification is a frequent issue. A case of expiratory limb occlusion due to rainout causing unexpected and excessive repetitive airway pressurisation in a Draeger VN500 prompted a systematic bench test examination of currently available ventilators.To assess neonatal ventilator response to partial or complete expiratory limb occlusion when set to non-invasive continuous positive airway pressure mode.Seven commercially available neonatal ventilators connected to a test lung using a standard infant humidifier circuit with partial and/or complete expiratory limb occlusion were examined in a bench test study. Each ventilator was set to deliver 6 cmH2O in non-invasive mode and respiratory mechanics data for 75%, 80% and 100% occlusion were collected.Several ventilators responded inappropriately with complete occlusion by cyclical pressurisation/depressurisation to peak pressures of between 19·4 and 64·6 cm H2O at rates varying between 2 to 77 inflations per minute. Tidal volumes varied between 10·1 and 24·3mL. Alarm responses varied from 'specific' (tube occluded to 'ambiguous' (Safety valve open. Carefusion Avea responded by continuing to provide the set distending pressure and displaying an appropriate alarm message. Draeger Babylog 8000 did not alarm with partial occlusions and incorrectly displayed airways pressure at 6·1cmH2O compared to the measured values of 13cmH2O.This study found a potential for significant adverse ventilator response due to complete or near complete expiratory limb occlusion in CPAP mode.

  13. A novel transgenic mouse model of growth plate dysplasia reveals that decreased chondrocyte proliferation due to chronic ER stress is a key factor in reduced bone growth

    Directory of Open Access Journals (Sweden)

    Benedetta Gualeni

    2013-11-01

    Disease mechanisms leading to different forms of chondrodysplasia include extracellular matrix (ECM alterations and intracellular stress resulting in abnormal changes to chondrocyte proliferation and survival. Delineating the relative contribution of these two disease mechanisms is a major challenge in understanding disease pathophysiology in genetic skeletal diseases and a prerequisite for developing effective therapies. To determine the influence of intracellular stress and changes in chondrocyte phenotype to the development of chondrodysplasia, we targeted the expression of the G2320R mutant form of thyroglobulin to the endoplasmic reticulum (ER of resting and proliferating chondrocytes. Previous studies on this mutant protein have shown that it induces intracellular aggregates and causes cell stress and death in the thyroid gland. The expression and retention of this exogenous mutant protein in resting and proliferating chondrocytes resulted in a chronic cell stress response, growth plate dysplasia and reduced bone growth, without inducing any alterations to the architecture and organization of the cartilage ECM. More significantly, the decreased bone growth seemed to be the direct result of reduced chondrocyte proliferation in the proliferative zone of growth plates in transgenic mice, without transcriptional activation of a classical unfolded protein response (UPR or apoptosis. Overall, these data show that mutant protein retention in the ER of resting and proliferative zone chondrocytes is sufficient to cause disrupted bone growth. The specific disease pathways triggered by mutant protein retention do not necessarily involve a prototypic UPR, but all pathways impact upon chondrocyte proliferation in the cartilage growth plate.

  14. Reduced proliferation and osteocalcin expression in osteoblasts of male idiopathic osteoporosis.

    Science.gov (United States)

    Ruiz-Gaspà, Sílvia; Blanch-Rubió, Josep; Ciria-Recasens, Manuel; Monfort, Jordi; Tío, Laura; Garcia-Giralt, Natàlia; Nogués, Xavier; Monllau, Joan C; Carbonell-Abelló, Jordi; Pérez-Edo, Lluis

    2010-03-01

    Osteoporosis is characterized by low bone mineral density (BMD), resulting in increasing susceptibility to bone fractures. In men, it has been related to some diseases and toxic habits, but in some instances the cause of the primary--or idiopathic--osteoporosis is not apparent. In a previous study, our group compared histomorphometric measurements in cortical and cancellous bones from male idiopathic osteoporosis (MIO) patients to those of control subjects and found reduced bone formation without major differences in bone resorption. To confirm these results, this study analyzed the etiology of this pathology, examining the osteoblast behavior in vitro. We compared two parameters of osteoblast activity in MIO patients and controls: osteoblastic proliferation and gene expression of COL1A1 and osteocalcin, in basal conditions and with vitamin D(3) added. All these experiments were performed from a first-passage osteoblastic culture, obtained from osteoblasts that had migrated from the transiliac explants to the plate. The results suggested that the MIO osteoblast has a slower proliferation rate and decreased expression of genes related to matrix formation, probably due to a lesser or slower response to some stimulus. We concluded that, contrary to female osteoporosis, in which loss of BMD is predominantly due to increased resorption, low BMD in MIO seems to be due to an osteoblastic defect.

  15. IPSN and the mastery of proliferation risks; L'IPSN et la maitrise des risques de proliferation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-04-14

    Since 20 years, the French Institute of Nuclear Protection and Safety (IPSN) works for the reinforcement of the efficiency of the actions against nuclear proliferation. This dossier takes stock of the means and action developed by the IPSN in this domain: nuclear and chemical proliferation: towards a reinforced mastery of risks (status of proliferation during the last 10 years, the aim of the international and national controls, the role of IPSN); nuclear proliferation: the technical control means of the IPSN (inspection, containment/surveillance of nuclear materials (PLUM and FUNE apparatuses), the cooperation between the IPSN and the Kurchatov institute (Russia)); the action of the IPSN in the application of international controls: example of chemistry (conventions, negotiations and expertise, inspections); appendixes: nuclear materials (declaration and permission thresholds), the different steps of the nuclear weapons non-proliferation policy. (J.S.)

  16. The Prevalence of Inappropriate Image Duplication in Biomedical Research Publications

    Science.gov (United States)

    Casadevall, Arturo; Fang, Ferric C.

    2016-01-01

    ABSTRACT Inaccurate data in scientific papers can result from honest error or intentional falsification. This study attempted to determine the percentage of published papers that contain inappropriate image duplication, a specific type of inaccurate data. The images from a total of 20,621 papers published in 40 scientific journals from 1995 to 2014 were visually screened. Overall, 3.8% of published papers contained problematic figures, with at least half exhibiting features suggestive of deliberate manipulation. The prevalence of papers with problematic images has risen markedly during the past decade. Additional papers written by authors of papers with problematic images had an increased likelihood of containing problematic images as well. As this analysis focused only on one type of data, it is likely that the actual prevalence of inaccurate data in the published literature is higher. The marked variation in the frequency of problematic images among journals suggests that journal practices, such as prepublication image screening, influence the quality of the scientific literature. PMID:27273827

  17. Short notes and reviews Simplifying hydrozoan classification: inappropriateness of the group Hydroidomedusae in a phylogenetic context

    OpenAIRE

    Marques, Antonio C.

    2001-01-01

    The systematics of Hydrozoa is considered from the viewpoint of logical consistency between phylogeny and classification. The validity of the nominal taxon Hydroidomedusae (including all groups of Hydrozoa except the Siphonophorae) is discussed with regard to its distinctness and inclusive relationships. In general, phylogenetic systematic evidence suggest that the use of the term Hydroidomedusae is inappropriate given our current level of understanding. It is concluded that no new, or resurr...

  18. The handbook of nuclear non-proliferation

    International Nuclear Information System (INIS)

    Yang, M. H.; Lee, B. W.; Oh, K. B.; Lee, H. M.; Ko, H. S.; Ryu, J. S.; Lee, K. S.

    2003-07-01

    This report analyzed international non-proliferation regime preventing from spread of nuclear weapon. This report took review from the historical background of non-proliferation regime to the recent changes and current status. It is here divided into multilateral and bilateral regime. First of all, this report dealt four multilateral treaties concluded for international non-proliferation such as NPT, NWFZ, CTBT and others. And international organization and regimes concerned with non-proliferation are also analyzed focused on UN, IAEA, ZC and NSG, regional safeguards system and international conferences. In addition, this report reviewed the nuclear cooperation agreement related with Korea which is a important tool for bilateral regime

  19. Perspectives of the nuclear non-proliferation regime

    International Nuclear Information System (INIS)

    Koungou, Leon

    2004-01-01

    To join traditional methods and new approaches of 'non-proliferation'. This is a technical method and the best way to fight against 'non-proliferation' which is facing few preoccupations: knowledge's disseminations; technologies; equipments and weapons that should be stopped. As it's important to note the return of nuclear danger as the end of confrontation between west-east which should be reduce. As the adaptation of mechanisms is necessary today, as it is important to react about states' incitations to violate international engagement of non-proliferation. Areas control allows finding out change and evolution, but more insufficient. Functional difficulties show that the IAEA (International Agency of Atomic Energy) does not work good. Safeguard system does not allow to respect 'non-proliferation' engagements; for instance 'junkies states' that they cannot dissuade traditional methods. The fight of 'non-proliferation' shows new progresses with fearing methods of prevention actions and heaviest international controls of exportation. The target of this is very ambitious. This new method is self-successful because it contributes to re-enforce international security when defeating acquisition of nuclear and mass destruction weapons by non-states factors. Therefore non-proliferation regime and especially 'non-proliferation treaty' remains delicate as long as some militaries state such USA will reject their 'non-proliferation' engagement. (author) [fr

  20. Unusual presentations of acute kidney injury and neurologic complications due to snake bite

    Directory of Open Access Journals (Sweden)

    Hamid Noshad

    2015-06-01

    Full Text Available Introduction: Vascularity of kidneys is very high, so these organs are potentially susceptible to be affected with toxins including snake venom. Hypersensitivity to snake venous could cause some neurological problem. Case Report: We present a 14-year-old boy with acute kidney injury (AKI due to snake bite. After a few days, kidney failure with hematuria was developed. His serum creatinine level rose to 3 mg/dl and following 2 weeks gradually and decreased to normal level without any special treatment except for anti-venom, which was not prescribed inappropriate time (this type of AKI is not reported previously. He had seizure attacks, which were according to magnetic resonance imaging due to posterior reversible encephalopathy syndrome (PRES (This neurologic complication has been seen in other kidney injuries but up to now it was not reported in snake bite victims. Conclusion: Sanke venom could cause PRES due to AKI and seizure could be one of the most important complications in snake bite.

  1. Nuclear proliferation: prospects, problems, and proposals

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    This issue of the ANNALS addresses itself to three aspects of nuclear proliferation: the prospect that new nuclear powers will come on the scene, the problems that their arrival may create, and ways of coping with those problems. In an introductory paper, ''Quo Vadimus,'' Joseph I. Coffey investigates the pros and cons of proliferation, concluding that it is not a question of whether there will be nuclear proliferation, but in what countries. Part I, Where We Are, contains five papers preceded by introductory comments by Joseph I. Coffey. The papers and their authors are: Why States Go--and Don't Go--Nuclear, William Epstein; How States Can ''Go Nuclear,'' Frank C. Barnaby; What Happens If. . .Terrorists, Revolutionaries, and Nuclear Weapons, David Kreiger; Safeguards Against Diversion of Nuclear Material: An Overview, Ryukichi Imai; and Reducing the Incentives to Proliferation, George H. Quester. Part II, And Where We May Go, again includes some introductory remarks by Joseph I. Coffey. The seven succeeding papers are: Nth Powers of the Future, Ashok Kapur; Nuclear Proliferation and World Politics, Lewis A. Dunn; Arms Control in a Nuclear Armed World, Colin Gray; The United Nations, the Superpowers, and Proliferation, Abraham Bargman; Proliferation and the Future: Destruction or Transformation, Frederick C. Thayer; Decision Making in a Nuclear Armed World, Michael Brenner; and The United States in a World of Nuclear Powers, Michael Nacht. This special report is concluded with a glossary

  2. Potentially inappropriate medications in elderly Japanese patients: effects of pharmacists' assessment and intervention based on Screening Tool of Older Persons' Potentially Inappropriate Prescriptions criteria ver.2.

    Science.gov (United States)

    Kimura, T; Ogura, F; Yamamoto, K; Uda, A; Nishioka, T; Kume, M; Makimoto, H; Yano, I; Hirai, M

    2017-04-01

    The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2. The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016. Pharmacists assessed and detected PIMs based on stopp criteria ver.2 and considered the patient's intention to change the prescription at the time of admission of each patient. If the pharmacists judged that benefits outweighed risks of prescription change and the patients consented to change the medications, they recommended the doctor to change the prescription. If there was a risk of exacerbation of disease by the change of medications and the pharmacists judged it to be difficult to adjust medications during hospitalization or the patients did not consent to change the medications, they did not recommend to change it. The pharmacists and the doctors discussed and finally decided whether to change the PIMs or not. The number of patients prescribed PIMs, the number and contents of PIMs, and the number of medications changed after pharmacists' intervention were calculated. Totally, 822 new inpatients aged ≥65 years prescribed ≥1 daily medicine were included. Their median (interquartile range) age was 75·0 (71·0-80·0) years, and 54·9% were male. According to the criteria, 346 patients (42·1%) were prescribed ≥1 PIMs. Patients prescribed PIMs took significantly more medications than others: 10·0 (7·0-13·0) vs. 6·0 (4·0-9·0), P older people (benzodiazepines) (30/67) and (iii) drugs that predictably increase the risk of falls in older people (hypnotic Z-drugs) (15/31). Over 40% elderly patients were prescribed PIMs

  3. A case of appropriate inappropriate device therapy: Hyperkalemia-induced ventricular oversensing

    Science.gov (United States)

    Oudit, Gavin Y; Cameron, Doug; Harris, Louise

    2008-01-01

    The present case describes a patient who received inappropriate, but potentially life-saving, therapy from her implantable cardioverter defibrillator (ICD) in the setting of acute hyperkalemia (plasma potassium concentration = 8 mM). Hyperkalemia was associated with the development of a slow sinusoidal ventricular tachycardia, at a rate of 100 beats/min to 125 beats/min (610 ms to 480 ms) in a patient who is pacemaker-dependent. There was associated fractionation of the ICD electrogram and T wave oversensing, leading to ventricular oversensing with resultant detection in the ventricular fibrillation rate zone. This was followed by shock therapy, even though the ventricular tachycardia rate was below the programmed detection rate of the ICD. The subsequent emergency treatment of the hyperkalemia normalized the electrogram, corrected the ventricular oversensing and arrhythmia, and restored rate-adaptive single-chamber ventricular pacing. PMID:18340383

  4. Inhibition of vascular smooth muscle cell proliferation by Gentiana lutea root extracts.

    Directory of Open Access Journals (Sweden)

    Rushendhiran Kesavan

    Full Text Available Gentiana lutea belonging to the Gentianaceae family of flowering plants are routinely used in traditional Serbian medicine for their beneficial gastro-intestinal and anti-inflammatory properties. The aim of the study was to determine whether aqueous root extracts of Gentiana lutea consisting of gentiopicroside, gentisin, bellidifolin-8-O-glucoside, demethylbellidifolin-8-O-glucoside, isovitexin, swertiamarin and amarogentin prevents proliferation of aortic smooth muscle cells in response to PDGF-BB. Cell proliferation and cell cycle analysis were performed based on alamar blue assay and propidium iodide labeling respectively. In primary cultures of rat aortic smooth muscle cells (RASMCs, PDGF-BB (20 ng/ml induced a two-fold increase in cell proliferation which was significantly blocked by the root extract (1 mg/ml. The root extract also prevented the S-phase entry of synchronized cells in response to PDGF. Furthermore, PDGF-BB induced ERK1/2 activation and consequent increase in cellular nitric oxide (NO levels were also blocked by the extract. These effects of extract were due to blockade of PDGF-BB induced expression of iNOS, cyclin D1 and proliferating cell nuclear antigen (PCNA. Docking analysis of the extract components on MEK1, the upstream ERK1/2 activating kinase using AutoDock4, indicated a likely binding of isovitexin to the inhibitor binding site of MEK1. Experiments performed with purified isovitexin demonstrated that it successfully blocks PDGF-induced ERK1/2 activation and proliferation of RASMCs in cell culture. Thus, Gentiana lutea can provide novel candidates for prevention and treatment of atherosclerosis.

  5. Inhibition of vascular smooth muscle cell proliferation by Gentiana lutea root extracts.

    Science.gov (United States)

    Kesavan, Rushendhiran; Potunuru, Uma Rani; Nastasijević, Branislav; T, Avaneesh; Joksić, Gordana; Dixit, Madhulika

    2013-01-01

    Gentiana lutea belonging to the Gentianaceae family of flowering plants are routinely used in traditional Serbian medicine for their beneficial gastro-intestinal and anti-inflammatory properties. The aim of the study was to determine whether aqueous root extracts of Gentiana lutea consisting of gentiopicroside, gentisin, bellidifolin-8-O-glucoside, demethylbellidifolin-8-O-glucoside, isovitexin, swertiamarin and amarogentin prevents proliferation of aortic smooth muscle cells in response to PDGF-BB. Cell proliferation and cell cycle analysis were performed based on alamar blue assay and propidium iodide labeling respectively. In primary cultures of rat aortic smooth muscle cells (RASMCs), PDGF-BB (20 ng/ml) induced a two-fold increase in cell proliferation which was significantly blocked by the root extract (1 mg/ml). The root extract also prevented the S-phase entry of synchronized cells in response to PDGF. Furthermore, PDGF-BB induced ERK1/2 activation and consequent increase in cellular nitric oxide (NO) levels were also blocked by the extract. These effects of extract were due to blockade of PDGF-BB induced expression of iNOS, cyclin D1 and proliferating cell nuclear antigen (PCNA). Docking analysis of the extract components on MEK1, the upstream ERK1/2 activating kinase using AutoDock4, indicated a likely binding of isovitexin to the inhibitor binding site of MEK1. Experiments performed with purified isovitexin demonstrated that it successfully blocks PDGF-induced ERK1/2 activation and proliferation of RASMCs in cell culture. Thus, Gentiana lutea can provide novel candidates for prevention and treatment of atherosclerosis.

  6. Proliferation: does the peaceful use of nuclear energy have to lead to proliferation of nuclear weapons

    International Nuclear Information System (INIS)

    Muench, E.; Stein, G.

    The question of whether the proliferation of nuclear weapons is promoted by an increasing use of peaceful nuclear energy can be answered with a well-founded no. Even a regional renouncing of the peaceful use of nuclear energy would not reduce the worldwide problem of nuclear weapons' proliferation. Therefore, joint efforts must be aimed at promoting trust between peoples in the nuclear sphere and the political reasons for the proliferation of nuclear weapons must be reduced in order also to promote international harmony

  7. Framework of Comprehensive Proliferation Resistance Evaluation Methodology

    International Nuclear Information System (INIS)

    Kim, Min Su; Jo, Seong Youn; Kim, Min Soo; Kim, Jae San; Lee, Hyun Kyung

    2007-01-01

    Civilian nuclear programs can be used as a pretext to acquire technologies, materials, equipment for military weapon programs. Consequently, international society has a strong incentive to develop a nuclear system more proliferation resistant to assure that the civilian nuclear energy system is an unattractive and least desirable route for diversion of weapon usable material. The First step developing a more proliferation resistant nuclear energy system is to develop a systematic and standardized evaluation methodology to ensure that any future nuclear energy system satisfies the proliferation resistance goals. Many attempts to develop systematic evaluation methodology have been proposed and many systems for assessing proliferation resistance have been previously studied. However, a comprehensive proliferation resistance evaluation can not be achieved by simply applying one method since complicated proliferation resistance characteristics, including inherent features and extrinsic features, should be completely evaluated. Therefore, it is necessary to develop one incorporated evaluation methodology to make up for weak points of each evaluation method. The objective of this study is to provide a framework of comprehensive proliferation resistance evaluation methodology by incorporating two generally used evaluation methods, attribute and scenario analysis

  8. International proliferation on nuclear weapons

    International Nuclear Information System (INIS)

    Hill, J.

    1977-01-01

    The subject is dealt with under the following headings: introduction; routes to proliferation (preparation of U 235 , Pu 239 , U 233 ); nuclear power fuel cycles and proliferation; the fast reactor fuel cycle; security aspects of the existing fuel cycle; the IAEA and the nuclear non-proliferation treaty. It is concluded that 'the basis for sound international control exists, and taken together with the further technical steps which will be taken to make the existing fuel cycles more robust against the diversion of materials by terrorists and the abuse of civil nuclear power programmes by governments, we have good reason to proceed now with the orderly exploitation of ...nuclear energy...'. (U.K.)

  9. The crystal structure of Haloferax volcanii proliferating cell nuclear antigen reveals unique surface charge characteristics due to halophilic adaptation

    Directory of Open Access Journals (Sweden)

    Morroll Shaun

    2009-08-01

    Full Text Available Abstract Background The high intracellular salt concentration required to maintain a halophilic lifestyle poses challenges to haloarchaeal proteins that must stay soluble, stable and functional in this extreme environment. Proliferating cell nuclear antigen (PCNA is a fundamental protein involved in maintaining genome integrity, with roles in both DNA replication and repair. To investigate the halophilic adaptation of such a key protein we have crystallised and solved the structure of Haloferax volcanii PCNA (HvPCNA to a resolution of 2.0 Å. Results The overall architecture of HvPCNA is very similar to other known PCNAs, which are highly structurally conserved. Three commonly observed adaptations in halophilic proteins are higher surface acidity, bound ions and increased numbers of intermolecular ion pairs (in oligomeric proteins. HvPCNA possesses the former two adaptations but not the latter, despite functioning as a homotrimer. Strikingly, the positive surface charge considered key to PCNA's role as a sliding clamp is dramatically reduced in the halophilic protein. Instead, bound cations within the solvation shell of HvPCNA may permit sliding along negatively charged DNA by reducing electrostatic repulsion effects. Conclusion The extent to which individual proteins adapt to halophilic conditions varies, presumably due to their diverse characteristics and roles within the cell. The number of ion pairs observed in the HvPCNA monomer-monomer interface was unexpectedly low. This may reflect the fact that the trimer is intrinsically stable over a wide range of salt concentrations and therefore additional modifications for trimer maintenance in high salt conditions are not required. Halophilic proteins frequently bind anions and cations and in HvPCNA cation binding may compensate for the remarkable reduction in positive charge in the pore region, to facilitate functional interactions with DNA. In this way, HvPCNA may harness its environment as

  10. The crystal structure of Haloferax volcanii proliferating cell nuclear antigen reveals unique surface charge characteristics due to halophilic adaptation

    Science.gov (United States)

    Winter, Jody A; Christofi, Panayiotis; Morroll, Shaun; Bunting, Karen A

    2009-01-01

    Background The high intracellular salt concentration required to maintain a halophilic lifestyle poses challenges to haloarchaeal proteins that must stay soluble, stable and functional in this extreme environment. Proliferating cell nuclear antigen (PCNA) is a fundamental protein involved in maintaining genome integrity, with roles in both DNA replication and repair. To investigate the halophilic adaptation of such a key protein we have crystallised and solved the structure of Haloferax volcanii PCNA (HvPCNA) to a resolution of 2.0 Å. Results The overall architecture of HvPCNA is very similar to other known PCNAs, which are highly structurally conserved. Three commonly observed adaptations in halophilic proteins are higher surface acidity, bound ions and increased numbers of intermolecular ion pairs (in oligomeric proteins). HvPCNA possesses the former two adaptations but not the latter, despite functioning as a homotrimer. Strikingly, the positive surface charge considered key to PCNA's role as a sliding clamp is dramatically reduced in the halophilic protein. Instead, bound cations within the solvation shell of HvPCNA may permit sliding along negatively charged DNA by reducing electrostatic repulsion effects. Conclusion The extent to which individual proteins adapt to halophilic conditions varies, presumably due to their diverse characteristics and roles within the cell. The number of ion pairs observed in the HvPCNA monomer-monomer interface was unexpectedly low. This may reflect the fact that the trimer is intrinsically stable over a wide range of salt concentrations and therefore additional modifications for trimer maintenance in high salt conditions are not required. Halophilic proteins frequently bind anions and cations and in HvPCNA cation binding may compensate for the remarkable reduction in positive charge in the pore region, to facilitate functional interactions with DNA. In this way, HvPCNA may harness its environment as opposed to simply surviving in

  11. North-East Asia: a risk of nuclear proliferation; Un risque de proliferation nucleaire en Asie du Nord-Est?

    Energy Technology Data Exchange (ETDEWEB)

    Courmont, B. [Centre d' Etudes Transatlantiques, 75 - Paris (France)

    2009-04-15

    North-East Asia is distinguished by being potentially one of the world's most nuclearised regions. It includes two nuclear powers recognised by the Non-Proliferation Treaty (Russia and China), a proliferating state (North Korea) and three countries that could very quickly complete nuclear programmes (Japan, South Korea and Taiwan). Now that the question of nuclear proliferation has again surfaced on the international strategic scene, and that North Korea's test of October 2006 has introduced a new security paradigm into the region, how real is the risk of nuclear proliferation in North-East Asia? (author)

  12. Advanced core concepts with enhanced proliferation resistance by transmutation of minor actinides

    International Nuclear Information System (INIS)

    Saito, Masaki

    2005-01-01

    ''Protected Plutonium Production (P 3 )'' has been proposed to establish high burn-up cores and to produce protected with high proliferation resistance due to high decay heat and large number of spontaneous fission neutron of 238 Pu by the transmutation of Minor Actinides (MAs) which is presently treated as high-level waste. The burn-up calculations have shown that the advanced fuel with UO 2 (11-13% enrichment of 235 U) by doping 237 Np to produce 238 Pu in the commercialized large LWRs burn up to 100 GWd/t with 238 Pu to Pu ratio of about 20% which means the fuel is highly protected from proliferation. It was also predicted that medium or small size LWR cores with 15-17% enrichment, liquid metal cooled cores, and gas cooled cores added by 1-2% Np could achieve 100 GWd/t burning with bearing high proliferation resistance. The 237 Np mass balance calculations have revealed that more than 20 nuclear P 3 plants of 300 MWe could be supplied with enough 237 Np from the Japanese commercial plants in equilibrium fuel cycles. From the present studies, it is confirmed that MAs are treated as burnable and fertile materials not only to extend the core life but also to improve plutonium proliferation resistance of the future nuclear energy systems instead of their geological disposal or just their burning through fission. (author)

  13. Introduction of Counter-Proliferation Capabilities in Development States

    International Nuclear Information System (INIS)

    Caulfield, P.; Edwards, T.; Witkin, A.; Elgebaly, A.

    2010-01-01

    In recent history we have seen a number of States develop their indigenous industrial skills to a point suitable for the manufacture of nuclear components. Private individuals unbeknown to the State have then utilized this capability to supply directly into proliferation networks - potentially reducing international confidence in such a State. To combat this possibility, a developing State must recognize the challenges that are raised by its emerging skills and take action to introduce measures that not only help the State identify proliferation activities but also ensure the national security of the State. One of those measures might be to develop a capability within the State to recognize and counter the activities of would-be-proliferators. In many States this capability is managed and applied through a dedicated counter-proliferation unit that has strong links with border controls and customs organizations. A counter-proliferation unit, once established could show dramatic returns for a modest investment. The activities of such a Unit could save the State political embarrassment by hindering and narrowing the chances of unintentional proliferation activities. The Unit should not be introduced as part of a Safeguards agreement or as part of a non proliferation treaty. It should rather be established as an act by the State to protect and control its emerging technologies from being involved, willingly or unwittingly, in proliferation activities. This is a sovereign act of the State - solely for its benefit and should not be imposed by any external power. Today's would-be-proliferators around the world cooperate and act together; similarly emerging counter-proliferation units should act and work together in order to be a step ahead of the proliferators. Improved world-wide cooperation should increase the detection rate of proliferation incidents which will in turn curtail the spread of nuclear weapons - for the benefit of all. (author)

  14. Nuclear proliferation and terrorism

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    This section of the book, Part III, has two chapters (9 and 10). Chapter 9, Nuclear Power and Proliferation of Nuclear Weapons, is disucssed under these subjects: nuclear nonproliferation: origins and status; requirements for nuclear weapons manufacture; current nuclear programs and proliferation capabilities; encouraging decisions to forego weapons; arms control; safeguards; attitudes and expectations. Chapter 10, Nuclear Terrorism, discusses these areas: theft of nuclear materials; attacks on nuclear reactors; responding to nuclear terrorism; security and civil liberties

  15. Nuclear power and nuclear-weapons proliferation

    International Nuclear Information System (INIS)

    Moniz, E.J.; Neff, T.L.

    1978-01-01

    Concern over the risk of nuclear proliferation has led to extensive reexamination of the technical, economic, and political assumptions underlying both national and international nuclear policies. An attempt is made in the present article to clarify the basic technical and political issues. The connections between various fuel cycles and their possible proliferation risks are discussed. As the resolution of the existing differing views on proliferation risks will be largely a political process, solutions to the problem are not proposed

  16. China's position on nuclear non-proliferation

    International Nuclear Information System (INIS)

    Qian Jiadong.

    1986-01-01

    The paper discusses China's position on nuclear non-proliferation, in view of the fact that China does not subscribe to the Non-Proliferation Treaty (NPT). China refuses to accede to the NPT because it considers the treaty to be discriminatory, and reasons are given for this point of view. However its stand for nuclear disarmament and disapproval of nuclear proliferation are declared. Nuclear arms race, prevention of nuclear war, and nuclear disarmament are also considered. (UK)

  17. Cell Cycle Phase Abnormalities Do Not Account for Disordered Proliferation in Barrett's Carcinogenesis

    Directory of Open Access Journals (Sweden)

    Pierre Lao-Sirieix

    2004-11-01

    Full Text Available Barrett's esophagus (BE epithelium is the precursor lesion for esophageal adenocarcinoma. Cell cycle proteins have been advocated as biomarkers to predict the malignant potential in BE. However, whether disruption of the cell cycle plays a causal role in Barrett's carcinogenesis is not clear. Specimens from the Barrett's dysplasia—carcinoma sequence were immunostained for cell cycle phase markers (cyclin D1 for G1; cyclin A for S, G2, and M; cytoplasmic cyclin B1 for G2; and phosphorylated histone 3 for M phase and expressed as a proportion of proliferating cells. Flow cytometric analysis of the cell cycle phase of prospective biopsies was also performed. The proliferation status of nondysplastic BE was similar to gastric antrum and D2, but the proliferative compartment extended to the luminal surface. In dysplastic samples, the number of proliferating cells correlated with the degree of dysplasia (P < .001. The overall levels of cyclins A and B1 correlated with the degree of dysplasia (P < .001. However, the cell cycle phase distribution measured with both immunostaining and flow cytometry was conserved during all stages of BE, dysplasia, and cancer. Hence, the increased proliferation seen in Barrett's carcinogenesis is due to abnormal cell cycle entry or exit, rather than a primary abnormality within the cell cycle.

  18. Evaluation of fibroblasts adhesion and proliferation on alginate-gelatin crosslinked hydrogel.

    Directory of Open Access Journals (Sweden)

    Bapi Sarker

    Full Text Available Due to the relatively poor cell-material interaction of alginate hydrogel, alginate-gelatin crosslinked (ADA-GEL hydrogel was synthesized through covalent crosslinking of alginate di-aldehyde (ADA with gelatin that supported cell attachment, spreading and proliferation. This study highlights the evaluation of the physico-chemical properties of synthesized ADA-GEL hydrogels of different compositions compared to alginate in the form of films. Moreover, in vitro cell-material interaction on ADA-GEL hydrogels of different compositions compared to alginate was investigated by using normal human dermal fibroblasts. Viability, attachment, spreading and proliferation of fibroblasts were significantly increased on ADA-GEL hydrogels compared to alginate. Moreover, in vitro cytocompatibility of ADA-GEL hydrogels was found to be increased with increasing gelatin content. These findings indicate that ADA-GEL hydrogel is a promising material for the biomedical applications in tissue-engineering and regeneration.

  19. Harmine stimulates proliferation of human neural progenitors

    Directory of Open Access Journals (Sweden)

    Vanja Dakic

    2016-12-01

    Full Text Available Harmine is the β-carboline alkaloid with the highest concentration in the psychotropic plant decoction Ayahuasca. In rodents, classical antidepressants reverse the symptoms of depression by stimulating neuronal proliferation. It has been shown that Ayahuasca presents antidepressant effects in patients with depressive disorder. In the present study, we investigated the effects of harmine in cell cultures containing human neural progenitor cells (hNPCs, 97% nestin-positive derived from pluripotent stem cells. After 4 days of treatment, the pool of proliferating hNPCs increased by 71.5%. Harmine has been reported as a potent inhibitor of the dual specificity tyrosine-phosphorylation-regulated kinase (DYRK1A, which regulates cell proliferation and brain development. We tested the effect of analogs of harmine, an inhibitor of DYRK1A (INDY, and an irreversible selective inhibitor of monoamine oxidase (MAO but not DYRK1A (pargyline. INDY but not pargyline induced proliferation of hNPCs similarly to harmine, suggesting that inhibition of DYRK1A is a possible mechanism to explain harmine effects upon the proliferation of hNPCs. Our findings show that harmine enhances proliferation of hNPCs and suggest that inhibition of DYRK1A may explain its effects upon proliferation in vitro and antidepressant effects in vivo.

  20. Nuclear energy and nuclear weapons proliferation

    International Nuclear Information System (INIS)

    1989-01-01

    A summary of the report dispatched in the middle of 1978 by the Atlantic Council of United States, organized by North American citizens, is presented. The report considers the relation between the production of nucleoelectric energy and the capacity of proliferation of nuclear weapons. The factors which affect the grade of proliferation risk represented by the use of nuclear energy in the world comparing this risk with the proliferation risks independently of nuclear energy, are examined. (M.C.K.) [pt

  1. How to predict a high rate of inappropriateness for upper endoscopy in an endoscopic centre?

    Science.gov (United States)

    Buri, L; Bersani, G; Hassan, C; Anti, M; Bianco, M A; Cipolletta, L; Di Giulio, E; Di Matteo, G; Familiari, L; Ficano, L; Loriga, P; Morini, S; Pietropaolo, V; Zambelli, A; Grossi, E; Intraligi, M; Tessari, F; Buscema, M

    2010-09-01

    Inappropriateness of upper endoscopy (EGD) indication causes decreased diagnostic yield. Our aim of was to identify predictors of appropriateness rate for EGD among endoscopic centres. A post-hoc analysis of two multicentre cross-sectional studies, including 6270 and 8252 patients consecutively referred to EGD in 44 (group A) and 55 (group B) endoscopic Italian centres in 2003 and 2007, respectively, was performed. A multiple forward stepwise regression was applied to group A, and independently validated in group B. A <70% threshold was adopted to define inadequate appropriateness rate clustered by centre. discrete variability of clustered appropriateness rates among the 44 group A centres was observed (median: 77%; range: 41-97%), and a <70% appropriateness rate was detected in 11 (25%). Independent predictors of centre appropriateness rate were: percentage of patients referred by general practitioners (GP), rate of urgent examinations, prevalence of relevant diseases, and academic status. For group B, sensitivity, specificity and area under receiver operating characteristic curve of the model in detecting centres with a <70% appropriateness rate were 54%, 93% and 0.72, respectively. A simple predictive rule, based on rate of patients referred by GPs, rate of urgent examinations, prevalence of relevant diseases and academic status, identified a small subset of centres characterised by a high rate of inappropriateness. These centres may be presumed to obtain the largest benefit from targeted educational programs. Copyright (c) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Nuclear proliferation and safeguards. Summary

    International Nuclear Information System (INIS)

    1982-03-01

    This comprehensive analysis of the technological, economic, and political factors affecting the potential spread of nuclear weapons proved useful in the congressional debate which culminated in the Nuclear Non-Proliferation Act of 1978. The report was subsequently published commercially and has been a frequently cited reference in the literature on proliferation and nuclear power. Despite developments since 1977, the information in the OTA report is still useful to those wishing to obtain an indepth understanding of the issues. Included is an analysis of why a nation might want nuclear weapons development program and the various sources of nuclear material are discussed. The control of proliferation is considered as well as its relation to the nuclear industry

  3. Israel's position on non-proliferation

    International Nuclear Information System (INIS)

    Marom, R.

    1986-01-01

    Israel maintained that the complex international system and worldwide political tension created a situation in which comprehensive plans of disarmament could not produce any positive result. The deadlock in the field of general and complete disarmament has brought Israel to the realization that one possible way to alleviate the stalemate could be progress by stages through partial measures of disarmament. Israel's position on non-proliferation indicates that the establishment of a nuclear-weapon-free-zone (NWFZ), as it relates to the Middle-East, could serve as a credible alternative to the unilateral adherence to the Non-Proliferation of Nuclear Weapon (NPT) and an effective measure of non-proliferation in the region. (Author)

  4. Nuclear exports and non-proliferation

    International Nuclear Information System (INIS)

    Courteix, Simone.

    1978-01-01

    Increased preoccupation in present times with the risk of proliferation of nuclear weapons is reflected in the multiplication of international agreements such as the Non-proliferation Treaty and in the strengthening of consultations between industrialised countries (London Club). After analysing the IAEA safeguards system under the Non-proliferation Treaty and its shortcomings both technically and otherwise, the author considers how this situation can be remedied in the light of the London Agreements and in view of the position of the main countries concerned. The annex to the book contains the texts of many international agreements and relevant national regulations as well as nuclear policy statements. It also includes a detailed bibliograaphy. (NEA) [fr

  5. Implementation of a Computerized Order Entry Tool to Reduce the Inappropriate and Unnecessary Use of Cardiac Stress Tests With Imaging in Hospitalized Patients.

    Science.gov (United States)

    Gertz, Zachary M; O'Donnell, William; Raina, Amresh; Balderston, Jessica R; Litwack, Andrew J; Goldberg, Lee R

    2016-10-15

    The rising use of imaging cardiac stress tests has led to potentially unnecessary testing. Interventions designed to reduce inappropriate stress testing have focused on the ambulatory setting. We developed a computerized order entry tool intended to reduce the use of imaging cardiac stress tests and improve appropriate use in hospitalized patients. The tool was evaluated using preimplementation and postimplementation cohorts at a single urban academic teaching hospital. All hospitalized patients referred for testing were included. The co-primary outcomes were the use of imaging stress tests as a percentage of all stress tests and the percentage of inappropriate tests, compared between the 2 cohorts. There were 478 patients in the precohort and 463 in the postcohort. The indication was chest pain in 66% and preoperative in 18% and was not significantly different between groups. The use of nonimaging stress tests increased from 4% in the pregroup to 15% in the postgroup (p nonimaging stress tests increased from 7% to 25% (p nonimaging cardiac stress tests and reduced the use of imaging tests yet was not able to reduce inappropriate use. Our study highlights the differences in cardiac stress testing between hospitalized and ambulatory patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Inappropriate pharmacological treatment in older adults affected by cardiovascular disease and other chronic comorbidities: a systematic literature review to identify potentially inappropriate prescription indicators

    Directory of Open Access Journals (Sweden)

    Lucenteforte E

    2017-10-01

    Full Text Available Ersilia Lucenteforte,1 Niccolò Lombardi,1,* Davide Liborio Vetrano,2,* Domenico La Carpia,2,* Zuzana Mitrova,3 Ursula Kirchmayer,3 Giovanni Corrao,4 Francesco Lapi,5 Alessandro Mugelli,1 Alfredo Vannacci1 On behalf of the Italian Group for Appropriate Drug prescription in the Elderly (I-GrADE 1Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA, University of Florence, Florence, Italy; 2Department of Geriatrics Catholic University, Rome, Italy; 3Department of Epidemiology, ASL 1 Rome, Italy; 4Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; 5Epidemiology Unit, ARS Toscana, Florence, Italy *These authors contributed equally to this work Abstract: Avoiding medications in which the risks outweigh the benefits in the elderly patient is a challenge for physicians, and different criteria to identify inappropriate prescription (IP exist to aid prescribers. Definition of IP indicators in the Italian geriatric population affected by cardiovascular disease and chronic comorbidities could be extremely useful for prescribers and could offer advantages from a public health perspective. The purpose of the present study was to identify IP indicators by means of a systematic literature review coupled with consensus criteria. A systematic search of PubMed, EMBASE, and CENTRAL databases was conducted, with the search structured around four themes and combining each with the Boolean operator “and”. The first regarded “prescriptions”, the second “adverse events”, the third “cardiovascular conditions”, and the last was planned to identify studies on “older people”. Two investigators independently reviewed titles, abstracts, full texts, and selected articles addressing IP in the elderly affected by cardiovascular condition using the following inclusion criteria: studies on people aged ≥65 years; studies on patients with no restriction on age but with data on subjects

  7. Director`s series on proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, K.C.; Price, M.E. [eds.

    1995-11-17

    This is an occasional publication of essays on the topics of nuclear, chemical, biological, and missile proliferation. The views represented are those of the author`s. Essay topics include: Nuclear Proliferation: Myth and Reality; Problems of Enforcing Compliance with Arms Control Agreements; The Unreliability of the Russian Officer Corps: Reluctant Domestic Warriors; and Russia`s Nuclear Legacy.

  8. The risk of nuclear weapons proliferation

    International Nuclear Information System (INIS)

    Oelgaard, P.L.

    1994-01-01

    During the later years the risks of nuclear proliferation have again become a major topic of interest. This is primarily due to the acute problems caused by Iraq, North Korea, and the 3 new states of the former USSR, Ukraine, Kazakhstan and Belarus. Analysis shows that security problems and prestige are the two most important motives, when the risks of proliferation are considered. But motives are not enough. To produce nuclear weapons a number of technological requirements must also be fulfilled. The country must be able to produce almost pure fissile material, i.e. 235 U or 239 Pu. It must also be able to solve a number of metallurgical, explosive, ignition, physics and other problems. These are in particular non-trivial, if a implosion weapon is to be designed. A review is made of the nuclear facilities in a number of the countries which have been suggested as possible future nuclear weapons countries. In particular facilities which can produce almost pure fissile materials, 235 U and 239 Pu, are considered. The possibility of nuclear terrorists have often been discussed in the media. However, it seems very unlikely that even a major terrorist or mafia organization will be able to solve all the weapons design problems, even if they could steal the fissile material. It is finally discussed what can be done to reduce the risk of further nuclear proliferation. Political pressure can be brought to bear on countries outside the NPT to join it, but it can be counter-productive, and sometimes the countries that are able to exert such pressure, are not willing to do so for other political reasons. The problem of countries which are party to the NPT, but which are believed to acquire nuclear weapons capability in violation of the treaty, can be countered by unannounced inspections of non-declared facilities. However, such inspections can only be meaningfully performed if the necessary intelligence is available. (EG)

  9. The non-proliferation regime, vertical proliferation and the interests of the Federal Republic of Germany

    International Nuclear Information System (INIS)

    Fischer, W.

    1988-12-01

    The disarmament orientation of the NPT, which stands beside the central aim of avoiding horizontal proliferation, raises a question: Does a compatibility exist between the non-proliferation policy of the Federal Republic and its security policy, which has its basic pillar in the nuclear deterrence strategy? Critics of this deterrence policy therefore, hinting to the disarmament determination of the NPT, demand that the Federal Republic should exercise its influence for the conclusion of a 'Comprehensive Test Ban Treaty' (CTBT), the establishment of a 'Nuclear-Weapons-Free-Zones' (NWFZ) in Europe, a 'No First Use'-Treaty (NFU) and finally the abolishment of all atomic weapons ('Zero Solution'). According to them such disarmament 'remedies' can reestablish or assure the waning or damaged international consensus for horizontal non-proliferation. This is a contribution for the establishment of a stable world order and will smooth the way for a prolongation of the NPT in the year 1995. An analysis of the history and the structure of interests shows that the policy of the Federal Republic of Germany is deeply rooted in the NPT and that a prolongation of the treaty and its own membership is a substantial object of the foreign and security policy. Consequently the Federal Republic has to face the demands for an intensification of 'anti-nuclear measures' and has to examine their acceptability and their usefulness with respect to non-proliferation. The structure of the problem encloses the following aspects: The security conception of the Federal Republic with its military-strategic essence; the provisions in article VI NPT for negotiations with the object of a world free of atomic weapons; the derived disarmament 'remedies' for strengthening the consensus for horizontal non-proliferation and, finally, the real interface between horizontal and vertical proliferation. (orig./DG) [de

  10. Assessment of proliferation resistances of aqueous reprocessing techniques using the TOPS methodology

    International Nuclear Information System (INIS)

    Åberg Lindell, M.; Grape, S.; Håkansson, A.; Jacobsson Svärd, S.

    2013-01-01

    Highlights: • Proliferation resistances of three possible LFR fuel cycles are assessed. • The TOPS methodology has been chosen for the PR assessment. • Reactor operation, reprocessing and fuel fabrication are examined. • Purex, Ganex, and a combination of Purex, Diamex and Sanex, are compared. • The safeguards analysis speaks in favor of Ganex as opposed to the Purex process. - Abstract: The aim of this study is to assess and compare the proliferation resistances (PR) of three possible Generation IV lead-cooled fast reactor fuel cycles, involving the reprocessing techniques Purex, Ganex and a combination of Purex, Diamex and Sanex, respectively. The examined fuel cycle stages are reactor operation, reprocessing and fuel fabrication. The TOPS methodology has been chosen for the PR assessment, and the only threat studied is the case where a technically advanced state diverts nuclear material covertly. According to the TOPS methodology, the facilities have been divided into segments, here roughly representing the different forms of nuclear material occurring in each examined fuel cycle stage. For each segment, various proliferation barriers have been assessed. The results make it possible to pinpoint where the facilities can be improved. The results show that the proliferation resistance of a fuel cycle involving recycling of minor actinides is higher than for the traditional Purex reprocessing cycle. Furthermore, for the purpose of nuclear safeguards, group actinide extraction should be preferred over reprocessing options where pure plutonium streams occur. This is due to the fact that a solution containing minor actinides is less attractive to a proliferator than a pure Pu solution. Thus, the safeguards analysis speaks in favor of Ganex as opposed to the Purex process

  11. Criteria for proliferation resistance of nuclear fuel cycle options

    International Nuclear Information System (INIS)

    Kiriyama, Eriko; Pickett, Susan; Suzuki, Tatsujiro

    2000-01-01

    In order to understand the concept of nuclear proliferation resistance, this paper examines the technical definitions of proliferation resistance. Although nuclear proliferation resistance is often included as one of the major goals of advanced reactor research and development, the criteria for nuclear proliferation resistance of nuclear fuel cycles is not defined clearly. The implied meaning of proliferation resistance was compared in proposals regarding the nuclear fuel cycle. Discrepancies amongst the proposals regarding the technical definition of proliferation resistance is found. While all these proposals indicate proliferation resistance, few clearly spell out exactly what criteria they are measuring themselves against. However we found there are also common feature in many proposals. They are; (1) Reduction of Pu, (2) Less separated Weapon Usable Materials, (3) Fewer steps, (4) Barrier for Weapon Usable Materials. Recognizing that there are numerous political and infrastructure measures that may also be taken to guard against proliferation risks, we have focused here on the definition of proliferation resistance in terms of technical characteristics. Another important conclusion is that in many proposals proliferation resistance is only one of the important criteria such as energy security, economical efficiency, and safety. (author)

  12. Making the Tg-Confinement Effect Disappear in Thin Polystyrene Films: Good Physics vs. Inappropriate Analysis

    Science.gov (United States)

    Torkelson, John; Chen, Lawrence

    2013-03-01

    The Tg-confinement effect in polymers was first characterized in supported polystyrene (PS) films by Keddie et al. in 1994. Since then, many researchers have shown that (pseudo-)thermodynamic Tg measurements of supported PS films taken on cooling consistently yield the same qualitative results, with a decrease from bulk Tg beginning at 40-60 nm thickness and becoming very strong below 20 nm thickness. Some quantitative differences have been noted between studies, which may be ascribed to measurement method or the analysis employed. In 2004, we showed that the Tg-confinement effect in PS may be suppressed by adding several wt% of small-molecule diluents such as dioctyl phthalate. Recently, Kremer and co-workers (Macromolecules 2010, 43, 9937) reported that there was no Tg-confinement in supported PS films based on an analysis of the second derivative of ellipsometry data and use of a ninth order polynomial fit. Here, we demonstrate a new method for suppressing the Tg-confinement effect. In particular, PS made by emulsion polymerization yields no Tg-confinement effect as measured by ellipsometry or fluorescence, while PS made by anionic or conventional free radical polymerization yield strong Tg-confinement effects. The difference is hypothesized to result from surfactant in the emulsion polymerized PS. We also show that the absence of the Tg-confinement effect reported by Kremer is due to inappropriate analysis of ellipsometry data and that correct analysis yields Tg-confinement effects.

  13. Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors.

    Science.gov (United States)

    Lai, Pauline Siew Mei; Wong, Yin Yen; Low, Yong Chia; Lau, Hui Ling; Chin, Kin-Fah; Mahadeva, Sanjiv

    2014-01-01

    Background. Proton pump inhibitors (PPIs) are currently the most effective agents for acid-related disorders. However, studies show that 25-75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing. Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution. Setting. Prospective audit in a tertiary hospital in Malaysia. Method. Every 4th intravenous PPI prescription received in the pharmacy was screened against hospital guidelines. Interventions for incorrect indication/dose/duration were performed. Patients' demographic data, medical history and the use of intravenous PPI were collected. Included were all adult inpatients prescribed intravenous PPI. Main Outcome Measure. Proportion of appropriate IV PPI prescriptions. Results. Data for 106 patients were collected. Most patients were male [65(61.3%)], Chinese [50(47.2%)], with mean age ± SD = 60.3 ± 18.0 years. Most intravenous PPI prescriptions were initiated by junior doctors from the surgical [47(44.3%)] and medical [42(39.6%)] departments. Only 50/106(47.2%) patients had upper gastrointestinal endoscopy/surgery performed to verify the source of bleeding. Unexplained abdominal pain [81(76.4%)] was the main driver for prescribing intravenous PPIs empirically, out of which 73(68.9%) were for suspected upper gastrointestinal bleed. Overall, intravenous PPI was found to be inappropriately prescribed in 56(52.8%) patients for indication, dose or duration. Interventions on the use of intravenous PPI were most effective when performed by senior doctors (100%), followed by clinical pharmacists (50%), and inpatient pharmacists (37.5%, p = 0.027). Conclusion. Inappropriate intravenous PPI usage is still prevalent despite the enforcement of hospital guidelines. The promotion of prescribing awareness and evidence-based prescribing

  14. De-implementation strategy to Reduce the Inappropriate use of urinary and intravenous CATheters: study protocol for the RICAT-study.

    Science.gov (United States)

    Laan, Bart J; Spijkerman, Ingrid J B; Godfried, Mieke H; Pasmooij, Berend C; Maaskant, Jolanda M; Borgert, Marjon J; Opmeer, Brent C; Vos, Margreet C; Geerlings, Suzanne E

    2017-01-10

    Urinary and (peripheral and central) intravenous catheters are widely used in hospitalized patients. However, up to 56% of the catheters do not have an appropriate indication and some serious complications with the use of these catheters can occur. The main objective of our quality improvement project is to reduce the use of catheters without an appropriate indication by 25-50%, and to evaluate the affecting factors of our de-implementation strategy. In a multicenter, prospective interrupted time series analysis, several interventions to avoid inappropriate use of catheters will be conducted in seven hospitals in the Netherlands. Firstly, we will define a list of appropriate indications for urinary and (peripheral and central) intravenous catheters, which will restrict the use of catheters and urge catheter removal when the indication is no longer appropriate. Secondly, after the baseline measurements, the intervention will take place, which consists of a kick-off meeting, including a competitive feedback report of the baseline measurements, and education of healthcare workers and patients. Additional strategies based on the baseline data and local conditions are optional. The primary endpoint is the percentage of catheters with an inappropriate indication on the day of data collection before and after the de-implementation strategy. Secondary endpoints are catheter-related infections or other complications, catheter re-insertion rate, length of hospital (and ICU) stay and mortality. In addition, the cost-effectiveness of the de-implementation strategy will be calculated. This study aims to reduce the use of urinary and intravenous catheters with an inappropriate indication, and as a result reduce the catheter-related complications. If (cost-) effective it provides a tool for a nationwide approach to reduce catheter-related infections and other complications. Dutch trial registry: NTR6015 . Registered 9 August 2016.

  15. THE THIOREDOXIN SYSTEM IN REGULATING MCF-7 CELL PROLIFERATION UNDER REDOX STATUS MODULATION

    Directory of Open Access Journals (Sweden)

    E. A. Stepovaya

    2016-01-01

    Full Text Available Introduction. Despite the available data on tumor cell functioning under the conditions of free radical-mediated oxidation, the mechanisms of redox regulation, cell proliferation management and apoptosis avoidance remain understudied.The objective of the study was to identify the role of the thioredoxin system in regulating MCF-7 breast cancer cell proliferation under redox status modulation with 1.4-dithioerythritol.Material and methods. The studies were conducted on the MCF-7 breast cancer cell line, grown in adherent cell culture. Cell redox status was modulated with5 mM N-ethylmaleimide – an SH group and peptide inhibitor and5 mM 1.4-dithioerythritol – a thiol group protector. The cell cycle was evaluated by flow cytometry, the same technique was used to measure the reactive oxygen species concentration. The levels of reduced and oxidized glutathione and the activity of thioredoxin reductase were identified by spectrophotometry. The intracellular concentrations of thioredoxin, cyclin E and cyclin-dependent kinase 2 were determined by Western blot analysis.Results and discussion. The essential role of the thioredoxin system in regulating MCF-7 breast cancer cell proliferation was exhibited. S-phase arrest under the effect of N-ethylmaleimide and G0/G1-phase arrest under the effect of 1.4-dithioerythritol are associated with the changes in the activity of redox-sensitive protein complexes (cyclins and cyclin-dependent kinases that regulate cell proliferation.Conclusion. Redoxdependent modulation of proliferation regulating intracellular protein activity occurs due to the thioredoxin system. This is a promising research area for seeking molecular targets of breast cell malignization. 

  16. Plasma rich in growth factors promotes dermal fibroblast proliferation, migration and biosynthetic activity.

    Science.gov (United States)

    Anitua, E; Pino, A; Orive, G

    2016-11-02

    The use of plasma rich in growth factors (PRGF) has gained importance in many medical fields due to its regenerative potential. The aim of this study is to evaluate the effects of PRGF on primary skin fibroblasts assessing cell proliferation, migration and secretion of growth factors. The age of the patients from who PRGF was prepared was also studied to determine whether it influenced the outcomes. Human dermal fibroblasts were isolated from three healthy volunteers. Using PRGF-Endoret technology, PRGF was prepared from two groups of different ages (18-35 years and 50+ years). The effects of increasing concentration of PRGF (5%, 10% and 20%) on cell proliferation and migration was evaluated. Biosynthetic behaviour of cells was also analysed measuring vascular endothelial growth factor (VEGF), transforming growth factor b1 (TGFb1) and pro-collagen type I secreted levels with or without PRGF treatment. Mean platelet enrichment reached 2.4X and 2X in 18-35 and 50+ groups respectively. A dose-dependent response was observed in proliferation assays achieving the highest levels with 20% PRGF. Migration was also promoted in cells but not in a dose-dependent manner. Cell proliferation and migration outcomes obtained with PRGF (from both groups) were significantly higher compared to non-stimulated groups (pPRGF, however, with the exception of VEGF, no statistical significances were observed between the different age groups. Results from this study concluded that PRGF is safe and effective in stimulating skin regeneration by enhancing proliferation, migration and expression of pivotal bioactive molecules involved in wound healing and haemostasis.

  17. Can attribution theory explain carers' propensity to help men with intellectual disabilities who display inappropriate sexual behaviour?

    Science.gov (United States)

    Willner, P; Smith, M

    2008-01-01

    This study examined the responses of care managers and direct care staff to vignettes of inappropriate sexual behaviour by a man with an intellectual disability. The aim was to test the theory that helping behaviour is determined by emotional responses (positive and negative emotional reactions, and optimism), which in turn are determined by causal attributions (respectively: controllability and stability of the incident depicted in the vignette). The vignettes varied in response topography and the age of the victim. Regression analysis was used to examine the relationships between causal attributions, emotional responses, and willingness to invest extra time and effort in the service user's care. No support was found for the pathway: low controllability --> increased sympathy and/or decreased negative emotions --> increased helping. However, strong support was found for the pathway: low stability --> high optimism --> increased helping, particularly in direct care staff. High levels of sympathy were also associated with increased helping, the effect again being mediated by feelings of optimism. The data provide support for one (but not the other) strand of attribution theory as applied to inappropriate sexual behaviour. The discussion considers the discrepancy between the present data and the far less encouraging literature on attribution theory as applied to challenging behaviour.

  18. Interaction of osteoblast-like cells with serum and fibronectin: effects on cell motility and proliferation in vitro

    International Nuclear Information System (INIS)

    Zuk, A.

    1986-01-01

    Osteoblast migration and proliferation are believed to occur during bone remodelling, in particular after osteoclastic bone resorption and prior to osteoblastic bone formation. In order to study migration and proliferation in vitro, the model of Alessandri et al. (1983) was modified. The model entailed seeding osteoblast-like cells into wells cut in agar and quantifying migration and proliferation peripheral to the well. Cell morphology also was described. The data indicated that on growth surfaces enriched with varying concentrations of fetal calf serum (FSC), the quantification of migration and proliferation was related both to percent cell attachment and to FCS-concentration. Because few osteoblast-like cells incorporated ( 3 H-TdR), it was concluded that the appearance of cells peripheral to the well was due to migration, and not to proliferation. Cell morphology and myosin distribution and organization indicated that osteoblast-like cells at the periphery of the cell culture (i.e. leading edge) may have been directionally migrating whereas cells behind the leading edge may have been engaged in non-directional migration. The migration, proliferation, and morphology of osteoblast-like cells cultured on fibronectin (FN) enriched growth surfaces also was examined. The quantification of migration and proliferation was related to the FN-concentration applied to the growth surface. Because few osteoblast-like cells incorporated 3 H-TdR and cell morphology indicated migration, it was concluded that osteoblast-like cells on FN-enriched growth surfaces are specialized, in part, for migration

  19. Proliferation resistance characteristics of advanced nuclear energy systems: a safeguard ability point of view

    International Nuclear Information System (INIS)

    Sevini, F.; Cojazzi, G.G.M.; Renda, G.

    2008-01-01

    Among the international community there is a renewed interest in nuclear power systems as a major source for energy production in the near to mid future. This is mainly due to concerns connected with future availability of conventional energy resources, and with the environmental impact of fossil fuels. International initiatives have been set up like the Generation 4. International Forum (GIF), the International Project on Innovative Nuclear Reactors and Fuel Cycles (IAEA-INPRO), and, partially, the US driven Global Nuclear Energy Partnership (GNEP), aimed at defining and evaluating the characteristics, in which future innovative nuclear energy systems (INS) will have to excel. Among the identified characteristics, Proliferation Resistance plays an important role for being able to widely deploy nuclear technology worldwide in a secure way. Studies having the objective to assess Proliferation Resistance of nuclear fuel cycles have been carried out since the nineteen seventies, e.g., the International Nuclear Fuel Cycle Evaluation (INFCE) and the Non-proliferation Alternative Systems Assessment Program (NASAP) initiatives, and all agree in stating that absolute intrinsic proliferation resistance, although desirable, is not achievable in the foreseeable future. The above finding is still valid; as a consequence, every INS will have to comply with agreements related to the Non Proliferation Treaty (NPT) and will require safeguards measures, implemented through extrinsic measures. This consideration led to a renewed interest in the Safeguard ability concept which can be seen as a bridge between intrinsic features and extrinsic features and measures.

  20. Impact of legislation and a prescription monitoring program on the prevalence of potentially inappropriate prescriptions for monitored drugs in Ontario: a time series analysis

    Science.gov (United States)

    Juurlink, David; Yao, Zhan; Camacho, Ximena; Paterson, J. Michael; Singh, Samantha; Dhalla, Irfan; Sproule, Beth; Mamdani, Muhammad

    2014-01-01

    Background The increased use of opioid analgesics, sedative hypnotics and stimulants, coupled with the associated risks of overdose have raised concerns around the inappropriate prescribing of these monitored drugs. We assessed the impact of new legislation, the Narcotics Safety and Awareness Act, and a centralized Narcotics Monitoring System (implemented November 2011 and May 2012, respectively), on the dispensing of prescriptions suggestive of misuse. Methods We conducted a time series analysis of publicly funded prescriptions for opioids, benzodiazepines and stimulants dispensed monthly in Ontario from January 2007 to May 2013, based on information in the Ontario Public Drug Benefit Database. In the primary analysis, a prescription was deemed potentially inappropriate if it was dispensed within 7 days of an earlier prescription and was for at least 30 tablets of a drug in the same class as the earlier prescription, but originated from a different physician and a different pharmacy. Results After enactment of the new legislation, the prevalence of potentially inappropriate opioid prescriptions decreased by 12.5% in 6 months (from 1.6% in October 2011 to 1.4% in April 2012; p = 0.01). No further significant change was observed after the introduction of the narcotic monitoring system (p = 0.8). By May 2013, the prevalence had dropped to 1.0%. Inappropriate benzodiazepine prescribing was significantly influenced by both the legislation (p significantly influenced by the introduction of the monitoring system in May 2012, falling from 0.7% in April 2012 to 0.3% in May 2013 (p = 0.02). Interpretation For a select group of drugs prone to misuse and diversion, legislation and a prescription monitoring program reduced the prevalence of prescriptions suggestive of misuse. This suggests that regulatory interventions can promote appropriate prescribing which could potentially be applied to other jurisdictions and drugs of concern. PMID:25485251

  1. Proliferation and the Civilian Nuclear Fuel Cycle. Towards a Simplified Recipe to Measure Proliferation Risk

    Energy Technology Data Exchange (ETDEWEB)

    Brogli, R.; Krakowski, R.A

    2001-08-01

    The primary goal of this study is to frame the problem of nuclear proliferation in the context of protection and risks associated with nuclear materials flowing in the civilian nuclear fuel cycle. The perspective adopted for this study is that of a nuclear utility and the flow of fresh and spent nuclear fuel with which that utility must deal in the course of providing economic, safe, and ecologically acceptable electrical power to the public. Within this framework quantitative approaches to a material-dependent, simplified proliferation-risk metric are identified and explored. The driving force behind this search for such a proliferation metric derives from the need to quantify the proliferation risk in the context of evaluating various commercial nuclear fuel cycle options (e.g., plutonium recycle versus once-through). While the formulation of the algebra needed to describe the desired, simplified metric(s) should be straight forward once a modus operandi is defined, considerable interaction with the user of any final product that results is essential. Additionally, a broad contextual review of the proliferation problem and past efforts in the quantification of associated risks was developed as part of this study. This extensive review was essential to setting perspectives and establishing (feasibility) limits to the search for a proliferation metric(s) that meets the goals of this study. Past analyses of proliferation risks associated with the commercial nuclear fuel cycle have generally been based on a range of decision-analysis, operations-research tools. Within the time and budget constraints, as well as the self-enforced (utility) customer focus, the more subjective and data-intensive decision-analysis methodologies where not pursued. Three simplified, less-subjective approaches were investigated instead: a) a simplified 'four-factor' formula expressing as a normalized product political, material-quantity, material-quality, and material

  2. Proliferation and the Civilian Nuclear Fuel Cycle. Towards a Simplified Recipe to Measure Proliferation Risk

    International Nuclear Information System (INIS)

    Brogli, R.; Krakowski, R.A.

    2001-08-01

    The primary goal of this study is to frame the problem of nuclear proliferation in the context of protection and risks associated with nuclear materials flowing in the civilian nuclear fuel cycle. The perspective adopted for this study is that of a nuclear utility and the flow of fresh and spent nuclear fuel with which that utility must deal in the course of providing economic, safe, and ecologically acceptable electrical power to the public. Within this framework quantitative approaches to a material-dependent, simplified proliferation-risk metric are identified and explored. The driving force behind this search for such a proliferation metric derives from the need to quantify the proliferation risk in the context of evaluating various commercial nuclear fuel cycle options (e.g., plutonium recycle versus once-through). While the formulation of the algebra needed to describe the desired, simplified metric(s) should be straight forward once a modus operandi is defined, considerable interaction with the user of any final product that results is essential. Additionally, a broad contextual review of the proliferation problem and past efforts in the quantification of associated risks was developed as part of this study. This extensive review was essential to setting perspectives and establishing (feasibility) limits to the search for a proliferation metric(s) that meets the goals of this study. Past analyses of proliferation risks associated with the commercial nuclear fuel cycle have generally been based on a range of decision-analysis, operations-research tools. Within the time and budget constraints, as well as the self-enforced (utility) customer focus, the more subjective and data-intensive decision-analysis methodologies where not pursued. Three simplified, less-subjective approaches were investigated instead: a) a simplified 'four-factor' formula expressing as a normalized product political, material-quantity, material-quality, and material-protection metrics; b

  3. Oxidative stress induced pulmonary endothelial cell proliferation is ...

    African Journals Online (AJOL)

    Cellular hyper-proliferation, endothelial dysfunction and oxidative stress are hallmarks of the pathobiology of pulmonary hypertension. Indeed, pulmonary endothelial cells proliferation is susceptible to redox state modulation. Some studies suggest that superoxide stimulates endothelial cell proliferation while others have ...

  4. Long-term regulation of Na,K-ATPase pump during T-cell proliferation.

    Science.gov (United States)

    Karitskaya, Inna; Aksenov, Nikolay; Vassilieva, Irina; Zenin, Valerii; Marakhova, Irina

    2010-09-01

    The aim of the study was to elucidate the mechanism responsible for the proliferation-related regulation of Na,K-ATPase pump. Our data demonstrate that in mitogen-stimulated human blood lymphocytes, enhanced ouabain-sensitive Rb(K) fluxes in the middle/late stage of G(0)/G(1)/S transit are associated with the increased number of Na,K-ATPase pumps expressed at the cell surface (as determined by the [(3)H]ouabain binding). Analysis of total RNA (reverse transcription-polymerase chain reaction) and protein (Western blotting) showed a threefold increase in the level of Na,K-ATPase alpha1-subunit and beta1-subunit mRNAs and significant increase in the Na,K-ATPase alpha1-subunit protein during the first day of mitogen-induced proliferation. The elevated K transport as well as the increased expression of Na,K-ATPase is closely associated with the IL-2-dependent stage of T-cell response. The pharmacological inhibition of IL-2-induced MEK/ERK or JAK/STAT cascades suppressed the IL-2-induced proliferation and reduced the functional and protein expressions of Na,K-ATPase. It is concluded that during the lymphocyte transition from resting stage to proliferation, (1) long-term activation of Na,K-ATPase pump is due to the enhanced expression of Na,K-ATPase protein and mRNA, and (2) the cytokine signaling via the IL-2 receptor is necessary for the cell cycle-associated upregulation of Na,K-ATPase.

  5. Angiotensin Converting Enzyme Regulates Cell Proliferation and Migration.

    Directory of Open Access Journals (Sweden)

    Erika Costa de Alvarenga

    Full Text Available The angiotensin-I converting enzyme (ACE plays a central role in the renin-angiotensin system, acting by converting the hormone angiotensin-I to the active peptide angiotensin-II (Ang-II. More recently, ACE was shown to act as a receptor for Ang-II, and its expression level was demonstrated to be higher in melanoma cells compared to their normal counterparts. However, the function that ACE plays as an Ang-II receptor in melanoma cells has not been defined yet.Therefore, our aim was to examine the role of ACE in tumor cell proliferation and migration.We found that upon binding to ACE, Ang-II internalizes with a faster onset compared to the binding of Ang-II to its classical AT1 receptor. We also found that the complex Ang-II/ACE translocates to the nucleus, through a clathrin-mediated process, triggering a transient nuclear Ca2+ signal. In silico studies revealed a possible interaction site between ACE and phospholipase C (PLC, and experimental results in CHO cells, demonstrated that the β3 isoform of PLC is the one involved in the Ca2+ signals induced by Ang-II/ACE interaction. Further studies in melanoma cells (TM-5 showed that Ang-II induced cell proliferation through ACE activation, an event that could be inhibited either by ACE inhibitor (Lisinopril or by the silencing of ACE. In addition, we found that stimulation of ACE by Ang-II caused the melanoma cells to migrate, at least in part due to decreased vinculin expression, a focal adhesion structural protein.ACE activation regulates melanoma cell proliferation and migration.

  6. Involvement of WNT Signaling in the Regulation of Gestational Age-Dependent Umbilical Cord-Derived Mesenchymal Stem Cell Proliferation

    Directory of Open Access Journals (Sweden)

    Sota Iwatani

    2017-01-01

    Full Text Available Mesenchymal stem cells (MSCs are a heterogeneous cell population that is isolated initially from the bone marrow (BM and subsequently almost all tissues including umbilical cord (UC. UC-derived MSCs (UC-MSCs have attracted an increasing attention as a source for cell therapy against various degenerative diseases due to their vigorous proliferation and differentiation. Although the cell proliferation and differentiation of BM-derived MSCs is known to decline with age, the functional difference between preterm and term UC-MSCs is poorly characterized. In the present study, we isolated UC-MSCs from 23 infants delivered at 22–40 weeks of gestation and analyzed their gene expression and cell proliferation. Microarray analysis revealed that global gene expression in preterm UC-MSCs was distinct from term UC-MSCs. WNT signaling impacts on a variety of tissue stem cell proliferation and differentiation, and its pathway genes were enriched in differentially expressed genes between preterm and term UC-MSCs. Cell proliferation of preterm UC-MSCs was significantly enhanced compared to term UC-MSCs and counteracted by WNT signaling inhibitor XAV939. Furthermore, WNT2B expression in UC-MSCs showed a significant negative correlation with gestational age (GA. These results suggest that WNT signaling is involved in the regulation of GA-dependent UC-MSC proliferation.

  7. Involvement of WNT Signaling in the Regulation of Gestational Age-Dependent Umbilical Cord-Derived Mesenchymal Stem Cell Proliferation

    Science.gov (United States)

    Shono, Akemi; Yoshida, Makiko; Yamana, Keiji; Thwin, Khin Kyae Mon; Kuroda, Jumpei; Kurokawa, Daisuke; Koda, Tsubasa; Nishida, Kosuke; Ikuta, Toshihiko; Mizobuchi, Masami; Taniguchi-Ikeda, Mariko

    2017-01-01

    Mesenchymal stem cells (MSCs) are a heterogeneous cell population that is isolated initially from the bone marrow (BM) and subsequently almost all tissues including umbilical cord (UC). UC-derived MSCs (UC-MSCs) have attracted an increasing attention as a source for cell therapy against various degenerative diseases due to their vigorous proliferation and differentiation. Although the cell proliferation and differentiation of BM-derived MSCs is known to decline with age, the functional difference between preterm and term UC-MSCs is poorly characterized. In the present study, we isolated UC-MSCs from 23 infants delivered at 22–40 weeks of gestation and analyzed their gene expression and cell proliferation. Microarray analysis revealed that global gene expression in preterm UC-MSCs was distinct from term UC-MSCs. WNT signaling impacts on a variety of tissue stem cell proliferation and differentiation, and its pathway genes were enriched in differentially expressed genes between preterm and term UC-MSCs. Cell proliferation of preterm UC-MSCs was significantly enhanced compared to term UC-MSCs and counteracted by WNT signaling inhibitor XAV939. Furthermore, WNT2B expression in UC-MSCs showed a significant negative correlation with gestational age (GA). These results suggest that WNT signaling is involved in the regulation of GA-dependent UC-MSC proliferation. PMID:29138639

  8. A secreted factor represses cell proliferation in Dictyostelium

    OpenAIRE

    Brock, Debra A.; Gomer, Richard H.

    2005-01-01

    Many cells appear to secrete factors called chalones that limit their proliferation, but in most cases the factors have not been identified. We found that growing Dictyostelium cells secrete a 60 kDa protein called AprA for autocrine proliferation repressor. AprA has similarity to putative bacterial proteins of unknown function. Compared with wild-type cells, aprA-null cells proliferate faster, while AprA overexpressing cells proliferate slower. Growing wild-type cells secrete a factor that i...

  9. In vitro proliferation of adult human beta-cells.

    Directory of Open Access Journals (Sweden)

    Sabine Rutti

    Full Text Available A decrease in functional beta-cell mass is a key feature of type 2 diabetes. Glucagon-like peptide 1 (GLP-1 analogues induce proliferation of rodent beta-cells. However, the proliferative capacity of human beta-cells and its modulation by GLP-1 analogues remain to be fully investigated. We therefore sought to quantify adult human beta-cell proliferation in vitro and whether this is affected by the GLP-1 analogue liraglutide.Human islets from 7 adult cadaveric organ donors were dispersed into single cells. Beta-cells were purified by FACS. Non-sorted cells and the beta-cell enriched ("beta-cells" population were plated on extracellular matrix from rat (804G and human bladder carcinoma cells (HTB9 or bovine corneal endothelial ECM (BCEC. Cells were maintained in culture+/-liraglutide for 4 days in the presence of BrdU.Rare human beta-cell proliferation could be observed either in the purified beta-cell population (0.051±0.020%; 22 beta-cells proliferating out of 84'283 beta-cells counted or in the non-sorted cell population (0.055±0.011%; 104 proliferating beta-cells out of 232'826 beta-cells counted, independently of the matrix or the culture conditions. Liraglutide increased human beta-cell proliferation on BCEC in the non-sorted cell population (0.082±0.034% proliferating beta-cells vs. 0.017±0.008% in control, p<0.05.These results indicate that adult human beta-cell proliferation can occur in vitro but remains an extremely rare event with these donors and particular culture conditions. Liraglutide increases beta-cell proliferation only in the non-sorted cell population and only on BCEC. However, it cannot be excluded that human beta-cells may proliferate to a greater extent in situ in response to natural stimuli.

  10. Expression of WNT genes in cervical cancer-derived cells: Implication of WNT7A in cell proliferation and migration

    International Nuclear Information System (INIS)

    Ramos-Solano, Moisés; Meza-Canales, Ivan D.; Torres-Reyes, Luis A.; Alvarez-Zavala, Monserrat

    2015-01-01

    According to the multifactorial model of cervical cancer (CC) causation, it is now recognized that other modifications, in addition to Human papillomavirus (HPV) infection, are necessary for the development of this neoplasia. Among these, it has been proposed that a dysregulation of the WNT pathway might favor malignant progression of HPV-immortalized keratinocytes. The aim of this study was to identify components of the WNT pathway differentially expressed in CC vs. non-tumorigenic, but immortalized human keratinocytes. Interestingly, WNT7A expression was found strongly downregulated in cell lines and biopsies derived from CC. Restoration of WNT7A in CC-derived cell lines using a lentiviral gene delivery system or after adding a recombinant human protein decreases cell proliferation. Likewise, WNT7A silencing in non-tumorigenic cells markedly accelerates proliferation. Decreased WNT7A expression was due to hypermethylation at particular CpG sites. To our knowledge, this is the first study reporting reduced WNT7A levels in CC-derived cells and that ectopic WNT7A restoration negatively affects cell proliferation and migration. - Highlights: • WNT7A is expressed in normal keratinocytes or cervical cells without lesion. • WNT7A is significantly reduced in cervical cancer-derived cells. • Restoration of WNT7A expression in HeLa decreases proliferation and cell migration. • Silencing of WNT7A in HaCaT induces an increased proliferation and migration rate. • Decreased WNT7A expression in this model is due to hypermethylation

  11. Expression of WNT genes in cervical cancer-derived cells: Implication of WNT7A in cell proliferation and migration

    Energy Technology Data Exchange (ETDEWEB)

    Ramos-Solano, Moisés, E-mail: mrsolano84@gmail.com [División de Inmunología, Centro de Investigación Biomédica de Occidente (CIBO)-Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco (Mexico); Programa de Doctorado en Ciencias Biomédica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Jalisco (Mexico); Meza-Canales, Ivan D., E-mail: imezacanales@ice.mpg.de [Department of Molecular Ecology, Max Planck Institute for Chemical Ecology, 07745 Jena (Germany); Torres-Reyes, Luis A., E-mail: torres_reyes_88@hotmail.com [División de Inmunología, Centro de Investigación Biomédica de Occidente (CIBO)-Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco (Mexico); Programa de Doctorado en Ciencias Biomédica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Jalisco (Mexico); Alvarez-Zavala, Monserrat, E-mail: monse_belan@hotmail.com [División de Inmunología, Centro de Investigación Biomédica de Occidente (CIBO)-Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco (Mexico); Programa de Doctorado en Ciencias Biomédica, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Jalisco (Mexico); and others

    2015-07-01

    According to the multifactorial model of cervical cancer (CC) causation, it is now recognized that other modifications, in addition to Human papillomavirus (HPV) infection, are necessary for the development of this neoplasia. Among these, it has been proposed that a dysregulation of the WNT pathway might favor malignant progression of HPV-immortalized keratinocytes. The aim of this study was to identify components of the WNT pathway differentially expressed in CC vs. non-tumorigenic, but immortalized human keratinocytes. Interestingly, WNT7A expression was found strongly downregulated in cell lines and biopsies derived from CC. Restoration of WNT7A in CC-derived cell lines using a lentiviral gene delivery system or after adding a recombinant human protein decreases cell proliferation. Likewise, WNT7A silencing in non-tumorigenic cells markedly accelerates proliferation. Decreased WNT7A expression was due to hypermethylation at particular CpG sites. To our knowledge, this is the first study reporting reduced WNT7A levels in CC-derived cells and that ectopic WNT7A restoration negatively affects cell proliferation and migration. - Highlights: • WNT7A is expressed in normal keratinocytes or cervical cells without lesion. • WNT7A is significantly reduced in cervical cancer-derived cells. • Restoration of WNT7A expression in HeLa decreases proliferation and cell migration. • Silencing of WNT7A in HaCaT induces an increased proliferation and migration rate. • Decreased WNT7A expression in this model is due to hypermethylation.

  12. Potentially inappropriate liver transplantation in the era of the "sickest first" policy - A search for the upper limits.

    Science.gov (United States)

    Linecker, Michael; Krones, Tanja; Berg, Thomas; Niemann, Claus U; Steadman, Randolph H; Dutkowski, Philipp; Clavien, Pierre-Alain; Busuttil, Ronald W; Truog, Robert D; Petrowsky, Henrik

    2017-11-11

    Liver transplantation has emerged as a highly efficient treatment for a variety of acute and chronic liver diseases. However, organ shortage is becoming an increasing problem globally, limiting the applicability of liver transplantation. In addition, potential recipients are becoming sicker, thereby increasing the risk of losing the graft during transplantation or in the initial postoperative period after liver transplantation (three months). This trend is challenging the model for end-stage liver disease allocation system, where the sickest candidates are prioritised and no delisting criteria are given. The weighting of the deontological demand for "equity", trying to save every patient, regardless of the overall utility; and "efficiency", rooted in utilitarianism, trying to save as many patients as possible and increase the overall quality of life of patients facing the same problem, has to be reconsidered. In this article we are aiming to overcome the widespread concept of futility in liver transplantation, providing a definition of potentially inappropriate liver transplantation and giving guidance on situations where it is best not to proceed with liver transplantation, to decrease the mortality rate in the first three months after transplantation. We propose "absolute" and "relative" conditions, where early post-transplant mortality is highly probable, which are not usually captured in risk scores predicting post-transplant survival. Withholding liver transplantation for listed patients in cases where liver transplant is not deemed clearly futile, but is potentially inappropriate, is a far-reaching decision. Until now, this decision had to be discussed extensively on an individual basis, applying explicit communication and conflict resolution processes, since the model for end-stage liver disease score and most international allocation systems do not include explicit delisting criteria to support a fair delisting process. More work is needed to better

  13. Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria.

    LENUS (Irish Health Repository)

    Cooper, Janine A

    2016-01-28

    The purpose of this study is to establish the prevalence of potentially inappropriate prescribing (PIP) in middle-aged adults (45-64 years) in two populations with differing socio-economic profiles, and to investigate factors associated with PIP, using the PROMPT (PRescribing Optimally in Middle-aged People\\'s Treatments) criteria.

  14. Information report on Proliferation geo-strategic stakes

    International Nuclear Information System (INIS)

    2009-11-01

    This large report, notably based on interviews of many representatives of international institutions and politicians, ambassadors and researchers of different countries, all involved or specialized in nuclear and defence issues, starts with a description of the evolution of the international and geo-strategic context from the Cold War to a period of a new nuclear proliferation, with, in between, a period of stabilisation between the USA and the USSR. It also questions the various forms of proliferation which could be ballistic, biological, chemical, and cybernetic. Then, it analyses the role which mass destruction weapons have in international relationships, making a distinction between countries possessing such weapons (USA, Russia, China, France, Great-Britain), Israel which has been a newcomer for thirty years, the new actors (India, Pakistan, Iran, North Korea) with their own and different motivations, and the possible new actors (Libya, Syria). It comments the meaning of the ballistic threat and of the anti-missile defence. The third part of this report deals with the dissemination of proliferating technologies, describing the proliferation networks and the failure of actions against state-based proliferations, questioning the reality of the associated risks (discussion about the impact of September 11 attacks, about a chemical and biological terrorist threat which is realistic as well as difficult to be implemented, and about cybernetic attacks). The fourth part comments the impact of the international community on proliferation, outlining the different efficiencies of the international agreements and institutions (Chemical Weapons Convention, IAEA, Non Proliferation Treaty, Biological Weapons Convention, The Hague Code of Conduct), commenting the opportunities associated with other texts (those about nuclear free areas, or those produced by exporter groups), and discussing the attitude of the international community with respect to proliferation, and the

  15. Identifying and acting on potentially inappropriate care? Inadequacy of current hospital coding for this task.

    Science.gov (United States)

    Cooper, P David; Smart, David R

    2017-06-01

    Recent Australian attempts to facilitate disinvestment in healthcare, by identifying instances of 'inappropriate' care from large Government datasets, are subject to significant methodological flaws. Amongst other criticisms has been the fact that the Government datasets utilized for this purpose correlate poorly with datasets collected by relevant professional bodies. Government data derive from official hospital coding, collected retrospectively by clerical personnel, whilst professional body data derive from unit-specific databases, collected contemporaneously with care by clinical personnel. Assessment of accuracy of official hospital coding data for hyperbaric services in a tertiary referral hospital. All official hyperbaric-relevant coding data submitted to the relevant Australian Government agencies by the Royal Hobart Hospital, Tasmania, Australia for financial year 2010-2011 were reviewed and compared against actual hyperbaric unit activity as determined by reference to original source documents. Hospital coding data contained one or more errors in diagnoses and/or procedures in 70% of patients treated with hyperbaric oxygen that year. Multiple discrete error types were identified, including (but not limited to): missing patients; missing treatments; 'additional' treatments; 'additional' patients; incorrect procedure codes and incorrect diagnostic codes. Incidental observations of errors in surgical, anaesthetic and intensive care coding within this cohort suggest that the problems are not restricted to the specialty of hyperbaric medicine alone. Publications from other centres indicate that these problems are not unique to this institution or State. Current Government datasets are irretrievably compromised and not fit for purpose. Attempting to inform the healthcare policy debate by reference to these datasets is inappropriate. Urgent clinical engagement with hospital coding departments is warranted.

  16. Which future for the nuclear counter-proliferation?; Quel avenir pour la contre-proliferation nucleaire?

    Energy Technology Data Exchange (ETDEWEB)

    Duval, M

    2004-10-01

    After a recall of the permanent data about proliferation and of the safeguards implemented by the international community, the author demonstrates that proliferation has moved towards Asia where a real 'black market' has been created. Then he analyzes the consequences of this change on the future of nuclear deterrent. Finally, he expresses his nostalgia in front of this drift and worries about the future uselessness of the means devoted to this 'pacifying' strategy. (J.S.)

  17. Proliferation and differentiation of Trypanosoma cruzi inside its vector have a new trigger: redox status.

    Directory of Open Access Journals (Sweden)

    Natália P Nogueira

    Full Text Available Trypanosoma cruzi proliferate and differentiate inside different compartments of triatomines gut that is the first environment encountered by T. cruzi. Due to its complex life cycle, the parasite is constantly exposed to reactive oxygen species (ROS. We tested the influence of the pro-oxidant molecules H2O2 and the superoxide generator, Paraquat, as well as, metabolism products of the vector, with distinct redox status, in the proliferation and metacyclogenesis. These molecules are heme, hemozoin and urate. We also tested the antioxidants NAC and GSH. Heme induced the proliferation of epimastigotes and impaired the metacyclogenesis. β-hematin, did not affect epimastigote proliferation but decreased parasite differentiation. Conversely, we show that urate, GSH and NAC dramatically impaired epimastigote proliferation and during metacyclogenesis, NAC and urate induced a significant increment of trypomastigotes and decreased the percentage of epimastigotes. We also quantified the parasite loads in the anterior and posterior midguts and in the rectum of the vector by qPCR. The treatment with the antioxidants increased the parasite loads in all midgut sections analyzed. In vivo, the group of vectors fed with reduced molecules showed an increment of trypomastigotes and decreased epimastigotes when analyzed by differential counting. Heme stimulated proliferation by increasing the cell number in the S and G2/M phases, whereas NAC arrested epimastigotes in G1 phase. NAC greatly increased the percentage of trypomastigotes. Taken together, these data show a shift in the triatomine gut microenvironment caused by the redox status may also influence T. cruzi biology inside the vector. In this scenario, oxidants act to turn on epimastigote proliferation while antioxidants seem to switch the cycle towards metacyclogenesis. This is a new insight that defines a key role for redox metabolism in governing the parasitic life cycle.

  18. An Autocrine Proliferation Repressor Regulates Dictyostelium discoideum Proliferation and Chemorepulsion Using the G Protein-Coupled Receptor GrlH

    OpenAIRE

    Yu Tang; Yuantai Wu; Sarah E. Herlihy; Francisco J. Brito-Aleman; Jose H. Ting; Chris Janetopoulos; Richard H. Gomer; Scott D. Emr

    2018-01-01

    In eukaryotic microbes, little is known about signals that inhibit the proliferation of the cells that secrete the signal, and little is known about signals (chemorepellents) that cause cells to move away from the source of the signal. Autocrine proliferation repressor protein A (AprA) is a protein secreted by the eukaryotic microbe Dictyostelium discoideum. AprA is a chemorepellent for and inhibits the proliferation of D. discoideum. We previously found that cells sense AprA using G proteins...

  19. Nuclear experts and nuclear weapons proliferation

    International Nuclear Information System (INIS)

    Mueller, H.

    1979-01-01

    In Germany the issue of nuclear weapons proliferation has attracted scant attention. Most potential nuclear weapon states are important trade partners of the FRG and, since further proliferation of nuclear weapons could worsen conflicts involving these, it should be in the FRG's interest to limit proliferation. The security of the FRG is also dependent on the common interest of the great powers to avoid nuclear war. The contradictory positions of Usa and the USSR on nuclear weapons policy regarding themselves and non-nuclear weapon states encourages less developed countries to see nuclear weaponry as useful. The NPT and IAEA safeguards have only limited inhibiting effect. The nuclear export policy of the FRG has been dominated by short term economic advantage, neglecting the negative long term effects of decreased political stability. The FRG should formulate a policy based on self-restraint, positive stimuli and extension of controls, using its economic strength to deter proliferation. (JIW)

  20. Proliferation in cycle

    Energy Technology Data Exchange (ETDEWEB)

    Piao Yunsong [College of Physical Sciences, Graduate School of Chinese Academy of Sciences, Beijing 100049 (China)], E-mail: yspiao@gucas.ac.cn

    2009-06-15

    In the contracting phase with w{approx_equal}0, the scale invariant spectrum of curvature perturbation is given by the increasing mode of metric perturbation. In this Letter, it is found that if the contracting phase with w{approx_equal}0 is included in each cycle of a cycle universe, since the metric perturbation is amplified on super horizon scale cycle by cycle, after each cycle the universe will be inevitably separated into many parts independent of one another, each of which corresponds to a new universe and evolves up to next cycle, and then is separated again. In this sense, a cyclic multiverse scenario is actually presented, in which the universe proliferates cycle by cycle. We estimate the number of new universes proliferated in each cycle, and discuss the implications of this result.

  1. Proliferation in cycle

    International Nuclear Information System (INIS)

    Piao Yunsong

    2009-01-01

    In the contracting phase with w≅0, the scale invariant spectrum of curvature perturbation is given by the increasing mode of metric perturbation. In this Letter, it is found that if the contracting phase with w≅0 is included in each cycle of a cycle universe, since the metric perturbation is amplified on super horizon scale cycle by cycle, after each cycle the universe will be inevitably separated into many parts independent of one another, each of which corresponds to a new universe and evolves up to next cycle, and then is separated again. In this sense, a cyclic multiverse scenario is actually presented, in which the universe proliferates cycle by cycle. We estimate the number of new universes proliferated in each cycle, and discuss the implications of this result.

  2. Utility of Social Modeling for Proliferation Assessment - Preliminary Findings

    International Nuclear Information System (INIS)

    Coles, Garill A.; Gastelum, Zoe N.; Brothers, Alan J.; Thompson, Sandra E.

    2009-01-01

    Often the methodologies for assessing proliferation risk are focused around the inherent vulnerability of nuclear energy systems and associated safeguards. For example an accepted approach involves ways to measure the intrinsic and extrinsic barriers to potential proliferation. This paper describes preliminary investigation into non-traditional use of social and cultural information to improve proliferation assessment and advance the approach to assessing nuclear material diversion. Proliferation resistance assessment, safeguard assessments and related studies typically create technical information about the vulnerability of a nuclear energy system to diversion of nuclear material. The purpose of this research project is to find ways to integrate social information with technical information by explicitly considering the role of culture, groups and/or individuals to factors that impact the possibility of proliferation. When final, this work is expected to describe and demonstrate the utility of social science modeling in proliferation and proliferation risk assessments.

  3. Trends and interaction of polypharmacy and potentially inappropriate prescribing in primary care over 15 years in Ireland: a repeated cross-sectional study.

    LENUS (Irish Health Repository)

    Moriarty, Frank

    2015-03-01

    To examine: (1) changes in polypharmacy in 1997, 2002, 2007 and 2012 and; (2) changes in potentially inappropriate prescribing (PIP) prevalence and the relationship between PIP and polypharmacy in individuals aged ≥65 years over this period in Ireland.

  4. Biglycan deficiency increases osteoclast differentiation and activity due to defective osteoblasts

    DEFF Research Database (Denmark)

    Bi, Yanming; Nielsen, Karina L; Kilts, Tina M

    2006-01-01

    to be independent of the differential production of soluble RANKL and OPG and, instead, due to a decrease in osteoblast maturation accompanied by increase in osteoblastic proliferation. In addition to the imbalance between differentiation and proliferation, there was a differential decrease in secretory leukocyte......Bone mass is maintained by a fine balance between bone formation by osteoblasts and bone resorption by osteoclasts. Although osteoblasts and osteoclasts have different developmental origins, it is generally believed that the differentiation, function, and survival of osteoclasts are regulated...... by osteogenic cells. We have previously shown that the extracellular matrix protein, biglycan (Bgn), plays an important role in the differentiation of osteoblast precursors. In this paper, we showed that Bgn is involved in regulating osteoclast differentiation through its effect on osteoblasts...

  5. RELATIVE PROLIFERATION RISKS FOR NUCLEAR FUEL LEASING ARRANGEMENT

    International Nuclear Information System (INIS)

    CHENG, L.Y.; YUE, M.; BARI, R.A.

    2007-01-01

    The present study demonstrates a probabilistic approach to quantify the proliferation risks of fuel leasing and recycling. A Markov model approach is applied to evaluate the probability of proliferation success by diversion or theft. Proliferation risk is calculated as a product of the probability of success and the corresponding consequences

  6. Complexities in gauging time-dependency of proliferation resistance

    International Nuclear Information System (INIS)

    Avens, L.R.; Eller, P.G.; Stanbro, W.D.

    2004-01-01

    To a considerable extent, policy decisions on nuclear fuel cycle issues depend upon how decision makers recognize and weigh 'long-term' and 'short-term' nuclear proliferation risk factors. Priorities and structures of advanced fuel cycle and safeguards research and development programs are affected similarly. Unfortunately, there is a diversity of understanding of the precise meanings of these proliferation risk terms, leading to lack of precision in their usage. In addition, proliferation risk evaluation fundamentally involves value judgments on the relative importance of time-dependent risks. Poor communication and diverse conclusions often result. This paper explores some complexities in gauging 'long-term' and 'short-term' proliferation risk in the context of advanced nuclear fuel cycles. A convenient vehicle for this purpose is a commonly used notional plot of some proliferation resistance attribute of spent fuel or separated plutonium versus years from reactor discharge, often overlain with similar notional curves denoting multiple fuel irradiation and recycle. A common basis for misuse of such plots is failure to clearly define the range of proliferation threats being evaluated, as illustrated by several common examples of such omissions. Partial arguments of this type can be misleading and provide a disservice to policy makers who must have a clear picture of the tradeoffs being made. This paper concludes with a call for much greater care to avoid overly simplistic interpretations of notional proliferation-related concepts and greater precision in general in use of proliferation-related terminology.

  7. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review.

    Science.gov (United States)

    Tommelein, Eline; Mehuys, Els; Petrovic, Mirko; Somers, Annemie; Colin, Pieter; Boussery, Koen

    2015-12-01

    Potentially inappropriate prescribing (PIP) is one of the main risk factors for adverse drug events (ADEs) in older people. This systematic literature review aims to determine prevalence and type of PIP in community-dwelling older people across Europe, as well as identifying risk factors for PIP. The PubMed and Web of Science database were searched systematically for relevant manuscripts (January 1, 2000-December 31, 2014). Manuscripts were included if the study design was observational, the study participants were community-dwelling older patients in Europe, and if a published screening method for PIP was used. Studies that focused on specific pathologies or that focused on merely one inappropriate prescribing issue were excluded. Data analysis was performed using R statistics. Fifty-two manuscripts were included, describing 82 different sample screenings with an estimated overall PIP prevalence of 22.6 % (CI 19.2-26.7 %; range 0.0-98.0 %). Ten of the sample screenings were based on the Beers 1997 criteria, 19 on the Beers 2003 criteria, 14 on STOPP criteria (2008 version), 8 on START-criteria (2008 version), and 7 on the PRISCUS list. The 24 remaining sample screenings were carried out using compilations of screening methods or used country-specific lists such as the Laroche criteria. It appears that only PIP prevalence calculated from insurance data significantly differs from the other data collection method categories. Furthermore, risk factors most often positively associated with PIP prevalence were polypharmacy, poor functional status, and depression. Drug groups most often involved in PIP were anxiolytics (ATC-code: N05B), antidepressants (N06A), and nonsteroidal anti-inflammatory and anti-rheumatic products (M01A). PIP prevalence in European community-dwelling older adults is high and depends partially on the data collection method used. Polypharmacy, poor functional status, and depression were identified as the most common risk factors for PIP.

  8. Commonly used bowel preparations have significant and different effects upon cell proliferation in the colon: a pilot study

    Directory of Open Access Journals (Sweden)

    Riley Stuart A

    2008-11-01

    Full Text Available Abstract Background Markers of crypt cell proliferation are frequently employed in studies of the impact of genetic and exogenous factors on human colonic physiology. Human studies often rely on the assessment of tissue acquired at endoscopy. Modulation of cell proliferation by bowel preparation with oral laxatives may confound the findings of such studies, but there is little data on the impact of commonly used bowel preparations on markers of cell proliferation. Methods Crypt length, crypt cellularity and crypt cell proliferation were assessed in biopsies acquired after preparation with either Klean-Prep or Picolax. Crypt cell proliferation was assessed by whole-mount mitotic figure count, and by two different immunohistochemical (IHC labelling methods (Ki-67 and pHH3. Subsequent biopsies were obtained from the same patients without bowel preparation and similarly assessed. Parameters were compared between groups using analysis of variance and paired t-tests. Results There were significant differences in labelling indices (LI between biopsies taken after Klean-prep and those taken after Picolax preparation, for both Ki67 (p = 0.019 and pHH3 (p = 0.017. A similar trend was seen for whole-mount mitotic figure counts. Suppression or elevation of proliferation parameters by bowel preparation may mask any effect due to an intervention or disease. Conclusion Commonly used bowel preparations may have significant and different effects on crypt cell proliferation. This should be taken into account when designing studies and when considering the findings of existing studies.

  9. Protocatechuic aldehyde inhibits migration and proliferation of vascular smooth muscle cells and intravascular thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Chang Yoon [The Hotchkiss School, Lakeville, CT (United States); Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Ku, Cheol Ryong [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cho, Yoon Hee, E-mail: wooriminji@gmail.com [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Eun Jig, E-mail: ejlee423@yuhs.ac [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Endocrinology, Northwestern University Feinberg School of Medicine, Chicago, IL (United States)

    2012-06-22

    Highlights: Black-Right-Pointing-Pointer Protocatechuic aldehyde (PCA) inhibits ROS production in VSMCs. Black-Right-Pointing-Pointer PCA inhibits proliferation and migration in PDGF-induced VSMCs. Black-Right-Pointing-Pointer PCA has anti-platelet effects in ex vivo rat whole blood. Black-Right-Pointing-Pointer We report the potential therapeutic role of PCA in atherosclerosis. -- Abstract: The migration and proliferation of vascular smooth muscle cells (VSMCs) and formation of intravascular thrombosis play crucial roles in the development of atherosclerotic lesions. This study examined the effects of protocatechuic aldehyde (PCA), a compound isolated from the aqueous extract of the root of Salvia miltiorrhiza, an herb used in traditional Chinese medicine to treat a variety of vascular diseases, on the migration and proliferation of VSMCs and platelets due to platelet-derived growth factor (PDGF). DNA 5-bromo-2 Prime -deoxy-uridine (BrdU) incorporation and wound-healing assays indicated that PCA significantly attenuated PDGF-induced proliferation and migration of VSMCs at a pharmacologically relevant concentration (100 {mu}M). On a molecular level, we observed down-regulation of the phosphatidylinositol 3-kinase (PI3K)/Akt and the mitogen-activated protein kinase (MAPK) pathways, both of which regulate key enzymes associated with migration and proliferation. We also found that PCA induced S-phase arrest of the VSMC cell cycle and suppressed cyclin D2 expression. In addition, PCA inhibited PDGF-BB-stimulated reactive oxygen species production in VSMCs, indicating that PCA's antioxidant properties may contribute to its suppression of PDGF-induced migration and proliferation in VSMCs. Finally, PCA exhibited an anti-thrombotic effect related to its inhibition of platelet aggregation, confirmed with an aggregometer. Together, these findings suggest a potential therapeutic role of PCA in the treatment of atherosclerosis and angioplasty-induced vascular restenosis.

  10. An Autocrine Proliferation Repressor Regulates Dictyostelium discoideum Proliferation and Chemorepulsion Using the G Protein-Coupled Receptor GrlH

    Directory of Open Access Journals (Sweden)

    Yu Tang

    2018-02-01

    Full Text Available In eukaryotic microbes, little is known about signals that inhibit the proliferation of the cells that secrete the signal, and little is known about signals (chemorepellents that cause cells to move away from the source of the signal. Autocrine proliferation repressor protein A (AprA is a protein secreted by the eukaryotic microbe Dictyostelium discoideum. AprA is a chemorepellent for and inhibits the proliferation of D. discoideum. We previously found that cells sense AprA using G proteins, suggesting the existence of a G protein-coupled AprA receptor. To identify the AprA receptor, we screened mutants lacking putative G protein-coupled receptors. We found that, compared to the wild-type strain, cells lacking putative receptor GrlH (grlH{macron} cells show rapid proliferation, do not have large numbers of cells moving away from the edges of colonies, are insensitive to AprA-induced proliferation inhibition and chemorepulsion, and have decreased AprA binding. Expression of GrlH in grlH{macron} cells (grlH{macron}/grlHOE rescues the phenotypes described above. These data indicate that AprA signaling may be mediated by GrlH in D. discoideum.

  11. Trends in the proliferation of weapons of mass destruction

    International Nuclear Information System (INIS)

    Karp, A.

    1995-01-01

    Nuclear and missile proliferation are neither unique nor necessarily the most imposing proliferation challenges, but they are probably the most visible and mature aspects of the proliferation problem. In nuclear proliferation there the news are very ambivalent. Today we face somewhat between 7 and 9 counties with nuclear weapons: 5 acknowledged nuclear powers, Israel and Ukraine as well as the uncertain status of Pakistan and North Korea. The growing number of countries that have given up their nuclear programs is impressive, most spectacularly Argentina, Brazil and South Africa. Recently Kazakhstan has signed the Non-proliferation Treaty, and Belarus seems certain to follow. Thus the problem list is a short one now. The remaining issues are to be treated at the 1995 Non-proliferation Treaty Extension Conference

  12. Supporting non proliferation and global security efforts

    International Nuclear Information System (INIS)

    Pochon, E.

    2013-01-01

    CEA contributes as a major actor of France's action against nuclear proliferation and to the strengthening of nuclear security at national level as European and International levels, in particular through the support of the IAEA activities in nuclear non proliferation with the French Support Programme for the IAEA safeguards system and security with the contribution to the IAEA Nuclear Security Plan and cooperation projects with the European Commission. The CEA is a French government funded technological research organization, organized around 5 branches: Nuclear Energy, Technological Researches, Defence (DAM), Material Sciences and Life Sciences. Within the scope of its activities, CEA covers most of the research areas and techniques in nuclear non-proliferation and security. The CEA is also the advisor of the French Government on nuclear policy. Treaty monitoring and the development and implementation of non proliferation and global security programs is an important mission of DAM which rely on nuclear weapons manufacture and past testing experience. The programmes on non proliferation and global security carried out to fulfil DAM's mission cover the following areas: development of monitoring and detection methods and equipments, country profiles and nuclear stockpiles assessment, arms control instruments, proliferation resistance of nuclear fuel cycle, monitoring of nuclear tests, operation and maintenance of national detection capabilities and contribution to CTBT verification systems. (A.C.)

  13. Intermittent pressure decreases human keratinocyte proliferation in vitro.

    Science.gov (United States)

    Nasca, Maria R; Shih, Alan T; West, Dennis P; Martinez, Wanda M; Micali, Giuseppe; Landsman, Adam S

    2007-01-01

    The aim of this study was to investigate the correlation between pressure changes and keratinocyte proliferation by determining whether keratinocytes exposed to altered mechanical pressures would proliferate at different rates compared to control cells not subjected to pressure changes. Tissue culture flasks of human keratinocytes plated at an approximate density of 15,000 cells/cm(2) undergoing an intermittent cyclic pressure of 362 mm Hg at a frequency of 2.28 or 5.16 cycles/min (0.038 or 0.086 Hz) for 8 h were compared to control flasks grown at ambient room pressure. An in-line pressure transducer was used to monitor and adjust pressure within the cell chambers, using a solenoid valve. A thymidine incorporation assay assessed the amount of cell proliferation in each set of experiments. Differences in proliferation between keratinocytes subjected to cyclic pressure changes and control cells were found to be statistically significant (p < 0.05) in 4 out of 5 proliferation assays. Also, a higher frequency of pressure changes consistently generated a reduced proliferation rate compared to that seen in cells exposed to a lower frequency of pressure changes. These data indicate that keratinocytes undergoing intermittent pressure changes exhibit decreased proliferation rates compared to controls. Furthermore, an increased frequency rate seems to have a greater effect on proliferation than low-frequency rate pressure changes, suggesting that the stress caused by frequently changed pressure may play a greater role in reducing keratinocyte proliferation than the actual magnitude of load applied to the cells. Our results support the current treatment protocol of reducing speed and duration of walking on the site of the wound to promote healing of foot ulcers. (c) 2007 S. Karger AG, Basel.

  14. Low dose perfluorooctanoate exposure promotes cell proliferation in a human non-tumor liver cell line

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hongxia; Cui, Ruina [Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101 (China); Guo, Xuejiang [State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 210029 (China); Hu, Jiayue [Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101 (China); Dai, Jiayin, E-mail: daijy@ioz.ac.cn [Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101 (China)

    2016-08-05

    Highlights: • Differential expression of proteins induced by PFOA in HL-7702 was identified. • Most of the differentially expressed proteins are related to cell proliferation. • A low dose of PFOA stimulates HL-7702 cell proliferation. • A high dose of PFOA inhibits HL-7702 cell proliferation. - Abstract: Perfluorooctanoate (PFOA) is a well-known persistent organic pollutant widely found in the environment, wildlife and humans. Medical surveillance and experimental studies have investigated the potential effects of PFOA on human livers, but the hepatotoxicity of PFOA on humans and its underlying mechanism remain to be clarified. We exposed a human liver cell line (HL-7702) to 50 μM PFOA for 48 h and 96 h, and identified 111 significantly differentially expressed proteins by iTRAQ analysis. A total of 46 proteins were related to cell proliferation and apoptosis. Through further analysis of the cell cycle, apoptosis and their related proteins, we found that low doses of PFOA (50–100 μM) promoted cell proliferation and numbers by promoting cells from the G1 to S phases, whereas high doses of PFOA (200–400 μM) led to reduced HL-7702 cell numbers compared with that of the control mainly due to cell cycle arrest in the G0/G1 phase. To our knowledge, this is the first report on the promotion of cell cycle progression in human cells following PFOA exposure.

  15. Low dose perfluorooctanoate exposure promotes cell proliferation in a human non-tumor liver cell line

    International Nuclear Information System (INIS)

    Zhang, Hongxia; Cui, Ruina; Guo, Xuejiang; Hu, Jiayue; Dai, Jiayin

    2016-01-01

    Highlights: • Differential expression of proteins induced by PFOA in HL-7702 was identified. • Most of the differentially expressed proteins are related to cell proliferation. • A low dose of PFOA stimulates HL-7702 cell proliferation. • A high dose of PFOA inhibits HL-7702 cell proliferation. - Abstract: Perfluorooctanoate (PFOA) is a well-known persistent organic pollutant widely found in the environment, wildlife and humans. Medical surveillance and experimental studies have investigated the potential effects of PFOA on human livers, but the hepatotoxicity of PFOA on humans and its underlying mechanism remain to be clarified. We exposed a human liver cell line (HL-7702) to 50 μM PFOA for 48 h and 96 h, and identified 111 significantly differentially expressed proteins by iTRAQ analysis. A total of 46 proteins were related to cell proliferation and apoptosis. Through further analysis of the cell cycle, apoptosis and their related proteins, we found that low doses of PFOA (50–100 μM) promoted cell proliferation and numbers by promoting cells from the G1 to S phases, whereas high doses of PFOA (200–400 μM) led to reduced HL-7702 cell numbers compared with that of the control mainly due to cell cycle arrest in the G0/G1 phase. To our knowledge, this is the first report on the promotion of cell cycle progression in human cells following PFOA exposure.

  16. The US proliferation security initiative (PSI); L'initiative americaine de securite contre la proliferation (PSI)

    Energy Technology Data Exchange (ETDEWEB)

    Gregoire, B

    2004-10-01

    The proliferation security initiative (PSI), launched by President Bush on May 31, 2003, aims at intercepting any transfer of mass destruction weapons, of their vectors and related equipments, towards or coming from countries or organizations suspected to have a proliferation activity. This initiative, which involves coercive means to fight against proliferation, raises international lawfulness and legal questions, the answers of which are today under construction. This article analyzes the place of the European Union in the PSI, the action means (optimization of existing means, cooperation between intelligence and interception services), and the PSI stakes (lawfulness with respect to the international law, bilateral agreements, draft boarding agreement, sustain of the United Nations, widening of the partnership and of the field of action). (J.S.)

  17. Molecular mechanisms involved in the inhibition of tumor cells proliferation exposed to elevated concentrations of the epidermal growth factor

    International Nuclear Information System (INIS)

    Guillen, Isabel A; Berlanga, Jorge; Camacho, Hanlet

    2013-01-01

    The EGF promotes inhibition of cell proliferation in vitro and in vivo models depending on its concentration, application schema and the type of tumor cells on which it acts. Our research hypothesis was based on the fact that the EGF varies the expression of genes involved in a negative regulation of tumor cell lines proliferation carrying high levels of its receptor (EGFR). Our objectives were, to obtain information about the effect of EGF on tumor cell proliferation in vitro and in vivo models and, know the gene expression patterns of a group of genes involved in cancer signaling pathways and EGFR. The results showed that EGF at nanomolar concentrations inhibits the tumor cells proliferation bearing high levels of EGFR and, promotes the survival of treated animals, establishing a direct relationship between the inhibition of cell proliferation, high concentrations of EGF and, high amount of EGFR in the cells. The differential gene expression profile showed a variation in a group of genes which exert a powerful control over the cell cycle progression, gene transcription and apoptosis. It was concluded that the inhibition of tumor cell proliferation by the action of EGF is due to activation of molecular mechanisms controlling cell cycle progression. This work won the Annual Award of the Cuban Academy of Sciences in 2012

  18. A secreted factor represses cell proliferation in Dictyostelium.

    Science.gov (United States)

    Brock, Debra A; Gomer, Richard H

    2005-10-01

    Many cells appear to secrete factors called chalones that limit their proliferation, but in most cases the factors have not been identified. We found that growing Dictyostelium cells secrete a 60 kDa protein called AprA for autocrine proliferation repressor. AprA has similarity to putative bacterial proteins of unknown function. Compared with wild-type cells, aprA-null cells proliferate faster, while AprA overexpressing cells proliferate slower. Growing wild-type cells secrete a factor that inhibits the proliferation of wild-type and aprA- cells; this activity is not secreted by aprA- cells. AprA purified by immunoprecipitation also slows the proliferation of wild-type and aprA- cells. Compared with wild type, there is a higher percentage of multinucleate cells in the aprA- population, and when starved, aprA- cells form abnormal structures that contain fewer spores. AprA may thus decrease the number of multinucleate cells and increase spore production. Together, the data suggest that AprA functions as part of a Dictyostelium chalone.

  19. Endocarditis due to Lactobacillus jensenii in a Salvin's Amazon parrot (Amazona autumnalis salvini).

    Science.gov (United States)

    Foldenauer, Ulrike; Rusch, Martina; Simova-Curd, Stefka; Nitzl, Dagmar; Hoop, Richard K; Hatt, Jean-Michel

    2009-02-01

    A 30-year-old Salvin's Amazon parrot (Amazona autumnalis salvini) with a history of a lifelong poor diet and inappropriate housing was presented in lateral recumbency to a veterinary teaching hospital for further evaluation. Radiological and ultrasonographic examination revealed a mild proventricular dilatation, mild hepatomegaly, signs of enteritis and airsacculitis. The main laboratory findings included a mild macrocytic hyperchromic anaemia, hypoglobulinaemia, decreased bile acids and increased alkaline phosphatase. In this bird a liver pathology was suspected because of the clinical, laboratory and ultrasonographic findings. The bird was treated with supportive care and metabolic aids. After initial improvement of the clinical signs, the bird's condition deteriorated and it died. Pathological findings revealed an endocarditis and myocarditis due to Lactobacillus jensenii and a bacteraemia. Endocarditis due to Lactobacillus sp. is a rare phenomenon in humans not yet described in animals. It is associated with severe underlying illnesses leading to translocation of otherwise non-pathogenic bacteria in the bloodstream. A similar pattern might be assumed in animals with compromised immunity.

  20. Colon Cancer Chemoprevention by Sage Tea Drinking: Decreased DNA Damage and Cell Proliferation.

    Science.gov (United States)

    Pedro, Dalila F N; Ramos, Alice A; Lima, Cristovao F; Baltazar, Fatima; Pereira-Wilson, Cristina

    2016-02-01

    Salvia officinalis and some of its isolated compounds have been found to be preventive of DNA damage and increased proliferation in vitro in colon cells. In the present study, we used the azoxymethane model to test effects of S. officinalis on colon cancer prevention in vivo. The results showed that sage treatment reduced the number of ACF formed only if administered before azoxymethane injection, demonstrating that sage tea drinking has a chemopreventive effect on colorectal cancer. A decrease in the proliferation marker Ki67 and in H2 O2 -induced and azoxymethane-induced DNA damage to colonocytes and lymphocytes were found with sage treatment. This confirms in vivo the chemopreventive effects of S. officinalis. Taken together, our results show that sage treatment prevented initiation phases of colon carcinogenesis, an effect due, at least in part, to DNA protection, and reduced proliferation rates of colon epithelial cell that prevent mutations and their fixation through cell replication. These chemopreventive effects of S. officinalis on colon cancer add to the many health benefits attributed to sage and encourage its consumption. Copyright © 2015 John Wiley & Sons, Ltd.

  1. ASSESSING THE PROLIFERATION RESISTANCE OF INNOVATIVE NUCLEAR FUEL CYCLES

    International Nuclear Information System (INIS)

    BARI, R.; ROGLANS, J.; DENNING, R.; MLADINEO, S.

    2003-01-01

    The National Nuclear Security Administration is developing methods for nonproliferation assessments to support the development and implementation of U.S. nonproliferation policy. This paper summarizes the key results of that effort. Proliferation resistance is the degree of difficulty that a nuclear material, facility, process, or activity poses to the acquisition of one or more nuclear weapons. A top-level measure of proliferation resistance for a fuel cycle system is developed here from a hierarchy of metrics. At the lowest level, intrinsic and extrinsic barriers to proliferation are defined. These barriers are recommended as a means to characterize the proliferation characteristics of a fuel cycle. Because of the complexity of nonproliferation assessments, the problem is decomposed into: metrics to be computed, barriers to proliferation, and a finite set of threats. The spectrum of potential threats of nuclear proliferation is complex and ranges from small terrorist cells to industrialized countries with advanced nuclear fuel cycles. Two general categories of methods have historically been used for nonproliferation assessments: attribute analysis and scenario analysis. In the former, attributes of the systems being evaluated (often fuel cycle systems) are identified that affect their proliferation potential. For a particular system under consideration, the attributes are weighted subjectively. In scenario analysis, hypothesized scenarios of pathways to proliferation are examined. The analyst models the process undertaken by the proliferant to overcome barriers to proliferation and estimates the likelihood of success in achieving a proliferation objective. An attribute analysis approach should be used at the conceptual design level in the selection of fuel cycles that will receive significant investment for development. In the development of a detailed facility design, a scenario approach should be undertaken to reduce the potential for design vulnerabilities

  2. Role of MXD3 in proliferation of DAOY human medulloblastoma cells.

    Directory of Open Access Journals (Sweden)

    Gustavo A Barisone

    Full Text Available A subset of medulloblastomas, the most common brain tumor in children, is hypothesized to originate from granule neuron precursors (GNPs in which the sonic hedgehog (SHH pathway is over-activated. MXD3, a basic helix-look-helix zipper transcription factor of the MAD family, has been reported to be upregulated during postnatal cerebellar development and to promote GNP proliferation and MYCN expression. Mxd3 is upregulated in mouse models of medulloblastoma as well as in human medulloblastomas. Therefore, we hypothesize that MXD3 plays a role in the cellular events that lead to medulloblastoma biogenesis. In agreement with its proliferative role in GNPs, MXD3 knock-down in DAOY cells resulted in decreased proliferation. Sustained overexpression of MXD3 resulted in decreased cell numbers due to increased apoptosis and cell cycle arrest. Structure-function analysis revealed that the Sin3 interacting domain, the basic domain, and binding to E-boxes are essential for this activity. Microarray-based expression analysis indicated up-regulation of 84 genes and down-regulation of 47 genes. Potential direct MXD3 target genes were identified by ChIP-chip. Our results suggest that MXD3 is necessary for DAOY medulloblastoma cell proliferation. However, increased level and/or duration of MXD3 expression ultimately reduces cell numbers via increased cell death and cell cycle arrest.

  3. Low disease prevalence and inappropriate implantable cardioverter defibrillator shock rate in Brugada syndrome

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Jensen, Henrik Kjærulf; Eschen, Ole

    2012-01-01

    AimsBrugada syndrome (BrS) is an inherited channelopathy that predisposes to malignant ventricular arrhythmias and thereby syncope and sudden cardiac death. Prior studies characterizing BrS patients have used highly selected referral populations from tertiary centres and prevalence estimates have...... been carried out using electrocardiogram (ECG) surveys only. We aimed to identify and characterize all diagnosed BrS patients in Denmark (population 5.4 million).Methods and resultsBrugada syndrome patients were identified using several modalities including identification in all Danish tertiary......%) experienced inappropriate shocks during a median follow-up of 47 months. No patient died or experienced aborted sudden cardiac death during follow-up.ConclusionsWe report the first nationwide study of BrS patients. We found a low incidence of diagnosed definite BrS compared with estimates from ECG surveys...

  4. Inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' in the peer-reviewed biomedical literature

    Directory of Open Access Journals (Sweden)

    Wenban Adrian B

    2006-08-01

    contact with the principal researcher revealed that the care provider was not a chiropractor, as defined by the World Federation of Chiropractic. The authors of the other two case reports did not respond to my communications. In the case series, which involved twenty relevant cases, the principal researcher conceded that the term chiropractor had been inappropriately used and that his case series did not relate to chiropractors who had undergone appropriate formal training. The author of the secondary report, a British Medical Journal editor, conceded that he had misused the title chiropractor. Letters to editors were accepted and published by all four journals to which they were sent. To date one of the four journals has published a correction. Conclusion The results of this year-long prospective review suggests that the words 'chiropractor' and 'chiropractic manipulation' are often used inappropriately by European biomedical researchers when reporting apparent associations between cervical spine manipulation and symptoms suggestive of traumatic injury. Furthermore, in those cases reported here, the spurious use of terminology seems to have passed through the peer-review process without correction. Additionally, these findings provide further preliminary evidence, beyond that already provided by Terrett, that the inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' may be a significant source of over-reporting of the link between the care provided by chiropractors and injury. Finally, editors of peer-reviewed journals were amenable to publishing 'letters to editors', and to a lesser extent 'corrections', when authors had inappropriately used the title 'chiropractor' and/or term 'chiropractic manipulation'.

  5. The future of non-proliferation

    International Nuclear Information System (INIS)

    Gere, F.

    2000-01-01

    This paper comprises two parts. The first part makes a status of the non-proliferation policy: problems of ratification of Start 2 and CTBT treaties, nuclear tests in India and Pakistan in May 1998 etc. The second part makes a prospective reflexion on the evolution of the position of nuclearized countries at the 2015-2030 vista: role of Asia, nuclear perception, evolution of the US perception of non-proliferation, military strategy and European unification. (J.S.)

  6. Director`s series on proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, K.C. [ed.

    1993-09-07

    Two essays are included in this booklet. Their titles are ``The Dynamics of the NPT Extension Decision`` and ``North Korea`s Nuclear Gambit.`` The first paper discusses the conference to be held in 1995 to review the Nuclear Non-Proliferation Treaty (NPT) which will decide whether the treaty shall continue in force indefinitely, or shall be extended for an additional fixed period or periods. Topics relevant to this discussion are: Arms control issues, the nuclear test ban, the limited test ban treaty, the French nuclear testing moratorium, former Soviet nuclear weapons, Iraq, North Korea, nuclear-weapon-free zones, security, controls on nuclear weapon materials, peaceful uses of nuclear energy, safeguards, politics, and organizational and procedural issues. The second paper examines short, medium, and long term issues entailed in Korea`s nuclear proliferation. Topics considered include: Korean unification, North Korean politics, the nuclear issue as leverage, and the Nuclear Non- Proliferation Treaty.

  7. Dedifferentiation and proliferation of mammalian cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Yiqiang Zhang

    2010-09-01

    Full Text Available It has long been thought that mammalian cardiomyocytes are terminally-differentiated and unable to proliferate. However, myocytes in more primitive animals such as zebrafish are able to dedifferentiate and proliferate to regenerate amputated cardiac muscle.Here we test the hypothesis that mature mammalian cardiomyocytes retain substantial cellular plasticity, including the ability to dedifferentiate, proliferate, and acquire progenitor cell phenotypes. Two complementary methods were used: 1 cardiomyocyte purification from rat hearts, and 2 genetic fate mapping in cardiac explants from bi-transgenic mice. Cardiomyocytes isolated from rodent hearts were purified by multiple centrifugation and Percoll gradient separation steps, and the purity verified by immunostaining and RT-PCR. Within days in culture, purified cardiomyocytes lost their characteristic electrophysiological properties and striations, flattened and began to divide, as confirmed by proliferation markers and BrdU incorporation. Many dedifferentiated cardiomyocytes went on to express the stem cell antigen c-kit, and the early cardiac transcription factors GATA4 and Nkx2.5. Underlying these changes, inhibitory cell cycle molecules were suppressed in myocyte-derived cells (MDCs, while microRNAs known to orchestrate proliferation and pluripotency increased dramatically. Some, but not all, MDCs self-organized into spheres and re-differentiated into myocytes and endothelial cells in vitro. Cell fate tracking of cardiomyocytes from 4-OH-Tamoxifen-treated double-transgenic MerCreMer/ZEG mouse hearts revealed that green fluorescent protein (GFP continues to be expressed in dedifferentiated cardiomyocytes, two-thirds of which were also c-kit(+.Contradicting the prevailing view that they are terminally-differentiated, postnatal mammalian cardiomyocytes are instead capable of substantial plasticity. Dedifferentiation of myocytes facilitates proliferation and confers a degree of stemness

  8. Ultracentrifuge and non-proliferation

    International Nuclear Information System (INIS)

    Voortman, A.J.

    1977-01-01

    The author states that there is no meaningful difference, from the point of view of proliferation between peaceful, civil, scientific application of nuclear fission, and the use of it in nuclear weapons. The proliferation of the nuclear technology for weapons appeared and appears to be closely connected with the spread of peaceful applications of nuclear technology. In connection with this, he discusses the Ultracentrifuge plant at Almelo (Netherlands) and the supply of nuclear technology by West-Germany especially to Brazil. Further the changed American policy and the possibility of an American/Russian deal to prevent the spread of the nuclear enrichment technology is discussed

  9. Interaction of LY171883 and other peroxisome proliferators with fatty-acid-binding protein isolated from rat liver.

    Science.gov (United States)

    Cannon, J R; Eacho, P I

    1991-01-01

    Fatty-acid-binding protein (FABP) is a 14 kDa protein found in hepatic cytosol which binds and transports fatty acids and other hydrophobic ligands throughout the cell. The purpose of this investigation was to determine whether LY171883, a leukotriene D4 antagonist, and other peroxisome proliferators bind to FABP and displace an endogenous fatty acid. [3H]Oleic acid was used to monitor the elution of FABP during chromatographic purification. [14C]LY171883 had a similar elution profile when substituted in the purification, indicating a common interaction with FABP. LY171883 and its structural analogue, LY189585, as well as the hypolipidaemic peroxisome proliferators clofibric acid, ciprofibrate, bezafibrate and WY14,643, displaced [3H]oleic acid binding to FABP. Analogues of LY171883 that do not induce peroxisome proliferation only weakly displaced oleate binding. [3H]Ly171883 bound directly to FABP with a Kd of 10.8 microM, compared with a Kd of 0.96 microM for [3H]oleate. LY171883 binding was inhibited by LY189585, clofibric acid, ciprofibrate and bezafibrate. These findings demonstrate that peroxisome proliferators, presumably due to their structural similarity to fatty acids, are able to bind to FABP and displace an endogenous ligand from its binding site. Interaction of peroxisome proliferators with FABP may be involved in perturbations of fatty acid metabolism caused by these agents as well as in the development of the pleiotropic response of peroxisome proliferation. Images Fig. 2. PMID:1747111

  10. Evaluation of proliferation resistance using the INPRO methodology

    International Nuclear Information System (INIS)

    Yang, Myung Seung; Park, Joo Hwan; Ko, Won Il; Song, Kee Chan; Choi, Kun Mo; Kim, Jin Kyoung

    2007-01-01

    The IAEA launched the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) and developed the INPRO Methodology to provide guidelines and to assess the characteristics of a future innovative nuclear energy system in areas such as safety, economics, waste management, and proliferation resistance. The proliferation resistance area of the INPRO Methodology is reviewed here, and modifications for further improvements are proposed. The evaluation metrics including the evaluation parameters, evaluation scales and acceptance limits are developed for a practical application of the methodology to assess the proliferation resistance. The proliferation resistant characteristics of the DUPIC fuel cycle are assessed by applying the modified INPRO Methodology based on the developed evaluation metrics and acceptance criteria. The evaluation procedure and the metrics can be utilized as a reference for an evaluation of the proliferation resistance of a future innovative nuclear energy system

  11. Polypharmacy and potentially inappropriate medication use as the precipitating factor in readmissions to the hospital

    Directory of Open Access Journals (Sweden)

    Vishal Sehgal

    2013-01-01

    Full Text Available Background and Aim: Readmission to the hospital within 30 days of discharge from the hospital is a common occurrence. Congestive heart failure is the most common cause of readmissions in the hospital. We hypothesized that irrespective of the admission diagnosis polypharmacy and potentially inappropriate use of medications (PIM leads to readmissions within 30 days of discharge from the hospital. Materials and Methods: A retrospective study was carried out by reviewing the hospital records of 414 patients who were readmitted to the hospital within 30 days of discharge from the hospital between January 2008 and December 2009. The data was stratified to see which patients were on polypharmacy and/or on PIM. Polypharmacy was defined as use of more than 5 medications. PIM was defined as per the modified Beers criteria. Day 0 was defined as the day of discharge and day1 was defined as the day-after Admission to the hospital. Statistical analysis was carried out using a two-way analysis of variance (ANOVA on the data to see if polypharmacy and/or PIM was related to readmission within 30 days of discharge irrespective of admission diagnosis. Results: Polypharmacy was related to hospital readmission at day 1 and day 0, however inappropriate drug use was found to be not related at any day. Polypharmacy and PIM combined had a positive correlation to readmission only on days 1 and 0 and it was statistically significant. The use of minimal and appropriate use of drugs was statistically significant compared to polypharmacy and PIM use. Conclusions: Polypharmacy and PIM are under recognized cause of readmissions to the hospital.

  12. Les perceptions de justice et de discrimination des candidats face à des questions inappropriées au recrutement

    OpenAIRE

    Ocana , Tania

    2017-01-01

    Applicants’ reaction research has mostly focused on fairness perceptions, but several researchers encourage the study of perceived job discrimination during the selection process, as well as specific consequences of that discrimination. In order to create a situation in which discrimination was possible, we studied the effects of inappropriate job interview questions related to a stigma on fairness and discrimination perceptions as well their impact on the recruiters’ and the organization’s i...

  13. Cell migration or cytokinesis and proliferation? – Revisiting the “go or grow” hypothesis in cancer cells in vitro

    International Nuclear Information System (INIS)

    Garay, Tamás; Juhász, Éva; Molnár, Eszter; Eisenbauer, Maria; Czirók, András; Dekan, Barbara; László, Viktória; Hoda, Mir Alireza; Döme, Balázs; Tímár, József; Klepetko, Walter; Berger, Walter; Hegedűs, Balázs

    2013-01-01

    The mortality of patients with solid tumors is mostly due to metastasis that relies on the interplay between migration and proliferation. The “go or grow” hypothesis postulates that migration and proliferation spatiotemporally excludes each other. We evaluated this hypothesis on 35 cell lines (12 mesothelioma, 13 melanoma and 10 lung cancer) on both the individual cell and population levels. Following three-day-long videomicroscopy, migration, proliferation and cytokinesis-length were quantified. We found a significantly higher migration in mesothelioma cells compared to melanoma and lung cancer while tumor types did not differ in mean proliferation or duration of cytokinesis. Strikingly, we found in melanoma and lung cancer a significant positive correlation between mean proliferation and migration. Furthermore, non-dividing melanoma and lung cancer cells displayed slower migration. In contrast, in mesothelioma there were no such correlations. Interestingly, negative correlation was found between cytokinesis-length and migration in melanoma. FAK activation was higher in melanoma cells with high motility. We demonstrate that the cancer cells studied do not defer proliferation for migration. Of note, tumor cells from various organ systems may differently regulate migration and proliferation. Furthermore, our data is in line with the observation of pathologists that highly proliferative tumors are often highly invasive. - Highlights: • We investigated the “go or grow” hypothesis in human cancer cells in vitro. • Proliferation and migration positively correlate in melanoma and lung cancer cells. • Duration of cytokinesis and migration shows inverse correlation. • Increased FAK activation is present in highly motile melanoma cells

  14. Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors

    Directory of Open Access Journals (Sweden)

    Pauline Siew Mei Lai

    2014-06-01

    Full Text Available Background. Proton pump inhibitors (PPIs are currently the most effective agents for acid-related disorders. However, studies show that 25–75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing.Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution.Setting. Prospective audit in a tertiary hospital in Malaysia.Method. Every 4th intravenous PPI prescription received in the pharmacy was screened against hospital guidelines. Interventions for incorrect indication/dose/duration were performed. Patients’ demographic data, medical history and the use of intravenous PPI were collected. Included were all adult inpatients prescribed intravenous PPI.Main Outcome Measure. Proportion of appropriate IV PPI prescriptions.Results. Data for 106 patients were collected. Most patients were male [65(61.3%], Chinese [50(47.2%], with mean age ± SD = 60.3 ± 18.0 years. Most intravenous PPI prescriptions were initiated by junior doctors from the surgical [47(44.3%] and medical [42(39.6%] departments. Only 50/106(47.2% patients had upper gastrointestinal endoscopy/surgery performed to verify the source of bleeding. Unexplained abdominal pain [81(76.4%] was the main driver for prescribing intravenous PPIs empirically, out of which 73(68.9% were for suspected upper gastrointestinal bleed. Overall, intravenous PPI was found to be inappropriately prescribed in 56(52.8% patients for indication, dose or duration. Interventions on the use of intravenous PPI were most effective when performed by senior doctors (100%, followed by clinical pharmacists (50%, and inpatient pharmacists (37.5%, p = 0.027.Conclusion. Inappropriate intravenous PPI usage is still prevalent despite the enforcement of hospital guidelines. The promotion of prescribing awareness and evidence

  15. Prevalence and Risk of Inappropriate Sexual Behavior of Patients Toward Physical Therapist Clinicians and Students in the United States.

    Science.gov (United States)

    Boissonnault, Jill S; Cambier, Ziádee; Hetzel, Scott J; Plack, Margaret M

    2017-11-01

    For health care providers in the United States, the risk for nonfatal violence in the workplace is 16 times greater than that for other workers. Inappropriate patient sexual behavior (IPSB) is directed at clinicians, staff, or other patients and may include leering, sexual remarks, deliberate touching, indecent exposure, and sexual assault. Inappropriate patient sexual behavior may adversely affect clinicians, the organization, or patients themselves. Few IPSB risk factors for physical therapists have been confirmed. The US prevalence was last assessed in the 1990s. The objectives of this study were to determine career and 12-month exposure to IPSB among US physical therapists, physical therapist assistants, physical therapist students, and physical therapist assistant students and to identify IPSB risk factors. This was a retrospective and observational study. An electronic survey was developed; content validity and test-retest reliability were established. Participants were recruited through physical therapist and physical therapist assistant academic programs and sections of the American Physical Therapy Association. Inappropriate patient sexual behavior risk models were constructed individually for any, mild, moderate, and severe IPSB events reported over the past 12 months. Open-ended comments were analyzed using qualitative methods. Eight hundred ninety-two physical therapist professionals and students completed the survey. The career prevalence among respondents was 84%, and the 12-month prevalence was 47%. Statistical risk modeling for any IPSB over the past 12 months indicated the following risks: having fewer years of direct patient care, routinely working with patients with cognitive impairments, being a female practitioner, and treating male patients. Qualitative analysis of 187 open-ended comments revealed patient-related characteristics, provider-related characteristics, and abusive actions. Self-report, clinician memory, and convenience sampling are

  16. The effects of radiofrequency fields on cell proliferation are non-thermal.

    Science.gov (United States)

    Velizarov, S; Raskmark, P; Kwee, S

    1999-02-01

    The number of reports on the effects induced by radiofrequency (RF) electromagnetic fields and microwave (MW) radiation in various cellular systems is still increasing. Until now no satisfactory mechanism has been proposed to explain the biological effects of these fields. One of the current theories is that heat generation by RF/MW is the cause, in spite of the fact that a great number of studies under isothermal conditions have reported significant cellular changes after exposure to RF/MW. Therefore, this study was undertaken to investigate which effect MW radiation from these fields in combination with a significant change of temperature could have on cell proliferation. The experiments were performed on the same cell line, and with the same exposure system as in a previous work [S. Kwee, P. Raskmark, Changes in cell proliferation due to environmental non-ionizing radiation: 2. Microwave radiation, Bioelectrochem. Bioenerg., 44 (1998), pp. 251-255]. The field was generated by signal simulation of the Global System for Mobile communications (GSM) of 960 MHz. Cell cultures, growing in microtiter plates, were exposed in a specially constructed chamber, a Transverse Electromagnetic (TEM) cell. The Specific Absorption Rate (SAR) value for each cell well was calculated for this exposure system. However, in this study the cells were exposed to the field at a higher or lower temperature than the temperature in the field-free incubator i.e., the temperature in the TEM cell was either 39 or 35 +/- 0.1 degrees C. The corresponding sham experiments were performed under exactly the same experimental conditions. The results showed that there was a significant change in cell proliferation in the exposed cells in comparison to the non-exposed (control) cells at both temperatures. On the other hand, no significant change in proliferation rate was found in the sham-exposed cells at both temperatures. This shows that biological effects due to RF/MW cannot be attributed only to a

  17. The Asian countries and the non-proliferation treaty prorogation

    International Nuclear Information System (INIS)

    Hoffmann, N.

    1995-01-01

    This work deals with the non-proliferation treaty prorogation of Asia. The position of the asian countries under the old non-proliferation treaty is given. It includes the 1968 non-proliferation treaty signatories, the calling in question again and the criticisms revealed by the asian countries. The positions and the open forecasts expressed on the non-proliferation treaty prorogation and the article on the elimination of the nuclear weapons are also given. (O.L.)

  18. Domestic Politics and Nuclear Proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chul Min; Yim, Man Sung [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    The external security threat is known as the most important factor of nuclear weapons program, the domestic politics situation can also affect the nuclear proliferation decision of a country. For example, when a leader wants nuclear weapons as an ultimate weapon, the domestic politics situation can determine the effectiveness of the weapons program of a country. This study analyzes the current knowledge of the relationship between domestic politics and nuclear proliferation and suggests the main challenges of the quantitative models trying to calculate nuclear proliferation risk of countries. The domestic politics status is one of the most important indicators of nuclear program. However, some variables have never been used in quantitative analyses; for example, number of veto players and the public opinion on nuclear weapons; despite they are considered to be important in various qualitative studies. Future studies should focus on how should they be coded and how can they be linked with existing domestic politics variables.

  19. Domestic Politics and Nuclear Proliferation

    International Nuclear Information System (INIS)

    Kim, Chul Min; Yim, Man Sung

    2016-01-01

    The external security threat is known as the most important factor of nuclear weapons program, the domestic politics situation can also affect the nuclear proliferation decision of a country. For example, when a leader wants nuclear weapons as an ultimate weapon, the domestic politics situation can determine the effectiveness of the weapons program of a country. This study analyzes the current knowledge of the relationship between domestic politics and nuclear proliferation and suggests the main challenges of the quantitative models trying to calculate nuclear proliferation risk of countries. The domestic politics status is one of the most important indicators of nuclear program. However, some variables have never been used in quantitative analyses; for example, number of veto players and the public opinion on nuclear weapons; despite they are considered to be important in various qualitative studies. Future studies should focus on how should they be coded and how can they be linked with existing domestic politics variables

  20. Sustaining non-proliferation in the 1980s

    International Nuclear Information System (INIS)

    Nye, J.S.

    1984-01-01

    The subject is discussed as follows: introduction; the non-proliferation regime - 1950s to 1970s (IAEA safeguards; Non-proliferation Treaty; oil crisis; proposed sale of facilities for producing weapons-usable materials; USA position); the Carter Administration approach; INFCE (International Nuclear Fuel Cycle Evaluation); incentives (USA); export legislation (USA); domestic breeder policy (USA); maintaining the regime in the 1980s (safeguards; Pu and highly enriched uranium management; international spent fuel storage; fuel assurances); the problem of priority; rate vs. degree of proliferation; relations among regimes (international regimes); conclusion. (U.K.)

  1. Canada and international safeguards. Verifying nuclear non-proliferation

    International Nuclear Information System (INIS)

    1990-01-01

    The Non-Proliferation Treaty (NPT) came into force in 1970 and now has about 140 signatory nations. By creating legal barriers against proliferation and by promoting an international non-proliferation ethic, the NPT has promoted international peace and security. A key ingredient has been the confidence generated through verification by IAEA safeguards. By the end of 1988 IAEA safeguards agreements had been concluded with about 100 countries, including Canada. Over 500 nuclear facilities worldwide are under safeguards or contain safeguarded nuclear material. The existence of this credible and effective safeguards system makes international trade in nuclear equipment and materials possible, monitoring the transfer of nuclear technology to developing countries as well as between industrial countries. Canada is committed to non-proliferation and IAEA safeguards. Canadian non-proliferation policy is among the strictest in the world, even though opportunities have been lost to sell Canadian technology abroad as a result

  2. Non-proliferation

    International Nuclear Information System (INIS)

    Deiseroth, D.; Gustafsson, S.

    1993-01-01

    The issue of Nuclear Non Proliferation has been moved to a leading place on the contemporary international security agenda. What about the situation of nuclear weapons and nuclear technology in Russia, Kazakhstan, Ukraine and Belorussia? Why did the IAEA-inspectors totally failed to discover any sign of Iraq's clandestine nuclear-weapon programme before the Gulf War? Do the NATO and their nuclear power states violate Art. VI of the Non-Proliferation-Treaty (NPT), because they are - despite the end of the cold war - not willing to renounce of the ''option of the first use of nuclear weapons''? Does the NPT establish a form of nuclear apartheid? What will be the situation if the NPT-Extension-Conference in 1995 will be unable to obtain a majority of the parties for any one extension proposal? Do we need a new international nuclear control agency with severe powers, a sort of nuclear Interpol? The Colloquium ''Saving NPT and abolishing Nuclear Weapons'', held in Stockholm in September 1992, organized by the Swedish and the German Sections of IALANA, tried to analyse some of the raised issues. (orig.) [de

  3. The US proliferation security initiative (PSI)

    International Nuclear Information System (INIS)

    Gregoire, B.

    2004-01-01

    The proliferation security initiative (PSI), launched by President Bush on May 31, 2003, aims at intercepting any transfer of mass destruction weapons, of their vectors and related equipments, towards or coming from countries or organizations suspected to have a proliferation activity. This initiative, which involves coercive means to fight against proliferation, raises international lawfulness and legal questions, the answers of which are today under construction. This article analyzes the place of the European Union in the PSI, the action means (optimization of existing means, cooperation between intelligence and interception services), and the PSI stakes (lawfulness with respect to the international law, bilateral agreements, draft boarding agreement, sustain of the United Nations, widening of the partnership and of the field of action). (J.S.)

  4. The economics of proliferation and counterproliferation

    International Nuclear Information System (INIS)

    Murray, B.L.; Hallenbeck, R.A.; Gill, J.M.

    1993-01-01

    On June 2, 1993, the fourth meeting of the seminar series on open-quotes Proliferation of Ballistic Missiles and Weapons of Mass Destruction and Implications for Regional Stabilityclose quotes was held at SAIC in McLean, Virginia. This series is sponsored by the Arms Control and Disarmament Agency and is cosponsored by the Ballistic Missile Defense Organization, the Defense Nuclear Agency, the Department of Energy, and the Office of the Secretary of Defense for International Security Policy. The June seminar, open-quotes The Economics of Proliferation and Counterproliferation,close quotes discussed how economic issues and interests affect proliferation judgments. Seminar participants also examined three economic tools for advancing counterproliferation objectives: Economic Development Assistance, Export Controls, and Economic open-quotes Burdensharingclose quotes and Conversion Assistance

  5. Proliferation risks; Proliferatierisico's

    Energy Technology Data Exchange (ETDEWEB)

    Carchon, R

    1998-09-01

    The report gives an overview of different aspects related to safeguards of fissile materials. Existing treaties including the Non-Proliferation Treaty, and the Tlatelolco and the Rarotonga Treaties are discussed. An overview of safeguards systems for the control of fissile materials as well as the role of various authorities is given. An overall overview of proliferation risks, the physical protection of fissile materials and the trade in fissile materials is given. Finally, the status in problem countries and de facto nuclear weapon states is discussed.

  6. Decreasing Inappropriate Use of Mobile Devices in Urban High School Classrooms: Comparing an Antecedent Intervention With and Without the Good Behavior Game.

    Science.gov (United States)

    Hernan, Colleen J; Collins, Tai A; Morrison, Julie Q; Kroeger, Stephen D

    2018-03-01

    As the capabilities of portable technology continue to advance and become more accessible, educators express concern about the impact of the inappropriate use of mobile devices on academic engagement and learning. An alternating treatments design was used to compare the effectiveness of an antecedent (Clear Box) intervention and an interdependent group contingency (Clear Box + Good Behavior Game [GBG]) intervention to typical classroom management techniques (Control) in increasing the academic engagement and decreasing mobile device use of high school students during instruction. The results indicate an increase in academic engagement and a decrease in the inappropriate presence of mobile devices in both classrooms with the implementation of the Clear Box + GBG, as compared with the Clear Box and Control conditions. In addition, teacher and student social validity data suggested that teachers and students viewed the Clear Box + GBG intervention favorably. Discussion focuses on contributions to the current literature, implications for practice, and suggestions for future areas of research.

  7. Cell proliferation of Paramecium tetraurelia under simulated microgravity

    Science.gov (United States)

    Sawai, S.; Mogami, Y.; Baba, S. A.

    Paramecium is known to proliferate faster under microgravity in space and slower under hypergravity Experiments using axenic culture medium have demonstrated that the hypergravity affected directly on the proliferation of Paramecium itself Kato et al 2003 In order to assess the mechanisms underlying the physiological effects of gravity on cell proliferation Paramecium tetraurelia was grown under simulated microgravity performed by clinorotation and the time course of the proliferation was investigated in detail on the basis of the logistic analysis P tetraurelia was cultivated in a closed chamber in which cells were confined without air babbles reducing the shear stresses and turbulence under the rotation The chamber is made of quartz and silicone rubber film the former is for the optically-flat walls for the measurement of cell density by means of a non-invasive laser optical-slice method and the latter for gas exchange Because the closed chamber has an inner dimension of 3 times 3 times 60 mm Paramecium does not accumulate at the top of the chamber despite its negative gravitactic behavior We measured the cell density at regular time intervals without breaking the configuration of the chamber and analyzed the proliferation parameters by fitting the data to a logistic equation Clinorotation had the effects of reducing the proliferation of P tetraurelia It reduced both the saturation cell density and the maximum proliferation rate although it had little effect on the

  8. Human gastric mucins differently regulate Helicobacter pylori proliferation, gene expression and interactions with host cells.

    Directory of Open Access Journals (Sweden)

    Emma C Skoog

    Full Text Available Helicobacter pylori colonizes the mucus niche of the gastric mucosa and is a risk factor for gastritis, ulcers and cancer. The main components of the mucus layer are heavily glycosylated mucins, to which H. pylori can adhere. Mucin glycosylation differs between individuals and changes during disease. Here we have examined the H. pylori response to purified mucins from a range of tumor and normal human gastric tissue samples. Our results demonstrate that mucins from different individuals differ in how they modulate both proliferation and gene expression of H. pylori. The mucin effect on proliferation varied significantly between samples, and ranged from stimulatory to inhibitory, depending on the type of mucins and the ability of the mucins to bind to H. pylori. Tumor-derived mucins and mucins from the surface mucosa had potential to stimulate proliferation, while gland-derived mucins tended to inhibit proliferation and mucins from healthy uninfected individuals showed little effect. Artificial glycoconjugates containing H. pylori ligands also modulated H. pylori proliferation, albeit to a lesser degree than human mucins. Expression of genes important for the pathogenicity of H. pylori (babA, sabA, cagA, flaA and ureA appeared co-regulated in response to mucins. The addition of mucins to co-cultures of H. pylori and gastric epithelial cells protected the viability of the cells and modulated the cytokine production in a manner that differed between individuals, was partially dependent of adhesion of H. pylori to the gastric cells, but also revealed that other mucin factors in addition to adhesion are important for H. pylori-induced host signaling. The combined data reveal host-specific effects on proliferation, gene expression and virulence of H. pylori due to the gastric mucin environment, demonstrating a dynamic interplay between the bacterium and its host.

  9. Cell kinetics of irradiated experimental tumors: cell transition from the non-proliferating to the proliferating pool

    International Nuclear Information System (INIS)

    Potmesil, M.; Goldfeder, A.

    1980-01-01

    In murine mammary carcinomas, parenchymal tumor cells with dense nucleoli traverse the cell cycle and divide, thus constituting the proliferating pool. Cells with trabeculate or ring-shaped nucleoli either proceed slowly through G 1 phase or are arrested in it. The role of these non-proliferating, G 1 phase-confined cells in tumor regeneration was studied in vivo after a subcurative dose of X-irradiation in two transplantable tumor lines. Tumor-bearing mice were continuously injected with methyl[ 3 H]thymidine before and after irradiation. Finally, the labeling was discontinued, mice injected with vincristine sulfate and cells arrested in metaphase were accumulated over 10-hrs. Two clearly delineated groups of vincristine-arrested mitoses emerged in autoradiograms prepared from tumor tissue at the time of starting tumor regrowth: one group with the silver-grain counts corresponding to the background level, the other with heavily labeled mitoses. As the only source of unlabeled mitoses was unlabeled G 1 phase-confined cells persisting in the tumor, this indicated cell transition from the non-proliferating to the proliferating pool, which took place in the initial phase of the tumor regrowth. Unlabeled progenitors have apparently remained in G 1 phase for at least 5-12 days after irradiation. (author)

  10. Lithium doped calcium phosphate cement maintains physical mechanical properties and promotes osteoblast proliferation and differentiation.

    Science.gov (United States)

    Li, Li; Wang, Renchong; Li, Baichuan; Liang, Wei; Pan, Haobo; Cui, Xu; Tang, Jingli; Li, Bing

    2017-07-01

    Calcium phosphate cement (CPC) has been widely used in bone tissue repairing due to its physical mechanical properties and biocompatibility. Addition of trace element to CPC has shown promising evidence to improve the physical properties and biological activities of CPC. Lithium (Li) has effect on osteoblast proliferation and differentiation. In this study, we incorporated Li to CPC and examined the physical properties of Li/CPC and its effect on osteoblast proliferation and differentiation. We found that Li doped CPC maintained similar setting time, pore size distribution, compressive strength, composition, and morphology as CPC without Li. Additionally, Li doped CPC improved osteoblast proliferation and differentiation significantly compared to CPC without Li. To our knowledge, our results, for the first time, show that Li doped CPC has beneficial effect on osteoblast in cell culture while keeps the excellent physical-mechanical properties of CPC. This study will lead to potential application of Li doped CPC in bone tissue engineering. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 944-952, 2017. © 2016 Wiley Periodicals, Inc.

  11. Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors

    OpenAIRE

    Pauline Siew Mei Lai; Yin Yen Wong; Yong Chia Low; Hui Ling Lau; Kin-Fah Chin; Sanjiv Mahadeva

    2014-01-01

    Background. Proton pump inhibitors (PPIs) are currently the most effective agents for acid-related disorders. However, studies show that 25–75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing. Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution. Setting. Prospective audit in a tertiary hosp...

  12. Proliferation resistance assessment of pyro processing

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, E. H.; Ko, W. I.; Kim, H. D. [KAERI, Daejeon (Korea, Republic of)

    2012-10-15

    In 2002, world experts gathered and defined the term proliferation resistance as 'the characteristic of a nuclear energy system that impedes the diversion or undeclared production of nuclear material, or misuse of technology, by State in order to acquire nuclear weapons or other nuclear explosive devices.' The same report also defines the following terms: Intrinsic barriers (technical features) of proliferation resistance are features that result from the technical design of nuclear energy systems, including those that facilitate the implementation of extrinsic measures. Extrinsic barriers (institutional measures) of proliferation resistance are features that result from the decisions and undertakings of states related to nuclear energy system. Intrinsic barriers are further divided into material barriers.the 'intrinsic, or inherent, qualities of materials that reduce the inherent desirability or attractiveness of the material as an explosive' and technical barriers. The 'intrinsic technical lements of the fuel cycle, its facilities, processes, and equipment that serve to make it difficult to gain access to materials and/or to use or misuse facilities to obtain weapons usable materials.' Material barriers include isotopic, chemical, radiological, mass and bulk, and detectability, whereas technical barriers include facility unattractiveness, accessibility, available fissile mass, detectability of and time required for diversion, and skills, expertise, and knowledge. Assessing the proliferation resistance of pyro processing is meaningful only when compared with other processes. This paper attempts to discuss the features of pyro processing by comparing it with direct disposal and aqueous separation processes from a proliferation resistance viewpoint.

  13. Panel on nuclear export and proliferation

    International Nuclear Information System (INIS)

    Kimel, W.R.

    1977-01-01

    Summaries of six panelists' remarks make the following points: one cannot suppress nuclear weapons by suppressing nuclear power; a proliferated world would be extremely dangerous; US supports IAEA safeguards; plutonium shouldn't be recycled in power reactors; and the problem of nonproliferation is a social and institutional problem, not a technological one. Viewographs showing the semantics of proliferation, ways to get nuclear weapons materials, etc. are included

  14. Russia and proliferation in Northeast Asia

    International Nuclear Information System (INIS)

    Ignatov, A.I.

    1995-01-01

    For Russia, security, including non-proliferation, in Northeast Asia means in particular the maintenance of stability. Progress in arms control and non-proliferation may enhance regional stability. A common regional approach is proposed. Russia recognizes the US alliances with Japan and republic of Korea and is searching for a new cooperation framework in the region, namely further development of relations with China and reasonable rapprochement with Japan

  15. Non proliferation 1980 - INFCE and TnP

    International Nuclear Information System (INIS)

    Rainer, R.

    1981-01-01

    The TNP (non-proliferation agreement of nuclear weapons), its non proliferation policy and the peaceful use of fuel cycle are described, as well as the safeguards of IAEA. It is also mentioned the functions of INFCE (International Nuclear Fuel Cycle Evaluation). (A.B.T.) [pt

  16. Potentially inappropriate medicines in elderly hospitalised patients according to the EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol.

    Science.gov (United States)

    Mucalo, Iva; Hadžiabdić, Maja Ortner; Brajković, Andrea; Lukić, Sonja; Marić, Patricia; Marinović, Ivana; Bačić-Vrca, Vesna

    2017-08-01

    The aim of this study was to measure the prevalence of potentially inappropriate medications (PIMs) by using the EU(7)-PIM list, STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) version 2 criteria and the new comprehensive protocol. This prospective study involved a sample of 276 consecutive elderly patients discharged from the university teaching hospital. Age, gender, diagnoses, medication history and medicines at discharge were recorded. The main outcome measure was the prevalence of PIMs according to each set of criteria: EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol. The median patient age (range) was 74 (65-92) years. The median number of prescribed medications was 7 (1-17). STOPP identified 393 PIMs affecting 190 patients (69%), EU(7)-PIM list identified 330 PIMs in 184 patients (66.7%) whilst the comprehensive protocol identified 134 PIMs in 102 patients (37%). STOPP version 2 criteria identified significantly more PIMs per patient than the other two protocols (p comprehensive protocol and was found as a more sensitive tool for PIM detection.

  17. Plant root proliferation in nitrogen-rich patches confers competitive advantage

    Science.gov (United States)

    Robinson, D.; Hodge, A.; Griffiths, B. S.; Fitter, A. H.

    1999-01-01

    Plants respond strongly to environmental heterogeneity, particularly below ground, where spectacular root proliferations in nutrient-rich patches may occur. Such 'foraging' responses apparently maximize nutrient uptake and are now prominent in plant ecological theory. Proliferations in nitrogen-rich patches are difficult to explain adaptively, however. The high mobility of soil nitrate should limit the contribution of proliferation to N capture. Many experiments on isolated plants show only a weak relation between proliferation and N uptake. We show that N capture is associated strongly with proliferation during interspecific competition for finite, locally available, mixed N sources, precisely the conditions under which N becomes available to plants on generally infertile soils. This explains why N-induced root proliferation is an important resource-capture mechanism in N-limited plant communities and suggests that increasing proliferation by crop breeding or genetic manipulation will have a limited impact on N capture by well-fertilized monocultures.

  18. Effects of X-rays on the proliferation dynamics of cells in the imaginal wing disc of Drosophila melanogaster

    Energy Technology Data Exchange (ETDEWEB)

    Haynie, J L; Bryant, P J [California Univ., Irvine (USA). Dept. of Developmental and Cell Biology; California Univ., Irvine (USA). Center for Pathobiology)

    1977-01-01

    The size distribution of clones marked by mitotic recombination induced by several different doses of X-rays applied to 72 h old Drosophila larvae is studied. The results indicate that irradiation significantly reduces the number of cells which undergo normal proliferation in the imaginal wing disc. It is estimated that 1000R reduces by 40-60% the number of cells capable of making a normal contribution to the development of the adult wing. Part of this reduction is due to severe curtailment in the proliferative ability of cells which nevertheless remain capable of adult differentiation: this effect is possibly due to radiation-induced aneuploidy. Cytological evidence suggests that immediate cell death also occurs as a result of radiation doses as low as 100R. The surviving cells are stimulated to undergo additional proliferation in response to the X-ray damage so that the result is the differentiation of a normal wing.

  19. Modeling and evaluating proliferation resistance of nuclear energy systems for strategy switching proliferation

    International Nuclear Information System (INIS)

    Yue, M.; Cheng, L.-Y.; Bari, R.A.

    2013-01-01

    Highlights: ► Sensitivity analysis is carried out for the model and physical input parameters. ► Interphase drag has minor effect on the dryout heat flux (DHF) in 1D configuration. ► Model calibration on pressure drop experiments fails to improve prediction of DHF. ► Calibrated classical model provides the best agreement with DHF data from 1D tests. ► Further validation of drag models requires data from 2D and 3D experiments on DHF. - Abstract: This paper reports a Markov model based approach to systematically evaluating the proliferation resistance (PR) of nuclear energy systems (NESs). The focus of the study is on the development of the Markov models for a class of complex PR scenarios, i.e., mixed covert/overt strategy switching proliferation, for NESs with two modes of material flow, batch and continuous. In particular, a set of diversion and/or breakout scenarios and covert/overt misuse scenarios are studied in detail for an Example Sodium Fast Reactor (ESFR) system. Both probabilistic and deterministic PR measures are calculated using a software tool that implements the proposed approach and can be used to quantitatively compare proliferation resistant characteristics of different scenarios for a given NES, according to the computed PR measures

  20. Nuclear power and nuclear weapon proliferation

    International Nuclear Information System (INIS)

    Apold, A.

    1978-01-01

    The theme of Dr. Marshall's lecture was that it is, from the viewpoint of prevention of proliferation of nuclear weapons,preferable to use plutonium as a fuel in FBR reactors rather than store it in what, in effect, would be plutonium mines. The true threat of proliferation lies in uranium enrichment. The FBR reactor is misunderstood and the US policy is not against breeders as such. Safeguards against the misuse of plutonium by leaving a residue of radioactivity after reprocessing is quite feasible, despite certain practical problems and extra costs. Weapon proliferation is subject to political objectives and intentions. Definite proposals are, (a) a limited number of reprocessing centres, (b) an accelerated development of FBR reactors, (c) a new FBR fuel cycle, (d) stop storage of spent thermal reactor fuel, (e) reinforced safeguards. (JIW)

  1. Nuclear non-proliferation

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    This patent describes the treaty on the non-proliferation of nuclear weapons which is the corner-stone of an international non-proliferation regime which has grown to embrace the overwhelming majority of countries in the world in the period since the Treaty. The other elements of the regime include, first of all, the safeguards system of IAEA-which operates to prevent the diversion of nuclear materials to military or other prohibited activities and must be accepted by all non-nuclear-weapon parties to the Treaty and, secondly, the Antarctic Treaty, the Treaty for the Prohibition of Nuclear Weapons in Latin America (Treaty of Tlatelolco) and the south Pacific Nuclear Free zone Treaty (Treaty of Rarotonga)-which serve to extend the regime geographically. The last two Treaties require safeguards agreements with IAEA. In addition, the Treaty of Tlatelolco contains provisions establishing the agency for the Prohibition of Nuclear Weapons in Latin America and the Caribbean to ensure compliance

  2. Fisetin regulates astrocyte migration and proliferation in vitro

    OpenAIRE

    Wang, Nan; Yao, Fang; Li, Ke; Zhang, Lanlan; Yin, Guo; Du, Mingjun; Wu, Bingyi

    2017-01-01

    Fisetin (3,3?,4?,7-tetrahydroxyflavone) is a plant flavonol found in fruits and vegetables that has been reported to inhibit migration and proliferation in several types of cancer. Reactive astrogliosis involves astrocyte migration and proliferation, and contributes to the formation of glial scars in central nervous system (CNS) disorders. However, the effect of fisetin on the migration and proliferation of astrocytes remains unclear. In this study, we found that fisetin inhibited astrocyte m...

  3. Nuclear proliferation in developing countries: A comparative study for selected countries

    International Nuclear Information System (INIS)

    Chun Woong.

    1991-01-01

    This study explores major conditions conducive to nuclear proliferation to project possible proliferation trends in the future and, hopefully, to suggest some effective strategies to address the problem of nuclear proliferation. It attempts to provide a qualitative analysis of the causes and trends of nuclear proliferation by presenting generalizations of the causes of proliferation. While a variety of factors can be considered as causes of proliferation, three primary factors appear to influence the prospects for proliferation: (1) the technical capabilities and constraints; (2) motivation: incentives and disincentives; and (3) particular domestic and international situations. It is generally hypothesized that in order for a country to go nuclear, two basic conditions - some minimum level of indigenous national capability and strong motivations - must be simultaneously satisfied. It is concluded that while technology is, of course, one element necessary for the nuclear-proliferation process, the fundamental conditions of nuclear proliferation appear to be motivational factors

  4. Inappropriately low aldosterone concentrations in adults with AIDS-related diarrhoea in Zambia: a study of response to fluid challenge

    Directory of Open Access Journals (Sweden)

    Lumayi Ruth

    2008-04-01

    Full Text Available Abstract Background Chronic diarrhoea is one of the most debilitating consequences of HIV infection in sub-Saharan Africa and it carries a high mortality rate. We report unexpectedly low concentrations of circulating aldosterone in 12 patients (6 men, 6 women in the University Teaching Hospital, Lusaka, who all had diarrhoea for over one month. Changes in serum electrolytes, blood pressure, Karnofsky score and serum aldosterone concentration were being monitored during a short study of responses to saline infusion (3 litres/24 h over 72 hours. Findings At baseline, 9/12 (75% of the patients were hyponatraemic, 10/11 (91% were hypokalaemic, and 6/12 (50% had undetectable aldosterone concentrations. Blood pressure and Karnofsky score rose and creatinine concentration fell in response to the infusion. Conclusion Circulating aldosterone concentrations were inappropriately low and complicate the profound electrolyte deficiencies resulting from chronic diarrhoea. Management of these deficiencies needs to be more aggressive than is currently practised and consideration should be given to a formal clinical trial of mineralocorticoid replacement in these severely ill patients. If the inappropriately low aldosterone reflects a general adrenal failure, it may explain a considerable proportion of the high mortality seen both before and after initiation of anti-retroviral therapy.

  5. The effect of stem cell from human exfoliated deciduous teeth on T lymphocyte proliferation.

    Science.gov (United States)

    Alipour, Razieh; Adib, Minoo; Hashemi-Beni, Batool; Sadeghi, Farzaneh

    2014-01-01

    Mesenchymal stem cells (MSC), a specific type of adult tissue stem cell; have the immunosuppressive effects that make them valuable targets for regenerative medicine and treatment of many human illnesses. Hence, MSC have been the subject of numerous studies. The classical source of MSC is adult bone marrow (BM). Due to many shortcomings of harvesting MSC from BM, finding the alternative sources for MSC is an urgent. Stem cells from human exfoliated deciduous teeth (SHED) are relative new MSC populations that fulfill these criteria but their potential immunosuppressive effect has not been studied enough yet. Thus, in this work the effect of SHED on the proliferation of in vitro activated T lymphocytes were explored. In this study, both mitogen and alloantigen activated T cells were cultured in the presence of different numbers of SHED. In some co-cultures, activated T cells were in direct contact to MSCs and in other co-cultures; they were separated from SHED by a permeable membrane. In all co-cultures, the proliferation of T cells was measured by ELISA Bromodeoxyuridine proliferation assay. In general, our results showed that SHED significantly suppress the proliferation of activated T cells in a dose-dependent manner. Moreover, the suppression was slightly stronger when MSCs were in physical contact to activated T cells. This study showed that SHED likewise other MSC populations can suppress the activation of T lymphocytes, which can be used instead of BM derived MSCs in many investigational and clinical applications.

  6. Mycophenolic acid suppresses human pterygium and normal tenon fibroblast proliferation in vitro.

    Science.gov (United States)

    Amer, Radgonde; Rabinowich, Liane; Maftsir, Genia; Puxeddu, Ilaria; Levi-Schaffer, Francesca; Solomon, Abraham

    2010-10-01

    To investigate whether mycophenolic acid (MPA) exerts antifibrotic effects on pterygium fibroblasts (PFB) with and without stimulation with fibrogenic cytokines, and to compare the efficacy of MPA with mitomycin (MMC) and dexamethasone (DXM) on PFB and tenon fibroblasts (TFB). TFB and PFB were obtained from tissue explants during strabismus or pterygium surgery. Proliferation of subconfluent fibroblasts ± basic fibroblast growth factor (bFGF) (10 ng/ml) was assessed by using the (3H) thymidine-incorporation assay. Cell cultures were incubated with MPA, MMC or DXM. Apoptosis was evaluated by quantifying Annexin V and propidium iodide positive cells with flow cytometry. MPA showed a concentration-dependent inhibition of proliferation of PFB ± bFGF as well as TFB ± bFGF. The antiproliferative effect of MPA was comparable with that of MMC and DXM. Short exposure of PFB to MPA under profibrogenic conditions was significantly inhibitory. No apoptotic effect was found on TFB. MPA suppressed tenon and pterygium fibroblast proliferation in vitro under basal and profibrogenic conditions. It was comparable with MMC under long-term exposure, but MMC was more suppressive under short-term exposure. MPA may be safer than MMC due to a more specific mechanism of action and lack of cytotoxicity. Further investigation is warranted regarding MPA concentrations that will lead to a potent antiproliferative effect in vivo.

  7. Inhibitory efficacy of bufadienolides on Na+,K+-pump activity versus cell proliferation.

    Science.gov (United States)

    Xu, Yinfang; Liu, Xuan; Schwarz, Silvia; Hu, Lihong; Guo, Dean; Gu, Quanbao; Schwarz, Wolfgang

    2016-07-01

    Bufadienolides are cytotoxic drugs that may form the basis for anticancer agents. Due to structural and functional similarity to cardiotonic glycosides, application is restricted. We, therefore, investigated correlation of their putative anticancer effects with inhibition of Na + ,K + pumps. The natural bufalin and three derivatives were tested. The anticancer effects of the drugs were checked by observing their inhibitory effects on proliferation of rat liver cancer cells using MTT assay. Inhibition of Na + ,K + -pump was determined by measuring pump-mediated current of rat α1/β1 and α2/β1 Na + ,K + pumps expressed in Xenopus oocytes. All tested bufadienolides inhibited cell proliferation and Na + ,K + pump activity. An activity coefficient A =100x IC 50 Na,K pump /IC 50 pr o liferation was used to describe drug effectivity as anticancer drug. Natural bufalin exhibited lowest effectivity on cell proliferation, and also the A value for rat α1 isoform was the lowest (0.08), the α2 isoform was much less sensitive ( A =1.00). The highest A values were obtained for the BF238 derivative with A =0.88 and 2.64 for the α1 and α2 isoforms, respectively. Therefore, we suggest that search for bufalin derivatives with high anticancer effect and low affinity for both Na + ,K + pump isoforms may be a promising strategy for development of anticancer drugs.

  8. Nuclear power and the proliferation issue

    International Nuclear Information System (INIS)

    Marshall, W.

    1978-02-01

    The purpose of the lecture is to discuss nuclear proliferation, analyse which problems are real and which are a misapprehension, and to suggest a way forward which retains the benefits of nuclear power while providing a more certain protection against undesirable proliferation. After an introductory section the lecture continues under the following headings: plutonium production and accessibility; the use of plutonium; fast reactor fuel; the interim period; conclusions. (U.K.)

  9. Andrographolide suppresses preadipocytes proliferation through glutathione antioxidant systems abrogation.

    Science.gov (United States)

    Chen, Wei; Su, Hongming; Feng, Lina; Zheng, Xiaodong

    2016-07-01

    Oxidative stress is considered to play a profound role in lipid storage and whole-body energy homeostasis. Inhibition of preadipocytes proliferation by natural products is one of the strategies to prevent obesity. Andrographolide, a small molecule, has been reported to possess versatile bioactivities. However, molecular mechanism underlying the potential effect of andrographolide on preadipocytes proliferation remains obscure. In the present study, 3T3-L1 preadipocytes were employed to determine whether andrographolide could affect the proliferation of preadipocytes. Our results demonstrated andrographolide suppressed 3T3-L1 preadipocytes proliferation. The casual relationship analysis indicated that andrographolide (10 and 20μg/ml) appeared to exert the proliferation inhibitory effect through suppression of glutathione peroxidase 1 (GPX1) activity and depleting GSH by promoting its efflux in 3T3-L1 preadipocytes, which subsequently resulted in 2.06-2.41 fold increase in ROS accumulation. Excessive ROS eruption could account for oxidative damage to mitochondrial membranes as well as ultimately inhibition of cell proliferation. Taken together, our study reveals that suppression of GPX1 and GSH depletion by andrographolide seems to play a critical role in the inhibition of 3T3-L1 preadipocytes proliferation, which might have implication for obesity prevention and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Emerging nuclear energy systems and nuclear weapon proliferation

    International Nuclear Information System (INIS)

    Gsponer, A.; Sahin, S.; Jasani, B.

    1983-01-01

    Generally when considering problems of proliferation of nuclear weapons, discussions are focused on horizontal proliferation. However, the emerging nuclear energy systems currently have an impact mainly on vertical proliferation. The paper indicates that technologies connected with emerging nuclear energy systems, such as fusion reactors and accelerators, enhance the knowledge of thermonuclear weapon physics and will enable production of military useful nuclear materials (including some rare elements). At present such technologies are enhancing the arsenal of the nuclear weapon states. But one should not forget the future implications for horizontal proliferation of nuclear weapons as some of the techniques will in the near future be within the technological and economic capabilities of non-nuclear weapon states. Some of these systems are not under any international control. (orig.) [de

  11. A Dictyostelium chalone uses G proteins to regulate proliferation.

    Science.gov (United States)

    Bakthavatsalam, Deenadayalan; Choe, Jonathan M; Hanson, Nana E; Gomer, Richard H

    2009-07-27

    Several studies have shown that organ size, and the proliferation of tumor metastases, may be regulated by negative feedback loops in which autocrine secreted factors called chalones inhibit proliferation. However, very little is known about chalones, and how cells sense them. We previously identified two secreted proteins, AprA and CfaD, which act as chalones in Dictyostelium. Cells lacking AprA or CfaD proliferate faster than wild-type cells, and adding recombinant AprA or CfaD to cells slows their proliferation. We show here that cells lacking the G protein components Galpha8, Galpha9, and Gbeta proliferate faster than wild-type cells despite secreting normal or high levels of AprA and CfaD. Compared with wild-type cells, the proliferation of galpha8-, galpha9- and gbeta- cells are only weakly inhibited by recombinant AprA (rAprA). Like AprA and CfaD, Galpha8 and Gbeta inhibit cell proliferation but not cell growth (the rate of increase in mass and protein per nucleus), whereas Galpha9 inhibits both proliferation and growth. galpha8- cells show normal cell-surface binding of rAprA, whereas galpha9- and gbeta- cells have fewer cell-surface rAprA binding sites, suggesting that Galpha9 and Gbeta regulate the synthesis or processing of the AprA receptor. Like other ligands that activate G proteins, rAprA induces the binding of [3H]GTP to membranes, and GTPgammaS inhibits the binding of rAprA to membranes. Both AprA-induced [3H]GTP binding and the GTPgammaS inhibition of rAprA binding require Galpha8 and Gbeta but not Galpha9. Like aprA- cells, galpha8- cells have reduced spore viability. This study shows that Galpha8 and Gbeta are part of the signal transduction pathway used by AprA to inhibit proliferation but not growth in Dictyostelium, whereas Galpha9 is part of a differealnt pathway that regulates both proliferation and growth, and that a chalone signal transduction pathway uses G proteins.

  12. H2A/K pseudogene mutation may promote cell proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Jisheng; Jing, Ruirui; Lv, Xin; Wang, Xiaoyue; Li, Junqiang; Li, Lin; Li, Cuiling; Wang, Daoguang; Bi, Baibing; Chen, Xinjun [Cancer Research Center, Shandong University School of Medicine, Jinan 250012 (China); Yang, Jing-Hua, E-mail: sdu_crc_group1@126.com [Cancer Research Center, Shandong University School of Medicine, Jinan 250012 (China); Department of Surgery, VA Boston Healthcare System, Boston University School of Medicine, Boston 510660, MA (United States)

    2016-05-15

    Highlights: • The mutant H2A/K pseudogene is active. • The mutant H2A/K pseudogene can promote cell proliferation. - Abstract: Little attention has been paid to the histone H2A/K pseudogene. Results from our laboratory showed that 7 of 10 kidney cancer patients carried a mutant H2A/K pseudogene; therefore, we were interested in determining the relationship between mutant H2A/K and cell proliferation. We used shotgun and label-free proteomics methods to study whether mutant H2A/K lncRNAs affected cell proliferation. Quantitative proteomic analysis indicated that the expression of mutant H2A/K lncRNAs resulted in the upregulation of many oncogenes, which promoted cell proliferation. Further interaction analyses revealed that a proliferating cell nuclear antigen (PCNA)-protein interaction network, with PCNA in the center, contributes to cell proliferation in cells expressing the mutant H2A/K lncRNAs. Western blotting confirmed the critical upregulation of PCNA by mutant H2A/K lncRNA expression. Finally, the promotion of cell proliferation by mutant H2A/K lncRNAs (C290T, C228A and A45G) was confirmed using cell proliferation assays. Although we did not determine the exact mechanism by which the oncogenes were upregulated by the mutant H2A/K lncRNAs, we confirmed that the mutant H2A/K lncRNAs promoted cell proliferation by upregulating PCNA and other oncogenes. The hypothesis that cell proliferation is promoted by the mutant H2A/K lncRNAs was supported by the protein expression and cell proliferation assay results. Therefore, mutant H2A/K lncRNAs may be a new factor in renal carcinogenesis.

  13. International nuclear proliferation: multilateral diplomacy and regional aspects

    Energy Technology Data Exchange (ETDEWEB)

    Kapur, A.

    1979-01-01

    Confidential interviews with about 200 officials at 18 nuclear research sites around the world form the background for this discussion of the proliferation issues as they affect the Nuclear Non-Proliferation Treaty (NPT). Critics of the NPT cite its narrow focus on horizontal proliferation and its failures in the areas of vertical proliferation, nuclear technology transfers, heavy-water-reactor systems, and safeguards. The international negotiations necessary to resolve these issues and the difficulty of reaching a global consensus indicate a need to restructure the U.S. decision process before diplomacy can progress. The book discusses the history and nature of proliferation and its relationship to multinational diplomacy; the problems of permanent and workable safeguards; and regional political ramifications in the creeping dependencies of South Asia, apartheid in South Africa, militarization in Japan, and the nuclearization of Brazil and Argentina. The analysis concludes that central issues were not settled by the NPT and that U.S. failures to speak without consulting allies may mean that a bilateral rather than multinational approach should be tried. 105 references, 5 figures, 12 tables. (DCK)

  14. Canada's nuclear non-proliferation policy

    International Nuclear Information System (INIS)

    1985-01-01

    Canada's non-proliferation and safeguards policy has two objectives: 1) to promote the emergence of a more effective and comprehensive international non-proliferation regime; and 2) to assure the Canadian people and the international community that Canadian nuclear exports will not be used for any nuclear explosive purpose. By emphasizing the key role of the NPT, by promoting reliance upon and improvements in the IAEA safeguards system, by treating nuclear weapon and non-nuclear weapon states alike regarding Canadian nuclear exports, by working for new approaches covering the sensitive phases (e.g. reprocessing) of the nuclear fuel cycle, Canada's policy promotes attainment of the first objective. The latter objective is served through the network of bilateral nuclear agreements that Canada has put into place with its nuclear partners. Those agreements provide assurance that Canada's nuclear exports are used solely for legitimate, peaceful, nuclear energy production purposes. At the same time, Canada, having formulated its non-proliferation and safeguards policy during the period 1945 to 1980, has recognized that it has gone as far as it can on its own in this field and that from this point on any further changes should be made on the basis of international agreement. The Canadian objective in post-INFCE forums such as the Committee on Assurances of Supply is to exert Canada's best efforts to persuade the international community to devise a more effective and comprehensive international non-proliferation regime into which Canada and other suppliers might subsume their national requirements

  15. Nuclear Proliferation Technology Trends Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zentner, Michael D.; Coles, Garill A.; Talbert, Robert J.

    2005-10-04

    A process is underway to develop mature, integrated methodologies to address nonproliferation issues. A variety of methodologies (both qualitative and quantitative) are being considered. All have one thing in common, a need for a consistent set of proliferation related data that can be used as a basis for application. One approach to providing a basis for predicting and evaluating future proliferation events is to understand past proliferation events, that is, the different paths that have actually been taken to acquire or attempt to acquire special nuclear material. In order to provide this information, this report describing previous material acquisition activities (obtained from open source material) has been prepared. This report describes how, based on an evaluation of historical trends in nuclear technology development, conclusions can be reached concerning: (1) The length of time it takes to acquire a technology; (2) The length of time it takes for production of special nuclear material to begin; and (3) The type of approaches taken for acquiring the technology. In addition to examining time constants, the report is intended to provide information that could be used to support the use of the different non-proliferation analysis methodologies. Accordingly, each section includes: (1) Technology description; (2) Technology origin; (3) Basic theory; (4) Important components/materials; (5) Technology development; (6) Technological difficulties involved in use; (7) Changes/improvements in technology; (8) Countries that have used/attempted to use the technology; (9) Technology Information; (10) Acquisition approaches; (11) Time constants for technology development; and (12) Required Concurrent Technologies.

  16. Comparative analysis of proliferation resistance assessment methodologies

    International Nuclear Information System (INIS)

    Takaki, Naoyuki; Kikuchi, Masahiro; Inoue, Naoko; Osabe, Takeshi

    2005-01-01

    Comparative analysis of the methodologies was performed based on the discussions in the international workshop on 'Assessment Methodology of Proliferation Resistance for Future Nuclear Energy Systems' held in Tokyo, on March 2005. Through the workshop and succeeding considerations, it is clarified that the proliferation resistance assessment methodologies are affected by the broader nuclear options being pursued and also by the political situations of the state. Even the definition of proliferation resistance, despite the commonality of fundamental issues, derives from perceived threat and implementation circumstances inherent to the larger programs. Deep recognitions of the 'difference' among communities would help us to make further essential and progressed discussion with harmonization. (author)

  17. Limiting Future Proliferation and Security Risks

    International Nuclear Information System (INIS)

    Bari, R.

    2011-01-01

    A major new technical tool for evaluation of proliferation and security risks has emerged over the past decade as part the activities of the Generation IV International Forum. The tool has been developed by a consensus group from participating countries and organizations and is termed the Proliferation Resistance and Physical Protection (PR and PP) Evaluation Methodology. The methodology defines a set of challenges, analyzes system response to these challenges, and assesses outcomes. The challenges are the threats posed by potential actors (proliferant states or sub-national adversaries). It is of paramount importance in an evaluation to establish the objectives, capabilities, resources, and strategies of the adversary as well as the design and protection contexts. Technical and institutional characteristics are both used to evaluate the response of the system and to determine its resistance against proliferation threats and robustness against sabotage and terrorism threats. The outcomes of the system response are expressed in terms of a set of measures, which thereby define the PR and PP characteristics of the system. This paper summarizes results of applications of the methodology to nuclear energy systems including reprocessing facilities and large and small modular reactors. The use of the methodology in the design phase a facility will be discussed as it applies to future safeguards concepts.

  18. Nuclear Society and non-proliferation problems

    International Nuclear Information System (INIS)

    Gagarinskij, A.Ya.; Kushnarev, S.V.; Ponomarev-Stepnoj, N.N.; Sukhoruchkin, V.K.; Khromov, V.V.; Shmelev, V.M.

    1997-01-01

    In the USSR Nuclear Society in 1991 the special working group on the problems of nuclear weapons non-proliferation and nuclear materials control, uniting the experts of different types (nuclear physicists, lawyers, teachers), was created. This group became the mechanism of the practical Nuclear Society activity realization in this sphere. Three milestones of the innovative activity can be specified. First Milestone. In January 1992 the Central Nuclear Society Board (of the International Public Nuclear Society Association) published a special appeal to the First Leaders of all countries - former USSR republics. This address paid a special attention to the unity of the USSR power-industrial complex, and numerous problems arisen while separating this complex, including nuclear weapons non-proliferation problems, were indicated as well. Second Milestone. In 1992 and 1993 the Nuclear Society experts issued two selection 'Nuclear Non-proliferation and Control Problems' including reviewing basic papers. In addition, materials on non-proliferation and control are published regularly in the organs. Third Milestone.In 1993 - 1997 some special scientific and technical events (conferences, workshops, meetings) allowing to analyze the joint international projects and contracts outcomes, and establish new contacts between the specialists of NIS, Baltic states and others, have been hold

  19. Mullerian papilloma-like proliferation arising in cystic pelvic endosalpingiosis.

    Science.gov (United States)

    McCluggage, W Glenn; O'Rourke, Declan; McElhenney, Clodagh; Crooks, Michael

    2002-09-01

    This report describes an unusual epithelial proliferation occurring in pelvic cystic endosalpingiosis. A cyst mass lined by a layer of ciliated epithelial cells involved the posterior surface of the cervix and vagina. The epithelial proliferation within the wall resembled a mullerian papilloma with fibrous and fibrovascular cores lined by bland cuboidal epithelial cells. Other areas had a microglandular growth pattern resembling cervical microglandular hyperplasia, and focally there was a solid growth pattern. Foci of typical endosalpingiosis involved the surface of both ovaries and pelvic soft tissues. The cystic lesion recurred after partial cystectomy and drainage and was followed up radiologically and with periodic fine-needle aspiration. Part of the wall of the cyst removed 11 years after the original surgery showed an identical epithelial proliferation. MIB1 staining showed a proliferation index of less than 5%, contrasting with the higher proliferation index of a typical serous borderline tumor. The differential diagnosis is discussed. As far as we are aware, this is the first report of such a benign epithelial proliferation involving cystic endosalpingiosis. Copyright 2002, Elsevier Science (USA). All rights reserved.

  20. Nuclear dilemma: power, proliferation, and development

    International Nuclear Information System (INIS)

    Miller, M.

    1979-01-01

    Debate over President Carter's nuclear energy policy centers on how to develop nuclear power for civilian use and prevent the proliferation of nuclear materials for weapons. Both supporters and opponents of nuclear energy have been critical of Carter's policies because each side fails to see the linkage between the two concerns as codified in the 1978 Non-Proliferation Act. The author uses a dialogue format to illustrate the arguments for resisting proliferation and recognizing nuclear energy as an appropriate technology. The consequences of a nuclear moratorium are explored along with implications for foreign policy. U.S. leadership in developing energy technologies that can meet a broad range of appropriate applications, combined with leadership in building appropriate political frameworks, is needed if nuclear energy is to make a positive contribution toward world peace and acceptable living standards. 8 references

  1. Safeguards and non-proliferation: current challenges and the implications for Australia

    International Nuclear Information System (INIS)

    Leask, A.; Carlson, J.

    2006-01-01

    Full text: The expansion of nuclear programs raises the issue of how to ensure this does not increase the risk of nuclear weapons proliferation. The non-proliferation regime - based on the NPT and its verification mechanism, the IAEA safeguards system - has been developed to provide assurance that nuclear programs are exclusively peaceful. Although to date the non-proliferation regime has been remarkably successful, in recent years it has come under serious challenge. Nuclear proliferation is emerging as one of the major issues facing the international community. Addressing technical and institutional aspects of the non-proliferation regime - especially safeguards, but also complementary measures such as export controls, proliferation-resistant technology, and an international framework on sensitive technology - is important. But proliferation is a political problem, and ultimately the success of the non-proliferation regime depends on political resolve to uphold compliance, using incentives and if necessary sanctions. These issues are vitally important to Australia's future. Being a major uranium supplier has strengthened Australia's influence in non-proliferation and safeguards developments

  2. Director`s series on proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, K.C.; Price, M.E. [eds.

    1994-12-27

    The Director`s Series on Proliferation is an occasional publication of essays on the topics of nuclear, chemical, biological, and missile proliferation. The seven papers presented in this issue cover the following topics: Should the Treaty on the Nonproliferation of Nuclear Weapons (NPT) be amended?; NPT extension - Legal and procedural issues; An Indonesian view of NPT review conference issues; The treaty of Tlatelolco and the NPT - Tools for peace and development; Perspectives on cut-off, weapons dismantlement, and security assurances; Belarus and NPT challenges; A perspective on the chemical weapons convention - Lessons learned from the preparatory commission.

  3. Energy efficiency and proliferation assessment factors

    International Nuclear Information System (INIS)

    1979-02-01

    The objective of INFCE is to evaluate the nuclear fuel cycles from the point of view of their ability to satisfy the worldwide nuclear energy needs, while minimizing the proliferation risks. Accordingly, the different working groups have to take into consideration as well the energy-efficiency and the proliferation-resistance of these nuclear fuel cycles. The present working paper is aimed at suggesting the main assessment factors which should be taken into consideration

  4. An Introduction to The Interdisciplinary Concept of Risk-Informed Proliferation Resistance

    International Nuclear Information System (INIS)

    Gouveia, Fernando

    2010-01-01

    The nonproliferation community is rich in diverse attempts aimed at predicting and preventing attempts at nuclear proliferation. Such efforts, however, are rarely incorporated into a holistic approach well-suited to solving both existing and emerging proliferation dilemmas. This division is particularly apparent with respect to the partition that separates the socio-political and technical approaches to solving such problems, approaches which are very often developed and utilized in isolation. Complicating matters further, are the diverse positions taken by various entities as they relate to the secure implementation of nuclear energy world-wide. Such positions range from the obdurate belief in the supposed inherent proliferation resistance of traditional spent fuel, to those regarding all nuclear energy systems as inherently proliferation prone, given their core reliance on the sensitive technologies of enrichment and reprocessing. Accordingly, moderates have argued for a risk-informed approach to combat nuclear proliferation, combining institutional factors, such as IAEA safeguards, with innovative reactor and fuel designs to bring about an acceptable notion of proliferation resistance. To this end, methodologies have been developed, which seek to assess and score attained proliferation resistance. Most notably, these include, the Proliferation Resistance and Physical Protection (PR and PP) methodology prepared by the GEN-IV International Forum and the IAEA's International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO). Such approaches have greatly advanced the concept of proliferation resistance; however, they remain limited by their exclusive concentration on the technological determinants of proliferation and non-consideration of other, equally important, socio-political determinants. This limitation is significant as numerous incidents have illustrated the ability of atypical states to find alternate paths to proliferation, for example

  5. TGF-β2 inhibits AKT activation and FGF-2-induced corneal endothelial cell proliferation

    International Nuclear Information System (INIS)

    Lu Jiawei; Lu Zhenyu; Reinach, Peter

    2006-01-01

    The corneal endothelial cells form a boundary layer between anterior chamber and cornea. This single cell layer is important to maintain cornea transparency by eliciting net fluid transport into the anterior chamber. Injuries of the corneal endothelial layer in humans lead to corneal swelling and translucence. This hindrance is thought to be due to limited proliferative capacity of the endothelial layer. Fibroblast growth factor 2 (FGF-2) and transforming growth factor-beta 2 (TGF-β2) are both found in aqueous humor, and these two cytokines promote and inhibit cell growth, respectively. The intracellular signaling mechanisms by which TGF-β2 suppresses the mitogenic response to FGF-2, however, remain unclear. We have addressed this question by investigating potential crosstalk between FGF-2-induced and TGF-β2-regulated intracellular signaling events in cultured bovine corneal endothelial (BCE) cells. We found that TGF-β2 and FGF-2 oppositely affect BCE cell proliferation and TGF-β2 can override the stimulating effects of FGF-2 by increasing COX-2 expression in these cells. Consistent with these findings, overexpression of COX-2 significantly reduced FGF-2-induced cell proliferation whereas a COX-2 specific inhibitor NS398 reversed the effect of TGF-β2 on FGF-2-induced cell proliferation. The COX-2 product prostaglandin E2 (PGE-2) blocks FGF-2-induced cell proliferation. Whereas FGF-2 stimulates cell proliferation by activating the AKT pathway, TGF-β2 and PGE-2 both inhibit this pathway. In accordance with the effect of PGE-2, cAMP also inhibits FGF-2-induced AKT activation. These findings suggest that the mitogenic response to FGF-2 in vivo in the corneal endothelial layer may be inhibited by TGF-β2-induced suppression of the PI3-kinase/AKT signaling pathway

  6. Proliferation of massive destruction weapons: fantasy or reality?

    International Nuclear Information System (INIS)

    Duval, M.

    2001-01-01

    This article evaluates the threat of massive destruction weapons (nuclear, chemical, biological) for Europe and recalls the existing safeguards against the different forms of nuclear proliferation: legal (non-proliferation treaty (NPT), comprehensive nuclear test ban treaty (CTBT), fissile material cut off treaty (FMCT) etc..), technical (fabrication of fissile materials, delays). However, all these safeguards can be overcome as proven by the activities of some countries. The situation of proliferation for the other type of massive destruction weapons is presented too. (J.S.)

  7. Laser isotope separation and proliferation risks

    Energy Technology Data Exchange (ETDEWEB)

    Fuss, Werner

    2015-02-15

    There is an ongoing discussion on the proliferation danger of laser enrichment of uranium by the Silex process. Here this risk is compared to that of other processes, in particular centrifuges. The two methods need a similar size of the plant for a comparable production rate (in separative work units per year) and the time and costs for their construction do not differ much. This conclusion from published material does not depend on technical details of Silex. But enough details are known to allow for additional conclusions: Whereas the selectivity (enrichment factor) in the Silex process seems higher, the energy consumption is probably larger. Due to the laser's repetition rate being insufficient for the molecular beam, the method has probably a low depletion factor; this is a serious disadvantage for cascading for high enrichment such as for bomb uranium, although it may be acceptable for low enrichment without cascading for reactor purposes.

  8. The year 2000 examination conference of the non-proliferation treaty and the future of the nuclear non-proliferation regime

    International Nuclear Information System (INIS)

    Grand, C.

    2001-01-01

    The nuclear weapons non-proliferation treaty (NPT), signed on July 1, 1968 and enforced on March 5, 1970, has been progressively considered as the headstone of the international non-proliferation and disarmament regime. The sixth NPT examination conference took place at New York (USA) in the year 2000, 5 years after the previous conference but also after the first nuclear weapon tests of India and Pakistan. This article recalls up the main non-proliferation events that took place between the 1995 and 2000 conferences and presents the progresses and results of the New York conference. Finally, it wonders about the ambiguities in the conclusions of this last conference. (J.S.)

  9. Two case of osteoarthropathy due to mediastinal tumor

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S; Lee, C S; Shin, Y K; Kim, B S [Busan National University College of Medicine, Busan (Korea, Republic of)

    1972-12-15

    Authors experienced two cases of osteoarthropathy due to mediastinal tumor, which are reported with a review of the literature. A case was 59 years old man, who complained chest discomfortness, coughing, dyspnea and clubbing fingers. The other was 39 years old man, who complained arthralgia, clubbing of digits and pain in the left medial clavicular area. Their family histories were not contributory. The radiologic findings of the chest showed timorous mass in the mediastinum. Examination of the extremities showed periosteal reaction and subperiosteal proliferation along the long bones and digits. Distal phalanges revealed clubbing without bone changes.

  10. An Atypical Case of Methemoglobinemia due to Self-Administered Benzocaine

    Directory of Open Access Journals (Sweden)

    Thomas M. Nappe

    2015-01-01

    Full Text Available Acquired methemoglobinemia is an uncommon hemoglobinopathy that results from exposure to oxidizing agents, such as chemicals or medications. Although, as reported in the adult population, it happens most often due to prescribed medication or procedural anesthesia and not due to easily accessed over-the-counter medications, the authors will describe an otherwise healthy male adult with no known medical history and no prescribed medications, who presented to the emergency department reporting generalized weakness, shortness of breath, headache, dizziness, and pale gray skin. In addition, the patient reported that he also had a severe toothache for several days, which he had been self-treating with an over-the-counter oral benzocaine gel. Ultimately, the diagnosis of methemoglobinemia was made by clinical history, physical examination, and the appearance of chocolate-colored blood and arterial blood gas (ABG with cooximetry. After 2 mg/kg of intravenous methylene blue was administered, the patient had complete resolution of all signs and symptoms. This case illustrates that emergency physicians should be keenly aware of the potential of toxic hemoglobinopathy secondary to over-the-counter, nonprescribed medications. Discussion with patients regarding the dangers of inappropriate use of these medicines is imperative, as such warnings are typically not evident on product labels.

  11. An Atypical Case of Methemoglobinemia due to Self-Administered Benzocaine.

    Science.gov (United States)

    Nappe, Thomas M; Pacelli, Anthony M; Katz, Kenneth

    2015-01-01

    Acquired methemoglobinemia is an uncommon hemoglobinopathy that results from exposure to oxidizing agents, such as chemicals or medications. Although, as reported in the adult population, it happens most often due to prescribed medication or procedural anesthesia and not due to easily accessed over-the-counter medications, the authors will describe an otherwise healthy male adult with no known medical history and no prescribed medications, who presented to the emergency department reporting generalized weakness, shortness of breath, headache, dizziness, and pale gray skin. In addition, the patient reported that he also had a severe toothache for several days, which he had been self-treating with an over-the-counter oral benzocaine gel. Ultimately, the diagnosis of methemoglobinemia was made by clinical history, physical examination, and the appearance of chocolate-colored blood and arterial blood gas (ABG) with cooximetry. After 2 mg/kg of intravenous methylene blue was administered, the patient had complete resolution of all signs and symptoms. This case illustrates that emergency physicians should be keenly aware of the potential of toxic hemoglobinopathy secondary to over-the-counter, nonprescribed medications. Discussion with patients regarding the dangers of inappropriate use of these medicines is imperative, as such warnings are typically not evident on product labels.

  12. Non-proliferation and security: synergy and differences

    International Nuclear Information System (INIS)

    Joly, J.

    2013-01-01

    Operators of nuclear facilities put in place both physical and organisational means to meet in a comprehensive way the requirements associated with Nuclear Non-Proliferation, Safety and Security. The common aim is to protect man and the environment from ionising radiation. The approaches for meeting these requirements have real similarities, but also differences which need to be respected in order to develop an appropriate synergy for obtaining the best possible level of safety, security and non-proliferation. This article aims to show the provisions that have been taken with regard to non-proliferation, security and safety which complement and reinforce each other.The paper is followed by the slides of the presentation. (author)

  13. Interaction between shock coils increased the incidence of inappropriate therapies and lead failure in implantable cardioverter defibrillator.

    Science.gov (United States)

    El Garhy, Mohammad; Ohlow, Marc-Alexander; Lauer, Bernward

    Shock coil interaction in patients with multiple implantable cardioverter defibrillator (ICD) leads is occasionally observed. We aimed to evaluate the incidence of shock coil interaction and its clinical relevance. All ICD patients (646 patients) who came to follow up control in our ICD ambulance between January 1, 2011, and December 31, 2011 in the department of cardiology in Bad Berka hospital were retrospectively evaluated in this study. All baseline demographic, clinical, and procedural characteristics and postoperative chest x ray in postero-anterior and lateral view as well as clinical and ICD follow up data were evaluated. Among 646 patients 42 had multiple ICD leads (6.5%) of whom 36 patients (5.5% of total cohort patients and 85.7% of patients with multiple ICD leads) had shock coil interaction and presented the study group (Group I). The control group (Group II) consisted of 610 patients without coil-coil interaction including patients with single shock lead (604 patients) or patients with multiple leads but without interaction between shock coils (6 patients). Inappropriate anti-tachycardia therapies and RV lead revisions were more frequent in patients with interaction between shock coils (Group I vs Group II: 27.7% and 5.7%; p = 0.049 and 30.6% vs 6.4; p = 0.0001, respectively). Interaction between shock coils may be one of possible causes of lead failure and resulted in inappropriate therapies and subsequent lead revision. Copyright © 2018 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.

  14. Nuclear proliferation: present, past and future

    International Nuclear Information System (INIS)

    Alonso, M.; Zaleski, P.

    1993-01-01

    Since the end of WW II one of the more, if not the most, serious concerns of all people in the world has been to preserve this planet avoiding a nuclear war. On the positive side, in spite of the huge arsenal of strategic and tactical nuclear weapons (NW) accumulated over the years by the US and the former SU and the innumerable military conflicts we have witnessed since WW II, no NW have been used again. But this should not be a great consolation: the fact that countries have refrained from using NW does not necessarily mean that it will always be that way. As long as countries try to solve their differences by the use of force the danger of a nuclear confrontation remains, and nuclear disarmament and proliferation should cotinue to be a serious concern. This concern has profound political, social and ethical components that have been analyzed extensively and profusely. The purpose of this paper is more limited: to provide an overview of the national and international efforts to minimize the risk of a nuclear war by regulating, restricting and containing the development and possession of NW. This is what has become know as the nuclear non-proliferation regime. Any nuclear non-proliferation regime must have two essential goals: achieving nuclear disarmament by the NWS (and thereby eliminating vertical proliferation). To make a regime effective it must rely on international agreements, a system of safeguards coupled with inspection and verification procedures, and above all on the good faith of all nations involved. It should be stated from the very beginning that nuclear non-proliferation efforts, like all disarmament efforts, are essentially of political nature, albeit having an important scientific and technological component. They are effective only to the extent that countries really renounce NW and are prepared to severely sanction those who do not. (Author) 31 refs

  15. A Dictyostelium chalone uses G proteins to regulate proliferation

    Directory of Open Access Journals (Sweden)

    Hanson Nana E

    2009-07-01

    Full Text Available Abstract Background Several studies have shown that organ size, and the proliferation of tumor metastases, may be regulated by negative feedback loops in which autocrine secreted factors called chalones inhibit proliferation. However, very little is known about chalones, and how cells sense them. We previously identified two secreted proteins, AprA and CfaD, which act as chalones in Dictyostelium. Cells lacking AprA or CfaD proliferate faster than wild-type cells, and adding recombinant AprA or CfaD to cells slows their proliferation. Results We show here that cells lacking the G protein components Galpha8, Galpha9, and Gbeta proliferate faster than wild-type cells despite secreting normal or high levels of AprA and CfaD. Compared with wild-type cells, the proliferation of galpha8-, galpha9- and gbeta- cells are only weakly inhibited by recombinant AprA (rAprA. Like AprA and CfaD, Galpha8 and Gbeta inhibit cell proliferation but not cell growth (the rate of increase in mass and protein per nucleus, whereas Galpha9 inhibits both proliferation and growth. galpha8- cells show normal cell-surface binding of rAprA, whereas galpha9- and gbeta- cells have fewer cell-surface rAprA binding sites, suggesting that Galpha9 and Gbeta regulate the synthesis or processing of the AprA receptor. Like other ligands that activate G proteins, rAprA induces the binding of [3H]GTP to membranes, and GTPgammaS inhibits the binding of rAprA to membranes. Both AprA-induced [3H]GTP binding and the GTPgammaS inhibition of rAprA binding require Galpha8 and Gbeta but not Galpha9. Like aprA- cells, galpha8- cells have reduced spore viability. Conclusion This study shows that Galpha8 and Gbeta are part of the signal transduction pathway used by AprA to inhibit proliferation but not growth in Dictyostelium, whereas Galpha9 is part of a differealnt pathway that regulates both proliferation and growth, and that a chalone signal transduction pathway uses G proteins.

  16. Nuclear proliferation in South Asia; La proliferation nucleaire en Asie du Sud

    Energy Technology Data Exchange (ETDEWEB)

    Lamballe, A

    2007-07-15

    Neither India nor Pakistan has signed the Nuclear Non-Proliferation Treaty or the Comprehensive Test Ban Treaty.By carrying out tests in 1998, they therefore violated no international agreement but dealt a severe blow to non-proliferation by inciting other countries, including Iran, to develop nuclear weapons. The purpose of India strike force is to deter China; Pakistan hopes that with a credible strike force it will be able to deter any major attack by India. The nuclear phenomenon is now firmly entrenched in the minds of all those on the subcontinent, where the arms race continues without let-up on all fronts: witness the many launches of ballistic and cruise missiles by both countries. And now that radical Islamist movements are showing an interest in nuclear weapons systems there is a risk of tipping from the rational to the irrational world, with all its attendant dangers. (author)

  17. Dynamics of proliferating powers. For a new interdisciplinary approach

    International Nuclear Information System (INIS)

    Archambault, Jean-Claude; GRAND, Camille; Pasco, Xavier; SITT, Bernard

    2002-01-01

    The authors highlight that conventional approaches to the proliferation of arms of massive destruction are not sufficient to provide a generic evaluation grid whereas such a grid is clearly needed. In a first part, they discuss the contribution of various theories of proliferation of arms of massive destruction which generally address this phenomenon through three main points of view: legal and political means of struggle against proliferation, analysis of technical capacities, and motivations of proliferating States. The authors indicate and briefly present the various associated models. Then, they develop the basis of an analytical method aimed at a better understanding of the 'proliferating power', and at using various approaches, and notably that related to leader's psychology. They comment the content of studies already published on these issues, more precisely address the psycho-sociological dimension, outline the interest of diplomacy in this psychological approach, evoke the different typologies of personality, and propose elements of a new matrix of analysis of the proliferation phenomenon which takes national resources, history and strategic context, type of political regime, history and personality typology of the leader, and international dependencies, alliances, elites and mediators of the inner power, and public opinions into account

  18. EDA-containing fibronectin increases proliferation of embryonic stem cells.

    Directory of Open Access Journals (Sweden)

    Noelia Losino

    Full Text Available Embryonic stem cells (ESC need a set of specific factors to be propagated. They can also grow in conditioned medium (CM derived from a bovine granulosa cell line BGC (BGC-CM, a medium that not only preserves their main features but also increases ESC´s proliferation rate. The mitogenic properties of this medium were previously reported, ascribing this effect to an alternative spliced generated fibronectin isoform that contains the extra domain A (FN EDA(+. Here, we investigated if the FN EDA(+ isoform increased proliferation of mouse and human ES cells. We analyzed cell proliferation using conditioned media produced by different mouse embryonic fibroblast (MEF lines genetically engineered to express FN constitutively including or excluding the EDA domain (FN EDA(-, and in media supplemented with recombinant peptides containing or not the EDA. We found that the presence of EDA in the medium increased mouse and human ESC's proliferation rate. Here we showed for the first time that this FN isoform enhances ESC's proliferation. These findings suggest a possible conserved behavior for regulation of ES cells proliferation by this FN isoform and could contribute to improve their culturing conditions both for research and cell therapy.

  19. Twenty years of the Non-proliferation Treaty

    International Nuclear Information System (INIS)

    Goldblat, Jozef.

    1990-01-01

    The report assesses the achievements of the Non-proliferation Treaty (NPT) and discusses ways in which the non-proliferation regime could be strenghtened. It recommends a series of measures to be taken by the parties of the Treaty, both nuclear and non-nuclear weapons states, with a view to reinforcing the Treaty and achieving its universality. 198 refs

  20. α-Ketoglutarate Promotes Pancreatic Progenitor-Like Cell Proliferation

    Directory of Open Access Journals (Sweden)

    Jing Song

    2018-03-01

    Full Text Available A major source of β cell generation is pancreatic progenitor-like cell differentiation. Multiple studies have confirmed that stem cell metabolism plays important roles in self-renewal and proliferation. In the absence of glucose, glutamine provides the energy for cell division and growth. Furthermore, α-ketoglutarate (αKG, a precursor for glutamine synthesis, is sufficient for enabling glutamine-independent cell proliferation. We have demonstrated that αKG contributes to the large-scale proliferation of pancreatic progenitor-like cells that can provide an ample amount of clinically relevant β cells. We compared the mRNA expression of a subset of genes, the abundance of ATP, reactive oxide species, mitochondrial number, and the colony-forming frequency between mouse pancreatic CD133+ and CD133− cells. We employed Real-Time PCR, immunostaining and passage assays to investigate self-renewal and proliferation of pancreatic progenitor-like cells in a 3D culture system in the presence and absence of αKG. The energy metabolism of CD133+ cells was more prone to oxidative phosphorylation. However, in the 3D culture system, when αKG was supplemented to the culture medium, the proliferation of the pancreatic progenitor-like cells was significantly elevated. We confirmed that the presence of αKG correlated with the up-regulation of Ten-Eleven Translocation (Tet. αKG can promote the proliferation of pancreatic progenitor-like cells via the up-regulation of Tet.

  1. α-Ketoglutarate Promotes Pancreatic Progenitor-Like Cell Proliferation.

    Science.gov (United States)

    Song, Jing; Ma, Dongshen; Xing, Yun; Tang, Shanshan; Alahdal, Murad; Guo, Jiamin; Pan, Yi; Zhang, Yanfeng; Shen, Yumeng; Wu, Qiong; Lu, Zhou; Jin, Liang

    2018-03-22

    A major source of β cell generation is pancreatic progenitor-like cell differentiation. Multiple studies have confirmed that stem cell metabolism plays important roles in self-renewal and proliferation. In the absence of glucose, glutamine provides the energy for cell division and growth. Furthermore, α-ketoglutarate (αKG), a precursor for glutamine synthesis, is sufficient for enabling glutamine-independent cell proliferation. We have demonstrated that αKG contributes to the large-scale proliferation of pancreatic progenitor-like cells that can provide an ample amount of clinically relevant β cells. We compared the mRNA expression of a subset of genes, the abundance of ATP, reactive oxide species, mitochondrial number, and the colony-forming frequency between mouse pancreatic CD133⁺ and CD133 - cells. We employed Real-Time PCR, immunostaining and passage assays to investigate self-renewal and proliferation of pancreatic progenitor-like cells in a 3D culture system in the presence and absence of αKG. The energy metabolism of CD133⁺ cells was more prone to oxidative phosphorylation. However, in the 3D culture system, when αKG was supplemented to the culture medium, the proliferation of the pancreatic progenitor-like cells was significantly elevated. We confirmed that the presence of αKG correlated with the up-regulation of Ten-Eleven Translocation (Tet). αKG can promote the proliferation of pancreatic progenitor-like cells via the up-regulation of Tet.

  2. Tumor cell proliferation kinetics and tumor growth rate

    Energy Technology Data Exchange (ETDEWEB)

    Tubiana, M

    1989-01-01

    The present knowledge on the growth rate and the proliferation kinetics of human tumor is based on the measurement of the tumor doubling times (DT) in several hundred patients and on the determination of the proportion of proliferating cells with radioactive thymidine or by flow cytometry in large numbers of patients. The results show that the DT of human tumor varies widely, from less than one week to over one year with a median value of approximately 2 months. The DTs are significantly correlated with the histological type. They depend upon (1) the duration of the cell cycle whose mean duration is 2 days with small variations from tumor to tumor, (2) the proportion of proliferating cells and consequently the cell birth rate which varies widely among tumors and which is significantly correlated to the DT, (3) the cell loss factors which also vary widely and which are the greatest when proliferation is most intensive. These studies have several clinical implications: (a) they have further increased our understanding of the natural history of human tumor, (b) they have therapeutic implications since tumor responsiveness and curability by radiation and drugs are strongly influenced by the cell kinetic parameters of the tumor, (c) the proportion of proliferating cells is of great prognostic value in several types of human cancers. The investigation of the molecular defects, which are correlated with the perturbation of control of cell proliferation, should lead to significant fundamental and therapeutic advances. (orig.).

  3. TGF-β Signaling Regulates Pancreatic β-Cell Proliferation through Control of Cell Cycle Regulator p27 Expression

    International Nuclear Information System (INIS)

    Suzuki, Tomoyuki; Dai, Ping; Hatakeyama, Tomoya; Harada, Yoshinori; Tanaka, Hideo; Yoshimura, Norio; Takamatsu, Tetsuro

    2013-01-01

    Proliferation of pancreatic β-cells is an important mechanism underlying β-cell mass adaptation to metabolic demands. Increasing β-cell mass by regeneration may ameliorate or correct both type 1 and type 2 diabetes, which both result from inadequate production of insulin by β-cells of the pancreatic islet. Transforming growth factor β (TGF-β) signaling is essential for fetal development and growth of pancreatic islets. In this study, we exposed HIT-T15, a clonal pancreatic β-cell line, to TGF-β signaling. We found that inhibition of TGF-β signaling promotes proliferation of the cells significantly, while TGF-β signaling stimulation inhibits proliferation of the cells remarkably. We confirmed that this proliferative regulation by TGF-β signaling is due to the changed expression of the cell cycle regulator p27. Furthermore, we demonstrated that there is no observed effect on transcriptional activity of p27 by TGF-β signaling. Our data show that TGF-β signaling mediates the cell-cycle progression of pancreatic β-cells by regulating the nuclear localization of CDK inhibitor, p27. Inhibition of TGF-β signaling reduces the nuclear accumulation of p27, and as a result this inhibition promotes proliferation of β-cells

  4. Inappropriate prescribing and adverse drug events in older people

    Directory of Open Access Journals (Sweden)

    Gallagher Paul F

    2009-01-01

    Full Text Available Abstract Inappropriate prescribing (IP in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs, morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.

  5. Inappropriate prescribing and adverse drug events in older people.

    LENUS (Irish Health Repository)

    Hamilton, Hilary J

    2009-01-01

    Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.

  6. United States non-proliferation policy

    International Nuclear Information System (INIS)

    Scheinman, L.

    1978-01-01

    U.S. non-proliferation policy is aimed at slowing the spread of nuclear weapons capabilities, managing the destabilizing effects of nuclear technology for energy purposes, and fostering international standards and institutions to deal responsibly with global nuclear development. These goals assume that nuclear technology has not already precluded social control and recognize the social benefits offered by peaceful uses of atomic energy. Non-proliferation policies recognize that the motivation for possessing nuclear weapons is a more-difficult problem than technical ability and will concentrate on reducing those incentives through international agreements and safeguards and by maintaining the separation of commercial nuclear fuel cycles and military uses

  7. Denaturing of plutonium by transmutation of minor-actinides for enhancement of proliferation resistance

    International Nuclear Information System (INIS)

    Sagara, Hiroshi; Saito, Masaki; Peryoga, Yoga; Ezoubtchenko, Alexey; Takivayev, Alan

    2005-01-01

    Feasibility study for the plutonium denaturing by utilizing minor-actinide transmutation in light water reactors has been performed. And the intrinsic feature of proliferation resistance of plutonium has been discussed based on IAEA's publication and Kessler's proposal. The analytical results show that not only 238 Pu but also other plutonium isotopes with even-mass-number have very important role for denaturing of plutonium due to their relatively large critical mass and noticeably high spontaneous fission neutron generation. With the change of the minor-actinide doping ratio in U-Pu mix oxide fuel and moderator to fuel ratio, it is found that the reactor-grade plutonium from conventional light water reactors can be denatured to satisfy the proliferation resistance criterion based on the Kessler's proposal but not to be sufficient for the criterion based on IAEA's publication. It has been also confirmed that all the safety coefficients take negative value throughout the irradiation. (author)

  8. Risk of iatrogenic human immunodeficiency virus infection through transfusion of blood tested by inappropriately stored or expired rapid antibody assays in a Zambian hospital

    NARCIS (Netherlands)

    Consten, E. C.; van der Meer, J. T.; de Wolf, F.; Heij, H. A.; Henny, P. C.; van Lanschot, J. J.

    1997-01-01

    BACKGROUND: The purpose of this study was to estimate the risk of human immunodeficiency virus (HIV) infection via the transfusion of blood tested by inappropriately stored or expired rapid antibody assays in Zambia. STUDY DESIGN AND METHODS: Surgical patients (n = 370) were tested with antibody

  9. Methodologies for evaluating the proliferation resistance of nuclear fuel cycles

    International Nuclear Information System (INIS)

    Shiotani, Hiroki; Hori, Kei-ichiro; Takeda, Hiroshi

    2001-01-01

    The Japan Nuclear Cycle Development Institute (JNC) believes that the development of future nuclear fuel cycle technology should be conducted with careful consideration given to non-proliferation. JNC is studying methodologies for evaluating proliferation resistance of nuclear fuel cycle technologies. However, it is difficult to establish the methodology for evaluating proliferation resistance since the results greatly depend on the assumption for the evaluation and the surrounding conditions. This study grouped factors of proliferation resistance into categories through reviewing past studies and studied the relationships between the factors. Then, this study tried to find vulnerable nuclear material (plutonium) in some FBR fuel cycles from the proliferation perspective, and calculated the time it takes to convert the materials from various nuclear fuel cycles into pure plutonium metal under some assumptions. The result showed that it would take a long time to convert the nuclear materials from the FBR fuel cycles without plutonium separation. While it is a preliminary attempt to evaluate a technical factor of proliferation resistance as the basis of the institutional proliferation resistance, the JNC hopes that it will contribute to future discussions in this area. (author)

  10. MicroRNA-27a promotes myoblast proliferation by targeting myostatin

    International Nuclear Information System (INIS)

    Huang, Zhiqing; Chen, Xiaoling; Yu, Bing; He, Jun; Chen, Daiwen

    2012-01-01

    Highlights: ► We identified a myogenic role for miR-27a and a new target, myostatin. ► The miR-27a was confirmed to target myostatin 3′UTR. ► miR-27a is upregulated and myostatin is downregulated during myoblast proliferation. ► miR-27a promotes myoblast proliferation by reducing the expression of myostatin. -- Abstract: MicroRNAs (miRNAs) are a class of endogenous non-coding RNAs that play critical roles in skeletal muscle development as well as in regulation of muscle cell proliferation and differentiation. However, the role of miRNAs in myoblast proliferation remains poorly understood. Here we found that the expression of miR-27a was increased during proliferation of C2C12 myoblasts. Moreover, overexpression of miR-27a in C2C12 cells promoted myoblast proliferation by reducing the expression of myostatin, a critical inhibitor of skeletal myogenesis. In addition, the miR-27a was confirmed to target myostatin 3′UTR by a luciferase reporter analysis. Together, these results suggest that miR-27a promotes myoblast proliferation through targeting myostatin.

  11. MicroRNA-27a promotes myoblast proliferation by targeting myostatin

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Zhiqing; Chen, Xiaoling; Yu, Bing; He, Jun [Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Yaan, Sichuan 625014 (China); Chen, Daiwen, E-mail: dwchen@sicau.edu.cn [Key Laboratory for Animal Disease-Resistance Nutrition of China Ministry of Education, Institute of Animal Nutrition, Sichuan Agricultural University, Yaan, Sichuan 625014 (China)

    2012-06-29

    Highlights: Black-Right-Pointing-Pointer We identified a myogenic role for miR-27a and a new target, myostatin. Black-Right-Pointing-Pointer The miR-27a was confirmed to target myostatin 3 Prime UTR. Black-Right-Pointing-Pointer miR-27a is upregulated and myostatin is downregulated during myoblast proliferation. Black-Right-Pointing-Pointer miR-27a promotes myoblast proliferation by reducing the expression of myostatin. -- Abstract: MicroRNAs (miRNAs) are a class of endogenous non-coding RNAs that play critical roles in skeletal muscle development as well as in regulation of muscle cell proliferation and differentiation. However, the role of miRNAs in myoblast proliferation remains poorly understood. Here we found that the expression of miR-27a was increased during proliferation of C2C12 myoblasts. Moreover, overexpression of miR-27a in C2C12 cells promoted myoblast proliferation by reducing the expression of myostatin, a critical inhibitor of skeletal myogenesis. In addition, the miR-27a was confirmed to target myostatin 3 Prime UTR by a luciferase reporter analysis. Together, these results suggest that miR-27a promotes myoblast proliferation through targeting myostatin.

  12. Inappropriate nutrients intake is associated with lower functional status and inferior quality of life in older adults with depression.

    Science.gov (United States)

    Guligowska, Agnieszka; Pigłowska, Małgorzata; Fife, Elizaveta; Kostka, Joanna; Sołtysik, Bartłomiej K; Kroc, Łukasz; Kostka, Tomasz

    2016-01-01

    The study is a case-control analysis of whether depression impairs physical and cognitive functioning and quality of life, and whether there is a relationship between nutrient deficiencies and these adverse changes. A total of 130 older subjects participated in the study: 65 with diagnosed depression (16 men and 49 women) and 65 age- and sex-matched controls without depression. All patients underwent comprehensive geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment, cognitive performance was evaluated by the Mini-Mental State Examination and physical functioning by the Timed "Up & Go" test and handgrip strength. The pattern of consumption of various nutrients was analyzed in detail. The differences in cognitive functioning observed between the groups were related to specific nutrient intake, as was handgrip strength to some extent. The differences in nutritional status, several functional tests and muscle strength were related to both the presence of depression and inappropriate consumption of certain nutrients. The incidence of falls and poor quality of life may be partially associated with the presence of depression. The inappropriate intake of selected nutrients may impair the functioning and quality of life of older adults with depression, such as the excess consumption of sucrose and insufficient consumption of protein, fiber, eicosapentaenoic acid, niacin and vitamin B6. Particular nutrients should be translated into dietary patterns which allow the individual patient to address these nutrient deficiencies.

  13. Coach Expectations About Off-Field Conduct and Bystander Intervention by U.S. College Football Players to Prevent Inappropriate Sexual Behavior.

    Science.gov (United States)

    Kroshus, Emily; Paskus, Tom; Bell, Lydia

    2015-09-21

    The objective of the present study was to assess whether there is a positive association between expectations about off-field conduct set by the team coach and the likelihood that college football players intend to engage as prosocial bystanders in the prevention of what they consider to be inappropriate sexual behavior. In a sample of U.S. collegiate football players (N = 3,281), a path analysis model tested the association between coach expectations, perceived likelihood of discipline for off-field transgressions, and likelihood of intending to intervene to prevent inappropriate sexual behavior. Mediation of these relationships by the athlete's sense of exploitative entitlement and their attitudes about intervening were also assessed. Findings supported the hypothesized relationships, with expectations and discipline associated with bystander intentions both directly and indirectly through the mediating pathways of entitlement and attitudes about intervening. These findings provide evidence about the important role that sports team coaches can play in encouraging bystander intervention by clarifying expectations and consequences for conduct off the field of play. Athletic departments can provide a framework within which coaches are informed about the importance of setting and enforcing standards for off-field behavior, and are appropriately incentivized to do so. © The Author(s) 2015.

  14. STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2012-02-03

    Introduction: STOPP (Screening Tool of Older Persons\\' potentially inappropriate Prescriptions) is a new, systems-defined medicine review tool. We compared the performance of STOPP to that of established Beers\\' criteria in detecting potentially inappropriate medicines (PIMs) and related adverse drug events (ADEs) in older patients presenting for hospital admission. METHODS: we prospectively studied 715 consecutive acute admissions to a university teaching hospital. Diagnoses, reason for admission and concurrent medications were recorded. STOPP and Beers\\' criteria were applied. PIMs with clear causal connection or contribution to the principal reason for admission were determined. RESULTS: median patient age (interquartile range) was 77 (72-82) years. Median number of prescription medicines was 6 (range 0-21). STOPP identified 336 PIMs affecting 247 patients (35%), of whom one-third (n = 82) presented with an associated ADE. Beers\\' criteria identified 226 PIMs affecting 177 patients (25%), of whom 43 presented with an associated ADE. STOPP-related PIMs contributed to 11.5% of all admissions. Beers\\' criteria-related PIMs contributed to significantly fewer admissions (6%). CONCLUSION: STOPP criteria identified a significantly higher proportion of patients requiring hospitalisation as a result of PIM-related adverse events than Beers\\' criteria. This finding has significant implications for hospital geriatric practice.

  15. Inactivation of the infralimbic prefrontal cortex in rats reduces the influence of inappropriate habitual responding in a response-conflict task.

    Science.gov (United States)

    Haddon, J E; Killcross, S

    2011-12-29

    Previous research suggests the infralimbic cortex is important in situations when there is competition between goal-directed and habitual responding. Here we used a response conflict procedure to further explore the involvement of the infralimbic cortex in this relationship. Rats received training on two instrumental biconditional discriminations, one auditory and one visual, in two distinct contexts. One discrimination was "over-trained" relative to the other, "under-trained," discrimination in the ratio 3:1. At test, animals were presented with incongruent audiovisual stimulus compounds of the training stimuli in the under-trained context. The stimulus elements of these test compounds have previously dictated different lever press responses during training. Rats receiving control infusions into the infralimbic cortex showed a significant interference effect, producing more responses to the over-trained (habitual), but context-inappropriate, stimulus element of the incongruent compound. This interference effect was abolished by inactivation of the infralimbic cortex; animals showed a reduced tendency to produce the habitual but inappropriate response compared with animals receiving control infusions. This finding provides evidence that the infralimbic cortex is involved in attenuating the influence of goal-directed behavior, for example context-appropriate responding. Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

  16. The future of nuclear non-proliferation in South Asia

    International Nuclear Information System (INIS)

    Siddiqa, A.

    1997-01-01

    Nuclear proliferation in South Asia is currently one of the hot topics in world politics. The concern of the international community, and especially the USA, over this issue is coupled with the fear of nuclear conflict between India and Pakistan. As a result, Washington has been using its 'stick and carrot' policy to persuade the two countries involved not to develop their nuclear programs for military purposes. However both countries have not only continued to develop their nuclear ambitions, but seem to have achieved vertical nuclear proliferation. This paper examines the future non-proliferation in the South Asian region in the 1990s. This will be achieved by looking at the following: the development of the nuclear capabilities of both India and Pakistan; how these programs have been developed; the reasons for acquiring the capability for non-conventional defence; the real fear in terms of nuclear proliferation in the region; the possible options for dealing with nuclear proliferation in South Asia

  17. Nuclear power and nuclear weapons proliferation

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    An appropriate non-proliferation treaty should not discriminate among the non-weapon states, but should seek a cooperative approach with all countries seeking nuclear power and willing to accept international safeguards. Near-term proliferation problems, represented by nations already on the threshold of weapon capability, should not be confused with the long-term problem of world-wide nuclear development. The first can be handled with incentives and disincentives imposed on specific countries, while the latter involves the distribution of plutonium on the basis of alternative fuel cycles. To retain world leadership, U.S. efforts along these lines should be to encourage a dialogue between suppliers and recipients and to coordinate the economic and security issues of its own non-proliferation and foreign policies. One option is a U.S. commitment to a multinational fuel storage and reprocessing facility. Technical evaluation and demonstration of alternative fuel cycles to reach an international consensus would be a parallel activity

  18. Human tumor cell proliferation evaluated using manganese-enhanced MRI.

    Directory of Open Access Journals (Sweden)

    Rod D Braun

    Full Text Available Tumor cell proliferation can depend on calcium entry across the cell membrane. As a first step toward the development of a non-invasive test of the extent of tumor cell proliferation in vivo, we tested the hypothesis that tumor cell uptake of a calcium surrogate, Mn(2+ [measured with manganese-enhanced MRI (MEMRI], is linked to proliferation rate in vitro.Proliferation rates were determined in vitro in three different human tumor cell lines: C918 and OCM-1 human uveal melanomas and PC-3 prostate carcinoma. Cells growing at different average proliferation rates were exposed to 1 mM MnCl(2 for one hour and then thoroughly washed. MEMRI R(1 values (longitudinal relaxation rates, which have a positive linear relationship with Mn(2+ concentration, were then determined from cell pellets. Cell cycle distributions were determined using propidium iodide staining and flow cytometry. All three lines showed Mn(2+-induced increases in R(1 compared to cells not exposed to Mn(2+. C918 and PC-3 cells each showed a significant, positive correlation between MEMRI R(1 values and proliferation rate (p≤0.005, while OCM-1 cells showed no significant correlation. Preliminary, general modeling of these positive relationships suggested that pellet R(1 for the PC-3 cells, but not for the C918 cells, could be adequately described by simply accounting for changes in the distribution of the cell cycle-dependent subpopulations in the pellet.These data clearly demonstrate the tumor-cell dependent nature of the relationship between proliferation and calcium influx, and underscore the usefulness of MEMRI as a non-invasive method for investigating this link. MEMRI is applicable to study tumors in vivo, and the present results raise the possibility of evaluating proliferation parameters of some tumor types in vivo using MEMRI.

  19. Myopericytoma proliferating in an unusual anastomosing multinodular fashion.

    Science.gov (United States)

    Inoue, Takuya; Misago, Noriyuki; Asami, Akihiko; Tokunaga, Osamu; Narisawa, Yutaka

    2016-05-01

    We herein describe a case of myopericytoma that proliferated in an unusual fashion. Myopericytoma is described as a group of rare, benign, dermal or subcutaneous tumors that are characterized histologically by a striking, concentric, perivascular proliferation of spindle cells and showing apparent differentiation towards perivascular myoid cells. Myopericytoma forms a morphological continuum with myofibroma/myofibromatosis, glomus tumor and angioleiomyoma. The patient was a 64-year-old woman who demonstrated a recurrent ulcer on an atrophic plaque on her left shin. A histopathological examination of the plaque demonstrated that tumor cells proliferated in an anastomosing multinodular fashion along the vessels in the dermis and subcutaneous tissue. In those nodules, there were numerous, small, concentric proliferations of myoid-appearing spindle cells around small vascular lumina. The present case is an unusual example of myopericytoma, manifesting in a characteristic anastomosing, multinodular, infiltrating fashion. © 2015 Japanese Dermatological Association.

  20. Dictyostelium cells bind a secreted autocrine factor that represses cell proliferation

    OpenAIRE

    Choe, Jonathan M; Bakthavatsalam, Deenadayalan; Phillips, Jonathan E; Gomer, Richard H

    2009-01-01

    Abstract Background Dictyostelium cells secrete the proteins AprA and CfaD. Cells lacking either AprA or CfaD proliferate faster than wild type, while AprA or CfaD overexpressor cells proliferate slowly, indicating that AprA and CfaD are autocrine factors that repress proliferation. CfaD interacts with AprA and requires the presence of AprA to slow proliferation. To determine if CfaD is necessary for the ability of AprA to slow proliferation, whether AprA binds to cells, and if so whether the...

  1. Potential Teachers' Appropriate and Inappropriate Application of Pedagogical Resources in a Model-Based Physics Course: A "Knowledge in Pieces" Perspective on Teacher Learning

    Science.gov (United States)

    Harlow, Danielle B.; Bianchini, Julie A.; Swanson, Lauren H.; Dwyer, Hilary A.

    2013-01-01

    We used a "knowledge in pieces" perspective on teacher learning to document undergraduates' pedagogical resources in a model-based physics course for potential teachers. We defined pedagogical resources as small, discrete ideas about teaching science that are applied appropriately or inappropriately in specific contexts. Neither…

  2. IAEA safeguards and non-proliferation

    International Nuclear Information System (INIS)

    Harry, R.J.S.

    1995-02-01

    An overview is given of the efforts to contain the nuclear weapons proliferation during half a century of man-controlled nuclear fission. An initial policy of denial did not work, a following period of cooperation needed a gradual strengthening of international assurances on the exclusively peaceful character of the flourishing use of nuclear techniques for power generation and of other applications. The focus of the nuclear weapon proliferation concern changed from the highly developed states to developing states. The Non-Proliferation Treaty laid the basis for a unique system of voluntarily accepted international inspections to verify the peaceful use of nuclear energy. The IAEA got the task to implement this 'Full Scope Safeguards' on all nuclear material and all nuclear activities in the non-nuclear weapon states. Thanks to the structure of the IAEA, in which both proponent and states with a critical attitude take part in the decision making process on the IAEA execution of its tasks, a balanced, and widely acceptable system emerged. International developments necessitated additional improvements of the non-proliferation system. The increase of strength of sub-national groups triggered international cooperation on physical protection, about a quarter of a century ago. More recently, it appeared that NPT states with assumed nuclear weapon ambitions operated in the margins between the interpretation of IAEA safeguards and the spirit and purpose of NPT. Improvements of the IAEA safeguards and a stronger cooperation between states, including the constraints which exporting states have imposed on nuclear supplies, strengthen the safeguards system. The important reductions in the two largest nuclear weapon arsenals lead, together with the delay in the fast breeder implementation, to large stockpiles of nuclear weapon usable materials. Also in this areas new internationally credible assurances have to be obtained, that these materials will never return to nuclear

  3. IAEA safeguards and non-proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Harry, R J.S.

    1995-02-01

    An overview is given of efforts to contain the nuclear weapons proliferation during half a century of man-controlled nuclear fission. An initial policy of denial did not work, a following period of cooperation needed a gradual strengthening of international assurances on the peaceful character of the flourishing use of nuclear techniques for power generation and of other applications. The focus of the nuclear weapon proliferation concern changed from the highly developed states to developing states. The Non-Proliferation Treaty laid the basis for a unique system of voluntarily accepted international inspections to verify the peaceful use of nuclear energy. The IAEA got the task to implement this `Full Scope Safeguards` on all nuclear material and all nuclear activities in the non-nuclear weapon states. Thanks to the structure of the IAEA, in which both proponent and states with a critical attitude take part in the decision making process on the IAEA execution of its tasks, a balanced, and widely acceptable system emerged. International developments necessitated additional improvements of the non-proliferation system. The increase of strength of sub-national groups triggered international cooperation on physical protection, about a quarter of a century ago. More recently, it appeared that NPT states with assumed nuclear weapon ambitions operated in the margins between the interpretation of IAEA safeguards and the spirit and purpose of NPT. Improvements of the IAEA safeguards and a stronger cooperation between states, including the constraints which exporting states have imposed on nuclear supplies, strengthen the safeguards system. The important reductions in the two largest nuclear weapon arsenals lead, together with the delay in the fast breeder implementation, to large stockpiles of nuclear weapon usable materials. Also in this areas new internationally credible assurances have to be obtained, that these materials will never return to nuclear weapon applications.

  4. Sphingosine-1-phosphate stimulates rat primary chondrocyte proliferation

    International Nuclear Information System (INIS)

    Kim, Mi-Kyoung; Lee, Ha Young; Kwak, Jong-Young; Park, Joo-In; Yun, Jeanho; Bae, Yoe-Sik

    2006-01-01

    Rat primary chondrocytes express the sphingosine-1-phosphate (S1P) receptor, S1P 2 , S1P 3 , S1P 4 , but not S1P 1 . When chondrocytes were stimulated with S1P or phytosphingosine-1-phosphate (PhS1P, an S1P 1 - and S1P 4 -selective agonist), phospholipase C-mediated cytosolic calcium increase was dramatically induced. S1P and PhS1P also stimulated two kinds of mitogen-activated protein kinases, extracellular signal-regulated kinase (ERK) and p38 kinase in chondrocytes. In terms of the two phospholipids-mediated functional modulation of chondrocytes, S1P and PhS1P stimulated cellular proliferation. The two phospholipids-induced chondrocyte proliferations were almost completely blocked by PD98059 but not by SB203580, suggesting that ERK but not p38 kinase is essentially required for the proliferation. Pertussis toxin almost completely inhibited the two phospholipids-induced cellular proliferation and ERK activation, indicating the crucial role of G i protein. This study demonstrates the physiological role of two important phospholipids (S1P and PhS1P) on the modulation of rat primary chondrocyte proliferation, and the crucial role played by ERK in the process

  5. Perspectives and benefits of the non-proliferating fuel cycle

    International Nuclear Information System (INIS)

    Parker, F.

    2012-01-01

    The world community has faced the issues of nuclear non-proliferation for decades. Frank Parker, Emeritus Distinguished Professor at Vanderbilt University, has proposed a non-proliferating fuel cycle, which greatly reduces the risk of use of nuclear materials for military purpose. A simplified fuel cycle with reduced opportunities for proliferation of nuclear weapons and permanent disposal of radioactive wastes as well as a reference sub-seabed HLW disposal system are described [ru

  6. Epigenetic regulation of vascular smooth muscle cell proliferation and neointima formation by histone deacetylase inhibition.

    Science.gov (United States)

    Findeisen, Hannes M; Gizard, Florence; Zhao, Yue; Qing, Hua; Heywood, Elizabeth B; Jones, Karrie L; Cohn, Dianne; Bruemmer, Dennis

    2011-04-01

    Proliferation of smooth muscle cells (SMC) in response to vascular injury is central to neointimal vascular remodeling. There is accumulating evidence that histone acetylation constitutes a major epigenetic modification for the transcriptional control of proliferative gene expression; however, the physiological role of histone acetylation for proliferative vascular disease remains elusive. In the present study, we investigated the role of histone deacetylase (HDAC) inhibition in SMC proliferation and neointimal remodeling. We demonstrate that mitogens induce transcription of HDAC 1, 2, and 3 in SMC. Short interfering RNA-mediated knockdown of either HDAC 1, 2, or 3 and pharmacological inhibition of HDAC prevented mitogen-induced SMC proliferation. The mechanisms underlying this reduction of SMC proliferation by HDAC inhibition involve a growth arrest in the G(1) phase of the cell cycle that is due to an inhibition of retinoblastoma protein phosphorylation. HDAC inhibition resulted in a transcriptional and posttranscriptional regulation of the cyclin-dependent kinase inhibitors p21(Cip1) and p27(Kip). Furthermore, HDAC inhibition repressed mitogen-induced cyclin D1 mRNA expression and cyclin D1 promoter activity. As a result of this differential cell cycle-regulatory gene expression by HDAC inhibition, the retinoblastoma protein retains a transcriptional repression of its downstream target genes required for S phase entry. Finally, we provide evidence that these observations are applicable in vivo by demonstrating that HDAC inhibition decreased neointima formation and expression of cyclin D1 in a murine model of vascular injury. These findings identify HDAC as a critical component of a transcriptional cascade regulating SMC proliferation and suggest that HDAC might play a pivotal role in the development of proliferative vascular diseases, including atherosclerosis and in-stent restenosis.

  7. Utility of Social Modeling for Proliferation Assessment - Preliminary Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Coles, Garill A.; Gastelum, Zoe N.; Brothers, Alan J.; Thompson, Sandra E.

    2009-06-01

    This Preliminary Assessment draft report will present the results of a literature search and preliminary assessment of the body of research, analysis methods, models and data deemed to be relevant to the Utility of Social Modeling for Proliferation Assessment research. This report will provide: 1) a description of the problem space and the kinds of information pertinent to the problem space, 2) a discussion of key relevant or representative literature, 3) a discussion of models and modeling approaches judged to be potentially useful to the research, and 4) the next steps of this research that will be pursued based on this preliminary assessment. This draft report represents a technical deliverable for the NA-22 Simulations, Algorithms, and Modeling (SAM) program. Specifically this draft report is the Task 1 deliverable for project PL09-UtilSocial-PD06, Utility of Social Modeling for Proliferation Assessment. This project investigates non-traditional use of social and cultural information to improve nuclear proliferation assessment, including nonproliferation assessment, proliferation resistance assessments, safeguards assessments and other related studies. These assessments often use and create technical information about the State’s posture towards proliferation, the vulnerability of a nuclear energy system to an undesired event, and the effectiveness of safeguards. This project will find and fuse social and technical information by explicitly considering the role of cultural, social and behavioral factors relevant to proliferation. The aim of this research is to describe and demonstrate if and how social science modeling has utility in proliferation assessment.

  8. Does interdependence alleviate proliferation risks in Asia?

    International Nuclear Information System (INIS)

    Yoshida, Osamu

    1997-01-01

    As the extension Conference of the Non-Proliferation Treaty ended with its unlimited extension without any modification of the treaty obligation of the nuclear-weapon states to nuclear disarmament, the prospect of the regime to incorporate those suspected nuclear powers in Asia, namely India, Pakistan and Israel, has become dark. In this paper the problem of proliferation risk centred in India is analysed. It is well known that India was the first to criticize the Non-Proliferation Treaty regime as highly discriminating between the five nuclear haves and the rest. As was always the case, India's point is logically persuasive and consistent. However, it is also true that the logical or legal point of view does not always solve the problem. Therefore, we look at the regional and international political constellation in which any assertion has to be constructed. At present there is very little possibility that this region will become nuclear-free. This is because the horizontal proliferation, that has seemingly taken place here, is the result of a 'nuclear chain reaction', starting with a minor nuclear-weapon state, China. However, the economic upsurge in the region now throws the nuclear chain-reactions into the background. It has come to a standstill and the future of nuclear proliferation here will have to be decided by global nuclear disarmament, as there is no motivation on the side of the two Asian giants to agree on the reduction in their nuclear arsenals, though under American pressure, another suspected nuclear power, Pakistan, may have to give up its nuclear development plan

  9. Modelling the interplay between hypoxia and proliferation in radiotherapy tumour response

    International Nuclear Information System (INIS)

    Jeong, J; Deasy, J O; Shoghi, K I

    2013-01-01

    A tumour control probability computational model for fractionated radiotherapy was developed, with the goal of incorporating the fundamental interplay between hypoxia and proliferation, including reoxygenation over a course of radiotherapy. The fundamental idea is that the local delivery of oxygen and glucose limits the amount of proliferation and metabolically-supported cell survival a tumour sub-volume can support. The model has three compartments: a proliferating compartment of cells receiving oxygen and glucose; an intermediate, metabolically-active compartment receiving glucose; and a highly hypoxic compartment of starving cells. Following the post-mitotic cell death of proliferating cells, intermediate cells move into the proliferative compartment and hypoxic cells move into the intermediate compartment. A key advantage of the proposed model is that the initial compartmental cell distribution is uniquely determined from the assumed local growth fraction (GF) and volume doubling time (T D ) values. Varying initial cell state distributions, based on the local (voxel) GF and T D , were simulated. Tumour response was simulated for head and neck squamous cell carcinoma using relevant parameter values based on published sources. The tumour dose required to achieve a 50% local control rate (TCD 50 ) was found for various GFs and T D ’s, and the effect of fraction size on TCD 50 was also evaluated. Due to the advantage of reoxygenation over a course of radiotherapy, conventional fraction sizes (2–2.4 Gy fx −1 ) were predicted to result in smaller TCD 50 's than larger fraction sizes (4–5 Gy fx –1 ) for a 10 cc tumour with GFs of around 0.15. The time to eliminate hypoxic cells (the reoxygenation time) was estimated for a given GF and decreased as GF increased. The extra dose required to overcome accelerated stem cell accumulation in longer treatment schedules was estimated to be 0.68 Gy/day (in EQD2 6.6 ), similar to published values derived from clinical

  10. Proliferation Vulnerability Red Team report

    Energy Technology Data Exchange (ETDEWEB)

    Hinton, J.P.; Barnard, R.W.; Bennett, D.E. [and others

    1996-10-01

    This report is the product of a four-month independent technical assessment of potential proliferation vulnerabilities associated with the plutonium disposition alternatives currently under review by DOE/MD. The scope of this MD-chartered/Sandia-led study was limited to technical considerations that could reduce proliferation resistance during various stages of the disposition processes below the Stored Weapon/Spent Fuel standards. Both overt and covert threats from host nation and unauthorized parties were considered. The results of this study will be integrated with complementary work by others into an overall Nonproliferation and Arms Control Assessment in support of a Secretarial Record of Decision later this year for disposition of surplus U.S. weapons plutonium.

  11. Arsenic and urinary bladder cell proliferation

    International Nuclear Information System (INIS)

    Luster, Michael I.; Simeonova, Petia P.

    2004-01-01

    Epidemiologic studies have demonstrated that a close association exists between the elevated levels of arsenic in drinking water and the incidence of certain cancers, including transitional cell carcinomas of the urinary bladder. We have employed in vitro and in vivo models to examine the effects of sodium arsenite on the urinary bladder epithelium. Mice exposed to 0.01% sodium arsenite in drinking water demonstrated hyperproliferation of the bladder uroepithelium within 4 weeks after initiating treatment. This occurred in the absence of amorphous precipitates and was accompanied by the accumulation of trivalent arsenite (iAs 3+ ), and to a lesser extent dimethylarsenic (DMA), arsenate (iAs 5+ ), and monomethylarsenic (MMA) in bladder tissue. In contrast to the bladder, urinary secretion was primarily in the form of DMA and MMA. Arsenic-induced cell proliferation in the bladder epithelium was correlated with activation of the MAP kinase pathway, leading to extracellular signal-regulated kinase (ERK) kinase activity, AP-1 activation, and expression of AP-1-associated genes involved in cell proliferation. Activation of the MAP kinase pathway involved both epidermal growth factor (EGF) receptor-dependent and -independent events, the latter involving Src activation. Studies summarized in this review suggest that arsenic accumulates in urinary bladder epithelium causing activation of specific signaling pathways that lead to chronic increased cell proliferation. This may play a non-epigenetic role in carcinogenesis by increasing the proliferation of initiated cells or increasing the mutational rate

  12. Does nuclear proliferation in Asia threaten the future of the NPT?

    International Nuclear Information System (INIS)

    Vandier, Pierre

    2005-01-01

    Asia is a region which presents all kinds of situation with respect to nuclear proliferation: nuclear countries, proliferating countries, countries non members of the NPT, countries violating the NPT, pacifist countries, threshold countries, and so on. Through an assessment of nuclear proliferation in Asia, the author first outlines the weaknesses of the Non Proliferation Treaty (NPT), and then discusses origins of tensions which may re-launch a nuclear arms race. In a third part, the author assesses the future of the Treaty within the arrangement for the struggle against nuclear proliferation as its has been strengthened in 2005

  13. Proliferation resistance assessment of thermal recycle systems

    International Nuclear Information System (INIS)

    1979-02-01

    This paper examines the major proliferation aspects of thermal recycle systems and the extent to which technical or institutional measures could increase the difficulty or detectability of misuse of the system by would-be proliferators. It does this by examining the various activities necessary to acquire weapons-usable material using a series of assessment factors; resources required, time required, detectability. It is concluded that resistance to proliferation could be improved substantially by collecting reprocessing, conversion and fuel fabrication plants under multi national control and instituting new measures to protect fresh MOX fuel. Resistance to theft at sub-national level could be improved by co-location of sensitive facilities high levels of physical protection at plants and during transportation and possibly by adding a radiation barrier to MOX prior to shipment

  14. Severe Hyponatremia due to Levofloxacin Treatment for Pseudomonas aeruginosa Community-Acquired Pneumonia in a Patient with Oropharyngeal Cancer

    Directory of Open Access Journals (Sweden)

    Mihaela Mocan

    2016-01-01

    Full Text Available Hyponatremia (serum Na levels of <135 mEq/L is the most common electrolyte imbalance encountered in clinical practice, affecting up to 15–28% of hospitalized patients. This case report refers to a middle-aged man with severe hyponatremia due to Syndrome of Inappropriate Antidiuretic Hormone Secretion related to four possible etiological factors: glossopharyngeal squamous cell carcinoma, cisplatin treatment, right basal pneumonia with Pseudomonas aeruginosa, and the treatment with Levofloxacin. This case report discusses a rare complication of common conditions and of a common treatment. To our knowledge this is the first case of hyponatremia related to Levofloxacin and the second related to fluoroquinolones.

  15. Model for nuclear proliferation resistance analysis using decision making tools

    International Nuclear Information System (INIS)

    Ko, Won Il; Kim, Ho Dong; Yang, Myung Seung

    2003-06-01

    The nuclear proliferation risks of nuclear fuel cycles is being considered as one of the most important factors in assessing advanced and innovative nuclear systems in GEN IV and INPRO program. They have been trying to find out an appropriate and reasonable method to evaluate quantitatively several nuclear energy system alternatives. Any reasonable methodology for integrated analysis of the proliferation resistance, however, has not yet been come out at this time. In this study, several decision making methods, which have been used in the situation of multiple objectives, are described in order to see if those can be appropriately used for proliferation resistance evaluation. Especially, the AHP model for quantitatively evaluating proliferation resistance is dealt with in more detail. The theoretical principle of the method and some examples for the proliferation resistance problem are described. For more efficient applications, a simple computer program for the AHP model is developed, and the usage of the program is introduced here in detail. We hope that the program developed in this study could be useful for quantitative analysis of the proliferation resistance involving multiple conflict criteria

  16. Model for nuclear proliferation resistance analysis using decision making tools

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Won Il; Kim, Ho Dong; Yang, Myung Seung

    2003-06-01

    The nuclear proliferation risks of nuclear fuel cycles is being considered as one of the most important factors in assessing advanced and innovative nuclear systems in GEN IV and INPRO program. They have been trying to find out an appropriate and reasonable method to evaluate quantitatively several nuclear energy system alternatives. Any reasonable methodology for integrated analysis of the proliferation resistance, however, has not yet been come out at this time. In this study, several decision making methods, which have been used in the situation of multiple objectives, are described in order to see if those can be appropriately used for proliferation resistance evaluation. Especially, the AHP model for quantitatively evaluating proliferation resistance is dealt with in more detail. The theoretical principle of the method and some examples for the proliferation resistance problem are described. For more efficient applications, a simple computer program for the AHP model is developed, and the usage of the program is introduced here in detail. We hope that the program developed in this study could be useful for quantitative analysis of the proliferation resistance involving multiple conflict criteria.

  17. Model for evaluating nuclear strategies with proliferation resistance

    International Nuclear Information System (INIS)

    Shay, M.R.; Hardie, R.W.; Omberg, R.P.

    1979-03-01

    A model was developed at HEDL to specifically analyze proliferation resistant strategies. The model was not designed to predict the future, but rather to provide a method for estimating the consequences of decisions affecting proliferation resistance in a rational and plausible manner. The characteristics of the model are described

  18. INCREASED PROLIFERATION RESISTANCE FOR 21ST CENTURY NUCLEAR POWER

    International Nuclear Information System (INIS)

    Demuth, Scott F.; Thomas, Ken E.; Wallace, Richard K.

    2007-01-01

    World energy demand and greenhouse gases are expected to significantly increase in the near future. Key developing countries have identified nuclear power as a major contributor to their future energy sources. Consequently, the US and others are currently exploring the concept of a Global Nuclear Energy Partnership (GNEP) to address the concerns of nuclear proliferation. This effort is also being encouraged by the International Atomic Energy Agency (IAEA). While the IAEA currently provides the framework for monitoring of state sponsored nuclear proliferation by way of international treaties, a complimentary action is to promote more proliferation resistant fuel cycles and advanced safeguards technology. As such, it is the responsibility of current technology owners to increase their nuclear fuel cycle proliferation resistance. For those countries that have an active and well-developed fuel cycle, it will require future enhancements. For those countries with extensive nuclear energy experience, yet less active programs, it requires re-engagement for technology development and deployment. The following paper discusses potential fuel cycle and technology changes that affect proliferation resistance; and consequently, may form the basis of future technology development efforts.

  19. Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory.

    Science.gov (United States)

    Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C

    2014-01-01

    Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Erroneous Magnet Positioning Leads to Failure of Inhibition of Inappropriate Shock during Fast Conducting Atrial Fibrillation Episodes.

    Science.gov (United States)

    Römers, Hans; VAN Dijk, Vincent; Balt, Jippe

    2017-06-01

    We present the case of a 75-year-old patient with a single-chamber St. Jude Medical internal cardioverter defibrillator (ICD; St. Jude Medical, St. Paul, MN, USA) for primary prevention, who was admitted with 39 inappropriate ICD shocks because of atrial fibrillation with rapid ventricular frequention, despite magnet placement. Review of the device manual and literature revealed that apart from different responses to magnet placement programmed for the various manufacturers, the type of magnet and the positioning can be of specific interest. In the case presented, the donut-shaped magnet should have been placed off-center instead of directly over the device. © 2017 Wiley Periodicals, Inc.